Moving Forward as a Family: Crafting a 2-Generation Strategy for Central Texas, PRP 192

United Way for Greater Austin commissioned this policy research project to guide their focus on helping low socioeconomic families achieve greater financial stability through the development of a Two-Generation (2-Gen) strategy for the Central Texas region. Two-Gen programs emphasize the importance of education as a means for better economic outcomes. High-quality early childhood education programs allow children to make critical neural connections during a period of substantial growth and development, ultimately better preparing them for pre-kindergarten programs and academic success in subsequent years. Adults working low-paying jobs encounter barriers to career advancement due to lacking credentials or relevant education. It is not uncommon for parents working long hours for low wages to have at least one child in need of high-quality early childhood education, yet they are unable to enroll their child in such programs due to issues such as cost, transportation, and time away from work. Two-Gen programs seek to resolve the issues complicating this problem of financial instability by providing high-quality educational and training programs for both parents and children, which are even more effective when intentionally coordinated so that the family develops as a single unit in a positive direction. The research consisted of a literature review; a program scan at the local, state, and federal levels; and site visits within Austin, Dallas, and San Antonio, as well as Boston and Miami. Data collected specific to the Central Texas region include a labor market analysis, a needs assessment, and a mapping of current organizational assets. Obtaining and analyzing this data allowed the team to better understand 2-Gen program development, outcomes, impact measurements, and areas for improvement. The research team developed practical applications for the information collected, ultimately contributing to the proposed anti-poverty strategy through the intentional coordination of 2-Gen services by leveraging existing organizational assets to best address the area’s most salient needs. In addition, the team proposed an evaluation strategy involving cost-benefit equations, program evaluation metrics, and a screening tool to predict the likelihood of a program achieving successful outcomes. The report concludes with policy recommendations at the local, state, and federal levels, as well as a summary of the populations affected by financial instability and future directions for this field.United Way for Greater AustinPublic Affair

Early Childhood Fine Motor Assessment

The development of hand function is ongoing from infancy through adulthood. Hand function is especially important in the early years as a child prepares for school. As with all skills, the level of hand function can range from excellent to average to clumsy or immature. Stability, strength, and endurance are key components of adequate hand skill development. These components are often areas of weakness in today\u27s society of technology and passive activities. Creating an assessment designed specifically for the identification of skill acquisition, as it pertains to hand function and fine motor development, in the early childhood years will assist therapists in establishing an intervention plan for that child. In tum, this will facilitate the development of pre-writing, pre-cutting, and grasp or manipulation skills. Early childhood education programs are designed to ensure school readiness and it is an appropriate location to incorporate an early childhood fine motor assessment tool for the initial and ongoing analysis of a child\u27s development in hand function and manipulation skills. The methodology used to gather the information for the development of the early childhood fine motor assessment included an extensive review of literature and research regarding the developmental milestones and the ancillary factors contributing to fine motor development in children age eighteen months to five and one half years of age. Consultation and feedback pertaining to the assessment was obtained from professionals within the field of occupational therapy and early childhood special education. Practice trials of the early childhood fine motor assessment tool included one hospital based pediatric setting, one early childhood classroom setting, and one rural consultation based early childhood school setting. The information gathered from an extensive literature review led to and supported the need to develop a quick, user-friendly early childhood fine motor assessment tool for children age eighteen months to five and one half years of age. The assessment tool is specifically intended to serve children in early childhood settings however, it may also be of benefit in the medical model setting. The assessment is specifically designed to address fine motor skill development in children 18 months to five and a half years. The tool can be administered in its entirety, in specific sections, or in segments to accommodate the early learner\u27s attention span and specific needs. Information gathered during this process is meant to be used as baseline for comparative data, for treatment planning, conference reporting, and for classroom, caregiver, and/or parent education. The Early Childhood Fine Motor Assessment Tool administration manual provides brief descriptions of each component to observe. The manual also provides age approximations, skill completion techniques, and observation cues to assist data collection. Each suggestion is intended only as that, as it is certain that each child develops individually and may utilize alternative successful techniques to achieve skills and each child may progress at varying speeds of development

Aprendizagem Digital: Modelos diferenciados de ensino utilizando TICs para alunos com problemas de visão – Boas práticas: Jogando entre 1 a 10

