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February 2018Vol. 19, No. 1Spotlight on Early Childhood Collaboration/Early Intervention

Collaboration among early childhood professionals, parents, and other stakeholders is important to ensuring children's developmental needs are being met and that children reach their full potential. In this issue, read about a range of products developed to facilitate partnerships between professionals and parents to promote the developmental, social, and educational growth of young children; a case study of a collaboration between a daycare and early childhood education agency and a traditional academic children's hospital; the extent to which pediatric primary care providers share hearing and vision screening results with early care and education programs; and a study that explores and compares parents' and preschool workers' perceptions of bullying with respect to preschool workers' competence, collaboration with parents, and strategies for dealing with bullying.

Issue Spotlight

  • Parents' and Preschool Workers' Perceptions of Bullying in Early Childhood

    Parents' and Preschool Workers' Perceptions of Bullying in Early Childhood

    Bullying can have negative, long-term psychological and social consequences, and children bullied in preschool are at no less risk than older children of experiencing these outcomes.

    A recent article in Child Care in Practice highlights a study that explores and compares parents' and preschool workers' perceptions of bullying with respect to preschool workers' competence, parent-preschool collaboration, and strategies for ending bullying in order to assess the extent of the collaboration between preschools and families.

    The study comprised 141 parents and 81 preschool workers from six preschools and focused on children between the ages of 3 and 6 years. These participants were asked to complete an 80-item, Likert-scale-based survey designed to cover a range of aspects of bullying, including attitudes toward bullying and the children involved, the definition of bullying, personal and professional experiences with bullying, and the various approaches to dealing with bullying. Statements in the survey included "I believe that staff in my preschool use effective strategies to deal with bullying" and "I can work well together with parents in cases of bullying." Respondents were asked about the degree to which they agreed or disagreed with the statements.

    Based on the responses to the survey, both parents and preschool staff tended to be confident in the preschool's competence in handling bullying among students. Further, respondents showed they had a positive perception of collaboration between parents and preschool staff. However, there was some disagreement regarding a few of the strategies for addressing bullying, with seeking assistance from psychological services or other support groups outside of school being more recommended by preschool workers and telling bullies to "say they're sorry" being more supported by parents. In addition, parents' higher exposure to bullying (i.e., bullying parents have witnessed or reported to them by their children) was associated with more negative views of collaboration and competence, and parents having little to no exposure to bullying was associated with them being more likely to report they were unable to evaluate the competence of preschools and preschool staff.

    The authors concluded that efforts by preschools to use evidence-based strategies for the prevention of bullying, and communicating these efforts to parents, can improve the quality of the collaboration between educational personnel and parents and bolster the impact of bullying interventions during these early school years.

    "Parents' and Preschool Workers' Perceptions of Competence, Collaboration, and Strategies for Addressing Bullying in Early Childhood," by David Lansing Cameron and Velibor Bobo Kovac (Child Care in Practice, 23), is available at

  • A Children's Hospital and an Early Childhood Education Center Collaborate to Provide Health-Care Ser

    A Children's Hospital and an Early Childhood Education Center Collaborate to Provide Health-Care Ser

    Community agencies serving underprivileged children and families often focus on the social aspects of health and well-being and may not usually have the expertise or resources to provide adequate health-care services. This gap in services can be problematic for parents, as they may lack the resources, time, and knowledge needed to navigate multiple providers. A recent article in Current Problems in Pediatric and Adolescent Health Care highlights a case study of a collaboration between Operation Breakthrough (OB), a federally subsidized daycare and early childhood education and social services agency serving economically disadvantaged children in Kansas City, MO, and Children's Mercy Hospital (CMH), a traditional academic children's hospital.

    The collaboration was created as a means to incorporate health care into OB's list of services, since an absence from work to deal with a child's illness may result in lost wages or even jobs for the many parents with children in OB who hold jobs that do not provide sick leave. Onsite health care for children with minor illnesses would alleviate this burden from working parents.

