upSTART Community Programs: Pioneering Early Childhood Health Programs That Make a Difference
At Texas Children’s Hospital and Baylor College of Medicine, an understated but powerful project is transforming the lives of families across Greater Houston. Centering on early childhood health, education and resilience, upSTART Community Programs have become a vital support network for families navigating the challenges of early parenthood and child development. Through this group of community-driven initiatives, parents gain access to education on early brain and language development, as well as social support and mental health services, creating opportunities to make a life-changing difference for their families.
The Vision: Supporting Families Through Early Intervention
upSTART Community Programs, which is housed in the Division of Public Health Pediatrics, launched with upWORDS in 2016 at Texas Children’s West Campus. The foundation of upWORDS lies in addressing the critical “30 million word gap”—the disparity in the number of words heard by children from affluent families versus those from less affluent families by the time they reach kindergarten. This gap, which can reach up to 30 million words by age 3, significantly impacts early language development and long-term educational outcomes.
The program emerged out of an identified need to support families with accessible early childhood education and intervention. “We started with upWORDS as a way to help families learn about early brain development,” explains Maura Dugan, assistant director of Population Health. “We wanted to give parents the tools to support positive relationships in the earliest days, when 80% of brain development occurs.”
Maura, a certified speech-language pathologist, was inspired by her experience working with children with hearing loss. Many families were struggling to navigate developmental concerns alone. The program provides group education on “serve and return” interactions. Research has shown these back-and-forth exchanges between parent and child are most important for brain growth, helping build foundational language and social skills that are the building blocks for literacy.
The LENA device, which Maura describes as a language “Fitbit,” plays a crucial role in upWORDS. This small device, worn by the child, tracks the number of words spoken and the frequency of back-and-forth interactions. “The LENA device helps parents see how much they’re talking to their child and where they can improve,” Maura notes. “It’s an incredible tool for giving parents insight into their interactions and encouraging positive change.”
One upWORDS participant shared, “I saw the book with the upWORDS info on it when my child was in the NICU. I kept it by his crib and read it to him every day. When we went home, I decided to call the number on the back of the book. This program has changed our lives.”
Expanding to Meet Families Where They Are
As upWORDS gained momentum, it expanded beyond early language skills to address deeper needs within the community. Chris Greeley MD, division chief of the Division of Public Health Pediatrics at Texas Children’s and Baylor College of Medicine, emphasized that the program’s growth has been driven by feedback from the families they serve. “We started with upWORDS, and then began asking, ‘What else do you need? What are the other barriers you’re facing?’ With the focus on responding to the needs of families, additional partners and avenues for support began to emerge, and new services and programs were developed,” Dr. Greeley explains.
The first expansion included upWORDS², focusing on understanding behaviors and socioemotional development by offering parents tools for positive parenting. upWORDS Bridges was created to help families with concerns for speech and language delays. This program serves to bridge a gap between a concern and a formal developmental or speech and language evaluation.
Next came upLIFT, a program developed in partnership with public health team members and maternal mental health experts. upLIFT supports pregnant women and women who have given birth within the past year. The program provides tools and strategies to help ease symptoms of perinatal depression and anxiety, which can adversely impact caregiver bonding and interactions during a critical period for mothers, families and their babies. For mothers experiencing depression or anxiety who have children under three, the team recently launched upLIFT Group, with groups available in both English and Spanish. A former upLIFT participant affectionately calls the team her “magical fairy godparents” for helping her find mental stability.
The suite of upSTART programs also includes upREACH+, which provides support for families experiencing high-risk pregnancies; Community Connections, to further support parents in building stable, nurturing environments for their children; and several pilot projects like Community Health Worker Certification Training and Long-Term Case Management.
upSTART’s Community Impact by the Numbers
upSTART Community Programs continue to grow, making a significant difference across Greater Houston. The Division has secured a total of 16 grants amounting to $14 million, including a $4.6 million grant from the Harris County Early Childhood Impact Fund and $6.1 million from the State of Texas, to fund these crucial initiatives and expand their reach.
Over the past two years, 1,103 families have participated in the upWORDS program, with an additional 298 engaging in upWORDS2 and 215 receiving extra support through upWORDS Bridges. Furthermore, 266 mothers have been supported through the upLIFT, and 1,028 families have benefited from community connection efforts.
In addition to direct services, upSTART programs build community resilience. In collaboration with the Children’s Museum and other local partners, 14,374 Welcome Baby Bags have been distributed, providing parents with helpful resources for their newborns. Program educators have also, so far, trained 6,555 providers on early brain development and parenting strategies.
One of the most telling measures of success is the feedback from parents themselves. A young mom in the upWORDS program shared, “Starting with him in the program early has helped me learn as he grows. I haven’t needed to turn to TikTok or Google, as many of my peers would do.” This kind of empowerment—the ability to navigate parenting challenges confidently—is at the heart of what Texas Children’s aims to achieve through upSTART.
Multidisciplinary Collaboration: The Diverse Team Behind upSTART
A core strength of upSTART is the diverse, multidisciplinary team driving them forward. As Maura explains, “We have community health workers, social workers, nurses, health educators, public health experts, former teachers and speech-language pathologists. All are committed to the families we serve and to creating safe places for them.”
The team’s collaborative approach ensures families in our community receive services that holistically address social drivers of health, such as food security. Nancy Correa, the Director of Population Health at Texas Children’s points out, “If you don’t know how you’re going to pay for dinner tonight, it’s difficult to focus on positive interactions with your child. We realized that while early language is our goal, we can’t ignore basic needs.”
The Future of upSTART: Creating Healthier Futures Together
As upSTART continues to evolve, Texas Children’s remains committed to meeting the community’s needs through innovative and compassionate approaches. Nancy reflects, “The families are our true north—it’s about what these families need, and how we can do a better job of helping.”
This commitment to listening, adapting and expanding based on real family experiences is what sets upSTART apart. It’s more than providing resources; it’s walking alongside families, empowering them with the tools they need to give their children the best possible start in life. As one participant simply put it, “This was fun! I feel more confident in my parenting.”
How to Enroll
upWORDS is accepting enrollment for new classes throughout Houston and the surrounding counties. If you are a parent with a child 0-36 months old or want to refer families to the program, please visit texaschildrens.org/upwords-program and complete the interest form. Referrals may also be emailed to [email protected].
To refer yourself, a patient or friend to the upLIFT program, please complete the upLIFT referral form. To join an upLIFT Group, please visit the upLIFT Group Referral Portal.
Be the Difference
If you are inspired by the work of upSTART Community Programs and want to be a part of Texas Children’s mission-driven culture, explore career opportunities with us. Together, we can create healthier futures for children and families across Greater Houston and beyond.
