4/28/2016 NEBRASKA EARLY DEVELOPMENT NETWORK & CAPTA LAW - - PDF document

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NEBRASKA EARLY DEVELOPMENT NETWORK & CAPTA LAW

Nebraska Young Child Institute

June 2016

Presented by Amy Bunnell, Nebraska Department of Education Julie Docter, Nebraska Dept of Health & Human Services

Early Development Network (EDN) Overview

• Serves infants and toddlers from birth to 3 who

have developmental delays or disabilities

• Provides year-round early intervention services to a

child’s family as it relates to the child’s special needs

• No income guidelines for eligibility
• Evaluation and services provided at no cost to families
• Voluntary program for families

Multidisciplinary Evaluation Team (MDT)

• Evaluation of child by school district trained

professionals

• Evaluates child functioning in developmental domains:

 Cognitive  Motor Development  Communication Skills  Social/Emotional Development  Self-help skills

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Individualized Family Service Plan (IFSP)

• IFSP is family driven plan
• Provides support/services to child and family
• Identifies family’s concerns/priorities
• Developmental/health and Family outcomes
• Services provided in home or community settings
• Speech/Language services
• Physical and Occupational therapy services
• Vision and Audiology services
• Nutrition
• Early Childhood Special Education
• Social Emotional Supports/Services
• Transportation to receive services
• Assistive Technology services

45 calendar days from referral to MDT Evaluation and IFSP completion

• Plan reviewed every 6 months or sooner

EDN Services Coordination

• Entitlement for all families
• Begins with referral to EDN
• Work with family, foster parent and all agency providers to

coordinate and develop IFSP

• Work with family and agencies to provide a seamless

transition at age 3

Why Intervene Early?

• 700 new neural connections are formed every

second – especially through “serve and return” interaction with adults - foundation upon which all later learning, behavior and health depend.

• https://youtu.be/m_5u8-QSh6A
• 18 months of age : Disparities in vocabulary

begin to appear

• By age 3, children with college-educated

parents/caregivers had vocabularies 2 to 3 times larger than those parents who had not completed high school.

Source: Center on the Developing Child – Harvard University

4/28/2016 3 Benefits of Early Intervention

• Improves child’s developmental outcomes across all

domains: health, language, cognitive and social-emotional

• Families better able to meet child’s special needs from an

early age

• Community benefits: reduces economic burden through

academic success and a decreased need for special education in school

CAPTA

Child Abuse Prevention and Treatment Act

What is CAPTA?

• Child Abuse Prevention and Treatment Act
• Federally enacted through Dept(s) of Education and

Health and Human Services in 2003 to ensure maltreated infants/toddlers are referred to IDEA Part C

• State mandate for HHS and EDN to work together to

make referrals and follow up with a developmental screening or an evaluation for children under age 3 with a substantiated case of abuse/neglect.

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Why is the CAPTA Law Important?

2015: *1314 CAPTA referrals for children ages 2 and under in Nebraska. Research:

• 50% of children in foster care demonstrate developmental delays at 4

times the rate of children in general population

• Children with developmental delays have a higher propensity to be

abused

• Early experiences, both positive and negative, have a decisive impact
• n how the brain is wired

https://youtu.be/bF3j5UVCSCA *source: NDHHS

Why is the CAPTA Law Important?

Evidence:

• Highly specialized interventions are needed as early as possible for

children experiencing toxic stress

• Early Intervention is most effective in the first 3 years of life when the

brain is establishing foundations of cognitive, social, and developmental domains. Without Intervention/services:

• Children with developmental delays perform poorly in school,

experience language delays, misunderstand social cues, and show poor judgment. This leads to failure in school, loss of employment, and high costs to the community. What works:

• High quality early intervention and programs are more effective when

the developing brain is most capable of change (first 3 years of life) and less costly to society.

