PUTTING INFANTS AND TODDLERS ON THE PATH TO SCHOOL READINESS:

PUTTING INFANTS AND TODDLERS ON THE PATH TO SCHOOL READINESS: An Agenda for the Administration and 113 th Congress M ost parents watch proudly as their 5-year-old grabs her backpack and heads out the door to her first day of kindergarten her official start in the world of education and learning. Few might imagine that their child has actually been preparing for this day since she first opened her eyes. A child s life of learning begins at birth, with brain development shaped by early experiences setting the foundation for all learning that follows. This early path to school readiness unfolds in everyday moments, within caring relationships that nurture confidence and security. How very young children are cared for teaches them how to interact with the world and profoundly shapes who they will become. In essence, the first steps toward school readiness also lead to the resiliency and positive behaviors needed for success in the workforce and in life. But too many infants and toddlers lack the key resources needed for a good start on the school readiness path. They fall behind even before arriving at a pre-kindergarten class door. Their preschool experience is playing catch-up, not forging ahead. The solution: public policies that ensure children are ready for school and life by incorporating the infant-toddler years as an essential part of the birth-to-8 continuum. EARLY BRAIN DEVELOPMENT LAYS THE FOUNDATION During the remarkable first three years of life, the brain creates 700 new neural connections every second. 1 Synapse formation for functions such as hearing, language, and cognition peak during this time before children reach preschool. These peak periods create the important foundation for higher level functions that will be built on top of them. During this sensitive period, early experiences influence whether this important foundation will be strong or fragile. The early years thus present a prime opportunity to positively influence the course of a young child s life. My School Readiness Checklist Someone who is just crazy about me: talks to me, sings to me, reads me books, plays finger games, lets me explore but is always there Someone who does all these things when my parents are at work Good food (even peas) A place to call home Being warm when it s cold outside Safe neighborhood A doctor just for kids and one for my teeth (when I get them) Lots of toys and books Playing inside and outside Parents who aren t worried all the time Someone who helps me when I can t do what other kids do FIGURE 1: HUMAN BRAIN DEVELOPMENT NEURAL CONNECTIONS FOR DIFFERENT FUNCTIONS DEVELOP SEQUENTIALLY Sensory Pathways (Vision, Hearing) Language Higher Cognitive Function FIRST YEAR -8-6 -4-2 2 4 6 8 10 2 4 6 8 10 12 14 16 18 BIRTH MONTHS YEARS GRAPHIC COURTESY OF THE CENTER ON THE DEVELOPING CHILD AT HARVARD UNIVERSITY. SOURCE: C. A. NELSON (2000).

RELATIONSHIPS ARE THE KEY TO BABY LEARNING Our earliest experiences, along with genetic influences, shape our brain architecture and take place in the context of relationships with important adults in our lives, primarily our parents. With 6 million infants and toddlers spending time in child care, other caregivers also play a key role. These trusting relationships foster the social and emotional skills confidence, persistence, self-regulation, attentiveness, and ability to form relationships that set infants and toddlers on the path to being confident learners, productive workers, and emotionally competent human beings. Emotions drive learning, as social-emotional and cognitive development intertwine to form the bricks and mortar of early brain architecture. 2 Gaps Appear Before the Preschool Years When the key ingredients for healthy, positive development are not present, the early years become a time of vulnerability rather than promise. Persistent environmental stress from unstable housing, an absence of adequate nutrition, and high parental stress, coupled with few opportunities for rich early learning experiences, can be toxic to early brain development. Children with risk factors, such as living in low-income households, abuse or neglect, prenatal exposure to alcohol or other substances, and low parental education, have a higher incidence of developmental delays and disabilities than the general population. Disparities emerge as early as 9 months and widen by 24 months of age. 3 Divergence in language abilities begins to emerge before a child s first birthday and widens by age 3. 4 Infants and toddlers from low-income families are less likely to be in very good health or receive positive behavior ratings than those from higher income families. 5 By age 2, toddlers in the lowest socioeconomic quintile are behind all other children in measures of cognitive skills and emotional attachment. 6 Infants and toddlers who experience or are at risk for maltreatment are most vulnerable. More than half of children under age 2 who have any contact with the child welfare system regardless of substantiation of abuse or neglect are considered at high risk for developmental delays or neurological impairment. 7 FIGURE 2: THE GAP IN CHILDREN S LANGUAGE ABILITY BEGINS EARLY 1200 1000 800 High SES Middle SES Low SES SES = Socioeconomic Status Cumulative vocabulary words 600 400 200 10 12 14 16 18 20 22 24 26 28 30 32 34 36 Age of child in months SOURCE: ADAPTED FROM BETTY HART AND TODD R. RISLEY, MEANINGFUL DIFFERENCES IN THE EVERYDAY EXPERIENCE OF YOUNG AMERICAN CHILDREN (BALTIMORE, MD: PAUL H. BROOKES, 1995). 2

