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suhyeon-choi-251615Today we are going to start our discussion by painting a picture with our minds. Envision the sights, sounds, and even smells of this description and drift into the shoes of this couple that is about to be described. It’s the beginning of November, the air that once felt like fall now brings about the chilling winds of winter. A couple expecting their very first child rushes about their home early in the morning to prepare for their work day. The aroma of breakfast cooking on the stove fills the home as the expectant mother slowly sits down at the kitchen table to have a morning meal. Only moments after taking a seat, the mother’s water breaks. Shrills of excitement fill the mother’s and father’s voice as they rush to deliver their baby at exactly 40 weeks. Delivery is difficult of course, but after a long night, a beautiful baby is placed in the arms of the mother. After spending a couple of days in the hospital, the couple is sent home with their new bundle of joy. We wish every single delivery could go as smoothly as the one described, but we know this scenario is not the reality for so many parents.

Parents all hope for routine deliveries that provide them with a healthy baby who can return home in just a few short days, but many babies are born into this world before spending 40 weeks in the womb. In these emotionally trying times, babies are not sent home after delivery, but usually placed in the Neonatal Intensive Care Unit (NICU). No parent should have to watch their precious newborn from afar, but thousands of parents have to visit their baby in the NICU each year. As November marks National Prematurity Awareness Month, let’s take an opportunity to discuss prematurity further and how parents can promote a healthy and full-term pregnancy.

Prematurity among infants is a public health concern in the United States. Each year, roughly 400,000 babies are born preterm leaving about 1 in 10 infants to face prematurity in the year 2015 (Barfield, 2016; Centers for Disease Control and Prevention (CDC), 2017). These numbers pose a serious threat to babies as preterm birth has been listed as one of the top 5 leading causes of infant death in past years (CDC, 2017). The American Academy of Pediatrics (2015) explains that a baby is considered preterm when they are born before 37 weeks of pregnancy. Infants born prematurely can face a number of concerns. These concerns include: respiratory problems, feeding difficulties, cerebral palsy, developmental delay, and problems with hearing and vision (CDC, 2017). As a home visitor, it is highly likely that your heart breaks at the thought of a baby being born into a world where they have to fight extra hard to keep up every day. Prematurity is a difficult topic to discuss as we don’t want to think that the smallest humans in the world are starting out life with struggles. Luckily, research is showing there are precautions that can be taken to promote a healthy and full-term pregnancy.

It is important to mention that even what seems like the healthiest of pregnancies can end in a preterm birth (CDC, 2016). There is no way we can guarantee parents that their pregnancy will be problem free. Despite this, research has identified factors that can increase the risk of preterm labor (CDC, 2016; Thomas, Copen, Kirmeyer, 2016). These factors include:

• Cigarette smoking

• Substance abuse

• Stress

• Depression

• Short interpregnancy intervals

Many of these factors may seem out of your control, but there are ways you can help. That’s right, you as a home visitor have wonderful opportunities to talk with parents about how they can have a healthy pregnancy! You even have your Growing Great Kids (GGK) and Growing Great Families Curricula (GGF) available to you which provides conversation guides around what can be uncomfortable subject matter. For example, you might be thinking how do I even begin a conversation around using drugs or smoking while pregnant? These are extremely difficult conversations to have with parents, but not to worry. There are modules like Healthy Pregnancy…Healthy Baby that provide a conversation guide around prenatal smoking and drug use. GGF even offers numerous modules on stress which we learned can be a contributing factor in preterm birth. Before wrapping up this discussion, please review the list of GGK and GGF modules that can provide support for healthy pregnancies and help prevent preterm births.

Growing Great Kids Prenatal Manual

Unit 2 Module 3: Prenatal Depression In Moms And Dads Is Not Uncommon

Unit 3: Module 3 Healthy Pregnancy… Healthy Baby

Unit 4: Module 2 Power Down Stress…Power Up Happiness

Growing Great Families Manual

Unit 2: Module 2…Sizing Up Your Strengths…Reducing Stress

Unit 2: Module 5… Warning Signs For Stress Overload

Unit 3: Module 10…Planning A Family

Unit 3: Module 8…When Depression Is A Concern

November is a busy month as the holiday season begins and the new year approaches, but in the hustle and bustle of the month, don’t forget it is National Prematurity Awareness Month. Remember, you have the ability to help prevent preterm births using modules like the ones listed above. The factors that can cause preterm birth can be hard subjects to discuss, but there are already conversation guides created to make these conversations easier. We hope you have enjoyed this discussion and that have a wonderful November. Please go forth and share with parents how to turn healthy pregnancies into healthy babies!

References

American Academy of Pediatrics. 2015. Caring for a premature baby: What parents need to know. Retrieved from: https://www.healthychildren.org

Barfield, W. 2016. National prematurity awareness month: Celebrating successes and taking           action. Retrieved from: https://www.cdc.gov

Centers for Disease Control and Prevention. 2017. Infant mortality. Retrieved from:           https://www.cdc.gov

Centers for Disease Control and Prevention. 2017. Preterm birth. Retrieved from:           https://www.cdc.gov

Thomas, M. E., Copen, C. E., & Kirmeyer, S. E. 2016. Short interpregnancy intervals in     2014: Differences by maternal demographic characteristics. Retrieved from: https://www.cdc.gov

 

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October is often associated with fun fall activities. Those who celebrate Halloween will fill their front porches with decorative pumpkins, while others will head to the nearest apple orchard to pick the fresh fall fruit. The sports fans will cheer on their favorite football teams and others will find themselves getting lost in the fun of a corn maze. October truly is a wonderful month for many individuals, but there is a characteristic of the month that is often forgotten. The tenth month of the year marks Domestic Violence Awareness Month. A public concern that is familiar to adults and children alike. Children living in homes where domestic violence is occurring experience the unfortunate consequence of toxic stress.