4/28/2016 5 CAPTA Referrals

• Nebraska DHHS and EDN established policies and

procedures for CAPTA

• DHHS must make a referral to EDN within 7 days of

the substantiated finding

• Automation of CAPTA referrals

CAPTA Referrals, cont’d

• EDN Services Coordinator (SC) is assigned upon

receipt of referral and makes contact with family within 7 calendar days.

• EDN SC coordinates services to meet the

developmental needs of the child, once the child is found eligible for the EDN program

• DHHS remains responsible for all services related to

abuse/neglect involvement with the child and family

CAPTA – Roles & Responsibilities

• Roles and Responsibilities for CAPTA (handout &

flowchart)

• State wards - Notification to School Districts

 Parent retains educational rights

• EDN: 45 calendar days from referral to MDT/IFSP

Informs Referral Source of outcome of Referral Distributes copy of MDT and/or IFSP(signed release or court order)

• CFS: Utilizes MDT/IFSP info for safety assessment, court

report/case plan – include updated IFSP Distributes copy of MDT/IFSP to court parties

4/28/2016 6 CAPTA

• DHHS is mandated to make referral to Early Development

Network (EDN)

• EDN is a voluntary program
• Collaboration between CFS manager and EDN Services

Coordinator promotes family entering into EDN when there is reluctance to engage

Unique Challenges of CAPTA referrals:

• Change of placements and CFS worker assignments

creates communication barrier between DHHS and EDN regarding child’s current placement, family location/contact info, case status

• EDN is a voluntary program. Bio-parent retains

educational rights – must sign consent for EDN evaluation and services.

• Leads to high parent refusal rate due to distrust of public

service agencies, overwhelming number of court-

• rdered services and difficulty in acceptance of child’s

disability (“stigma”, parental guilt, further judgment by court/DHHS personnel)

Importance of Collaboration

• Critical Component: Collaboration between CFS and EDN
• At Referral
• At Pre-Hearing Conference
• At Family Team Meetings
• At IFSP Meetings

Pre-Hearing Conference Collaboration:

• EDN Services Coordinator can meet the Caseworker, the Attorney

for the child, the parents, the foster parents all at once

• Parents can meet with the EDN Services Coordinator to get

information on services and provide consent

• Background information from the DHHS Caseworker, Guardian Ad

Litem, Court Appointed Special Advocate (CASA) can be given to EDN

• Attorneys can be notified of the possibility of a developmental

evaluation for the child that will be provided to the court

4/28/2016 7 The Payoff:

• Gives parents a face to face contact with a Services

Coordinator to increase engagement

• Services Coordinator can set appointments with parents

and foster parents rather than making multiple phone calls

• Consents/Releases can be signed at the Prehearing

Conference

• Increased awareness for all involved in the Prehearing

Conference about EDN Services

• Increases awareness of the unique needs of children

under age 3 for all the parties in the case and the Judge

• DHHS Caseworker and EDN Service Coordinator meet

regularly

Overall Benefits of Collaboration:

• Shared/timely info about family and services
• Sharing of resources- efficiency and less staff

time

• Updated child/family info for Court Report/Case

Plan

• Sharing of local CAPTA data tracked by EDN

(Handout - CAPTA suggestions for Local Discussions)

Importance of Re-Referral to EDN

• If child found not eligible for EDN services or

parent refused to participate & child is not meeting developmental milestones at later date: PLEASE RE-REFER TO EDN (phone call)

• EDN Processes begin again:
• Home visit by SC
• MDT
• IFSP

4/28/2016 8 How can EDN assist you?

