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Building Bridges for Children from Birth to School Neal Halfon, MD, MPH Director UCLA Center for Healthier Children,

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Building Bridges for Children from Birth to School Neal Halfon, MD, MPH Director UCLA Center for Healthier Children,

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    1. Building Bridges for Children from Birth to School Neal Halfon, MD, MPH Director UCLA Center for Healthier Children, Families and Communities

    2. Family relationships in community contexts

    4. Neuroscience of Brain Development Brain is not mature at birth Brain is changed by experiences Critical periods imply timing is important Relationships program social emotional function Adversity impacts brain development

    5. Brain is Not Mature at Birth

    7. Brain is Changed By Experiences

    11. Critical Periods Imply Timing is Important

    12. Relationships Program Social Emotional Function

    13. Adversity Impacts Brain Development

    14. Maternal Depression Common Higher rates in inner city, poor, single mothers Multiple impacts Treatable

    15. Depressed Mothers: Response Patterns to Infants Express less positive and more negative affects Less attentive and more disengaged When engaged are more intrusive and controlling Fail to respond adaptively to infant emotional signals

    16. Infants of Depressed Mothers Shorter attention spans Less motivation to master new tasks Elevated heart rates Elevated cortisol Reduce EEG activity right frontal cortex

    17. Clinical and Epidemiological Research Many mental health problems have their origin early in a child’s life Many health problems of adult have their origin early in life

    18. Research on School Achievement Children from disadvantaged backgrounds start school one year behind and don’t catch up Developmental inputs by age six accounts for significant variance in educational achievement at age 18

    19. Public Policy Research Brain development and public investment are not synchronized

    21. Missed Opportunity to Invest Given what we know about the significance of the first three years of life, as individuals and a society, we need to ask ourselves what the optimal pattern of investment would be for our children, both by families and collectively, through our government. Currently, as illustrated in the chart, the bulk of public-sector spending on children occurs during the school-age years (Haveman and Wolfe, 1995). For example, 8% of all public spending (by the federal, state, and local governments) that will be spent on the average child has occurred by age 5, one-quarter of the time spent in childhood. Per- child public spending averages about $1,472 per year (in 1992 dollars) for children through age 5. This includes expenditures on such programs as early childhood development, welfare, and health care. For children age 6 to 18, public spending averages $6,567 per child per year (in 1992 dollars). The increase is due primarily to expenditures on primary and secondary schools. Other public expenditures at those ages include funds for criminal justice, youth employment, and other youth programs. The relationship between the two curves in the chart poses a challenge for policymakers: Does this time path of spending represent a missed opportunity? Is there evidence that greater investments in early childhood would produce short- and long-run benefits? Given what we know about the significance of the first three years of life, as individuals and a society, we need to ask ourselves what the optimal pattern of investment would be for our children, both by families and collectively, through our government. Currently, as illustrated in the chart, the bulk of public-sector spending on children occurs during the school-age years (Haveman and Wolfe, 1995). For example, 8% of all public spending (by the federal, state, and local governments) that will be spent on the average child has occurred by age 5, one-quarter of the time spent in childhood. Per- child public spending averages about $1,472 per year (in 1992 dollars) for children through age 5. This includes expenditures on such programs as early childhood development, welfare, and health care. For children age 6 to 18, public spending averages $6,567 per child per year (in 1992 dollars). The increase is due primarily to expenditures on primary and secondary schools. Other public expenditures at those ages include funds for criminal justice, youth employment, and other youth programs. The relationship between the two curves in the chart poses a challenge for policymakers: Does this time path of spending represent a missed opportunity? Is there evidence that greater investments in early childhood would produce short- and long-run benefits?

    22. Public Policy Research Brain Development and public investment are not synchronized Early childhood provides greatest return on investment Early childhood interventions have been demonstrated to be cost effective Many opportunities to intervene go unrecognized and are not addressed

    23. Public Policy Research Today’s schools and tomorrows work force require both academic skills and emotional intelligence There are effective and innovative models of service delivery (that are ripe for franchising)

    24. What Do We Know About the Impact of Providing Early Intervention and Preventive Services?

    25. Early childhood programs differ in services provided Programs can also vary in the location and nature of the services provided. Some programs offer services in the family’s home, others provide services in a center setting—-such as a child care center or health clinic—and others may provide services in both. Finally, programs provide different treatments. Examples of different treatments are shown here, according to whether they are targeted to the mother or child and whether they are typically provided in the home or in a center. Programs provide a mix of services consistent with their objectives: For instance, a program designed to improve child health might provide the mother training in parental skills in the home; for the child, there might be home-safety inspections and child-abuse recognition in the home and health screenings in a clinic. Another program that strives to promote school readiness might only provide services to the child in a center, such as social interaction and cognitive stimulation. Note that programs providing services for children in centers may also have the added benefit of facilitating the mother’s employment, because they provide child care. Programs can also vary in the location and nature of the services provided. Some programs offer services in the family’s home, others provide services in a center setting—-such as a child care center or health clinic—and others may provide services in both. Finally, programs provide different treatments. Examples of different treatments are shown here, according to whether they are targeted to the mother or child and whether they are typically provided in the home or in a center. Programs provide a mix of services consistent with their objectives: For instance, a program designed to improve child health might provide the mother training in parental skills in the home; for the child, there might be home-safety inspections and child-abuse recognition in the home and health screenings in a clinic. Another program that strives to promote school readiness might only provide services to the child in a center, such as social interaction and cognitive stimulation. Note that programs providing services for children in centers may also have the added benefit of facilitating the mother’s employment, because they provide child care.

    26. Building Bridges Birth to School

    27. Building Bridges: Policy Context White House Conference: Brain development and childcare (1996) NAS/IOM: Neurons to Neighborhood (2000) Surgeon General Report: Children’s Mental Health (2000) Crisis in public education: school reform and school readiness Statewide early childhood initiatives in 5 states, with 10-15 states launching significant new programs

    28. Building Bridges: Policy Context School Readiness Crisis in (Public) Education School reform - curriculum, management, accountability School readiness - redefined Childcare as early education Educational Reform is at the top of the political agenda nationally and in many states

    29. School Readiness Redefining to include: Cognition and general knowledge Social Emotional Development Physical Well Being & Motor Development Language Development Impact of school readiness on life long learning better specified

    30. Building Bridges Policy Context- State Wide Early Childhood Initiatives NGA, NCSL, National and Local Foundations are supporting initiatives throughout the US Many up and running: North Carolina’s: Smart Start California’s: Children and Families First 20-30 states moving in this direction

    36. Service Organization for Early Child Development and Parenting

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