3/20/2019 1 1 gradelevelreading.net / @readingby3rd / #GLReading Upcoming Webinars GLR Campaign Learning Conversation: Community Data Warehouse Tuesday, March 26, 3 p.m. ET/12 p.m. PST Register Housing Partner Discussion Series #3: Innovations in Public Housing Around Early School Success Tuesday, May 7, 2 p.m. ET/11 a.m. PST Register Save the Date — Science Matters! Tuesday, June 11, 2 p.m. ET/11 a.m. PST Early Relational Health An Essential Foundation for Early School Success March 12, 2019
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GLR SM ERH rev2 - final from Ellen post webinar · 3/12/2019 · Cultural Humility Tervalon M, Murray-Garcia J: “Cultural humility versus cultural competence: a critical distin
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Ellen GalinskyChief Science Officer, Bezos Family FoundationCo-Sponsor of the GLR Science Matters! Series
Welcome and Introduction
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Early Relational HealthFoundations for Health, Early Learning and Future Wellbeing
Science Matters WebinarCampaign for Grade Level ReadingMarch 12, 2019
David Willis, M.D., Executive Director, Perigee Fund
Clinical Transformations: Campaign for Grade Level Reading Webinar on Relational Health
Dayna Long, MD UCSF Benioff Children’s Hospital OaklandDepartment of Community Health and EngagementMarch 12, 2019
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Dina Lieser Early Childhood Systems Program Director and Team Lead, Division of Home Visiting and Early childhood System (DHVECS)Maternal and Child Health Bureau (MCHB)Health Resources and Services Administration (HRSA)
Home Visiting and Early Childhood SystemsCampaign for Grade Level Reading Webinar on Relational Health
March 12, 2019
Why is Early Relational Health a New Concept?
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David Willis, M.D., Executive Director, Perigee Fund
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Early Relational Health
A multi-dimensional and dyadic construct established by the parent-child interactions during the First 1000 Days of life that build lifelong health, early learning, social-emotional capacities, self-regulation and resiliency.
Physical Health
Biological, Genetic, Prenatal Factors
DevelopmentalHealth
Social-economic, educational, and
community involvement
Early Relational Health
Attachment and Relational Patterns (Special attn. to ACE’s, current and historical
trauma)
What is the Science Behind Early Relational Health? What are its Guiding Principles?
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Bio‐behavioral synchrony and dyadic neurodevelopment
Feldman, Ruth., The Neurobiology of Human Attachments, Trends in Cognitive Science, Feb 2017.
Behavioral Synchrony
Synchronized behavior in gaze, affect, vocal, and touch
Mother-specific Father-specific
Heart Rate Coupling
Synchronized HR during synchronized interactions
Endocrine Fit
Coordinated OT response following contact
Coordinated cortisol response to stress
Brain to Brain Synchrony
Coordinated brain oscillations in alpha and gamma rhythms
Bio‐behavioral synchrony in human attachments
• A dyadic and two-generational focus
• A bi-directional perspective for parent-child development with the centrality of shared positive affect
• Foundational to equity, resiliency, recovery and protection
• Health, early learning and social-emotional competences are outcomes of ERH
• Science-based, strength-based and family-centric
• Recognizes cultural variability in parenting, but sees ERH as universal
• A paradigm shift for early childhood, society and our culture
Principles for Early Relational Health
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What are Best Practices in Early Relational Health?
engage and support the Johnson Family, our providers, pediatric clinics and communities
to promote wellness?
Survey Data from Children’s Hospital Association
N=213
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A lifelong commitment to self‐evaluation and self‐critique
Redressing the power imbalances in the patient‐physician dynamic
Developing mutually beneficial partnerships with communities on behalf of individuals and defined populations
Advocating for and maintaining institutional accountability
Cultural Humility
Tervalon M, Murray-Garcia J: “Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education, “Journal of Health Care for the Poor and Underserved 1998; 9(2):117-124
Cultural HumilityDeveloped by Doctors Melanie Tervalon and Jann Murray‐Garcia, cultural humility is…
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Primary Care Interventions
FINDing Joy through Care Coordination
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Trauma-Informed Systems Initiative
Healing Ourselves, Our Communities
and Our City
UCSF BenioffChildren’s Hospital Oakland
TRAUMA‐INDUCING TO TRAUMA‐REDUCING
TRAUMA‐INDUCING TO TRAUMA‐REDUCING
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In collaboration with Genentech Charitable Giving,
the Center for Care Innovations (CCI) launched a
program called Resilient Beginnings Collaborative: a
24‐month learning program dedicated to addressing
childhood adversity and strengths in pediatric safety
Maternal, Infant and Early Childhood Home Visiting (MIECHV)
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Dina Lieser Early Childhood Systems Program Director and Team Lead, Division of Home Visiting and Early childhood System (DHVECS)Maternal and Child Health Bureau (MCHB)Health Resources and Services Administration (HRSA)
Early Childhood Comprehensive Systems (ECCS) Impact
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• AIM‐ASPIRATIONAL GUIDING STAR:
Thrive by Three.
Improvements in developmental skills of 3 year olds by 25% within 5 years
• Drivers:
Family Partnership
Universal Developmental Promotion
Social Determinants of Health
Linked and Coordinated Systems
Policy
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ECCS Aims• Build leadership and expertise in CQI
• Achieve collective impact at state, county and community level
• Implement 2‐generation strategies to integrate vertically within sectors and horizontally across sectors
• Develop and adopt early childhood system process measures and outcome indicators to measure population impact around children’s developmental health and family well‐being
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Opportunities and Challenges
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• Reach Out and Read (ROR)
• Promoting First Relationships in Pediatrics (PFR)
• Triple P Positive Parenting Program
• Video Interaction Project (VIP)
• Early Relational Health Screen (ERHS) and video feedback
• Welch Emotional Connection Scale (WECS)
• Filming Interactions to Nurture Development (FIND)
• Evidence-based home visiting
Early Relational Health in actionExemplars for promotion, prevention and early intervention
What Changes in Practice, Systems, Policy are Needed?
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Systems Thinking
• Approach to grappling with adaptive problems in complex environments with the aim of making enduring social change at scale