• Share multidisciplinary evaluation (MDT) on

child’s development

• Provide you with Individualized Family Service

Plan (IFSP) family outcomes

• Court plan and IFSP can complement each other

CAPTA

• What court stakeholders can do:
• Ensure that the child has been referred to EDN (early in the case) &

follow-up on evaluation/screening outcomes

• If necessary, make a second referral (later in the case)
• If parents refuse, and concerns with infant’s/toddler’s development

remain, request a court order for screening/evaluation

• Become a member of Planning Region Team
• What Judge’s, CFS, Attorneys, and CASA’s can do:
• Develop an in-court procedure which child’s developmental

milestones are routinely addressed (use developmental wheel & Infant-Toddler checklist)

• Ensure referrals and re-referrals (when needed) are made to EDN
• Introduce and review child’s Screening/MDT evaluation results and

IFSP

4/28/2016 9 Resources

EDN App A Family’s Guide to Early Intervention IFSPweb.org Home Visitation On-line Training Modules

https://www.answers4families.org/classroom

Thank You!

Amy Bunnell

Nebraska Department of Education 402-471-0817 amy.bunnell@nebraska.gov

Julie Docter

Nebraska Department of Health and Human Services 402-471-1733 julie.docter@nebraska.gov

EDN Website: http://edn.ne.gov

45 Days Begin Refer to IFSP Process Flow Chart

CAPTA referral is mandated. Referrals for Non-Education Services Multi-Disciplinary Team Evaluation (MDT) Parents sign EI-2 (Consent for Evaluation and Assessment). DHHS cannot sign for consent. Not Verified Formal Exit DHHS worker suspects infant

• r toddler in the family has

a developmental delay. EDN Services Coordinator is assigned and EDN services coordination begins. DHHS CFS worker has contact with family. CAPTA Services Coordinator completes the PS-90 Form and returns it to the DHHS worker.

Protocol for Referral

from DHHS-CFS to the Early Development Network

CAPTA Referral Within seven (7) days, the DHHS worker completes the PS-90 Form and forwards it to Early Development Network (EDN) Services Coordination Agency and the IFSP process timeline begins. CAPTA DHHS worker makes determination of substantiated abuse or neglect of an infant or toddler (under age 3).

Initial Contact with Family

Services Coordinator arranges a personal contact within seven calendar days of the initial contact or acknowledgement by the family, unless the family requests a delay. The Services Coordinator shares information about the Early Development Network

FlowchartCAPTA:rev.4-2016

If child is made a state ward, DHHS worker sends state ward notification letter to school. School determines if a parent represents the child

• r if a

parent surrogate is needed.

7 Calendar Days

Family agrees to continue in the early intervention process and Services Coordinator sends consent for MDT to school. Referral Within seven (7) days, the DHHS worker forwards a referral to Early Development Network (EDN) Services Coordination Agency and the IFSP process timeline begins. Family declines to participate in the early intervention process. Family declines to meet with the Services Coordinator IFSP Meeting Verified

Roles and Responsibilities for CAPTA

The Keeping Children Safe Act of 2003 amended CAPTA, the Child Abuse Prevention and treatment Act (PL 108-36), and was signed into law on June 25, 2003. This law includes the requirement that Protection and Safety refer a child under the age of 3 who is involved in a substantiated case of child abuse or neglect to Early Development Network for early intervention services funded under Part C of the Individuals with Disabilities Education Act (section 106(b)(2)(A)(xxi)).” Part C is a component of PL 105-17, IDEA (Individuals with Disabilities Education Act). Agencies providing Part C services are required to provide comprehensive, coordinated, multidisciplinary, early intervention for infants and toddlers with disabilities or developmental delays and their families.

DHHS – Children and Family Services Early Development Network

Philosophical Base

The Nebraska Department of Health and Human Services (DHHS) Children and Family Services Division provides family-centered services to protect children from abuse and neglect, to improve conditions in families that place children at risk, and assisting youth to be productive and law-abiding citizens. The goal of services coordination is to give families a good start in supporting their child with a disability and to develop their own skills in accessing, utilizing, and coordinating supports within their natural environments. “Natural Environments means settings that are natural or normal for the child’s age peers who have no disabilities.” (34 CFR 303.18)

Referral

• At initial assessment, the primary roles of

the DHHS Worker are to gather information to validate maltreatment or allegations on a court petition and to determine what services, if any are

• needed. The priority at this phase is

securing child safety with attention to working with the family to preserve the family unit whenever possible.

