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:
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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
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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