    The case study showed there were several challenges that needed to be addressed. For example, OB had to adhere to state daycare licensing policies and federal Head Start administrative and health regulatory policies that did not always coincide with American Academy of Pediatrics recommendations. Another challenge was that parents and caregivers were often wary of social services agencies and health-care institutions because they were worried about being reported and having their children taken away.

    To mitigate these and other challenges, OB and CMH decided to conduct listening sessions with key stakeholders, including OB staff, CMH clinic staff, and the leaders of each organization, as well as focus groups with the parents and caregivers with children attending OB. Based on these meetings, OB and CMH determined that there were a number of unmet needs, including the following:

    • Child and adult mental health care
    • A "sick bay" to care for children with minor illnesses who could not, by state regulation, stay in the daycare or the classrooms
    • Including parents and caregivers in the leadership structure of OB

    The case study also emphasizes the need for commitment and compromise among the leadership of both institutions. Staff from both institutions must be willing to understand each other's organizational culture and be willing to try new ways of doing things, as well as tolerate the iterative processes that are required to develop and implement collaborative programs to help children.

    "Building a Collaboration Between a Children's Hospital and an Early Childhood Education and Social Services Center," by Donna O'Malley, Briana A. Woods-Jaeger, and M. Denise Dowd (Current Problems in Pediatric and Adolescent Health Care, 4), is available at

  • Sharing Screening Results With Early Care, Education Programs

    Sharing Screening Results With Early Care, Education Programs

    A recent study published in the Journal of Early Hearing Detection and Intervention examines the extent to which pediatric primary care (PPC) providers share hearing and vision screening results with early care and education (ECE) programs. The study also analyzed providers' reports of being unable to assess hearing and vision among very young children.

    The study sample comprised eight communities in Connecticut that responded to a request for participation in the Early Childhood Health Data pilot project. These communities all engaged in a minimum of two school-based or licensed center-based ECE programs. From these 8 communities, 26 ECE programs participated. The study reviewed a total of 4,119 early childhood health assessment records for children between the ages of 1 month and 6 years.

    This study is a follow-up to the Early Childhood Health Data pilot project, which was designed to help community stakeholders in early childhood determine early childhood planning by using health data reported to ECE programs and to evaluate how the Connecticut Early Childhood Health Assessment (CECHA) supports communication between PPC providers and ECE programs. ECE programs electronically submitted de-identified copies of their health datasets in May 2013 and again in October 2014 for newly enrolled children. Researchers combined the datasets for aggregate analysis and extracted hearing and vision screening data from the aggregate dataset.

    The study findings include the following:

    • Most PPC providers shared screening results with ECE programs.
    • Three-quarters of the CECHA records had hearing and vision screening information.
    • The programs were less likely to share results regarding younger children.
    • Programs were less likely to be able to assess the hearing or vision of younger children due to a variety of factors, including the child not cooperating and not having the proper instruments in the PPC office.

    The findings of this study highlight the need for ECE programs to be vigilant about screening and reviewing health assessment forms, especially when PPC providers report that they were unable to perform the task; completing missing screenings; and reporting the results to the child's PPC. This will ensure that, between the two settings, the screenings are completed, especially for younger children.

    Sharing hearing and vision screening information is crucial to being able to detect impairments that might hinder the child's development and early learning as well as to enable the development and implementation of services, programs, and accommodations that support families with children with sensory impairments.

    "Hearing and Vision Screening in Pediatric Primary Care and the Sharing of Results With Early Care and Education Programs," by Susan J. Macary, Lisa Honigfeld, Margaret W. Berry, and Dorothy B. Wakefield (Journal of Early Hearing Detection and Intervention, 2), is available at

  • Early Intervention Collaboration

    Early Intervention Collaboration

    Tools To Grow, Inc., offers a range of products developed to facilitate partnerships between professionals and parents as they work to promote the age-appropriate developmental, social, and educational growth of young children. These resources and tools are designed to be applied within the context of the child's family and natural setting.

