FRONT COVER STATE OF EARLY CHILDHOOD ON GUAM A Progress Report of Guam’s Early Childhood Comprehensive System of Services and Supports SEPTEMBER 2011 This publication is 100% federally funded by the U.S. Department of Health & Human Services, Health Resources & Services Administration, Maternal Child Health Bureau, Grant No. H25MC06097, administered by the University of Guam, Center for Excellence in Developmental Disabilities Education, Research, & Service (UOG CEDDERS) in partnership with the Governor’s Early Learning Council. Page 2 – Full page photo of parents kissing newborn baby Hafa Adai! Welcome to the second edition of the “State of Early Childhood on Guam: A Progress Report of Guam’s Early Childhood Comprehensive System of Services and Supports – September 2011.” We are pleased to report that the child-serving agencies on Guam continue to work together to improve supports to our island’s young children birth to eight years old. Focusing on a “systems change” approach to improve supports to our young citizens is an often times slow moving and challenging process. The first step in this process is to bring all child-serving organizations to “one table” to meet regularly to address issues that impact this vulnerable population. A second step is to look at the mission of each entity and recognize that there are more commonalities than differences, and as such, we should all aim to look beyond our theoretical boundaries and strive to create collaborative programs that ideally evolve to “seamless systems” to meet identified goals and provide services that deliver a full array of needed supports to our little ones and their families. In the two years since our last report, several major accomplishments have taken place to help existing systems evolve and grow. While Executive Order 2008-03 established the first Guam Early Learning Council in 2008, the Council has now been formalized legislatively with the enactment of Public Law 31-62, “An Act….Relative to Establishing The Guam Early Learning Council For Guam’s Early Childhood Comprehensive System” which was passed by I Mina’trentai Unu Na Liheslaturan Guåhan on May 10, 2011, and signed into law by Governor Edward J.B. Calvo on May 24, 2011. This legislation is included towards the end of this report. Following the mandate of this law, a new Guam Early Learning Council was appointed. A membership listing is included on page 25 with the 33 governor-appointed members who were sworn in on June 28, 2011. Another key accomplishment, over seven years in the making, was the enactment of Public Law 31-73, which establishes the administrative rules and regulations of the Department of Public Health & Social Services relative to child care centers and group child care homes. This law updates child care regulations that have not been revised since they were first established in 1978! Other achievements are highlighted on the following pages. In addition to what is reported, please know that there are many dedicated individuals in our community that are working very hard towards a well-coordinated comprehensive system of services and supports for our young children birth to eight years old aimed at helping each child reach his or her full potential. Christine Calvo First Lady of Guam Co-Chairperson Elaine B. Eclavea Project Tinituhon Director Co-Chairperson Page 4 PROJECT TINITUHON STRATEGIC MANAGEMENT TEAM PROJECT TINITUHON STRATEGIC MANAGEMENT TEAM FOCUS AREA WORK GROUPS Access to Health Insurance and Medical/Dental Home Ma. Theresa Arcangel, DPHSS Vera Blaz, UOG CEDDERS facilitator Daryl Diras, DPHSS Estela Gapas, PNG Child Care & Learning Center Margarita Gay, DPHSS Brihinia Habin, NetCare Life & Health Cathy Schroeder, DOE Head Start Suzanne Sison, D.D.S., DPHSS Roselie Zabala, DPHSS Social Emotional Development and Mental Health Terry Aguon, DPHSS Tom Babauta, DOE Special Education Mariles Benavente, UOG CEDDERS Florence Blas, DPHSS Bonnie Brandt, UOG CEDDERS Evelyn Claros, Parent Sherry Cruz, DOE, Guam Early Intervention System Cheryl De Roca, UOG CEDDERS facilitator Elaine Eclavea, UOG CEDDERS Margarita Gay, DPHSS Patricia Mantanona, DOE, Guam Early Intervention System Ann Marie Cruz, Guam Positive Parents Together Lilli Perez, Ph.D., DPHSS Carmen Quenga, DOE Head Start Suzanne Sison, D.D.S., DPHSS Lydia Tenorio, DPHSS Cathy Tydingco, DOE, Guam Early Intervention System Roselie Zabala, DPHSS Early Care and Education and Child Care Carmen Babauta, DPHSS Vera Blaz, UOG CEDDERS facilitator Clare Camacho, Ph.D., GCC Teresita Catahay, DPHSS Delilah Charfauros, Guam Child Care & Development Association Arlene Cura, Head Start & Technical Asst. Office Michele Huffer, Adventures in Learning Child Development Center Ruth Leon Guerrero, DOL Cathy Schroeder, DOE Head Start Lydia Tenorio, DPHSS Ama Underwood, Honey Bear Kids Center Parent Education and Family Supports Margaret Bell, DPHSS Stasia Borja, Parent Diana Calvo, Catholic Social Services Pauline Camacho, Guam