Skip to Content

Bright Futures Leads to We Are Resilient

As Project Director for Bright Futures two decades ago, I and my team helped shepherd in a whole new era of “well child” visits.  Since the healthcare system is one of the few systems that touch almost every child in America from the time they are born, we knew it could be a critical vehicle for helping parents, caregivers, and families understand the range of issues that would affect their child’s growth and development. Healthcare providers could ask questions and provide anticipatory guidance about everything from second-hand smoke and sunscreen to picky eating and bike helmets. We focused on the whole child, and what might be the key stressors that would affect the child’s development over the child’s lifetime. With funding and guidance from the Maternal and Child Health Bureau of the Department of Health and Human Services, we gathered pediatricians and others across the United States to review the evidence and infuse their clinical experience into the work. This book, Bright Futures: Guidelines for Health Supervision for Infants, Children, and Adolescents, made a big change in pediatric practice and has been used to train most pediatric health professionals in the U.S. in the last two decades. 

Fast forward to today. We have become aware over the last two decades of the profound effect of trauma on children, thanks to  Dr. Vincent J. Felitti and Dr. Robert Anda who demonstrated how ACEs (Adverse Childhood Experiences) can create toxic stress in children that dramatically injures their growth and development throughout their lifetime.  Other doctors, including Nadine Burke Harris and Dayna Long – and hundreds of other committed health professionals – have extended the original research and amplified the findings to ensure thousands of people understand the powerful biological effects of ACEs and how they can affect everything from asthma to heart attacks. 

Now that we know about ACEs, what can we do about them?  Along with basic self-care skills like good nutrition, exercise, and sleep, it is clear that strengthening resilience is the best way to mitigate the effects of ACEs.  Dovetail Learning is working with healthcare providers to bring a new form of anticipatory guidance into their work. By providing healthcare providers with tools to strengthen the resilience in their patients and families, providers can help families become centered, connect better with each other, and collaborate on the solutions they need to improve their lives. 

We also know that when we “go first” with resilient practices, we are much more effective at teaching these practices to others.  So we are working with health care providers to help them understand how to use resilient practices in their own lives. Moreover, we have learned that “the helping professionals”, like healthcare providers and educators–are prone to vicarious trauma which is absorbed from working with others who have undergone trauma. Practices that strengthen their own resilience can also be used by helping professionals to mitigate vicarious trauma.  

In my time at the Bright Futures project, we emphasized the need for partnerships with the entire community – particularly the family and the school system.  We knew that community support is essential for children and youth to thrive. Now, Dovetail Learning’s We Are Resilient™ approach is focused on supporting whole communities — educators, healthcare providers, business professionals, families, and others. When all sectors of the community are using strategies to strengthen their resilience, children have the support they need to flourish.  With this work, we are excited to bring the dream of healthy communities into the 21st century.