Early Childhood Education Update - November 2013
November 12, 2013 | Child Care and Early Education
In this issue:
- CLASP Releases New Head Start Preschool and Early Head Start Fact Sheets
- CLASP Responds to Senate Finance Committee on Mental Health Improvements
- New Report Addresses Opportunities for System and Policy Changes for Linking Depressed Mothers to Effective Services and Supports
- NBCDI Presents a Strengths-Based Look at the State of the Black Child
- New Report Provides Further Evidence that Investing in High-Quality Preschool Provides Long-Term Benefits
- The Urban Institute Releases Report About Economic Insecurity in Children's Lives
- The Migration Policy Institute Releases Report on Risk and Resilience Among Young Children of Immigrants
- New NWLC Report: Child Care Assistance Policies Show States Are at a Pivot Point
- The Alliance for Early Success Outlines Birth Through Eight State Policy Framework
Head Start (HS) and Early Head Start (EHS) provide poor children and their families with vitally important early education and family support services. In 2012, the Head Start preschool program served over 946,000 young children and their families, and Early Head Start served more than 151,300 children under age 3 and 16,175 pregnant women. CLASP's new fact sheets on Head Start preschool and Early Head Start, based on Program Information Report (PIR) data from the 2011-2012 school year, explore the characteristics of children and families served by the programs, as well as the programs themselves and their staff.
Highlights from the 2011-2012 program year:
- Ninety-seven percent of Head Start preschool children have obtained a medical home for routine care and source for ongoing dental care (95 percent) by the end of the program year.
- Most Head Start (91 percent) and Early Head Start (86 percent) children received a medical screening and nearly all (91 and 96 percent, respectively) who require follow-up treatment receive it.
- Eighty-one percent of Early Head Start families accessed at least one support service in 2012 ranging from parenting education to emergency and crisis intervention.
- Seventy-five percent of Head Start preschool families accessed at least one support service in 2012, with parenting education (50 percent) and health education (46 percent) accessed most frequently.
- Ninety-three percent of pregnant women enrolled in EHS received prenatal health care and 75 percent received postnatal health care.
- In 2012, the percent of EHS teachers with at least an associate degree increased 3 percent from the previous year to 57 percent. Twenty-nine percent of EHS teachers have bachelor's degrees in early childhood education or a related field (up from 27 percent in 2011).
- Fifty-seven percent (up 11 percent from the previous year) of home visitors had a bachelor's degree (B.A.) or higher in early childhood education or a related field.
- In 2012, 62 percent of HS preschool teachers had a bachelor's degree or an advanced degree (up 5 percent from 2011).
Mental illness affects many Americans and disproportionately affects low-income vulnerable families, who typically have less access to treatment even for serious problems. Its effects can be two-generational, with untreated mental illness in a parent potentially affecting children, thus expanding even further the potential importance of effective treatment. Depression, which is highly treatable, is a prime example of a parental mental illness that affects large numbers of families and poses risks to children's safety and cognitive development when untreated.
Last month, CLASP submitted comments to the U.S. Senate Finance Committee in response to its letter soliciting recommendations on how to improve the mental health system. CLASP's comments highlighted both barriers in the current mental health system and opportunities for improvement.
While low-income parents experience a relatively high risk of depression and other mental health problems, they unfortunately are less likely to get treatment than higher-income adults. A number of barriers in today's health financing and service systems help explain this disparity:
- Eligibility gaps for low-income adults. Many state Medicaid programs prior to the Affordable Care Act (ACA) only cover parents when their income is extremely low - a fraction of the poverty level. Pregnant women are eligible up to somewhat higher income levels, but the result is that mothers may lose Medicaid eligibility shortly after their child is born, when they are no longer eligible under that higher threshold.
- Fragmentation of mental and physical health services and fragmentation of services for children and their parents. Health care providers, particularly primary care providers like family doctors, may be in the best position to build trust on sensitive issues like mental health but are generally not well-connected to mental health providers. Additionally, care for adults and care for children are also fragmented and not designed with a two-generation approach.
- Access. While Medicaid is a crucial provider of mental health services to low-income people, access to necessary services may be limited by complex billing and reimbursement issues (which vary by state) and by an insufficient supply of qualified and trained providers. Another potential barrier is stigma related to mental illness, causing those affected to withhold information or only tell someone they trust.
- Mutual lack of understanding between health/ Medicaid agencies and human services and youth-serving agencies (such as those administering child welfare) that serve vulnerable families and individuals. While public agencies could collaborate to overcome some of these other barriers, program complexity and the pressure of deadlines often get in the way.
Today, there are important opportunities to address these barriers, help low-income parents get treatment, and strengthen children's development as a result. Among the key opportunities arising from the passage of the Affordable Care Act and other related innovations in health care are the following:
- Simplified Enrollment provisions in the ACA, which build on lessons learned from national and state initiatives to streamline and simplify enrollment into Medicaid and CHIP.
