Watch as NEAR@Home facilitators explore topics such as the power of listening, the parallel process and the therapeutic use of self in these meaningful conversations that discuss best practices and aim to empower home visitors.

The term doula is one that most people might think of when it comes to celebrity pregnancies, but know little else about. At the Start Early, we know that creating strong bonds between parents and babies is crucial to a baby’s future development. Our Healthy Parents & Babies program’s doulas and home visitors serve children and families, beginning prenatally and through age 3. Our doulas and home visitors are trained professionals who provide the highest level of care to help families from under-resourced communities thrive. In the wake of COVID-19 crisis, our program has had to adapt services to a virtual format to continue to meet families’ needs while keeping everyone safe and healthy. ­­

But first, what is a doula?

A doula is trained professional who provides continuous educational, emotional and physical support to a mother before, during and shortly after childbirth to help achieve the healthiest pregnancy, labor and delivery possible. Doulas support and comfort mothers and help them to have a safe and memorable birthing experience. A doula is responsible for informing and educating families about the different medical interventions, comfort measures, patient rights and other topics related to childbirth and post-partum education. Typically, doulas accept mothers who are entering into their third trimester. Doulas are required to have a series of monthly home visits with the participants to ensure they are able to not only retain the information, but to also make informed decisions.

What is the difference between a doula and a home visitor?

A doula coaches mothers through pregnancy and the first few weeks of their baby’s life. This helps the mother to develop healthy habits prior to birth, prepare for a successful pregnancy, labor and delivery, and create strong bonds with the baby. Our Healthy Parents & Babies program empowers mothers to make the right decisions for herself and advocate for her child’s health.

Once the baby is born, families transition from a doula to a home visitor who helps continue building a strong relationship between parent(s) and their baby, creating a safe and stimulating home environment, developing healthy eating routines for the family and connecting families to health care resources. Parents learn activities and habits that will stimulate their child’s brain development to help them thrive.

Why are doulas/home visitors important during a child’s early stages of life?

Doulas are important during pregnancy as they provide education to women about the stages of pregnancy, changes to their body and fetal development. Doulas also provide support to pregnant women during labor and delivery by providing comfort measures, support and guidance to advocate for their laboring and delivery preferences.

Home visitors are important during a child’s early stages of life as they provide families with individual educational support with early attachment and learning about their child’s growth and development. Home visitors also support families with individual parent-child education and recognize that parents and caregivers are the child’s first teacher.

What does doula/home visiting look like at Healthy Parents & Babies?

Start Early’s Healthy Parents & Babies Program offers support and coaching to pregnant women, young parents and children birth through age 3. Each family is provided with an individualized home visiting plan that is tailored to meet their needs. Pregnant women learn about their pregnancy and their child’s growth and development. Home visits include story time, parent-child development activities, parent reflections and planning for the next home visit.

How has Healthy Parents & Babies adapted services during the COVID-19 pandemic?

Out of an abundance of caution for the health and well-being of our families, doulas, home visitors and family support staff, Healthy Parents & Babies has moved all of its work to a virtual format in the wake of the current health crisis.

Our doula’s have continued to support families with weekly virtual check-ins and support during labor and delivery. Our home visitors have maintained contact with their families on their scheduled home visit day by checking-in via cellphone, FaceTime, messenger, Class Dojo and Zoom.

Our family support specialists have been maintaining weekly contact with parents and providing information on proper hand washing, symptoms of COVID-19 and locations where families can get tested for COVID-19. Family support staff have also continued to provide weekly check-ins with families that include well-being checks, and information on resources such as: support services for unemployment, community food pantries and resources for immigrant families.

What makes Healthy Parents & Babies unique?

Healthy Parents & Babies serves children and families prenatally through age 3. Women can enter our program at any stage of their pregnancy, and after their children are born, they transition to our Early Head Start home visiting program. Program participation is not limited to first-time mothers or first-time participants in the program. Participants must meet Early Head Start income eligibility guidelines.

We also support families with children who have special needs through individualized lesson plans which are inclusive to the child’s Individual Family Service Plan. Our team serves a diverse population, and we employ bilingual staff to support the families we serve.

