Introduction To Connected Kids Key Goal Connected Kids: Safe Strong Secure is an AAP program designed to support clinicians’ efforts to prevent youth violence by.

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Transcript Introduction To Connected Kids Key Goal Connected Kids: Safe Strong Secure is an AAP program designed to support clinicians’ efforts to prevent youth violence by.

Introduction To

Connected Kids

Key Goal

Connected Kids: Safe Strong Secure

is an AAP program designed to support clinicians’ efforts to prevent youth violence by promoting the development of resilient children.

Why Is This Important?

Violence is a major cause of childhood morbidity and mortality in the United States.

Homicide is the 2nd leading cause of death for 13- to 21-year-olds

The leading cause of death for African Americans 13 to 21 years old 1

Increase in community violence during 1990s

21st century rates in the United States still among the highest in the world

Why Is This Important?

Many parents and pediatricians feel community violence screening should be routine in well child care.

2-5

Results from the 1998 and 2003 AAP Periodic Surveys of Fellows show that a majority of pediatricians feel unprepared to manage community violence.

2-4

Why Is This Important?

Parents want more doctors to discuss community violence.

5 Community violence Supportive partner

Provider should ask Provider asked

Parent's emotional support Alcohol/drug use in household 0 20 40 % 60 80 100

Results from the National Survey of Early Childhood Health

Connected Kids provides…

Tools and strategies to help parents raise resilient children:

Educational materials for parents and youth

  

Effective anticipatory guidance Developmentally appropriate guidelines Easy-to-use Clinical Guide with links to research

Development Process

Development of Connected Kids included 6 :

    

Input from parents, clinicians, and other experts Testing of program materials in focus groups with diverse families and clinicians 7 Incorporation of stakeholder feedback A broad and respectful approach for all of the educational materials Coordination with other AAP efforts

Objectives

Connected Kids will:

 

Strengthen the connections among children and youth, their families, and their community Reduce risk factors by building resilience 8

Presentation Goals

1.

Become familiar with the underlying theoretical model for Connected Kids 2.

Review the counseling schedules for Infancy and Early Childhood, Middle Childhood, and Adolescence 3.

Learn how to prepare a strategy for implementing this program in your practice

Connected Kids . . .

Uses an asset-based approach to prevention that:

Emphasizes the identification and enhancement of strengths

Enhances clinician-family alliance

Helps parents with strategies to:

Promote positive development

Develop prosocial interpersonal skills

Obtain support and resources to help raise children

Asset- Versus Risk-based Approaches to Guidance

Assets:

Goal: Help improve child’s resilience

Assess family strengths

Link to community resources Risks:

Goal: Reduce known risks

Screen for risk factors

Refer to services

Connected Kids Includes:

   

Clinical guide Counseling schedule Handouts for parents and families Web site

This training presentation

Database of violence prevention materials

Success stories

Clinical Guide

• •

This presentation supplements the clinical guide, available online at www.aap.org/ConnectedKids Clinical guide contains

Background information

• •

Counseling schedule Visit-by-visit suggestions from birth to age 21

Building Blocks

Connected Kids centers on 4 overlapping themes of anticipatory guidance Child Centered Community Connections Parent Centered Physical Safety

Child-Centered

Recognizes:

Child’s changing abilities

Cognitive development of child

Related parental concerns Child Centered Parent Centered Community Connections Physical Safety

Parent-Centered

   

Addresses the importance of parental supports Incorporates the idea that parents develop along with the child Contributes to the quality of family life Promotes positive parenting Child Centered Parent Centered Community Connections Physical Safety

Positive Parenting

Teaching desired behavior begins with a positive and nurturing foundation 9 What to do when your child misbehaves How to manage conflict and teach responsibility Ways to nurture your children and prevent misbehavior

Community Connections

Research underscores the importance of 10 :

Social capital: a measure of the interconnectedness among people with their community

Community connections

Clinicians can help connect families to community resources Child Centered Parent Centered Community Connections Physical Safety

Physical Safety

Counseling schedule focuses on violence and intentional injury

Complements AAP’s TIPP ® (The Injury Prevention Program)

Handguns in the home placed in the context of child development

Provides objective information to help families make their own decisions Child Centered Parent Centered Community Connections Physical Safety

Connected Kids Counseling Schedule

 

Lists topics to introduce and reinforce at each visit Provides asset-based assessment and anticipatory guidance for each visit

Links to use of parent and patient brochures:

Distributed when a topic is first introduced

Promote discussion between provider and family

Give useful information to foster the development of strong, resilient children

Counseling Schedule

Front Cover Anatomy of a Brochure

Cover image visually conveys core message

Designed by Artists for Humanity, a non profit arts and entrepreneurship program for Boston teens.

