Baby Policy Blog

Back in May, a group of concerned children’s organizations issued A Call to Action on Behalf of Maltreated Infants and Toddlers, urging policymakers and practitioners at all levels to adopt a developmental approach to caring for babies in the child welfare system. Last week, Congress answered the call. Both House and Senate passed and sent to the President the Child and Family Services Improvement and Innovation Act (H.R. 2883, S. 1542), reauthorizing federal child welfare programs. One of the provisions requires states to describe in their child welfare plans how they address the developmental needs of young children in their care—a first for federal legislation.

The Call to Action grew out of a concern on the part of ZERO TO THREE and colleagues at the American Humane Association, Center for the Study of Social Policy, Child Welfare League of America, and Children’s Defense Fund that the child welfare system does not adequately address the potentially devastating effects of maltreatment on infants and toddlers. Infants and toddlers are most vulnerable to maltreatment and its effects, because their brains are developing at life-altering rates. Maltreatment can cause chemical alterations that undermine the brain’s architecture, resulting in a weak foundation for all learning that follows. Babies placed in foster care can experience further damage if their care is not viewed through a developmental lens, beginning with the trauma of being removed from their parents’ care. Speaking at a Congressional Baby Caucus briefing last spring, psychologist Dr. Brenda Jones Harden described this trauma as “major surgery without an anesthetic.” Once in foster care, multiple changes in placement may add to the damage that these infants and toddlers have already experienced, as fragile new relationships are severed. While it is often assumed that infants and toddlers are immune to early adversity and maltreatment, in reality more than one third of babies in the child welfare system have developmental delays.

Not even one baby should be sent through life without the care that could prevent or repair developmental damage, yet the number of young children affected makes the situation truly alarming. A quarter of substantiated abuse and neglect cases nationally involve children under age 3, who also account for almost a third (31%) of children entering foster care. Once in, they tend to stay longer and return at greater rates even after being reunited with their parents.

Whether the requirement that states address the developmental needs of young children is a baby step or a giant step depends on how states respond. It is important that they see this new provision as an opportunity to reexamine the care they provide to these most vulnerable children, rather than as another item to check off their state plan. We hope they will use the Call to Action as a resource to think about the series of steps within a developmental approach. We also hope other state and local stakeholders and advocates will join with state child welfare agencies to achieve the goal of infusing what we know from the science of brain development into what we do for infants and toddlers who deserve a good start in life.

Here are a few ideas for getting started:

• Ensure that procedures are in place and are being followed to fulfill the requirement in the Child Abuse Prevention and Treatment Act that all infants and toddlers with substantiated cases be referred to Part C Early Intervention for developmental services. 
• Incorporate training on early childhood development into training for social workers, judges, court personnel, and anyone else who touches these young children’s lives so that they understand both the effects of maltreatment and the importance of supporting strong relationships as the context in which a young child’s development unfolds. 
• Emphasize concurrent planning that includes a strong focus on the parents’ needs to give families a real shot at staying together.
• Work with the mental health system to increase development of and access to services appropriate for young children together with their parents.
• Bring child welfare to the table in planning for the Race to the Top - Early Learning Challenge so that these vulnerable children will have access to appropriate services to support their development, and so that the early childhood education system will understand their special needs for continuity with familiar caregivers.

As these are just a few steps, the task of undertaking a truly developmental approach can seem daunting. Yet, we know it is possible if we are determined. Along with other successful initiatives, the Call to Action describes ZERO TO THREE’s Safe Babies Court Teams, which put this developmental approach in action every day for babies in their care. Safe Babies Court Teams identify resources throughout the community and bring them to bear for each baby and family. Their judges make decisions based on what will best support the baby’s development.

Is implementing a developmental approach easy? No—it requires a lot of hard work and thoughtful changes in how things are done in child welfare. But is it worth it? You bet it is!

In the midst of the uproar over our nation’s deficit crisis and jobs crisis, Census Bureau data released yesterday paints a picture of a quiet crisis: more than one in four infants and toddlers in America lives in poverty – 3.2 million of them, to be exact, or 26% of all children under age 3. This poverty measurement means that, for example, a baby in a family with two parents and a sibling would have a family income of $22,113 or less. The poverty rate for all children under 18 is 22%, testament that poverty in the U.S. really does have a child’s face. Children account for 35.5% of poor people but only 24.4% of the total population.

This grim economic situation for young children is both broad and deep. Data for related children under age 6 in families (which generally track closely with data for infants and toddlers) show that 47% of young children live in families with incomes at or below 200% of the Federal Poverty threshold. That’s almost half of all young children living in families without enough income to meet their basic needs. Many young children are in deep poverty: 46% of related children under age 6 who are poor live in families with incomes that are actually at or below 50% of the poverty line.

What does it mean that more than a quarter of American infants and toddlers are spending their earliest years in poverty? The science of early childhood development tells us that during the first three years of life the brain undergoes dramatic development as the child acquires the ability to think, speak, learn and reason. Our earliest experiences help shape the architecture of our brains, forming the foundation – either sturdy or fragile – for all that follows. Early adverse experiences can literally alter the architecture of the developing brain, limiting a child’s potential. For young children growing up in poverty, these adverse experiences can include decreased access to good nutrition, fewer enriching learning experiences, and heightened stress, which can impair the relationships that nurture a baby’s development. Thus, the timing of a baby’s experience with poverty is important because this rapid period of brain development makes them particularly sensitive to poverty’s ill effects. These effects can follow them all through life, placing them at greater risk for later school failure, behavior problems, and health problems as adults.