Our families genuinely love the program, their doulas and home visitors:

“Healthy Parents & Babies has helped not only my family but every family in this program and I can only speak for myself, but we will forever be grateful that during this time you are able to help us.” –Elizabeth H.

“I’m really thankful with all of you for all your support, I know it’s a lot of people who are a part of the program that don’t even know me. But Rosa and Vicky thank you so much you are always there for us, in the times when I even need to talk to someone you have been there, always trying to look for help for us. And loving my girls. I will be sure to tell my girls all about my experience with you all and pray that they grow up to help and care for the next family in need of help. Thank you so much!” –Debbie C.

Other program benefits include:

• Prenatal and parent group meetings
• Events to socialize and interact with other children and parents
• Literacy events
• Male involvement groups
• Limited transportation assistance
• Services for children with special needs

In this blog post, Melissa Manning, with contributions from Sarah Bergman, share perspectives from the Educare Learning Network’s Early Head Start-Child Care Partnerships Community of Practice on rebuilding and recovery post COVID-19. Including, specific thoughts on equitable access to high-quality early care and learning and the need for viewing early childhood systems through a racial equity lens.

In mid-June, after early learning settings were initially impacted by the COVID-19 pandemic, 12 early learning practitioners from seven states gathered virtually for a Build It Back Better dialogue. The dialogue took place during a meeting of the Educare Learning Network’s Community of Practice for Early Head Start-Child Care Partnership grantees and included leaders of Educare schools and child care providers. Below is a summary of what these leaders in the early childhood field shared about their experience with rebuilding and recovery post-COVID-19:

1. What are some of the hopes, dreams and goals for children that were shared during your Build It Back Better dialogue?

A hope is to provide children with the same educational opportunities as children in more affluent communities, as well as resourcing teachers to support their implementation of best practices in service of children’s school readiness and their own personal growth. We hope that all children will have the opportunity to reach their full potential and want to be mindful of what is needed for staff, communities and families to ensure children have those opportunities. We hope that a young child’s family income, race and/or adverse experiences do not predict their later success. Finally, when we see our kids, especially our Black and Latino kids, we want to be able to give them a fair shake in a world we know is not set up for them currently. Kids in our community who came to our programs are no longer living because of street and police violence. There is hopefulness to see changes to systemic racism in our lifetime.

2. What are some of the worries or concerns for children that were shared? What is keeping people up at night?
Children of color are growing up in a society with a long history of structural, institutionalized racism. So many kids are not in quality programs right now as programs start to reopen in limited capacities. We worry about the domestic and child abuse that might be going unreported right now. We are also worried about the social and emotional development and relationship-based work at every level – including physical contact especially with younger children.

Everything we know about child development is seemingly unavailable during this pandemic. We are worried about what the child care landscape is really going to look like for families. There was a teacher who tested positive the night before school was scheduled to reopen. The Remind app was then used to notify parents of a delayed reopening date. There were 55 families who were scheduled to arrive. Four families did not get the information – one uncle even tried to drop off a little girl, who got so upset that school was not open that day. This incident was a reminder that these kids are at home with family members and wanting to come back. Our kids need these environments. In some cases, we are their stability – their constant.

3. According to participants, how did the supports for young children and families respond or fare? Who has been disproportionately impacted by the challenges?
A positive has been that there was some security built in for families through child care subsidies. There was no parent fee, and slots were saved. Another positive has been smaller group sizes. Adults have time to build relationships with each other and kids.

Some negatives? It is up to states to figure out where their money lands, and that really varies. Also, funding that came through in grant form was insufficient in many cases. Head Start and child care in Illinois are not on the same page, and many programs could not open as emergency care because of the loopholes and discrepancies in policies and procedures. The longer a program stays closed, the harder it is to reopen. The Black Lives Matter movement has had a significant impact on the Educare Seattle community. For equity and racial justice to be a part of what we do, we must understand how white privilege plays out in the child care setting.

4. With respect to concerns or challenges shared, what did participants say has or would help alleviate these issues or make things better?
It would be helpful if different sub-systems were firmly aligned and communicating clear expectations. The conversation should also be raised between public school leaders and local child care providers. Providers want to be responsive to school decisions in order to best serve the community. We are still concerned, though, about how do we partner with families to empower themselves as the most important teacher for their child, while also meeting the need for child care and education? Some families are not quite ready to return on-site, but also not quite comfortable being their child’s teacher.

