P3B368: Early Childhood Developmental Navigators: Combining Practice Change with Policy Advocacy

Background: Systemic barriers drive inequities in early childhood developmental services. Screening tools lack multicultural and multilingual approaches and fail to celebrate families’ strengths. Complex evaluation and enrollment processes, lack of interpretation, limited transportation, and systems working in silos are other barriers.

Caregivers, home-visitors, educators, social workers, and medical providers intimately know these barriers and work tirelessly to help each child receive the support they need to thrive.

The advocacy project described seeks to bring to light these individual experiences and to transform systems and policies through a medical home-early childhood partnership and support of a public policy fellow.

Project Description: The Early Childhood Developmental (ECD) Navigator Program was formed as a partnership between a medical home and community-based early childhood organization to strive for equitable support of early childhood. Bringing together the typically siloed healthcare and education systems, the program transforms care for individual families and collaboratively advocates for system and policy change.

Core to the program are multicultural, multi-lingual ECD navigators who: 1) form trusted relationships with families and support the early child-caregiver relationship through approaches such as Promoting First Relationships, 2) provide linguistically, culturally adapted screening to identify strengths and developmental, behavioral, or social needs and 3) facilitate connections with community-based services with advocacy to overcome barriers.

The program, rooted in supporting individual families, has grown to policy advocacy to transform systems.

Discussion: Advocacy for the Individual Family

The navigators alongside families advocate to ensure interpretation, translated forms, transportation, and timely evaluation and receipt of services within the early childhood system.

Advocacy to Change Systems

Over the past 5 years, the Navigators supported 1,300 children whose families speak approximately 38 languages. Through this family-centered work, the need for system change was recognized. The navigators, with the clinic’s medical-legal partnership, shared barriers and recommendations for change to local school districts and the state’s Office of Superintendent of Public Instruction.

Advocacy to Change Policy

The program fosters the personal and professional growth of the navigators. Compelled to change the systems that are not serving families, one navigator was mentored to transition from navigator role to a state level public policy early childhood Pathwaves fellowship (Figure 1). The fellow elevates the voice and experience of many families. In the first few months, the fellow organized an advocacy day at the state’s capitol, authored an Op-Ed, and successfully advocated for policies and funding in the Washington State Legislature.

Conclusion: A medical home-early childhood partnership has started the long journey to reduce, and eventually eliminate, inequities in early childhood development through program development and systems and policy advocacy. Centering the experience of individual families and supporting the professional and personal growth of the navigators is core to this journey.