Columbia University Mailman School of Public Health

Alabama

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Alabama Strategies

Child Social-Emotional Screening and Response and Case Management/Linking Families to Services

Alabama is one of only a few states that has a statewide Help Me Grow (HMG) initiative. HMG has a presence in 9 regions of the state covering all 67 counties. As a national model, HMG has been implemented in 30 states and 99 systems. Alabama’s HMG incorporates the four core components of the national model:

  • A central call line allows parents, health care providers, early childhood professionals and others to talk with a HMG specialist about a child’s needs and assist in connecting families to appropriate services (e.g., Part C Early Intervention, mental health care, parenting programs);
  • Through outreach and training activities, HMG staff educate health care and other professionals about screening children for developmental and social-emotional concerns, and help link families to community services and supports;
  • HMG builds a network of services and organizations and keeps up-to-date information about local resources for children and their families;
  • Using data concerning family needs and the outcomes of efforts to connect families to resources, HMG identifies gaps and barriers that result in families’ unmet needs; HMG works with its network to reduce these obstacles.

While retaining the core elements, states also implement the model in different ways (e.g., the extent to which they emphasize social-emotional screening and their approach to monitoring children’s development). Alabama’s HMG places strong emphasis on social-emotional screening, recruiting families that face significant challenges, and engaging health and early care and education professionals and parents in screening children.

One way families reach AL HMG is by dialing toll-free or enrolling online at www.helpmegrowalabama.org, to get connected with a HMG Care Coordinator who will help link families to a wide range of services to meet the needs of the whole family, including programs that provide health and mental health care, services that help address behavioral, communication, and other developmental concerns, and resources to meet basic needs. HMG has contracts with local agencies statewide to ensure that local connections with parents and providers can be made, as well as to keep information about local resources up to date.

While families can self-enroll in HMG, HMG conducts extensive outreach to providers serving families with young children about the importance of early detection, using a valid, reliable screening tool such as the ASQ-3 and ASQ:SE-2, and making sure they know that they can refer families they are working with to HMG for connection to resources when concerns are identified. Currently, concerns about a child’s behavior and development trigger the largest number of calls to HMG.

When a family or provider calls HMG, a care coordinator talks with the caller about their concerns and identifies appropriate programs in the community. Families may be referred to Early Intervention (EI), Home Visiting, a mental health provider or other programs as well as local organizations that might be able to help address basic family needs. Currently, the state has a shortage of evidence-based dyadic treatment providers, and efforts are underway to increase the number of trained providers. To accomplish this, the state has created First 5 Alabama, a member of the Alliance for the Advancement of Infant Mental Health, to increase the professional capacity of the state to address the infant and early childhood mental health needs being seen statewide. In addition, the state’s EI program has been working to increase its capacity to support very young children’s social-emotional needs by training EI providers to use the SEAM (Social-Emotional Assessment/Evaluation Measure) to assess and monitor infants and toddlers found in screenings to be at-risk of social-emotional problems, and parents’ strengths and needs. The EI program also uses training materials from The Pyramid Model to help providers equip families in responding effectively to very young children’s challenging behavior.

All families that call HMG are asked if they would like to participate in developmental and behavioral screening in order to monitor their child’s growth. Parents that agree receive screening tools, the ASQ (Ages and Stages) and the ASQ:SE-2 (Ages and Stages Social-Emotional), to complete and return to HMG who score the screener, discuss results with parents, and connect the families to services when concerns are identified. HMG uses the ASQ in both English and Spanish. In addition, HMG participates in Quality Improvement-Maintenance of Certification projects facilitated by the Alabama Child Health Improvement Alliance (ACHIA) and American Academy of Pediatrics-Alabama Chapter, which are focused on increasing the developmental screening rates through the ASQ-3 and ASQ:SE-2 among pediatricians statewide.

Help Me Grow uses the ASQ Enterprise system for screening completion and gives free access to early care and education programs statewide. This system helps programs store screening results and follow-up decisions in child records; track when children need to be screened, access activities parents can try at home to promote child progress; access automatic scoring and screening selection to help eliminate scoring errors and provide more accurate referral information, and analyze both child and program level data and track trends across time. Currently, pediatric practices, home visiting, licensed center and family home providers, and all state Pre-K classrooms use this system.

HMG also trains providers in pediatric practices, home visiting, and early care and education professionals on the importance of developmental screening, how to use the ASQ-3 and ASQ:SE-2, and how to connect with HMG to assist families when concerns are identified. Training and support are usually delivered in-person with additional follow-up webinar calls to answer questions. In 2018, HMG served 1,380 families statewide, and helped facilitate 23,229 screens for children enrolled in HMG and partnering agencies.

Monitoring and evaluation

The ASQ Enterprise system for screening completion, used by early care and education programs, home-visitors, and pediatric practices, provides data on screening and follow-up actions across these settings. Alabama, like all affiliates of the National HMG Center collects data on its implementation of the four service components, including outreach to providers and families, the number of families served, follow-up methods after referrals to services, and whether needs were met with referrals. Affiliate data are used in an annual national report.

Financing

Help Me Grow Alabama is funded by the Alabama Department of Early Childhood Education through the Preschool Development Grant, the Alabama Department of Human Resources through the Child Care and Development Fund, and the Alabama Department of Mental Health through a Project LAUNCH Grant from the Substance Abuse and Mental Health Services Association. In addition, Help Me Grow Alabama is supported by an AmeriCorps State Grant from the Corporation for National and Community Service provided by The Governor's Office of Volunteer Services.

Special thanks to Katie Prince, Help Me Grow Alabama Director, Alabama Partnership for Children, for providing information for and reviewing this profile.