This episode was pre-recorded as part of
a live continuing education webinar. On demand CEUs are still available for this
presentation through ALLCEUs. Register at ALLCEUscom/CounselorToolbox. I'd like to welcome everybody to today's
presentation on the role of the family and community in prevention and
treatment. We're going to define what family and community really are because
when we're talking about this who are the players involved who are the
stakeholders that we're really talking about and the short version is everybody
and we're going to explore skills and strengths to help prevent medical
emotional and behavioral disorders and throughout the presentation
sometimes it's I've abbreviated it meb medical emotional and behavioral
disorders so if you see that that's what it means the committee the opiate
Commission that the president requested or whatever the report one of their
recommendations was that evidence-based prevention programs for schools and
tools and for teachers and parents to enhance youth knowledge of the dangers
of drug use as well as early intervention strategies for children
with environmental and risk factors be implemented well that's great that
sounds wonderful but how are we going to do it what interventions are we going to
use and how are we going to work that into the already present demands on
teachers and parents and everybody else so we're gonna look at that some of the
risk factors they identified and we went over this last week but I'll just recap
for those who weren't there trauma those who are in foster care
those who've experienced adverse childhood experiences which includes
substance misuse not even addiction but substance misuse in the household
divorce an incarcerated parent or mental illness within the household and it
doesn't have to be a severe and persistent mental illness like
schizophrenia so that really boils down to about 70% of children in school or
children period really need some level or would benefit from some level of
early intervention strategies because they've been exposed to environmental
and individual risk factors and developmental disorders is another
one that's a risk factor so what our family and community community we can
really think of as like our neighborhood you know the really small community
where junior goes out in plays and interacts with the kids in the
neighborhood more or less you know depending on where you live we live out
in the country where everybody has you know five or more acres in our
neighborhood so you know generally people who move into those types of
neighborhoods are less interested in block parties so depending on the
neighborhood will influence the types of interventions that you're able to do I
mean in neighborhoods where there's a clubhouse obviously it's going to be
easier to facilitate stuff than in neighborhoods where you know you've got
15 farms or something schools schools are another thing that another place
that we can consider community it may not be in your neighborhood but a school
is where you spend a majority of their time each week social service
organizations that are available in the community that go out and do
presentations that sometimes come into the schools and new school based
counseling they qualify businesses what kinds of things can businesses do to
promote positive interactions and promote health and wellness behaviors
one of the things and it's a little bit off topic but Pizza Hut does this book
reading thing where you read the child reads five books a week and they get
their teacher to sign off on it and they get a free personal pan pizza I know for
my kids that motivated a whole lot of reading so what can we do that will
engage children that will get them excited and I'm not saying give them
food for everything but that was one way to kind of tap in kids like videogames
so maybe giving them time at an arcade or you know I don't know but businesses
can think about what types of fun things they can offer or rewards they can offer
and how they can promote health and wellness not only in the in the youth
but in the adult people in the come unity sometimes book stores will have
presentations like little wellness presentations there are a lot of
different things we'll talk about local media can be responsible for doing
segments on health and wellness and healthy communication
more so than just identifying that there's a problem and saying as a
treatment center over here but actually doing segments that give practical tools
for people to use what can you do to help yourself get in shape what can you
do to deal with conflict what can you do to survive the holidays the national
media can go along with that and that includes if you will your actors
actresses your media your movies your sitcoms those sorts of things what types
of things can those venues promote if you remember I mean I think back to when
I was little and we had to ask after-school specials you know you may
think they were hokey but a lot of people watched them and they did
communicate a message you may not be able to engage somebody for an entire
after-school special now but when we think about what kind of messages the
television shows are communicating now you know this is where we can really or
Hollywood could actually make a positive impact to discourage bullying even on
the news to discourage name-calling and some of the conflictual interactions
that that seem to be pretty pretty harsh the internet is another place that is
the community I mean people spend a significant amount of
time on the Internet so how can we use the internet to reach out to people and
I'll give you a couple of hints advertising you have those annoying
pop-up ads but you do tend to look at them online chat rooms online forums and
support rooms like I've talked about before but also organizations that are
interested or that can provide this kind of information helpful tips can sponsor
videos can sponsor YouTube channels that are popular with a particular
demographic I know there are certain YouTube you tubers that my son watches
religiously so if I were trying to reach his particular demographic then I would
see about sponsoring or supporting those particular things and even getting some
