1. Reducing Child Welfare Involvement: The Promise and Limitations of Early Intervention Deborah Daro

2. 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

3. 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

4. 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

5. Evolution of CAN Prevention Framework Horizontal imageryVertical imagery Multiple age cohortsBirth to five Promotion of any promising program Emphasis on evidence-based programming Alter participantsAlter participants and context

6. 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?

7. Who Uses Early Intervention Services? EHSHead StartNFPHFNYDurham Connects Whites33%35%34%44%34% African Americans 26%33%28%31%42% Hispanics25%23%30%21%23% Other7%8%4%

8. 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

9. 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

10. 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 delays Toddlers  Early literacy skills  Social competence  Parent involvement in learning

11. 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

12. Prevention’s Circular Debate EFFICIENCY STIGMATIZING UNIVERSAL PREVENTION TARGETED PREVENTION

13. 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

14. 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

15. 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