Supporting Early Development Is a Wise Investment At the same time that science reveals the importance of development in the earliest years, program evaluation research is able to highlight effective strategies to improve the lives of at-risk children and their families. Strong relationships can help buffer children from the toxic stress that can undermine healthy brain development. Proven approaches some beginning during the important prenatal period can help diminish the gaps and promote stronger social-emotional foundations. Economists estimate that for every dollar invested in early childhood programs, savings of $3.78 to $17.07 can be expected in future public expenditures, in part by reducing the occurrence of negative educational and life outcomes. 8 Effective interventions include: Early Head Start A rigorous evaluation found positive impacts on children s cognitive and language development, more positive approaches to learning, and fewer behavior problems. Parents were more involved, provided more support for learning, and had reduced risk for depression. 9 Evidence-Based Home Visiting Depending on the model used, positive impacts have been shown in one or more domains, including child health, child development and school readiness, maternal health, reductions in child maltreatment, family economic self-sufficiency, positive parenting practices, and linkages and referrals. 10 High-Quality Child Care Positive effects have been shown in the areas of early learning, cognitive and language development, and school achievement, as well as positive associations with early social and emotional development. 11 Positive effects can endure into the adult years, particularly for children from the poorest home environments. 12 A special note: The tragic shootings at Sandy Hook Elementary School have led to a renewed focus on preventing violence, including mental health policy. As these issues are discussed among policymakers and the public, we must acknowledge the important role of social and emotional development in addressing these challenges. Children s early development starts them on a path on which school readiness is only an interim step. Early experiences and relationships set the stage for how individuals relate to other people and cope with life in general. The critical ingredients and influences that are the seeds for school readiness also determine later resiliency. The beginnings of mental health problems often may be found in early social-emotional development. Thus, policies to promote strong early childhood development should be seen in this broader context, and young children should be included in any response that promotes more support for mental health services. FIGURE 3: RATES OF RETURN TO HUMAN CAPITAL INVESTMENT AT DIFFERENT AGES: RETURN TO AN EXTRA DOLLAR AT VARIOUS AGES Programs targeted towards the earliest years Preschool programs Rate of return to investment in human capital School Job training 0-3 4-5 Preschool School Post-school 0 Age SOURCE: JAMES HECKMAN, INVESTING IN DISADVANTAGED YOUNG CHILDREN IS GOOD ECONOMICS AND GOOD PUBLIC POLICY. STATEMENT PRESENTED TO THE JOINT ECONOMIC COMMITTEE OF THE UNITED STATES CONGRESS. 110TH CONGRESS, FIRST SESSION, JUNE 27, 2007. REPRINTED WITH PERMISSION. 3

THE AGENDA: PAVING THE PATH TO SCHOOL READINESS AND BEYOND Early childhood policy needs to be built as brains are from the bottom up. We know from science that critical brain functions take shape before age 3, at-risk children fall behind before they reach preschool, and, above all, intervening early can make a difference and is a wise place to invest public dollars. In shaping policy and setting priorities, two critical points emerge from the research: The rapid development of young brains means some babies can and do experience problems, such as developmental delays or mental health issues, that they do not grow out of. These problems must be addressed in a comprehensive manner before they balloon into more difficult and expensive problems later. Most important, the early years represent an unparalleled opportunity for true prevention policies that promote positive, healthy development that will resonate throughout a child s school career and life, increasing the individual s well-being and future