Violence has become a part of our everyday life. Children can experience violence in various settings…schools, neighborhoods, and even within their own homes (American Academy of Pediatrics, 2016). Researchers now warn that violence experienced within the family is considered the most damaging type of violence for children (Maneta, White, & Mezzacappa, 2017). This research raises concern as it is estimated that 20 to 30% of American children have witnessed violence between their parents (Fowler, Cantos, & Miller, 2016). Among the children who are exposed to intimate partner violence, roughly 57% of these children report being maltreated at some point in their lifetime (Kiesel, Pieschar, & Edleson, 2016). Unfortunately, various researchers are finding that domestic violence and child maltreatment co-occur (Casanueva, Smith, Ringeisen, Dolan, & Tueller, 2014; Katz, 2014; Kiesal et al., 2016). Some researchers are even discovering that children who live with domestic violence witness between 70-85% of the abuse (Katz, 2014). As you read these statistics, you may be wondering why such devastating numbers are being shared with you. The reason is that you, as a home visitor, can empower caregivers to prevent this violence. Domestic violence causes toxic stress for children, however, you can support parents to prevent toxic stress within their families, by guiding them as they increase their understanding of its impact.

What is toxic stress? You may know the answer to this because you have worked through the GGF module that discusses toxic stress. Maybe you have not gotten to this module yet, but you have heard the concept tossed around among individuals or maybe you have seen toxic stress mentioned in the literature. Researchers describe toxic stress as the extreme or recurrent activation of the stress response, in the absence of a supportive adult to assist with co-regulation. The Center on the Developing Child at Harvard University (2011) describes in detail how the brain responds to stress. The Center explains that when the body experiences stress, the stress response system is activated. This activated response system causes increased heart rate and stress hormones. When a child experiences stress, but a loving and caring adult responds to the child, the stress response system can return to normal. However, when a child does not have an adult to respond in moments of extreme stress, like often is the case during domestic violence, the child’s stress response system stays activated. This continuous activation can cause a reduction in the connection between neurotransmitters in the brain comprised for learning and reasoning. Does this information remind you of any specific daily do? Yes, Brain Builders!

When discussing toxic stress that is rooted in domestic violence, think of the bubble brains. We know little brains that face trauma miss out on important connections that need to form in early childhood. Even though toxic stress can be a difficult topic to explore, the great news is you have various tools in your GGK Curriculum that can guide conversations around toxic stress and healthy brain development for children. Please see the list of useful modules or subsections listed below that can guide you as you support parents to prevent toxic stress and promote healthy brain development.

Growing Great Kids Prenatal

Unit 3 Module 4: Your Baby’s Developing Brain

Growing Great Kids Birth to 12 Months Manual

0-3 Months: Physical and Brain Development

Growing Great Kids 13 to 24 Months

16-18 Months: Physical and Brain Development-Building a Great Brain: Parental Influences

Growing Great Families 

Unit 2 Module 1: Protecting Your Children from Toxic Stress

Unit 2 Module 5: Warning Signs for Stress Overload

As you settle into October, please remember it is Domestic Violence Awareness Month. When raising awareness for this type of violence, don’t forget to be a voice for the children who are a part of this violence.

References

American Academy of Pediatrics. (2016). Childhood exposure to violence. Retrieved from:           https://www.healthychildren.org

Casanueva, C., Smith, K., Ringeisen, H., Dolan, M., & Tueller, S. (2014). Families in need of domestic violence services reported to the child welfare system: Changes in the         national survey of child and adolescent well-being between 1999-2000 and 2008-        2009. Child    Abuse and Neglect, 38, 1683-1693. Retrieved from:          http://www.sciencedirect.com

Center on the Developing Child Harvard University.  (2011). Three core concepts in early           development. Retrieved from: https://developingchild.harvard.edu

Fowler, D. R., Cantos, A. L., & Miller, S. A. (2016). Exposure to violence, typology, and     recidivism in a probation sample of domestic violence perpetrators. Child Abuse &       Neglect, 59, 66-67. Retrieved from: http://www.sciencedirect.com

Johnson, S. B., Riley, A. W., Granger, D. A., & Riis, J. (2013). The science of early life      toxic stress for pediatric practice and advocacy. Pediatrics, 131,319-327. doi:     10.1542/peds.2012-0469

Katz, C. (2014). The dead end of domestic violence: Spotlight on children’s narrative        during           forensic investigations following domestic homicide. Child Abuse and          Neglect, 38, 1976-1984. Retrieved from: http://www.science direct.com

Kiesel, L. R., Pieschar, K. N., & Edleson, J. L. (2016). The relationship between child           maltreatment, intimate partner violence exposure, and academic performance.     Journal of Public Child Welfare, (10) 4, 434-456. doi:         10.1080/15548732.2016.1209150

Maneta, E. K., White, M., & Mezzacappa, E. (2017). Parent-child aggression, adult-partner           violence, and child outcomes: A prospective, population-based study. Child abuse & Neglect, 68, 1-10. Retrieved from: http://www.sciencedirect.com

 

 

 

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As summer comes to an end, fall quickly approaches. Many people await the season with excitement as the leaves begin to change and the temperatures slowly drop. Despite the refreshing changes the season brings about, it also comes with lots of sneezing, sniffling, and coughing. Yes, the fall season is infamous for the flu. Though this virus  is well known, it is easy for caregivers to forget how dangerous it can be for infants and children. As yesterday marked the end of summer, our discussion today will focus on how to prepare for the arriving flu season.

Influenza, commonly known as the flu, can often be mistaken for the common cold, but usually strikes more suddenly and makes you feel much worse than a cold does (Canadian Pediatric Society, 2015). According to the Canadian Pediatric Society (CPS) (2015) and the Centers for Disease Control and Prevention (CDC) (2017), infants and children can experience a wide range of symptoms from the flu. These symptoms include:

• Fever or feeling feverish

• Dry cough and sore throat

• Headache

• Muscle/body aches

• Fatigue

• Runny or stuffy nose

• Vomiting and diarrhea, especially common in children

Most people recover quickly from the flu, but it is crucial for caregivers to understand that young children are at a high risk for developing complications (CPS, 2015). A bout of the flu can lead to pneumonia, bacterial infections, croup, and bronchiolitis in children. Unfortunately, the virus is highly contagious and spreads easily among groups of children -  particularly in childcare settings (AAP, 2016). Even though infants and children can easily catch the flu, there are several steps caregivers can take to keep their little ones protected.

