Building Resilience

RESOURCES TO HELP FAMILIES GROW FROM CHALLENGING TIMES

BY CAROLINE COFFIELD, STEPHANIE MICHAEL AND DEEPA SRINIVASAVARADAN

The ability to cope with stresses and continue to move forward is known as resilience (American Psychological Association, 20121). While certain factors contribute to some people being more resilient than others, everyone can develop and strengthen their ability to endure, bounce back, and grow from adversity. Being resilient doesn't mean that you won't experience stress or trauma, but that when you do, you have developed some tools that can help you get through hard times.

STRONGER TOGETHER Using the Strengthening Families approach to building resilience can benefit families of children with disabilities and special health care needs by offering small, but meaningful changes families can incorporate into their lives to enhance strengths.

The COVID-19 pandemic, and the nation's response to it, have created stress for all of us, but particularly for families with children with special health care needs or disabilities. The experience of being home, with many communities shuttered, businesses and services closed, schools moved to virtual learning, and supports provided virtually, if at all, has been extremely challenging. Stress, social isolation, and new ways of accessing school, work, and other services have tested our collective capacity to adapt in the midst of an ever-evolving public health crisis. Now, more than ever, a focus on resilience among families is critical.

One way of building resilience among families is through the Strengthening Families approach. This approach was introduced in 2003 by the Center for the Study of Social Policy (CSSP) to help families identify and build on their own strengths in five different categories, called protective factors:2

• Parental resilience

• Social connections

• Knowledge of parenting and child development

• Concrete support in times of need

• Social and emotional competence of children

Using the Strengthening Families approach to building resilience can benefit all families, including those of children with disabilities and special health care needs, by offering small, but meaningful changes families can incorporate into their lives to enhance strengths. This article will describe each protective factor in this approach along with related resources for building resilience through crisis and change.

Parental Resilience and Social Connections

No one can prevent stress or crisis from happening in their lives; however, it is possible to find the tools needed to respond effectively so a crisis does not escalate, and to effectively minimize the ways a crisis might negatively impact parenting practices. In the Strengthening Families framework, we think about two different components of resilience – the ability to function well under stress and the ability to parent well in times of stress. Parents and caregivers may exhibit greater resilience in one area than in the other. We need to think about both as we look at strategies parents can use to strengthen resilience.

Networks of support are essential to parents. Friends, family members, neighbors and community members often provide emotional support, help solve problems, offer parenting advice, and give concrete assistance. Social connections also offer opportunities for people to "give back," an important part of bolstering selfesteem, as well as a benefit for the community.

Parents of children with disabilities report less stress and lower feelings of depression when they have access to social support (Dunn et al., 20013). While many parents of children with disabilities credit their children for strengthened family ties and expanded social networks, some families may experience loss of friendships or feelings of isolation (Paster, Brandwein, & Walsh, 20094). Isolated families may need extra help in reaching out to build positive relationships.

The Mapping Relationships tool, developed by the Charting the LifeCourse Nexus, can help you identify the different people in your life and the ways they support you and your family. It can also be used to guide conversations about the future and who may fill those roles when others are no longer able. To access the Mapping Relationships tool, visit lifecoursetools.com/lifecourse-library/foundational-tools/family-perspective/

Knowledge of Parenting and Child Development

Parents who have accurate information about child development and appropriate expectations for their child's behavior are able to see their children in a positive light. As a parent, you know your child best. Knowing what to expect from your child at a particular age can help relieve stress. It can also point toward clear action when these expectations and developmental milestones are not met. Information about child development can come from many sources, including family members, friends, physicians, parent education classes, and the plethora of parenting resources available online. Regardless of the source, information is likely to be most helpful and effective if it comes at the time parents need it to understand their own children. Children with special health care needs should also be monitored and screened for developmental delays and, depending on their condition, they may need more frequent monitoring and screening (See resource box, below).

