Helping Kids Grow is an innovative approach to assuring the health, development and school readiness of preschool children. From its inception the focus has been on supporting parents who are the caretakers, educators, nurturers, and the key to a child’s development.Helping Kids Grow is a community case management model that provides support from birth to age five for all 3,800 families in the community with preschool children. It is supported by a core partnership between child health and education advocates who formed an Early Childhood Taskforce.
Families are actively engaged shortly after the birth of their child and guided with timely reminders, age appropriate information, and periodic developmental screenings to ensure the proper growth and development. The products and services are called “One for the Money”, “Two for the Show”, “Three to Get Ready” and “Four to Go”.
A multifaceted evaluation of the program has shown positive outcome measures.
In the City of West Allis and the Village of West Milwaukee, a significant number of children entering kindergarten have developmental delays that impede their ability to succeed in school. For years, the West Allis Health Department provided traditional public health nursing services to families with newborn children. Copies of birth certificates are received by the department and letters are sent to families offering services. Home visits are made by public health nurses if problems were indicated on the birth certificate or if referrals were made by hospital discharge planners. Client cases were closed when the infant’s condition stabilized and offers were made to contact the health department for additional assistance, which rarely were accepted. The health department, which provides school health services, would see the families again during kindergarten registration and would see a number of undiagnosed health and developmental deficits of the incoming children, including hearing and vision problems, developmental delays, and poor immunization status.
Kindergarten teachers and elementary school principals would also decry the readiness to learn of children entering school. Significant numbers of children were found to have developmental and educational deficits and were referred to exceptional education services for remedial services.
The first five years of life are incredibly important in a child’s development and parents have a difficult time at this stage. It was this need to support parents that prompted officials from the West Allis-West Milwaukee School District and West Allis Health Department to convene an Early Childhood Taskforce to address supporting parents of pre-school children.
The process differed significantly from similar early childhood programs in other communities in that the target population was global; all families with pre-school children were provided support, not just children labeled high risk. This innovation has been called a Community Case Management Model.
The call to join the Early Childhood Taskforce attracted a diverse and dedicated group of individuals. They spent over a year in organizing, assessing the community, and developing a comprehensive community improvement plan for children from birth to five years of age.Two of the volunteer parents co-chaired the taskforce during this development phase and guided by a school readiness assessment and planning tool completed the planning process. The process involved the creation of three committees: Maternal and Child Health, Early Childhood Education and Parenting. Each committee conducted community assessments, which included a community health survey, a survey of kindergarten teachers, and a family survey of all parents of children entering kindergarten.
The assessment brought the problems into focus. The health department led the maternal and child health assessment and found that 35 percent of two-year-old children were not properly immunized and 12.6 percent of children were defined as having lead poisoning. School district staff and parents led the early education assessment that included a survey of public and private kindergarten teachers. The survey revealed that 21 percent of children entering kindergarten were unprepared to learn in terms of intellectual abilities (e.g. knowledge of shapes, colors, numbers, etc.), 16 percent had behavioral problems that prevented them from concentrating on school work and 6 percent had physical problems (e.g. vision, hearing, speech, etc.) that limited their ability to learn. Parents led the parenting assessment through interviews with parents of children that were entering school. The findings demonstrated that parents wanted resources and support in raising their children.
When the planning phase was completed, it provided a blueprint for achieving specific community goals to improve the well-being of pre-school children. The activities and services collectively came to be called Helping Kids Grow.
The taskforce does not have a budget nor does it control funds necessary for the programs it sponsors. Partners in the taskforce have taken the fiscal responsibility for the various programs and events conducted. This has created a varied and diverse funding mechanism that draws on many sources and thus has resulted in fiscal stability. In addition to the 2003 sources of funding for each program below, a tremendous amount of in-kind and voluntary support comes from members in the taskforce.
