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Social-Emotional What is Social-Emotional Wellness? The Division of Family Health (DFH), located in the Office of Public Health and working with the Maternal and Child Health Services Block Grant is pleased to welcome you to the Spring/Summer 2018 edition of the Social-Emotional Wellness Update! Positive social-emotional development and relationships are the building blocks of healthy development that help young people grow up healthy, caring and responsible (Search Institute; Healthy Commu- nities—Healthy Youth). The DFH has identified social-emotional development and relationships as a priority for both children and adolescent programming. This semi-annual newsletter provides a brief overview on specific aspects concerning social-emotional wellness for children and ad- olescents, explores relevant data, discusses the public health im- pact of trauma, adverse childhood experiences and toxic stress, offers resources for further exploration, and addresses the im- portance of using evidence-informed strategies that focus on the provision of trauma-informed care, resilience and building devel- opmental assets through a positive youth development frame- work. Social-Emotional Development and Relationships in Children & Adolescents Spring/Summer 2018 Wellness Update In this issue: Focus on Social- Emotional Wellness Social-emotional Development of Infants and Toddlers Information on ACEs NYS Health Homes for Children Resources for Expanding Knowledge Photo: “Young people need adults and peers in their lives who express care, challenge growth, provide support, share power and expand possibilities” - The Search Institute ---PAGE BREAK--- Why Social-Emotional Well- ness? We believe that social-emotional wellness in children and adolescents impacts nearly all of the work that is done on some level within the New York State Department of Health’s Division of Family Health (DFH). This emerging field integrates mental, physical and social domains that support healthy life outcomes beyond adolescence. Social-emotional wellness has been described as a “soft- skill”, while important, not often the primary focus for our Maternal and Child Health (MCH) programs. Currently, there is no specific set of standards that address social- emotional wellness across all of the age groups encom- passed by this designation (from birth through adoles- cence). That being said, there is growing research and data that highlight evidence-based, evidence-informed and best prac- tices for increasing social-emotional wellness. MCHS Block Grant In recognition of the importance of social-emotional well- ness in children and adolescents, DFH added this as a prior- ity area in the Maternal and Child Health Services Block Grant as part of a shared priority within the chil- dren and adolescent domains. NY’s priorities for child and adolescent health reflect con- sistent stakeholder concerns regarding the impact of pov- erty, toxic stress, early development and social-emotional relationships on lifelong health and well-being impacting physical and behavioral health as well as school success. Root Causes? Particular factors that have been shown to have an impact on children’s social, emotional and mental health include ex- posure to adverse childhood experiences (ACEs), poverty, trauma, and inadequate treatment. While these root causes are dif- ficult to address, concentrating efforts among priority youth is a good start for the Social- Emotional Wellness initiatives. For more information on ACEs and trauma informed care practices, please see page four. ---PAGE BREAK--- Social-Emotional Wellness of Infants and Toddlers In 2017, The Division of Family Health (DFH) announced the issuance of the guidance document, Meeting the Social -Emotional Development Needs of Infants and Toddlers: Guidance for Early Intervention and Other Early Childhood Professionals. This guidance is geared towards early childhood health, development specialists, and early care and learning pro- fessionals to partner with families to promote and support healthy social-emotional development in infants and toddlers. The Department encourages anyone who services infants and toddlers, including those in the State’s Ear- ly Intervention Program (EI) for young children with disabilities and their families, to use this document. Young children’s positive social-emotional development, and their capacity to form strong, secure and positive relation- ships with caregivers is foundational to their overall healthy development. The guidance was written to achieve the following four objectives: • Ensure that the general population of young children receive routine and ongoing screening of children’s de- velopment, • Identify children at risk of experiencing a social-emotional development delay or disability and ensure that their families receive the assistance they need, • Improve the early identification of children who may already be experiencing developmental delays in social- emotional development, • Ensure the evaluations and assessments for all children in the Early Intervention Program adequately address the area of social-emotional development and service coordinators, evaluators and providers who are deliver- ing EI services understand the importance of and pay attention to this area of development. Click here to open the publication and learn more! ---PAGE BREAK--- For the first time in 2016, the New York State (NYS) Depart- ment of Health (DOH) collected regional and state-level ACEs data from over 9,000 adults through the Behavioral Risk Factor Surveillance System The is an an- nual statewide telephone survey of adults developed by the CDC and administered by DOH. Findings from the survey were similar to the original ACE study and include that ACEs are common in NYS, six out of 10 adults reported having experienced at least one ACE and 13% reported four or more ACEs. Additionally, par- ticipants who reported three or more ACEs are six times more likely to report being depressed, four times more likely to report HIV risk behaviors, three times more like- ly to have arthritis or be current smokers, and twice as likely to be obese, ever have asthma or report binge drinking. The ACEs workgroup is recommending the following ac- tion steps. 