Concrete Support in Times of Need

Oftentimes, we take our everyday successes for granted and focus on how far we have to go, forgetting to consider how far we have come. Think about the things you have accomplished, large and small, and the barriers that you have overcome. Now think about the people, institutions, and organizations that helped you achieve those accomplishments: a partner; a family member; a hospital; a non-profit organization. Could you have done it on your own? Maybe, but how much easier was it with their help? That's what the concept of Concrete Support in Times of Need is all about - acknowledging when support is needed and being able to access that support for the growth and healthy development of you and your family. When support is easily accessible, it can reduce familial stress, and we all want that, especially during a pandemic.

An important element of this protective factor is being resourceful. This means that we are able to find creative ways to solve problems, are persistent, and work with what we have and know in order to make things happen. Inc.com ( inc.com/bill-murphy-jr/7-things-really-resourceful-people-do.html) notes these among the seven things that resourceful people do:

1.Bend the rules: Rules have a purpose, but when they block progress, a truly resourceful person chooses progress. They decide to get things done, not just go along with how things have always been done.

2.Look for the common good: Resourceful people recognize that they need help. Finding out how to show people that by helping you, they can help themselves, too, sets you up to be more likely to find success.

3.Adapt and apply other experiences: There may not always be a clear path to your goal, but think about how you or others got things done and used challenges as advantages.

4.Play a few hands at once: A plan might not work out, so really resourceful people are always working on multiple plans.

5.Dare to ask for what you need: Your original plan may not have succeeded, however, the experience and the contacts made in the process may lead to other opportunities you never even considered!

This protective factor is also about understanding your rights to receive available services and being able to navigate through service systems. Many such services and service systems are organized at the state and local level. Therefore, the best way to better understand these rights is to connect with local community resources such as advocacy/family organizations in your state who are in the best position to help you understand the services and systems available in your community. (See resource box, below).

Social and Emotional Competence of Children

Social and emotional competence is a child's ability to interact in a positive way with others, communicate feelings positively, and regulate behavior. Skills needed for healthy social and emotional development can include: self- esteem, self-confidence, friendmaking skills, self-control, persistence, problem solving, self-sufficiency, focus, patience, good communication skills, empathy, and knowing right from wrong. All of these skills play a critical role in a child's overall wellbeing. Although this protective factor is focused on children, parents and caregivers are really at the heart of it. It is based on the idea that family and child interactions help children develop critical relationship skills like communicating clearly and recognizing and regulating their emotions. Explore resources from The Center on the Social and Emotional Foundations of Early Learning to assist with teaching social emotional health skills: csefel.vanderbilt.edu/resources/family.html

To engage in healthy interactions with their children, parents and caregivers must first engage in healthy self-interactions. Proper self-care, or doing things that make you happy and feel good about yourself, can help in achieving this protective factor by improving your mood. When you are in a good mood, it is easier to respond warmly and consistently to your child's needs, which contributes to feelings of satisfaction about your parental role. All too often, parents and caregivers ignore their own needs for the sake of taking care of their child, especially if their needs seem more present and pressing. Self-care is not an indulgence. It is the ongoing practice of keeping ourselves physically and emotionally healthy.

The Program for Early Parent Support (PEPS), a nonprofit organization that has helped parents connect and grow as they begin their journey into parenthood ( peps.org/ParentResources/by-topic/self-care/self-care-for-parents), offers great suggestions for parent self-care, including meeting physical needs like:

1. Exercising, on your own and as a family

2. Sleeping (as much as you can)

3. Eating right: food affects mood, so try to cut down on sugars and processed foods

4. Going for a long walk outdoors

…meeting emotional needs like:

1. Being creative/flexible about social activities you can work around your child's needs

2. Scheduling time each day to talk to another adult

3. Allowing yourself to cry

4. Finding things that make you laugh

…meeting intellectual needs like:

1. Listening to radio programs, audio books, or podcasts from the web while you drive, or while you work around the house.

