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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 old1

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

Provider
should ask
Provider
asked

Supportive partner

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 included6:


Input from parents, clinicians, and other experts
Testing of program materials in focus groups with
diverse families and clinicians7
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 resilience8

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:

Risks:

Goal: Help improve childs

Goal: Reduce known risks

resilience

Assess family strengths


Link to community
resources

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

ChildCentered

Community
Connections

ParentCentered

Physical
Safety

Child-Centered

Recognizes:
Childs changing abilities
Cognitive development of child
Related parental concerns

ChildCentered
ParentCentered

Community
Connections

Physical
Safety

Parent-Centered

ChildCentered

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

ParentCentered
Community
Connections

Physical
Safety

Positive Parenting
Teaching desired behavior begins with a
positive and nurturing foundation9

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 of10:

Social capital: a measure of the


interconnectedness among people
with their community
Community connections

Clinicians can help connect


families to community resources

ChildCentered

ParentCentered
Community
Connections

Physical
Safety

Physical Safety

Counseling schedule focuses on


violence and intentional injury

Complements AAPs 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

ChildCentered

ParentCentered

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

Anatomy of a Brochure

Front Cover
Cover image visually conveys
core message

Designed by Artists for Humanity, a nonprofit 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

Counseling Schedule

Infancy & Early


Childhood
2 days 4 years

Middle Childhood

Adolescence

5 10 years

11 21 years

Counseling Schedule:
Infancy
VISIT

2 DAYS to
4 WEEKS

INTRODUCE

2 and 4
MONTHS

6 and 9
MONTHS

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

Infancy11-17

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 more18-25:

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. Youre 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 newborns
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 infants 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 childs 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

INTRODUCE

12 and 15
MONTHS

Child Development and


Behavior

18 MONTHS
and 2 YEARS

Childs Assets
Guided Participation
Media

3 and 4 YEARS

Peer Playing
Safety in Others Homes
Talking About Emotions
Promoting Independence

Early Childhood26-30

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 toddlers 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 childs 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:

Whats your favorite TV show?

The childs 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 parents 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

INTRODUCE

5 YEARS

Establishing Routines and


Setting Limits

6 YEARS

Teaching Behavior
Bullying
Out-of-School Time

8 YEARS

School Connections
Alcohol and Drugs
Interpersonal Skills

Child Mental Health


School Performance

10 YEARS

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 transition31,32
Children learn by watching and interacting with
parents, other adults, and other children
Parents can consciously model and expect respectful
behavior33,34

Middle Childhood

Play is another way children learn social skills35


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

Schools can have a significant impact on


preventing violence36,37
Besides academics, children learn how to function in

society
Parental involvement with schools improves their
childrens experience and attachment

Middle Childhood
Counseling for the Parent
Do you have rules
or limits with
respect to TV, video
games, and
computer time?
Are you involved
in any schoolrelated
activities?

Who is your
childs best
friend?

Children grow and develop


within a context of family,
school, and community.

How does your


child help around
the home?

Is your child
happy most of
the time or
withdrawn?

Middle Childhood
Counseling for the Child

Have you been in


any pushing or
shoving fights?
What happens
when you and
your friends
argue or
disagree?

What do you
do for fun?

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

What do you like


best about
school?

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 childrens


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 childs
genitals

Im here with your mother so


its OK. No adult should ever
tell you to keep a secret from
your parents.

Bullying: Its 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
themselves38,39
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 childs role.

Drug Abuse Prevention Starts With


Parents
Visit: 8 Years

Discusses connection between a


teens 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
childs 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 childs


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 childs 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 bodys 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 ones 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 relationships40
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 safe42

Early Adolescence

Teens with friends engaged in risky behaviors are


more likely to imitate these behaviors43
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 parents44
Youth who have a variety of ways to solve conflicts
are less likely to be hurt in a fight or arrested45

Early Adolescence

FISTS
Fighting
Injuries
Sex
Threats
Self-defense

Use this mnemonic as


the basis for assessing
an adolescents risk for
involvement in violence.
See the Connected Kids
Clinical Guide for more
details.

Early Adolescence
Counseling for Parents
What do you
think of your
teenagers
friends?

How are you


monitoring your
teenager?

What kind of
activities does
your child enjoy?

Address parents
concerns about safety
while still helping them
encourage their teens
independence

How do you
negotiate rules
of behavior?

What most concerns


you about your
teenagers safety?

Early Adolescence
Counseling for Youth

Whom do you
turn to for
advice and
encouragement?

What do you do
to stay safe?

What after-school
activities are you
involved with?

With independence
comes the responsibility
for staying safe.

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

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,Im


sure there are many other changes going on
that you cant see with your eyes, arent
there?