What helps? Making it possible for their parents to find jobs, for one thing. When we look at families with children under age 6, having no workers in the family virtually guarantees living in poverty. 89% of all such families are poor. The rate for families headed by single women is 93%. Put one family member to work full time for a full year, and the poverty rate for all such families drops to 11.5%. The rate for families headed by single women falls to 21%, showing that parents can work hard and still not pull their families over the poverty threshold. All this suggests that job creation should be at the top of the legislative agenda and policymakers should seriously consider President Obama’s proposal.

Children who face such adversity need more. The Census figures reveal the importance and success of another government support for young children’s development: health insurance. Nine of every ten infants and toddlers have health insurance. Two of every five infants and toddlers (41%) are covered by Medicaid – making it a vital avenue to the all-important pediatric care in the first years of life. Our challenge now is to cover the 9.5% of babies who lack insurance.

Other programs help to fill in the resources that poor families are not able to give their children. Programs such as the Supplemental Nutrition Assistance Program (SNAP), Unemployment Insurance, and the Earned Income Tax Credit help cushion the impact of the recession and lift families out of poverty.  Supplemental Nutrition for Women, Infants, and Children (WIC) provides special nutrition for pregnant women and babies. Temporary Assistance for Needy Families (TANF) provides income and other supports. Low Income Home Energy Assistance (LIHEAP) helps keep small bodies warm. Child care and Early Head Start, which reaches only a handful of infants and toddlers, help parents work and put babies and their families on the right path for positive early learning experiences. And the list goes on.

These programs are often called the “social safety net”. That’s a misnomer. They are actually the “social scaffolding” that supports healthy and positive development for infants and toddlers (as well as older children) who find themselves having to navigate a cradle full of adverse experiences. Tear it down and we risk undermining the healthy development of a vast segment of young children.

Yet, we are at risk of doing just that. Some of these programs’ appropriations may be cut as a result of the $917 billion in discretionary savings included in the Budget Control Act (i.e., the debt ceiling bill). Many, particularly those like Medicaid with mandatory funding, may be targeted as the Joint Select Committee hunts for $1.2 trillion in savings by Thanksgiving.

The deficit reduction process needs an infusion of the concept of investment. Economics Professor and Nobel Laureate James Heckman has shown that the rate of return on human capital investment is greatest in programs that target the earliest years. The Joint Select Committee should heed him – because the implication of a quarter of infants and toddlers living in poverty and almost half of young children living in families who can’t make ends meet is not just about limiting the potential of millions of small children. It is about limiting our nation’s ability to compete in the global economy in the future. The infants and toddlers of today will form the backbone of our nation’s workforce at mid-century. We cannot afford to let today’s quiet crisis steal so much potential.

For More Information:

Krutsinger and N. Tarr. Poverty Fact Sheet: Implications for Infants and Toddlers. ZERO TO THREE, 2011. http://www.zerotothree.org/public-policy/pdf/poverty-fact-sheet-5-10-11-final.pdf

Pathways Winter 2011 edition on “Does Poverty Get Under the Skin? The Effects of Deprivation on Blood, the Brain, and the Body.” At http://www.stanford.edu/group/scspi/_media/pdf/pathways/winter_2011/PathwaysWinter11.pdf

The Joint Select Committee on Deficit Reduction created by the Budget Control Act (BCA) holds its first hearing tomorrow as it begins its work to erase some of the government’s red ink. Senator Patty Murray (D-WA) and Representative Jeb Hensarling (R-TX) co-chair the Committee, which must make recommendations by November 23 for at least $1.2 trillion in deficit reductions over 10 years. Congress and the President must agree with those recommendations by December 23 or automatic cuts (called a sequester) will be triggered. According to the CBO, a sequester would lower the nondefense discretionary funding cap by another 7.8% in 2013. While programs that benefit low-income children, such as Medicaid, Supplemental Nutrition Assistance Program, and Temporary Assistance for Needy Families, are exempt from the automatic cuts, other programs that support positive early childhood development are not. Head Start/Early Head Start, child care, and Part C Early Intervention, for example, would be vulnerable to automatic cuts. And, as noted in the previous blog post, all programs important to young children and their families are on the table for the Committee as they tackle this immense task.

Infant-toddler advocates need to let their policymakers know that these important programs form not just a social “safety net”, but the social scaffolding for supporting healthy and positive development in vulnerable young children. ZERO TO THREE will be posting fact sheets on babies in states represented on the Joint Select Committee, so check the blog for this information.

Members of the Joint Select Committee on Deficit Reduction

Meanwhile, consideration of appropriations for the 2012 fiscal year that begins October 1 is proceeding. To date, no appropriations bills have been enacted. Neither the House nor the Senate has considered legislation to set funding levels for programs in the Departments of Health and Human Services and Education, which include most of the federal programs important to babies. One issue is whether House Members will agree to use the higher level of overall spending set by BCA instead of the lower limits approved in the House Budget Resolution, which could significantly affect the outlook for early childhood programs. Clearly no decision will be reached before current funding runs out on September 30. The House will start debating a Continuing Resolution next week to keep the government running while efforts to pass appropriations continue.

The Bigger Picture for Babies:

Although we all get caught up in the most immediate funding debate, it is important to remember that our advocacy for infants and toddlers must be broader and more far-reaching. Here are two opportunities to help promote the “big picture” need to support children and families:

Grandparents Week and the 4^th National GrandRally: This week, Generations United is celebrating the contributions of grandparents to our families and to our entire society. The high point will be when grandfamilies from around the country gather in Washington on Wednesday for a GrandRally to advocate for policies that benefit all generations. Find out more at www.gu.org and www.grandrally.org.

National Movement for America’s Children: This grass-roots movement is seeking to develop a comprehensive national strategy to ensure that all of our children are given an opportunity to develop - socially, emotionally and cognitively - in healthy, nurturing homes, schools, neighborhoods and communities. You can help shape the strategy at www.movementforchildren.org.