1. Facilitate cross-sectoral engagement in developing, implementing and evaluating the action plan. 2. Offer Technical support on best practice to prevent, reduce and respond to ACEs. 3. Support alignment of actions to address ACEs 4. Strengthen capacity for training and communications. 5. Collect data and information on ACEs and resilience periodically. The ACEs workgroup will soon be posting a detailed re- port on the site, entitled Understanding and Re- sponding to Adverse Childhood Experiences in New York State. The ACEs workgroup included staff from DOH, OASAS and OMH with support provided by the Bureau of Chronic Dis- ease Evaluation and Research, Bureau of Occupational Health and Injury Prevention and Office of Public Health Practice. The report Understanding and Responding to Ad- verse Childhood Experiences in New York State will be posted on the website soon. Adverse Childhood Experiences (ACEs) The CDC-Kaiser Permanente Adverse Childhood Experiences Study looked at how childhood trau- mas (abuse, neglect, and family/household chal- lenges) affect an individual’s health throughout their life-course. Participants in the study complet- ed a survey regarding their childhood experiences and current health / behaviors. The study asked 10 questions, each representing an ACE. Study findings revealed that the majority of individ- uals have experienced at least one ACE as well as a graded dose-response relationship between ACEs and negative health and well-being outcomes across the life course, meaning the higher an indi- vidual’s ACE score is, the more likely they are to have negative health/well-being outcomes. ACEs have been linked to: risky health behaviors, chronic health conditions, low life potential, and early death (CDC.gov). Please visit the CDC website to learn more about this study and it’s implications. Because of the health impacts that can occur from traumatic environments, it is important for commu- nity-based programs to use resilience building initi- atives with youth. Taking a trauma-informed care approach can help establish safe, stable and nurtur- ing environments for children. ---PAGE BREAK--- New York State Children’s Health Homes The New York Health Homes Serving Children (HHSC) coordinates trauma-sensitive care efforts for youth who have complex trauma. A children’s Health Home is a care management model that is designed to coordinate care of individuals with Medicaid who have chronic conditions. This model of care management is provided by commu- nity care managers who oversee and provide access to all the services an individual needs to ensure they stay healthy, out of the emergency room and out of the hospital. Care Managers build linkages to other community and social supports, and enhance coordination of medical and behavioral health care, with the main focus on the needs of persons with multiple chronic illnesses. All of an individual´s providers communicate with one another so the individual´s needs are addressed in a comprehensive manner. There are 16 adult Health Homes that also provide services to children and three that only serve children. Health Home enrollment for children began in December 2016. The Health Home model has been designed to incorporate the expertise of existing care managers, including Early In- tervention, Voluntary Foster Care Agencies, Office of Mental Health Targeted Care Manage- ment (OMH TCM) and Care at Home providers that have and will operate under the Health Home program to provide care management and develop plan of care . A multiple state agency partnership has leveraged expertise from trauma-informed care experts to assist with identifying the procedures / approaches for verifying and documenting complex trauma. By recognizing children with complex trauma, the indi- viduals are more likely to receive trauma-sensitive care throughout their health ser- vices. For more information on this initiative, please visit the program site by clicking here. ---PAGE BREAK--- Contact Us Thanks for reading! Please feel free to contact the Social-Emotional Wellness (SEW) team for more information about our initiatives or to share any additional resources future training events. We welcome all feedback and any topic suggestions to consider for future e-newsletters. SEW Team Members Eric Zasada Susan Penn Marina Sepowski Hoyt Katherine Reksc Lisa Adami Please email any team member ([EMAIL REDACTED]) if you would like to be added to any additional SEW-related mailings. Links & Data Resources Please click on the links to obtain more information/data on topics related to the im- pacts for social-emotional wellness in children and adolescents. New York State Prevention Agenda Youth Risk Behavior Survey – NY Data Meeting the Social-Emotional Development Needs of Infants and Toddlers: Joint Task Force on Social-Emotional Development. Assets Coming Together for Youth - Center for Community Action (ACT CCA): Posi- tive Youth Development 101 CDC Behavioral Risk Factor Surveillance System: ACE Data Search Institute Developmental Assets Resources: A positive youth development framework TED Talk: How childhood trauma affects health across a lifetime—Dr. Nadine Burke Harris