Nanaimo TDI November 2016

Building a comprehensive, population-based

child development monitoring system

www.childdevelopmentmonitoring.net www.earlylearning.ubc.ca

“Owen & Mzee: The true story of a remarkable friendship”

Dolinoy, Weidman, & Jirtle, 2007

Identical genes, but different prenatal diet

Waterland & Jirtle, 2003

Restricted diet: More obesity More diabetes More cancers

Fagen & Fagen, 2004

Play & brain size across speciesSocial play

Relative size of brain regions withsocio-cognitive, motor, emotional, & visual functions

Lewis, 2003

Play & brain size across speciesSocial play

Relative size of brain regions withsocio-cognitive, motor, emotional, & visual functions

Lewis, 2003

Play & brain size across speciesSocial play

Relative size of brain regions withsocio-cognitive, motor, emotional, & visual functions

Lewis, 2003

Fertile Minds

From birth, a baby’s brain cells proliferate wildly, making connections that may shape a lifetime of experience. The first three years are critical.

February 3, 1997

2nd Decade

3rd/4th Decade

5th/6th

DecadeOld Age

School Failure

Teen Pregnancy

Criminality

Obesity

Elevated Blood Pressure

Depression

Coronary Heart Disease

Diabetes

Premature Aging

Memory Loss

The long reach of early experience….

'Fair Society Healthy Lives’http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review

Vision & goalsToward a longitudinal ECD monitoring system

EDI

Context factors

EDI

Context factors

EDIMDI MDI

Context factors

EDIMDI MDI

Medical records

Educational assessments

Context factors

EDIMDI MDITDI

CHEQ

Medical records

Educational assessments

Toddler Development

Instrument

Key milestones

“Getting it right at 18 months: In support of an enhanced well-baby visit”

• R Williams, J Clinton; Canadian Paediatric Society , Early Years Task Force

• Paediatr Child Health 2011; 16(10):647-50

Enhanced 18-month well-baby visit

• Ontario, Canadahttp://www.children.gov.on.ca/htdocs/English/topics/earlychildhood/health/enhanced_18-month.aspx

Provincial government provides funding

Nipissing District Developmental Screenhttp://www.ndds.ca/international/

Rourke Baby Recordhttp://www.rourkebabyrecord.ca

Components of a platform• Short questionnaire filled out by parents• Universal access – voluntary participation• Practical benefits to practitioners and families (e.g.,

context-specific feedback; referral to resources)• Easy to implement for parents and professionals• Inexpensive• Secure and privacy protected (confidential)• Person-specific linkages to other data sources• Aggregate-able for geo-spatial neighborhood mapping• Scientifically valid (i.e., predictive)

Work to date

Forum for Early Child Development Monitoring– Expert consultation– Literature review– Analyses of longitudinal studies

• (e.g., ELDEQ; ASQ data)– Focus groups with parents and ECD professionals

Constructs on TDI pilot version– Developmental milestones– Child-parent/adult at home interaction– Social play, outdoor play, screen time– Sleep, nutrition, dental care, family doctor, immunization– Child care and access barriers– Community child-family resources and access barriers– Neighborhood safety, residential stability, interactions– Social support for parent/caregiver– Family dynamics (e.g., family functioning)– Parenting beliefs and practices (e.g., parental impact,

competence)– Parental well-being and mental health– Demographic & socioeconomic background questions

Pilot sites

TrailKamloopsRevelstokeEast KootenayComoxVancouver Powell RiverFraser Region

Trail• Main contact: Christy Anderson – Executive Director, Family Action Network;

Member of IRESN • TDI implementation set to start end of October• Ongoing TDI collection through various early years organizations:

– Strong Start Programs; Aboriginal Family Gathering Program; Columbia Basin Alliance for Literacy

Kamloops• Main contact: Judy Treherne – Consultant, Make Children First; Member of IRESN• TDI implementation to start early November• Early Years Centre will serve as centre for coordination and distribution of TDI• Additional locations interested in/committed to TDI implementation:

– Children’s Therapy & Family Resource Centre; Interior Community Services; School District #73 Strong Start programs; Lii Michif Otipemisiwak Family and Community Services; Secwepemc Child and Family Services; Kamloops Aboriginal Friendship Society; Q’wemtsin Health Society; Interior Health Public Health (Baby Clinics, Speech & Dental); Thompson Rivers University, ECE Program, Infant Toddler program

Revelstoke• Main contact: Tracy Spannier – Early Years Coordinator, Revelstoke Early Years Centre• TDI implementation set to start at community event on November 19th • Additional implementation sites include:

– Public Health; Revelstoke Child Care Society; Revelstoke Speech & Language Clinic; Strong Start, Revelstoke Leap Land, Columbia Basin Alliance for Literacy

East Kootenay• Main contact: Gina Panattoni – Regional Manager, Children First/Success by Six • Interest expressed by four communities to partner in pilot implementation

– Cranbrook, Ktunaxa Nation, Kimberly, Fernie• Specific implementation locations, dates, and details TBD

Comox• Main contact: Joanne Schroeder – Executive Director, Comox Valley Child Development

Association• TDI implementation to start January 2017• Four key agencies to facilitate TDI implementation:

– Public Health; School District #71; Family Services; Comox Valley Child Development Association

Vancouver• Main contact: Susan Conley – Regional Manager, Public Health, Perinatal & Early

Childhood; Radhika Bhagat – Manager, Public Health • TDI implementation to start January 2017• TDI collection to be facilitated by PHNs in community health centres (CHC)

Powell River• Main contact: Rita John – Early Learning Coordinator, School District #47• TDI implementation to start in November and be co-coordinated between SD47 and

Public Health• Proposed implementation sites include:

– Powell River CHC Baby Clinics, School District #47 Strong Start Programs

Fraser Region• Main contact: Sherry Sinclair – Executive Director, BC Association of Family Resource

Programs• Interest expressed in partnering for pilot implementation• Implementation locations, dates, and details TBD