The CPS (2015) and the CDC (2016) recommend the following precautions this flu season:

  •  If you have a child who is 6 months or older, speak with a healthcare provider about the flu vaccine
  •  Wash hands frequently, especially after coughing, sneezing, or wiping noses
  •  Avoid touching your nose, eyes, and mouth as these areas allow for spreading of germs
  •  Clean and disinfect areas that could be contaminated with flu germs
  •  Avoid letting your child share toys that other children have placed in their mouth
  •  Do not share cups, utensils, or towels
  •  When coughing or sneezing, use a tissue to cover your mouth or nose

There are no GGK modules that specifically discuss the dangers of the flu virus for infants and children, but there are various subsections that can support caregivers in keeping their little ones healthy and free of illness. When preparing for upcoming home visits, please keep the following sections in mind:

Growing Great Kids Birth to 12 Months Manual

0-3 Months: Basic Care - When Baby Is Sick or Needs Health Care

4-6 Months: Basic Care - Keeping Your Baby Healthy

4-6 Months: Basic Care - Body Builders Daily Do Introduction

10-12 Months: Basic Care - Keeping Your Baby Healthy

Growing Great Kids 13 to 24 Months Manual

13-15 Months: Basic Care - Body Builders Daily Do

13-15 Months: Basic Care - Routine and Responsive Health Care

As you enjoy the break that Fall brings, don’t forget to protect your family from illness! Remember, even though young children are susceptible to viruses, there are lots of things caregivers can do to keep kids healthy this upcoming flu season.

 

References

American Academy of Pediatrics. 2016. Preventing the flu: Resources for parents and child care     providers. Retrieved from: https://www.healthychildren.org

Canadian Pediatric Society. 2015. Influenza in children. Retrieved from:     http://www.caringforkids.cps.ca

Centers for Disease Control and Prevention. 2017. Flu symptoms & complications. Retrieved          from: https://www.cdc.gov

Centers for Disease Control and Prevention. 2016. Preventive steps. Retrieved from:         https://www.cdc.gov

 

madi-robson-113924“As Ben and his mom walked to a store, they saw a woman sitting on the sidewalk with a young child hugging her.  The woman had a box of candies and a container for money in front of them. As soon as Ben realized he could help the family, he turned to his mom and asked, “Mom can I have money to give to them?” His mom, who knew how sensitive and empathic Ben is to homeless people, responded “Yes… my son, you can have this money to help the family!” He put money in the container, but most importantly he gave them a sincere, warm smile and a tender look. This is a true story I recently experienced and it inspired me to reflect on the challenges that homeless families face in our communities. Ben, who is only 10-years-old, has the capacity to leave any judgment out AND the ability to respond with empathy and genuine care. What a gift to be a compassionate human being! Sadly, many times these families sense our judgment or anger, or, even worse they experience our indifference; they have become invisible to us. I wish many of us could see through the lens of compassion and kindness, just like Ben did.

Today, we will devote our blog to homeless families who, despite their struggles and financial limitations, can give their children love and security.  We will support our discussion with research around this topic, as well as national statistics that indicate that the number of homeless families and children is on the rise in our country.  Additionally, we will review The Growing Great Kids and Growing Great Families Curriculum tools and resources around this topic. We’ll conclude by and discussing how you can support parents as they build bridges to self-sufficiency.

According to The American Institutes for Research, recent data from the US Department of Education and the 2013 US Census estimates, 2.5 million children in America, one in every 30 children, go to sleep without a home of their own each year. The American Institutes for Research reported that child homelessness increased in 31 states and the District of Columbia from 2012 to 2013.  There are homeless children in every city, county, and state – this situation impacts every part of our country. It is important to note that statistics show significant progress is being made in reducing homelessness among veterans and chronically homeless individuals, but no special attention has been directed toward homeless children. This has resulted in an alarming increase for this group (American Institutes for Research.com, November 2014).  Families experiencing homelessness are obviously at greater risk. They often suffer economic and health challenges, and a wide range of social risks including poverty, job loss, disrupted relationships, substance abuse, and domestic violence. Children exposed to all these adversities are at higher risks for poor physical, emotional, and academic outcomes.

Some additional interesting research to point out in today’s discussion is the study done by Dr. Staci Perlman and a group of colleagues. Their study addresses the urgency of promoting positive parenting in the context of homelessness. In this study, they concluded that the parent-child relationship is affected by the parent’s experiences and by influences from the surrounding environment.  Some parents seem to be resilient to the risks associated with poverty and homelessness and can provide nurturing and supportive caregiving. While other parents struggle to provide responsive parenting and empathic discipline. Researchers found that poor parenting practices appear to be connected to the experience of being homeless in combination with co-occuring risk factors. Research has shown that parents experiencing homelessness have higher than average rates of chronic medical conditions, untreated emotional and behavioral disturbances, substance abuse, physical and sexual abuse, and emotional victimization. They also tend to have low education and job training, and in most cases, they have limited role models for positive parenting (Perlman et al., 2012). The combination of all these risk factors puts homeless children in a highly vulnerable position in terms of optimal development.

Now let’s discuss how the Growing Great Kids curriculum can promote positive parent-child relationships that support optimal development for their child, particularly with families who are facing homelessness. The Growing Great Kids curriculum includes eleven design features in every Growing Great Kids (GGK) and Growing Great Families (GGF) Module. All these design features work together to create opportunities for, and address the needs of, both vulnerable parents and their children. Each design feature is intentionally woven throughout each conversation guide to allow parents to become relationship based with their children, while growing their parenting and life skills.   A critical perspective utilized in The GGK curriculum is to draw parents’ attention to their strengths and motivations for growing their knowledge and skills. Every time parents experience a GGK module they are provided with opportunities to strengthen their parenting practices, problem solving skills, stress management ability, and other important life skills.  All families, including those living in transitional housing or shelters will benefit from experiencing the GGK and GGF Modules. We encourage you to partner with parents in selecting GGK and GGF modules, as well as Child Development activities, to maximize parents’ autonomy and choice.

At Great Kids, we believe every parent and every family has many strengths and core values that can be built upon to supporting families in getting what they want for themselves and their children.  The GGK curriculum includes extensive materials designed specifically to enhance parents’ confidence and competence, through practice, feedback, and reflection. Whether families are experiencing a temporary or long-term homelessness challenge, every child deserves to thrive in a healthy, safe, and loving environment.  Supporting homeless parents on their journey out of poverty and homelessness WHILE creating spaces for positive parent-child interactions, implementing quality parenting practices, and fostering child optimal development is an important part of the GKI vision.

