Building impactful changes for children and families by supporting Positive Childhood Experiences
Carol Baumgupta and Kari Hironaka, both developmental and behavioral pediatricians at Tufts Developmental and Behavioral Pediatrics (DBP), had been thinking about moving from a deficit-based model to a strengths-based model for a long time before they encountered the HOPE framework. From the intake forms to the name of the center, they knew they wanted change. But HOPE was a catalyst.
“Our field has been asking questions about bigger experiences that affect children’s lives,” said Baumgupta, referring to Adverse Childhood Experiences (ACEs) which had been understood for years. “But it was just such an incredibly transformative kind of twist to look at how we can support the positive experiences.”
Using the HOPE framework to guide practical and physical changes
Hironaka and Baumgupta had both witnessed what was possible when they saw Tufts Medicine’s Pediatric Primary Care in Boston get certified in HOPE first. The framework, and seeing others do it, inspired them.
“There are a lot of things that we had been thinking about. But it’s always hard to get going on things, and [HOPE] helped provide the framework we needed to move forward,” said Hironaka.
DBP has been rolling out changes, large and small, to move toward a strengths-based model. For one, they changed the name of the center.
“We used to be called the Center for Children with Special Needs, and that is a term that didn’t feel comfortable to a lot of our families who came in,” said Baumgupta. DBP is a more value-neutral way of describing the services offered. (Note: The website still reads Center for Children With Special Needs, but the waiting room signage has changed).
They’ve also been thinking of the physical environment.
“Our front staff group has definitely been involved not only in their approach when patients enter, but also in helping to design our waiting room space and make it more positive and patient-centered,” said Hironaka. “We have… a nice calming bubble tube. And we have sensory kits coming…headphones and fidget toys and things that families can borrow during the time that kids are at our center.”
Creating changes to the intake process to promote the positive
In terms of changing their intake forms, Hironaka and Baumgupta wanted to use more strengths-based language. Instead of simply using numbers to measure a child’s developmental delays, they wanted to capture more nuance about the patient, to focus on “all the dimensions of what a child brings.”
“One of the challenges of this field is that we’re often working with children who have delays or areas in which they are somehow maybe behind a standard in some way. And so that is a way where we have a tendency to look for the negatives,” said Hironaka.
To make the intake form more strengths-based, they added a question that asks the parent or teacher to describe the child in three adjectives.
“When you’re asked that question, you start thinking of your child as a whole, and that’s what we wanted: just three–often positive–thoughtful descriptions of your kid,” said Hironaka.
Establishing lasting change through training, evaluation, and community voice
“From nuts to bolts, [HOPE] gave us an opportunity to really look into our physical space, our online presence and materials that are going out to families and teachers,” said Baumgupta.
In addition to the staff getting exposure to the HOPE framework, DBP is a training site for medical residents. Hironaka and Baumgupta say that because of this, they are informally exposing future doctors to the framework.
“We’re trying to spread some more hopeful messaging as folks come through.”
Looking forward, one of the center’s HOPE-related goals is re-establishing an parent advisory board back to weigh in on the changes being made. Creating a more formal evaluation process will help Hironaka and Baumgupta understand what changes are working and what are not.