Speak with parents regarding concerns


about their childs 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:

Youre very healthy, but Im worried about


all the fights youre getting into.
Your exam looks good and Im also glad to
hear that you havent 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 childs 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 success46
Identify and support a teens:

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

Middle Adolescence
Counseling for Parents

If you have guns,


how do you store
them?

How is your teen


getting along
with friends?

Do you talk
about future
plans?

Help parents with the


teens dilemma of quick
decisions and long-term
consequences.

How do you stay


in touch with
your teen?

What non-school
activities is your
teen involved with?

Middle Adolescence
Counseling for Youth

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

What do you
want to do after
high school
graduation?

What do you like


best about
yourself?

Teens are living in the


moment, but need to
think about the future.

Can you get a gun


if you want to?

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? Im 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

Late Adolescence
Counseling for Youth

What are your


plans down the
road?

Do you plan to
move out of your
parents home?

Can I help with


getting you
where you want
to go?

Support patients with the


transition to becoming a
young adult.

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 familys starting
pointand the familys interest in our inputwe
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!

References

1.
2.
3.
4.
5.
6.
7.
8.

Centers for Disease Control and Prevention. Web-based Injury Statistics Query and
Reporting System [Online]. (2001) National Center for Injury Prevention and Control,
Centers for Disease Control and Prevention. Available at: www.cdc.gov/ncipc/wisqars
American Academy of Pediatrics. AAP Periodic Survey of Fellows #38. 1998
American Academy of Pediatrics. AAP Periodic Survey of Fellows #55. 2003
Trowbridge MJ, Sege RD, Olson L, OConnor K, Flaherty E, Spivak H. Intentional injury
management and prevention in pediatric practice: results from 1998 and 2003 American
Academy of Pediatrics Periodic Surveys. Pediatrics. 2005;116:996-1000
Kogan MD, Schuster MA, Yu SM, et al. Routine assessment of family and community health
risks: parent views and what they receive. Pediatrics. 2004;113(6 suppl):1934-1943
Sege RD, Flanigan E, Levin-Goodman R, Licenziato VG, De Vos E, Spivak H. American
Academy of Pediatrics Connected Kids program: case study. Am J Prev Med. 2005;29(5
suppl 2):215-219
Sege RD, Hatmaker-Flanigan E, De Vos E, Levin-Goodman R, Spivak H. Anticipatory
guidance and violence prevention: results from family and pediatrician focus groups.
Pediatrics. 2006;117:455-463
Resnick MD, Ireland M, Borowsky I. Youth violence perpetration: what protects? What
predicts? Findings from the National Longitudinal Study of Adolescent Health. J Adolesc
Health. 2004;35:424.e1-424.e10

References

9.
10.
11.
12.
13.
14.
15.

University of Minnesota Extension Service. Positive Parenting. Minneapolis, MN: University of


Minnesota; 2000
Drukker M, Kaplan C, Feron F, van Os J. Childrens health-related quality of life,
neighbourhood socio-economic deprivation and social capital. A contextual analysis. Soc Sci
Med. 2003;57:825-841
Bretherton I, Munholland KA. Internal working models in attachment relationships: a construct
revisited. In: Cassidy J, Shaver PR, eds. Handbook of Attachment: Theory, Research, and
Clinical Applications. New York: Guilford Press; 1999:89-111
Sroufe LA, Fleeson J. Attachment and the construction of relationships. In: Hartup WW, Rubin
Z, eds. Relationships and Development. Hillside, NJ: Lawrence Erlbaum Associates; 1986:5171
Sroufe LA, Fleeson J. The coherence of family relationships. In: Hinde RA, Stevenson-Hinde
J, eds. Relationships Within Families: Mutual Influences. Oxford, UK: Clarendon; 1988:27-47
Thompson RA. Early sociopersonality development. In: Damon W, Eisenberg N, eds.
Handbook of Child Psychology. Vol 3: Social, Emotional, and Personality Development. 5th
ed. Hoboken, NJ: John Wiley & Sons; 1998:25-104
Sroufe LA, Egeland B. Illustrations of person-environment interaction from a longitudinal
study. In Wachs TD, Plomin R, eds. Conceptualization and Measurement of OrganismEnvironment Interaction. Washington, DC: American Psychological Association; 1991:68-84

References

16.

17.
18.
19.
20.
21.
22.
23.