Anatomy of a Brochure Content

Each brochure addresses one specific issue

Content based on all four building block themes

Reading level: 2nd to 6th grade

Contains concrete examples for key concepts

Anatomy of a Brochure Back Cover

 

Summarizes topics Space provided for:

Parent/patient guidance

Follow-up suggestions

Community resources

• •

Next appointment Practice name and address

Infancy & Early Childhood 2 days – 4 years

Counseling Schedule

Middle Childhood 5 – 10 years Adolescence 11 – 21 years

Counseling Schedule: Infancy

VISIT 2 DAYS to 4 WEEKS 2 and 4 MONTHS 6 and 9 MONTHS

• • • • • • • • • • • • •

INTRODUCE What Babies Do Parental Frustration Parent Mental Health Parent Support Child Care Family Safe Environment Parenting Style Bonding and Attachment Establishing Routines Discipline = Teaching Firearms Modeling Behavior

Infancy

11-17

Early caregiver relationships set the stage for future relationships

Securely attached young children have an easier time developing positive, supportive relationships

Emerging evidence shows that securely attached young children are found to have more 18-25 :

• • • •

Balanced self-concept Advanced memory processes Sophisticated grasp of emotion Positive understanding of friendship

Infancy Counseling

Be on the lookout for families who are socially isolated or experiencing family discord.

Who helps you with your baby?

If there is a gun in the home, how is it stored?

Is this what you expected?

How much time do you have off from work?

Being a new parent can be exhausting. How are you doing?

Infancy Brochures

Welcome to the World of Parenting!

Visit: 2 Days to 4 Weeks

Helps parents understand the normal development of newborns

Provides information about coping skills for parents

Discusses changes in the ways parents may now relate as a couple

How to Use this Tool

Whenever appropriate, include both parents in the conversation

Discuss infant crying and ways to handle it:

• • •

Crying is normal Crying upsets parents Sometimes, parents just need to let the baby cry Helpful Hint!

Support new parents with positive statements:

I love the way your baby looks at you, soothes to your voice. You’re doing a great job!

Parenting Your Infant

Visit: 2 and 4 Months

Helps parents understand normal development of 4- to 9-month-old infants

Stresses importance of building family connections

Discusses 3 problems:

Colic

Trouble sleeping

Clinging to parents

How to Use this Tool

Reiterate messages about crying and parental frustration

Emphasize to parents the importance of having time together without their baby Helpful Hint!

Support new parents with positive statements:

Your infant is alert, growing well, and has a beautiful smile!

How Do Infants Learn?

Visit: 6 and 9 months

Offers practical suggestions to parents based on a newborn’s brain development

Encourages activities like reading or singing to promote brain growth

Helps parents understand that exploration is a natural developmental need

How to Use this Tool

Ask parents about their social connections. Refer to sections “Others Who Care for Your Baby” and “Taking Care of Yourself”

Utilize the “Social Connections” worksheet from the Clinical Guide

Talk about child care arrangements Helpful Hint!

Notice infant’s new behaviors and parent-child interaction:

Wow, your baby is really interested in my stethoscope! I like the way she lets me examine her, but she is always looking over at you for assurance.

Your Child is on the Move: Reduce the Risk of Gun Injury

Visit: 6 and 9 months

Correlates childhood injuries/ deaths due to firearms and presence of handguns in the home

Emphasizes that a child’s curiosity about guns overwhelms any lessons learned about gun safety

Provides information needed to make informed decisions

How to Use this Tool

• •

Discuss handguns in the context of other household hazards Since some parents may not be in agreement concerning the presence of handguns in the home, encourage them to look at the brochure together to make an informed decision

• •

Helpful Hints!

In areas of country with high rates of gun ownership, some practices offer reduced price or free gun locks Be aware of the potential lethality of domestic violence in homes with handguns

Counseling Schedule: Early Childhood

VISIT 12 and 15 MONTHS

INTRODUCE Child Development and Behavior 18 MONTHS and 2 YEARS 3 and 4 YEARS

• • • • • • •

Child’s Assets Guided Participation Media Peer Playing Safety in Others’ Homes Talking About Emotions Promoting Independence

Early Childhood

26-30

Communication skills allow young children to sustain bouts of play

How young children learn to react is greatly influenced by:

Parental relationship

Parental behavior

Home environment

Early Childhood Counseling

Encourage alternatives to TV, such as outdoor activity or reading.

