Five Ways Pediatrics Can Support Social Emotional Development

Mom and sonSupporting young children’s social emotional development is just as important as supporting their cognitive capabilities and physical health. For children to succeed at school and build healthy relationships, they need to be able to express and experience emotions, self-regulate, and manage challenges and conflict. By working with families to support social emotional development, pediatric health professionals can set children up for a successful future.

CapitalCare Developmental Pediatrics, a division of Community Care Physicians, P.C., located in Troy, New York, is working to do exactly that. Since its inception, the practice has focused on children with special health care needs, including autism and Down Syndrome, which gives them unique insight into supporting social and emotional well-being.

“A major part of what we do is working with children with social emotional challenges,” explains practice co-founder Anthony Malone, MD. “The response from all our families about prioritizing social emotional development has been overwhelmingly positive—families like that we are seeing the bigger picture and they want to talk about their children’s emotional health.”

CapitalCare is one of 18 pediatric practices participating in Pediatrics Supporting Parents, a NICHQ-led quality improvement initiative seeking to better utilize the well-child visit to foster healthy social emotional growth. NICHQ is working with the CapitalCare team to refine their approach and test new ways to help parents learn about and support social emotional development.

From enhancing parent-child relationships to supporting children in foster care, CapitalCare’s efforts to promote social emotional development are inspiring. Here, Malone shares five opportunities pediatric professionals can use in their own work.

1. Commit to a culture shift

Pediatric practices can fall into the trap of looking at social emotional development as something they need to “fit in” to well-child visits, says Malone. This mindset automatically positions social emotional health as secondary to physical health, and consequently, supporting it becomes the first thing to go when schedules get too busy. Shifting to a culture that views social emotional health as paramount to children’s health is essential.

“Shifting our office culture has been the driving force behind every change we’ve made,” says Malone. “We always say, ‘you need a champion to encourage buy-in,’ and that’s true; champions bring enthusiasm and a clear message to the table and inspire others. But champions can’t do it alone; they need to have administrative support behind them, so they don’t get backed into a corner when trying to change processes.”

2. Make breastfeeding a priority

Breastfeeding not only has incredible nutritional benefits for both mom and baby; it also promotes social emotional development, says Malone. Studies show that the oxytocin from breastmilk and released through breastfeeding can facilitate social emotional growth and reduce negative tendencies, such as withdrawal and anxiety. Moreover, breastfeeding promotes a trusting mother-baby relationship, which fosters healthy brain development. Malone advises talking to families about the benefits of breastfeeding during well-child visits and, if possible, having a lactation consultant on staff who can support new mothers in breastfeeding.

3. Help parents be great teachers

CapitalCare uses a multimodal approach to help parents and caregivers learn how to best support their children’s social emotional development. They play educational videos in the waiting room so families can learn about social emotional development while they wait for appointments; and they’ve recently started giving families parenting books they can take home, so learning doesn’t stop after the pediatric visit.

They’ve also implemented multiple strategies to encourage positive parent-child interactions once families go home. For the past four years, CapitalCare has participated in Reach Out and Read, a national program for public literacy that provides children’s books during well-child visits so that families can read to their children at home. Now, through Pediatrics Supporting Parents, CapitalCare has added a new interactive element to the well-child visit: a toy giveaway. The practice staff provide a simple toy to encourage play when parents get home, review a set of instructions about how to use the toy, and then follow up with families at their next visit. The response from families has been entirely enthusiastic.

4. Provide all relevant screenings and follow-up

Along with screening for developmental milestones such as speech or language disorders, screening for social emotional milestones matters too. The CapitalCare team not only include social emotional screenings at every well-child visit, but they also provide screenings for Adverse Childhood Experiences (ACEs), which can adversely affect brain development. And since caregiver mental health directly affects child development, CapitalCare includes maternal depression screens for mothers during the well-child visit as well.

Looking for screening tools? The Ages and Stages Questionnaire includes a social emotional screening.

It’s important to remember that screening is just one part of the solution, says Malone. When children screen positive, practices need an appropriate and automatic response for connecting families with services. If feasible, Malone recommends having a dedicated mental health therapist in the clinic, so that families can receive an immediate evaluation in a place they already know.

5. Support children in foster care

“Any child placed in foster care should have a comprehensive assessment of their social emotional development and then be connected with mental health services,” says Malone. “We’ve found that these children almost always have an unidentified need, but still so many are never screened or referred to supportive services. There is something so wrong with that, which is why we’re working really hard to support foster children in our area.”

CapitalCare has partnered with their county’s social service department foster care program to provide screenings and support to local foster children. By providing comprehensive assessments, they give foster parents a better understanding of the child’s needs and how they can best support social emotional development.

As practices pursue these opportunities in their own work, remember to take it slowly, concludes Malone. “It’s okay to try half a dozen things and realize not all of them work for you—you just need an open attitude and willingness to try new things. Partnering with NICHQ on this collaborative has helped cement the importance of starting small, testing changes, and tracking outcomes through data.”

Interested in hearing from another practice participating in Pediatrics Supporting Parents? Here, learn how one practice developed a program to help pediatric health professionals promote loving connections between parents and children.