Sroufe LA, Carlson E, Schulman S. Individuals in relationships: development from infancy


through adolescence. In: Funder DC, Parke RD, Tomlinson-Keasey C, Widaman K, eds.
Studying Lives Through Time: Personality and Development. Washington, DC: American
Psychological Association; 1993:315-342
Thompson RA. Early attachment and later development. In: Cassidy J, Shaver PR, eds.
Handbook of Attachment: Theory, Research, and Clinical Applications. New York: Guilford
Press; 1999:265-286
Cassidy J. Child-mother attachment and the self in six-year-olds. Child Dev. 1988;59:121134
Verschueren K, Marcoen A, Schoefs V. The internal working model of the self, attachment,
and competence in five-year-olds. Child Dev. 1996;67:2493-2511
Belsky J, Spritz B, Crnic K. Infant attachment security and affective-cognitive information
processing at age 3. Psychol Sci. 1996;7:111-114
Kirsh SJ, Cassidy J. Preschoolers attention to and memory for attachment-relevant
information. Child Dev. 1997;68:1143-1153
Laible DJ, Thompson RA. Attachment and emotional understanding in preschool children.
Dev Psychol. 1998;34:1038-1045
Cassidy J, Kirsh SJ, Scolton KL, Parke RD. Attachment and representations of peer
relationships. Dev Psychol. 1996;32:892-904

References

24.
25.
26.
27.
28.
29.
30.
31.

Kerns KA. Individual differences in friendship quality: links to child-mother attachment. In:
Bukowski WM, Newcomb AF, Hartup WW, eds. The Company They Keep: Friendship in
Childhood and Adolescence. New York: Cambridge University Press; 1996:137-157
Park KA, Waters E. Security of attachment and preschool friendships. Child Dev.
1989;60:1076-1081
Bradley RH, Caldwell BM, Rock SL. Home environment and school performance: a ten-year
follow-up and examination of three models of environmental action. Child Dev. 1988;59:852867
Collins WA, Laursen BP, Hartup WW. Relationships As Developmental Contexts. Minnesota
Symposia on Child Psychology 30. Mahwah, NJ: Lawrence Erlbaum Associates; 1999
Dunn J. Young Childrens Close Relationships. Newbury Park, CA: Sage; 1993
Hartup WW, Rubin Z, eds. Relationships and Development. Hillsdale, NJ: Lawrence
Erlbaum Associates; 1986
Maccoby E, Martin J. Socialization in the context of the family: parent-child interaction. In:
Mussen P, Hetherington E, eds. Handbook of Child Psychology, Volume 4: Socialization,
Personality, and Social Development. 4th ed. New York: John Wiley & Sons; 1983:1-102
Maccoby EE. The role of parents in the socialization of children: an historical overview. Dev
Psychol. 1992;28:1006-1017

References

32.
33.
34.
35.
36.
37.
38.
39.

Eisenberg N, Murphy B. Parenting and childrens moral development. In: Bornstein MH, ed.
Handbook of Parenting, Volume 4: Applied and Practical Parenting. Hillsdale, NJ: Lawrence
Erlbaum Associates, Inc; 1995:227-257
Kohlberg L. Development of moral character and moral ideology. In: Hoffman ML, Hoffman
LW, eds. Review of Child Development Research, Volume 1. New York, NY: Russell-Sage
Foundation; 1964:383-431
Bandura A. Social Learning Theory. Englewood Cliffs, NJ: Prentice Hall; 1977
Shonkoff JP, Phillips DA, eds. Making friends and getting along with peers. In: From
Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC:
National Academy Press; 2000:163-181
ODonnell DA, Schwab-Stone ME, Muyeed AZ. Multidimensional resilience in urban children
exposed to community violence. Child Dev. 2002;73:1265-1282
Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm. Findings from
the National Longitudinal Study on Adolescent Health. JAMA. 1997;278:823-832
Olweus D. Bullying at School: What We Know and What We Can Do. Oxford, UK: Blackwell
Publishers; 1993
Farrington DP. Understanding and preventing bullying. In: Tonry M, ed. Crime and Justice: A
Review of Research, Volume 17. Chicago, IL: University of Chicago Press; 1993:381-458

References

40.
41.

42.
43.

44.
45.
46.

Kingon YS, O'Sullivan AL. The family as a protective asset in adolescent development. J
Holist Nurs. 2001;19:102-121
Jekielek SM, Moore KA, Hair EC, Scarupa HJ. Mentoring: a promising strategy for youth
development. Child Trends Research Brief. Washington, DC: Child Trends; 2002. Available
at http://12.109.133.224/Files/MentoringBrief2002.pdf. Accessed June 27, 2005
McMahon SD, Singh JA, Garner LS, Benhorin S. Taking advantage of opportunities:
community involvement, well-being, and urban youth. J Adolesc Health. 2004;34:262-265
Urberg KA, Luo Q, Pilgrim C, Degirmencioglu SM. A two-stage model of peer influence in
adolescent substance use: individual and relationship-specific differences in susceptibility to
influence. Addict Behav. 2003;28:1243-1256
Grunbaum JA, Kann L, Kinchen SA, et al. Youth risk behavior surveillance--United States,
2001. MMWR Surveill Summ. 2002;51:1-62
Slaby RG, Guerra NG. Cognitive mediators of aggression in adolescent offenders: I.
Assessment. Dev Psychol. 1988;24:580-588
Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel
study of collective efficacy. Science. 1997;277:918-924

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.

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