Works Cited:

American Institutes for Research (November 2014). National Center on Family Homelessness: American’s Youngest Outcasts: A Report Card on Child Homelessness. Retrieved from http://www.air.org/resource/americas-youngest-outcasts-report-card-child-homelessness

 

Perlman, S., Cowan, B., Gewirtz, A., Haskett, M., Stokes, L. (2012). Promoting Positive Parenting Within the Context of Homelessness. American Journal of Orthopsychiatry, Vol. 82, No. 3, 402-412. DOI 10.1111/j.1939-0025.2012. 01158.x

 

 

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Today we are going to put a spotlight on a topic of critical importance to all parents of newborns…reducing the risks of Sudden Unexpected Infant Death (SUID). To enhance our understanding around this issue, we will review recent research and statistics along with recommendations from the experts. We will also talk about Baby Boxes, a new trend in US hospitals to reduce infant mortality. At Great Kids, Inc. this topic is a priority; thus, we will conclude today’s discussion by reviewing the specific Growing Great Kids Curriculum tools and resources that parents can incorporate to prevent SUID.

Let’s get started with some definitions. The Centers for Disease Control and Prevention (CDC) defines SUID as the death of an infant less than 1-year of age that occurs suddenly and unexpectedly, and whose cause of death is not immediately obvious before investigation. In 2015, the Centers for Disease Control and Prevention reported 3,700 SUIDs in the United States. SUIDs are reported as one of the three following types:

Sudden infant death syndrome (SIDS)

The sudden death of an infant less than 1-year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and a review of the clinical history. About 1,600 infants died of SIDS in 2015. SIDS is the leading cause of death among infants 1 to 12 months old.

Unknown cause
The sudden death of an infant less than 1-year old that remains undetermined because one or more parts of the investigation were not completed. About 1,200 infants died of Unknown Cause in 2015.

Accidental suffocation and strangulation in bed
In 2015, 900 deaths occurred due to accidental suffocation and strangulation in bed. The sudden death of an infant less than 1-year of age can happen because of

  • Suffocation by soft bedding—for example, when a pillow or waterbed covers an infant’s nose and mouth.
  • Overlay—when another person rolls on top of or against the infant while sleeping.
  • Wedging or entrapment—when an infant is wedged between two objects such as a mattress and wall, bed frame, or furniture.
  • Strangulation—for example, when an infant’s head and neck become caught between crib railings.

According to CDC data and statistics, the SUID rate has been in decline over the last 25+ years.   Initiatives such as Safe Sleep Recommendations and Back to Sleep campaigns by the American Academy of Pediatrics reduced the SUID rates significantly between 1992-2009. However, the SUID rate increased slightly from 87.5 deaths per 100,000 live births in 2014 to 92.6 deaths per 100,000 live births in 2015 (CDC.gov, February 1, 2017).

In October 2016, the American Academy of Pediatrics announced the New Safe Sleep Recommendations, which include

  • Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.
  • Avoid use of soft bedding, including crib bumpers, blankets, pillows, and soft toys. The crib should be bare.
  • Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns 1 but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent.
  • Avoid baby's exposure to smoke, alcohol, and illicit drugs (AAP.org, October 16, 2016).

Now let’s talk about a new trend in US hospitals intended to reduce SUID risks. Several hospitals across the nation now provide free cardboard boxes where babies can sleep safely, along with education resources and basic baby necessities. This year the state of New Jersey plans to distribute105,000 boxes; Ohio, 140,000; Alabama, 60,000 (Cleveland.com, March 2017) along with hospitals in other major cities including Philadelphia and San Antonio, Texas. According to NBCNews.com, proponents of baby boxes say the combination of educational tools and free resources will reduce America’s infant mortality rate (NBCNews.com, March 2017).

Here are the highlights of a few of the many GGK tools and resources around this topic.

Growing Great Kids Prenatal

Unit 3: Module 7-The Baby is Coming Home…Get Ready!

Preparations for bringing the baby home, including supplies for basic care such as sleeping

Unit 4: Module 6-Cultural Influences on Caring for Infants.

Explores the family’s cultural influences on infant sleeping practices

Growing Great Kids B-12 Months Manual

0-3 Months: Basic Care – Sleeping. 

Discusses normal sleep patterns for infants, explores parents’ opinions regarding sleeping, provides researched information regarding prevention of SIDS, and provides infant sleeping safety guidelines

0-3 Months: Basic Care – Infant Safety Tips Handout.

Explores Safe Sleep Guidelines and information on SIDS

7-9 Months: Basic Care – Home Safety Checklist Handout.

Encourages parents to complete a home safety checklist and remove safety hazards

Check them out! These are great resources to share with parents. While SIDS can happen to anyone, it is also true that every family can make their baby’s sleep environment safer through simple preventative measures.

Works Cited:

Centers for Disease Control and Prevention (2017). About SUID and SIDS. Retrieved from https://www.cdc.gov/sids/AboutSUIDandSIDS.htm

American Academy of Pediatrics (2016). AAP Announces New Safe Sleep Recommendations to Protect Against SIDS, Sleep-Related Infant Deaths. Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/american-academy-of-pediatrics-announces-new-safe-sleep-recommendations-to-protect-against-sids.aspx

Cleaveland.com (2017). Ohio becomes 2nd state to offer free baby boxes to curb infant deaths. Retrieved from http://www.cleveland.com/metro/index.ssf/2017/03/free_baby_boxes_offered_to_ohi.html

NBCNews.com (2017). Hospitals Give Away Baby Boxes to Curb Infant Mortality. Retrieved from http://www.nbcnews.com/news/us-news/hospitals-u-s-give-away-free-baby-boxes-curb-infant-n732421

Photo by Andrew Branch on Unsplash

 

 

nurpalah-dee-226216 (1)Not all praise is equal! Most of us have probably heard this phrase, but do we all know what it really means? Today’s blog will discuss the power of praising and its impact on child development. We will start our discussion by highlighting the 4 Steps to Success Daily Do, one of the most important strategies in the Growing Great Kids Curriculum. It is designed to provide parents the framework for helping their baby learn new things while experiencing fun and encouragement for their efforts. As with all our blog posts, we will review recent research and literature to support our discussion. Our conclusion will include curriculum recommendations to enhance parents’ skills in using praise to recognize the efforts and accomplishments of their children.

