When trained in a model program of prenatal and infancy home visiting, paraprofessionals produced small effects that rarely achieved statistical or clinical significance; the absence of statistical significance for some outcomes is probably attributable to limited statistical power to detect small effects. Nurses produced significant effects on a wide range of maternal and child outcomes.

In a high-risk sample, short-term, family-based NICU interventions may enhance mothers' knowledge, sensitivity, contingency, and stress.

Since the 1998 publication of the groundbreaking Adverse Childhood Experiences (ACE) Study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente, increased research and funding has focused on mitigating experiences that place children at risk for developmental disruption. Surprisingly, the death of a parent, sibling, or other important attachment figure-often noted as one of the most disruptive and potentially traumatic experiences for a child-has received relatively little attention in these efforts. This article explores the current landscape of support for grieving children and families- including significant barriers to care and gaps in empirical knowledge. Given the complexity of the issue and the nascent state of the childhood bereavement field, it is fertile ground for social innovations that challenge current norms. In addition, the argument is made for a strengths-based, wellness approach to childhood bereavement that seizes upon opportunities to both promote adaptive adjustment and prevent further complications of unaddressed grief and trauma. (PsycINFO Database Record

BACKGROUND AND OBJECTIVES: Screening, early identification, and referral improves outcomes for young children at risk for developmental delays. Effective developmental screening processes should include efforts to ensure referral completion and documentation of evaluation results and service eligibility in the child' s medical record. Our objectives were to improve provider documentation of actions taken after an abnormal developmental screening result and increase Early Intervention (State Part C) referrals. METHODS:Various strategies including an electronic medical record template, monthly clinical informatics reporting, and a phone follow-up after an abnormal screening result were implemented to enhance provider documentation of screening results and improve referral actions and outcomes. RESULTS:Of the children eligible for screening (n = 3023), 2610 (86%) were screened, with 382 (15%) scoring in the abnormal range. With phone follow-up, 50% of the abnormal screenings were referred to community resources, including 43% to Early Intervention (EI), in contrast to 20% community referrals and 13% EI referrals with the screening template only (P , .0001). Provider documentation of EI outcomes increased when screening templates and follow-up calls were implemented together (31%) as compared with using the screening template alone (15%).CONCLUSIONS: Enhanced documentation of developmental screening efforts using screening templates and clinical informatics reporting in combination with phone follow-up after an abnormal screening result improved developmental screening outcomes, including referral rates, completed evaluations, and provider documentation of EI services. Such strategies can be effectively used in pediatric primary care settings to improve screening processes and ensure that young children access appropriate services. Dr Talmi conceptualized and designed the study, supervised intervention implementation, directed data collection, analysis, and preparation, drafted the initial manuscript, and reviewed and revised the manuscript; Dr Bunik helped conceptualize the study, oversaw developmental screening implementation, and drafted the results section of the initial manuscript; Mr Asherin developed the database management strategy used to integrate study data, managed data collection efforts, compiled and prepared data tables for the manuscript, and reviewed and revised the manuscript; Mr Rannie developed and implemented the clinical informatics reporting mechanisms used to gather data from electronic medical records, programmed informatics reports, and compiled data for analysis; Dr Watlington participated in study conceptualization and developed and implemented the provider templates (data collection tools) used to gather data; Ms Beaty prepared and analyzed the data and drafted sections of the manuscript; Dr Berman participated in study conceptualization, provided ongoing feedback during study implementation and data analysis, and critically reviewed the manuscript; and all authors approved the ...

Pediatric BHCs provide a wide range of services to pediatric populations in the context of integrated behavioral health programs. Implications for workforce capacity development, evaluation of outcomes and impact, and sustainability are discussed.