1 Project Kariñu Loving Our Babies Making a Difference for Guam’s Young Children and Families Photo: Happy family posing for camera CONTENTS 2 Early Childhood Mental Health / Project Kariñu 3 Social Emotional Development Milestones 4 Families Share 6 How is Project Kariñu Helping? 7 Partnering for Success 8 The ABC’s of Children’s Mental Health 2 Early Childhood Mental Health Matters Babies are born ready to learn, and during the first years of life, they grow and change rapidly. Early experiences, especially their relationships with their parents and caregivers, literally shape babies’ developing brains. Secure, positive, and responsive relationships help babies’ brains grow and support positive social emotional development, which is the foundation for all later learning. In fact, the quality of relationships between caregivers and children is the single most important predictor of children’s long-term health and well-being. Mental health begins in early childhood with positive social emotional development. Disruptions in children’s social emotional growth can have a negative impact on their ability to learn, school readiness, and their ability to relate to others and regulate their behavior. Young children with challenging behaviors are more likely to be rejected by their peers, receive less positive feedback, and are less likely to succeed in kindergarten. Early childhood mental health does matter! It supports all other aspects of development from the ability to form healthy relationships, to the ability to deal with challenges and adversity, to the achievement of success in home, school, and community. Project Kariñu, Guam’s Early Childhood System of Care is making a difference for Guam’s young children and their families. Project Kariñu works to support children ages birth – five years who are experiencing challenges in their social, emotional, and/or behavioral development, as well as children who are considered “at risk.” Working closely with families and other service providers, Project Kariñu supports young children’s social emotional development through: • Building awareness and parenting skills; • Conducting assessments; • Providing family supports and activities; • Delivering individualized treatment, and interventions. In partnership with other agencies, programs, and initiatives, Project Kariñu works to enhance Guam’s early childhood workforce and to create systems change and policy reform. Woven throughout all of its activities is the belief that early childhood mental health services should be community based, child centered and family driven, and culturally and linguistically responsive. Photo: Happy mother holding son on her lap Project Kariñu: 2015 MagPro Program of the Year In November 2015, Project Kariñu received the prestigious MagPro award as the 2015 Program of the Year under the Large Department Category. The MagPro Awards are the highest most competitive awards program bestowed by the Governor of Guam, showcasing the achievements of outstanding employees and programs within the Government of Guam. Photo: Project Kariñu and other agency representatives 3 Social Emotional Developmental Milestones Keep Track of Your Child’s Social Emotional Development 3 Months 9 Months 6 Months Smiles spontaneously, especially at people Likes to play with people and might cry when playing stops Copies some movements and facial expressions, like smiling or frowning Knows familiar faces and begins to know if someone is a stranger Likes to play with others, especially parents Responds to other people’s emotions and often seems happy May be afraid of strangers May be clingy with familiar adults Has favorite toys 12 Months 18 Months 2 Years Shows feelings by smiling, crying, pointing Has special relationship with parents and caregivers Is curious about playthings and imitates others May have temper tantrums May be afraid of strangers Shows affection to familiar people Copies others, especially adults and older children Gets excited when with other children, but mainly plays beside them Shows more and more independence 3 Years 4 Years 5 Years Copies adults and friends Expresses affection openly; shows a wide range of emotions Can take turns in games Enjoys doing new things Is more and more creative with make-believe play Cooperates with other children Wants to please friends Shows concern and sympathy for others Shows more independence Photo: Collage of kids playing in play port 4 Families Share About Project Kariñu Photo: Janel with husband and son Janel San Nicolas What brought you to Project Kariñu? At age 3, I noticed some concerns with my child, but as a first time mother I didn’t think that it was a big deal. He was just a kid, and he will grow out of whatever phase he was going through. Then in August 2014, at age 4, he started school. After one week, his teachers observed behaviors and tantrums and they would call me on a daily basis informing me about my child’s behavior. I was told that he would get easily frustrated and would be aggressive towards other children for no apparent reason. He also had a difficult time following directions. Several actions were taken but none of them seemed to work. Each day I thought to myself, what other strategies and techniques can the school and I use to better my child? However, nothing was working. His behaviors only seemed to get worse. During a meeting with his teachers and principals, they decided that I should withdraw my son from school and recommended that I get him tested. He showed signs such as not being able to sit still for long periods of time, aggressiveness to other children, difficulty socializing in a friendly manner towards other children and authorities higher than him, and getting easily frustrated. Still, I thought that maybe it just wasn’t the kind of school setting for him; maybe it was just too early. In October 2014, I withdrew him from school and enrolled him in a childcare setting. They noticed the same issues and recommended the same thing. Following my motherly instincts, I sensed that something just wasn’t right. I called different agencies and had my child tested through Special Education. I was informed that through all the tests, my child did not qualify for the services. I was