The 4 Steps to Success is a set of essential parenting skills designed to promote children’s self-esteem and motivation for learning. This strategy consists of four steps that, when incorporated into daily routines and family activities throughout every day, results in children feeling valued and competent. The idea is to leave them with the feeling that the effort they put into something is as important as the accomplishment itself. The fourth step in the 4 Steps to Success strategy is about “Praising the Child’s Effort and Pointing Out What She Has Learned.” When parents lay the foundation for children feeling good about learning, they are also helping their child build positive self-esteem and confidence.

The 4 Steps to Success Daily Do offers multiple benefits for the child, the parents, and the community. Just to list a few:

  • Children are more able to concentrate on learning
  • Children and parents feel proud of their efforts and accomplishments
  • Both parents and children also learn to be “patient”, because they understand that learning takes practice and effort
  • Children and parents are encouraged to be persistent in figuring out solutions
  • Within their community there is a value for putting effort into learning and accomplishing common goals

Now let’s review some research behind the 4 Steps to Success Daily Do. Stanford University Professor Carol S. Dweck has done significant research on the topic of praise. According to Mueller and Dweck (1998), in comparing behaviors of children praised for intelligence (i.e. “You’re smart”) with those children praised for effort (i.e. “You worked hard!”), they found that children who experience praise for their effort display persistence, enjoyment, and continued performance in the face of challenges. This is because they learn to attribute their performance to the effort, rather than to a stable ability, which is how praise for intelligence is often perceived. In other words, children who have been praised for their effort will interpret subsequent poor performance as indicating a temporary lapse in effort rather than as a deficit in intelligence (Mueller & Dweck, 1998).

In 2013, Elizabeth A. Gunderson and a group of colleagues conducted a study revealing similar findings to those concluded by Dr. Dweck regarding the impact of praising the effort. This study showed that praising children’s efforts encourages motivation to engage in challenging tasks and the ability to generate strategies for improvement. They concluded that children who received praise for their efforts tend to value learning over performance, view efforts as positive, and interpret a challenging situation as an opportunity to learn rather than an obstacle (Gunderson, et.al., 2013).  This literature helps us understand that praising the effort plays a key role in positive parenting by creating possibilities for learning and motivation for achievement.

The Growing Great Kids Curriculum includes hundreds of child development activities that are connected to the 4 Steps to Success Daily Do. Each activity is crafted to support parents and children in building self-esteem and motivation for learning, while focusing attention on lots of opportunities to praise effort.  At Great Kids, Inc. we believe that every parent has the power to set their child up to feel confident, to be a good learner, and to feel successful in school.

Let’s not forget that “praising the effort” is not just about children; it applies to all of us in any role. As a home visitor, we encourage you to take every opportunity to point out parents’ efforts for growing their parenting style and practicing new parenting skills and/or life skills. Support them by praising their efforts and acknowledging the challenges they faced. This will foster motivation for continued learning and growth of new skills in the future.

We will conclude with a note that a man wrote to Dr. Dweck after he read some of her work (Dweck, 2007):

Dear Dr. Dweck,

                It was painful to read your chapter…as I recognized myself therein.

               As a child, I was a member of The Gifted Child Society and continually praised for my                            intelligence.  Now, after a lifetime of not living up to my potential (I’m 49), I’m learning to                     apply myself to a task. And also, to see failure not as a sign of stupidity but as lack of                             experience and skills. Your chapter helped me see myself in a new light.

                                                                                Seth Abrams

Works Cited:

Mueller, C. M., & Dweck, C. S. (1998). Praise for intelligence can undermine children's motivation and performance. Journal of Personality and Social Psychology: Attitudes and Social Cognition, 75(1), 33-52. doi: http://dx.doi.org/10.1037/0022-3514.75.1.33

Gunderson, E A., Gripshover, S.J., Dweck, C.S., Goldin-Meadow, S., Levine, S. (2013). Parent Praise to 1- to 3- Year-Olds Predicts Children’s Motivational Frameworks 5 Years Later. Child Development, Society for Research in Child Development, Inc. September/October 2013, Volume 84, Number 5, Pages 1526–1541. DOI: 10.1111/cdev.12064 http://onlinelibrary.wiley.com/doi/10.1111/cdev.12064/pdf

Dweck, C. S. (2007). Mindset. The New Psychology of Success. How We Can Learn to Fulfill Our Potential. Ballantine Books, a division of Random House, Inc. New York.

“Vaccination is one of the best ways parents can protect infants, children, and teens from 16 potentially harmful diseases.  Vaccine-preventable diseases can be very serious, may require hospitalization, or even be deadly – especially in infants and young children” (CDC, For Parents: Vaccines for Children, 2016). Due to the importance of immunizations in children’s health and physical development, today we will explore this topic by referencing the latest research on immunization and the benefits of well-child visits. We’ll put a spotlight on The Growing Great Kids Curriculum tools and resources around this topic and discuss how to support parents to be proactive and responsive regarding their children’s health. We’ll wrap up today’s discussion with additional online resources that you may want to pass on to your families.

The Centers for Disease Control and Prevention (CDC) National Immunization Survey found that the 2015 immunization rates for children aged 19-35 months sustained high coverage in the United States. More than 90% of children by age 2 years were up to date with vaccination against polio, hepatitis b; measles, mumps; rubella; and varicella. There were no significant coverage rate changes between 2014 and 2015 (CDC, Morbidity and Mortality Weekly Report, 2016).  Health care professionals feel that immunizations are one of the most effective health prevention strategies discovered in our society during the last century.  Other research indicates that the average life expectancy of US citizens increased by 30 years, primarily due to improvements in sanitation and development of vaccines and antimicrobial agents (Abramson and Pickering, 2002). National efforts and initiatives on vaccine education have resulted in the elimination of smallpox and polio from the United States.  It has also increased awareness around prevention of other serious diseases, including diphtheria, tetanus, whooping cough, hepatitis b, measles, mumps, and rubella. This has resulted in lower hospitalizations and deaths due to vaccine-preventable diseases, saving society more than $5 for each dollar spent on most of the vaccines that are recommended for children in the United States (Abramson and Pickering, 2002).