ads on YouTube but it's a little hit or miss about which ones they'll they will
display next to which YouTube programs but if you contact the program directly
and say hey I would like to sponsor your program and do a 30-second ad you know
you're going to get a much more targeted audience and politicians I mean that's
kind of the meta concept of community but politicians have a huge impact on
where funding goes and on what the priorities are so if we want to improve
the priority on health and wellness in the school system then we need the
politicians to get on board and provide some money for it as well as provide a
little less emphasis on testing scores and it's all about the test right now
the family is considered the biological mother and you know I put mom out there
I am one but when the baby is in utero we're we're that we're it so we want to
look at prevention through healthy pregnancies the biological family but
not everybody is still in contact or wants to be in contact with their
biological family so we need to extend our notion of family to significant
others that are not blood-related so who is it that you call your family
and you know some use and even some older people that I've worked with will
identify their family very differently than their blood relatives so asking
clients who is in your family but those people we want to get involved if you
think back to broth and Brenner's model you know you're thinking of the the meso
system and you're thinking of all of the different influences and if
you've got healthy family however you define it if you've got a healthy school
system if you've got a healthy local community then you're probably going to
have a positive influence on the individual that's at the core of that
community so what are we doing now now we know why we're doing it and who we're
trying to get to buy into this preconception we want to prevent
high-risk pregnancies some of the risks are poor maternal nutrition and anemia
so making sure that people have access to food stamps WIC those sorts of things
that's already pretty much done but we want to make sure that people who need
it know how to access it and can access it and and there are some caveats and
there are some gotchas that I know prevents some pregnant women from being
able to access it even when they truly need it so it would be nice to take a
look at that system that's on a much larger scale maternal smoking alcohol
and drug use can all have significant impacts on the fetus we know that
alcohol can cause fetal alcohol spectrum disorders drug use can contribute to
behavioral and neurological issues and maternal smoking is strongly linked with
low birth weight and certain behavioral neurological problems exposure to neuro
toxic substances and this includes like lead we don't have lead paint anymore
for this reason and it's also recommended that pregnant women limit
their intake of certain fish when they're pregnant because the levels of
mercury are higher than what a fetus should be exposed to
important to educate pregnant mothers about this maternal depression and this
is when she's pregnant not just after after delivery but postpartum depression
as well as depression during the pregnancy period has been correlated
with lower child IQ adrenal fatigue and anywhere from Addison's disease to just
plum exhaustion if you've got a mom who's barely getting by and she's
drinking caffeine you know by the gallon number one the caffeine is not good for
the baby but number two it creates a situation where the body might feel it's
too taxed and it make it increases the risk of preterm delivery low birth
weight we want to do everything we can to get the birth weight up on the baby's
logo ternal weight and this is another one where the community as well as the
family can kind of pitch in a lot of moms don't really worry about it they
know they're gonna gain some weight when they're pregnant but then there's a
certain segment those with eating disorders and body dysmorphic disorder
especially who have difficulty when they start putting on the pregnancy weight
and so they may refuse to eat in order to support both mom and baby which
creates a high risk pregnancy can have damaging effects on the fetus so we want
to make sure that mom is putting on enough weight most of us put on too much
I know I did with both of my kids multiple previous preterm deliveries and
actually multiple is exaggerated they say once you have a preterm delivery
you're most likely going to have preterm deliveries after that I was lucky with
mine generally each baby after that is cooks stays in less time and it's more
preemie than the one before it I was lucky my daughter came out six
weeks later than her brother did so score for me but one previous preterm
delivery creates the designation of a high-risk pregnancy
another interesting one periodontal disease now this is one I didn't know
about so if you're working with a mom who is pregnant or thinking about
getting pregnant making sure that she has access to dental care to prevent
periodontal disease which has been linked to preterm delivery and physical
and emotional stress can cause preterm delivery it can also you know have some
adverse effects on the on the fetus but they put that in there the CDC put that
in there as something that you want to minimize in
pregnant women now that doesn't mean you know your run-of-the-mill stress you go
to work you have a bad day you're stuck in traffic
there are stressors that happen and that doesn't have a negative effect on the
fetus what we're talking about is extreme physical or emotional stress
during the fetal development period it's important to recognize we're still kind
of on healthy pregnancies preterm births have increased from eight to twelve and
a half percent over the past 20 years now granted we are able to keep babies
alive that are born much earlier now than we could
thirty years ago so that's good but even controlling for all that preterm births
are going up so why is this well they don't really know great we want to make
sure that women are getting adequate nutrition and that's not just making
sure they have WIC that means making sure they know what adequate nutrition
healthy nutrition is so they may need to speak with a nutritionist libraries can