“Does your child have opportunities to play with other children this age?” “Teach your child by providing positive reinforcement for desired behaviors.” Normal toddler behavior may be especially difficult for families with little social support.

“She really pays attention when we talk; does she understand when you speak to her?” “What do you think your child does best? What does he enjoy doing?”

Early Childhood Brochures

Teaching Good Behavior: Tips on How to Discipline

Visit: 12 and 15 Months

Describes the basics of a behavioral approach to parenting toddlers

Positive reinforcement for desired behaviors

Limit setting

Advises parents about effective alternatives to corporal punishment

How to Use this Tool

Start conversations about toddler behavior with gentle inquiries

“Your child is growing and developing well. Have tantrums started? How do you handle them?”

“What is your child doing new since last visit? What do you want to change?”

Endorse the core message: a simple approach for teaching toddlers how to behave well Helpful Hint!

Be on the lookout for children with difficult temperaments, families who are socially isolated, and families experiencing discord

Playing is How Toddlers Learn

Visit: 18 Months and 2 Years Helps parents understand normal toddler behavior and advises them how to

Provide a stimulating environment during this period of major brain development

Understand the natural curiosity and exploration of toddlers

How to Use this Tool

• •

Discuss normal toddler play behavior Provide parents with guidance on the types of toys that stimulate imagination

Help parents identify places where they can meet other toddlers and their parents

• •

Helpful Hints!

Check in with parents about how their family relationships are faring Support toddler’s parents with positive statements:

What a delightful child you have! He is really curious about the world. This is great to see!

Pulling the Plug on TV Violence

Visit: 18 Months and 2 Years

Provides information about the influence of TV violence on children

Offers tips for parents

Set limits on TV time

Know what children are watching

• •

Watch programs with children Do not put TV in a child’s room

How to Use this Tool

Identify alternatives to TV, such as toys that use imagination or outdoor play when possible

Recognize that alternatives can be challenging, as TV often provides free in-home child care for families who cannot afford organized activities or who live in unsafe areas Helpful Hint!

Ask the child:

What’s your favorite TV show?

The child’s response often indicates the kind of TV programs being watched, which provides a topic to open discussion with parents

Young Children Learn A Lot When They Play

Visit: 18 Months and 2 Years

Introduces the importance of peer playing

Includes tips on how to make play opportunities successful

Assists parents in solving common difficulties, such as aggression and rejection

How to Use this Tool

Ask if child has opportunities to play with other children of the same age

Use parent’s answer to discuss how the child plays or how to find other children

Help parents problem solve any play or playmate issues Helpful Hint!

Try to notice something about what children are wearing, the toys they bring, or their behavior:

I see you really like trucks. Do you and your friends play with trucks a lot?

Counseling Schedule: Middle Childhood

VISIT 5 YEARS

INTRODUCE Establishing Routines and Setting Limits 6 YEARS 8 YEARS 10 YEARS

• • • • • •

Teaching Behavior Bullying Out-of-School Time School Connections Alcohol and Drugs Interpersonal Skills

• •

Child Mental Health School Performance

Middle Childhood

Rapid development of knowledge and skills characterizes middle childhood

Routines and limits will help children feel loved and secure during this time of transition 31,32

Children learn by watching and interacting with parents, other adults, and other children

Parents can consciously model and expect respectful behavior 33,34

Middle Childhood

Play is another way children learn social skills 35

Many parents have concerns regarding safety and supervision for after-school activities

Schools can have a significant impact on preventing violence 36,37

Besides academics, children learn how to function in society

Parental involvement with schools improves their children’s experience and attachment

Middle Childhood Counseling for the Parent

Do you have rules or limits with respect to TV, video games, and computer time?

Children grow and develop within a context of family, school, and community.

Are you involved in any school-related activities?

How does your child help around the home?

Who is your child’s best friend?

Is your child happy most of the time or withdrawn?

Have you been in any pushing or shoving fights?

What happens when you and your friends argue or disagree?

Middle Childhood Counseling for the Child

School-age children need to be active participants in learning how to avoid and react to conflict.

