This field report outlines the goals of providing a blended learning model for an interdisciplinary training program for healthcare professionals who care for children with disabilities. The curriculum blended traditional face-to-face or on-site learning with integrated online interactive instruction. Credit earning and audited graduate level online coursework, community engagement experiences, and on-site training with maternal and child health community engagement opportunities were blended into a cohesive program. The training approach emphasized adult learning principles in different environmental contexts integrating multiple components of the Leadership Education in Neurodevelopmental and Related Disabilities Program. This paper describes the key principles adopted for this blended approach and the accomplishments, challenges, and lessons learned. The discussion offers examples from training content, material gathered through yearly program evaluation, as well as university course evaluations. The lessons learned consider the process and the implications for the role of blended learning in this type of training program with suggestions for future development and adoption by other programs.

Children's emergent language develops in a rich context of varied influences afforded by their familial and social environments. Using data collected during a longitudinal prospective service project, this study examined the direct and indirect contributions of parenting knowledge and practices and maternal postnatal depression on emergent language competencies of 198 very young children in high-risk Latino and African/American families in an urban area. The study used the Knowledge of Infant Development Inventory, a constructed measure of risky parenting practices for child well-health, home-safety, and corporal discipline, a constructed measure for children's involvement in literacy oriented activities, Edinburgh Postnatal Depression Scale, and MacArthur Communicative Development Inventories to build and test a structural equation model with AMOS/SPSS 16. The results provide support for a mediated path model. Parenting knowledge and maternal postnatal depressive symptoms interacted directly and indirectly in influencing risky parental practices and children's exposure in literacy oriented stimulation activities and emergent language. Children's involvement in stimulation activities mediated the effects of parenting and maternal mental health and directly predicted a robust amount children's emergent vocabulary. The model produced similar results for boys and girls, although boys had poorer outcomes. These findings provide empirical evidence that clinical practice and policy efforts are needed for reducing maternal postnatal depression in strengthening parenting efforts and in affording meaningful parent-child interactions and for assuring that children receive adequate exposure to activities that promote language development. Methodological limitations and recommendations for future research are addressed.

Women's postnatal depressive symptoms have been associated with many adverse outcomes for children. The current study examined the frequency association with relative risk between postnatal depressive symptoms and mothers' use of preventative infant health practices. The study used the Edinburgh Postnatal Depression Scale (EPDS) and Parental Health and Depression Questionnaire (PHDQ) to identify women's depressive symptoms in a prospective longitudinal sample of 134 high-risk non-white mothers receiving well-baby health services. Unadjusted frequency comparisons examined the effect of women's postnatal depressive symptoms on infant outcomes. Results found that compared to 60 women without postnatal depressive symptoms, 74 women with symptoms engaged in significantly fewer well-child health-visits, were less likely to use home safety devices or place their infants in the preferred back-to-sleep position, and did not complete immunizations. Depressed women were also more likely to lack knowledge of nurturing and sensitive parenting, use corporal punishment and inappropriate foods, and to show poor parenting practices. These findings provide additional supportive evidence that more efforts are needed to identify and assess women's depressive symptoms to promote health and safety of young children. Methodological limitations and recommendations for future research are addressed.

Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers.

Reducing parenting stress and enhancing parental engagement in child routines are theorized as two important factors for ameliorating effects that maternal depression exerts on young children's development. These connections are supported by behavioral parenting processes within attachment theory. Through secondary analysis of a large population of preschool-aged children, this study empirically examines the connections among parental mental health, stress, and engagement in child routine activities with children's emotional regulatory competence. Path analysis using structural equation modeling demonstrates that maternal depression indirectly but significantly impacts children's development. Parenting stress mediates the connection to parental engagement in child bedtime routines and to children's regulatory competence. Parental engagement in child bedtime routines partially mediates the influence of parenting stress. The study also examines moderation effects of children's gender and race/ethnicity. The results imply that although parents may be reluctant to seek professional help to address mental health difficulties for themselves, reducing parental stress and encouraging engagement in shared bedtime routines offers benefits to children's regulatory competencies. Limitations of the study and future directions are considered as well.