The idea of inclusion encourages an inclusive, open-door school. By adapting formal instruction to standard instruction that is acceptable for everyone while taking into account the requirements, quirks, skills, interests, and experiences of each student, the use of ICTs aids in this direction. One such group is the visually challenged, whose inclusion in general education classes is made possible with the use of ICTs. In the current study, a method of individualized education in the field of mathematics is developed and put into practice, allowing all students-visually impaired or not-to master the mathematical operation of adding to the first ten at their own speed and time. Results show that differentiated instruction improves students' ability to understand mathematical operations: ADDITION from 1 to 10.La idea de inclusión fomenta una escuela inclusiva y de puertas abiertas. Al adaptar la instrucción formal a la instrucción estándar aceptable para todos, teniendo en cuenta los requisitos, peculiaridades, habilidades, intereses y experiencias de cada estudiante, el uso de las TIC ayuda en esta dirección. Uno de estos grupos es el de los discapacitados visuales, cuya inclusión en las clases de educación general es posible con el uso de las TIC. En el presente estudio se desarrolla y pone en práctica un método de enseñanza individualizado en el área de matemáticas, que permite a todos los alumnos -con discapacidad visual o no- dominar la operación matemática de sumar al top ten a su propio ritmo y tiempo. Los resultados muestran que la enseñanza diferenciada mejora la capacidad de los estudiantes para comprender las operaciones matemáticas: SUMA del 1 al 10.A ideia de inclusão incentiva uma escola inclusiva e de portas abertas. Ao adaptar a instrução formal à instrução padrão aceitável para todos, levando em conta os requisitos, peculiaridades, habilidades, interesses e experiências de cada aluno, o uso das TICs auxilia nessa direção. Um desses grupos é o dos deficientes visuais, cuja inclusão nas classes de educação geral é possível com o uso das TICs. No presente estudo, é desenvolvido e colocado em prática um método de ensino individualizado na área da matemática, permitindo que todos os alunos-deficientes visuais ou não-dominem a operação matemática de somar aos dez primeiros no seu próprio ritmo e tempo. Os resultados mostram que o ensino diferenciado melhora a capacidade dos alunos de entender as operações matemáticas: ADIÇÃO de 1 a 10

Implementation of child-centred outcome measures in routine paediatric healthcare practice: a systematic review

Background: Person-centred outcome measures (PCOMs) are commonly used in routine adult healthcare to measure and improve outcomes, but less attention has been paid to PCOMs in children’s services. The aim of this systematic review is to identify and synthesise existing evidence of the determinants, strategies, and mechanisms that influence the implementation of PCOMs into paediatric healthcare practice. Methods: The review was conducted and reported in accordance with PRISMA guidelines. Databased searched included CINAHL, Embase, Medline, and PsycInfo. Google scholar was also searched for grey literature on 25th March 2022. Studies were included if the setting was a children’s healthcare service, investigating the implementation or use of an outcome measure or screening tool in healthcare practice, and reported outcomes relating to use of a measure. Data were tabulated and thematically analysed through deductive coding to the constructs of the adapted-Consolidated Framework for Implementation Research (CFIR). Results were presented as a narrative synthesis, and a logic model developed. Results: We retained 69 studies, conducted across primary (n = 14), secondary (n = 13), tertiary (n = 37), and community (n = 8) healthcare settings, including both child self-report (n = 46) and parent-proxy (n = 47) measures. The most frequently reported barriers to measure implementation included staff lack of knowledge about how the measure may improve care and outcomes; the complexity of using and implementing the measure; and a lack of resources to support implementation and its continued use including funding and staff. The most frequently reported facilitators of implementation and continued use include educating and training staff and families on: how to implement and use the measure; the advantages of using PCOMs over current practice; and the benefit their use has on patient care and outcomes. The resulting logic model presents the mechanisms through which strategies can reduce the barriers to implementation and support the use of PCOMs in practice. Conclusions: These findings can be used to support the development of context-specific implementation plans through a combination of existing strategies. This will enable the implementation of PCOMs into routine paediatric healthcare practice to empower settings to better identify and improve child-centred outcomes. Trial registration: Prospero CRD 42022330013

It is time to talk about people: a human-centered healthcare system

Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a) Reason's system approach [1] and b) User-centered design [2,3]. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system