PIRC Roy Candaso, DPHSS Evelyn Claros, Parent Mary-Therese Edgerle, G.I.F.T.S. Margarita Gay, DPHSS Jeffrey Pinaula, UOG CEDDERS facilitator Carmen Quenga, DOE Head Start Laura Taisipic, DOE Sped Parent Services Project Tinituhon Staff Elaine Eclavea, Project Director Vera Blaz, Project Training Associate Jeffrey Pinaula, Project Research Associate Terry Naputi, Early Learning Council Assistant Tamara S. Flores, Project Office Technician Ruth Leon Guerrero, Project Office Technician Agency & Organization Key DOE - Department of Education DOL - Department of Labor DPHSS - Department of Public Health & Social Services GCC - Guam Community College G.I.F.T.S. - Guam Identified Families with Terrific Strength Guam PIRC - Guam Parent Information Resource Center UOG CEDDERS - University of Guam Center for Excellence in Developmental Disabilities Education, Research & Service Page 5 GUAM’S EARLY CHILDHOOD SYSTEM Timeline Year & Event 2000 – Neurons to Neighborhoods 2002 – President Bush’s EC Initiative: Good Start, Grow Smart 2004 – Executive Order: ECCEC2004-14 2004 – Guam Comprehensive Plan for the Care and Education of Young Children Birth to 5 Years 2005 – Project Tinituhon, “The Beginning” Guam’s Early Childhood Comprehensive System 2007 – The Science of Early Childhood Development “Closing the Gap!” 2008 – Guam’s Early Learning Council 2009 – Project Kariñu: Early Childhood Mental Health System of Care 2010 – PROJECT BISITA I Familia Infant & Early Childhood Visitation Program 2011 – PL 31-62 Establishing the Early Learning Council Footer: State of Early Childhood on Guam 2011 / 3 Text in colored column: Tinituhon |Tee nee t? hon | The Beginning of a child’s early life experiences requires that basic needs are met, to include a feeling of safety and security with a sense of belonging and love, in order to set the stage to grow to become well-adjusted, healthy, and productive adults. OVERVIEW-2011 Project Tinituhon, (Tee´nee t? hun), is a collaborative project designed to enhance and refine the planning, development, implementation, and maintenance of an island-wide, cross-agency Early Childhood Comprehensive System (ECCS) to support families and the community of Guam in developing and nurturing young children who are healthy and ready to learn at school entry. The Chamorro word Tinituhon, “the beginning,” communicates how Guam has embraced the physical, social, emotional, and educational needs of its youngest citizens. The beginning of a child’s early life experiences requires that basic needs are met, to include a feeling of safety and security with a sense of belonging and love, in order to set the stage for young children to grow to become well-adjusted, healthy, and productive adults. Project Tinituhon is a federal grant awarded by the U.S. Department of Health & Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. During the first four years of funding from 2005 to 2009, the Early Childhood Comprehensive Systems (ECCS) grant was awarded to the Guam Department of Public Health & Social Services, and administered through a contract with the University of Guam Center for Excellence in Developmental Disabilities Education, Research, & Service (UOG CEDDERS). In spring 2009, UOG CEDDERS submitted the grant application for continued funding of the Project, and was awarded the grant in June 2009. UOG CEDDERS continues to administer this grant at present. The goal of Project Tinituhon is to promote the health and well-being of young children by reducing the gaps in and improving the coordination of services for all young children and their families. This project is supported by Guam’s first planning and implementation ECCS grant, which provides the means for facilitating collaborative and coordinated services between public and private early childhood service agencies, organizations, and families. Strategic Management Teams (SMTs) meet to continue carrying out the goals, objectives, and activities across four areas of focus: 1) Access to Health Insurance & Medical/Dental Homes: 2) Social Emotional Development and Mental Health; 3) Early Care and Education & Child Care; and 4) Parent Education & Family Support. Accomplishments in these areas, along with System Sustainability, a new area of focus added in 2009, are detailed in this report. Footer: 4 NEXT STEPS-2012 Overall next steps for Project Tinituhon include: • Coordination and collaboration for data collection and information sharing; • Blending and braiding of resources; • Supporting and directing public awareness and an information campaign through an overall social marketing plan; and • A continued focus on shared outcomes for children and families describing the overall next steps for Project Tinituhon. Access to Health Insurance and Medical/Dental Home • Continue training on developmental screening and movement towards adoption of a standardized developmental screening tool and promotion of the Medical/Dental Home framework throughout the