University of Washington

Elders; (2) having engaged fathers mentor other fathers who are struggling; (3) creating "islands of safety" where children feel safe and providers can further nurture their development; (4) building facilities where assisted living for Elders is attached to the early learning center, further connecting Elders and youth; (5) creating community gardens where children can be taught about nutrition, tradition and giving back to the community; (6) having tribal leadership publicly acknowledge when children are doing well (attendance at school, working hard, etc.); (7) making sure Native people are serving on school boards and committees; and (8) having community-wide discussions about avoiding alcohol and drug affected births, and how to assess and plan for alcohol and drug affected children. Many common themes regarding early learning health rose to the surface. Infancy and young childhood are critical periods for healthy lifestyle and skill development. Behavior and environmental change can be more difficult as youth get older. Another theme was the importance of healthy family relationships, with a focus on fathers, as they are often left out of the intervention picture. Fathers can also be the nurturers in the family. All agreed that basic life needs should be met first (food, nutrition, shelter, safety) before moving into programming that addresses more holistic health. Another important theme was that domestic violence and sexual assault are not just about individual families, but also the community. Community level intervention should not be overlooked. Last but not least, participants emphasized the importance of integrating traditional culture, language, stories and practices into western approaches and interventions. Many remarked that young Native children might not behave at school but are often respectful and appropriate at cultural/community events. Tribes and Urban Indian centers can work together to leverage resources, culture, Elders and sovereignty to educate and support youth and their families in this way. Below are listed the key items generated by participant discussions, grouped into concerns, challenges, strengths, needs, and suggestions. Also included is a list of formal and informal promising programs and practices related to early learning health. CONCERNS •Members are having babies when very young — still in high school. May not know how to care for their children, may not have the support they need. •Young parents involved in gangs. •Suicides of young parents. •Young children are around others who are using. •Sexual assault. •Experiencing/witnessing violence in the home. •Lack of parental support and engagement with their young children with regards to learning culture, life skills, education, etc. This is due in part to historical trauma. •History of boarding schools has left an impact — during this era Native families were told NOT to be involved in their children's education, that the boarding school would teach them. Now they are supposed to be involved and judged negatively when not. •Schools and communities are not educated about how to support children who are born alcohol and drug affected. These children may have lifelong challenges. They are often being medicated rather than properly diagnosed. •School and teachers are doing more behavior management than teaching if a child has experienced family difficulties or not been nurtured. •Children are being misdiagnosed with mental health or behavioral problems — sometimes includes prescription of medication that does harm. •Costs of intervention increase as the child grows. •Children are being labeled "learning disabled" when it may be that they are not adequately prepared, or may have been born alcohol and drug affected. In fact, these children are often smart and capable. •Schools and other institutions have less and less resources, which impacts Native youth. • Bullying — the child is afraid, which interferes with early learning. CHALLENGES Services •Promising programs like home visiting (as an example) can be viewed with apprehension as parents worry that they will be reported for something — trust is critical and takes time. •Working with Regional Support Networks- no communication, funds not flowing to tribes appropriately. Tribes can't control how the funds can be used. •Providing services in rural, dispersed, non-reservation, and/ or urban settings. •"I was just saying you go to an Indian Health Service meeting and that's how it always happens is prevention, you know, it comes down to the bottom because there's other priorities that are not being funded." •"Everybody wants prevention but when it comes to paying/ supporting the funds go to contract health services — dental, deferred services, eyes, etc." •Having to juggle budgets to keep staff paid. Summary Report: April 4-5, 2012 11

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