Transcript Slide 1
Reducing Child Welfare Involvement:
The Promise and Limitations
of Early Intervention
Deborah Daro
Key concepts
Review key expectations regarding child wellbeing and well-becoming
Discuss the evolution of prevention policy and
practice in targeting these outcomes
Examine the populations being served and
service impacts of early intervention efforts
Highlight opportunities for enhancing impacts
Steps Toward Child “Well-Becoming”
Arriving at school ready to learn
Succeeding in school and achieving academic
excellence
Being fully employed in line with one’s skills and
competencies
Achieving economic stability and independence
Being socially well-adjusted and emotionally
healthy
Earliest Well-Being Objectives
Being raised in familial and community
environments that promote:
Safety
Stability
Nurturing
Appropriate stimulation and early learning opportunities
Avoid preventable injury and illness
Avoid being victims of child maltreatment and other
forms of trauma
Evolution of CAN Prevention Framework
Horizontal imagery
Vertical imagery
Multiple age cohorts
Birth to five
Promotion of any
promising program
Emphasis on
evidence-based
programming
Alter participants
and context
Alter participants
Prevention’s Impact on Racial Disparities
Are children of color over represented among the
caseloads of early intervention programs?
Are children of color more likely to benefit from early
intervention efforts?
Does an emphasis on target prevention programs
improve the odds of long term positive outcomes for
all children and reduce racial disparities?
Who Uses Early Intervention Services?
EHS
Head Start
NFP
HFNY
Durham
Connects
Whites
33%
35%
34%
44%
34%
African
Americans
26%
33%
28%
31%
42%
Hispanics
25%
23%
30%
21%
23%
7%
8%
4%
Other
Early Head Start Impacts
Positive Trends
Decrease in aggressive behaviors
More positive approaches to learning
Enhanced parent support for language and literacy
development
Concerns
Early modest gains in language and cognitive
development fade over time
Head Start Impacts
Positive Trends
Children are fully immunized
Most attend enriched pre-K programs and full-day
Kindergarten
Successfully screened for vision, dental and behavioral
health
Receiving stable medical care
Concerns
Modest gains in language and cognitive development
that fade over time
Early Home Visitation Impacts
Initiated During Pregnancy/Birth
Better birth outcomes (if offered during pregnancy)
Enhanced parent-child interactions
Positive maternal life and health choices
More efficient use of health care and community services
Enhanced child development and early detection of
developmental delays
Toddlers
Early literacy skills
Social competence
Parent involvement in learning
Factors Influencing Outcomes
Programs that are fully operational and
implemented with fidelity
Provision of multiple early learning opportunities
offered sequentially
Attention to the diverse range of difficulties facing
high risk families
Strongest gains among the most disadvantaged
and, in some cases, African American children
Prevention’s Circular Debate
EFFICIENCY
UNIVERSAL
PREVENTION
TARGETED
PREVENTION
STIGMATIZING
Limits of the “Targeted/Scientific” Approach
Requires highly predictive and accurate risk assessment
protocols or eligibility criteria
Assumes we can successfully identify all those at risk
Assumes highest risk families will engage and remained
involved in voluntary interventions
Promotes the message collective or social assistance
with parenting is required only for those unable to do the
job on their own
Assumes if we just had the “right” program models and
took them to scale, population-level impacts will follow
Prevention as Change Agent
Technical solutions to strengthening community
capacity
Creating new programs and supportive services for all parents
Building partnerships among key stakeholders
Mobilizing residents to better support service expansion
Adaptive challenges to transforming communities
Achieving consistent service quality and access
Creating institutional incentives for sustaining collaboration
Creating a context of personal responsibility for child wellbeing
Altering the political process to embrace prevention
Grow Prevention Systems
“It is shocking that so many have chosen to focus on one
year or two when the child was a preschooler and have
disregarded the many subsequent years of development,
exalted a single experience over myriad others, and are
now putting their hopes and money on early childhood
programs as the solution--not part of a solution -- to
pervasive social problems.”
Edward Zigler, 1993