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Policies and Procedures: Issues for Implementation, Policy and Scaling up

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Center for Evidence-based Practice: Young Children with Challenging Behavior ... Shared training on evidence-based practices among different professions, ... – PowerPoint PPT presentation

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Title: Policies and Procedures: Issues for Implementation, Policy and Scaling up


1
Policies and Procedures Issues for
Implementation, Policy and Scaling up
  • Barbara J. Smith, U. of Colorado at Denver and
    Health Sciences Center
  • Policy Makers Summit
  • November 17, 2006
  • Washington, DC
  • www.challengingbehavior.org

2
Research Framework Direct Services/Indirect
Supports
  • Longitudinal, multi-site study (KIDS)
  • Research on direct interventions/services e.g.,
    emotional/social competence, parent-child
    interaction, PBS and cultural diversity,
    family-centered interventions, interventions with
    toddlers, program-wide PBS
  • Research on indirect supports
  • Personnel Preparation and Utilization
  • Administrative Operations and Policy

3
Promotion, Prevention, Intervention Conceptual
Framework The Teaching Pyramid
Individualized Intensive Interventions
Social and Emotional Learning Strategies
Preventive Practices
Building Positive Relationships
4
Policy Research Literature Syntheses, Focus
Groups Surveys
  • What are the barriers and/or challenges to
    effective promotion, prevention and intervention
    services for young children at risk for or who
    have challenging behavior?
  • What are policy and administrative
    strategies/remedies for addressing the challenges
    or barriers?

5
Information Sources
  • Center for Evidence-based Practice Young
    Children with Challenging Behavior
  • Literature syntheses re systems and policies
  • Focus groups
  • National survey
  • National TA Center for Childrens MH
  • Discussion groups, Natl. scan and TA with states
  • Centers collaborative survey of states

6
National Survey
  • State Agency Leaders IDEA Part C, ICC and 619
    Child Mental Health Child Welfare Maternal and
    Child Health Health
  • Local Program Administrators Head Start, Child
    Care (including military programs), Public
    Schools, mental health consultants, home visitors
    and other TA providers
  • Family Members Lists from PACER and FFCMH,
    parents involved with programs

7
Focus Groups
  • 619 and Part C Coordinators
  • Parents (Il., Fl., Co.)
  • Direct Service Providers (Il., Fl., Co.)
  • Administrators (Il., Fl., Co.)

8
Findings
  • Categories of barriers/challenges
  • Knowledge Skills (including eligibility)
  • Finance (including eligibility)
  • Beliefs and Attitudes
  • Collaboration/Coordination/System

9
Survey and Focus Groups Challenges
National Survey
Focus Groups
10
National Survey Challenges (Eligibility)
11
Focus Groups Challenges (Eligibility)
12
Challenge Knowledge and Skills (workforce
development support)
  • Availability quality of pre-service training
  • Availability quality of in-service training,
    TA, mentoring and other on-going support
  • Quality of content of training/support
  • Evidence-based
  • Eligibility
  • Working with families
  • High turnover rates

13
Challenge Attitudes Beliefs
  • Differing philosophies approaches
  • Perceptions of children, mental health,
    social-emotional development and behavior
  • Perceptions between professionals and parents

14
Challenge Collaboration Coordination
  • Lack of coordination of programs, systems
  • and resources/funding streams
  • Lack of collaboration among service providers
  • Poor collaboration between professionals and
    parents
  • Lack of integrated practice/services
  • Failure to reach under-served populations
  • Lack of leadership/ownership

15
Challenge Finance
  • Eligibility criteria and requirements
  • (inconsistent across funding sources, do not
    support promotion prevention, do not include
    child and family, etc.)
  • Insufficient resources
  • Limits on blending resources
  • Insurance, Medicaid and other third party payment
    restrictions
  • Low compensation for EC personnel

16
Survey Focus Groups Strategies/Remedies
Focus Groups
National Survey
17
Remedies Knowledge Skills
  • Availability of pre-service training in
    evidence-based practices re young childrens
    social-emotional development and behavior
  • Availability of in-service training, TA,
    mentoring, and other on-going support in
    evidence-based practices
  • Availability of information and models of
    evidence-based practices, programs and systems
  • Higher compensation and other workforce supports
  • Awareness campaigns

18
Remedies Attitudes Beliefs
  • Shared training on evidence-based practices among
    different professions, agencies and with parents
  • Awareness campaigns about the importance of young
    childrens social-emotional development, mental
    health and behavior

19
Remedies Finance
  • Policies that support blending and coordinating
    resources
  • Policies that support promotion prevention and
    support reaching children early
  • Adequate resources for programs and
    training/TA/on-going, on-site support
  • Adequate compensation for EC personnel

20
Remedies Collaboration Coordination
  • Policies that promote collaboration and
    coordination, e.g.,
  • System of care
  • Wrap around
  • Addressing differing eligibility limits
  • Skills in collaborating with families and other
    professionals
  • Addressing attitudes and beliefs (turf guarding,
    trust, differing philosophies)
  • Inclusion of diverse stakeholders

21
Conclusions and Next Steps
  • There are real policy barriers such as
    eligibility criteria and service limitations
    associated with funding sources that are
    incompatible with a promotion, prevention,
    intervention model.
  • By far and away, the majority of barriers to
    delivering effective promotion, prevention,
    intervention services to children and families is
    the lack of know-how and support to implement
    evidence-based practices.
  • Strategies that promote, scale-up and sustain
    the everyday use of evidence-based practices,
    services and programs in the context of a system.

22
Program Wide Adoption
Program Wide Adoption
Well defined procedures
Program Philosophy
Individualized Interventions
Teacher Training/Implementation
Administrative Supports
Social Emotional Teaching Strategies
Data Based Decision Making
Partnerships with Families
Creating Supportive Environments
Positive Relationships with Children, Families,
and Colleagues
23
Early Childhood System of CareFosters the
social and emotional well-being of infants,
toddlers, preschool-aged children and their
families
Services and Supports
VALUES Family Voice Child and Family
Centered Relationship Based Culturally
Competent Infused into Natural Settings and
Services Grounded in Developmental Knowledge
Supports for Parents and Families
Supports for Other Caregivers
Infants, Young Children and Families
Services for Children and Families
Building Blocks
Strategic Planning, Interagency Partnerships
Family Consortium
Outcome Evaluation
Maximized and Flexible Funding
Prepared Workforce
Policies and Procedures
Developed by Roxane Kaufmann, GUCCHD
24
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