- Opportunities for integrated care that will address fragmentation of services and utilize a two-generation approach.
- Workforce Initiatives to increase the number of skilled, qualified providers.
- Home visiting services that provide the opportunity to identify and engage isolated or hard-to-reach families who have mental health concerns, particularly maternal depression.
- Federal technical assistance, guidance, and support for Medicaid-mental health - child welfare partnerships. These partnerships could overcome the barriers of fragmentation and lack of common understanding across the system.
In the spring of 2013, the Urban Institute convened a roundtable discussion to identify promising opportunities for system and policy changes for linking depressed mothers to effective services and supports. The roundtable brought together federal policymakers, researchers, public experts, advocates, philanthropic funders, and practitioners. The convening resulted in recommendations and next steps for identifying and treating maternal depression, which are outlined in the recently released summary of the culminating roundtable.
The summary of the roundtable highlights what is already known about maternal depression and why it is important as well as the vision created for effective services and the discussion of how to get there. The summary outlines the opportunities to identify and engage mothers through various avenues including home visiting and opportunities to treat mothers including the immediate and long-term opportunities in the Affordable Care Act.
Highlights of the recommendations from the roundtable include:
- Using maternal depression information to improve early learning and child welfare programs at the community, county, and state level.
- Infusing maternal depression knowledge into existing work that addresses youth substance abuse, pregnancy, and teen parenting.
- Working with experts in the group to design an improved home visiting strategy that targets very low income mothers who are likely to experience depression or trauma.
- Distributing materials and technical assistance from federal officials on a broader level.
The National Black Child Development Institute's (NBCDI) latest publication, Being Black Is Not a Risk Factor: A Strengths-Based Look at the State of the Black Child, seeks to change the narrative of the limitations and deficits of black children and instead look at the strengths, opportunities and resilience that black children and their families possess. The report includes essays that focus on utilizing strengths to improve outcomes for black children, highlights examples of black children succeeding, and includes data on how black children and families are doing.
From early childhood to young adulthood, Being Black is Not a Risk Factor identifies the ways that black children and youth benefit from the strengths and resilience of their families and communities and offers a starting point for a national conversation on how black children can be supported to achieve their very best in a culture that has placed many impediments in front of them.
The narrative outlined in the report, supported with data, highlights some positive opportunities: black children are more likely to be enrolled in preschool than white children (75 percent of black 4-year-olds, compared to 69 percent of white 4-year-olds); more than 3 in 4 young black children have at least one working parent; and 79 percent of young black children are read to by a family member regularly.
CLASP is pleased to have contributed data analysis to this publication.
Currently, 42 percent of 4-year-olds attend publicly funded preschool programs, and attention on expansion of these programs is a focus of public debate. A new report from the Society for Research in Child Development and the Foundation for Child Development provides an updated and more clearly defined evidence base to support what many have long known-that investment in high-quality preschool provides long-term benefits for individuals, families and the economy.
The report shows that:
- Preschool programs can have considerable impacts on children's early learning. Oftentimes, children gain language, reading, math, and socio-emotional skills-all important to school readiness.
- Investing in preschool is profitable investment and financially wise. Estimates of the economic benefits of preschool outweighing the cost show that there is an economic return on investment.
- Supporting teachers can provide important benefits for children. Coaching or mentoring teachers can help ensure that curriculum is implemented properly and teachers are supported.
- Investment in preschool yields long-term benefits. These include important outcomes such as graduation rates, earnings, and reduced crime, among others.
- When comprehensive services are carefully chosen and targeted, they can yield important benefits. When implemented well, comprehensive services can provide important, positive health and parenting outcomes.
The Urban Institute recently released a report comparing economic insecurity levels in children before and after the Great Recession (2007 and 2010). Data for the report came from the Current Population Survey (CPS), a project sponsored by the US Census Bureau and the Bureau of Labor Statistics (BLS). During the recession, economic insecurity increased as unemployment rose 5 percent. Children were hit especially hard during these times, with child poverty increasing from 18 to 22 percent. During difficult economic times, children are particularly vulnerable. Often, family resources are diverted from meeting the child's health needs to meeting basic housing and food needs. In addition, financial stressors affect parenting behavior and often result in unresponsive parenting. Given that economic insecurity is correlated with developmental risks, it is important to examine rates of economic insecurity in children to determine which children were affected the most during the Great Recession.
Key findings include:
- Economic hardship and employment instability rose from 2007 to 2010. The percent of families below the poverty line rose from 18 to 22 percent as child food insecurity increased. In addition, the percent of children with unemployed parents went from 9 to 16 percent. All of the measures of economic insecurity were affected by parental education and race. For example, poverty increased 8 percent for families with parents without a high school diploma compared to 2 percent for families of parents with a bachelor's degree.
