HealthySteps Provides Holistic Care During Crucial First Three Years of a Child’s Life

The pediatric primary care program works closely with families and focuses on closing health-equity gaps.

Dr. Alba Cabral, a HealthySteps specialist (standing at right), meets with a family and their pediatrician at a well-child visit. Rebecca Drobis Photography, Courtesy of Zero To Three

The first three years of a child’s life are crucial for development, setting the foundation for later success.

HealthySteps—an evidence- and team-based pediatric primary care program that promotes the health, well-being and school readiness of babies and toddlers, with a focus on closing health-equity gaps—works closely with families of children in this pivotal age group. In New Jersey, HealthySteps—which is a program of  Zero To Three—is being piloted in three of Hackensack Meridian Health’s pediatric primary care practices.

The program, funded by the Nicholson Foundation, Burke Foundation, Turrell Fund and Hackensack Meridian Health, integrates a child-development professional, called a HealthySteps specialist, into the pediatric primary care team. (The Turrell Fund and Hackensack Meridian Health are underwriters of the public policy programming I anchor on public broadcasting.)

The specialist “oversees the holistic, family-centered piece, including social determinants of health, child development, caregiver mental health and well-being, all to help ensure that a foundation is as good as possible for our young children,” says HealthySteps national director Rahil Briggs, a clinical psychologist.

Parents bring their children to the pediatrician 12 to 13 times in the first three years of life just for well-child visits, says Briggs. A HealthySteps specialist builds upon this process by connecting families with additional services like early intervention and answering questions so that all babies and toddlers can have a strong start in life.

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Judy Aschner, physician in chief of Hackensack Meridian Children’s Health, was awarded the grant to pilot HealthySteps in New Jersey and has seen the positive impact firsthand. Says Aschner, “There are many areas, such as maternal depressions, positive-parenting techniques, childhood-vaccination rates, and outcomes such as childhood obesity, where the HealthySteps model allows us to address challenges early and move the needle in the state to improve outcomes for children.”

As for the importance of targeting our children aged 0–3, Briggs says it is always better to work preventively. Says Briggs, “The best way we try to explain this is that age 3 is about middle age when it comes to brain development. Around half of what we expect as far as those neural pathways getting laid down and those specific connections being made has been laid down by age 3.” During these formative years, if a child sees fear, aggression and food insecurity, the outcome will be very different than if a child is read to or has a caregiver who can moderate their own stress. “Think of it as a foundation of a house. If the foundation is strong, it can withstand a storm,” Briggs says.

And, according to Aschner, collaboration is key to making an impact. Evan Delgado, vice president of programs for the Turrell Fund, agrees and says, “All families deserve access to high-quality services…right from the time of birth, and they deserve to be given individualized, one-on-one support.”

Concludes Ascher, “This model of interprofessional care is a thing of beauty to watch, and we are hearing stories and getting feedback every day from families about how this interaction has made a huge difference in their lives.”

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