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Key Goal

Key Goal. Connected Kids: Safe Strong Secure is an AAP program designed to support clinicians’ efforts to prevent youth violence by promoting the development of resilient children. Why Is This Important?. Violence is a major cause of childhood morbidity and mortality in the United States.

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Key Goal

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  1. Key Goal Connected Kids: Safe Strong Secure is an AAP program designed to support clinicians’ efforts to prevent youth violence by promoting the development of resilient children.

  2. Why Is This Important? • Violence is a major cause of childhood morbidity and mortality in the United States. • Homicide is the 2nd leading cause of death for 13- to 21-year-olds • The leading cause of death for African Americans 13 to 21 years old1 • Increase in community violence during 1990s • 21st century rates in the United States still among the highest in the world

  3. Why Is This Important? • Many parents and pediatricians feel community violence screening should be routinein well child care.2-5 • Results from the 1998 and 2003 AAP Periodic Surveys of Fellows show that a majority of pediatricians feel unprepared to manage community violence.2-4

  4. Why Is This Important? Parents want more doctors to discuss community violence.5 Results from the National Survey of Early Childhood Health

  5. Connected Kids provides… Tools and strategies to help parents raise resilient children: • Educational materials for parents and youth • Effective anticipatory guidance • Developmentally appropriate guidelines • Easy-to-use Clinical Guide with links to research

  6. Development Process Development of Connected Kids included6: • Input from parents, clinicians, and other experts • Testing of program materials in focus groups with diverse families and clinicians7 • Incorporation of stakeholder feedback • A broad and respectful approach for all of the educational materials • Coordination with other AAP efforts

  7. Objectives Connected Kids will: • Strengthen the connections among children and youth, their families, and their community • Reduce risk factors by building resilience8

  8. Presentation Goals 1. Become familiar with the underlying theoretical model for Connected Kids 2. Review the counseling schedules for Infancy and Early Childhood, Middle Childhood, and Adolescence 3. Learn how to prepare a strategy for implementing this programin your practice

  9. Connected Kids . . . • Uses an asset-based approach to prevention that: • Emphasizes the identification and enhancement of strengths • Enhances clinician-family alliance • Helps parents with strategies to: • Promote positive development • Develop prosocial interpersonal skills • Obtain support and resources to help raise children

  10. Assets: Goal: Help improve child’s resilience Assess family strengths Link to community resources Risks: Goal: Reduce known risks Screen for risk factors Refer to services Asset- Versus Risk-based Approaches to Guidance

  11. Connected Kids Includes: • Clinical guide • Counseling schedule • Handouts for parents and families • Web site • This training presentation • Database of violence prevention materials • Success stories

  12. Clinical Guide • This presentation supplements the clinical guide, available online at www.aap.org/ConnectedKids • Clinical guide contains • Background information • Counseling schedule • Visit-by-visit suggestions from birth to age 21

  13. Child-Centered Parent-Centered Physical Safety Community Connections Building Blocks Connected Kids centers on 4 overlapping themes of anticipatory guidance

  14. Child-Centered Child-Centered Recognizes: • Child’s changing abilities • Cognitive development of child • Related parental concerns Parent- Centered Community Connections Physical Safety

  15. Parent- Centered Parent-Centered Child-Centered • Addresses the importance of parental supports • Incorporates the idea that parents develop along with the child • Contributes to the quality of family life • Promotes positive parenting Community Connections Physical Safety

  16. Positive Parenting Teaching desired behavior begins with a positive and nurturing foundation9 What to do when your child misbehaves How to manage conflict and teach responsibility Ways to nurture your children and prevent misbehavior

  17. Community Connections Community Connections Child-Centered • Research underscores the importance of10: • Social capital: a measure of the interconnectedness among people with their community • Community connections • Clinicians can help connect families to community resources Parent- Centered Physical Safety

  18. Child-Centered Physical Safety Physical Safety • Counseling schedule focuses on violence and intentional injury • Complements AAP’s TIPP® (The Injury Prevention Program) • Handguns in the home placed in the context of child development • Provides objective information to help families make their own decisions Parent- Centered Community Connections

  19. Connected Kids Counseling Schedule • Lists topics to introduce and reinforce at each visit • Provides asset-based assessment and anticipatory guidance for each visit • Links to use of parent and patient brochures: • Distributed when a topic is first introduced • Promote discussion between provider and family • Give useful information to foster the development of strong, resilient children

  20. Counseling Schedule

  21. Anatomy of a Brochure Front Cover Cover image visually conveys core message Designed by Artists for Humanity, a non-profit arts and entrepreneurship program for Boston teens.