contributions to our society. Public policies that promote positive infant-toddler development will look different from those for preschool and older children. The path to school readiness begins with a baby blanket of care that reaches all vulnerable infants and toddlers where they are: at home with parents or relatives, in formal and informal child care settings, or in comprehensive settings such as Early Head Start. In any deficit reduction, tax, or entitlement reform effort, protect programs that support low-income families in providing critical ingredients for positive early development: For families who lack resources, many federal programs help supply the ingredients for healthy development for infants and toddlers. With almost half of young children living in low-income families, these children and other vulnerable individuals should not be called on to forego essential needs. Deficit reduction efforts should use a balanced approach that includes increased revenues. Help parents support their children s early development: Create a federal Paid Family Leave program to ensure that parents can afford ample time off from work to build all-important attachments with new babies. Enhance the Maternal, Infant, and Early Childhood Home Visiting program by providing grants to states to increase the capacity to address social-emotional health and development, continuing to integrate the approach into a broader system of prenatal and early childhood supports, and expanding the program through reauthorization. Expand comprehensive early development and learning opportunities: Increase funding for Early Head Start to double the number of spaces in 2 years to provide an additional 100,000 infants, toddlers, families, and pregnant women comprehensive services and developmental experiences. Early Head Start should remain the centerpiece of federal strategies to improve early development because of its proven approach, intergenerational nature, inclusion of pregnant women, and availability to children independent of parents employment status. Leverage Early Head Start-Child Care partnerships to increase quality child care and comprehensive services. Use center-based Early Head Start programs as hubs and models for providing comprehensive and individualized services for vulnerable children in other early care and education settings. Through partnerships, Early Head Start can also provide comprehensive services for partner programs. 4

Reauthorize the Child Care and Development Block Grant to expand access and set aside a percentage of funds to improve the quality of infant-toddler child care by supporting infant-toddler programs in meeting Early Head Start standards or attaining national accreditation; supporting overall systems improvement such as including infant-toddler components in Quality Rating and Improvement Systems, professional development for infant-toddler caregivers, infant-toddler specialist networks, and staffed family child care networks; and expanding access to high-quality inclusive settings for infants and toddlers with disabilities or developmental delays. Include a focus on child well-being in the reauthorization of the Temporary Assistance for Needy Families program, recognizing the risks faced by the young children in these very poor families and seizing the opportunity to ensure they receive high-quality early childhood services. Identify and address developmental needs earlier: Provide incentives and technical assistance to state and community efforts to implement integrated developmental screening efforts for young children across settings in order to reduce duplicate screening, ensure results can be used to connect parents and children to the right services, and coordinate among service providers and the family. Reauthorize Part C of the Individuals with Disabilities Education Act, Infants and Toddlers with Disabilities, which provides access to early intervention services, by increasing states ability to: identify and serve more eligible children; increase capacity to address the social and emotional needs of infants and toddlers; support professional development of the early intervention workforce; and invest in research on effective practice, quality improvement strategies, and effective system functioning. Innovative approaches to addressing the needs of infants and toddlers across the spectrum of delays and disabilities could be promoted through a Meeting Early Milestones Challenge Fund to encourage states and communities to build a more comprehensive network that could connect children with milder developmental disabilities and delays to beneficial treatment services. Underscore the importance of social and emotional development by increasing access to and the quality of Infant/Early Childhood Mental Health Services: Direct mental health services funding to increase the availability of mental health professionals trained to address