Reducing Child Welfare Involvement: The Promise and Limitations

of Early Intervention Deborah Daro

Key concepts

Review key expectations regarding child well-being 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 Alter participants and context

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 DurhamConnects

Whites 33% 35% 34% 44% 34%

African Americans

26% 33% 28% 31% 42%

Hispanics 25% 23% 30% 21% 23%

Other 7% 8% 4%

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 delaysToddlers

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

STIGMATIZING

UNIVERSALPREVENTION

TARGETEDPREVENTION

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 well-

being 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