• DHHS worker completes Protection and

Safety referral form (PS-90) and sends it to Early Development Network Services Coordination Agency no more than seven (7) days after a case of abuse or neglect has been substantiated. Family is informed of referral to Early Development Network.

• If child is a state ward DHHS worker

sends state ward notification letter to school district.

• If an intake has been received within 6

months (180 calendar days) or less after an initial referral to Early Development Network has been made, a new referral is not necessary.

• The Early Development Network (EDN)

Services Coordinator contacts family to set up home visit to discuss Early Development Network Program (or family declines to meet).

• At the home visit Early Development

Network Services Coordinator explains program and obtains consent to evaluate child (or family declines to participate).

• School determines if a parent represents

the child or if a surrogate parent is needed based on Rule 52 and shares the information with Early Development Network Services Coordinator.

• School begins the process of verification

for early intervention for child not already in EDN program.

• Early Development Network Services

Coordinator notifies DHHS worker of child’s early intervention eligibility. If found not eligible Early Development Network Services Coordinator sends HHS 6 notification and school sends family notice of ineligibility.

→→→Over

RolesCAPTA:jledn 7-12-06

Roles and Responsibilities for CAPTA, continued

The Case is Opened for Ongoing Services Evaluation/Review

Ongoing cases are reviewed at least every 6 months (180 calendar days) if court is involved. A review of the IFSP plan must be conducted every six months or more frequently if needed. A meeting must be conducted at least annually to evaluate and develop a new IFSP.

Case Closure

Case plan and goal have been met and the child is no longer at risk of maltreatment. Services Coordinator makes sure that transition planning is started early enough to assure that the family as well as child needs are addressed and referrals and coordination with other programs can be done in a quality way. An infant or child with a disability and their family are eligible until August 31st of the child's third birthday, the services are no longer needed, or the family declines services.

• Rev. 4-2016

RolesCAPTA:AB_edn_rev.4-2016

Child Abuse Prevention and Treatment Act (CAPTA)

Suggestions for Local Discussions between DHHS and EDN

Suggested Training

• Cross training between DHHS CFS workers, Early Development Network Services

Coordinators and public school districts.

• Local clarification of roles for an understanding of referral process (see CAPTA roles and

responsibility chart and referral flowchart).

• Planning Region Teams can provide leadership in facilitation of local trainings.
• Inclusion of families as presenters along with agency personnel.

Suggested Outline for Regional Discussions

• What is CAPTA and why are we doing it?
• When is a referral sent from the DHHS-CFS worker?
• Legal Issues for sharing of information between agencies.
• Use sample cases and talk through “roles and responsibilities”.
• How do we avoid role drift?
• How can we ensure communication when child is not a ward of the state?
• How do we strengthen communication between DHHS and Early Development Network?
• When is the state ward notification letter sent from DHHS to the school district?

Need for a Surrogate Parent

• When is the surrogate notification letter sent to a school district’s superintendent?
• How do you know if a surrogate parent has been appointed?
• When does the school notify the Early Development Network Services Coordinator that a

surrogate has been appointed?

Page 1 of 1 DiscussCAPTA:AB_edn4-2016rev.

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Why is it important to regularly assess and address the physical health, mental health, and developmental needs of maltreated infants and toddlers?

Rapid development during the fjrst years of life makes very young children extremely vulnerable to the negative and long-lasting impacts of maltreatment. Early and sustained exposure to child abuse and neglect can infmuence the physical architecture of the brain,1,2 interfering with healthy development, and can lead to long-term negative effects in social-emotional, physical, and cognitive realms.3,4 These negative consequences are seen in maltreated young children regardless of whether they have been placed in foster care.5 Early identifjcation of developmental delays, followed by appropriate, timely support services can help reduce or alleviate maltreatment’s impact.6 Requiring that all maltreated children receive regular medical care, including the full schedule of immunizations, regular dental exams, and screening for vision and hearing problems and developmental delays, can help ensure children are referred to the services they