There is also some interesting information regarding immunization statistics provided by the Canadian Government. In 2013, the Childhood National Immunization Coverage Survey (cNICS) reported that most Canadian children, at age two, are immunized against vaccine preventable diseases including Polio 91%, DPT 77%, Hib 72%, MMR 89%, Varicella 73%, Meningococcal C 89%, and Pneumococcal 79%. The 2013 cNICS incorporated questions on parental knowledge, attitudes and beliefs related to vaccines and vaccination. This information allows the Canadian Government to identify trends over time in attitudes that may influence parental decisions regarding vaccination.  In 2013, the cNICS showed that 95% of parents believed that childhood vaccines are safe and 97% thought that vaccines are effective for keeping children’s health (Government of Canada, 2013).

Part of keeping children healthy is making sure that they are examined regularly by their Health Care Provider. According to the American Academy of Pediatrics (AAP), parents know who they should go to when their child is sick, but pediatrician visits are just as important for healthy children. The focus during these visits should be on developmental milestones, immunizations, physical examinations, nutrition, safety, the child’s and family’s emotional well-being, general health education, and teaching about injury prevention (HealthyChildren.org, 2015).  To support parents to maximize their well-child visits, the AAP developed age appropriate pre-visit questionnaires. These tools are designed to allow parents to prepare for asking questions and discussing concerns related to the child’s health. They also help parents to plan for well-child visits based on the timing of recommended immunizations.

Let’s take a few minutes now to discuss how the Growing Great Kids Curriculum supports practices related to immunizations, reaching out to health care services, regular monitoring of developmental milestones, and other related topics. For every three months of a child’s development, GGK incorporates a Module on Basic Care.   Just to highlight a sample of topics:

  • 0-3 months: When Baby is Sick or Needs Health Care; Signs of Illness
  • 4-6 months: Keeping Your Baby Healthy; Well Baby Care and Immunization
  • 7-9 months: Changing Needs for Home Safety
  • 10-12 months:  Keeping Your Baby Healthy; Well Baby Care and Immunization; Preventing Animal-Related Illnesses
  • 13-15 months: Routine and Responsive Health Care
  • 19-21 months: Checking in on Body Builders
  • 25-30 months: Growing Healthy Kids

Another GGK essential tool is the Body Builders Daily Do, a parenting skill set designed to support excellent physical development and health in children. Through the Home Visitor’s use of GGK, parents are supported as they practice this Daily Do and reinforce the four main components of physical development and health: good nutrition, responsive and preventive health care, daily exercise, and predictable and safe environments.

One of the most important features of the GGK Curriculum is that all Conversation Guides are designed to offer anticipatory guidance about health, safety, and nutrition.  This approach allows parents to engage in reflective and proactive practices that allow them to be more prepared for every stage of their baby’s development--- including knowing when it’s time for immunizations and well-child visits.

While immunizations are considered one of the major public health achievements of the 20th century, there are still some challenges to overcome in this arena.  Some of these challenges include increased educational awareness regarding various vaccine safety concerns, the increased costs of vaccines, and shortages of vaccine supply. The Centers for Disease Control and Prevention regularly provides updates on these areas along with multiple tools and resources.

The following includes a list of tools provided by the CDC, check them out and pass them on to your families at https://www.cdc.gov/vaccines

  • Immunization Schedules for Infants and Children (English and Spanish)
  • Immunization and Developmental Milestones
  • Interactive Make Your Immunization Schedule for Your Child
  • Immunization Tracker
  • Videos and Useful Lists
  • Infographics, Handouts, and Booklets
  • Parents’ Guide to Childhood Immunization Guide

The American Academy of Pediatrics provides the following online resources and tips, (HealthyChildren.org, 2015):

  • Ask your healthcare provider.  He or she can give you the vaccine package insert or suggest other sources of information.
  • Call your local or state health department.
  • Contact the Centers for Disease Control and Prevention (CDC):

Works Cited:

The US Centers for Disease Control (2016). National Center for Immunization and Respiratory Diseases: For Parents: Vaccines for Children. Retrieved from https://www.cdc.gov/vaccines/parents/index.html

Government of Canada (2013). Vaccine coverage in Canadian Children: Highlights from the 2013 childhood National Immunization Coverage Survey. Retrieved from https://www.canada.ca/en/public-health/services/publications/healthy-living/vaccine-coverage-canadian-children-highlights-2013-childhood-nation

The US Centers for Disease Control (2016). Morbidity and Mortality Weekly Report: Vaccination Coverage Among Children Aged 19-35 Months- United States, 2015. Retrieved from https://www.cdc.gov/mmwr/volumes/65/wr/mm6539a4.htm?s_cid=mm6539a4_w

Abramson, J.S. MD, Pickering, L.K. MD (2002). US Immunization Policy. Published by the Journal of the American Medical Association, Issue Volume 287(4) January 23/30, 2002 pp 505-509.

HealthyChildren.org (2015). Family Life: AAP Schedule of Well-Child Care Visits. Retrieved from https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx

Today’s blog will highlight a topic that comes up in GGK Seminars quite frequently --- How to support 3-Generation Families. It’s not unusual for a home visitor to have several 3-Generation Families they visit who are looking for effective strategies for creating a healthier balance with care-giving tasks and relationships.  We will enhance today’s discussion with the latest, relevant research pertaining to this topic and conclude with exploring the associated Growing Great Families resources and tools.

For the purpose of this discussion, let’s get started with some definitions. The term 3-Generation Family refers to multigenerational family households where two or more adult generations live together under the same roof; this generally includes a grandparent, parent, and child. Our definition also embraces multigenerational families where grandparents have major influences in caretaking and raising small children, even though all generations are not living together.  According to the American Association of Retired Persons (AARP), there are strong indications that US and Canadian multigenerational living is on the rise. Approximately 51 million Americans, or 16.7 percent of the population, live in a house with at least two adult generations, or a grandparent and at least one other generation, under one roof. This trend is linked to cultures, such as Hispanic, Asian, and African American, who embrace multigenerational housing (AARP.org, April 2013).

It’s interesting to note that the 2010 US Census indicated that 7.5 million children lived with a grandparent in 2010; that’s about 10 percent of all children in the United States.  Of these children, 4.9 million lived in the grandparent’s home.  Additionally, among children younger than 5 whose mothers were employed, 30% were cared for, on a regular basis, by a grandparent during their mother’s working hours in 2005 (US Census.gov, 2010). Research indicates that the multigeneration housing phenomenon is increasing due to a variety of factors including economics, child care benefits, preventing elder isolation, family dysfunction connected to teen pregnancy, substance abuse, etc.  PEW Charitable Trust research found that in 2015 the number of grandparents solely responsible for the care of grandchildren had risen to 2.9 million (Wiltz, 2016).