have a shelf full of books that talks about prenatal nutrition doctors can
have handouts that summarize prenatal nutrition because it can get
overwhelming when you're looking at it and there's a lot of conflicting
information so ideally it would come from the OBGYN but anyway we can get
this information into the hands of pregnant women would be good preventing
exhaustion making sure that pregnant women are able to get enough sleep that
they're not working 12 15 hour days standing on their feet some people
that's what they have to do to make ends meet so how can we help them with this
identify and control bacterial vaginosis this is a bacterial condition that
sometimes is looked at as an STD because it can be gotten from sex with multiple
partners but there's a lot of other ways and a lot of women get really what you
start talking about this because they think of it as an STD but you can get
bacterial vaginosis when you have an imbalance in the good
bacteria the lactobacilli bacteria and and it's important to recognize that
that can be caused by using antibacterial soap to wash so there are
a lot of reasons there are a lot of things that can cause bacterial
vaginosis but it is highly correlated with preterm birth and mothers with
bacterial vaginosis are usually put on antibiotics either until it goes away or
until they deliver mother baby prenatal treatment programs now that medicaid can
be built for residential services this is going to potentially be awesome
because getting mom and baby in or mother in when she's still pregnant and
being able to keep baby after the delivery is huge I ran a mother baby
unit when I was in Florida and it was just beautiful to be able to work with
mom through the pregnancy however long we were lucky enough to have her through
the delivery and then for six months postpartum and it was an awesome
experience to be able to work with these women but it prevented a lot of problems
and a lot of women will avoid going to treatment if they think they're going to
be separated from their infant once there they deliver or if they've got
other kids at home and we were able to accommodate mothers that had multiple
children they would have their own room and they could have children that were
under the age of five in the program with them and then they would go to
daycare or whatever during or school during the day so this is huge now
because these women will have Medicaid most of the time because they have
dependent children or some sort of insurance the ability to open more
mother-baby prenatal treatment programs is going to go way up and this isn't
just for substance abuse this can be for major depressive disorder or bipolar
disorder peri and postpartum depression changes in sleep appetite weight energy
level and physical discomfort during pregnancy and postpartum
can cause significant emotional strain if you've been pregnant you know you
have those days where you don't sleep at all because jr.
Is kicking you in the
abdomen all night or you just can't get comfortable especially once you get into
that third trimester so it's important to work with moms and help them
understand how to take care of themselves because a lot of women will
still push through even though they're not sleeping well which can contribute
to problems with the pregnancy so once the baby's out and we've got a little
swaddled bottle bundle of joy this is the trust mistrust period and during
this period is when the child forms their initial attachment relationships
the mother infant attachment relationship is a well-established
influence on the infant's eventual successful development if this goes awry
the kids probably going to be a much greater risk of having problems so one
of the things that they look at during this period is maternal sensitivity in
in creating infant attachment and what that means sensitivity I don't like that
word but it's the best one they came up with is the mom actually understanding
what baby needs being sensitive to what this cry means what that crying means
instead of just okay here stick a pacifier and a bottle in his mouth the
mom actually being aware and responsive to the child's needs and a lot of moms
aren't you know they just either didn't have the training they didn't come from
that background or they're emotionally unable to really differentiate right now
because they're dealing with postpartum depression or anxiety or something so
they're not a as able to be as responsive
we'll use that word instead of sensitivity home-visiting is an
intensive intervention that targets successful pregnancies and infant
development so you know with my son he was born at 29 weeks so he was a TBD
buddy when he came home from the hospital we were enrolled in the early
intervention program and this is really important to know about
most pediatricians know about it so it's not a surprise to them but the early
intervention program is available for any child that either is at risk of
developmental disability or has demonstrated a developmental disability
so since Shawn was so preemie they I mean literally the day we got out
of the hospital we had an assessment set up and then we started having home
visits and he had ot and PT and a home visit therapists that would come in and
work with us but it provides assistance with physical delays cognitive
communication social emotional and even self-help in older children so there's
lots of examples of other services a lot of times it's paid for by Medicaid Part
D I believe so you can read over this but it's important to recognize that if
you have a mom who has a baby and a lot of our moms that came through the
program ended up having children that had developmental delays or seemed to
have so they got evaluated by the early intervention program and in most cases
it didn't cost them anything and it provided a lot of additional services to
the parents and it relieved a lot of stress I know for me it did having
experts being like you know it's all good he's gonna he's gonna figure this
out Florida has the early steps program and this is the one we were enrolled in so
you know I'm more familiar with it but it brings services into the child's life
than fitting rather than fitting the child into services so they were really
attentive to the fact that you know I was working and in school and my husband