We want to make sure we are supporting families’ mental health situations and ensuring families have access to services and affordable technology. In order to make things better, we need to be able to manage movement effectively in case someone tests positive for COVID-19. Tulsa Educare was operating 7 a.m. – 6 p.m., and to make it work, there were so many substitutes, interns and aides required. So many folks going in and out. They’ve adjusted, so that now, there are three teachers with children all day. It is so calm. That is a solution that children will really benefit from.

5. As we work together to rebuild the early childhood system, what questions should we all be asking to ensure that ALL young children and families thrive?

We need to ask ourselves: what is it we really want? We need to slow down and have dialogues about this. What is it we want our children to experience? What kind of citizens do we want them to become? What is the role of profit in our child care industry? How can we cultivate more respect for teachers, especially our birth-to-age 5 teachers? Who do we want to be taking over this world? What skills do they need? And of course, in each conversation, we need to ask ourselves, how are the children?

To learn more about how Early Head Start-Child Care Partnership grantees have faced the COVID-19 pandemic and what policy recommendations they have made, please read the Educare Learning Network’s blog series “A Path to High-Quality Child Care through Partnerships.”

Build It Back Better is a project of Start Early (formerly the Ounce) focused on identifying the critical questions that early childhood systems and services must ask as we rebuild after the COVID-19 pandemic. The writings that emerge from the initiative center the experiences and voices of those most directly and disproportionately affected by the pandemic’s impact on early care and learning. Join the conversation at the Early Child Connector’s Recovery and Rebuilding Hub.

Melissa Manning is the Early Childhood Services Training and Professional Development Coordinator at Sunbeam Family Services and Co-Chair of the Educare Learning Network’s Early Head Start-Child Care Partnerships Community of Practice. Melissa has been in the field of early childhood education for three decades in a variety of capacities including, Infant/Toddler teacher, Center Director, Health Services Manager, Program Operations Manager, Quality Assessor and her current role as Training & Professional Development Coordinator for Sunbeam Family Services’ Early Childhood department. Melissa has worked with Head Start programs since 2002 and has extensive knowledge about Head Start Program Performance Standards, nonprofit management and best practices in the field.

Sarah Bergman was the Leadership and Educational Equity Fellow at Start Early this past summer. Sarah has her Master’s in Early Childhood Education from Erikson Institute and is a Chicago Public Schools teacher. Sarah’s interests are focused on bringing developmentally appropriate teaching practices to all primary aged students and connecting the dots between policy decisions and everyday life in the classroom.

In the last three decades, scientific research has demonstrated how deeply adversity in childhood becomes embedded into biology, behavior, and risk, and how these can be passed on to future generations. This body of science — Neuroscience, Epigenetics, Adverse Childhood Experiences (ACE), and Resilience research, or NEAR — is one of the largest public health discoveries of our time.

Home visitors knowledgeable about the NEAR sciences and research are interested in bringing this information to families but worry about causing harm. The NEAR@Home toolkit addresses these concerns and provides strategies for engaging parents in discussing NEAR sciences and using the ACEs questionnaire in a safe, respectful and effective way for both home visitor and family.

Home visitors are uniquely positioned to help families mitigate the effects of past, present, and future adversity through supporting protective, responsive parenting and safe attachment relationships. The NEAR@Home process gives parents choice, offering information, assuring safety, being respectful, allowing time and space for reflection, and by always closing with hope and resilience.

The NEAR@Home toolkit was created, tested, and revised by home visitors, mental health providers, and other experts in the field of NEAR and home visiting in Alaska, Idaho, Oregon, and Washington. The NEAR@Home toolkit is designed as a training manual with guided processes to help you learn and practice language and strategies to safely and effectively talk about the trauma of ACEs. We emphasize safety and reflective support for the home visitor as a critical element in this process.

The NEAR @Home toolkit was developed as a self-study process and is being shared without cost because we believe that all home visitors deserve to have access to this guidance. Many home visitors discovered that while self-study of the NEAR@Home toolkit was useful, they preferred a supported learning experience and have informed the development of NEAR@Home Facilitated Learning. Learning how to be safe, respectful, and effective while talking about the NEAR sciences with parents is a complex process that requires and deserves time and support.

