A staggering 46% of all children in Hawaii have experienced an adverse childhood experience. This can include abuse, neglect or various other traumatic experiences. Early childhood mental health is a critical yet often overlooked aspect of mental well-being. It’s an arresting statistic worth repeating: Close to half of our island keiki have been exposed to trauma.
We know from research that exposure to trauma at an early age can have profound impacts on a child’s mental health throughout their life, potentially leading to developmental delays. In a world experiencing a surge in mental health cases, prioritizing early intervention for our youngest keiki and their families can ensure that they have a healthier and brighter future.
Here is a great example of how a local health center can put our children’s needs first. Last year, the Hawai‘i Island Community Health Center implemented a nationally recognized development screening tool during well-child exams — an innovative approach to preventative care through early childhood screenings and intervention.
The health center provides services and care to residents who live in the most remote and under resourced districts in the state. It currently serves more than 10,000 patients who are 18 years old and under. In 2023, the center implemented standardized developmental observation using the Ages and Stages Questionnaire (ASQ) during all well-child exams. ASQ is a developmental screening tool designed for early educators and health care professionals to identify delays in infants and young children.
The adoption of a standardized developmental tool during annual well-child exams represents a crucial step toward early detection and intervention for developmental delays. By integrating the ASQ into their workflow and electronic health record system, and training staff on topics related to early child development, the health center has seen a significant increase in early detection in children under the age of three. What does this mean for our keiki and their families? Before the integration of ASQ during well child visits, there were only two opportunities to screen for developmental concerns before the age of 5. Now there are 14 opportunities.
But the impact of this project extends beyond the immediate identification of developmental concerns. By leveraging regular well-child visits as a conduit to connect families with behavioral health services and community support resources, the Hawai‘i Island Community Health Center is empowering families to address developmental concerns proactively and holistically. It shares information with patients about parent and child programs in the community to create an ecosystem of support for a child with a developmental concern.
This comprehensive approach recognizes the interconnectedness of physical, mental and emotional well-being in early childhood development. The health center’s commitment to innovative and preventative care serves as a model for other clinics and communities across the state. By investing in the well-being of our youngest keiki and addressing their unique needs early on, we can create a ripple effect of positive outcomes that extends far beyond childhood. This can include reduced likelihood of developing mental health disorders later in life, improved academic performance and the ability to develop and sustain healthy adult relationships, and can help to prevent substance abuse and risky behaviors.
As we continue to observe Mental Health Awareness Month this May, let’s not forget to focus on the well-being of our keiki. After all, they are Hawaii’s adults of the future.
Justina Acevedo-Cross is senior director for the Promising Minds initiative at the Hawai‘i Community Foundation.