island. • Continue to work with insurance providers to support billing processes within Medicaid/Medicare for both a well-checkup and a developmental screen within one visit. • Work with Health Care professionals to promote Bright Futures programs. Social Emotional Development and Mental Health • Continue training in social emotional development strategies and activities for young children to care providers as well as continue training for families on positive solutions for social emotional development. • Gather data describing baby needs from birth and braid with the Medical/Dental Home and Health Insurance. • Plan for the parents of each baby leaving the hospital to receive a collection of resources on ways to nurture their child's positive growth and development and early childhood services available. • Develop a collaborative and integrated professional development plan to highlight all the training needs of all Early Childhood Agencies and provide cross system capacity building. • Develop a one-point of access for referrals and intakes to serve families and their children with at-risk criterion. Early Care and Education and Child Care • Continue development of a quality rating system with developmental assessment kits to measure child outcomes. • Continue development of a School Readiness plan to ensure that all Guam’s children are ready to learn at school entry. Parent Education and Family Supports • Develop family leadership modules and training plans. • Gather data to better understand parent needs (braided with the Medical/Dental Home and Health Insurance Focus Area). • Publish an updated edition of the Nene Directory. Footer: State of Early Childhood on Guam 2011 | 5 Divider page: Access to Health Insurance and Medical/Dental Home Goal: Increase the number of children who have access to health care. Progress to Date • Project Tinituhon, in partnership with public and private early childhood serving agencies, co-sponsored the “All Eyes on Five Family Information Fair” in May 2010 and participated in the annual “Check Me Out Fair” sponsored by Guam Early Intervention System (GEIS) in November 2010. • UOG CEDDERS, in collaboration with GEIS, conducted a training in January 2011 entitled, “Young Children At Risk…Whom Do I Call?” for 44 early childhood providers, including childcare center directors, early intervention service providers and community health nurses. All participants received the Ages and Stages Questionnaires (ASQ) 3 Developmental Screening Toolkit for use in their respective programs. In addition, information about the Individuals with Disabilities Education Act (IDEA) as well as checklists of possible “red” flags were provided to participants. • The Project Tinituhon Director and Project Coordinator participated in the Association of Maternal & Child Health Programs (AMCHP) annual conference held in Washington, D.C. in February 2011. The Project Director and Project Coordinator attended several presentations on Bright Futures, a national health care promotion and disease prevention initiative that uses a developmentally based approach to address children’s health care needs in the context of family and community. • Project Tinituhon aims to bring Bright Futures to Guam. The SMT for this focus area was introduced to Bright Futures during their bi-monthly meeting in August 2011. The SMT members are developing a plan to bring Bright Futures to Guam and conduct orientations for all health professionals. • The Ages and Stages Questionnaires: Social Emotional (ASQ: SE) Developmental Screening Tool training took place April 2011. This training was a follow-up to the January ASQ3 training. Eleven early childhood providers, including childcare center directors, early intervention service providers, and community health nurses participated in the training. TABLE 1: Number and Percent of Children with Medical/Dental Home Year Total Births on Guam Total Civilian Births Total in ChildLink Number/Percent with indicated physician Number/Percent with Medical Home (% in ChildLink) 2004 3427 2867 2847 31 (1%) 22 (1%) 2005 3203 2798 2764 74 (3%) 29 (1%) 2006 3414 2909 2854 1990 (68%) 238 (8%) 2007 3493 3007 2976 2604 (87%) 414 (14%) 2008 3466 3017 3006 2921 (97%) 426 (14%) 2009 3428 2991 2955 2910 (97%) 772 (26%) 2010 3422 2901 2897 2325 (80%) 1945 (67%) Data Source: Department of Public Health & Social Services Footer: State of Early Childhood on Guam 2011 | 7 Divider page: Social Emotional/Mental Health Goal: Increase early childhood awareness and outreach on the importance of social emotional and mental health development of young children. Progress to Date • The Department of Public Health & Social Services (DPHSS) received an early childhood system of care grant which established Project Kariñu (Loving Our Babies) to develop and implement a system of care for young children birth to five years old. The Strategic Management Team under this focus area has merged with the Project Kariñu Governance Advisory