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428 Anchor programme: pilot home visitation programme for children with adverse childhood experiences (ACES)
  1. Li Ming Ong,
  2. Padmini Yeleswarapu Sita,
  3. Jean Yin Oh,
  4. Helen Chen,
  5. Oh Moh Chay
  1. Singapore


Background Early childhood is a critical period for brain and biological development. Children with adverse childhood experiences (ACES) including maltreatment are at a high risk of developmental, behavioural and health problems lasting into adulthood. Anchor, a home visitation programme was commenced to support these children aged 0–3 years old who have been maltreated and their families.

Objectives 1.To review the uptake of the families into the programme 2. To understand the profile of the children and their families enrolled into the programme

Methods Children enrolled into the programme undergo baseline evaluation of their health, development and behavior through ASQ-3 (Ages and Stages Questionnaire, Third Edition), ASQ: SE 2 (Ages and Stages Questionnaire: Social Emotional, Second Edition), CBCL (Child Behavior Checklist), YCPC (Young Child PTSD Checklist) and M-CHAT (Modified Checklist for Autism in Toddler, Revised). The primary caregiver undergoes evaluation of mental health through PHQ-9 (Patient Health Questionnaire-9) and GAD-7 (General Anxiety Disorder-7), and an assessment of bonding with the child using PICCOLO (Parenting Interactions with Children: Checklist of Observations Linked to Outcomes). After multidisciplinary team discussion of the above assessments, cases are tiered. The frequency of home visitation is determined based on the tiering of the case and the intervention plan is developed in discussion with the family using the principles of family centered practice. Their needs are identified early and supported with relevant home-based interventions. These children and their caregivers are also referred to medical and community services, as deemed necessary.

Results By December 2020, a total of 121 cases were referred to Anchor. 57 (42%) of these cases are actively followed up by the programme. Approximately 15% of the referred families were not keen on the programme, while 3 of the families withdrew from Anchor. The remaining cases includes those that are pending enrolment and those rejected by the team as the family was being supported through other services. Physical abuse was the most common reason for referral. Approximately 50% of the children had a significant developmental delay (2 standard deviation) in at least 1 developmental domain and a third of them had delays in 2 or more domains on the ASQ-3 assessment. Based on ASQ: SE, 33% of these children were reported to have mild to significant social-emotional developmental delays. 48% of the children were reported with behavioral and emotional concerns in CBCL assessments. 30% of the children had incomplete vaccination. A third of caregivers had mental wellness concerns as indicated by PHQ-9 and GAD-7 scores. M-CHAT and PICCOLO results are being analysed and will be presented in the conference.

Conclusions Anchor programme and its holistic evaluation showed that children with ACES and their families are a vulnerable group with high needs. It is imperative that these needs are identified in a timely manner to ensure that targeted support services are provided through home visitation and inter-agency collaboration.

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