  22. Anatomy of a Brochure Content • Each brochure addresses one specific issue • Content based on all four building block themes • Reading level: 2nd to 6th grade • Contains concrete examples for key concepts

  23. Anatomy of a Brochure Back Cover • Summarizes topics • Space provided for: • Parent/patient guidance • Follow-up suggestions • Community resources • Next appointment • Practice name and address

  24. Counseling Schedule Infancy & Early Childhood 2 days – 4 years Middle Childhood 5 – 10 years Adolescence 11 – 21 years

  25. VISIT INTRODUCE 2 DAYS to 4 WEEKS • What Babies Do • Parental Frustration • Parent Mental Health • Parent Support 2 and 4 MONTHS • Child Care • Family • Safe Environment • Parenting Style • Bonding and Attachment 6 and 9 MONTHS • Establishing Routines • Discipline = Teaching • Firearms • Modeling Behavior Counseling Schedule: Infancy

  26. Infancy11-17 • Early caregiver relationships set the stage for future relationships • Securely attached young children have an easier time developing positive, supportive relationships • Emerging evidence shows that securely attached young children are found to have more18-25: • Balanced self-concept • Advanced memory processes • Sophisticated grasp of emotion • Positive understanding of friendship

  27. Infancy Counseling Is this what you expected? Be on the lookout for families who are socially isolated or experiencing family discord. Who helps you with your baby? How much time do you have off from work? If there is a gun in the home, how is it stored? Being a new parent can be exhausting. How are you doing?

  28. Infancy Brochures

  29. Welcome to the World of Parenting!Visit: 2 Days to 4 Weeks • Helps parents understand the normal development of newborns • Provides information about coping skills for parents • Discusses changes in the ways parents may now relate as a couple

  30. How to Use this Tool • Whenever appropriate, include both parents in the conversation • Discuss infant crying and ways to handle it: • Crying is normal • Crying upsets parents • Sometimes, parents just need to let the baby cry Helpful Hint! I love the way your baby looks at you, soothes to your voice. You’re doing a great job! Support new parents with positive statements:

  31. Parenting Your InfantVisit: 2 and 4 Months • Helps parents understand normal development of 4- to 9-month-old infants • Stresses importance of building family connections • Discusses 3 problems: • Colic • Trouble sleeping • Clinging to parents

  32. How to Use this Tool • Reiterate messages about crying and parental frustration • Emphasize to parents the importance of having time together without their baby Helpful Hint! Support new parents with positive statements: Your infant is alert, growing well, and has a beautiful smile!

  33. How Do Infants Learn?Visit: 6 and 9 months • Offers practical suggestions to parents based on a newborn’s brain development • Encourages activities like reading or singing to promote brain growth • Helps parents understand that exploration is a natural developmental need

  34. How to Use this Tool • Ask parents about their social connections. Refer to sections “Others Who Care for Your Baby” and “Taking Care of Yourself” • Utilize the “Social Connections” worksheet from the Clinical Guide • Talk about child care arrangements Helpful Hint! Wow, your baby is really interested in my stethoscope! I like the way she lets me examine her, but she is always looking over at you for assurance. Notice infant’s new behaviors and parent-child interaction:

  35. Your Child is on the Move: Reduce the Risk of Gun InjuryVisit: 6 and 9 months • Correlates childhood injuries/ deaths due to firearms and presence of handguns in the home • Emphasizes that a child’s curiosity about guns overwhelms any lessons learned about gun safety • Provides information needed to make informed decisions