was working and they worked around our schedule they brought like I said we had
in-home therapists come in in addition to the other therapy
that we went out with but there's a special certification for counselors
that work with early intervention services is a really fun program to be
involved with from from a professional standpoint to so those are things we can
do during the early period to help mom and baby bond to help mom become more
responsive and prevent some problems that may happen later during early
childhood and childhood the child is working on developing autonomy their
ability to control their own body that goes through the no-face and initiative
you know can they do something and succeed and what happens if they do
something and they fail how do they deal with that during this period aggressive
social behavior often starts to emerge when you see hitting and biting and you
know temper tantrums and lots of externalizing behavior so a key risk
factor for the progression of externalizing disorders is whether we
can get this externalizing behavior under control during the early childhood
period so instead of hitting Sammy when he takes your toy how can you deal with
that harsh and inconsistent parenting practices contribute to aggressive
social behavior children learn what they live if you you know a child hits
another child and you walk up to them and pop them on the butt and say don't
hit excuse me what what so you want to make sure that the parenting practices
make sense to the child and looking at positive involved involved mminton
positive reinforcement of desirable behavior so when they're doing well
remembering to say awesome job Sam or you did really well at the playground
today that contributes to cooperative and pro-social behavior it's also
important to help parents learn and you know I would struggle with this
sometimes to remember it's not just about the no it's about especially with
young children or you know whatever it's about positive redirection so if you're
not gonna do this what are you gonna do and teaching parents how to figure out
what a reasonable alternative is is helpful and they can practice this even
before they have kids we use it with our foster animals if they're having
difficulty chewing on something they're not supposed to instead of just taking
it away and going no you can't chew on that we take it away say no you can't
chew on that here chew on this this is appropriate
same thing with when the cat's scratch on things so you can help parents from
before juniors even born start learning how to identify posit and use positive
redirection programs that target child maltreatment have the potential to
prevent multiple medical emotional and behavioral disorders and promote healthy
development across several domains of functioning so we really want to look at
who's at risk of child maltreatment and how can we prevent child maltreatment
and that can be intervening in a family that has already had child maltreatment
issues and it can be providing education to parents who are at higher risk for
child maltreatment such as teenage mothers and single teenage mothers family poverty is associated with
increased parental depression increased spousal and parent-child conflict and
ineffective parenting so let's think about this for a second increase
parental depression well if there's their impoverished they are having
difficulty getting their basic needs met they're stressed about how to you know
pay the rent there's going to be a lot of stress anxiety it's going to get
exhausting and can contribute to depression so to that end we want to
look at how can we alleviate depression how can we network the family with
social services so they're making sure they get their basic needs met increased
spousal and parent-child conflict when when
stressed about things it tends to be more difficult to be patient so helping
parents and end children helping families develop distress tolerance
skills anger management skills and effective use of communication that you
know I in an ideal world would be available in community programs and
people would go to them in reality people don't go to community community
programs a lot so you've got to figure out how can you get this to people in
small enough sound bites you know over the internet or in on TV on something
they're watching so they can hear it and some of it sinks in an ineffective
parenting a lot of that has to do with the parents especially in an
impoverished environment maybe working multiple jobs so they're exhausted when
they come home and they're not as attuned to what juniors doing so they're
not as consistent and we know that consistency is the key we're not saying
they're bad parents but what we're looking at in most cases of this
ineffective parenting it's parents that are either harsh or inconsistent or both so then we move into early adolescence
young people are developing the concept of Industry and identity who am i what
can I do what am I good at what do I contribute to the world this is the
period during which the prevalence of substance use delinquency and depression
begin to rise psychological and behavioral problems tend to be
interrelated so risk factors include family conflict in poverty this one
keeps coming up so guess what this is one of the areas we need to intervene
increases in the rates of teasing and harassment in middle school
although elementary schools are getting pretty rough now significant physical
changes everybody goes through that awkward stage during this early early
adolescence we're talking middle school and maybe early high school social
changes including the transition from elementary to middle school there's a
whole lot going on during this period and if children don't have a supportive
environment to you know deal with it then they're going to find other ways to
deal through cycling through depression through acting out externalizing there's
increased concern about peer acceptance so they may be more likely to give in on
something and do things they're not supposed to increase demand for autonomy
in early adolescence youth really want to start spreading their wings a little
bit they want to be able to go out on their own and not be supervised and so
