Eight years ago, Dr. Joseph Donnelly never imagined he would ever leave Massachusetts.  A lifelong Boston Red Sox, Celtics and New England Patriots fan, Dr. Donnelly says he was looking forward to “staying in Massachusetts for the rest of my life.”

Then he heard about California’s Proposition 10 funding, the initiative that directed state tobacco tax money into child development.

“Every state claims that children are the most important part of our future,” this pediatrician says.  “But, I didn’t see anyone following up on that concept with any funding-.  California did.”

That is all it took for this pediatric neurologist, educated at Harvard and Georgetown, to move west. He is now the director of the Children’s Hospital of Orange County/University of California, Irvine, Neurodevelopmental Programs, supported by $13.5 million in Prop. 10 funds from the Orange County Children and Families Commission.

“The Commission’s support has been a catalyst, helping to join people who otherwise would not have come together,” Dr. Donnelly says.  “It has pushed experts to talk to each other, to work together ,and to make collaborative programs possible.”  He especially credits the Commission for being “gutsy” by wading directly into the complex world of medical and developmental services critical to children.

As a result, the CHOC/UCI Neurodevelopmental Programs, consisting of  four components, provide a continuum of services for families whose children have developmental delays and/or behavioral concerns.

“Where do you go for help when your child is born eight weeks premature and you are worried about their not walking ?” Dr. Donnelly asks.  “Who do you ask for help when your three-year-old screams inconsolably every time he is around strangers?  What do you do when your child is kicked out of preschool for behavioral issues, or when your child might have autism?”

The programs Dr. Donnelly oversees have knowledgeable and passionate people who work collaboratively to make sure that families with children who have developmental and behavioral concerns are connected to the services they need.  These programs also provide education, training and support to families, health care professionals and educators, helping them recognize developmental delays, learn when to refer children for assessment, as well as to help them manage behavioral issues.

            “We’re not just about diagnosing,” Dr. Donnelly says.  “We’re dedicated to  early intervention and helping parents .  After all, a developmental disorder affects the whole family.”

            Dr. Donnelly has seen the developmental issues of a child plunge a family into emotional turmoil, financial difficulty and divorce. And, he has seen families grow together, overcome all odds and demonstrate great resiliency. Over the years, he has learned an enormous amount from the families under his care.

“Early intervention is not just about improving the optimal outcome for children, but strengthening the whole family as well,” Dr. Donnelly says.  “The earlier we start, the healthier the family will be.”

In one way or the other, each of the four programs he manages, supported by the Children’s and Families Commission of Orange County, helps such children and families in need.

HELP ME GROW (Connecting Children & Families to Developmental Services)

            This program gives parents, caregivers, child-care providers, early educators and health-care professionals a single point of access to developmental services for all young children who live in Orange County.

            That point of entry is a single, toll-free number, 1-866-476-9025 (or 1-866-GROW-025) which is operated in partnership with 2-1-1.

“Our program is modeled on Help Me Grow Connecticut, a comprehensive, statewide, coordinated system of early identification and referral for children at risk for developmental delay or behavioral problems,” Dr. Donnelly says.  “We looked at what worked in Connecticut in 2005, and decided it should be replicated in Orange County.  There were too many parents who did not know where to go for help and good services not being fully utilized.”

            Help Me Grow, funded by Prop. 10 monies from the Children and Families Commission, in the last year received 1,755 calls from parents and 1,012 from providers to inquire about and be connected to essential services.  In 2008, it provided outreach to 63 primary health care practices to promote routine development screening. It also conducted a pilot of technical assistance to pediatricians that led to 432 Orange County children receiving developmental screens and being connected to appropriate resources as necessary.  It works with 2-1-1 to maintain an updated database of community resources and is also working to identify gaps and barriers for families.

            One of these callers was an Orange County mom with a four-year-old son who had been thrown out of three preschools for his behavior, and was on the verge of being thrown out of a fourth one.  Help Me Grow referred her to a service that would observe her son and work with the childcare provider to address his difficult behavior.  The result?  Her child successfully stayed in the fourth preschool.       

CUIDAR ( CHOC/UCI Initiative for the Development of Attention and Readiness)

CUIDAR, which is Spanish for “to take care of,” identifies and helps children with attention and/or behavior difficulties before they enter school so that they will have a more successful experience.

Families participate in parenting skills classes while their children attend social skills groups.  As a result of this preparation, parents report a decrease in their use of physical punishment and parental stress, as well as an increase in their child’s pro-social behavior.

