How MaineHealth Early Childhood Support Specialists help families reduce stress, build confidence, and nurture healthy relationships

The mother was adamant—she wouldn’t do it.

As an Early Childhood Support Specialist at a MaineHealth pediatric clinic in Rockland, Annette Burns helps parents support their children’s healthy development. Sometimes, that means helping families navigate deep poverty, substance use, or the child welfare system. Other times, it means offering tools for universal parenting challenges, such as keeping calm with a young child when stress runs high.

This young mother needed support in one of the most stressful settings for any parent of a toddler: the grocery store.

“She said, ‘I can’t bring him there. It’s horrible,’” Burns recalled. “I said, ‘Yes. We are going to meet at Hannaford.’”

Supporting Families Growing Together

Since 2020, the John T. Gorman Foundation has worked with MaineHealth to support Supporting Families Growing Together, an initiative that embeds Early Childhood Support Specialists, or ECSSs, within pediatric practices in Portland and Rockland. Both clinics serve many families facing significant adversity, including economic hardship, language and cultural barriers, and isolation.

The role grew out of efforts to identify children at heightened risk of Adverse Childhood Experiences, or ACEs, and provide support to prevent or mitigate the long-term effects of these potentially traumatic events on children’s health and development.

Working alongside medical providers, ECSSs help families overcome barriers to medical care and developmental services; provide necessities such as diapers and strollers; and connect parents with food, housing, benefits, and mental health supports. Over time, they often become trusted allies parents can call when they need help.

In addition to helping families access critical resources and services, the initiative has strengthened families’ engagement with pediatric care and allowed medical providers to focus more fully on children’s clinical needs.

Another goal of the program is strengthening relational health – supporting caregivers’ ability to provide the positive, caring moments of connection that are crucial during a child’s early years. While it is well known that pediatricians can play an important role in supporting early relational health, they are often limited in their touchpoints with families and their capacity to respond to needs. This initiative provides the pediatric team with the capacity and flexibility to provide a higher frequency and more intensive model of preventative care that is rooted in relationships.

“Relational health is the driver of human development. Our experiences with our caretakers open the pathways to reach our full development potential,” said Dr. Stephen DiGiovanni, who helps lead the initiative. “In building trust with families and having the flexibility to pivot when needs arise, the ECSS is able to support parents in developing the skills and actions to create safe, supportive and loving interactions.”

Those connections can be harder to create when parents are carrying intense economic, emotional, or practical stress. ECSSs help in three closely connected ways.

Reducing Stress and Creating Capacity

Strengthening the parent-child relationship often begins with addressing basic needs and relieving emotional pressures.

At the Portland clinic, ECSS Alicia Black works with many New Mainer families facing language and cultural barriers, limited financial resources, fear, and uncertainty. She has found home visits especially effective for delivering essentials, talking through challenges, and building trust.

Black has seen how quickly that support can change the tone of an interaction between a parent and child.

“I’ve seen visits where parents start off very stressed, and then toward the end, they’re warmly interacting with their child,” she said. “When stressors are alleviated, parents are more present and more confident. In return, we’re seeing children who are more attached and engaged with their parents.”

Burns sees the same connection in Rockland.

“If you can eliminate those stressors just a little bit—even by giving a pack of free diapers—that positivity is reflected in the parenting with their child,” she said.

Building Parenting Confidence and Skills

ECSSs also help parents understand their children’s development and respond confidently to everyday challenges.

Black may show a parent how to use a toy to strengthen a child’s fine motor skills, suggest ways to encourage imaginative play, or demonstrate positions that can soothe an uncomfortable infant. Rather than provide a list of instructions, she offers practical ideas parents can use in the moment.

Burns often models strategies while spending time with families at home or in the community.

“It’s all done through interaction,” she said. “I don’t look at a parent and say, ‘Okay, I’m going to work on parent coaching with you.’ It’s always through modeling.”

During an outing, that might mean setting clear expectations, keeping a child engaged, or using distraction and redirection. Seeing those strategies work in real time helps parents respond calmly and maintain connection when a child becomes overwhelmed.

Expanding Families’ Circles of Support

Relational health is shaped by both the parent-child bond and the network surrounding a family.

Both Black and Burns see isolation as a major source of stress. The trusting relationship an ECSS builds with a family can be the first step in helping parents feel less alone.

ECSSs also help families develop wider networks by connecting them with community organizations and helping them build confidence to take their child to playgrounds, libraries, story hours, and other free or low-cost activities. These connections reduce isolation and create opportunities for parents and children to have positive experiences together.

Which brings us back to the grocery store.

“Things got a little bit tricky in the cookie aisle,” Burns laughed. But with clear expectations, games, and well-timed redirection, they made it to the checkout line.

“The mother teared up,” Burns said. “She’d never made it past the bakery.”

It was a small but meaningful success – one that left the mother and son with a blueprint for more positive outings.