Project Description:
Approximately 15-18% of children in the United States (10-13 million) have a chronic medical condition with an associated need for ongoing consultation, support or technology, and the number is increasing (Lowman, 1993; Stein, 2001). Prevalence estimates for children with developmental delays and disabilities range from 3-15% and increase with the rise in poverty (Fujiura & Yamaki, 2000). Similarly, between 15% and 30% of children demonstrate social behavior problems that are so challenging as to present barriers to their adjustment and success in preschool and the early primary grades (Knitzer, 2000a; Cohen & Kaufmann, 2000). The impact of these broad array of “developmental healthcare needs†indicates that public schools, Head Start programs, early intervention programs, and early care and education centers face a crisis in promoting the adjustment, health, progress, success, and general wellness of these and all children in inclusive early learning settings.
HealthyCHILD is a partnership among Children’s Hospital, the UCLID Center at the University of Pittsburgh, all types of school- and community-based early childhood programs (e.g., Head Start, early intervention, early care and education), and primary care physicians to deliver medical and behavioral healthcare support to young children (age 0-8) by providing teachers, caregivers, parents and administrators with consultation, intervention, mentoring/education and technical assistance. HealthyCHILD is unique in that it provides on-site consultation and support on-site within the child’s classroom, and sometimes in the home. HealthyCHILD specializes in the needs of children with challenging or atypical behaviors, developmental delays/disabilities, and acute and chronic medical concerns (e.g., asthma, seizures, syndromes, diabetes).
The operational feature of the HealthyCHILD model is a mobile team composed of interdisciplinary healthcare professionals who are both generalists and specialists. The full team is composed of a pediatric nurse, developmental school psychologist, developmental/behavioral healthcare consultant, an interagency liaison, the child’s teacher, the child’s parent(s), other team members, and graduate student Fellows within the UCLID Center. A developmental pediatrician offers consultation to the team.
HealthyCHILD Services are based on individual child and classroom needs. Services include: direct
classroom consultation about children, professional development training and mentoring of staff,
technical assistance, observational assessment, direct service, diagnosis, referral, and parent-
professional team meetings based on program needs-assessment.
What specifc help will teachers, caregivers and parents get from HealthyCHILD?
On-site, in-vivo training on healthcare issues in the classroom or home setting
Ongoing classroom visits and consultations by developmental consultants regarding changes in classroom climates that will improve child health, development, behavior and adjustment.
Modeling of healthcare strategies for teachers, caregivers and parents.
Written Developmental Healthcare Plan of individual goals and strategies to meet the physical and behavioral needs of referred children.
Written consultation summary report with diagnosis to gain access to behavioral health/mental health wrap-around services
Liaisons with primary care physicians.
Collaborative meetings between parents, agency staff, and school personnel.
Support at transition meetings to advise on childrens’ entry into kindergarten and first-grade.
Linkages with community resources, various health and human service agencies (e.g., early intervention, wrap-around mental health) and public schools.
Provision of written resources about developmental healthcare.
HealthyCHILD supports have four major objectives: (1) Promoting children’s success in all types of early care and education settings including Head Start, early intervention, early care and education classrooms, and family child care; (2) increasing the skills of teachers and caregivers through both preventive and supportive healthcare strategies; (3) providing consultative and direct services to children with a range of behavioral health concerns and acute and chronic medical conditions; (4) identifying the impact of the child’s healthcare needs on performance and early learning in the early childhood setting.
Increased social skills and self-regulatory behaviors
Increased teacher and parent confidence and competencies in managing medical and behavioral problems at home and in the classroom
Fewer medical crisis incidents and hospitalizations
Eighty-eight percent of the IEP-IFSP healthcare goals accomplished for children in HealthyCHILD
Increased program intensity
Seventy-eight percent of transagency goals accomplished for integration of teamwork and systems reform
Enduring needs for more comprehensive and integrated family support