    The products in the suite of resources include the following:

    • "Dressing Skills: What to Expect Next" is a chart and guide for children ages 12 months to 7 years that provides step-by-step guidance on how to dress themselves.
    • "Tummy Time: Developmental Consequences and Future Implications" is a brochure for health-care professionals that discusses the principles of normal development, developmental consequences, future implications, and chronological development in the prone position.
    • Occupational Therapy Early Childhood Skills Checklist 0-60 Months is an 8-page PDF for occupational therapists to assess the developmental status of fine motor, visual motor, and self-help skills for children under 5 years old.
    • What to Expect and How to Develop Fine Motor Skills: 0-36 Months is a guide for parents to teach them what fine motor skills to expect between the ages of 0 and 36 months and how to help their child move to the next stage.  

    While some resources and tools are free to download, some require a paid membership. To view all the components of the Tools to Grow Early Intervention Collaboration, visit

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News From the Children's Bureau

We highlight findings from the most recent Adoption and Foster Care Analysis and Reporting System data for fiscal year 2016, a research snapshot about how parental work schedules affect the way families use public or private early care and education and nonparental care services, a new podcast that highlights a child welfare veteran's perspective on the biggest lessons learned by agencies and professionals, and a list of the latest updates to the Children's Bureau website.

Child Welfare Research

Read a report that highlights the need for protective relationships for youth aging out of care and an article that discusses California's trauma screening implementation process and its implications for other child welfare systems as they implement their own screening processes.

  • Screening for Trauma-Related and Mental Health Needs in California's Child Welfare Systems

    Screening for Trauma-Related and Mental Health Needs in California's Child Welfare Systems

    Many children involved in child welfare have experienced trauma in one form or another, including interpersonal violence, accidents, injuries, maltreatment, and other adverse childhood experiences. Although screening for trauma has become an integral part of trauma-informed care, to date there has been no systemic evaluation of how screening efforts have been implemented by child welfare leaders.

    The article "Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California's Child Welfare Systems" discusses California's screening implementation process under Pathways to Mental Health Services (a class-action settlement agreement) and how child welfare systems have responded to implementation mandates. The article also provides new frameworks for other child welfare systems as they implement their own screening processes.

    The evaluation included a web-administered survey to obtain information on mental health and trauma screening in each county in California. Of the 58 counties in the state, 46 participated in the survey, which  contained questions about the extent to which screening had been implemented in the county, the degree of satisfaction with the current procedures, and whether changes to the existing procedures were being considered. The survey respondents were also asked to review a list of tools commonly used to screen for mental health and trauma-related issues (e.g., the Acute Stress Checklist for Children, Children's Revised Impact of Event Scale, Trauma Symptom Checklist) and indicate which tools were used in their county.

    About 85 percent of respondents reported that a screening procedure to assess mental health and trauma had been implemented in their counties, 13 percent indicated their county had partially implemented a screening procedure, and about 2 percent indicated that their county was planning to implement a screening procedure. Nearly all respondents (96 percent) reported use of at least one of the tools listed in the survey or of at least one other tool that was not listed, and almost a quarter of the respondents reported that at least one tool was being considered for use in their county.

    The report also provides three implementation considerations for future trauma-informed care efforts:

    • Maintain a focus on childhood trauma rather than general mental health.
    • Acknowledge the need for collaboration among child welfare leaders with diverse science- and practice-related expertise.
    • Implement a feasible, evidence-based screening process.

