May Monthly Newsletter
Prevention Across the Lifespan: Infancy and Early Childhood
In this Issue:
  • Prevention Across the Lifespan: Infancy and Early Childhood
  • Additional Resources
  • Responding to COVID-19
  • What's Happening Around the Region?
  • Epi Corner: Reducing Substance Misuse Risk Factors in Early Childhood

A developmental approach to prevention helps to ensure that interventions have the broadest and most significant impact. Risk and protective factors and their potential consequences and benefits are organized according to defined developmental periods. This enables practitioners to match their prevention and promotion efforts to the developmental needs and competencies of their audience. It also helps planners align prevention efforts with key periods in peoples’ development, when they are most likely to produce the desired, long-term effects . 1

Research funded by the National Institute on Drug Abuse (NIDA) shows focusing prevention interventions in early childhood (prenatal through age 8) has a significant influence on the child’s family, school, and community. Addressing the risk and protective factors of substance misuse prevention at this stage of life can also significantly influence the mental, emotional, and behavioral health over the child’s lifetime. 2 Some evidence even reveals a positive effect on the genetics of that individual.
 
Below are NIDA’s Principles of Substance Abuse Prevention for Early Childhood: A Research-Based Guide. It highlights seven principles for use in your early childhood prevention work.

  • Principle 1 (Overarching Principle): Intervening early in childhood can alter the life course trajectory in a positive direction. Substance abuse and other problem behaviors that manifest during adolescence have their roots in the developmental changes that occur earlier—as far back as the prenatal period. While prevention can be effective at any age, it can have particularly strong effects when applied early in a person’s life, when development is most easily shaped and the child’s life is most easily set on a positive course.

  • Principle 2: Intervening early in childhood can both increase protective factors and reduce risk factors. Risk factors are qualities of children and their environments that place children at greater risk of later behavioral problems such as substance misuse; protective factors are qualities that promote successful coping and adaptation and thereby reduce those risks. All children have a mix of both. Interventions aim to shift the balance toward protective factors.

  • Principle 3: Intervening early in childhood can have positive long-term effects. Early childhood interventions focus on settings and behaviors that may not appear relevant for adjustment later in childhood or in adolescence, but they help set the stage for positive self-regulation and other protective factors that ultimately reduce the risk of drug use.

  • Principle 4: Intervening in early childhood can have effects on a wide array of behaviors, even behaviors not specifically targeted by the intervention. Because behaviors (both positive and negative) are linked to each other, risk factors for substance use may simultaneously put a child at risk for other problems such as mental illness or difficulties at school. This is why intervening to prevent one undesirable outcome may have a broad effect, improving the child’s life trajectory in multiple ways.

  • Principle 5: Early childhood interventions can positively affect children’s biological functioning. The benefits of intervention are not limited to behavioral or psychological outcomes—research has shown they can also affect physical health. For example, one intervention for young children in the foster care system looked at cortisol level, a biological measure of the stress response. Over time, the stress response of children receiving the intervention showed better regulation and became similar to that of children in the general population.

  • Principle 6: Early childhood prevention interventions should target the proximal environments of the child. The family environment is the most important context across all periods of early child development, and thus parents are a major target of many early childhood interventions. But as a child grows older, he or she typically spends more and more time out of the home, perhaps attending day care, then attending preschool followed by elementary school. Interventions for different age groups and targeting different types of problems should focus on the most relevant context(s)—the home, school, day care, or a combination.

  • Principle 7: Positively affecting a child’s behavior through early intervention can elicit positive behaviors in adult caregivers and in other children, improving the overall social environment. Behavioral changes in children and the adults who interact with them can be mutually self-reinforcing. Improving the child’s family or school environment can, over time, cause the child’s social behavior to become more positive and healthy (or pro-social); this, in turn, can elicit more positive interactions with others and improve the social environment as a result.3

1 Substance Abuse Prevention Skills Training (SAPST), Information sheet 1.10, Developmental Perspective , https://pttcnetwork.org/centers/south-southwest-pttc/sapst-session-1-handout
2 National Academies of Sciences, Engineering and Medicine (2019). Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda.  Washington, DC. The National Academies Pres, PDF available at http://nap.edu/25201 .
3 National Institute on Drug Abuse (March 2016). Principles for Substance Abuse Prevention for Early Childhood https://www.drugabuse.gov/publications/principles-substance-abuse-prevention-early-childhood/introduction
Additional Resources
Self-Paced Online Course: Early Childhood Development: Toxic Stress and Adverse Childhood Experiences
New England Prevention Technology Transfer Center (PTTC)
Those working with young children have long known the importance of early experiences and relationships in healthy child development. Newer terms such as toxic stress and ACEs are used when describing these not-so-new ideas and are particularly important when working with families impacted by substance misuse. During this online training, learners will expand their current knowledge about early development to include up-to-date science that is accessible and useful in daily real-life interactions. Using a case-based approach, participants will apply new knowledge to familiar scenarios to enhance their engagement with high-risk young children and families.