2. If your child is doing an art project, sit down and create your own art!

3.Writing – stories, a blog, a personal journal – to get your thoughts out on paper

4. Returning to old hobbies you may not have pursued in a long time

…and meeting spiritual needs like:

1. Going to religious services

2. Meditating or praying each morning, or each evening

3. Spending time outdoors

4. Contributing to causes you believe in

Fostering a strong and secure parent-child relationship is also crucial in this factor. Zero to Three ( zerotothree.org) has a variety of resources on accomplishing this during the early years. One resource in particular, Tips for Families: Coronavirus ( zero- tothree.org/resources/3210-tips-for-families-coronavirus), offers relevant tips for families, including age-appropriate responses to common questions, a guide to self-care, and activities for young children experiencing social distancing.

The Think Babies™ Infant and Early Childhood Mental Health Resource List ( zerotothree.org/resources/2195-think-babies-infant-and-early-childhood-mental-health-resource-list), offers policy briefs, fact sheets, websites and tools to help you learn more about infant and early childhood mental health services. This protective factor is also about teaching children how to identify and manage their emotions by identifying and managing our own emotions. At a time when social distancing, quarantining, mask-wearing, and frequent hand-washing to avoid COVID19 are all too familiar, as parents, being in control of our emotions can be a tall order! With this in mind, it is still important to remember that you are your child's first, and most important, teacher. Practicing self-care and knowing when to ask for help, as mentioned above, are critical components in being able to manage your emotions. Zero to Three ( zerotothree.org/search?q=managing%20emotions) also has some great tips on this skill! See resource box, left).

Fostering Resilience Amid the COVID-19 Pandemic

The global response to COVID-19 has changed daily life in many ways for many people. Yet, child development has not paused, and supporting children, families, and care providers of all kinds is as important as ever. Each of the national parent-led, family-serving organizations listed above have specific resources relating to COVID-19.

The Early Childhood Technical Assistance Center provides a list of resources related to fostering resilience among children and families during the pandemic. Resources listed here include those specific to returning to childcare settings post-shut down; virtual schooling; and helping children understand and cope with social distancing, masks, and other restrictions. ectacenter.org/topics/disaster/coronavirus-talking.asp

In Conclusion

Resilience is not only about "bouncing back" after a stressful event. It is also about "bouncing forward." In the face of challenges, resilience allows us to identify our motivations, reprioritize, and shift course so that we can keep going. This past year and the COVID-19 pandemic have challenged us all to continually bounce forward. As we keep navigating these times of stress and uncertainty, we hope that some of the resources provided here are helpful in supporting you and your family. environment under the current circumstances. •

References

1. apa.org/topics/resilience

2. cssp.org/our-work/project/strengthening-families

3. link.springer.com/article/10.1023/A:1026592305436

4. sciencedirect.com/science/article/pii/S0891422209000894 canr.msu.edu/news/social_emotional_competence_an_important_protective_factor_part_6

ABOUT THE AUTHORS:

Caroline Coffield, PhD is an Assistant Professor of Pediatrics and Director of Preservice Training at The Boggs Center on Developmental Disabilities, part of the Department of Pediatrics at Rutgers Robert Wood Johnson Medical School. Dr. Coffield's work includes partnering in projects sponsored by the CDC's "Learn the Signs. Act Early." Campaign and conducting research to better understand health disparities in diagnosis and access to care for children with Autism Spectrum Disorders and their families, transition to adult healthcare, and the impact of education and training about disabilities on future healthcare providers. Dr. Coffield obtained her doctorate in Psychology from Rutgers University in 2010.

Stephanie Michael, BA, IMH-E is the NJ Positive Behavior Support in Schools Data and Program Coordinator at The Boggs Center on Developmental Disabilities at Rutgers Robert Wood Johnson Medical School. Prior to joining The Boggs Center, Stephanie provided training and technical assistance at Prevent Child Abuse — New Jersey, supporting the agency's child abuse prevention education programs. Stephanie earned her bachelor's degree in Journalism from Baruch College, The City University of New York. She is a registered Music Together teacher, certified Positive Discipline parent educator, a Circle of Security Parenting facilitator.

