Interventions for Toddlers
and Infants At Risk

Toddlers and Infants In Foster Care

Half of the 650,000 children in the child welfare system are age 5 or younger. (US Dept. of Health and Human Services, 2011)

Children need interventions from their caregivers to assist with recovering from the neglect or abuse. The interventions need to include a plan for the child to cope with their past neglect.

Four areas that Ackerman and Dozier identify as the essentials of caregiving are: synchrony, nurturance, stability of care, and commitment.

Interventions for children in the welfare system:

Attachment and Biobehavioral Catch-up (ABC)
  • Focuses on synchrony and nurturance
  • 10 week program focusing on changing the birth parents' behavior
  • The parent is coached to follow the child's lead. When the parent follows what the child is doing, it lets the child know he has an effect on the world.
  • The other intervention was coaching the parent in nurturing. Parents watched video clips as well as interacted with their child in the presence of a behavior coach. The parent or caregiver was coached on how to recognize when a child needs nurturing. Whether the child appears to need it or not. (Ackerman and Dozier, 2005)

New Orleans Intervention

  • Focuses on synchrony, nurturance, stability, and commitment
  • It is an ongoing program provided to children in foster care.
  • A team of mental health professionals provide services to the child, become an advocate for the child, and work with any adult that is associated with the child.
  • Families who participated had significantly less foster care placement (Zeanah, 2001)

Interventions for children of poverty:

Odom describes several interventions for families in poverty:

Early Head Start program

  • Early Head Start programs support the mental, social, and emotional development of children from birth to age 3.
  • In addition to education services, programs provide children and their families with health, nutrition, social, and other services.
  • Early Head Start helps families care for their infants and toddlers through early, continuous, intensive, and comprehensive services.

The high risk infants and families who do not respond, need the following interventions:

  1. Provide health and developmental services for children and family members. These services would include providing time for the caregiver to look for work and to provide job training and mental health services. (Watamura, 2011)
  2. Provide home/family component - include prenatal care, post natal care programs, nutritional system support, and early parenting education.  (Jones Harden, 2006)

Other areas of interventions for children and parents of poverty

  • Physical activity and motor development opportunities - provide a space and plan daily activities
  • Early cognitive skills - practice having the child move from fixation on objects to the adult; important for the caregiver to encourage attention and to provide the child time to process the information; establishes memory skills which build vocabulary
  • Language and communication - singing, oral narratives, nursery rhymes, repeated story telling and linkage of vocabulary to pictures in storybooks all enhance language development and early literacy skills of infants and toddlers. (Odom, 2012)

Children's vocabulary at age 3 predicts language competence (Hart and Risley, 1995) and reading performance in later childhood (Dickson, 2010).

Interventions for children of teen parents:

Teenage pregnancy has decreased, but it still effects children:

All females:       1991 - United States - 61.8 per 1000 females age 15-19 (Martin, 2013)

                             2012 - United States - 29.4 per 1000 females age 15-19 (Martin, 2013)

                            2011 - TEXAS - 46.9 per 1000 females age 15-19 (Center, 2013)

                            2012 - McLennan County - 53.0 ages 15-19 (Robert Wood Johnson, 2013)

Biggest concern is teenage parents are not prepared to meet the developmental needs of their child. They do not have the experience or resources to fulfill their parenting obligations. (Osofsky, 1993)

What interventions can be effective for children of teenage parents?

Start with the teenager - teach them:

  • to set goals
  • how to make good decisions
  • how to solve problems
  • how to communicate effectively (Moore, 1995)

Program in Hawaii, 1994:

  • Identified students who were pregnant or were parenting
  • Counseled them on goal setting, child development, and vocational skills
  • Health department addressed prenatal, birthing, and postnatal needs; monitored immunizations, scheduled medical visits, and provided nutritional counseling
  • Created an infant/toddler day care center on the high school campus. The program was staffed by early childhood educators.
  • Jog training agency offered vocational training in the summer

The program turned an 80% dropout rate into 90% graduation or promotion to the next grade level. School based childcare ensures high quality care for infants and toddler while their parents attend school. (Thomson, 1994)

Public school districts who currently offer a similar program are San Marcos, Waco, Crockett, NE ISD in San Antonio and Loredo.

What do these interventions have in common?

Exit ticket - 3/2/1 activity:

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