3/30/2016 Social Connections in Early Childhood Relationships Imagine Conference April 7, 2016 Albuquerque, NM Tory Everhart, LISW Sylvia Sarmiento, MS, CCC-SLP Christine B. Vining, Ph.D., CCC-SLP Objectives • Understand unique New Mexico family demographics • Describe three ideas on early childhood relationship development • Identify four elements of social communication engagement • Identify three natural daily structured activities in which to play to increase social communication Introduction • There at least 3.8 million children with developmental disabilities, including autism in the US • It is increasingly difficult for children and adults with developmental disabilities to obtain appropriate services and supports due to • Lack of accessibility to systems of care • Lack of trained providers • Language and cultural differences 1
3/30/2016 NM Demographics • 5 th largest • One of four geographically “minority - majority” states • 2010 census • Ethnicity/Race • 36 th in population • Hispanic - 46% (55% children 0-19) • 31% live in and around • White (non-Hispanic)- 41% Albuquerque (28%) • AI - 9% (10%) • Asia - 1% Child well-being • 2015 KIDS COUNT Data Book annual publication on the well-being of children in four domains: • economic well being • health • education • family and community • Based on policy agenda established in 2014: • NM was 50 th for child-well being in national KIDS COUNT data as indicated in 2013 profile NM KIDS are COUNTing on Us Policy Agenda (2014) Health • 8.7% of NM babies are born with low birth-weight (<5.5 pounds). • 9% of NM children lack health insurance • Impact: • Greater risk for developmental delays and health problems. • Children need regular well-baby/child checkups to detect developmental delays. • Without early intervention, developmental problems are not addressed adequately. NM KIDS are COUNTing on Us Policy Agenda (2014) 2
3/30/2016 Family and Community • 43% of NM children live in single-parent families • 21% of NM children live in areas where the overall poverty rate is 30% or higher Impact: • High poverty areas likely to feel disenfranchised and experience social problems e.g., crime, substance/drug use, substandard housing that may put children at risk NM KIDS are COUNTing on Us Policy Agenda (2014) Economic • 31% of NM children live at the poverty level (<$23,550 for a family of four). • 25% live in low income – families earning 2x the poverty level. • 36% of NM children live in households that spend 30% or more of their income on housing. Education • 62% of NM children ages 3-4 are not attending preschool Impact: • Brain development in first 5 years of development and dependent upon nurturing and stimulating experiences • High quality programs foster cognitive, social and behavioral skills development and prepare children for school success NM KIDS are COUNTing on Us Policy Agenda (2014) 3
3/30/2016 Kicked Out • Preschoolers are 3 times more likely to be “expelled” than children in grades K-12 (Gilliam, 2005) Who gets expelled? • 4-year olds 50% more likely than 3year olds • Boys 3 ½ times more likely than girls • African American 2 times rate of European Americans • Forms of suspension: • “Come pick up your child” when child is having a bad day • “Child can only handle 2 hours/day • We don’t collect data on this or call it suspension “Data shows no kid getting kicked out when parent and teacher have a relationship” Corso – 2016 Preschool ASD Institute Education: Social- Emotional/Behavioral Challenges • Children who are identified as hard to manage at ages 3 and 4 have a high probability (50:50) of continuing to have difficulties into adolescence (Campbell & Ewing, 1990) • Of the young children who show early signs of challenging behavior, it has been estimated that fewer than 10% receive services for these difficulties Corso – 2016 Preschool ASD Institute Center on Social Emotional Foundations for Early Learning (CSEFEL) • National Center focused on promoting the social emotional development and school readiness of young children birth through age 5 • Incorporating an Evidence-Based Framework: the Pyramid approach. http://www.pyramidmodel.org/ 4
3/30/2016 Ongoing Needs • Coordinated, comprehensive systems of care • Early screenings for developmental and special health care needs • Families in accessing services, information and resources they need • Families as partners at all levels of service delivery • Early diagnosis and early intervention for children with ASD and other developmental disabilities • Diverse workforce and cultural competency to build capacity and address significant needs in a multicultural society Parent Home Training • Need for Parent Training • Teach families skills for promoting development • Research shows numerous benefits for both child and parent when caregivers are actively involved in intervention for children with ASD. • Work within the strengths of parent-child relationship Parent Home Training Topics • Understanding ASD • Accessing resources • Improving Skills • Communication • Social skills • Transitions • Toilet training • Behaviors • Sensory • Feeding 5
3/30/2016 Evidence Based Practices • Integrate research-based techniques into daily interactions with their children: • Functional communication • Visual schedules/supports • Social narratives • Naturalistic Developmental Behavioral Interventions (“NDBIs”) Features: • Use natural contingencies • Are implemented in natural settings • Involve shared control between participants • Use a variety of behavioral strategies to teach developmentally appropriate and prerequisite skills Schreibman et al. 2015 Common Features of NDBIs • Child Initiated • Environmental Arrangement • Natural Reinforcement and Related Methods for Enhancing Motivation of the Child • Use of Prompting and Prompt Fading • Balancing Turns Within Object or Social Play • Modeling • Adult imitation of the Child’s Language, Play or Body Movements • Broadening Attentional Focus of the Child Schreibman et al. 2015 Relationships • Children learn and develop in the context of relationships that are responsive, consistent and nurturing • Important to build these relationships Building relationships are at the early on rather foundation of everything we do than waiting until there is a problem. Corso - 2016 Preschool Institute 6
3/30/2016 Remembering the Past, Looking to the Future Trends in Intervention for Young Children 1. Professional Centered 2. Parent-Allied or Parent Focused 3. Family Centered Past Models for Intervention • Professional • Parent-Allied Centered Parents participated The professional is in order to implement at home the expert and holds Power remained with the power Child Focused the professional Intervention still child Intervention is child and deficit focused and deficit (problem) focused Family Centered Intervention • Shift in power Parents are seen as the experts on their child Professionals bring knowledge from their area of expertise Collaborative relationship between parents and professionals • Family Focused Intervention is based on family priorities, parents participate in planning and implementing Promotes family choice and control over desired resources • Strength Based 7
3/30/2016 The First Social Connection Relationship between infant and primary caregiver • Initially a means for survival of the infant, but plays a central role in social and emotional development and well-being • Based on reciprocal exchanges (communication) This relationship develops within everyday natural routines • Through caregiving activities, feeding bathing, changing, playing… • Infants’ earliest communication is initiated to maintain proximity from caregiver to promote security, safety Communication between infant and caregiver Eye Gaze Facial Expression Body language Voice Touch (Affective exchanges) 8
3/30/2016 The Importance of the young child and caregiver relationship • Children don’t exist independently, they require on support of others through the juvenile period. • Young children and their development should be understood within the context of their caregiver relationships. Nature vs. Nurture Most researchers now conceptualize development as some transactional exchange between genetic, inherited factors and environmental factors Emerging evidence of the effects of relationship experiences upon the brain (Schore, A.N., p. 10,12) Attachment • The relationship that develops during the first years of life • When an infant’s communicative attempts are met consistently and appropriately, a secure attachment develops 9
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