All this data resonates with the composition of today’s home visitor caseloads, doesn’t it?  Most home visiting models are designed to integrate services focusing on addressing the needs of the whole family. This multigeneration approach supports inclusiveness of all family members from a programmatic and cultural perspective. However, it can sometimes be challenging for home visitors when it comes to addressing sensitive topics such as parenting, role clarification, making decisions about childcare practices--- in other words, “who does what” when it comes to the baby and child care decisions, in addition to providing financial support and responsibility for  other household tasks.

Your Growing Great Families manual includes two modules specific to 3-Generation Families.  The modules are intentionally designed to approach sensitive intergenerational topics, while exploring strategies families might consider for promoting more harmony in their home. The conversation guides provided encourage families to reflect on how healthier relationships between parents and grandparents, and a better balance with caregiving might benefit the child and all of his/her caregivers. Let’s take a moment now to spotlight these modules:

  • Becoming a 3-Generation Family- This module is the first in the series designed to explore initial feelings and concerns young parents and grandparents experience upon learning of an unexpected pregnancy; increase understanding and build a more positive relationship by pointing out common feelings and goals parents and grandparents have for the new baby; and to increase positive connections between parents and grandparents by sharing meaningful affirmations with each other.  This Conversation Guide also incorporates a couple of handouts to support parents to give each other more affirmations and appreciation messages.

 

  • Role Clarification in 3-Generation Families- This module is meant to be used as a follow up to the Becoming a 3-Generation Family and Protecting Your Children from Toxic Stress modules.  This Conversation Guide explores several important topics including changing the “emotional tone” of relationships; old and new ways: making decisions about infant care; grandparenting styles; and role clarification. This module also includes great handouts to explore grandparenting styles and a plan for creating a healthier balance with caregiving.

Check-out this GGF 2 -Modules Series along with their corresponding handouts! Share with your families and remind them of the following:

“Children learn the most about life and how to live it from the day-to-day interactions they experience and observe as they grow up.  Brain research has shown that an infant’s brain stores memories of all these experiences.  We know positive memories will contribute to the child’s long-term happiness and success.”

Works Cited:

AARP.org (April 2013). Home and Family: Three Generations Under One Roof Bulletin by Sally Abrahms. Retrieved from http://www.aarp.org/home-family/friends-family/info-04-2013/three-generations-household-american-family.html.

US Census.gov (2010). Profile America Facts: Grandchildren. Retrieved from https://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb11-ff17.html

Wiltz, T. (2016, November 2). Why More Grandparents are Raising Children. Retrieved from PEW Charitable Trusts: http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/11/02/why-more-grandparents-are-raising-children

Partnering with families is at the heart of the Growing Great Kids Curriculum. Today’s Great Vine blog is devoted to one of the most important and useful modules for Partnering with families---Successes and Next Steps. We will review this module’s design and structure, content, and how to use with families to enhance our partnering relationship with them.  We will also discuss literature around partnering with families, the power of acknowledgment, and the reflective component of our conversations with parents.  Finally, we’ll conclude with a brief discussion on how to grow home visiting partnership skills during supervision.

Each quarter, parents annext steps cropd home visitors complete the Successes and Next Steps module along with the GGK Tool.   This quarterly review offers families the opportunity to reflect on their parenting skill building process, the knowledge they have gained around child development, family functioning, and protective factors. It also gives them a chance to think about how they are practicing their new skills to support their family and grow their personal successes.  The Successes and Next Steps
conversation guide and The GGK Tool provide a structured format for home visitors to acknowledge family members for their accomplishments and to explore new interests and skills they would like to grow over the next three months.

The Successes and Next Steps conversation guide and The GGK Tool are intentionally crafted to support in-depth conversations around growing skills related to each Daily Do. This also provides the opportunity to reflect on child development screening findings, parents’ management of family sufficiency, expanded life skills, while reviewing progress on family goals. Through this reflective process, home visitors and families determine how they wish to use the Growing Great Kids Curriculum Components during the next quarter.

Now let’s spend a few minutes reviewing the research behind this essential GGK curricula component.  Partnering with families has different names; in health care, it is referred to as family centered; in mental health, family driven; and in social work, relationship based. Regardless of the name, these concepts share the following core principle as professionals intentionally partner with families: (1) seeking family input, (2) viewing the family as the primary expert on the child, and (3) responding to family concerns and needs in a strength-based manner that incorporates the philosophical, cultural, values, and unique needs of the family and individual (Goldfarb et.al, 2010).

This approach is about understanding that each family may need information presented in a different way, and with a different frequency. It is only through a team effort that you and the family can evaluate options and decide together what will work best in each situation, with a genuine willingness to listen and learn about the family’s motivation(s) for growth. The Successes and Next Steps conversation guide, to be used every 3 months with families, encourages parents to be active participants and decision makers in determining “how” and “what” pieces of the GGK Curriculum would be most beneficial to them. This is also a great time to talk about the pacing that would be right for them during the next three months.

Another important component of connecting with families is incorporating acknowledgment and recognition in our conversations with them. Taking the time to acknowledge others is about making a meaningful impact on a human being.  A few genuine words of acknowledgment and recognition brightens anyone’s day, but most importantly it can translate into increased motivation, higher self-esteem, and more confidence in taking on new challenges (Forbes.com 2013). The Successes and Next Steps module is about acknowledging parents’ successes by pointing out specific accomplishments through the 3-step Accentuating the Positive (ATP) Action Tool during the conversation. This practice reinforces the home visitor-parent relationship. As parents see that their efforts are being noticed and appreciated they not only feel proud of themselves as individuals and parents BUT ALSO, strengthen their commitment to the partnership with their home visitor.

Partnering with families, as well as offering ATPs, requires reflection on the part of the home visitor. It is important to reflect on what personal and professional experiences, values, and feelings are supporting you, as a home visitor, in building a healthier professional relationship with family members and/or what is getting in the way of having positive interactions with them.   This practice will only be true and relevant when you can be fully present and connected during your interactions with families.  The Successes and Next Steps module also provides insights for the home visitor’s areas of growth as new GGK topics are explored with each family.

