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
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 child’s
• 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:
• Child’s changing abilities
• Cognitive development of child
• Related parental concerns
ChildCentered
ParentCentered
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
ChildCentered
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 AAP’s TIPP®
(The Injury Prevention Program)
 Handguns in the home placed in
the context of child development
• Provides objective information to help
ChildCentered
ParentCentered
Community
Connections
families make their own decisions
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
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
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, O’Connor 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.
University of Minnesota Extension Service. Positive Parenting. Minneapolis, MN: University of
Minnesota; 2000
Drukker M, Kaplan C, Feron F, van Os J. Children’s health-related quality of life,
neighbourhood socio-economic deprivation and social capital. A contextual analysis. Soc Sci
Med. 2003;57:825-841
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.