    "Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California's Child Welfare Systems," by Brent R. Crandal, Andrea L. Hazen, and Jennifer Rolls Reutz (Advances in Social Work, 18), is available at

  • Bridging Relational Gaps for Youth in Foster Care

    Bridging Relational Gaps for Youth in Foster Care

    Youth transitioning out of foster care are faced with numerous challenges and disadvantages. Of the 20,000 youth who age out of foster care in the United States each year, only about half attain their GED by the age of 19, compared with their 87 percent of their peers not in foster care; about one-third are employed at the age of 19, compared with 44 percent of their peers; and one-fourth become parents before the age of 21, compared with 6.6 percent of their peers. In addition, youth coming from foster care are also more likely than their peers who have not been in foster care to be diagnosed with a mental illness, be homeless, suffer from substance use, and become involved in the justice system. Many youth in foster care are at high risk for poor outcomes because they originate from unsafe and unhealthy family situations. Further, these youth often develop relational deficiencies as a result of being removed from their parents, relatives, and friends and lack the ability to develop relationships and strong connections.

    Care and Connections: Bridging Relational Gaps for Foster Youths highlights the need for protective relationships for youth aging out of care as well as positive youth development programs that promote relationship-building skills. The report presents a case study of The DREAMR (Determined, Responsible and Empowered Adolescents Mentoring Relationships) Project, one of four Children's Bureau-funded interventions that aimed to increase relationship-building skills for youth transitioning out of care.

    The DREAMR Project was a randomized controlled trial conducted in Clark County, Nevada. Project participants (a total of 121 individuals who were currently or formerly youth in foster care and were aged 12-21 during the time of the study) received a range of services or supports that included a mentor from Big Brothers/Big Sisters, a youth specialist, a sex education class, a cell phone to maintain contact with service providers, and, for youth who were parents or pregnant, a parenting class. For the evaluation, the project randomly assigned participants to control and treatment groups and collected data at baseline, after 6 months, and after 12 months. The outcome measures used to track progress focused on emotional well-being, knowledge of reproductive health, and relational skills.

    Although the findings of the evaluation showed no significant differences between control and treatment participants across the various outcome measures used to gauge participant progress, the implications of this research for practice include the following:

    • Child welfare agencies should collect data about youth's relational capacities as well as the number of supportive adults a youth in care has.
    • Youth in care already have a large number of professionals working with them on a day-to-day basis, which can be overwhelming. Future interventions should focus more on consolidating services and minimizing the number of people delivering them.
    • Relationship-based interventions should tailor services to the particular needs of each youth.
    • Caregivers, caseworkers, birth parents, and other stakeholders should be engaged and supportive of the intervention to ensure proper implementation.

    The report Care and Connections: Bridging Relational Gaps for Foster Youths is available at

Strategies and Tools for Practice

This section of CBX offers publications, articles, reports, toolkits, and other resources that provide either evidence-based strategies or other concrete help to child welfare and related professionals.

  • Barriers to Screening Children for Traumatic Stress

    Barriers to Screening Children for Traumatic Stress

    Children entering the child welfare system are likely to have experienced traumatic events that can negatively impact their mental health, behaviors, learning capacities, and interpersonal relationships. While there are multiple barriers to screening children for traumatic stress in the child welfare system, it is important to identify prior exposure as soon as possible to access appropriate treatment and interventions.

    "Barriers to Traumatic Stress Screenings in Child Welfare Settings," a recent Practice Notes issue, explains these hurdles and offers child welfare workers tips and recommendations for overcoming them. It points out that while an estimated two-thirds of children in the United States will have experienced a traumatic life event before age 16, fewer than one-tenth receive successful interventions. This may be due to a number of factors, including a failure to recognize trauma, reluctance by a child to revisit upsetting memories or related guilt or shame, and caseworker concerns about retraumatizing a child.