it can become sort of a battleground for the parents who are trying to make sure
that their young fledged safely from the nest and the young who are ready to just
kind of open their wings and see what happens
inadequate parental monitoring during this time it's not just you know mom and
dad not necessarily being there but juniors not around as much Junior's
going over for visits with friends having sleepovers going out on you know
scouting trips or whatever so there's less parental monitoring and depending
on how good the chaperones are on some of these other outings adolescents may
get away with more if you will deviant peer group formation
so going towards that unhealthy group an aggressive social behavior contributes
to social rejection and deviant peer group formation
so junior never learned to stress tolerance and coping skills and still
externalizes a lot they're probably not going to be as accepted into the
mainstream of middle middle and early high school that crowd they're probably
going to go more to the fringes and experience more social rejection so we
want to teach and encourage parents teachers and after-school care workers
after-school care workers are a huge niche here because a lot of youth go to
after-school care and this is where you're not worried about the testing
this is where youth I mean they need to let their hair down and get some energy
out but they can also participate in team-building activities and who funk
some fun stuff but these groups of people need to use praise and rewards to
reinforce desirable behavior and replace criticism and physical punishment with
mild and consistent negative consequences for undesirable behavior
like timeout or a brief loss of privileges so you know you need to go
sit down you can't play right now we also want to teach and this isn't on the
slide but we want to encourage parents teachers and after-school care workers
to be aware of signs of problems in youth that may need to be addressed such
as ADHD or FASD or cognitive disabilities which may be contributing
to their externalizing or inappropriate behaviors because if junior can't help
it the junior is going to keep doing it and gonna is going to get frustrating so
we need to help this group of people understand that you know children are
going to respond in a certain way to meet a need so if that need gets met if
they develop another tool then they won't have to act out that way so
helping them learn how to do what you expect them to do whatever the desirable
behavior is and if they can't do that especially if
they keep making the same error then considering is it is the child even able
to do what I'm expecting them to do and if not what do we need to do to
intervene and increasing positive involvement of adults with children such
as playing with them reading to them and listening to them so not just you know
throwing them out on the playground and go go go play you know I'll sit here and
make sure nobody breaks it breaks their neck but other than that I'm
disconnected you know actually getting out playing
hide-and-go-seek or pushing somebody on a swing or talking to a chil child
really increases that positive involvement and increases children's
positive view of adults early childhood interventions there are parent training
programs best practices that can help with creating positive parent-child
interactions these programs revolve around increasing effective emotional
communication skills being able to say how you feel without having to
externalize using timeout instead of physical punishment and emphasizing
parental consistency or parenting consistency so let's look at this first
one The Incredible Years program includes parent teacher and social
skills training components the parent training program shows parents brief
videotaped vignettes of interactions as examples of positive interactions the
value of praise and reward and the use of timeout and other mild negative
consequences so this is a video thing it's not a lecture so they're seeing
Shen it's been extensively evaluated and treating children with conduct disorder
so this is one that can be really helpful not only for parents but also
for teachers and after scale after-school care workers to learn these
skills through observation another one is Triple P the positive parenting
program which focuses on the general population not just individual families
and has selected components tailored to at-risk groups such as young single
mothers or children with behavioral problems
the program includes five levels of parenting guidance based on family needs
and preferences the universal level provides information by a mass media
like we were talking about about effective parenting and solutions to
common child-rearing problems so those little 60-second commercial snippets
that you know CBS used to do and stuff could be used to deliver this kind of
information remember I said we want to have it in digestible chunks that people
can hear sometimes repeatedly before they act it actually sinks in but they
can get it and they can get a tool from it the second level provides brief
advice to parents for dealing with specific concerns such as toileting
bedtime problems and parents are typically reached through contact with
their primary health care provider such as a pediatrician but not always you
know the nurse at the pediatricians office may provide educational sessions
or the pediatrician might have videos on his or her website that communicates
this information so parents don't have to come to the office but can get it via
you know tuning into that to that pediatricians website the third level
provides skills training for parents who are having problems with aggressive or
uncooperative children and the fourth level provides up to 12 one-hour
sessions on parenting skills for parents whose children have multiple behavioral
problems particularly aggressive behavior so this requires the parent to
be able to be present for 12 sessions but if they're working with a child if
they have a child with multiple behavioral problems one of them being
aggressive behavior a lot of times you'll see more compliance because
parents are at their wit's end and they're just like I need to know what to
do to you know get jr.
