Why Pediatricians Say They Can't Do Their Jobs Without This Program

Can you explain a little bit, what is the serve and return?

So the serve is what the baby, how the baby cues you that they are in need of something or want something or are trying to get your attention, and the return is the way the caregiver reacts to those cues.

So if I have my two-year-old and we're sitting in the waiting room, and maybe the specialist is there and noticing that my serve and return skills could use a little help, would they come up to me and say something or suggest maybe something, or how would that work to get that interaction going?

So that could happen.

Every practice is different.

So there's...

We really, um, focus on the capacity of the Healthy Steps specialist.

We say that one specialist can serve up to 2,000 kids on a patient panel in that age group.

They're probably only gonna interact or work with about 30% of those children in that age range, either, um, Tier 2, which is sort of short-term supports, or Tier 3, which is ongoing support.

Um, and so I would say in most practices, the Healthy Steps specialist is not in the waiting room necessarily.

And pediatricians focus on serve and return.

It's certainly a big part of what they do.

Um, there's another evidence-based program here in New Jersey called Reach Out and Read.

It's a national model.

Um, it uses a book to model to caregivers how to have positive interactions around early literacy, early math skills, um- For children in that primary care setting with a book.

But if that, um, pediatrician has a concern in that, you know, talking about the book or some- something else, maybe mom's struggling with depression, and they, the primary care provider notices that they aren't responding to their baby's cues.

Maybe the baby's crying, and they're not consoling them necessarily the way that the provider would expect.

Not that they're doing anything necessarily wrong, but isn't that an opportunity to strengthen? Not all parents know about...

I didn't know about serve and return [laughs] when my b- my kids were little, right? So it's, um, yeah, it's just such an opportunity to give a little bit of information that could have a huge impact.

So that's what I'm thinking-

Mm-hmm

... because especially a- as a new parent, you j- you don't know.

Mm-mm.

Or you've read a lot of books.

That doesn't mean you can implement-