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MNAAP Newsletter

Expanding Help Me Grow in Minnesota

By Elsa Keeler, MD, MPH

When a child age birth to five is at risk for or identified with developmental delays, referral for education evaluation through Minnesota’s current Help Me Grow connects the family to evaluation and possible early intervention/special education services. This robust system has positive developmental resources and assures early intervention for positive developmental outcomes (see sidebar).

Yet, we know that not all children at risk are referred, and even if referral takes place, many may not qualify for education-based early intervention services. We understand the need to refer a child with a medical diagnosis to early intervention. However, we also know that social determinants and toxic stress contribute to mental and physical health and developmental outcomes. That is, even a healthy appearing baby may be on an at-risk developmental trajectory when his family encounters environment stress, parent mental health concerns, trauma, poverty, or lack of social supports. For pediatric clinicians, knowing what referral resources are available to offer families can be challenging, given factors such as family culture, preference, and community.

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Building Healthy Development for a Lifetime Effect

By Michael Georgieff, MD, FAAP

Every child has a right to optimal cognitive, social and emotional behavioral development. Since behavior is the efferent expression of the brain, medical stakeholders — including pediatricians — have a stake in ensuring brain health across the lifespan. Brain health begins prenatally and likely even pre-conceptionally, implying that the first point of education/prevention may be in non-pregnant women of child-bearing age. Many of the principles of developmental (i.e., fetal) origins of adult metabolic health (obesity, type 2 diabetes, hypertension) apply to adult health (e.g., depression, anxiety, schizophrenia). Thus, the metabolic and structural brain development that occurs early in life provides a scaffold for complex adult mental capabilities. New brain/behavior assessment tools have allowed identification of important environmental events that promote or pose risks to normal brain development and identify critical and sensitive periods for these environmental effects.

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