• Health and Well-Being
  • Safety and Resilience

 Format: Project-Based

Childhood exposure to toxic stress alters the rapidly-developing brain and can have a lifetime effect on learning, behavior, physical, and mental health (Center on the Developing Child, 2007; Robinson et al., 2017). The brain may be protected through supportive parenting and a nurturing, developmentally-stimulating environment (CDC, 2018). For families experiencing stress, protection must begin early in the child’s life. Based on a Los Angeles home visiting program, this presentation explores strategies to help high-needs families of newborns strengthen protective buffers and ensure optimal child development.

Select Home Visitation at Children’s Institute in Los Angeles is a weekly home visiting program for mothers of newborn infants. All families enrolled experience stress factors such as poverty and/or a history of violence. Visits are guided by the evidence-based Growing Great Kids (GGK) parenting, attachment, and child development curriculum. GGK includes age-specific, development-supporting activities for parent and child, which build parenting skills while simultaneously helping the child grow. Additionally, staff utilize ongoing developmental screens to ensure early identification and intervention for developmental concerns that may arise.

Attendees will learn about Select Home Visitation’s multi-generational prevention strategies that mitigate the effects of toxic stress and ensure optimal development. They will see examples of how results from developmental screens can be aligned with specific parent-child activities to support the identified areas of need. Finally, they will see aggregate outcomes demonstrating that this strategy is effective. During the project portion, attendees will apply what they’ve learned in small-group scenarios. They will be asked to interpret sample developmental screens, select an appropriate parent-child activity to support the delays expressed, and prepare a prototype of the selected activity. For example, they may prepare paper supplies for an activity that supports fine motor delays.

This workshop is relevant to conference attendees because it is about equity at its core, and practical because attendees will gain replicable strategies for action. By addressing a root cause of lifelong health problems, attendees who are motivated to ensure all children have a healthy start regardless of the circumstances they’re born into will be interested in attending.

Learning Objectives:

  • Understand the connection between early exposure to toxic stress and lifelong health disparities
  • Describe strategies to implement a multi-generational, prevention-first model for newborns born in high-stress conditions
  • Replicate methods for early identification and intervention of developmental delays in young children


  • Elana Muldavin, research associate, Children's Institute
  • Nancy Watt, select home visitation program manager, Children's Institute

Elana Muldavin
Research Associate
Children's Institute

Elana Muldavin is a research associate with the Research and Evaluation Center at Children’s Institute (CII), a multi-service organization in Los Angeles that addresses childhood trauma, poverty, and violence. Elana manages program evaluation and reporting for CII’s early childhood services. In this role, she collaborates with program staff to continuously improve service quality through individual and aggregate outcome data analysis. In her tenure at CII, Elana has presented at the 38th Annual California Mental Health Advocates for Children and Youth Conference, 2018 and the 23rd International Summit on Violence, Abuse, and Trauma Across the Lifespan, 2018. She also was co-author for the 2016, 2017, and 2018 publications of CII’s annual Impact Report, serving as co-lead editor in 2017 and 2018.

Nancy Watt, LMFT
Select Home Visitation Program Manager
Children's Institute

Nancy Watt is a licensed marriage and family therapist. Presently, she is serving as a program manager of Select Home Visitation at Children’s Institute (CII). Her early experiences working with at-risk families with young children inspired her passion for her career focus working with the 0-5 population. Ms. Watt has experience providing direct services to families in the in the home for over 12 years; first as a home visitor and then as a 0-5 therapist. Currently, Ms. Watt is in the process of becoming a Growing Great Kids Curriculum system trainer for CII. She is also a Reflective Parenting Program (RPP) trainer and enjoys supporting those who are new to using the RPP curriculum. Ms. Watt understands the importance of strength-based relationship work and strives to provide a safe and reflective space for those she trains and supports.