What do you like best about school?

What do you do for fun?

If you see someone being bullied, what do you do?

Middle Childhood Brochures

Growing Independence: Tips for Parents of Young Children

Visit: 5 Years

Emphasizes importance of beginning parent-child communication about peer relationships early

Teaches parents how to:

Listen to children

Help children assume more independence and responsibilities

How to Use this Tool

Address parents’ fears about children’s safety in the outside world

Ask about how the child is doing in school and address any behavioral or emotional issues

• •

Helpful Hints!

Let the child know that secrets are not OK Discuss child sexual abuse during or after examination of the child’s genitals

I’m here with your mother so it’s OK. No adult should ever tell you to keep a secret from your parents.

Bullying: It’s Not OK

Visit: 6 Years

Provides guidance for parents of victims, bullies, and bystanders

Victims may seek medical attention, but the poorest future outcomes are among bullies themselves 38,39

Schools can prevent bullying using proven interventions

How to Use this Tool

• •

Place brochure in the waiting room; it may be of interest to both parents and children Discuss specific strategies with those families whose children are being bullied

Use brochure as a guide when speaking to community groups Helpful Hint!

Ask the child:

Have you ever been in any pushing or shoving fights?

If the answer is yes, it is important to determine the child’s role.

Drug Abuse Prevention Starts With Parents

Visit: 8 Years

Discusses connection between a teen’s use and abuse of drugs and/or alcohol and:

Parent behavior and attitudes

Media influences

Communication

Addresses parental role in modeling and maintaining open communication

How to Use this Tool

Encourage parents to talk with and listen to their children

For parents who smoke, discuss the ease of starting and the difficulties of quitting; address other substance abuse problems if apparent

Have substance abuse resources on hand Helpful Hint!

Start conversations about drug abuse with the recent news:

Did you hear about _____ being charged with _____? What do you think about that?

Friends Are Important: Tips for Parents

Visit: 8 Years

Focuses on importance of peer relationships

Encourages parents to get to know their child’s friends

Provides guidance on monitoring behaviors to prevent unsafe activities

Reiterates Connected Kids theme of clear, consistent, and positive communication

How to Use this Tool

Encourage parents to know their child’s whereabouts and talk about expectations for staying in touch

Encourage parents to help their child develop a sense of belonging through prosocial youth groups and community-based organizations

Helpful Hints!

Address friendships and community activities while discussing school progress and promoting physical activity

Ask parent:

“Who is your child’s best friend?”

to initiate discussion

Everybody Gets Mad: Helping Your Child Cope With Conflict

Visit: 10 Years

Developed for parents of pre- and early adolescents

Describes the physiology of anger and offers strategies to avoid fighting when angry

Guides parents in teaching their children how to respond to conflict

How to Use this Tool

Introduce the topic with general questions such as

“Are there a lot of fights at school?”

or

“What happens when you get angry?”

Discuss the body’s physical response to anger and how to stay calm

Helpful Hints!

Ask patients who avoid fights if they have hints for other kids

Consider the possibility of abuse, exposure to violence, or history of ADHD or minimal brain trauma in children who have difficulty dealing with anger

Counseling Schedule: Early Adolescence

VISIT 11 to 14 YEARS

• • • • • • • •

INTRODUCE Family Time Together Peer Relationships Support System Staying Safe Teen Mental Health Conflict Resolution Skills Healthy Dating Gaining Independence

Early Adolescence

Independence is an overarching characteristic of the early teen years

Becoming independent means being more responsible for one’s own safety

Help teens stay safe by teaching them how to avoid violence through good communication skills

Effective communication is the common thread for the Connected Kids early adolescence counseling

Early Adolescence

Talk with teens and parents about activities that help families stay connected; many teens are unsure about family relationships 40

Parents influence their teen children; discuss parental use of alcohol, tobacco, and other drugs

Involving adults from outside the family has a positive effect on teen development 41

Encourage teens to get involved in their communities; it is one of the best ways to help them stay safe 42

Early Adolescence

Teens with friends engaged in risky behaviors are more likely to imitate these behaviors 43

Conversely, friends involved in constructive, prosocial activities encourage healthy and safe behaviors

Teen dating violence affects approximately 1 in 8 high school students. Discuss healthy dating with both teens and their parents 44

Youth who have a variety of ways to solve conflicts are less likely to be hurt in a fight or arrested 45

Early Adolescence

F I S T S

F ighting I njuries S ex T hreats S elf-defense Use this mnemonic as the basis for assessing an adolescent’s risk for involvement in violence. See the Connected Kids Clinical Guide for more details.

