HEAD START®

Well-Child Health Care: Making It Happen

Training Guides for the Head Start Learning Community

Table of Contents | Preface | Introduction | Module 1 | Module 2 | Module 3
| Continuing Professional Development | Resources

PREFACE

By assuring well-child health care, screening, assessment, and follow-up for every child, Head Start can make a real difference in the lives of children and families. Latrice tells us her story:

"My son Jamal began Head Start when he was four years old. Through my Family Service Worker, I found out that he had not received his state recommended shots. Our Family Service Worker also asked about Jamal's baby sister. She needed her shots too. Upon realizing that we had no regular health care providers, we sat down together and found the phone number for the nearest clinic. I got my family enrolled in a program of well-child exams and regular immunizations. So I took both of the children to the clinic for their checkups and shots. I found out it was a good thing, too, because that winter when our neighbors' babies were really sick with whooping cough, my children were fine. I feel very much at home at this clinic—I recommended it to my sister for her prenatal care.

Three months into the Head Start program, a teacher's aide noticed Jamal was always thirsty and needed to go to the bathroom often. I took him back to Dr. Spencer and a blood test showed he has diabetes—the same disease his grandpa has. I felt overwhelmed and scared. I didn't know how to give insulin or cook for him now.

With the help of the Head Start staff, my clinic set me up with a dietician and together we came up with menus using a lot of our family recipes. The nurse taught me all about giving shots and testing Jamal's sugar levels. There's even a Diabetes Support Group I attend to `get things off my chest'—my fears and all. I don't worry about him at school because the staff knows when to give Jamal his snacks and the right types of food to give him. I feel like I have a whole team of people behind me to keep my baby healthy."

The cornerstone of well-child health care is establishing a linkage and partnership between children and families and a "medical home." The "medical home" provides an ongoing source of continuous, accessible medical care, even after the child has left Head Start. Health care begins before a child is born by pregnant women's entrance into comprehensive prenatal care.

Jamal's story shows the importance of well-child health care and the vital role of Head Start staff as key players in a broader network of community support for children and their families. Without the observations of an astute aide, Jamal's diabetes may have gone undetected. Well-child health care is everyone's role; not just those with "health" in their job title. Ongoing observations throughout the year can pick up new or recurring health problems.

Latrice's comments show us how Head Start is most effective when it works in active partnership with parents: parents empowered by skills and knowledge. Latrice initially faced Jamal's chronic illness with anxiety and fear. But with the partnership of a dietician teaching her to adapt old recipes and a nurse teaching her to administer his medication, she can now face his illness with competence and confidence.

As a Head Start staff member, you have a key role in making a difference in a child's health—both now and in the long term. Who else has regular daily contact with children and families? Who better to link the children into a broader network of community services including medical, dental, vision, speech therapy, physical therapy, mental health, and counseling services? You can open the door to better health care for a family by first linking them to a "medical home" and then supporting follow-up for any identified medical needs. Through prenatal education, well-child health care begins before the child is born—a time when many health ailments can still be prevented. Ongoing health education helps the entire family.

Finally, working in partnership with families and community services, you have the opportunity to advocate for change—change that will improve services for families and meet the unique needs of your Head Start community.

The activities in this guide explore the challenges to assuring well-child health care and services for families, while enhancing skills to meet these challenges. The activities emphasize that a partnership between families, health-care providers, and all Head Start staff members is needed to promote well-child health care. Given the many challenges and changes in the Head Start population and health resources, each program must periodically re-evaluate how well it is doing in screening, linking families with health care, and advocating for better services with and for families.

One note of caution about using this guide—leading the activities in this guide can be challenging. It is best to use staff or consultants who are well-trained and experienced in health education, medicine, nursing, dentistry, or another area of public health or clinical care. Be sure that any trainer or coach understands both the facts of and the philosophy behind well-child health care. He or she must be well-versed in the Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) requirements of your state. Provide any trainer or coach with background materials such as the appendices, fact sheets, and publications listed in Resources.

The Training Guides for the Head Start Learning Community are designed to help programs support and enhance quality. The Foundation guides are for all staff and set forth the core principles and practices that comprise the Head Start approach. Subsequent guides may be used by the management team to plan and implement staff development activities. Together, they make up a comprehensive staff development library covering all aspects of Head Start.

The concepts in this guide build on each other. For a comprehensive approach, users should proceed from the beginning to the end. However, the learning activities in this guide can be adapted to your own situation. For example, you may adapt a workshop activity to use with a smaller group or insert stories from your own program.

Training materials are effective only when they can be applied to the everyday work setting. Knowledge and skills that are developed in training must be supported by follow-up activities. The guide contains sections titled "Next Steps: Ideas to Extend Practice" and "Continuing Professional Development," which help users design long-term learning plans.

This guide was developed with the assistance of many Head Start programs across the country. We would like to thank the Head Start staff and parents who discussed the challenges they faced in dealing with well-child health care and screening, shared their stories, participated in trainings, and provided feedback on the activities. We appreciate the feedback provided by the Head Start Bureau, Regional Offices, and Head Start's nationwide training and technical assistance network. We especially value the detailed review and input provided by the guide's development team of Head Start staff members and health professionals.

Throughout the guide, Well-Child Health Care: Making It Happen, we have inserted true stories from Head Start programs across the United States. These stories illustrate the many different ways that creative Head Start staff and families are forging the linkages needed for well-child health care. They are "making it happen" and we hope this guide will help you in your efforts, too.

Well-Child Health Care: Making It Happen...

A meeting of the minds: Starting with a $5,000 seed grant from Health Child Care America Campaign, the Region VII Head Start Quality Improvement Center helped host a planning summit attended by Head Start, Healthy Child America, Bureau of Maternal and Child Health, Administration of Children and Families, pediatricians, child care providers, and families. The goal? Bringing people together to make a state plan for the goal of child health.