To calm down the final level enhanced Triple P provides
skills and support to deal with parental depression marital discord and other
family challenges so remember we keep talking about family discord being a
risk factor even from pregnancy so this final level of Triple P starts
to address that and identify interventions to use to help with
postpartum depression or just regularly occurring depression in mom or dad or
caregivers I should say so this is a really awesome program and this entire
presentation is based largely on family school and community interventions here
so you can read more about these after the class preventative interventions for
divorcing families have also been shown to be really effective the new
beginnings program was designed to strengthen parenting in improving warmth
and discipline increase father-child contact as a non parental adult support
and reduced divorce stressors so this is a great program obviously if you've got
a child who's experiencing divorce and it can be implemented in a variety of
different ways but this is one that does require parental commitment to the
program so you know how you're able to disseminate that whether it's home
visits or after-school activities or something you know that may be hit or
miss school based the CDT C Task Force on community preventive services
recommends the use of universal school-based programs for preventing
violence and improving behaviors in school all right that's great wonderful
but schools are really not focused on behavior modification right now and
behavioral enhancement except for to prevent it from distracting from
academic work so getting some of these programs in is a challenge and I would
love to see the community and the PTA and you know at large and and the
parents in these schools be able to affect the school system and get some of
these programs in there one of the programs is called a good behavior game
which is an elementary school Universal intervention program and at targets
classroom behaviors and basically the classroom is divided
in half and they get the participants in each team are able to earn points for
their team by being on task and there are rewards at the end of the day and at
the end of the week for the team that has the most on task people which
promotes some social pressure and it promotes kids trying to you know do what
they need to do unfortunately good behavior game in order to even
begin to implement it costs about thirty five hundred dollars so it's a little
expensive to get started like most evidence-based practices but it can be
effective and it is something a teacher could easily implement fast track is a
comprehensive long-term multi-level intervention for students at high risk
of antisocial behavior it's a evidence-based practice but I couldn't
find much information on it except for the fact that it costs about ten
thousand dollars to get started guiding good choices is one that I'm familiar
with we used to use in the facility that I worked at and it got a lot of really
positive feedback from the parents and participants and the outcomes were
really stellar most of the time so guiding good choices it costs about
twenty five hundred dollars to get started with so is another one that's
expensive but if your school system or your local community mental health
agency wants to look into that all they need to do is go to the website for
guiding good choices it's a five session program it does require parents to show
up for five two-hour sessions that's where the problem lies and five
consecutive ones so it can't be like willy nilly hit or miss however if you
can get parental buy-in and get them to do it just for five weeks it does have a
significant impact the Seattle social development project was designed to
reduce risk build protective strengths and schools families and children
themselves this project the long-term follow-up revealed multiple
positive effects on mental health functioning in school and work and even
sexual health 15 years after the intervention ended now I went to the
Seattle social development projects website and there really wasn't a lot of
information about what they did and several of their links that were would
give more information were defunct so if you want to look around on the internet
you may find some more information but that was one that was mentioned in the
book that did have good results I'm hoping they end up publishing more early
headstart is a federally funded extension of the headstart program which
targets low-income pregnant women and families with infants and toddlers those
participating in early headstart showed improvements on the mental development
index of the Bayley scales which is what they use to assess child and infant
development that's the basic is kind of like the Beck inventories for children
they showed larger vocabularies lower levels of aggressive behavior higher
levels of sustained attention greater engagement with parents and less
negativity towards parents a lot of school systems already employ early
headstart so this is something we want to make sure that funding keeps going
for and you know some school systems also accept volunteers for this program interestingly though families with four
or five of the following risk factors did not benefit from early headstart if
the family had if the parents had no high school education it was a
single-parent household it was a teen parent if they were receiving public
assistance or not employed or in school now they said four or five now I'm
looking at those going if I had four out of those five risk factors I'd be hard
pressed to not be really stressed and anxious and maybe depressed too so
remembering that poverty which if they don't have a high school education if
they are receiving public assistance and aunt or not in
loitering school it's an indicator of poverty poverty isn't associated with
increased parental depression increased spousal and child parent conflict and
ineffective parenting so what I took away from that was the head Early Head
Start program is really awesome if the child's home life is moderately
functional if there is a lot of conflict and parental depression at home then it
doesn't matter how much enrichment you do for the four hours that jr.