What do you think of your teenager’s friends?

Early Adolescence Counseling for Parents

Address parents’ concerns about safety while still helping them encourage their teen’s independence How are you monitoring your teenager?

How do you negotiate rules of behavior?

What kind of activities does your child enjoy?

What most concerns you about your teenager’s safety?

Whom do you turn to for advice and encouragement?

Early Adolescence Counseling for Youth

With independence comes the responsibility for staying safe.

What do you do to stay safe?

Whom do you go to for help if you’re having trouble in your relationship?

What after-school activities are you involved with?

What do you and your friends like to do?

Early Adolescence Brochures

Talking With Your Teen: Tips for Parents

Early Adolescence

Describes typical teen behaviors and feelings and emphasizes parent-child communication as independence increases

Teaches parents how to:

establish reasonable limits

encourage safety as independence increases

How to Use this Tool

• • •

Initiate discussion at puberty by asking,

“I’m sure there are many other changes going on that you can’t see with your eyes, aren’t there?”

Speak with parents regarding concerns about their child’s puberty Helpful Hints!

Having both teens and parents read this brochure may encourage better communication between parent and child Ask parents to think about their own adolescence and how they behaved and coped at this age

Staying Cool When Things Heat Up

Early Adolescence

Encourages teens to think about ways to resolve conflicts other than fighting

Discusses the role bystanders play in promoting violent behavior

How to Use this Tool

Use different approaches based on violence history:

• •

“You’re very healthy, but I’m worried about all the fights you’re getting into.” “Your exam looks good and I’m also glad to hear that you haven’t been getting into a lot of fights.”

Helpful Hints!

Some clinicians leave this brochure in the waiting room for patients to read beforehand

It may help to let patients know that this information came from other teenagers.

Expect Respect: Healthy Relationships

Early Adolescence

Discusses healthy relationships and ways to recognize and prevent partner violence

Teens are still experimenting with intimate relationships and may be more open to improving the quality of their relationships

While designed for all teenagers, it had the most resonance with young female teens in focus groups.

How to Use this Tool

Introduce when teens show an interest in relationships, dating, and sexual behavior

Discuss healthy relationships along with physical concerns such as sexually transmitted diseases

Can be used with sex education courses in schools Helpful Hints!

At the end of an exam, say:

Today we have discussed some of the physical issues of intimate relationships, but the emotional issues are just as important.

Teen Dating Violence: Tips for Parents

Early Adolescence

Discusses parental response when partner abuse is suspected

The main concern for parents is their child’s happiness and welfare, not pointing out what is wrong with the abusive partner

How to Use this Tool

Encourage parents to:

• •

empathize with what their child is experiencing support their child in finding and maintaining non-abusive, healthy relationships Helpful Hint!

Give this brochure to parents at the same time Expect Respect: Healthy Relationships is given to teenagers

Counseling Schedule: Middle Adolescence

VISIT 15 – 17 YEARS INTRODUCE

Plans for the Future

Firearms and Suicide

Depression

Resiliency

Middle Adolescence

There is a direct link between assets and the risk for violence and future success 46

Identify and support a teen’s:

• • • •

strengths functional abilities positive relationships with others connections to groups, role models, and mentors

Middle Adolescence

A key in helping teens avoid violence is to teach them how to:

• •

assess risk and make an immediate decision think about the long-term consequences of that decision

If you have guns, how do you store them?

Middle Adolescence Counseling for Parents

Help parents with the teen’s dilemma of quick decisions and long-term consequences.

How is your teen getting along with friends?

How do you stay in touch with your teen?

Do you talk about future plans?

What non-school activities is your teen involved with?

Do you have somebody to talk to when you feel sad?

What do you want to do after high school graduation?

Middle Adolescence Counseling for Youth

Teens are living in the moment, but need to think about the future.

Can you get a gun if you want to?

What do you like best about yourself?

How do you get along with your friends?

Middle Adolescence Brochures

Teen Suicide and Guns

Middle Adolescence

Discusses the risks of guns in the home and the link to completed teen suicides

Objectively discusses guns and gun storage

How to Use this Tool

Use on an individual basis to support counseling

Can be distributed to schools and community groups

Parents of teens with mood disorders may benefit from this along with the brochure

Help Stop Teenage Suicide

Helpful Hints!

