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Promoting Healthy Social and Emotional Development in Young Children: Policy Challenges and Opportunities

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Title: Promoting Healthy Social and Emotional Development in Young Children: Policy Challenges and Opportunities


1
Promoting Healthy Social and EmotionalDevelopment
in Young Children Policy Challenges and
Opportunities
  • Jane Knitzer, Ed.D.
  • Project THRIVE and
  • National Center for Children in Poverty
  • March 7, 2005
  • AMCHP Annual Conference

2
Setting the Context About The National Center
for Children in Poverty (NCCP)
  • NCCP
  • Promotes the economic security, health and
    well-being of Americas low-income families
  • Is university-based (Mailman School of Public
    Health, Columbia University
  • Advances family-oriented policy solutions and the
    strategic use of public resources
  • Hosts Project THRIVE Policy analysis center for
    ECCS grantees
  • Provides Other Resources 50 state data tools
    Child Care and Early Education Research
    Connections Family Resource Simulator

3
Overview
  • What is healthy social-emotional development?
  • What is a public health policy framework to
    support healthy S-E development?
  • What are key policy building blocks?
  • How have some states responded?
  • What are special challenges opportunities?

4
What is Healthy Social, Emotional Development in
Young Children?
  • The age-appropriate ability for infants, toddlers
    and preschoolers to
  • Manage emotions (anger, frustration)
  • Relate to adults (parents, child care teachers)
  • Relate to peers and
  • Feel good about themselves (engaging with
    learning, curious, safe in approaching new tasks

5
Its not one size fits all
  • Early detection and prompt interventions can
    improve outcomes (i.e., shift the odds) for
    both children living in high-risk environments
    and those with biologically based disabilities.
    (IOM)
  • Interventions tailored to specific needs are more
    effective than services that provide generic
    advice and support. (IOM)
  • Pediatric child development, universal preschool,
    and services to promote healthy mental
    development are complementary. All are needed.

6
A Continuum of Services
  • Promotion

All kids
Prevention
Intervention
Increasing cost per child Increasing intensity of
need Decreasing numbers of children
7
What is A Policy Framework to Support Healthy S-E
Development?
  • A system of supports for young children, their
    families and other caregivers to promote
    age-appropriate social and emotional development
    especially for children whose development is
    compromised by poverty and other risk factors.
  • A public health approach to mental health that
  • Strengthens parental and other caregivers ability
    to promote young childrens healthy s-e
    development
  • Addresses prevention, early intervention
    treatment

8
Policy Framework System Goals
  • Common cross-system goals
  • Promote early learning healthy behaviors
  • Foster skills in other caregivers
  • Reverse a poor s-e developmental trajectory
  • Remove parental barriers and risks to effective
    parenting
  • Ensure that children with disorders get help

9
Policy Grounded in Research and Best Practices
  • Lessons from research
  • Lessons from other states
  • Cross-system fiscal and program analysis and
    planning
  • Intentional, research-informed intervention
    strategies

10
Policy Building Blocks Examples of Prevention
Strategies
  • Screening (EPSDT linked, Devereux parents)
  • Developmental services
  • Anticipatory guidance for parents
  • Community, state-level child development
    cross-training for staff working directly with
    young children and families (e.g. Touch Points)
  • Classroom-based curricula (e.g. Tools of the
    Mind)
  • Culturally appropriate parenting programs /
    relationship-based programs (Reach Out Read
    Baby Fast Incredible Years)

11
Policy Building Blocks Examples of Early
Intervention Strategies
  • Use ECMH Consultation
  • Embed child, staff and/or family focused
    interventions in pediatric and ece settings
  • Target high risk children
  • Maximize available federal funding
  • Develop common definitions of risk and criteria
    for eligibility across systems

12
Policy Building Blocks Examples of Treatment
Strategies
  • Parent-child therapies
  • Specialized family-driven interventions (Early
    Childhood Centers, Cleveland)
  • Classroom-based consultation
  • Treatment programs in courts, shelters foster
    families (MTFC-P Miami-Dade, trauma linked
    screening and treatment)
  • Family supports such as wraparound case
    management)

13
Policy Building Blocks Examples of
Infrastructure Building
  • Cross-system planning capacity
  • ECCS approaches
  • Common-cross-system tools
  • outcome measures, screening tools, definitions of
    risk, eligibility criteria, billing codes
  • Best policy and fiscal practices to support
  • Cross-training
  • MH Consultation
  • Family-focused treatment

14
Policy Building Blocks Examples of Best Fiscal
Policy Practices
  • Pay pediatric providers for developmental
    screening and services
  • Pay for family-focused treatment
  • Offer cross-training on child health
    development
  • Pay for screening for parental depression
  • Pay for child health mental health consultants

15
State Strategies in Action
  • Louisiana
  • In 6 of 64 parishes community-based,
    interdisciplinary assessment, training
    re-training funded with state dollars
  • Maryland
  • Statewide needs assessment ( 2002), Established
    consultation projects. In Eastern Shore 25 of
    children served had been in 3 or more child care
    settings. In Baltimore, implemented in child
    care, Head Start and family child care homes
    target, children at risk of removal. 84 not
    removed

16
State Strategies in Action (Cont)
  • Kentucky Early Childhood Mental Health Program
  • Provides ECMH consultation thru14 early childhood
    specialists across state Uses Devereaux Early
    Childhood Assessment (DECA) for screening in ECE
    settings Funded with tobacco settlement
    dollarsTrains existing and new providers.
  • Connecticut
  • Provides ECMH consultation through partnership
    with Behavioral Managed Care organization
    Evaluation in process Involves full assessment
    of child and settings

17
ECCS Needs and Objectives
  • Increase partnership with primary health care
  • Create incentives for screening
  • Improve Medicaid screening, referrals, and
    billing
  • Increase priority of young children in mental
    health
  • Create data systems that can track risk and need
  • Go from pilot projects to statewide
    programs/systems
  • Increase capacity through training of providers
  • Use common screening tools
  • Develop common, shared referral mechanisms
  • Use family resource centers and home visiting for
    family support

18
Some Challenges
  • Tough and uncertain federal context
  • Multiple consultants to child care
  • Identifying and using evidence-based practices
  • Making fiscal policies fit with best practice
  • e.g. paying for screening for moms, for
    relationship-based treatment
  • e.g. overcoming mental health/physical health
    barrier
  • Increasing work force capacity
  • Investing in research

19
Some Opportunities
  • Growth in state budgets
  • Push for school success by grade 3
  • Reduced child care churning
  • Increased recognition of the importance of
    healthy social-emotional development
  • Increase interest among state policy makers

20
Recent NCCP Publications www.nccp.org
  • Resources to Promote S/E Heath and School
    Readiness A Community Guide
  • Spending Smarter (and Project THRIVE Issue Brief
    1)
  • Pathways to Early School Success Helping the
    Most Vulnerable Infants, Toddlers Families

21
Questions?
Questions?
22
Questions?
Thank you!
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