"One for the Money" and "Two for the Show" programs are funded by the West Allis Health Department. The event, "Three to Get Ready," is operated solely with volunteer support. A small grant is provided annually by the West Allis Rotary Club for supplies and miscellaneous expenses. "Four to Go," the West Allis-West Milwaukee School District's Four-year-old Kindergarten Program, is funded by the district as part of their overall budget. A breakout of funds dedicated to run this program is not available. The three Family Resource Centers are funded by a variety of community resources, including the City of West Allis, United Way, West Allis Rotary Club and a Wisconsin Brighter Futures Grant. In addition, the entities that lease the space for the resource centers charge greatly reduced rent or no rent. The funding for the Parenting Newsletter is a collaborative effort between West Allis Memorial Hospital, West Allis Rotary Club, West Allis Kiwanis Club, and West Allis Health Department volunteers. The community hospital has pledged to cover all of the mailing costs and two community service clubs make periodic donations for the printing costs.
Helping Kids Grow is a comprehensive and multi-faceted approach to early childhood readiness. Progress toward achieving the goal of school readiness and child development is measured annually.
Immunization audits are conducted each year to measure compliance with immunization recommendations for two-year-old children. When children enter kindergarten they are required to provide an immunization record that includes dates of vaccination. Public health nurses conduct a "Look Back" audit of these records annually to see if the recommended immunizations were received by age two. Since the inception of the Early Childhood Taskforce in 1994, immunization compliance rates for two-year-olds have increased from 65 percent to 78 percent in 2002.
Child lead poisoning poses a significant risk in the community where 97 percent of the housing stock can potentially contain lead-based paint. Wisconsin law requires laboratories and medical providers to report the results of blood lead screening to the State Division of Public Health. Rates of lead poisoning within communities can be found in this database. After intensive efforts by the health department and the connections with parents through "One for the Money" and "Two for the Show," lead poisoning rates of children under the age of five have decreased from 12.7 percent in 1996 to 4.2 percent in 2002.
Children that have attended "Three to Get Ready" have been tracked and their scores from mandatory kindergarten screening were compared with the total population of children entering kindergarten. For 2003, children that participated in "Three to Get Ready" had a failure rate of 5.5 percent versus a failure rate of 12.2 percent for the entire population of children entering kindergarten. Children participating in other Helping Kids Grow programs will be tracked and scores compared for the kindergarten screening.
In retrospect, the time spent investing in organizing and planning built a solid foundation of commitment that has sustained the efforts of the taskforce.
For a program of the scope and magnitude of Helping Kids Grow, there are several challenges. One challenge is keeping parents engaged in the process. The taskforce has had to continue the dialogue with parents in an aggressive, not a passive manner. This approach involves continued outreach, contact, and requests for parents to partner with the taskforce to assure that their pre-school children are ready to achieve academically on that first day of school.
Another challenge is the mobile nature of families. Forty-two percent of housing units in the two communities is rental property. Staff have had to conduct ongoing outreach in immunization clinics, the WIC program, and city newsletter, to contact families that have recently moved into the community and inform them about the services of Helping Kids Grow for their preschool children.
There have also been many lessons learned from Helping Kids Grow and include the following:
Build a strong foundation by investing time in identifying a shared vision and shared values for the partnership.
Take the time necessary to thoroughly assess needs and develop a comprehensive plan. In retrospect, this time spent really helped to solidify the group and help foster a sustained community effort.
Develop evaluation methodologies as part of the planning process. Some mistakes were made in the project where data systems did not exist or data sets were not gathered which hampered project evaluation.
The minimum steps to replicating Helping Kids Grow in any community is as follows:
Cast a big net. The resources and skills needed to support parents of preschool children are varied and many. When organizing the community make sure you bring in the organizations, individuals, and especially parents that you will need to make your project a success.
Build a solid foundation of commitment. Spend the time necessary to create a shared vision and conduct a thorough assessment and plan of action, which includes outcome evaluations.
Create a diverse funding mechanism. You will be amazed at the resources your non-public health partners can bring to the project, which will enhance your fiscal stability.
Prioritize Projects. The commitment to improve child development and school readiness is a long-term process and every goal cannot be accomplished immediately.
Celebrate the success.