Is in
Early Head Start the other twenty hours are going to weigh down on the
effectiveness of that so we need to make sure to have interventions for the
families of these children in addition to just Early Head Start preschool the
CDC recommends publicly funded Center based comprehensive early childhood
development programs for low-income three to five year olds let's make sure
they're getting the enrichment they need preschool education has the positive
effects of increasing language skills literacy and general cognitive ability I
know my son really didn't talk a lot until he started preschool and that was
because he didn't have to you know I he would motion to something I'd get it for
him I didn't force him to talk at home and he got his needs met once he went to
preschool he had to articulate his needs and express himself and he became quite
expressive high-risk preschool prevention programs are available and
not widely though so again with the opening of the Medicaid doors I'm hoping
that some money will go in this area to supplement home visiting parent training
and preschool education this helps improve family functioning child
social-emotional functioning and cognitive functioning so again what
child learns during that four hours or six hours there in preschool is great
but then we want to see it reinforced at home interventions directed towards
children's early cognitive development are associated with long-term
improvement in multiple mental emotional and behavioral problems around Florida
many libraries have wings or areas of the library that are devoted to young
children and they have computer kiosks that are set up that have cognitive
enhancement enhancing programs on them to help them learn their ABCs or
whatever but they also have places they can lay on big beanbags and read child
appropriate books and parents can feel safe with the children in that area and
it's not necessarily one of those you gotta be you know use your library voice
because we recognize that children are gonna get a little excited so libraries
are a great place for early cognitive development enhancement in addition to
preschools and after-school care for those children who are in Early Head
Start headstart or kindergarten one little note child outcomes due to
reducing poverty remains limited and again I would assume and I don't know
this to be true that just reducing poverty doesn't necessarily improve the
family environment if there's already depression anxiety and conflict so we
need to not only reduce poverty but also improve family functioning in order to
improve child outcomes several preschool classroom curricula are designed to
improve teachers behavior management of classrooms by reducing child behavior
program problems and strengthening children's social skills or executive
functioning or both the promoting alternative thinking strategies
curriculum teaches elementary and preschool children about emotion
self-control and problem-solving it has shown been shown to be really really
effective so when you work that in I mean yeah that's great
wonderfully preschool doesn't have to have academic meet academic standards
every year so in preschool and Head Start and Early Head Start these things
can be taught to help children identify be able to
articulate their emotions and develop appropriate methods of dealing with
their feelings the community members influence legislation and we can
influence community members at large can influence the school by volunteering at
the school participating in the PTA advocating for children so they can have
access to school-based counseling health curricula promoting practical health and
wellness behaviors not just you know general these were the parts of the body
but how do you stay healthy home economics courses teaching basic life
skills how do you cook how do you shop how do you balance your checkbook and
school life balance programs and or school life balance and I emphasize this
because I know so many of my children's friends that are in public school will
come home from school and they spend the next five hours doing homework and you
know sometimes they don't even get to make it to their extracurriculars
because they've got so much homework to do
so there's not really a balance there at school front leave for school at 6:30 in
the morning and they study till 9:00 at night and you know that's their life and
we always warn adults from doing that with work going to work coming home
eating going to sleep getting up and going back to work it's not healthy well
it's not healthy for the kids either so we want to advocate for basically less
homework less busy mundane work you know there's a lot of stuff they can probably
get done in the classroom and school nutrition programs we want to keep those
going to make sure that children have access to healthy foods and you know
however you define healthy I thought the pizzas that we got when we were in high
school in school were just fine we can also as a community members model
healthy behaviors as it relates to smoking alcohol and drug use stress
management proper nutrition good sleep habits and effective communication
children learn when they're in Walmart looking at people or wherever you shop
when they're watching TV when they're with their family when they're in church
they learn so we as community members and model these healthier behaviors so
children can pick them up agencies and organizations can make prevention and
early mention intervention services affordable and available and sometimes
they got to be creative but that's what they get grants for salsa's prevention
week could be highlighted in your community and that could be a
centerpiece so to speak in order to launch initiatives to help the community
itself be stronger and healthier and we're gonna get to a program that builds
off of that in just a second home visiting community-based multi-component
interventions that provide services such as family support which this can be also
done some sometimes churches synagogues houses of worship whatever type you go
to the leader will maintain a list of people who are willing to help and
people who need help and that family support can come in really handy if
you've got a child in the hospital or you know a sick child or you just need
some respite time or whatever we can also make sure preschool education is
available childcare affordable good child care is available community
development and that means not only just talking about the people that are there
but developing the infrastructure so it brings business and brings jobs so we
have less poverty media interventions can be promoted by the community through
local news local channels intensive family preservation services can be
available for families that have existing maltreatment issues and social
skills development interventions can be shared along the way from the