Deepa Srinivasavaradan is the CDC's "Learn the Signs. Act Early" Ambassador and the Division for Early Childhood Recommended Practices Ambassador for NJ, the Lead for the Act Early COVID-19 Response Project and the State Parent Lead for NJ's Early Childhood Initiatives. She is also a NJ LEND Family Fellow and the Southern Regional Coordinator of the Family-to-Family Health Information Center at SPAN Parent Advocacy Network: spanadvocacy.org.

WHAT TO EXPECT : PROMOTING DEVELOPMENTAL MONITORING AND SCREENING AMONG PARENTS

There are a growing number of resources designed to help promote developmental monitoring and screening among parents, especially among parents of very young children, including:

CDC'S "LEARN THE SIGNS. ACT EARLY." cdc.gov/ncbddd/actearly/parents/index.html This program led by the Centers for Disease Control and Prevention that aims to improve early identification of children with autism and other developmental disabilities so children and families can get the services and support they need as early as possible. The program encourages parents and providers to learn the signs of healthy development, monitor every child's early development, and take action when there is a concern. The program offers free, parent-friendly checklists and other tools to make developmental monitoring practical and easy.

DIVISION FOR EARLY CHILDHOOD RECOMMENDED PRACTICES (DEC RPS) dec-sped.org/dec-recommended-practices The DEC RPs provide guidance to practitioners and families about ways to improve learning outcomes and promote the development of children (0-5) who have or are at-risk for developmental delays or disabilities. The DEC RPs help bridge the gap between research and practice by highlighting practices that have been shown to result in better outcomes for children, their families, and the personnel who serve them. The RPs consists of eight domains: • Assessment • Environment • Family • Instruction • Interaction • Leadership • Teaming • Transition

EARLY CHILDHOOD TECHNICAL ASSISTANCE (ECTA) CENTER ectacenter.org/decrp The Early Childhood Technical Assistance (ECTA) Center has developed a suite of resources available, free of charge, to support practitioners, families, and professional development providers in the use of the DEC RPs. Key TA products available include: • Performance Checklists for practitioners • Practice Guides for practitioners • Practice Guides for families ectacenter.org/decrp/type-pgfamily.asp • Guidelines for Selecting Checklists and Practice Guides • Resources for Professional Development Providers

ZERO TO THREE zerotothree.org Zero to Three is a non-profit organization that works to ensure that babies and toddlers benefit from the early connections critical to their well-being and development. It has a variety of resources on accomplishing this during the early years.

UNIVERSITY OF WISCONSIN-MADISON RESOURCES ON TEENAGERS AND ADOLESCENT DEVELOPMENT parenting.extension.wisc.edu/teenagers/additional-resources-on-teenagers ParentTeenConnect parenteenconnect.org/learn-more Having resources related to child development can be useful as children continue to age. Some of the parenting questions or challenges experienced by families of adolescents with special health care needs and disabilities will be unique, but others will be similar to the concerns experienced by other families of children the same age. Knowing where to go for accurate information in each of these scenarios is critical.

GENERAL PARENTING RESOURCES CDC Essentials for Parenting cdc.gov/parents/essentials/index.html Child Development cdc.gov/ncbddd/childdevelopment/index.html

AMERICAN PSYCHOLOGICAL ASSOCIATION (APA) apa.org/monitor/2018/04/parenting-resources

VERYWELL FAMILY verywellfamily.com/parenting-4157353

PARENT CENTER HUB parentcenterhub.org/journey

IN YOUR COMMUNITY : PARENT WORKSHOPS, SUPPORT GROUPS, RECREATIONAL PROGRAMS & OTHER RESOURCES

These local organizations may also provide support for you to navigate systems of care to access information about parent workshops, support groups, recreational programs, etc.

