Clark Parent and Child Network

Infant and Toddler Pillar

On July 1, 2020, Children’s National Hospital, with generous support from the A. James & Alice B. Clark Foundation, launched the Clark Parent & Child Network, to create a sustainable cycle of care for pregnant women and young children across Washington, D.C. With a five-year, $36 million gift and additional funding plan (2020 to 2025), the network drives the development of a new field of pediatric medicine encompassing maternal wellness, toxic stress and a child’s crucial development needs from conception to age 3. The Parent Child Network accelerates and elevates clinical and research innovations underway at Children’s National and harnesses them with place-based and community-based partnerships to achieve sustainable positive changes for district-wide families. Leading the Network is Lee Beers, M.D., and Catherine Limperopoulos, Ph.D.

Our Approach

The Clark Parent & Child Network focuses on improving maternal wellness, reducing toxic stress and better understanding child's crucial development needs from conception to age 3. We seek to accelerate and elevate clinical and research innovations Underway at Children's National and partner with local groups to achieve sustainable, positive change.

Our approach seeks to create a sustainable cycle of care that incorporates:

Community and place-based interventions
Partnerships with women's centers
Clinical investigations
A core of community outreach coordinators
Education and training World-class specialty care
Virtual health/technology
Robust engagement and advocacy

The Clark Parent & Child Network is incubating new ideas and approaches and training and building capacity among local partners and providers. The program empowers parents and other caregivers through 10 unique and complementary components.

Clark Infant and Toddler Pillar Programs

Community Health Educator and Outreach CORE

Goal: Create a network of place-based advocates who engage every aspect of Clark Parent & Child Network and support parents through collaborations with local partners.

Description: Community Core’s presence within the Family Services/Social Work Department, has allowed for collaboration and development of customized social needs resource sheets. There is now a patient-facing online repository with resources in English and Spanish for any number of areas that families may be looking for support in such as employment, food, childcare, etc. These resources can also be accessed by staff across Children’s National and the Pediatric Health Network. Our team has also been active in the hospital-wide Social Determinants of Health SIG, contributing to the decisions regarding four social needs questions that will be asked universally of all Children’s National patients no matter where/how they are interacting with our health system.

Healthy Generations

Goal: Comprehensive healthcare and wrap-around services for teen parents and their young children.

Description: Healthy Generations is recognized by the U.S. Department of Health and Human Services as an evidenced-based program to prevent repeat teen pregnancy. Generations provides community based, coordinated, and family-centered healthcare for teen parents and their children. Services offered in several services for the mother (breastfeeding support, gynecologic care, etc.) and the child (immunizations, nutrition, etc.), including mental health services. The program enrolls young parents up to 19 years old and offers healthcare and related services through age 21 for teen parents and their children, with services starting once the baby is born.

Whole Bear Care

Goal: Expanding primary care behavioral health services through specialist training and workforce development.

Description: Whole Bear Care places psychologists and postgraduate-level psychology students alongside clinical and social work staff to ensure timely diagnosis and treatment of mental health conditions. They address behavior and sleep concerns through caregiver trainings. They provide education and interventions to improve family communication. They refer patients to more specialized services. They also intervene when mothers experience depression and anxiety.

Hospital Caregiver Screenings for Perinatal Mood and Anxiety Disorders (PMADs Screenings)

Goal: Identifying struggling families in our emergency department, and neonatal intensive care unit (NICU), through perinatal mood and anxiety disorder (PMAD) screening.

Description: The pediatric emergency department and the NICU have developed a interdisciplinary team that offers postpartum mental health screenings for caregivers and referrals for further support services. The interdisciplinary team is composed of social workers, family services associates, physicians, data coordinators, and psychologists. Key components of the program include in-person and remote screening, repeat screening in the NICU using standardized tools, follow-up calls for those in need, development of resources addressing perinatal mood and anxiety disorders, and linkages to inhouse psychologists and outpatient resources including those that address social needs. The PMAD team is a specialty consult service for other providers throughout the hospital. Additionally, they are heavily involved in research and have had multiple presentations and publications of their work at major conferences and in major pediatric journals.

Unstuck and On Target

Goal: Adapt an evidence-based, bilingual program for early childhood education centers.