Pediatric decision support using adapted Arden Syntax

BACKGROUND: Pediatric guidelines based care is often overlooked because of the constraints of a typical office visit and the sheer number of guidelines that may exist for a patient's visit. In response to this problem, in 2004 we developed a pediatric computer based clinical decision support system using Arden Syntax medical logic modules (MLM). METHODS: The Child Health Improvement through Computer Automation system (CHICA) screens patient families in the waiting room and alerts the physician in the exam room. Here we describe adaptation of Arden Syntax to support production and consumption of patient specific tailored documents for every clinical encounter in CHICA and describe the experiments that demonstrate the effectiveness of this system. RESULTS: As of this writing CHICA has served over 44,000 patients at 7 pediatric clinics in our healthcare system in the last decade and its MLMs have been fired 6182,700 times in "produce" and 5334,021 times in "consume" mode. It has run continuously for over 10 years and has been used by 755 physicians, residents, fellows, nurse practitioners, nurses and clinical staff. There are 429 MLMs implemented in CHICA, using the Arden Syntax standard. Studies of CHICA's effectiveness include several published randomized controlled trials. CONCLUSIONS: Our results show that the Arden Syntax standard provided us with an effective way to represent pediatric guidelines for use in routine care. We only required minor modifications to the standard to support our clinical workflow. Additionally, Arden Syntax implementation in CHICA facilitated the study of many pediatric guidelines in real clinical environments

An Analysis of the Current United States and State of Washington\u27s Mental Health Policies Serving Children and Families

Due to continued fragmentation and gaps in mental health services and the increase in the prevalence of mental health problems for children, youth, and their families, these populations remain underserved. In 2003, the federal New Freedom Commission (Commission) responded by publishing policies to address these concerns. As directed in 2005, the Substance Abuse and Mental Health Services Administration (SAMHSA) funded planning incentive grants to states to transform their delivery of care. The study reviewed the federal policy, specifically the recommendations of the Commission’s Subcommittee on Children and Families, and Washington State’s policy and implementation actions of its five-year SAMHSA incentive grant. The method included searching, reviewing, and analyzing the literature on the topic published sinceapproximately 2002. The analysis distilled the recommended determinants in children’s mental health care transformation: prevention, early intervention, and screening in child welfare (juvenile justice and foster care) strategies; evidence-based practices; geographic disparities; workforce barriers; cultural competence aspirations; and consumer, schoolbased mental health, and primary care providers’ role expectations. Despite innumerable studies, policies and services remain fragmented with gaps. The following topics from the outcome data require continuing attention: increasing the 2 cultural competency of professional services that are efficacious, and designing and promulgating measures for evidence-based practice specific to children. Three themes emerged regarding how to serve children’s mental health needs in Washington State in a more efficacious manner. Within the penumbras of cultural competency and outcome-based measures, constructs for evidence-based practice for children need to be age-developmentally appropriate. Simultaneously, both the family role and venues of service delivery need to be considered, e.g., schools, out-of-home placement, and clinics. Access to mental health care through schools and primary care providers needs to be collaborative with behavioral health professionals. School policy needs to link students’ attendance and achievement with their physical and behavioral health. Training for the mental health workforce requires increased cultural competency. Rural mental health care requires incentives to train and retain a workforce reflective of the demographics, particularly in the areas populated by persons of color. Also, the number of prescribers needs to increase through certification of nurse practitioners and psychologists

Feel and Touch: A Haptic Mobile Game to Assess Tactile Processing

Haptic interfaces have great potential for assessing the tactile processing of children with Autism Spectrum Disorder (ASD), an area that has been under-explored due to the lack of tools to assess it. Until now, haptic interfaces for children have mostly been used as a teaching or therapeutic tool, so there are still open questions about how they could be used to assess tactile processing of children with ASD. This article presents the design process that led to the development of Feel and Touch, a mobile game augmented with vibrotactile stimuli to assess tactile processing. Our feasibility evaluation, with 5 children from 3 to 6 years old, shows that children accept vibrations and are able to use the proposed vibrotactile patterns. However, it is still necessary to work on the instructions to make the game dynamic clearer and rewards to keep the attention of children. We close this article by discussing future work and conclusions

Early Child Development: From Measurement to Optimal Functioning and Evidence-based Policy

In the early years of life, the environments that interact with a child—including families, schools, and communities—play a key role in the child’s brain development. Early child development and overall children’s developmental trajectories have long-term implications for health, happiness, and earning potential as these children become adults. Importantly, failing to reach developmental potential contributes to global cycles of poverty, inequality, and social exclusion. There is little public understanding of the importance of a child’s first years and the critical developmental opportunity to reach optimal functioning. As such, global data on early child developments are crucial to inform the public and demand evidence-based policies and high-quality programs for children around the world. This book includes initiatives assessing the impact of programs and interventions related to children’s health, education, and participation that inform evidence-based policies worldwide. Importantly, this book raises global awareness of the importance of children’s first years of life and the crucial role of child–environment interactions where the child lives, plays, and grows. The culturally diverse content comprises international representation of studies and classifications tools. International experts contributed high-quality reviews that collate valuable information and guide the adoption of a rights-based approach in early child development globally