Webinar Recording: Preventing Adverse Childhood Experiences (ACEs) in the Hispanic and Latinx Communities
National Hispanic and Latino PTTC
This webinar offers an overview of Adverse Childhood Experiences and its impact on population health with the emphasis on the prevention of ACEs in the Hispanic and Latinx communities by fostering resilience and building self-healing communities.

Webinar Recording: Exploring HOPE - Healthy Outcomes from Positive Experiences
Northwest PTTC
The Science of the Positive framework is based upon the realization that ‘The Positive’ exists in ourselves, our communities, and our cultures. The new language of HOPE – Healthy Outcomes from Positive Experiences utilizes The Cycle of Transformation which includes domains of Spirit – Science – Action – Return. Through science, this webinar explores the powerful lifelong effects of positive childhood experiences even in the midst of adversity. . This session will conclude by providing attendees with flexible building blocks to apply HOPE at individual, family, community, and societal levels to prevent adversity, support resilience, and promote healing and health equity based upon positive childhood experiences (PCEs).
 
Webinar Recording: Identifying Drug Endangered Children: A Collaborative Approach
Mid America PTTC
In this webinar, you will gain an awareness of drug endangered children and the risks they face. You will learn about the many opportunities (often missed) to identify children living in dangerous drug environments. The benefits of intervention at the earliest possible point to reduce physical and psychological harm to children will be emphasized. Learn what a multidisciplinary collaborative response looks like and how it incorporates the unique resources within a community and applies them in a manner that provides better care for drug endangered children.
Responding to COVID-19
Below is a collection of COVID-19 resources to help you with prevention planning. You will also find great information to share with your coalition and community members. 

Pandemic Response Resources
Prevention Technology Transfer Center
This site hosts a collection of resources that will help prevention professionals better provide services during the COVID-19 pandemic. Federal, PTTC, evidence-based prevention programs, and leadership resources are available now.
 
A Series: Challenges and Opportunities of the COVID-19 Work Environment
Northwest PTTC
Are you feeling a lack of connection and support with colleagues? Missing your break time with co-workers? Bring your morning coffee or tea to this series of 30-minute coffee breaks with colleagues. This is a time to connect and share challenges we’re experiencing and explore strategies for being well and productive while working in this new COVID-19 reality.
 
Webinar Recording: Building Resiliency and Protective Factors During Challenging Times  
CADCA
During these challenging times, coalitions can play a key role in ensuring families and communities implement strategies that build resiliency and strengthen attachment and connectedness among youth. Resilience is the ability to thrive, adapt, and cope despite tough and stressful times. The presence of caring adults and stable environments are necessary components for a child’s healthy development and for building resilience and protection. Specifically, safe, stable, and nurturing relationships between children and their parents or caregivers can act as a buffer against the effects the stresses experienced during this corona virus pandemic. This webinar provides practical information, hands-on tools, and resources that coalitions can share with coalition partners and families in the community.  

Guidance for Supporting Young Children Through COVID-19
Defending the Early Years
This guide contains resources and recommendations for parents and educators, including supporting play, communicating with loved ones, establishing routines, thoughts on screen-time, and how to talk to young children. Please download the PDF and share with others. No other permission is needed.
 
Kids Coping with the COVID-19 Pandemic
Mayo Clinic
COVID-19 (corona virus disease 2019) has become a source of daily conversation. As a caregiver, you may be wondering how to support your kids' developmental needs and understanding of COVID-19. Honest and accurate discussions with children about COVID-19 can help them understand what's happening, relieve some of their fears, make them feel safe, and help them begin to cope.
A great document to share on social media to support healthy child responses to COVID in your community.
What's Happening Around the Region?
COVID-19 Needs Survey

The South Southwest PTTC is conducting a training and technical assistance needs survey during the COVID-19 pandemic to better respond to the needs of prevention professionals during this time.