The NEAR@Home Facilitated Learning process is very different from most training programs. Thinking about, talking about childhood trauma stirs feelings in all of us, whether ACEs are part of our life story or not. Our learning process is guided by Facilitators who are relationship focused, trauma sensitive, and fluent in infant mental health concepts and processes. The Facilitators model self-regulation, co-regulation, spacious listening, and reflective processes to walk with home visitors and supervisors through learning how to do a NEAR home visit. Implementation Science guides the structure of the learning process from a mutual exploration of fit and feasibility to follow up reflective consultation to support home visitors as they integrate these new skills.

In this blog, Kristin Bernhard, Start Early senior vice president of policy and advocacy, shares our work towards building back a better early childhood system that addresses and diminishes the inequities that exist for our youngest learners and families.

The COVID-19 pandemic has served as a report card on the status of our society — and not a very flattering one. It has exposed and highlighted the profound inequities, from health care to affordable housing, that exist from coast to coast. We have seen that nearly every aspect of the social safety net is weaker than we had hoped; in particular, the limitations and weaknesses of our country’s early childhood system have been thrown into stark relief.

At the same time, we have been reminded that racism permeates our communities, risking the physical and social-emotional safety and well-being of the children, families and caregivers with whom we work so closely. We have been called upon to renew our collective commitment to racial equity and finally undo generations of institutional racism that continue to traumatically impact children and families.

Now, we have a choice: 1) rebuild the fragile, inequitable early childhood system that was in place prior to the pandemic, 2) or build it back better by collaboratively rethinking and improving early learning and care programs by proactively addressing existing disparities and ensuring that programs meet the needs of children and families. We must work towards the latter.

How?

• By inviting more voices into the conversation about rebuilding and recovery
• By identifying gaps in who is represented in these critical conversations and exploring how we can engage with and learn from more diverse groups of partners
• By centering voices of those most directly and disproportionately affected by the pandemic’s impact and amplifying them to make systemic changes that are responsive to the emergent needs of families and early learning and care programs
• By pairing the lived experiences of minority and historically under-resourced communities with the Start Early’s research, program, advocacy and policy tools — in order to activate the field to demand that policymakers build back better

In order to do this right, we must engage in conversations about building back a better system where race, ethnicity, zip code, socioeconomic status and other related factors do not predict a child’s growth and development or access to resources.

As we continue to see the detrimental impact of the COVID-19 pandemic unfold, we are, however, also witnessing innovation in action through the responses of providers, communities, policymakers, researchers and countless other early childhood stakeholders. For example:

• Teachers and other educators have rapidly learned and implemented new technologies to support at-home learning and family engagement efforts.
• Policy and practice changes have allowed the use of telehealth and other virtual communication tools for home visiting and early intervention services.
• Researchers have sprung into action to document the experiences of families and service providers.
• State administrators have streamlined the procedures for accessing child care subsidies and services.

We must acknowledge, applaud and leverage the flexibility and swift action brought on by the pandemic to inform how we rebuild.

Through the Build It Back Better initiative, Start Early is partnering with early childhood stakeholders from across the country to share their challenges, innovative solutions and ideas about what major questions must be asked and considered during this unprecedented time. It is our goal to collaborate with families, communities and local, state and federal leaders to amplify these critical questions and perspectives to best inform decision-makers’ efforts and respond to the changing needs of children, families and practitioners.

As we examine lessons learned so far from this pandemic, we can recreate the conditions in which inequities persist and worsen in crisis — or we can build it back better, more equitably and more sustainably. Now more than ever, we must underscore that ample investment in early learning and care is essential for addressing and diminishing the inequities that exist for our youngest learners and families.

Recommended for Preschoolers

Materials Needed:

• Eating the Alphabet by Lois Ehlert
• A pencil, crayon, pen or other writing tool, and paper
• Grocery store advertisements and scissors

Developmental Goals: 

• Identify a variety of healthy food options, in this case fruits and vegetables.
• Associate letters with the beginning sounds of words.
• Recognize upper and lower case letters. Categorize produce as either a fruit or a vegetable.