PARENT TRAINING AND INFORMATION CENTERS parentcenterhub.org/find-yourcenter for example, are funded by the US Department of Education to offer information, training, individual assistance, and emotional support to families of children with a disability, special health care need, or mental health concern, and assist with finding information, resources, and services. There is at least one Parent Center in every state; larger states have multiple centers organized by geographic area of service.

FEDERATION OF FAMILIES FOR CHILDREN'S MENTAL HEALTH CHAPTERS ffcmh.org/our-affiliates There are over 100 chapters of the National Federation of Families serving families of children, youth, and young adults with emotional, behavioral, and mental health challenges.

FAMILY-TO-FAMILY HEALTH INFORMATION CENTER familyvoices.org F2FHICS are family-led centers funded by the Health Resources and Services Administration (HRSA). There is one F2F HIC in each state, in the District of Columbia, in five U.S. territories, and there are three F2Fs serving tribal communities. Each F2F is staffed by highly-skilled, knowledgeable family members who have first-hand experience and understanding of the challenges faced by families of children and youth with special healthcare needs (CYSHCN). These uniquely qualified staff provide critical support to families caring for CYSHCN, particularly families of children with complex needs and those from diverse communities. F2Fs also assist providers, state and federal agencies, legislators, and other stakeholders to better understand and serve CYSHCN and their families.

PARENT TO PARENT USA AFFILIATES p2pusa.org/parents Parent to Parent programs pair parents of children with disabilities and special healthcare needs to trained Support Parents for support and connection to resources.

NEEDED SKILLS : SOCIAL & EMOTIONAL COMPETENCE

SUPPORTING SOCIAL AND EMOTIONAL COMPETENCE IN CHILDREN US DEPARTMENT OF EDUCATION www2.ed.gov/about/inits/ed/earlylearning/talk-read-sing/feelings-teachers.pdf

NATIONAL ASSOC. FOR THE EDUCATION OF YOUNG CHILDREN Supporting social and emotional competence in children naeyc.org/resources/pubs/yc/mar2018/promoting-social-and-emotional-health  SUPPORTING SOCIAL AND EMOTIONAL COMPETENCE OF OLDER CHILDREN VIRTUAL LAB SCHOOL virtuallabschool.org/school-age/social-emotional/lesson-2

CARNEGIE CORPORATION carnegie.org/topics/topic-articles/student-success/social-emotional-learning-helping-teens-navigate-all-the-things

CARNEGIE CORPORATION nobelcoaching.com/emotional-skills

COPING WITH COVID : PANDEMIC RESOURCES CDC's COVID-19 Parental Resource Kit cdc.gov/coronavirus/2019-ncov/daily-life-coping/parental-resource-kit/early-childhood.html

HARVARD CENTER ON THE DEVELOPING CHILD How to Support Children developingchild.harvard.edu/resources/how-to-support-children-and-yourself-dur- ing-the-covid-19-outbreak How to Help Families and Staff developingchild.harvard.edu/resources/how-to-help-families-and-staff-build- resilience-during-the-covid-19-outbreak

SUPPORT FOR FAMILIES : BUILDING RESILIENCE DURING TRYING TIMES

LIFECOURSE Essentials for Parenting lifecoursetools.com/lifecourse-library/foundational-tools/family-perspective

CDC'S "LEARN THE SIGNS. ACT EARLY." cdc.gov/ncbddd/actearly/parents/index.html

DIVISION FOR EARLY CHILDHOOD RECOMMENDED PRACTICES (DEC RPS) PARENT TO PARENT USA p2pusa.org dec-sped.org/dec-recommended-practices

PARENT TRAINING AND INFORMATION CENTERS parentcenterhub.org/find-yourcenter

FAMILY VOICES/ FAMILY-TO-FAMILY HEALTH INFORMATION CENTERS familyvoices.org

NATIONAL FEDERATION OF FAMILIES ffcmh.org

PARENT TO PARENT USA p2pusa.org

CENTER ON THE SOCIAL AND EMOTIONAL FOUNDATIONS OF EARLY LEARNING csefel.vanderbilt.edu/resources/family.html