    To address some of the most common barriers, the issue recommends several resources and suggests the following for caseworkers:

    • To overcome a lack of training, access free online resources for both screening and assessment, such as the The Traumatic Stress Screening for Child Welfare Professionals Module Series
    • To overcome a lack of time, build in a few extra minutes for a brief trauma screening (e.g., the Traumatic Stress Screen for Children and Adolescents)
    • For caseworkers who feel helpless in their ability to respond and help, access opportunities to learn more about trauma and the available resources
    • For caseworkers who are worried about offending families, ask what they would like to know about trauma and make sure they understand its effects
    • To overcome uncertainty about the appropriate intervention, use available resources to understand options and refer children for treatment
    • To address uneasiness about working with trauma-affected children, be aware that it is normal to feel some discomfort but also very important to overcome such feelings to help the affected children and families

    The issue concludes with several reflection questions such as "What are some difficulties you've experienced when trying to help a child you suspect has been exposed to trauma?," "Are there standard procedures in place at your agency?," and "What interventions and practices have been successful? Why do you think they have worked?"

    The Center for Advanced Studies in Child Welfare's Practice Notes issue 28 is available at (637 KB).

  • Alia UnSystem Innovation Cohort Seeks Agency Leaders

    Alia UnSystem Innovation Cohort Seeks Agency Leaders

    Alia's mission is to inspire and drive transformative change for the people and systems entrusted with the welfare and care of children.

    Through Ten of Ten for Kids, a national child welfare redesign event hosted by Alia in May 2017, and months of formal and informal follow up with child welfare professionals, innovators outside child welfare, foster care alumni, and parents with personal experience being investigated by child protective services, the Alia UnSystem was developed. The UnSystem is characterized by seven guiding principles and challenges every assumption on which the current system is built. 

    Alia is seeking agency leaders, public systems leaders, foster alumni and birth parents, and child welfare professionals to participate in the Alia UnSystem Innovation Cohort. This group will  guide their agencies through the transformation and shift the levers of accountability, decision-making power, culture, purpose, and rewards, revealing a revitalized network of community services and partnerships designed to preserve, restore, heal, and scaffold family relationships. Alia's goal is for every child to remain in the uninterrupted care of an already-trusted adult, where there is never a disruption to his or her sense of connection and belonging.

    Applications are due January 31, 2018; however, CBX readers can mention this article to extend the deadline for application to February 9, 2018.

    To apply, nominate an individual, or inquire about a cohort position, go to

  • Performance Tools Help Assess Best Practices, Outcomes in Youth Vocational Rehab Area

    Performance Tools Help Assess Best Practices, Outcomes in Youth Vocational Rehab Area

    Vocational rehabilitation (VR) agencies help transition-aged youth with disabilities who are preparing to enter employment or postsecondary education. Performance management tools can help state agencies tasked with VR for transition-aged youth to measure outcomes and inform evidence-based best practices. States use these tools to identify practices that are working well, change those that are not, and improve client outcomes.

    A September 2017 Mathematica Policy Research issue brief explores the performance management cycle and the tools and techniques that can help VR staff implement evidence-based decision-making, including the following:

    • Using a framework developed to help staff use performance management tools for organizing priorities
    • Identifying analytic options that are available for analyzing research questions or addressing a problem
    • Using a new tool, the VR Program Evaluation Coach, to help VR staff evaluate their programs and policies
    • Referencing concrete examples of how VR agencies can use data to inform practices and improve outcomes

    The issue brief, Performance Management for State Vocational Rehabilitation Agencies Serving Transition-Aged Youth, is available at


This section of CBX provides a quick list of interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials that can be used in the field or with families.

  • Postplacement Support Services for Adoptive, Foster, and Kinship Care Families

    Postplacement Support Services for Adoptive, Foster, and Kinship Care Families

    AdoptUSKids has compiled a primer on the 15 types of postplacement support services for adoptive, foster, and kinship care families. The support services fall into one of three categories (basic, enhanced, or more intensive).

    Basic services include the following:

    • Trauma-informed assessments for children and youth
    • Information resources
    • Navigation, advocacy, and referrals
    • Training
    • Birth family mediation and adoption search

    Enhanced services include the following:

    • Peer support
    • Mentoring
    • Supports for children and youth (e.g., cultural or recreational activities, job training and support)
    • Case management
    • Education support and advocacy
    • Respite
    • Camps or retreats
    • Financial supports

    More intensive support services apply to a much smaller target audience and typically address children and families with more challenging needs. They include the following:

    • In-home or community-based therapeutic services or access to residential treatment
    • Crisis intervention, including 24/7 hotlines, emergency respite care, and in-home crisis response teams

    For more information on the different types of support services, Support Matters: Lessons From the Field on Services for Adoptive, Foster, and Kinship Care Families, is available at (112 KB).