We will wrap up our discussion with encouraging the use of the supervision process to continue growing your partnership skills with families.  Supervision is the ideal place to discuss how you feel about your relationships with families, specific concerns, and how to support families through active partnership as they find solutions to their problems.  Remember… your role as a home visitor is to partner with families as they make informed decisions. It is their journey!

Works Cited:

Goldfarb, F. D., Devine, Kl, Yingling, J.T., Hill, A., Moss, J., Ogburn, E.S., & Pariseau, C. (2010). Partnering with Professionals: Family-Centered Care from the Parent Perspective. Journal of Family Social Work, 13(2), 91-99. DOI: 10.1080/10522150903487081.

Forbes.com (2013). Leadership: Feeling Appreciated? Why It Can Make All the Difference by Margie Warrell. Published online on 5/16/2013. Retrieved from http://www.forbes.com/sites/margiewarrell/2013/05/16/feeling-appreciated-why-it-can-make-all-the-difference/#7514886b76a5

mother and baby

Pregnancy is a natural state that is usually experienced as a happy, healthy, and exciting time for expecting parents.  Undoubtedly, it is also a period of significant changes in parents’ physical, emotional, mental, and even financial lifestyles as they adapt to meet the needs of a new baby. These adjustments, along with the typical hormonal changes that a mother-to-be experiences may trigger both major and minor depressive symptoms, beginning during prenatally and lasting up to twelve months post-birth.  Research has informed us that fathers-to-be may also experience depression prenatally and postnatally. However, distinguishing between symptoms of depression and normal responses to stressful experiences of pregnancy can be challenging for parents and their home visitors. Additionally, parents often find themselves feeling embarrassed  or shy about openly expressing their feelings of sadness or anxiety during pregnancy or right after birth due to fear of being judged. Let’s spend some time exploring the benefits of supporting your program families to enhance their understanding of pre-natal and post-partum depression. We’ll also review some strategies for encouraging them to seek treatment as needed.

According to Tiffany Field, the interaction disturbances of depressed parents and their infants appear to be universal. Regardless of culture or socioeconomic status groups, depressed mothers exhibit less sensitivity and responsivity in their relationships with their babies. In her study, Field indicated that the caregiving activities that get compromised by postpartum depression across all cultures include feeding practices, most especially breastfeeding, sleep routines, well-child visits, vaccinations, and safety practices (Field, 2010). This tells us that there is a great risk to child development when a parent experiences prenatal and/or postnatal depression.

There is extensive research on the effects of maternal depression on both parents and children.  Some of the effects on parents include failure to respond to infant cues and signals, emotional and physical disconnection from the infant. Parents engage less in vocalization, smiling, imitation, eye contact, and in general, there appears to be lack of feelings of joy toward the infant.  Their interactions tend to be overly intrusive or under-stimulating, and in extreme situations there is fear of harming or actually harming the infant.  The effects of maternal depression on the developing baby include a higher risk of low-term births, lower birth weight babies, higher risks for developmental delays especially in language and motor domains, excessive crying, challenges in adapting to sleep routines, failure to thrive and general feeding problems, among many other risks (Field, 2010)

When parents are depressed, they are unable to be emotionally available to their infant’s physical, emotional, and intellectual stimulation needs. When parents do not receive professional support to treat prenatal and/or postnatal depression, the long-term effects of detached parent-child interactions can give rise to insecure attachments. When young children experience insecure attachments, they display fear, distrust, anxiety, distress, and long-term adverse effects on their brain development, behavioral problems, and relationship challenges (Center for the Study of Social Policy, 2015).

Unfortunately, many expecting parents who recognize they might be experiencing symptoms of prenatal/postnatal depression may be unwilling to express openly their feelings due to fear of being judged as not being good parents.  Some parents go through this phase hoping that the symptoms will soon pass.  As home visitors, our role is to create opportunities for parents to feel safe sharing their feelings in a nonjudgmental environment.
Growing Great Kids Prenatal (GGK) and the Growing Great Families (GGF) curriculum manuals provide a variety of conversation guides to support parents’ increased understanding of depression and its effects, contributors and also indicators of depression. The introduction of modules and tools, aimed at assisting parents in reducing their stress are also valuable resources.  These modules are designed to help parents create awareness of their personal strengths and how they can use them to find solutions to the challenging circumstances they are facing.  Check out the following modules…

Growing Great Kids Prenatal Modules:

Unit 2:

  • Module 3: Prenatal Depression in Moms and Dads is Not Uncommon
  • Module 9: Dads’ Module 3: Driver’s Course for Dads

Unit 4:

  • Module 2: Power Down Stress…Power Up HappinessaH

Growing Great Families Modules:

Unit 2:

  • Module 1: Protecting  Your Children From Toxic Stress
  • Module 2:  Sizing Up Your Strengths… Reducing  Stress
  • Module 3:  Becoming Your Own Personal Coach
  • Module 6: Communicating Effectively…It’s More Than Texting/Talking
  • Module 7: The Power of Appreciation
  • Module 8: Problem Talk…A Problem Solving Skill
  • Module 9: Growing Your Support Network: Strengthening Protective Buffers

GGK is unique in that it provides conversation guides for home visitors and parents to engage in meaningful discussions and activities aimed at growing secure attachments both prenatally and post-birth. These discussions often result in parents feeling less stressed, more positive and hopeful, and more empowered to be open about sharing their feelings and potential risks for depression. When this occurs, home visitors have the opportunity to assess their needs and connect parents with professional support. Supporting families in this way allows them to create the life they want for themselves and their children.  Let’s capture this critical window of opportunity!

 

Works Cited:

Field, T. (2010). Postpartum Depression Effects on Early Interactions, Parenting, and Safety Practices: A Review. Infant Behavior & Development, 33(1), 1. http://doi.org/10.1016/j.infbeh.2009.10.005

Field, T. (2010). Prenatal Depression Effects on Early Development: A Review. Infant Behavior & Development, 34(2011), 1-14. http://dx.doi.org/10.1016/j.infbeh.2010.09.008

Center for the Study of Social Policy (2015). Strengthening Families: A Protective Factors Framework. 1575 Eye Street N.W., Suite 500, Washington, DC 20005. cssp.org. strengtheningfamilies.net

http://www.cssp.org/reform/strengtheningfamilies/about/protective-factors-framework