Board. • Project Kariñu held an orientation to inform and gain stakeholder interest and support for the project in May 2010. Project Kariñu also sponsored a presentation on System of Care values & principles and held a strategic planning summit, which featured presentations by consultants from the National Technical Assistance Partnership: Dr. Neal Horen (early childhood mental health content specialist); Bruce Strahl (governance and strategic planning content specialist); Rebecca Ornelas (Regional Technical Assistance Coordinator); and Sandra Spencer (Executive Director of the National Federation for Families). • A Service Delivery Focus group was developed in order to assess the intake/referral process in addition to the types of services to provide children who meet the criteria of “at-risk.” A Training and Capacity Building Focus group was also developed in order to assess the training needs of the community and other early childhood service providers, in addition to the types of knowledge based topics related to early childhood mental health, systems of care, and social emotional development. • Project Kariñu’s Training and Technical Assistance Coordinator attended a national conference on Systems of Care in Los Angeles hosted by Project ABC Los Angeles in February 2011. As part of the conference, the training coordinator attended the session on the mental health consultation model. • Twenty-nine early childhood service providers from DOE-GEIS, DPHSS-BOSSA and CPS Foster Families, and the Maternal and Child Health Bureau participated in a training co-sponsored by Project Tinituhon in collaboration with GEIS and Project Kariñu on the Center on the Social Emotional Foundations for Early Learning (CSEFEL) Social and Emotional Competence for Infants and Toddlers in March 2011. • Project Kariñu was selected to present at Guam’s National Association of Social Workers Conference in March 2011. The focus of this presentation centered on the disparities with mental health services especially for children. • Representatives from collaborating agencies and organizations participated in The Incredible Years training sponsored by Project Kariñu in May 2011. The Incredible Years is a research-based, proven effective program for reducing children’s aggression and behavior problems and increasing social competence at home and at school. • UOG CEDDERS, in partnership with Project Kariñu, hosted Guam’s first Children’s Healthy Development Fair on May 28 at the University of Guam Humanities and Social Science building. The fair featured displays and presentations from over 20 agencies from the Guam Department of Education (GDOE), Head Start, Early Childhood Special Education Program, Guam Early Intervention System, Guam Early Hearing Detection and Intervention Project, Guam Parent Information Resource Center, DPHSS, I Famagu’on-ta, and UOG CEDDERS. • On October 4, 2011, the Social Emotional SMT meeting resulted in the development of a collaborative agreement with all early childhood serving agencies to support an integrated system for referring families to the appropriate early childhood serving agency services and information that meet their particular needs. The Early Childhood agencies agreed to use a universal Standard Operating Protocol for Servicing Young Children with Social Emotional and Mental Health Challenges and their families. The SMT will also serve as the focus group for Project Kariñu’s development of a Professional Development Plan to support the Early Childhood workforce on Guam. Footer: State of Early Childhood on Guam 2011 | 9 Divider page: Early Care and Education and Child Care Goal: Increase availability of and access to quality childcare for all children. Progress to Date • Project Tinituhon published the All Eyes on Five newsletter twice a year. The newsletter provided information pertinent to each of the goals of Project Tinituhon and included information about services and supports available to the community. The September issue of All Eye on Five was disseminated throughout the island, targeting various clinics, childcare centers, and kindergarten classrooms in the public schools, public agencies, and mayor’s offices. The newsletter was renamed I Mandikiki (The Little Ones) to reflect the importance of early care and education from birth through age eight. I Mandikiki was disseminated in May 2011. • In September and October 2010, the SMT for this focus area reviewed and provided input on the social marketing plan stressing the importance of quality childcare. As a result of the feedback, Project Tinituhon worked in collaboration with DPHSS in preparing public awareness materials promoting the importance of updating childcare regulations and standards. Materials such as posters and Frequently Asked Questions (FAQs) pamphlets were produced and disseminated island-wide to childcare centers and pediatric clinics. In addition, advertisements on childcare standards were published in the local