In an effort to better address the needs of children affected by trauma at an early age, county health officials are kicking off a two-year pilot program aimed at detecting instances of childhood trauma, re-imagining staff training and generating and refining resources to help children avoid developmental setbacks.
Targeted for families of children under 5 years old, the pilot is expected to help some 500 children and 40 staff members working with children at the county’s South San Francisco Clinic at 306 S. Spruce Ave. and is one of eight projects in the Bay Area supported by the Tides Foundation’s Center for Care Innovations and Genentech Charitable Giving with an $80,000 grant award last month.
As Deputy Director of Children and Youth Services in the county Health System’s Behavioral Health and Recovery Services Division, Toni DeMarco sees the program as an opportunity to build on efforts to boost mental health resources for young children and their parents and to spread awareness of the impact of trauma among staff throughout the county’s Health System. As researchers have focused on trauma and its effects in recent years, DeMarco said health officials have grown in their understanding of the long-term developmental effects trauma can have on young children and how instances of trauma can play out in families through emotional neglect, domestic violence or sexual or physical abuse.
“By getting a better history and really understanding how the family came [into] our services the way that they did, we’re much more able to address the needs of the specific child or their family in a way that they’re going to be able to benefit,” she said.
By focusing on how to best screen children and their parents for instances of emotional disturbance when they visit the clinic or receive other services, such as home visits as part of the Health System’s Women, Infants and Children Program, DeMarco is hoping health officials can identify traumatic experiences early on so they can be connected with resources that can help them work through them.
DeMarco said the time before children turn 3 years old is especially critical since their brains are developing very rapidly at that time, making it easier in some cases for them to redirect thoughts and be supported with developmental resources than when they are older and certain behaviors or emotional patterns take root.
“Maximizing the resources at a younger age, it actually gives us a bigger impact,” she said.
Resources like home visits from health professionals as well as occupational, physical and speech and language therapy are among the interventions that can help children who have had traumatic experiences regulate their own emotions and avoid falling behind developmentally, said DeMarco.
To connect families with resources to help them deal with trauma, health officials are incorporating trauma-informed training for clinic staff, which includes physicians, receptionists, clinic managers and security guards, among others who work with children, said Trish Erwin, quality improvement manager in the Health System’s Family Health Services Division.
Erwin said health and medical staff across the country are finding that to bring many of these families into the care they need, those who work with them must shift from asking questions implying there is something wrong with a family’s situation to more neutral questions aimed at determining what has happened within a family.
She said the staff is developing a protocol for following up with families as soon as trauma is identified to ensure they are connected with resources. With the understanding parents lead busy lives and may not be able to pursue recommended treatment or therapy right away, Erwin said they are working to increase communication between the professionals families see at the clinic and those who provide different therapies so parents get a call the same day they are seen by someone to figure out next steps.
“I think for our training, it’s really trying to make that key shift in perspective for our staff,” she said. “I think the first step is trying to make the connection as quickly as possible.”
Through many of the Health System’s existing services, health officials have found trauma can be passed down between generations, meaning the parents of children the pilot could help may have experienced something similar in their own lives, said Erwin. She said the pilot is aimed at incorporating parents’ experiences when connecting families to resources to address their needs as well.
With better screening in place for young children who have experienced trauma, Erwin and DeMarco have noticed the rate of children being asked to leave preschool programs because of emotional and behavioral issues climb, a trend they are hoping to reverse with learnings from the pilot program. DeMarco said instances of trauma at home can easily become compounded when a child goes to school, which, can in turn, lead to anxiety about attending school or feelings of isolation among children who feel they are falling behind their peers. Erwin added the early interventions they are hoping to bolster with the pilot could also prevent children from ending up in high-intensity mental health programs and even juvenile probation later in life.
Stories of parents whose children have already used the county’s trauma-oriented resources — and found they are better able to manage their child’s behavior — gives DeMarco hope these resources can put children at risk of facing several challenges on a path toward success instead.
“That kind of intervention at an early age allows the child then to have a different trajectory,” she said.
(650) 344-5200 ext. 106