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Poster #168 - Trauma-Informed Care in Early Childhood System: A Systematic Review

Thu, March 21, 4:00 to 5:15pm, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Background
Research has shown a detrimental impact of trauma exposure on children’s development and overall mental and physical well-being. With the introduction of the newly enacted Family First Prevention Services Act, it is imperative to develop statewide guidance on how to implement TIC programs for children and families.

Purpose
Based on the literature review, we state the following questions:
What is the working definition of Trauma-Informed Care (TIC)?
What are the evidence-based models for TIC in early learning settings?
What are the funding sources of these evidence-based models for TIC?
Based on these results, how can we implement these models in a cost-effective and sustainable manner?

Methods
The resources reviewed in this proposal were focused on children birth to five in various care settings including center-based care, home-based care, and school-based programs. This includes the evaluations of evidence-based models implemented in early childhood settings as well as statewide and community level interventions.

Resources were selected from electronic database searches across Education Source, ERIC, Google Scholar, PsycInfo, and PsychArticles. Keywords used in the search process included “trauma-informed care,” “early childhood,” and “mental health.” An ancestry search was also conducted to collect briefs and reports from organizations including Administration for Children and Families (ACF), Substance Abuse and Mental Health Services Administration (SAMHSA), Early Childhood Mental Health Consultation (ECMHC), and National Center for Child Traumatic Stress (NCCTS).

Results
Of the 1,331 retrieved articles, 76 peer-reviewed articles, briefs, and reports were included in this review. In most cases, TIC was considered as a community-based approach to support all actors of the targeted system including children, families, and providers.

We define trauma-informed care (TIC) in the ECE system as an iterative and comprehensive approach that begins with trauma risk awareness and prevention. It is based on the understanding that trauma is pervasive, in which all parties (including children, care providers, family members, and social services) engage in care with the goal of supporting and empowering the affected or at-risk child while recognizing potential for and actively seeking to prevent trauma. All adults involved are committed to informed, active intervention, promoting healthy long-term development, and minimizing the risk of physical or emotional trauma to all involved in the system.
The majority of the community-wide TIC initiatives have focused on the child welfare system rather than providing direct services to early childhood care settings. The ECMHC is an example that has been implemented in federal and state level programs. In combination with TIC evidence-based interventions, these models have yielded positive outcomes on children’s mental health. States secured funding from federal agencies including ACF and SAMHSA through formula and discretionary funding, yet most states seek additional funding to continue services.

Conclusion
There is a growing need for states to develop a systematic approach for implementing TIC in a variety of early childhood care settings. States can build on and adapt the available evidence-based models to initiate a cost-effective and sustainable statewide system. Additional research is needed to examine effective statewide implementation of TIC.

Group Authors

Cultivate Learning, College of Education - University of Washington

Authors