devastated and worried that there were no agencies here on the island to help me or my child How has Project Kariñu helped your child and family? Special Education referred my child to Project Kariñu. I was able to talk with them about my concerns regarding my child. I was told I was at the right place, and they were able to assist me in helping my child. We scheduled meetings and met with a great team of professionals that worked with him. Project Kariñu showed me that they will not give up on helping my child as well as helping me guide him in the right path. As first time parents, Project Kariñu helped us a lot by providing us with ways and ideas to cope with tantrums and behaviors, good or bad. With all the services that were provided, they showed us that as overwhelming as it may seem, raising a child with this kind of problem, there are always ways to cope with them. Just when I thought about giving up, they taught me that giving up was not the answer, and at that point it wasn’t going to be an option. My overall experience with Project Kariñu has been great, they helped me push myself to accept this problem he was going through and helped my family and me strive to work together with them as a team to help him. My child is 5 years old now and because of the help they provided to us, he is progressing well. I would like to say Thank You to the team of professionals that has worked with us these past two years. Without them I would’ve never gotten a better understanding of my child and the issues he’s facing. What would you like to share with other families? One of the things that I learned in these past five years and I would like to share with other families and friends is that, just because a child has a problem or a disability, it doesn’t make them any different from other children. Don’t be afraid to seek the help that a child needs. No child should be left behind because of their age, development, race or color. My child has been through a lot and as a young mother; I still continue to not give up on him. Every day he surprises me with new things to learn about him. 5 Photo: Jolene with husband and son Jolene Degame What brought you to Project Kariñu? I initially came in to Project Kariñu because I was curious about my child’s development. My son was still an infant, maybe around six months old. Unfortunately, I did not finish the process and therefore did not receive services. I came back when my child was three years old because I had concerns with his speech and behavior. How has Project Kariñu helped your child and family? The assessment tools used were very helpful in painting a picture of where my son was developmentally. Although it turned out my son was ok, there were areas of concern. I was grateful that Project Kariñu did not turn us away, but instead worked on preventive measures to take with my son. Also, through Project Kariñu’s many programs like Peer Family Support Meetings and Parent Cafés, I have improved my parenting skills. In July 2014, I was chosen to participate in Georgetown University’s Children’s Mental Health training in Washington D.C. This trip was truly an eye opener for me and inspired me to work with young children. I am currently a student at UOG working towards a degree in Elementary Education and Psychology. Because of the passion that I now had for children, I also became a parent volunteer at Project Kariñu and worked with the program for about one year. In addition, I was also chosen as the parent representative for the MCH Workforce Development Cohort for Guam. The team traveled to North Carolina to learn about strategies for sustaining Guam’s early childhood system. Lastly, in May 2015, I was honored to be the recipient of the Goodwill Ambassador Award for Early Childhood. What would you share with other families? The first thing I would share with other families is that you are never alone. There may be times when you feel that no one understands the issues you have to face with your child or just with life in general. That is not true! Reach out and ask for help. If the Project Kariñu staff cannot help you, they will assist you with finding someone who can help. The next thing I want to share is that if you are invited to attend an event, GO! Not only will you learn a lot, but you will meet a multitude of new people. You may even make friends with someone who is going through the same challenges you are going through. Who better to make friends with than someone who understands the challenges you face? Photo: Carmeline sitting on wheelchair Carmeline Cepeda What brought you to Kariñu? At the time of my referral to Project Kariñu, there were many things that I was concerned about. I was mostly concerned about my son’s development. He was also having a lot of tantrums and was crying a lot and I didn’t know why. I felt I was to blame for how he was feeling. As a single mother, I tried my best, but I had a hard time comforting him by talking to him and calming him down. I felt overwhelmed and alone and without a consistent father figure in my son’s life, I realized I needed support and guidance in raising him to reach his full abilities with his development. How has Kariñu helped your child and family? While we were involved in Project Kariñu, my family experienced a lot of hard times. We had a loved one who passed and losing his grandfather has been the toughest time for my son. We also struggled with our living arrangements. Project Kariñu helped us through all of that and made me feel I had the ability to keep strong and think positive. My Wrap Coordinator (Social Worker) and Family Partner (Family Advocate) conducted home visits that were wonderful! During home visits, they helped me to increase communications and positive interactions with my son. We started to have a stronger bond. They helped me secure stable housing so I could provide a healthy environment for the both of us and they also assisted me with enrolling him in school. I participated in a lot of their fun activities and learned a lot about parenting. I met other families and hearing about their challenges made me feel like a stronger person. As a disabled mother, I saw that if others can do it, so could I. My son and I loved to attend their events, meet new families and friends. We just enjoyed the Project Kariñu staff that were always positive. They guided us and showed us they cared. I felt I wasn’t alone and now feel that I am a stronger person who will always move forward and not look back. What would you share with other families? Project Kariñu is a great organization. No matter the situation, the staff were always loving and understanding. Before I came into Project Kariñu, I felt broken and dealing with my young son was a struggle. Project Kariñu accepted who we were and guided us through loving and acceptance and encouraged us to be strong and stay positive. My son is now 7 years old and is doing very well in school and at home. 6 How is Project Kariñu Helping? 