HealthySteps offers a unique, practice-based opportunity for pediatric residents to deepen their understanding of child development, positive parenting, early relational health, and the social drivers of child and family health and well-being.
At participating practices nationwide, child development and behavioral health promotion and prevention experts—HealthySteps (HS) Specialists—serve as integrated members of the pediatric primary care team, working alongside residents during and between well-child visits.
HS Specialists support resident learning through observation, modeling, and consultation, helping residents strengthen their skills in relationship-based and family-centered care. This includes:
- Observing and modeling evidence-based practices: Observing parent-child and clinician-family interactions while demonstrating effective communication, relationship-building, anticipatory guidance, and family engagement strategies.
- Providing real-time consultation: Offering brief, informal “curbside” consultations when residents encounter questions or concerns during visits.
- Supporting continuity of care: Providing follow-up support to families when residents identify additional child or family needs but must move on to their next patient.
HS Specialists partner with residents within the typical trainee and attending workflows of busy clinics, fostering a truly integrated, effective clinical care team. Through this ongoing partnership, residents gain firsthand experience incorporating developmental, behavioral, and psychosocial support into routine pediatric care while strengthening competencies in communication, family-centered care, interprofessional collaboration, and systems-based practice.
Evidence of HealthySteps improving resident training includes:
- Residents’ overall knowledge of child development increased, as did overall screening and referral rates when components of HS were incorporated in resident training. These components included developmental screening and referral, perinatal depression screening and referral, early detection and referral for Autism, family risk factors and so on. (Bauer et al., 2009)
- Higher referral rates when their pediatric curriculum incorporated a weekly rotation in HealthySteps clinics for residents supervised by faculty trained in the HealthySteps model. (Hughes et al., 2014)
- When, in addition to the model, HS Specialists provided residents with hands-on training, conducted team-based well-child visits together with residents, and provided residents with feedback on their performance, faculty reported that residents were better prepared to provide care for children and families for behavioral and developmental issues after the HealthySteps training. (Randolph et al., 2011) The same model also improved continuity of care for children served by HealthySteps. (Niederman et al., 2007)
- In a survey, residents reported that the HS Specialists facilitated their learning of anticipatory guidance (69%), ensured that patients received information efficiently (69%), and did not interfere with their relationship with the patient’s primary care provider (62%). Additionally, 76 % of residents reported considering using HS Specialists in their future practice. (Kinzer et al. 2004)
Resources for Growing Great Doctors: How HealthySteps Enhances Residency Training
Recent changes to pediatric residency requirements aim to rebalance inpatient and outpatient experiences, prioritize behavioral health, and expand residents’ opportunities to provide patient-centered care. HealthySteps can support the newly required behavioral health rotation by more comprehensively addressing the rising behavioral health needs of children.
Below are links to a wide range of eLearning courses, articles, websites, and other training materials on infant mental health, early childhood development, and caregiver well-being to support resident learning. We recommend using them in conjunction with HealthySteps shadowing, team-based well-child visits, small-group learning, and focused didactic instruction.
Please note that the HS National Office is not responsible for the content of these resources unless otherwise noted.
From Tiny to Toddler (eLearning, HealthySteps National Office)
Developed by the HS National Office, this 12-module course guides HS Specialists and medical providers through pediatric well-baby checkups, reviewing pertinent information on development, anticipatory guidance, and positive parenting to support Residents and HS Specialists in conducting team-based well-child visits.
Residents can access this course, and all additional HS professional development resources, by adding them as contacts to your site’s Hub account. Under the contacts field, please select “other” and then “resident”.
HealthySteps Topical Handouts for Caregivers (printouts, HealthySteps National Office)
These concise, easy-to-read articles offer guidance on a broad range of topics essential to early childhood development and well-being. These can support both caregiver and resident understanding of development, behavior, and positive parenting guidance.
Keystones Curriculum (eLearning, Mt. Sinai Parenting Center)
This e-learning course was developed in collaboration with HealthySteps and ZERO TO THREE to help pediatric providers promote positive parenting behaviors and strong parent-child relationships within everyday healthcare.
You can access it for free by clicking “My Program Has a Token” and entering the code: ZTT-HSS-2019 (eLearning, Mt. Sinai Parenting Center)
FAN: Relational Practice Through Attunement and Self-Reflection (eLearning, AAP and Erikson Institute, $5)
Pediatric care relies on connections as much as clinical expertise. The FAN model helps pediatric teams communicate with attunement, uncover families’ true concerns, and build trust while supporting clinician well-being. This eLearning course, co-created by the AAP and The Erikson Institute, provides the rationale for and practice of reflective and relational partnership with caregivers in pediatrics.
Learn the Signs. Act Early. (website, Centers for Disease Control)
This website supports early identification of developmental delays and disabilities, including autism, by facilitating parent-engaged developmental monitoring and promoting developmental screening. The program has three components: Health Education Campaign, Act Early Initiative, and Research and Evaluation. These can support caregiver and resident understanding of behavior and development.
Addressing Early Childhood Emotional and Behavioral Problems (journal, AAP)
Technical report on treatment options for mental health concerns in early childhood.
Baby Sleep (website, Pediatric Sleep Council)
Support for caregivers in navigating baby/toddler sleep challenges. Appropriate for providers and caregivers as well.
Early Relational Health in Practice (eLearning, AAP)
Short videos for primary care providers and residents focusing on promoting early relational health in practice.