We ask that you complete the survey before Monday, June 1. Your input is important to us! The survey takes less than 10 minutes . Thank you!
Prevention Technology Transfer Center, Substance Abuse Prevention Skills Training (SAPST) Trainer Learning Community and Materials Portal

The PTTC Network now has a Learning Community and Materials Portal specifically for SAPST trainers and training coordinators who plan and coordinate the delivery of the SAPST four-day face-to-face training. Inside this virtual community, one will have access to the updated SAPST materials, upcoming SAPST and SAPST ToT events, and training tips from SAPST master trainers. Individuals will be able to connect with other SAPST trainers from across the U.S. and share ideas and resources. To register for the PTTC SAPST Trainer Learning Community and Materials Portal, visit www.tinyurl.com/SAPSTLearningCommunity .

For more information about how the PTTC Network supports the SAPST please visit: https://pttcnetwork.org/centers/global-pttc/network-sapst .
NEW Self-guided Learning Courses
 
Informing Prevention: Adolescent 6-part Webinar series
  • Informing Prevention: Understanding Adolescent Development (1 of 6)
  • Informing Prevention: Effectively Engaging Adolescents in Interventions (Part 2 of 6)
  • Informing Prevention: Effective Use of Epidemiological Data (Part 3 of 6)
  • Informing Prevention: Effectively Using Technology for School-Based Prevention (Part 4 of 6)
  • Informing Prevention: The Effects of Drug Use on Adolescent Brain Development (Part 5 of 6)
  • Informing Prevention: Vaping Among Adolescents (Part 6 of 6)

Today’s Marijuana: Stronger, More Edibles, Confusing Information about Driving

Early Childhood Development: Toxic Stress and Adverse Childhood Experiences
 
Online Courses
All online courses can be accessed at: healtheknowledge.org/courses
 
If you are new to HealtheKnowledge, please log in or set up an account here: healtheknowledge.org/new-user
2020 PFS Academy: Making the Steps of the Strategic Prevention Framework Work for You.

Each webinar will begin at 8:00 PT/9:00 MT/10:00 CT/11:00 ET

SAMHSA’s Strategic Prevention Framework (SPF) provides practitioners with comprehensive guidance to more effectively address substance misuse and related behavioral health problems in their communities. This seven-part webinar series will explore this five-step, data-driven process to identify genuine prevention needs, build capacity and plans to address those needs, implement effective programs and interventions, and evaluate and continually improve prevention efforts.

At each step of the SPF, and in separate sessions, practitioners will learn to incorporate the guiding principles of cultural competence and sustainability to help support the implementation of SAMHSA’s Strategic Prevention Framework (SPF). 

Certificates for prevention hours will be available upon registration and completion of the webinar.
 

  • June 23, Part 5: Evaluation, will offer helpful guides for the collection and analysis of prevention strategies and teach participants how to modify programming for future enhanced results.

  • July 21, Part 6: Sustainability,will provide participants with the elements needed for a sustainable prevention program and how to integrate sustainability into each step of the SPF.
 

Previously recorded training in the series can be found here by clicking on the training tab.
Why Context Matters: Towards a Place-Based Prevention Science Free Virtual Conference

Society for Prevention Research (SPR) 2020 Annual Meeting
July 21-23
As the premiere prevention research conference, the SPR Annual Meeting provides a unique opportunity to advance the vision of SPR by providing a centrally integrated forum for the exchange of new concepts, methods, and results from prevention research and related public health fields; and by providing a forum for the communication between scientists, public policy leaders and practitioners concerning the implementation of evidence-based preventive interventions in all areas of public health. Registration is free to all attendees.
The South Southwest PTTC is currently suspending in-person training and meetings until further notice. Virtual services will proceed as scheduled.
Epi Corner

Iris Smith, Ph.D., M.P.H.
South Southwest Prevention Technology Transfer Center
Reducing Substance Misuse Risk Factors in Early Childhood

Research has shown that infancy and early childhood are sensitive periods of the human developmental trajectory. This is also a period of rapid neurodevelopment influenced by both biological and environmental factors. 1 Animal and human studies have demonstrated that early life experiences including the absence of a nurturing family environment, abuse/neglect, and early exposure to trauma can increase an individual’s predilection to addiction later in life by influencing neurobiological pathways in early childhood. 2 Adverse childhood experiences (ACEs) can be especially damaging when they are extreme, frequent, and persistent during childhood. The repeated exposure to childhood stress (sometimes referred to as toxic stress) is not unusual in child refugees but has not been widely studied in children who grow up in communities plagued by poverty, violence, drug use, and crime. 3, 4 A 2001 study of 300 children in foster care found that 87% had witnessed or experienced at least one traumatic event and 48% had multiple exposures. The types of exposures included both domestic and community violence, including weapon-involved assaults. 5