49% of Children’s “Acting Out” Behaviors Improved Circle Graph Legend: Green: Improve; Blue: Stayed the Same; Gray: Got Worse 49% Improved 44% Stayed the Same 7% Got Worse Caregivers Report After Family Support Activities Bar Graph Legend: Green Agree; Blue: Disagree I learned something that will help me as a parent Green: 99% I plan to change something about my parenting Green: 97% Caregivers Are Positive About Services Caregiver Perspectives on Services % Reporting Positively at 12 Months Cultural Sensitivity 96% Participation in Treatment 82% Access to Services 77% Functioning 75% Social Connectedness 75% Satisfaction with Services 73% Outcome 73% Family Voices Photo: Happy Mother and kids sitting on bench “I’m not reactive anymore; more calm, patient.” Photo: Father and son smiling at camera “Play therapy helps parents understand children’s feelings, to better help the child.” Photo: Mother hugging son smiling “I find it most helpful that Project Kariñu taught my son how to relate well with other kids.” Photo: Father hugging daughter smiling at camera “My child is now listening to me… She comes out and talks about her feelings.” *Quotes were taken from family surveys and do not necessarily reflect the experiences of the individuals in the photos. 7 Partnering for Success Guam Head Start Program logo Guam Head Start. To augment its own mental health services, the Guam Head Start Program increased its advocacy efforts and strengthened collaboration through participation in mental health-related focus groups and coalitions. Project Kariñu has been an integral part of this process as Guam’s Early Childhood System of Care. The Guam Head Start Program has referred 142 children with identified concerns for further evaluation, identification, and provision of support services to Project Kariñu since its inception. As part of Head Start’s annual pre-service training, Project Kariñu has presented to Head Start teaching and family services staff on the importance of early identification of mental health concerns and Project Kariñu staff are available at Head Start parent training conferences to provide information. The Guam Head Start Program and Project Kariñu are also working together to implement the Strengthening Families Approach. Head Start and Project Kariñu staff assist each other through training facilitation of Strengthening Families events such as Parent Cafés. Parent Cafés teach parents about the five protective factors that help keep their families strong: (1) parent resilience, (2) social connections, (3) concrete support in times of need, (4) knowledge of parenting and (5) child development and social and emotional competence of children. During a Parent Café, parents learn from each other’s experiences. The Cafés help parents identify their strengths and challenges and give them new ideas on how to be strong parents and raise healthy and strong families. Guam LAUNCH. Guam LAUNCH, Linking Actions for Unmet Needs in Children’s Health, is an early childhood wellness promotion and prevention project within the Department of Public Health & Social Services. One of its primary activities is to conduct developmental and social & emotional screening of children from birth – eight years of age. Screening is conducted at the Community Health Centers, in families’ homes, or any place at the family’s request. Guam LAUNCH and Project Kariñu work closely together to: 1) review the results of the screenings, 2) identify children who may need early childhood mental health services and/or referrals to other programs and services, and 3) plan and provide services which support children’s healthy development and family resiliency. Guam LAUNCH also partners with other early childhood programs such as Head Start and the Guam Early Intervention System during community fairs and outreach events as well as family support activities, such as Parent Cafés. As of March 31st, 198 children have been screened by Guam LAUNCH and 27 children referred to Project Kariñu. Photo: Group of mothers and young children smiling at camera 8 The ABC’s of Children’s Mental Health Early childhood mental health is the social, emotional, and behavioral well-being of infants, toddlers, and young children. It includes young children’s developing capacity to: Image: Pink Alphabet Block Letter A Form close and secure relationships Image: Green Alphabet Block Letter B Experience, regulate, and express emotions Image: Yellow Alphabet Block Letter C Explore the environment and learn 1 From ZERO to Three organization. If You’re Concerned About A Young Child Because Of: Poor weight gain or slow growth Problems sleeping Problems being comforted or soothed Excessive fears or fussiness Delayed development Contact: Project Kariñu (671) 478-5400 Department of Public Health and Social Services Terlaje Professional Building, 2nd Floor, Suite 208 194 Herman Cortez Avenue, Hagatna, Guam 96910 www.projectKariñu.org Department of Public Health and Social Services logo Project Kariñu Loving Our Babies logo University of Guam CEDDERS logo Loving Our BabiesProject100% funded by the Child Mental Health Initiative (CMHI) Cooperative Agreement 5U79SM059022-06 between the U.S. Department of Health and Human Services/Substance Abuse and Mental Health Services Administration/Center for Mental Health Services and the Guam Department of Public Health and Social Services and facilitated by the University of Guam Center for Excellence in Developmental Disabilities, Education, Research, and Service (CEDDERS).