the needs of infants and toddlers. Promote strategies to identify and treat maternal depression, beginning prenatally. Expand Medicaid reimbursement for relationship-based mental health services (such as therapy provided to children and parents together). Increase the capacity for mental health training and consultation within early care and learning programs. Provide training and technical assistance to early childhood programs to build curricula that support foundational skills and social-emotional learning. Promote a developmental approach to ensuring the well-being of infants and toddlers in the child welfare system: Adopt policies and practices at the state and local level oriented toward the developmental needs of infants and toddlers, including assessment; health, mental health, and developmental services; and appropriate foster care practices. Direct funding to support state and community systems change and the provision of needed services, such as parent assessments; training in early childhood development for caseworkers, foster parents, and judicial personnel; parent child visit coaching; innovative partnerships between child welfare, mental health, health, and Part C early intervention; trauma-informed screening and interventions; and approaches such as Safe Babies Court Teams. 5

CONCLUSION While parents and other caregivers are the prime supporters of their young children s development, as a nation we all have a stake in ensuring that infants and toddlers have the best possible opportunities to realize their potential. Too many infants and toddlers are at risk of falling behind developmentally because of economic and other factors. We cannot be shortsighted about the consequences. Today s young children will form the backbone of the workforce at mid-century. With our support now, our youngest children have the future potential to continue our nation s place as a leader in the global economy. It is time to make infants and toddlers a national priority and guarantee they have the ingredients they need to grow up healthy, happy, and ready to succeed. 1 Center on the Developing Child, Child Development Fact Sheet. Harvard University. http://developingchild.harvard.edu/. 2 National Scientific Council on the Developing Child, The Science of Early Childhood Development. National Scientific Council on the Developing Child, 2007, www.developingchild.net. 3 T. Halle, N. Forry, E. Hair, et al., Disparities in Early Learning and Development: Lessons From the Early Childhood Longitudinal Study Birth Cohort (ECLS-B). Washington, DC: Child Trends, 2009. 4 Betty Hart and Todd R. Risley, Meaningful Differences in the Everyday Experience of Young American Children. Baltimore, MD: Paul H. Brookes, 1995. 5 Halle, Forry, Hair, et al., Disparities in Early Learning and Development. 6 National Center for Education Statistics, Table 120: Percentage of Children Demonstrating Specific Cognitive Skills, Motor Skills, and Secure Emotional Attachment to Parents at About 2 Years of Age, by Selected Characteristics: 2003 04. In Digest of Education Statistics, Institute of Education Sciences, January 25, 2013, http://nces.ed.gov/programs/digest/d11/tables/dt11_120.asp. 7 National Survey of Child and Adolescent Well-Being, Research Brief No. 4: Infants and Toddlers in the Child Welfare System. U.S. Department of Health and Human Services, 2007. http://www.acf.hhs.gov/sites/default/files/opre/infants_todd.pdf. 8 James Heckman, Rob Grunewald, and Arthur Reynolds, The Dollars and Cents of Investing Early: Cost-Benefit Analysis in Early Care and Education. Zero to Three 26, no. 6 (2006). 9 U.S. Department of Health and Human Services, Administration for Children and Families, Making a Difference in the Lives of Infants and Toddlers and Their Families: The Impacts of Early Head Start. Washington, DC: U.S. Department of Health and Human Services, 2002. 10 Elizabeth DiLauro and Lisa Shreiber, Reaching Families Where They Live: Supporting Parents and Child Development Through Home Visiting. Washington, DC: ZERO TO THREE, 2012. 11 J. Ronald Lally, Abbey Griffin, Emily Fenichel, et al., Caring for Infants and Toddlers in Groups: Developmentally Appropriate Practice. Washington, DC: ZERO TO THREE, 2003. 12 National Research Council and Institute of Medicine, From Neurons to Neighborhoods: The Science of Early Childhood Development. Jack Shonkoff and Deborah A. Phillips, eds. Washington, DC: National Academy Press, 2000. For more information about the policy recommendations in this agenda, please contact Patty Cole at PCole@zerotothree.org or at 202-638-1144. About Us: The ZERO TO THREE Policy Center is a nonpartisan, research-based resource for federal and state policymakers and advocates on the unique developmental needs of infants and toddlers. To learn more about this topic or about the ZERO TO THREE Policy Center, please visit our website at: www.zerotothree.org/public-policy 6