newspaper. Project Tinituhon also participated in public hearings in support of legislation. Public Law 31-73, which establishes the updated administrative rules and regulations of the Department of Public Health & Social Services relative to child care centers and group child care homes, was signed into law in June 2011. • Several SMT meetings were held to develop procedures for Guam’s Plan for Professional Development (GPPD) from December 2010 through March 2011. Representatives from University of Guam, Guam Community College, Guam Child Care and Development Association, DPHSS-BOSSA, and UOG CEDDERS met to revise the GPPD. As a result of these meetings, an Early Childhood Professional Development Subcommittee under the Guam Early Learning Council was formed to validate and certify early childhood providers. The Guam Commission on Educator Certification approved the requirements for a Basic Preschool Certificate that will be used by the Department of Education Head Start Program and is incorporated into Guam’s Plan for Professional Development. • Abby Cohen, Region IX State Technical Assistance Specialist from the National Child Care Information and Technical Assistance Center, provided technical assistance in May 2011 for the professional development plan and the development of a Quality Rating and Improvement System (QRIS) for center- and home-based childcare settings. • UOG CEDDERS sponsored a 15-hour training, “Train the Trainer: Implementing the Guam Early Learning Guidelines (GELG) Birth to Five Curriculum” in July 2011. The purpose of these sessions was to provide training to early childhood providers from center-based child care centers, Guam PIRC, Guam Head Start, and Project Kariñu on the GELG Birth to Five Curriculum. • A School Readiness Work Group was formed in July 2011 under this focus area to begin the development of a School Readiness Plan for Guam’s Schools. TABLE 2: Comparison of the Number of Children Served in Early Childhood Setting Early Childhood (EC) Program # Settings # Served 2005 *2011 2005 *2011 Licensed Child Care Centers 50 44 1,994 2,281 Family Home Providers 75 79 163 130 Guam Early Intervention System (GEIS) 1 1 195 275 Private Nursery & Preschool 7 9 184 306 GDOE - Special Education Preschool 5 5 171 177 GDOE Head Start 25 27 500 534 Total 163 165 3,207 3,703 Data Source: UOG CEDDERS Survey, *As of February 2011 Footer: State of Early Childhood on Guam 2011 | 11 Divider page: Parent Education and Family Goal: Increase public awareness of services and supports available for children birth to five and their families. Progress to Date • In May 2010, the "Second Annual Mini-Family Information Fair" was held at Guam Premiere Outlets. This outreach event provided an opportunity for over 100 families of young children birth to five years old to access information about the various services and supports available to families on Guam. • In July 2010, Project Tinituhon participated in the development of the Maternal, Infant & Early Childhood Home Visitation (MIECHV) Needs Assessment. Project Tinituhon continues to work collaboratively with DPHSS-MCHB in developing the implementation plan for home visiting. • In December 2010 & January 2011, SMT members for this focus area met to discuss and provide feedback on the revision of the Nene Directory of Services. The Nene Directory of Services was published and disseminated in April 2011. • Project Tinituhon in partnership with Guam PIRC developed the Guam Early Learning Guidelines (GELG) Curriculum which is used as part of the Guam PIRC home visiting program. Guam PIRC also conducts free early childhood trainings for parents with children birth through five years old. Guam PIRC uses curriculum developed by UOG CEDDERS to conduct trainings on the GELG and “All Learning Opportunities Nurture Growth” (A.L.O.N.G.) Curriculum. The A.L.O.N.G. trainings were conducted in January and March 2011. GELG trainings were conducted in February and April 2011. • The Guam Department of Education, Special Education Division, in collaboration with UOG CEDDERS and GPPT, hosted a Special Education Parent Conference on March 26, 2011. Parents were given resource binders which contained pertinent information about Individualized Education Plans (IEPs). Parents were encouraged to share their accomplishments and challenges in dealing with their child’s IEP during the conference. • The SMT for this focus area hosted the 2011 “Power of Play Interactive Parent Conference” for parents of young children birth to five years old on May 7 at the Guam Sports Complex in Dededo. This conference was an inter-agency collaboration with the Guam Department of Education, Head Start, Early Childhood Special Education Program, Guam Early Intervention System, Guam Parent Information Resource Center, Child Care Centers, and UOG CEDDERS. A total of 60 parents and 104 children attended. • To support Parent Leadership opportunities, Project Tinituhon, in collaboration with Parent