Use current events:

Did you hear about the teen who killed himself last month? I’m talking about this with all of my teenage patients.

Connecting With Your Community

Middle Adolescence

Teenagers who are involved in their communities are less likely to be involved with:

alcohol

drugs

• •

violence promiscuous sexual activity

How to Use this Tool

• •

As relationships with their parents become more complex, additional adult role models become more important for teens Support teens in finding adults in the community who believe in and support them

Helpful Hints!

Schools and community groups can help find opportunities that meet the interests and talents of young adults

It may be beneficial for clinics to develop a resource guide for teens about local community groups

Counseling Schedule: Late Adolescence

VISIT 18 – 21 YEARS INTRODUCE

Transition to Independence

Negotiating a New Environment (Post High School)

Late Adolescence

Transitioning to independence is a gradual process

Bringing closure to this process is essential

Many older teenagers are likely to be moving out of the home to:

higher education

their own living situation

an entirely new community

This is exciting and stressful for both teen and parent

What are your plans down the road?

Late Adolescence Counseling for Youth

Support patients with the transition to becoming a young adult.

Do you plan to move out of your parents’ home?

Can I help with getting you where you want to go?

Whom do you talk to about your future plans?

How do you feel about moving out?

Late Adolescence Brochures

Help Stop Teenage Suicide

Late Adolescence

Talks about common myths, gives the warning signs, and stresses that many teen suicides occur with little forethought

Designed for teens, parents, and other caregivers

How to Use this Tool

Use with patients with mental health issues, especially mood or conduct disorders, that often develop during these years

Stress link between presence of a handgun and increased likelihood of lethal suicide attempts

Helpful Hint!

Teens who think they may be gay, lesbian, bisexual, or transgender are at an increased risk for suicide; help them and their families find additional support

Next Stop Adulthood: Tips for Parents

Late Adolescence

Teens are renegotiating parental relationships as they transition into adult responsibilities

Helps parents let go while encouraging teens to seek guidance from their parents

How to Use this Tool

Use as a catalyst to discuss increasing independence

Teens who are already in trouble may need a social worker to help better understand and implement these concepts Helpful Hints!

• •

It is helpful to discuss employment, community service, sports, clubs, and other pursuits Teenagers need positive engagement with their outside community in order to thrive!

Ideas for Optimal Use

While implementing Connected Kids with an individual family depends on a family’s starting point —and the family’s interest in our input—we can begin to consider some strategies for implementation in the following areas:

• • • • •

Intake Forms Counseling Educational Materials Practice Changes Community Connections

Intake Forms

Use the Bright Futures Pediatric Intake Form

Introduce Connected Kids in a cover letter to families

Use information gathered to prioritize issues for families and tailor the program

As your relationship with a family evolves, it may become easier to discuss sensitive topics

Use the information gathered at every visit

Counseling

Be sensitive to issues that might be difficult for a particular family

Include both statistics and stories

Prioritize topics covered on the families’ needs

Use the adolescent brochures to facilitate new ways for parents and teens to talk

Educational Materials

Use brochures to introduce sensitive topics, such as domestic violence

Encourage the parent to share the information with other adults caring for the child

Ask support staff to help distribute materials while patients are waiting to be seen

Educational Materials

Personalize the brochures:

Circling or underlining a passage increases the likelihood that your advice will be followed

Write down family-specific information in the box on the back cover during the visit

Suggest placing it on the refrigerator so the cover image can be a reminder of what to do

Encourage parents/patients to write questions in the box on the back while they are waiting

Practice Changes

Involve all office staff; receptionists observe how parents and children interact

Use the Counseling Schedule from the Clinical Guide to document when you have introduced and reinforced topics

Talk with colleagues about how they have successfully implemented Connected Kids

Community Connections

Become familiar with programs in your community

If resources do not exist, advocate for services

Get involved:

Join coalitions working to rid the community of violence

• •

Speak to community and school groups Talk with the local media

In Summary All children deserve to grow up:

Safe

Strong

Secure We can help families achieve these goals!

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Acknowledgments

Howard Spivak, MD Robert Sege, MD, PhD Elizabeth Hatmaker-Flanigan, MS Bonnie Kozial Vincent Licenziato Kimberly Bardy, MPH This project was supported by Grant No. 2001-JN-FX-0011 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.