- Social program participation increased across all measures. Participation in the Supplemental Nutrition Assistance Program (SNAP) increased from 12 to 18 percent. Children receiving free school lunches rose from 23 to 27 percent. Children receiving Temporary Assistance for Needy Families (TANF) rose from 3 to 4 percent, representing a 27 percent increase. As with measures of economic insecurity, participation in social programs varied depending on race and education level.
- Overall, the number of families with no indicators of economic insecurity decreased 6 percent and families with 3 or more indicators increased 6 percent (from 28 to 34 percent). As before, these measures varied based on education and race. A full 65 percent of children with parents without a high school diploma had 3 or more indicators compared to only 3 percent for families with a master's. Families also differed based on race. Seventeen percent of white families, 19 percent of Asian families, 50 percent of black families, and 41 percent of Hispanic families had three or more indicators or economic insecurity. Increases in economic insecurity indicators were biggest for Hispanic and black children.
The demographics in the United States are changing. From 2000 to 2010, immigration accounted for a third of the population growth. At present, approximately one-quarter of American children have at least one immigrant parent. Past research reveals that immigrant status affects children's health and health risk. However, health risks differ greatly depending on country of origin. Is the United States Bad for Children's Health, a report by the Migration Policy Institute, summarizes the literature comparing the health of immigrant children to native-born children. The report then focuses on the health of Mexican immigrant children.
Key findings include:
- Early childhood is a critical period for overall health and development that influences subsequent development. Gaps caused during this period are difficult to close and are a key reason for social inequality later in life.
- Children of immigrants have some health advantages (lower rates of allergies, asthma, developmental problems, learning disabilities), but these advantages disappear by early childhood. Moreover, rates of obesity are higher among immigrant children.
- Children of Mexican immigrants comprise the largest ethnic group among immigrants as well as experience the most childhood health risks. This report focused on asthma and obesity. Asthma rates are lower in children of Mexican immigrants. There is interaction between obesity and immigrant status. Children of Mexican immigrants have higher rates of obesity than children of native-born Mexican-Americans. However, Mexican children who immigrate to the United States have higher rates of obesity than Mexican children who stay in Mexico. It may be that moving to the United States initially increases obesity risk but acculturation decreases it by providing parents with access to healthcare.
- Five factors-limited English language proficiency (LEP), low socioeconomic status, high levels of food insecurity, undocumented status, and lower receptivity in new destinations-are particularly likely to affect Mexican immigrant families and negatively influence children's health.
- In order to address the disparities in immigrant children's health, we need to create pathways to legal status. An added benefit to this would be more available survey data that would further the research on immigrant children's health.
The National Women's Law Center's (NWLC) annual report, Pivot Point: State Child Care Assistance 2013, finds that states are at a pivot point in child care assistance policy as states make important decisions to build on their subsidy systems. The report finds that families are better off under one or more key child care assistance policies than they were last year in 27 states - but in 24 states, families are doing worse. State policymakers play a key role in determining families' access to child care assistance.
Key findings from the report include:
- Nineteen states have waiting lists for child care assistance in 2013, a decrease from 23 states in 2012.
- Only three states pay rates at the federally recommended level (75th percentile of current market rates), a sharp decline from 2001 when 22 states had rates at the recommended level.
- The income eligibility limit was above 100 percent of the federal poverty level ($19,530 a year for a family of three) in all states in 2013. A family with an income above 150 percent of poverty ($29,295 a year for a family of three) could not qualify for child care assistance in 14 states. A family with an income above 200 percent of poverty ($39,060 a year for a family of three) could not qualify for assistance in 38 states.
- In eight states, copayments for a family of three at 150 percent of poverty increased as a percentage of income between 2012 and 2013.
- Forty-six states allowed families receiving child care assistance to continue receiving it while a parent searched for a job in 2013, the same as in 2012.
The Alliance for Early Success has developed the Birth Through Age Eight State Policy Framework to inform decision-making and guide policy choices for states. The collective work of over 150 experts, the framework emphasizes 1) health, family support, and learning as critical policy areas, and 2) standards, assessment practices, and accountability systems as critical foundations to implement the policies.
The research is clear: early childhood is a critical period for supporting children's health, familial relationships and learning opportunities. The physical and cognitive developments at this stage are important in that each experience influences the next and sustains the growth that came before.
A Birth Through Age Eight State Policy Framework builds on research and theory about essential supports for children's development and focuses attention on what is critical within and across different aspects of early childhood development, and it provides guidance for state-level investments that can lead to better health, family and learning outcomes. With aimed provisions, the period of time from birth through age eight can help put and keep children on a path to success.