            In CUIDAR’s COPE (Community Parent Education) classes, facilitators guide parents and children through ten classes, including a series of videotapes and brainstorming sessions.  In addition, the program also provides teacher training on behavior management in the classroom.

            One mother wrote in gratitude that before CUIDAR, her “marriage was hanging by a string because I could not convince my husband to be less authoritarian . . . the classes really saved us.  We are now moving in the right direction, together, for the first time in our seven-year marriage.”  Her son, she reports, “is so much more compliant.”

            Last year CUIDAR reached more than 1,300 Orange County families, screened more than 500 children, and trained 621 teachers.

EDAC (Early Developmental Assessment Center)

The children served by EDAC include the most fragile infants, often born premature, with low birth weight, and are usually graduates of the Neonatal Intensive Care Unit. These infants and toddlers are at the highest risk for developmental delays. EDAC provides multidisciplinary assessments, education, intervention strategies, care coordination and advocacy. It reassures parents, identifies developmental concerns and promotes integration into community resources.

“Thanks to support from the Orange County Children and Families Commission, EDAC can be more comprehensive, provide stronger care coordination and enhance family well being,” Dr. Donnelly says.  “EDAC goes into the community to ensure those needing follow up are able to get it. This is vital support that goes directly for children at highest risk.”

EDAC’s team includes neonatologists, developmental pediatricians, psychologists, nurses, social workers, dieticians, speech and language pathologists, physical and occupational therapists, child life specialists, and family support staff. 

The program supports and trains parents of infants and toddlers who have temperament or behavioral issues with role playing and coaching.  It also assists the brothers and sisters of high-risk infants, at risk themselves of becoming a secondary focus, to thrive in their families.

            In the last year, EDAC has evaluated 1,203 high-risk infants and toddlers, including 126 foster children.

One EDAC visit concerned six-month-old twins.  Only one of these twins qualified for high-risk infant follow-up, but the parents had concerns about the other twin as well.  Thanks to Prop 10 funding, EDAC was able to examine both children.  The twin who qualified for services was developmentally on target for his age, but the other twin had delays in gross motor skills.  Ultimately this twin received physical therapy and achieved appropriate development for her age.

For OC Kids Neurodevelopment Center (Dedicated to the Early Diagnosis & Treatment of Autism, ADHD And other developmental disorders)

The Center provides evaluation, diagnosis, treatment, support, education and advocacy for Orange County children with a wide range of developmental, behavioral or learning issues, including autism spectrum disorders and ADHD.  The For OC Kids team includes  pediatric neurology, developmental-behavioral pediatrics,  nursing, social work, speech and language pathology and family support staff. The program focuses on children age birth through five years living in OC, but will follow those seen through their school years to ensure continuity.

In the last year, the Center helped 776 children receive initial comprehensive medical evaluations, including 48 foster children.  It provided 1,872 follow-up visits to children diagnosed with autism or other developmental disorders, as well as providing specialized parenting education classes for 560 parents.

            “The Center started as a program for autism, but expanded to include help for children with ADHD,,  those in foster care, and with other learning and behavioral concerns,” Dr. Donnelly says.  “This is the only center in Orange County that is able to provide this type of service—a team approach, in a family friendly environment, with individuals who have the passion and the expertise to care for these special needs children and their families”

“The Center accepts most insurance plans” he says,
“but that funding is insufficient”. “We could not operate without the support of the Orange County Children and Families Commission.”

            For Dr. Donnelly and his colleagues, the work is less about numbers and more about families saved and futures enhanced.  He recalls with fondness the progress of one of his patients, a girl who came from a family with three children with autism.

“She is normal cognitively, and does very well in school,” Dr. Donnelly says.  “And yet she doesn’t know how to make friends, she stands out as different.  Mom shared with me that she just had a birthday party, and no classmates came.  That was just devastating.” 

For OC Kids held a holiday card making contest this year, for which this young lady made a creative, outstanding drawing.  Her entry was chosen as, one of three out of 60 submitted.  “As a result, there was a ceremony,” he says.  “She was all dressed up.  She was so obviously happy.  Her mom said that winning this award made her year.”

As a result of this encouragement, this girl has already started drawing for next year’s contest.

            “Without Commission support, these programs and their services would not exist. The difference our efforts and dollars make will be felt for years to come,” Dr. Donnelly says.  “Prop 10 funds are already wisely invested in the lives of children and families,  and California’s future.”