Integrated care fosters healthier beginnings for young children and their families

When a young child isn’t walking, talking, or engaging like their peers, parents often don’t know where to turn. For families facing barriers to care, that uncertainty can feel even more overwhelming.

Since 2024, Zufall Health’s Early Childhood Development (ECD) program, HealthySteps, has helped hundreds of families navigate developmental concerns through integrated support funded by the Health Resources and Services Administration.

During well visits for children ages 0–5, Zufall pediatricians use the Survey of Well-being of Young Children (SWYC), a questionnaire that screens for developmental delays, behavioral concerns, and social stressors such as food or housing insecurity. When a concern is flagged, families are referred to ECD Specialist Lesly Tinoco, LAC, who provides counseling and connects them to additional resources, in person or virtually.

Lesly Tinoco, LAC, provides counseling to a mother and her two young children in West Orange. Commenting on the significance of her collaboration with Tinoco, Pediatrician and ECD Champion Christine Pagano, MD, says, “HealthySteps has greatly enhanced the services we provide to families with children from birth to 5 years of age. By offering comprehensive parental support and structured surveillance of milestones, we are promoting school readiness and creating environments for optimal growth and development.”

As of June 30, 2025, the program has completed 2,200 screenings for more than 800 children—about 60% of whom had identifiable needs.

Among them was a toddler named Sara, diagnosed with hip dysplasia at seven weeks old. Thanks to a quick referral through the ECD program, Sara received intervention and is now walking.

Another family, Jennifer and her two-year-old son Devin (names changed for privacy), received in-home speech and occupational therapy after a screening revealed delays. Devin is now meeting age-appropriate milestones.

“Our youngest patients often have the least access to behavioral health services—and the most to gain,” said Sarah Aleman, MSW, LCSW, Zufall’s Senior Vice President of Behavioral Health Services. “HealthySteps is currently offered in Dover and West Orange, but with additional support, we could bring it to more locations. Pediatric providers across the Zufall system recognize the value of this integrated approach in preventing crises, reducing the need for costly interventions, and supporting the entire family.”

Tinoco helped Brenda secure a donated specialty car seat that can accommodate Sara’s hip brace. “Now I can take Sara with me in the car to visit my grandmother,” Brenda said. “I’m very appreciative.”

For Jennifer, who had previously experienced domestic violence, the program provided much-needed support. “I was very stressed at first to have my little one struggling,” she said. “But everything Zufall provided has been a big help to me.”

Brenda, Sara’s mother, said her regular counseling sessions with Tinoco have made a lasting impact. “I don’t have many people to lean on,” she said. “But when I come here, I can talk about the difficult things in motherhood and be reminded that I matter.”