This commentary is by Amy Johnson, director of the Parent Child Center of Northwestern Counseling & Support Services; Courtney Farrell, director of the LUND Parent Child Center and co-chair of theVermont Parent Child Center Network; and three physicians from Timber Lane Pediatrics in South Burlington and Milton, Leah Costello. Elizabeth Hunt and Kristen Connolly.
In six distinct communities across Vermont, a nationally recognized evidence-based model is providing unparalleled support to families with young babies.
DULCE (Developmental Understanding and Legal Collaboration for Everyone) is a universal approach that proactively addresses social determinants of health, promotes the healthy development of infants from birth to six months of age, and provides support to families in the pediatric health care setting.
With partners across the health, legal and early childhood sectors, this strength-based approach helps parents navigate the challenges of caring for babies, while addressing gaps early on so that children get the very best start.
A key component of this approach is the family specialist, who is embedded in the pediatric practice. Family specialists, who are Parent Child Center staff members, have advanced training in child development, family-centered relational care, and concrete support problem-solving.
Family specialists have access to an array of child and family supports and services through their Parent Child Center and often serve as connectors to ongoing services a family may need. Visits occur in the pediatric practice, starting with the baby’s first well-child visit until their six-month visit.
Family specialists attend well-child visits together with families and pediatric providers, discussing caregiver themes that matter most to parents. Their compassionate, flexible and empathic approach helps families to feel valued and allows for real, honest connections to be made to discover each family’s needs.
Family specialists join parents as allies in the systems of care for their children and work with the DULCE interdisciplinary team to connect families with resources and support. Using this approach, supports are secured for families at twice the rate of those not enrolled in the program.
From the pediatrician’s perspective, the doctor can get a better, more well-rounded grasp of family strengths and areas of concerns as well as infant development through working with the trained family specialist. In a busy clinic, it can be challenging to catch every risk factor for the family of an infant. The DULCE family specialist is thorough and present, often recognizing issues like postpartum depression even before the pediatricians sometimes do; they help steer supports directly to a family and allow for multi-layered follow-up.
The Parent Child Center partnership is a key part of the DULCE equation. Parent Child Centers are community-based organizations well-versed in caring for families with young children, understanding the myriad resources in the community, and can connect families to the services that are right for them.
These prevention hubs, written into state statute and held accountable to high-quality programming and care, use a strength-based, family-centered approach in providing essential prevention, early intervention, and early identification services for pregnant and postpartum families and families with young children.
Through their eight core services, Parent Child Center staff members are well versed in strategies that help families to build protective factors and build strong communities.
DULCE family specialists have a unique role in helping to fill the gap between family needs and access to critical supports early on. Data demonstrates that direct connection between the medical home and medical legal and community partners increases connection to resources, improves well visit utilization, decreases emergency room use, and improves patient satisfaction with services.
“As first-time parents, we were starting from zero. The information provided by the Parent Child Center’s family specialist has been very helpful and having them in-person at our child’s visit was beyond valuable,” said one DULCE family graduate.
While the DULCE approach supports and positively impacts the lives of families with young children, another integral aspect of the model is systems improvement. DULCE interdisciplinary teams focus on the systematic identification of families’ strengths and health-related social needs and use this as a lens through which continuous quality improvement work is viewed. Through the routine review of DULCE family data, gaps in systems supports are easily identified.
DULCE’s weekly case reviews and regular focus on Continuous Quality improvement informs the leadership team and helps to create early childhood policy change and systems improvements.
We applaud the governor’s plan to invest in and expand this incredibly successful approach for Vermont babies and their families. With 90% of Vermont families accessing well-child visits in the first weeks of a baby’s life, integrating the prevention and early childhood support services delivered by Parent Child Centers into pediatric practices will ensure a healthier start for Vermont’s youngest.
