Nurturing the Seed logo
Nurturing the Seed:
The Journey to Early Mental Health and Wellness

A Multi-Site Study 

Introduction

Originally, Nurturing the Seed (NtS) referred to a tool (Manual + Strategies) developed with Elders and advisors from several Indigenous communities and aiming to improve the developmental trajectories of Indigenous infants and preschoolers, particularly if they may be at risk of less-than-optimal outcomes. The idea is to act early since the first five years of a child’s life are critical to their lifelong wellness. In combination with a validated questionnaire that identifies infants and toddlers who are at risk of facing challenges in one or more key areas of development, using the Nurturing the Seed tool helps frontline workers suggest ways for the child’s caregivers to help the child strengthen specific skills through interactions and activities.

The Nurturing the Seed tool yields the best results when community practitioners across organizations and sectors are trained and supported in using it. So IEMHP developed a Nurturing the Seed program, or “community intervention”. This program is guided by and tailored to communities, and it includes training, coaching and other forms of support in implementing the NTS tool widely in the community.

Today, Nurturing the Seed has evolved into a large, pan-Canadian project. The Nurturing the Seed study measures the effectiveness of the Nurturing the Seed community intervention, in particular the use of the Nurturing the Seed tools with families of Indigenous children less than 6. It monitors the improvement of: 

  • infant and early mental health service delivery,
  • Indigenous families’ well-being and empowerment, and 
  • Indigenous children's developmental outcomes. 
Diagram depicting the process that lead to the NTS Study: The first 3 years are foundational to later physical and mental health outcomes, and influencing development is easier sooner than later. There is a lack of culturally-informed developmental screening tools and interventions to serve the specific needs of Indigenous families and children at risk of developmental delay. So IEMHP partnered with a team of Elders and a national Indigenous advisory to develop Nurturing the Seed, a culturally-informed screening and early intervention model to support the work of front-line practitioners. NTS involves a resource to assist practitioners in creating developmental support plans, clear strategies to support a young child's development and interim support while a child with an identified developmental concern is waiting for further assessment and services. The Nurturing the seed STUDY aims to assess the impact the tool has on children, their families and their community.

Methods

The Nurturing the Seed community intervention aims to support interested Indigenous communities across Canada, to: 

  • Increase practitioners’ competence, confidence and capacity in Infant and Early Mental Health across sectors. 
  • Support young children’s development with culturally-appropriate developmental screens and Developmental Support Plans, using the ASQ-3 and ASQ:SE-2 questionnaires, and the Nurturing the Seed toolkit. 
  • Collect and enter infant and early mental health data.  As per OCAP First Nations Principles, the data remains the property and responsibility of each community, and the research team only uses it with their permission. 
  • Monitor improvements in the delivery of IEMH services, the wellbeing of the family and the child’s developmental outcomes. 
  • Inform practice with learnings from the study. 

Main steps of the Nurturing the Seed community intervention:
Arrow diagram listing the main steps of the NTS intervention: 1.initial community advisory meetings, 2.community engagement events, 3. Training, 4. Ongoing support on research protocol, 5. family visits, every 3 to 4 month over the course of a year, 6. evaluation: Training knowledge, change in child and family outcomes, 7. data analysis stewardship and reporting

Nurturing the Seed interactions with families:
Diagram depicting the nurturing the seed protocol. After consenting front line staff receives training and mentoring from IEMHP, they recruit consenting family. The family starts a series of study cycles with the following steps:1. get to know the child and family: conversation and questionnaires, data is collected. 2. gather additional information: Administer ASQ, collect observations and family interpretation. Data is collected. 3. share what has been learned through a debrief with the family and team members. 4. Develop a DSP compiling the information collected so far. Data is collected. 5. Review and modify the DSP as needed before sharing plan with families and colleagues. 6. The family implements the plan and the practitioner follows-up with them at least once. 7. 3-4 months later, go back to step 1.


Who is Participating

The Research Team 

The Nurturing the Seed study is conducted by a partnership between IEMHP and Dr. Reynold’s lab at Queen’s University. It is funded by the Public Health Agency of Canada and the Kids Brain Health Network

Participating Communities 

  • Aamjiwnaang 
  • Amiskwaciy 
  • Bentarrow 
  • Child and Youth Milopemahtesewin Services (CYMS) 
  • Creighton 
  • La Ronge
  • Pidaban 
  • Simcoe
  • Timiskaming New Liskeard 
  • Timiskaming Kirkland Lake 


Current Progress and Preliminary Results

The study started in 2019.
Table indicating, for each community, the number of trained practitioners (column 1), the number of practitioners enrolled in the study (column 2), the number of families enrolled in the study (column 3) and the number of families who completed the study (column 4) Practitioners trained: Aamjiwnaang 30, Amiskwaciy 5, Bent Arrow 46, Creighton 3, CYMS 6, La Ronge 34, Pidaban 12, Simcoe 49 and Timiskaming 56. Practitioners enrolled: Aamjiwnaang 13, Amiskwaciy 3, Bent Arrow 32, Creighton 2, CYMS 4, La Ronge 9, Pidaban 0, Simcoe 18 and Timiskaming 32. Families enrolled: Aamjiwnaang 2, Amiskwaciy 0, Bent Arrow 0, Creighton 6, CYMS 0, La Ronge 16, Pidaban 0, Simcoe 45 and Timiskaming 92. Families completed: Aamjiwnaang 0, Amiskwaciy 0, Bent Arrow 0, Creighton 0, CYMS 0, La Ronge 9, Pidaban 0, Simcoe 2 and Timiskaming 10.

Number of sectors participating in the study for each community.

Bar graph indicating the number of sectors involved in the study for each participating community: Timiskaming (5), Simcoe (9) Pidaban (1), La Ronge (9), Cyms (3), Creighton (1), Bent Arrow (9), Amiskwaciy (2), Aamjiwnaang (9) and altogether (10)

The NTS Training increased infant and early mental health knowledge consistently and significantly:
Bar graph plotting the knowledge scores of front-line practitioners before (Series 1) and after (Series 2) the training. The training increased knowledge scores for all the following groups: All practitioners, trained in-person, trained on-line, hold a bachelor degree or higher, hold a college degree or less, 6 years of experience or more, 5 years of experience or less, child care sector, drop-in centre sector, home visiting program sector, child protection sector, head start sector, public health sector, child youth mental health and rehabilitation services sector, traditional healing sector and other sectors.
 

Interested in learning more?

Please contact us at iemhp.mail@sickkids.ca