• need. Infant-early childhood mental health services focused on children’s social and

emotional development must also be provided, to help maltreated infants and toddlers achieve their full potential.7 In recognition of the vulnerability of babies in the child welfare system and the importance of detecting developmental problems early, the Child Abuse Prevention and Treatment Act (CAPTA) requires that states have procedures for screening and, if necessary, referring young children to the early intervention evaluation and services mandated by Part C of the federal Individuals with Disabilities Education Act (IDEA).8 Little is known about implementation of this requirement across the states, but if implemented fully, it has the potential to connect many maltreated infants and toddlers to vital services.

Highlights from Changing the Course for Infants and Toddlers: A Survey of State Child Welfare Policies and Initiatives

October 2013

Ensuring Assessments and Services for All Maltreated Infants and Toddlers

All young children who have been maltreated—not just those in foster care—experience higher rates of developmental delays than their peers.9 With appropriate services for young children in place from the start, the negative impacts of maltreatment can be reduced.10

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Where do states stand?

Child welfare agency representatives from 46 states participated in the Survey of State Child Welfare Agency Initiatives for Maltreated Infants and Toddlers, completed in March 2013. The survey showed that states have a long way to go in ensuring all maltreated infants and toddlers receive the assessments and services they need. Less than a third of states require developmental screenings for all maltreated infants and toddlers, and less than one in fjve states require mental health screenings for all maltreated infants and toddlers. Nearly every other state has policies that only require developmental screenings or mental health screenings for young children in foster care. Just over half of responding states (26 out of 46) have policies requiring that referrals to specialists be made within a specifjc timeframe after a health or developmental concern is identifjed for a maltreated infant or toddler. Identifjed timeframes range from two to 60 days. Only nine states require that these referrals occur within one week. Five of the nine states require that referrals be made within two business days or 48 hours. States sometimes have policies that may support a child’s general mental well-being, but few provide the intensive mental health services needed to address the trauma young children experience from

• maltreatment. Although more than half of responding states reported that they routinely provide

guidance to foster parents to help children make the transition before and after visits with birth parents (33 states), and provide children in foster care with a keepsake from their birth parents’ home (25 states), far fewer provide more-intensive services to support maltreated infants’ and toddlers’ mental health, such as child-parent psychotherapy. Child welfare agencies face barriers in implementing the CAPTA requirement for referring maltreated infants and toddlers to Part C early intervention for screening. The most commonly reported “moderate” or “signifjcant” barriers to children receiving Part C services are: level of need/costs of services exceeding available funding; transportation/access issues; and challenges engaging children and families in the child welfare system.

Examples of state initiatives Ohio has an Early Childhood Mental Health consultation program and several National Child Traumatic Stress Network sites. These sites are part of a network of centers that provide services and support for children who have experienced trauma. South Dakota’s child welfare agency is focusing on the social-emotional well-being of children in the child welfare system by providing training to a variety of stakeholders—including all agency staff, as part of their initial training—and placement resources including kin, foster, group and residential. Louisiana developed an Infant Mental Health/Behavioral Health Screening Tool for children ages fjve and under to assist workers in identifying when assessments and treatment may be needed. All children are required by policy to be screened, unless they are already receiving Part C early intervention, Early Childhood Support and Services (ECSS), or other behavioral health services. ECSS provides a coordinated system of screening, evaluation, referral services, and treatment for families of children ages birth through fjve who are at risk of developing cognitive, behavioral, and relationship diffjculties.

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Require that all maltreated infants and toddlers receive regular health and dental care visits per a standardized visit schedule, such as those published by the American Academy of Pediatrics and American Academy of Pediatric Dentistry. Ensure that visits include regular screenings for developmental, hearing, vision, behavioral, motor, language, social, cognitive, and emotional skills using reliable tools that are age-appropriate and culturally sensitive. Require that maltreated infants and toddlers with suspected health or developmental problems are referred to services within one week of identifjcation of the problem. Connecting infants and toddlers to services early can minimize the long-term effects of developmental delays and

• ther health problems.

