Illinois Chapter, American Academy of Pediatrics (ICAAP) has been awarded a grant from the Health Resources and Services Administration (HRSA) to create a virtual PROTECT center to expand access to resources systemically and statewide, to coordinate efforts among systems and to engage and work with families and communities exposed to trauma to build resilience. PROTECT provides an opportunity to serve these families and communities through a trauma-informed lens. Over the course of three years, PROTECT efforts will include a website, consistent training and messaging modules, coaching guidelines, standards and protocols including systems and care coordination, and policy recommendations.Throughout Illinois, a strong commitment to providing trauma-informed support and quality services for children and families at risk exists among those working in many service sectors, including health care, mental and behavioral health, family support, home visiting, and education. While providing trauma-informed support throughout the lifespan is important, studies show that intervening in early childhood provides significant potential to reduce negative outcomes, which can include difficulties in the classroom setting like learning and behavior problems, poor social and emotional competence, and impaired relationships.Research also shows that the younger children are when they experience trauma, the more vulnerable they are to its effects on brain development.However, it’s unlikely that from one community to another or from one professional or system to another, every early childhood service provider a) has access to resources and training on trauma and toxic stress; b) is supported to implement best practices; and c) coordinates services with other systems interacting with the child and caregivers. In addition, existing resources and training for trauma and toxic stress are often inconsistent. The emerging efforts around trauma in Illinois were created in professional silos or particular communities for specific needs. For efforts to be effective, it is imperative to ensure comprehensive and coordinated training, consulting, and coaching of early childhood professionals. There also must be routine and effective information sharing between systems and consistent messaging to parents and caregivers. Additional work is needed to expand access to high-quality resources systemically and statewide, and to coordinate efforts between systems.
The PROTECT initiative has brought leaders from key early childhood systems and state agencies and initiatives together to address these challenges. Specifically, representatives of the Governor’s Office of Early Childhood Development, the Illinois Department of Human Services (IDHS), the Illinois Department of Children and Family Services (DCFS), the Maternal and Infant Early Childhood Home Visiting (MIECHV) initiative, the Ounce of Prevention Fund, Voices for Illinois Children, Advocate Health Care, the Illinois Childhood Trauma Coalition (ICTC), the Illinois Children’s Mental Health Partnership (ICMHP), Heartland Health Outreach, the Illinois Chapter of the American Academy of Pediatrics (ICAAP), and others will collaborate. ICAAP is the project lead, bringing pediatric experts and community-based medical homes to the table and building on important work of the national American Academy of Pediatrics via its policy statements and technical reportson trauma and toxic stress.The Illinois PROTECT initiative began in July 2013 and is planned for wrap-up in June 2016.
In planning for the initiative, the project leaders chose three core strategies:
- 1) Build community capacity by identifying relevant, existing screening tools and services (training, consulting, and coaching) that providers serving families with young children need and ensuring that these tools and services are both widely available and coordinated between systems;
- 2) Integrate a trauma-informed approach for providers by developing and spreading key messaging that caregivers and other community members can use to engage families about trauma, adverse childhood experiences (ACEs), and toxic stress; and
- 3) Facilitate robust and intentional coordination among systems for children impacted by trauma by identifying and creating joint tools and materials for communication such as system-specific best practices and protocols, including referral and feedback forms to be developed cooperatively by all appropriate systems and shared among them
The leadership also determined to create an implementation and roll-out strategy that would initially serve a limited number of communities. Those communities already engaged in the Illinois Maternal and Infant Early Childhood Home Visiting (MIECHV) project were chosen for many reasons, including identified need and development of an infrastructure for the Illinois PROTECT Initiative to build upon. The MIECHV needs assessment identified geographic regions (the Englewood, West Englewood and Greater Grand Crossing communities in the city of Chicago, Cicero Township, the cities of Elgin and Rockford; and Macon and Vermillion counties) as communities with a scarcity of services such as home visiting, early childhood mental health, and trauma-related services including domestic violence screening and trauma related therapy services. These communities, like others, also struggle with coordination between early childhood systems and lack of integration of medical homes into early childhood systems via routine and effective communications to better meet patient needs. These communities represent sufficient diversity and demonstrated need that makes them appropriate starting places.In its approach, the project will model and promote the Substance Abuse and Mental Health Services Administration (SAMHSA) trauma-informed “Three R’s” approach in each early childhood system. The “Embracing the Three R’s” approach requires programs, organizations and service providers to incorporate three key elements to be trauma-informed: realization of the widespread impact of trauma and understanding of potential paths for healing; recognition of the signs and symptoms of trauma in staff, clients and others involved with the program or system; and response by fully integrating knowledge about trauma into policies, procedures, practices and settings5. As existing efforts within early childhood systems are identified and new systems are engaged and integrated, they will be encouraged to understand and embrace the Three R’s approach, and provided with the tools to do so through the initiative.
Finally, because the availability of training, tools, and best practices alone will not create systems change, another component of the initiative will identify policy strategies to motivate, incentivize, and/or require service providers to participate and become trauma-informed. This activity will occur at the state and system levels with program administrators and may include changes to official policies, revision of service provider handbooks or other guidance, and more.
PROTECT is part of the Chicago Safe Start Collaborative
Project Medical Adviser: Michele Lorand, MD FAAP, John H. Stroger Jr. Hospital of Cook County
Course of Study
Committee Goal: By incorporating training, coaching, and mental health consultation, communities build capacity for and are committed to offering trauma-informed care and services that are of high quality, consistent, and coordinated among providers in multiple settings
Co-chairs: Mary Bergen, MS, LCSW, Illinois Action for Children and Anne G. Studzinski, BS, Illinois Childhood Trauma Coalition
Medical Adviser: Mary I. Dobbins, MD, FAAP, Southern Illinois University School of Medicine
Policy and Systems Integration
Committee Goal: State and system level health, education and social service programs support providers to offer and integrate high quality, coordinated trauma-informed care and services to their fullest extent, as appropriate to the agency or program, through initiatives including but not limited to promulgation of regulations and standards; consensual information sharing for care coordination; educational programs; referral assistance; professional development resources including reflective supervision.
Co-chairs: Carie Bires, Ounce of Prevention Fund and Elena Quintana, PhD, MA, BA, Adler Institute
Medical Adviser: Mariana Glusman, MD, FAAP, Ann & Robert H. Lurie Children’s Hospital
Standards and Protocols
Committee Goal: Children 0-3 and their caregivers receive community-based medical, social and educational care and services that are trauma-informed in diverse settings by incorporating standards and protocol (community wide)
Co-chairs: Ana Maria Accove, IDHS/DCFS, Fiona Anderson, MPH, Heartland Alliance, and Ann Marie Grimberg, MEd, Heartland Alliance
Medical Adviser: Marealita Pierce, MD, FAAP
Project Overview (PDF PowerPoint)