Training & Information Centers (PTIs), Guam’s Positive Parents Together, Inc. (GPPT) & Guam Department of Education - Guam Early Intervention System, sponsored a three-day Parent Leadership training on September 27-29, 2011. The training entitled, "Understanding the IFSP (Individualized Family Service Plan) & Changing the Future for Children: A Parent Leadership Opportunity," provided an opportunity for parents to help them advocate for themselves and their children. Footer: State of Early Childhood on Guam 2011 | 13 Divider page: SYSTEM SUSTAINABILITY Goal: Increase supports and services for young children and their families by strengthening cross agency coordination. Progress to Date • Christine Calvo, First Lady of Guam and Elaine Eclavea, Project Tinituhon’s director, continue to co-chair the Guam Early Learning Council (GELC). Project Tinituhon provides updates to its goals and objectives during the GELC quarterly meetings. • The GELC received funds for the Administration of Children and Families to support the State Advisory Council (SAC) to implement activities that support early childhood collaboration and coordination. Project Tinituhon is working closely with SAC project staff to plan for and complete these activities. • In March 2011, the Project Tinituhon director provided testimony in favor of Bill 89-31, which aims to sustain the GELC. • In May 2011, Governor Eddie Baza Calvo signed Public Law 31-62, which was introduced during a legislative session by Senator Aline Yamashita, Ph.D., a former UOG CEDDERS Training Associate. The law exists to promote the sustainability of the GELC and its work to ensure that children and families have access to early childhood services and supports. • The newly appointed GELC members were sworn in during the GELC Orientation Meeting on June 2011 by Governor Eddie Baza Calvo. Project Tinituhon and its collaborating early childhood partners provided history and updates to their respective projects. Footer: State of Early Childhood on Guam 2011 | 15 8 pages of images of PUBLIC LAW NO. 31-62 Website: http://202.128.4.46/Public_Laws_31st/P.L.%2031-62%20SBill%20No.%2089-31.pdf GOVERNOR’S EARLY LEARNING COUNCIL Christine Calvo, First Lady of Guam, Co-Chairperson Elaine Eclavea, Co-Chairperson - Project Tinituhon, UOG CEDDERS Wilfred Aflague, Director - Department of Mental Health & Substance Abuse Annie Unpingco, (Alternate) Project Director - I Famagu'on-ta, DMHSA Vicky Arriola, Parent Arthur Barcinas, Judge, - Superior of Guam Stasia Borja, Parent Richard Brown, Chairperson - Guam System of Care Council Diana Calvo, Executive Director - Catholic Social Services Delilah Charfarous, President - Guam Child Care Association Ross White (Alternate), Vice President - Guam Child Care Association Evelyn Claros, Parent Ann Marie Cruz, President - Guam Positive Parent Together Inc. Pauline Camacho (Alternate), Director - Guam Parent Information Resource Center Yolanda Gabriel, Assistant Superintendent, Special Education - Department of Education Cathy Tydingco (Alternate), School Program Consultant Part - Special Education, DOE Estela Gapas, PNG Child Care Development and Learning Center James Gillan, Director - Department of Public Health & Social Services Lydia Tenorio, (Alternate) Administrator - Bureau of Social Services Administration, DPHSS Mildred Lujan, Executive Director - Sanctuary, Inc. OJ Taitano, (Alternate) Project Administrator, COPED - Sanctuary, Inc. Leah Beth, Oligario Naholowaa Director - Department of Labor Ruth Leon Guerrero, (Alternate) Fair Employment Officer - Department of Labor Mary Okada, President - Guam Community College Clare Camacho, Ph.D., (Alternate) Professor of Education - Guam Community College Dennis Rodriguez, Senator - 31st Guam Legislature Melissa B. Savares, President - Mayors' Council of Guam Carol Tayama, (Alternate) Mayor - Mayors' Council of Guam Ama Underwood, Owner/Director - Honey Bear Kids Center Michele Huffer, (Alternate) Director - Adventures & Learning Child Development Center Robert A. Underwood, Ed.D., President - University of Guam Gena Rojas, (Alternate) Faculty Extension Agent - University of Guam Ray Vega, Administrator - Guam Memorial Hospital June Perez, (Alternate) Program Coordinator - Guam Memorial Hospital Judith T. Won Pat, Ed.D., Speaker - 31st Guam Legislature Back Cover: Poster: PROJECT TINITUHON "The BEGINNING" The Foundation for Lifelong Success for your child BEGINS with YOU! Social Emotional Development/Mental Health Holding and talking with your baby are the first steps to building a positive relationship with your child. Access to Universal Healthcare/Medical Homes Regular and consistent medical care is important for positive growth and development. Early Care and Education and Child Care Quality childcare provides positive learning opportunities for healthy growth and development. Family Support/Parent Education Be a positive role model! You are your child's first, most consistent, and enduring teacher.