By Paul Dworkin, MD, executive vice president for community child health at Connecticut Children’s, director of the Connecticut Children’s Office for Community Child Health and founding director of the Help Me Grow® National Center
On March 15, I was honored to participate in Public Health Grand Rounds, which is a monthly activity of the Centers for Disease Control and Prevention in Atlanta. The session focused on the important issue of “Addressing Health Disparities in Early Childhood.”
During my presentation, I was able to share the story of Help Me Grow®, which I developed as a pilot project in Hartford in 1997 and then successfully advocated for statewide expansion in 2002. The program has since expanded around the country through the Help Me Grow® National Center, which is a program of the Connecticut Children’s Office for Community Child Health that provides technical assistance to affiliates in 25 states and territories.
As part of my presentation, program organizers asked that I identify the key strategies by which Help Me Grow® addresses health disparities. I emphasized three key aspects of our work: a focus on vulnerable children who often elude early detection and typically do not meet the relatively restrictive eligibility criteria of state early intervention programs; support for interventions that strengthen protective factors and enable families to mitigate the impact of early adversity and stress; and the imperative of cross-sector collaboration to address the many adverse influences on children’s developmental outcomes. The reinforcement of the importance of these themes by CDC staff, my three co-presenters, and the audience was validating and inspiring.
While I correctly anticipated the benefits of sharing Help Me Grow® with the large audience for this event and of learning from the presentations of my esteemed co-presenters, I underestimated the value of participating in a remarkably comprehensive planning process. The support, guidance, and critical feedback provided by the course directors and many CDC staff members heavily informed both the content and language of my presentation.
Indeed, CDC leadership and staff expressed an extraordinary level of engagement and interest. Multiple conference call rehearsals enabled CDC staff to provide feedback and suggestions. I finalized my Powerpoint just days before the event, in response to several astute queries posed by CDC Director Tom Frieden. I was so impressed with Dr. Frieden taking the time to raise critical questions on the topic of early childhood interventions in the midst of his managing the Zika outbreak!
The event also afforded me the opportunity to vet several core concepts guiding our work. In view of the CDC’s world-class expertise in research and evaluation, I explored their response to our evaluating the impact of Help Me Grow® on children’s developmental outcomes by examining its success in strengthening families through protective factors known to promote children’s healthy development. While I was encouraged to continue to pursue the collection of long-term outcome data on children’s development and academic success, our demonstration of impact on more proximate measures was regarded as evidence of the effectiveness of Help Me Grow®.
I also tested our premise that developmental promotion of all children is an even more ambitious priority than the prevention of delays and disorders. I was gratified that the Centers for Disease Control and Prevention endorsed promotion as our penultimate goal. In fact, a post-event letter from Director Frieden endorsed the critical importance of developmental promotion.
I returned home from my visit to Atlanta even more confident as to the relevance and importance of our work in advancing developmental promotion, early detection, and linkage to services.