In the Future:

• The more opportunities young children have to explore a variety of foods, the more likely that they will eat a varied and healthy diet as they grow.
• As children build their understanding of letters and the sounds they make, they will begin to piece letters together in invented spelling.
• The ability to categorize objects is a beginning math skill that children will later build upon as they identify the properties of shapes and understand how to complete a pattern.

Activity:

1. Introduce the book to your child.  As with any new book, take time to allow her to explore the book’s pictures on her own before sitting down to read it out loud.
2. As you read the book, invite her to talk about the foods she sees on each page.
3. In addition to simply identifying the fruits and vegetables, talk about which ones she likes, which ones she wants to try, or what recipes you could make with the foods.
4. If your child has shown an interest in the alphabet, invite her to tell you the letters she recognizes.
5. For more letter play, you can encourage her to make connections among the letter sounds and the first letter of the foods on each page.
6. After enjoying the book a few times, invite your child to guess which foods are fruits and which are vegetables. You can extend on this idea by bringing out grocery store advertisements from the newspaper and having her cut out pictures of fruits and vegetables. Once she cuts out the pictures, have her sort them into two piles: a fruit pile and a vegetable pile.
7. You can take this further by having your child create a grocery list of fruits and vegetables by either drawing pictures of the foods, writing letters to represent the beginning sounds of each food, or using invented spelling. At the store, ask your child to look closely for the foods that she put on your list.

As our country has slowly started to reopen amid the COVID-19 pandemic, many schools and child care centers have been weighing their options when it comes to welcoming students back. Our early childhood center, Educare Chicago, after much careful consideration, made the decision to reopen and eagerly prepared to welcome children, families and educators back earlier this month.

Educare Chicago has been a lifeline to many parents throughout this time. The school serves families from under-resourced communities by providing high-quality child care and resources to their families.

Educare staff support parents as the primary nurturers and educators of their children. That support didn’t stop when the school closed back in March. Educare Chicago teachers and staff have been with parents every step of the way, providing helpful learning resources, spare masks and messages of encouragement.

“I appreciate you all so much for all you do,” another parent said of the support she’s received from the school. We know that these early years of a child’s education are critical to their future success in school. The current health crisis has shown just how important it is for working families to have access to high-quality early learning for their children. Without early childhood centers and schools being open, the families we serve are forced to stay home due to lack of child care and are unable to go to work, making it almost impossible to make ends meet. No parent should have to choose between providing care for their children or losing needed income.

What does back to school look like during COVID-19?

Both Illinois Governor Pritzker and Chicago Mayor Lightfoot determined that child care programs could reopen if specific requirements were met prior to accepting students back into the building. The safety of the children, families and educators at Educare Chicago has been paramount to the school’s leadership team and has informed their decision making every step of the way. The school established a Reopening Committee to help plan for the many requirements mandated by the City of Chicago and the Department of Children and Family Services (DCFS) to reopen their school. Prior to its reopening, the school also submitted a written plan to DCFS.

In accordance with state and city requirements, Educare Chicago resumed center-based school operations on Monday, August 3, and is allowed to serve a limited number of children. Educare Chicago is committed to safely providing comprehensive services for children and families. The school has had to adapt some practices due to the new rules and regulations. Several of the changes that have been put in place to ensure children, families and staff are safe include:

• Screening children and staff daily prior to entry into the school
• Limiting access to children throughout the day
• Increased cleaning and sanitation practices
• Social distancing and wearing of personal protective equipment (PPE) for staff and children over age 2
• Increased square footage of 50 square feet per child
• Excluding children and staff when there is a cough, temperature, diarrhea, rash or any COVID-19 symptoms
• 6 feet of space between cribs and sleeping cots
• Installation of protective barriers
• Updating policies and procedures

What is Educare Chicago?

Educare Chicago was founded in 2000 as an innovative early childhood education program providing comprehensive services to children and families in under-resourced neighborhoods on Chicago’s South Side. Educare has spawned a national network of 25 schools and has reimagined what it means to educate our earliest learners.

Educare Chicago was founded by Start Early after years of working with children and families in the Grand Boulevard community. The Start Early’s work prior to the opening of Educare Chicago provided critical insight into the Educare Model. Based on four core principles: intensive family engagement, continual professional development, high-quality teaching practices and data utilization, the Educare model has been shown to prepare children for kindergarten in multiple developmental categories.