Description: Unstuck and On Target is a school-based, cognitive behavioral curriculum targeting
executive function (EF) skills, with parent trainings and home extension materials. This widely adopted intervention has been proven to improve EF skills among elementary-age children with autism and ADHD in low-income schools. Preschool staff implement the 16-week curriculum in their classrooms, with training and support from our research team. Parents receive complementary tools and trainings to support their child’s skills at home. Our partners include AppleTree Early Learning Public Charter Schools, the Maddux School and the Early Childhood Behavioral Health Program already in place at Children’s National Hospital.

Research Impacts

Program Impact

Community Core: Community Core’s presence within Family Services/Social Work Department, has allowed for collaboration and development of customized social needs resource sheets. There is now a patient-facing online repository with resources in English and Spanish for any number of areas that families may be looking for support in such as employment, food, childcare, etc. These resources can also be accessed by staff across Children’s National and the Pediatric Health Network. Our team has also been active in the hospital-wide Social Determinants of Health SIG, contributing to the decisions regarding four social needs questions that will be asked universally of all Children’s National patients no matter where/how they are interacting with our health system.

Healthy Generations: The Healthy Generations Program is a "teen-tot" program that strives to provide comprehensive, family-centered healthcare for teen parents and their children. The program is available to all teen headed families receiving care at a Children’s National Goldberg Health Center and the goals are to:

Improve health, developmental and behavioral outcomes
Nurture positive parenting skills
Support educational and career goals
Strengthen relationships Support family planning

Healthy Generations is recognized by the U.S. Department of Health and Human Services as an evidenced-based program to prevent repeat teen pregnancy.

Whole Bear Care (WBC): The Whole Bear Care (WBC) team, comprised of licensed psychologists provides behavioral health consultation and some short-term follow-up for children, adolescents, and young adults within the primary care setting. The ability to provide consultation and short- term therapy within the same setting as well child visits enhance the ability to provide wholistic mind, body care.

Children’s National primary care patients and families can access this consultation service through referral by your child’s primary care provider during their regularly scheduled well child or sick visit.

Program Highlights

Community Core: This program is designed to increase the level of support provided to families of young children who may be experiencing (or at risk for experiencing) adverse effects of various social factors that influence health. The goal is to minimize with the impact these factors have on family wellness, and in particular, the child’s physical and emotional health. Our target population is families of children ages 0-3 years who are receiving primary care within one of the five Children’s Health Centers across the District.

Healthy Generations: The COVID-19 pandemic brought on a mental health crisis which led to many of the program participants identifying mental health concerns for themselves and requesting services. External agencies offering therapy became overwhelmed with referrals leading to long waitlists. The program heard from families served that they were less likely to engage in therapy due to high turnover in therapists, long waitlists (ie: no longer wanting therapy by the time it is offered) and uncertainty of the unknown outside. In 2020, Healthy Generations was able to hire a therapist as part of the program to provide flexible, virtual therapy for program participants. Having integrated mental health services has allowed for warm hand offs, an increase in participants attending an initial therapy appointment compared to when they were referred externally and understanding the specific scheduling needs of teen parents. Healthy Generations also noted an increase in parents expressing concerns for their child/children’s behavior and development. In 2022, the program brought on a psychologist who now provides evaluations on site as well as via telehealth.

Whole Bear Care (WBC): The WBC team has been able to expand through their psychology externship program to recruit and hire additional licensed psychologists to the team to support the increasing volume of patients needing to be seen for a behavioral health consultation. Patients referred for a behavioral health consultation have been able to receive at least one follow up appointment within their medical home. The ability to be able to care for mental and physical health within the same location helps reduce significant barriers with transportation and closed loop communication amongst providers, to better support quality of care and quality outcomes for pediatric patients and their families.

Panelists speak at the Maternal Infant Health Summit

About the Clark Network

The A. James and Alice B. Clark Parent & Child Network provides moms and dads early support to help kids bloom. Through innovative and accessible early behavioral health support for children ages 0-3, mental health support for post-partum caregivers and connection to community resources the network strives to ensure parents are able to provide a strong foundation for their families. Contact Jessica Miley to learn more.

Email Jessica Miley