Build your state’s capacity to provide infant-early childhood mental health services that are high-quality and designed to meet the unique developmental needs of maltreated infants and toddlers, including child- parent psychotherapy and parent-child relationship assessments. Assess how well your state is implementing the CAPTA-Part C provisions for referring maltreated infants and toddlers to Part C early intervention

• services. Take steps to address any barriers that are hindering full

implementation and preventing eligible young children from receiving Part C services.

T

• ols to help

Read more about assessments and services for maltreated infants and toddlers across the nation in Changing the Course for Infants and Toddlers: A Survey of State Child Welfare Policies and Initiatives, by Child Trends and ZERO TO THREE. Then take a look at the policies and services for maltreated infants and toddlers in your state and locality to assess areas of strength and places for

• improvement. Working through A Developmental Approach to Child Welfare

Services for Infants, Toddlers, and Their Families: A Self-Assessment Tool for States and Counties Administering Child Welfare Services is a great way to evaluate how your state is doing and begin the conversation on next steps.

1 Harden, B. J. (2007). Infants in the child welfare system: A developmental framework for policy and practice. ZERO TO THREE. 2 Halle, T., Tout, K., Daily, S., Albertson-Junkans, L., & Moodie, S. (2013). The research base for a birth through eight state policy framework. Bethesda, MD: Child Trends and Alliance for Early Success. Retrieved September 11, 2013, from http://www.childtrends.org/wp-content/uploads/2013/04/ChT-Alliance-R-at-a-Glance-v9-wactive-links.pdf 3 Cohen, J., Cole, P., & Szrom, J. (2011). A call to action on behalf of maltreated infants and toddlers. Washington, DC: American Humane Association, Center for the Study of Social Policy, Child Welfare League of America, Children’s Defense Fund and ZERO TO THREE. Retrieved September 4, 2013, from http://www.zerotothree.org/publicpolicy/newsletters/a- call-to-action-on-behalf-of.html 4 Cohen, J., Oser, C., & Quigley, K. (2012). Making it happen: Overcoming barriers to providing infant-early childhood mental health. ZERO TO THREE, 31. 5 Barth, R. P., Scarborough, A., Lloyd, E. C., Losby, J., Casanueva, C., & Mann, T. (2008). Developmental status and early intervention service needs of maltreated children. Washington, DC: U.S. Department of Health and Human Services, Offjce of the Assistant Secretary for Planning and Evaluation. 6 Cohen, J., Oser, C., & Quigley, K. 7 Shonkoff, J. P., & Phillips, D. A. (2000). From neurons to neighborhoods: The science of early childhood development. National Academies Press. 8 The Child and Family Services Improvement and Innovation Act, H.R. 2883 Cong. Rec. P.L. 112-134 (2011). 9 Barth, R. P., Scarborough, A., Lloyd, E. C., Losby, J., Casanueva, C., & Mann, T. 10 Cohen, J., Oser, C., & Quigley, K.

What can my state do?

www.developingchild.harvard.edu

FIVE NUMBERS TO REMEMBER ABOUT EARLY CHILDHOOD DEVELOPMENT

This feature highlights fjve numbers to remember about the development of young children. Learn how the numbers illustrate such concepts as the importance of early childhood to the learning, behavior, and health of later life and why getting things right the fjrst time is easier and more effective than trying to fjx them later. This feature is also available in a web-based slideshow format at http://developingchild.harvard.edu/resources/multimedia/interactive_features/fjve-numbers/ For more resources from the Center on the Developing Child at Harvard University visit http://developingchild.harvard.edu/resources/

