Integration of Learn the Signs. Act Early.

Materials
in Prenatal Care Coordination and Home Visiting in Wisconsin
Gail Chodron, MA, WI LEND, Waisman Center UCEDD Linda Hale, BSN, RN, EMT, Family Health Section, Bureau of Community Health Promotion, Wisconsin Department of Health Services Anne Bradford Harris, PhD, MPH, RD, WI LEND, Waisman Center UCEDD

I had not addressed child development much in PNCC visits until I received these booklets to share with moms. It is a good reminder to talk about this with moms.

It is easier to bring up development with a booklet to give them. It has helped the conversation with partners and parents. The materials prompt parents to ask questions that begin conversation from their end.

I feel better referring when the family is informed and comfortable with a referral concerning their babys development. It has helped parents understand the need for referral and improved follow through.

Purpose
Integrate Learn the Signs. Act Early. (LTSAE) materials into Prenatal Care Coordination (PNCC) and Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Programs service provision to families to support a coordinated system that supports healthy child development, early identification, developmental screening, and timely referrals among young children.

Implementation Strategy
Targeted programs based on: 1) Serving at-risk families of young children statewide; 2) Distribution, training, and technical assistance through state program coordinator; 3) Existing interest in LTSAE materials; 4) Use of SPHERE state MCH database to track dissemination Conducted needs assessments through focus group of home visitors and an online survey of PNCC providers, supervisors, and program managers Customized Milestone Moments booklet and LTSAE growth chart with state logos, Act Early Wisconsin website, and MCH hotline for Birth to 3 referral and community resource information Developed curriculum to support conversations with families about child development using LTSAE materials Implemented two-tiered dissemination tracking strategy, documenting distribution to programs and dissemination to program participants Conducted follow up survey with PNCC providers to assess impact on their work with families
PNCC providers rating of how valuable Act Early materials are in work with families
35 30 25 10 15
Very Valuable Valuable Not valuable enough to use often I am not familiar with this item

Outcomes and Provider Feedback

Integrated curriculum in existing provider training Developed dissemination tracking process Distributed 5,508 booklets and 2,768 growth charts (English and Spanish) to programs Disseminated 482 booklets and 287 growth charts to families over 6 months Strengthened partnerships between WI Title V MCH/CYSHCN, MIECHV home visiting (Dept. of Children and Families), WI LEND and UCEDD Increased level of comfort sharing information with clients about child development and recognizing developmental concerns among PNCC providers
Use of Act Early materials impacted PNCC providers level of comfort sharing information about child development and developmental concerns
16 14 12 10 8 6 4 2 0
Much more comfortable Somewhat more comfortable No change

Need
Child development identified as focus areas in WI MCH Needs Assessment, 2011-2015 Increase low Birth to 3 referral and service rate among children birth to 12 mos. (WI 2009 Part C State Annual Perform. Report) Improve early identification of autism (median age of diagnosis 53 mos., though 88% documented developmental concern by 12 mos. (WISADDS) Provide high quality, family-friendly materials on child development to service providers
PNCC providers identify what would help them share information with families about child development and developmental concerns:
80 70 60 50 40 30 20 10 0
Live training Online training Written training Quality materials to share with parents materials Other

Use of Act Early materials impacted PNCC providers level of comfort sharing information about developmental concerns
16 14 12 10 8 6 4 2 0
Much more comfortable Somewhat more comfortable No change

10 5 0

Milestone Moments booklet

Act Early Growth Chart

Developmental Milestones brochure

For more information www.actearly.wisc.edu Gail Chodron chodron@waisman.wisc.edu 608-890-0145