pediatricians office to after-school care to daycare you know there's a lot
of places where the providers have the time to provide handouts or to do some
training so they could work with children slightly differently in a way
that would model appropriate coping skills the school community
interventions add several elements including in-service training of school
staff on how to work with kids who are struggling how to identify
externalizing behaviors and deal with them as well as to how to identify
problems that may need referral for further assessment and intervention
Louis local task forces can develop policies conduct school-wide fairs seek
funds for the school and conduct field trips for parents and children so again
the community doesn't have to necessarily be parents can form a task
force to help enrich the school system and parent training workshops can be
made available online so people don't have to get childcare or in-person communities that care is a prevention system designed to
reduce adolescent delinquency provides processes for communities through a
community prevention board to identify their prevention priorities and develop
a profile of community risk and protective factors the logic model
involves community level training and technical assistance for adoption of
science based prevention frameworks creation of a plan for changing outcomes
through using evidence-based programs and implementation and evaluation I love
this program because it recognizes that each community has its own unique needs
and challenges and encourages communities to create a task force to
get together and go okay what's going on in our community and how can we address
it the media and the Internet are emerging as a means to reach local
communities beyond schools and families and their extensive use by today's young
people makes development of evidence-based promotion and prevention
interventions using these venues attractive so how can we develop an
evidence-based practice using YouTube for example that's what we want to start
looking at studies of the impact of electronic media such as TV and computer
assisted interventions on other health-related behaviors have found
positive effects in cognitive behavioral and mood management skills mental health
interventions and smoking cessation in the UK they actually have two
computerized cognitive behavioral interventions for depression and panic
phobia disorders that have been approved by the National Institute of Health and
Clinical Excellence so those are completely self run self-help type
computer-based intervention programs the ecological approach to family
intervention and treatment aka eco fit consists of a parenting
information program provided through a Family Resource Center along with
parent-child homework interactions so homeworks going and then the parent and
child have to work together to encourage effective family management it's based
on empirically based model of child adolescent problem
behavior its family-centered addressing adult leadership and support in the
change process mom and dad gotta buy into it
it's assessment driven identifying intervention needs in that family as
well as in that community addresses client motivation as a core component
we've got to get buy-in from everybody not just mom and dad but also Junior too
and utilizes a health maintenance model delivered in service settings that
involve children and families so real quickly let's talk about targeting
problem behaviors aggression violence and substance abuse many of the target
risk factors of prevention interventions are interrelated so what we're looking
at is AI addressing both aggressive and withdrawn behaviors because when they
occur together they impart a much higher risk of depression failure at school and
violence and substance abuse than just aggressive behavior alone both risk
factors are independently linked to concurrent and successive problems in
concentration attention and poor achievement and depression is also
associated with poor achievement externalizing behavior across different
social fields and deviant peer group contact in middle school will predict
later juvenile arrests drug use and higher levels of risky sexual behavior
so we really need to address that externalizing behavior when they're
knee-high to a grasshopper and help them learn how to deal with those angry or
unhelpful feelings many of the targeted risk factors can be addressed using
social skills training and cognitive components that ultra perception and
attributions basic CBT change behaviors and improve social relationships
interpersonal effectiveness skills if you want to go to DBT and promote non
response to provocative situations that doesn't mean avoiding all conflict
because you can't avoid all conflict that means having the skills and tools
to deal with conflict and if you are in a provocative situation not to get
provoked and externalize universal interventions are designed to affect
school structure improve classroom management and improve students
relationships self-awareness and decision-making skills so the
interventions that we've talked about can come from the media from you know
watching the news and you know newscasters even though kids don't
necessarily watch the news they hear it is on and if they're doing a lot of
bickering name-calling bullying kids are gonna pick up on that and you know let's
teach what we want kids to do and let's model it the TV the themes of different
programs that are on TV can impart healthy coping skills or unhealthy and
athletes a lot of youth look up to athletes so they can serve as great role
models the internet you can use ads you can support websites and different
things on the internet that target your population so you you're getting your
message out directly to them and you can have websites available that they can
get more information podcasts teachers are also part of the interventions and
they can have curricula that they use but they can also model healthy coping
skills and positive redirection physicians after-school providers
parents school-based counselors and staff at churches synagogues mosques and
other houses of worship can all play a part in getting this information out
getting these interventions out risk factors that seem to be cross-cutting
that we still want to make sure we're keeping a focus on lack of maternal
bonding during that infancy period parental depression family discord and
externalizing behaviors all righty are there any questions let's see here all righty okay you're able to unmute
yourself now so if you want to have a discussion type question I'm here and
I've got my headphones on if you are ready to go take your quiz and be done
with your day you are good and I will see you tomorrow or the next day so just let me know where you're at if you enjoy this podcast please like
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