Despite the recognition that ACEs experienced by young children are associated with substance use, physical and mental health, and other problems in adulthood, evidence-based strategies for prevention and intervention are only beginning to emerge. A systematic review by Marie-Mitchell & Kostolansky (2019) found that multi-component strategies incorporating parenting education, mental health counseling, social support, and social service referrals are effective in reducing the impact of early childhood trauma. 6 At the community level, reducing risk factors for ACEs include a focus on systemic risk and protective factors such as strategies to reduce community and domestic violence, enhancing support and resources for families at risk. Successful implementation depends upon community readiness, support, and partnerships with multiple community agencies. A detailed inventory of evidence-based school and community prevention programs can be found in, Fostering Healthy Mental, Emotional and Behavioral Development in Children and Youth: A National Agenda Part II; pgs. 91-163 ( National Academy of Sciences, 2019)

Data collected as part of the initial needs assessment can help community stakeholders identify and assess the scope and severity of salient community risk factors as well as potential protective factors which can be augmented as part of a coordinated community strategy. Collaborative problem analysis using local data can be an effective way to engage stakeholders and increase overall community readiness to support prevention strategies. Ross and Arsenault (2018) describe an effective approach for engaging community stakeholders in problem analysis that helped them to identify the relationship between early childhood trauma and gang violence using local data. 7  

Perhaps one of the most challenging aspects of prevention science is how to successfully “scale up” evidence-based interventions. Programs that demonstrate effectiveness in a limited community trial may not achieve the same level of impact when replicated on a larger scale. Implementation science is a relatively new discipline that is focused on identifying the necessary components of successful scale up strategies. A study by Keating et al (2019) provides a detailed description of the implementation of ACE screening in a pediatric clinic serving a predominantly Latinx population. 8 These researchers utilized community-based participatory research (CBPR) methodology to engage the community in a collaborative effort to address health equity, the barriers, and facilitators of the screening protocol. Studies of this type can provide valuable insights for future replications of evidence-based programs.

Epi Resources

National Academies of Sciences, Engineering and Medicine (2019). Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda.  Washington, DC. The National Academies Pres, PDF available at http://nap.edu/25201 .


Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence
 
Ross L & Arsenault S (2017). Problem analysis in Community Violence Assessment: Revealing Early Childhood Trauma as a Driver of Youth and Gang Violence.  Int J Offender Ther Comp Criminol 62(9); pg. 2726-2741.
 
Kia-Keating M, Barnett ML, Liu SR, Sims GM, Ruth AB (2019). Trauma-Responsive Care in a Pediatric Setting: Feasibility and Acceptability of Screening for Adverse Childhood Experiences, American Journal of Community Psychology, 64 (3-4), pg. 286-297.


References

1 National Academies of Sciences, Engineering and Medicine (2019). Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda.  Washington, DC. The National Academies Pres, PDF available at http://nap.edu/25201 .

2 Strathearn L, Mertens CE, Mayes L, Rutherford H, Raihans P, Xu G, Potenza MN, Kim S (2019). Pathways Relating the Neurobiology of Attachment to Drug Addiction.  Frontiers in Psychiatry 10 , pg. 737

3 Murray JS (2018). Toxic Stress and Child Refugees. Journal for Specialists in Pediatric Nursing, 23 (1); https://doi.org/10.1111jspn.12200 .

Fratto CM (2016). Trauma-Informed Care for Youth in Foster Care; Archives of Psychiatric Nursing, 30 (3) . 10.1016/j.apnu.2016.01.007
 
5 Stein BD, Zima BT, Elliott MN, Burnam A, Shahinfar A, Fox NA & Leavitt, LA (2001). Violence Exposure Among School-age Children in Foster Care: Relationship to Distress Symptoms.  Journal of American Academy of Child Adolescent Psychiatry, 40 (5) ; pg.588-594.

6 Marie-Mitchell A & Kostolansky R (2019). A Systematic Review of Trials to Improve Child Outcomes Associated with Adverse Childhood Experiences.  American Journal of Preventive Medicine, 56 (5 ); pg. 756-764.

7 Ross L & Arsenault S (2017). Problem analysis in Community Violence Assessment: Revealing Early Childhood Trauma as a Driver of Youth and Gang Violence.  Int J Offender Ther Comp Criminol 62(9); pg. 2726-2741.
 
8 Kia-Keating M, Barnett ML, Liu SR, Sims GM, Ruth AB (2019). Trauma-Responsive Care in a Pediatric Setting: Feasibility and Acceptability of Screening for Adverse Childhood Experiences, American Journal of Community Psychology, 64 (3-4), pg. 286-297.