Have you ever... Healthy mental development in the first five years

...had a family who is continually missing or rescheduling well-child visits due to family stress or challenges such as transportation? ...been concerned about a parent or caregiver’s stress or possible depression, but not been able to ask due to lack of time, screening tools, or referral resources? ...made a referral and been left wondering, “Did they make the call?” or “What was the outcome?” ...been concerned that parental issues may be negatively impacting the current and future social and emotional development of a child you are seeing?

1st Five can help! The 1st Five Healthy Mental Development Initiative builds a support system for families between medical practices, child health agencies and a wide variety of local services.

For more information about the 1st Five Healthy Mental Development Initiative, contact your local agency as listed on the insert or contact the state coordinator at 1-800-383-3826. For more information on the recommended early childhood standardized surveillance tools, go to www.iowaepsdt.org.

Components of a well-child exam The primary goal of routine preventive health care is to ensure that a child is developing normally, which includes social and emotional development. Health history Developmental screening Social history (including family stress and parental depression) Vision/hearing screening Complete physical exam, including dental screening Lab tests, including lead screening Immunizations Advice on what to expect and how to keep your child healthy

1st Five Information for Health Care Providers

Primary Care Physicians and Social/Emotional Development Over 90% of Iowa families take their children to a primary care provider before age 5. Primary care providers have a unique opportunity to play an important role in early identification and treatment for children’s developmental issues. In the first years of life, children rapidly develop the social and emotional capacities that prepare them to be self-confident, trusting, empathetic, intellectually inquisitive, competent with language, and capable of relating well with others. With the proper tools, a primary care provider can identify risk factors for poor social and emotional development.

Research on early child development... Nationally, 71% of pediatricians use only observation of development to screen children; however, clinical observation used in isolation identifies only 30% of young children with developmental concerns. While 15-18% of school-aged children have a developmental or behavioral disability, less than 50% are identified prior to starting school. If not identified early, these children are at risk for school failure.

What is 1st Five? Iowa’s 1st Five Healthy Mental Development Initiative builds partnerships between physician practices and public service providers to enhance high quality well-child care. 1st Five promotes the use of validated developmental surveillance tools that support healthy mental development for young children. By using a surveillance tool, which includes social/ emotional development and family risk factors, for all children, providers are able to identify children at risk for developmental issues that would play out later in life if left untreated. 1st Five has been legislatively funded since 2006. Seven child health agencies are implementing 1st Five, covering 17 counties and 60 medical practices.

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Emotional development in young children is now known to be as important as physical, cognitive and language development.

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Provider identifies patient with a need for referral

The foundations for school success, learning and general well-being are established before a child enters kindergarten. Children of depressed mothers are 6-8 times more likely to have a depressive disorder and five times more likely to develop a conduct disorder.

What can 1st Five do for medical practices? Promote primary care provider use of validated surveillance and screening tools to assess social and emotional development and family risk factors. Help providers integrate these tools into their practices. Link children and families to community resources and services to access appropriate follow-up care. Provide feedback on the referral process for each child and family.

What can medical practices do? Use validated surveillance tools for all children birth to five at well-child visits. Use appropriate developmental screening tools at ages recommended by the American Academy of Pediatrics. Identify children at risk as early as possible.

Referral is sent to 1st Five

Refer to local child health agency for early intervention services and community resources.

How does 1st Five work? 1st Five care coordinator follows up with the provider on the patient’s status

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1st Five contacts the family and links them with appropriate intervention services

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Making a Difference One Family at a Time