  • Updated Handbook Addresses Rights and Responsibilities of Youth in Foster Care

    Updated Handbook Addresses Rights and Responsibilities of Youth in Foster Care

    The Ohio Youth Advisory Board (OYAB) has issued an updated handbook on the rights and responsibilities of youth in foster care. The handbook was first published in 2009 by a team of young adults formerly in foster care to inform youth in foster care about their rights and responsibilities and to help them understand that there are people who care about them and want them to succeed. The handbook was developed to advise youth on how to talk to someone if their rights are violated.

    The updated handbook includes the following categories of foster youth rights and responsibilities:

    • Spirituality and religion
    • Privacy
    • Case plan
    • Living environment
    • Staying safe
    • Support and guidance
    • Right to protection
    • Mental and physical health
    • Personal items
    • Basic needs
    • Communicating with others
    • Being responsible
    • Education

    The updated handbook also addresses the rights and responsibilities of caseworkers and caregivers, the process of leaving foster care, independent living, how to find additional resources, and frequently asked questions. It includes real-life stories from current and former foster care youth about their experiences in foster care. Former OYAB president Alex McFarland explains in the introduction to the handbook that its underlying message is "You are important, you are loved, and you have a voice that nobody can take away."

    The Foster Youth Rights Handbook is available at (1,430 KB).

Training and Conferences

Find trainings, workshops, webinars, and other opportunities for professionals and families to learn about how to improve the lives of children and youth as well as a listing of upcoming events and conferences.

  • Conferences


    Upcoming national conferences and events on child welfare and adoption include the following:



    • 31st Annual Research & Policy Conference on Child, Adolescent, and Young Adult Behavioral Health
      University of South Florida Department of Child & Family Studies
      March 4-7, Tampa, FL
    • 14th Annual Childhood Grief and Traumatic Loss Conference
      Inter-Agency Council on Child Abuse and Neglect
      March 15, Los Angeles, CA
    • 2018 National Conference on Juvenile Justice
      National Council of Juvenile and Family Court Judges
      March 18-21, San Diego, CA



  • Trauma Systems Therapy for Foster Care Curriculum

    Trauma Systems Therapy for Foster Care Curriculum

    The Annie E. Casey Foundation recently released a new training curriculum designed to enhance foster parents' and other caregivers' understanding of how trauma affects children's behavior. Trauma Systems Therapy for Foster Care (TST-FC) includes the primer Implementing Trauma Systems Therapy for Foster Care, which is for child welfare agencies planning to implement the TST-FC curriculum within their existing inservice foster care trainings, and Facilitator Preparation and Planning for TST-FC, which contains tips for facilitators on scheduling, preparing, and presenting the TST-FC curriculum.

    The curriculum comprises the following four training modules that include facilitator guides and accompanying PowerPoint slides:

    • The Impact of Trauma module discusses the impact of trauma on children and caregivers as well as describes caregivers' role in assessing a child for trauma and working with the child's team to develop interventions.
    • Strategies to Assess Trauma focuses on interventions to address the specific needs of a particular child as well as strategies that work for children who have faced trauma.
    • Coping With Difficult Behavior addresses specific strategies to help children manage emotions and behavioral responses.
    • Generating Signals of Safety aims to help caregivers understand the importance of creating as many signals of safety as possible to help the child feel cared for and heal from past signals of harm.

    The curriculum also includes additional resources for trainers and caregivers, including The Foster Parent Resource Guide and Managing Emotions Guide as well as surveys and feedback for the TST-FC.

    The TST-FC curriculum is available at