The early years matter because, in the fjrst few years of life, 700 new neural connections are formed every second. Neural connections are formed through the interaction of genes and a baby’s environment and experiences, especially “serve and return” interaction with adults, or what developmental researchers call contingent reciprocity. These are the connections that build brain architecture – the foundation upon which all later learning, behavior, and health depend. Image source: Conel, JL. The postnatal development of the human cerebral cortex. Cambridge, Mass: Harvard University Press, 1959

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www.developingchild.harvard.edu

FIVE NUMBERS TO REMEMBER ABOUT EARLY CHILDHOOD DEVELOPMENT

Early experiences and the environments in which children develop in their earliest years can have lasting impact on later success in school and life. Barriers to children’s educational achievement start early, and continue to grow without intervention. Differences in the size of children’s vocabulary fjrst appear at 18 months of age, based on whether they were born into a family with high education and income or low education and income. By age 3, children with college-educated parents or primary caregivers had vocabularies 2 to 3 times larger than those whose parents had not completed high school. By the time these children reach school, they are already behind their peers unless they are engaged in a language-rich environment early in life. Source: Hart, B., & Risley, T. (1995). Meaningful differences in the everyday experiences of young American children. Baltimore, MD: Brookes.

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www.developingchild.harvard.edu

FIVE NUMBERS TO REMEMBER ABOUT EARLY CHILDHOOD DEVELOPMENT

Signifjcant adversity impairs development in the fjrst three years of life—and the more adversity a child faces, the greater the odds of a developmental delay. Indeed, risk factors such as poverty, caregiver mental illness, child maltreatment, single parent, and low maternal education have a cumulative impact: in this study, maltreated children exposed to as many as 6 additional risks face a 90-100% likelihood of having one or more delays in their cognitive, language, or emotional development. Source: Barth et al. (2008)

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www.developingchild.harvard.edu

FIVE NUMBERS TO REMEMBER ABOUT EARLY CHILDHOOD DEVELOPMENT

Early experiences actually get into the body, with lifelong effects—not just on cognitive and emotional development, but on long term physical health as well. A growing body of evidence now links signifjcant adversity in childhood to increased risk of a range of adult health problems, including diabetes, hypertension, stroke, obesity, and some forms of cancer. This graph shows that adults who recall having 7 or 8 serious adverse experiences in childhood are 3 times more likely to have cardiovascular disease as an adult. And children between birth and three years of age are the most likely age group to experience some form of maltreatment–16 out of every thousand children experience it. Source: Dong et al. (2004)

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www.developingchild.harvard.edu

FIVE NUMBERS TO REMEMBER ABOUT EARLY CHILDHOOD DEVELOPMENT

Providing young children with a healthy environment in which to learn and grow is not only good for their development—economists have also shown that high-quality early childhood programs bring impressive returns on investment to the public. Three of the of the most rigorous long-term studies found a range of returns between $4 and $9 for every dollar invested in early learning programs for low-income children. Program participants followed into adulthood benefjted from increased earnings while the public saw returns in the form of reduced special education, welfare, and crime costs, and increased tax revenues from program participants later in life. Sources: Masse, L. and Barnett, W.S., A Benefjt Cost Analysis of the Abecedarian Early Childhood Intervention (2002); Karoly et al., Early Childhood Interventions: Proven Results, Future Promise (2005); Heckman et al., The Effect of the Perry Preschool Program on the Cognitive and Non- Cognitive Skills of its Participants (2009)

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www.developingchild.harvard.edu

FIVE NUMBERS TO REMEMBER ABOUT EARLY CHILDHOOD DEVELOPMENT

• 1. Getting things right the fjrst time is easier and more effective than trying to fjx them later.
• 2. Early childhood matters because experiences early in life can have a lasting impact on later

learning, behavior, and health.

• 3. Highly specialized interventions are needed as early as possible for children experiencing

toxic stress.

• 4. Early life experiences actually get under the skin and into the body, with lifelong effects on

adult physical and mental health.

• 5. All of society benefjts from investments in early childhood programs.

www.developingchild.harvard.edu

WHAT THESE FIVE NUMBERS TELL US