  36. How to Use this Tool • Discuss handguns in the context of other household hazards • Since some parents may not be in agreement concerning the presence of handguns in the home, encourage them to look at the brochure together to make an informed decision Helpful Hints! • In areas of country with high rates of gun ownership, some practices offer reduced price or free gun locks • Be aware of the potential lethality of domestic violence in homes with handguns

  37. Counseling Schedule: Early Childhood VISIT INTRODUCE 12 and 15 MONTHS • Child Development and Behavior 18 MONTHS and 2 YEARS • Child’s Assets • Guided Participation • Media 3 and 4 YEARS • Peer Playing • Safety in Others’ Homes • Talking About Emotions • Promoting Independence

  38. Early Childhood26-30 • Communication skills allow young children to sustain bouts of play • How young children learn to react is greatly influenced by: • Parental relationship • Parental behavior • Home environment

  39. Early Childhood Counseling Normal toddler behavior may be especially difficult for families with little social support. Encourage alternatives to TV, such as outdoor activity or reading. “She really pays attention when we talk; does she understand when you speak to her?” “Does your child have opportunities to play with other children this age?” “Teach your child by providing positive reinforcement for desired behaviors.” “What do you think your child does best? What does he enjoy doing?”

  40. Early Childhood Brochures

  41. Teaching Good Behavior: Tips on How to DisciplineVisit: 12 and 15 Months • Describes the basics of a behavioral approach to parenting toddlers • Positive reinforcement for desired behaviors • Limit setting • Advises parents about effective alternatives to corporal punishment

  42. How to Use this Tool • Start conversations about toddler behavior with gentle inquiries • “Your child is growing and developing well. Have tantrums started? How do you handle them?” • “What is your child doing new since last visit? What do you want to change?” • Endorse the core message: a simple approach for teaching toddlers how to behave well Be on the lookout for children with difficult temperaments, families who are socially isolated, and families experiencing discord Helpful Hint!

  43. Playing is How Toddlers LearnVisit: 18 Months and 2 Years Helps parents understand normal toddler behavior and advises them how to • Provide a stimulating environment during this period of major brain development • Understand the natural curiosity and exploration of toddlers

  44. How to Use this Tool • Discuss normal toddler play behavior • Provide parents with guidance on the types of toys that stimulate imagination • Help parents identify places where they can meet other toddlers and their parents Helpful Hints! • Check in with parents about how their family relationships are faring • Support toddler’s parents with positive statements: What a delightful child you have! He is really curious about the world. This is great to see!

  45. Pulling the Plug on TV ViolenceVisit: 18 Months and 2 Years • Provides information about the influence of TV violence on children • Offers tips for parents • Set limits on TV time • Know what children are watching • Watch programs with children • Do not put TV in a child’s room

  46. How to Use this Tool • Identify alternatives to TV, such as toys that use imagination or outdoor play when possible • Recognize that alternatives can be challenging, as TV often provides free in-home child care for families who cannot afford organized activities or who live in unsafe areas Helpful Hint! What’s your favorite TV show? Ask the child: The child’s response often indicates the kind of TV programs being watched, which provides a topic to open discussion with parents

  47. Young Children Learn A Lot When They PlayVisit: 18 Months and 2 Years • Introduces the importance of peer playing • Includes tips on how to make play opportunities successful • Assists parents in solving common difficulties, such as aggression and rejection

  48. How to Use this Tool • Ask if child has opportunities to play with other children of the same age • Use parent’s answer to discuss how the child plays or how to find other children • Help parents problem solve any play or playmate issues Helpful Hint! I see you really like trucks. Do you and your friends play with trucks a lot? Try to notice something about what children are wearing, the toys they bring, or their behavior:

  49. Counseling Schedule: Middle Childhood VISIT INTRODUCE 5 YEARS • Establishing Routines and Setting Limits 6 YEARS • Teaching Behavior • Bullying • Out-of-School Time 8 YEARS • School Connections • Alcohol and Drugs • Interpersonal Skills • Child Mental Health • School Performance 10 YEARS

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