Developing a Comprehensive and Coordinated Early Childhood System of Care: Integrating Multiple Perspectives and Priorities

Creating a comprehensive and coordinated early childhood system of care is a critical goal for communities.  When working, these systems promote early identification of children and families and link them to appropriate supports, preferably evidence based services.  Because each child presents with a unique constellation of needs and has different points of entry into the system, a full continuum of prevention supports embedded in community settings is necessary to promote healthy development before behavioral or contextual risks become resistant to change.  This is a tall order, and a breakdown in any part of the system may lead to children falling through the cracks or, alternatively, referred to ineffective and uncoordinated services. 

This roundtable discussion brings together individuals involved in the dissemination and refinement of one state’s comprehensive early childhood system of care.  These panelists include (a) the Perinatal and Early Childhood Team Lead from the state Department of Health (and PI for the state’s Early Childhood Comprehensive System grant), (b) a senior academic prevention scientist and program evaluator, (c) a clinical psychologist involved in program development, service delivery, and infant mental health training, (d) a pediatrician and Pediatric Residency Training Director whose clinic is a key community partner, and (e) the Director of the state’s evidence-based home visiting system.  The discussant has conducted system change assessments for program evaluations associated with the state’s early childhood system of care initiatives.  Together, these individuals represent multiple settings, roles, and initiatives within the state.  Due to the small size of our state and individuals’ involvement in multiple projects, our panelists bring unique perspectives about coordinated care that allow for enhanced depth and breadth of conversation. 

We will address the following interrelated questions:

1. What promotes the development of a comprehensive and coordinated early childhood system of care?
2. How do we meet the continuum of needs for children and families?
3. What contributes to breakdowns in parts of the system?
4. How do we identify and prevent systemic schisms?

Anticipated themes for discussion include:

1. Strategies for integrating multiple priorities and perspectives (e.g., multiple system levels, multiple funding agencies, multiple initiatives);
2. Supporting and incentivizing collaboration and communication amongst stakeholders and across disciplines;
3. Promoting the use of evidence based practices (e.g., model fidelity, community adaptation);
4. Relevance of workforce development and training;
5. Importance, impact, and design of program evaluation and data systems;
6. Encouraging sustainability.