Wednesday, March 23, 2011

Prevention: NY Legislature Moves to Restore Home Visiting Funds

Last month, we were dismayed to learn that the Governor's proposed budget stripped funding for home visiting programs. Link

This month, we are delighted to learn that the Legislature intends to keep that funding in their budget bills.

Now, the challenge is to educate the Governor about the salutary benefit of home visiting services on the bottom line, and the consequences when those services are lost.

Prevent Child Abuse NY reports, and provides this sample letter. You can help by using this convenient PCANY site - Link:

I have good news! Both the Senate and Assembly restored funding to Healthy Families New York (HFNY) and other home visiting programs. We applaud the Legislature's commitment to New York's most effective prevention programs. And we thank you. This victory couldn't have been possible without the hundreds of emails, letters and phone calls from child abuse prevention advocates around the state.

Our work is not over.

Our next task is to ensure the Governor supports the legislative budget proposal. We can't do this without you.

Please email this letter asking the Governor to restore funding for Healthy Families New York.

You can also mail a letter. Below is a sample that you can copy, paste and edit.

The Honorable Andrew Cuomo
Governor of New York State
NYS State Capitol Building
Albany, NY 12224

Dear Governor Cuomo:

I am writing to urge you to fully restore funding for Healthy Families New York and other home visiting programs. Home visiting prevents child abuse, increases school readiness, and saves the state millions of dollars in Medicaid because it prevents low-weight births that require costly medical services.

As you know, vulnerable families that go unserved in the earliest years often need costly remediation services later on. Home visiting helps provide better outcomes for children and families. Full funding for Healthy Families New York will also allow New York to draw down millions in federal home visiting dollars to expand and strengthen our system.

Please restore funding for these critical programs.

Thank you.
[Your Name]

It is critically important that Governor Cuomo hear from all corners of the state that HFNY and other home visiting programs prevent child abuse, increase school readiness, and save the state millions in Medicaid costs.

Please contact the Governor today.

Thank you.

Christine Deyss
Executive Director

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Resource: Educating Policy Makers Influences Policy

While it should come as no surprise that educating policy makers about early childhood development results in more informed policy, it hasn't always been recognized by advocates that "telling ain't teaching."

Prevention Action (itself an interesting blog in the UK) reports on an important article in the February issue of Child Development by Jack Shonkoff and Susan Nall Bales: ‘Science does not speak for itself: Translating child development research for the public and its policy makersLink to PDF

It touches upon a couple of the paradoxes of sustainable advocacy: that every stage of parenthood is transient, and thus one important part of the constituency for early childhood programs (parents) are not only learning their new role as they go, but constantly going onwards to the challenges of the next stage of development, and that sustained advocacy therefore often devolves to institutional stakeholders, and those institutions require resources to sustain themselves.
Stated simply, the aim of this exercise is to communicate complex scientific principles simply but accurately, using techniques of investigation from the cognitive and social sciences in order to achieve that objective.

The lessons of this initiative so far are that child development researchers can influence the thinking and actions of the target group – comprising the professionals, policy makers, elected officials and interested parties mentioned earlier - if they focus on teaching about science and less on preaching about which policies and services should be supported. The authority of the ‘core story’ in terms of its scientific underpinning is essential for this. Second, the most effective dissemination occurs when scientists present their ideas directly to the target audiences but do so with advice and support from communication experts.

The benefit of this approach is that sound scientific knowledge is presented without being dumbed down and in a way that policy makers can understand, apply and pass on to colleagues.
The study offers some interesting lessons to those seeking to influence policy.
So what is special about this model? First, its intention is to convey a body of knowledge, in this case the theory of child brain development. Many disseminations exercise focus on one study and stop at summarising the findings and drawing out policy and practice implications. This exercise has a much wider educational brief affecting a whole way of thinking about the nature, cause and consequences of a social problem and the relevance of a whole area of child development to it.

Secondly, it seeks to present extremely complex theories and concepts in a new way without being selective or over-simplifying. The core story is a robust summary of current knowledge and not a list of findings presented as open to different interpretations.

Thirdly, the consultation and dissemination processes involve a lot of repetition as testing reveals failures, but it is ultimately cumulative as understanding grows.

Fourth, the need to link abstract ideas with policy and practice must always be in the mind of those seeking to explain.

The core story of brain development:

1. Child development is a foundation for community development and economic development, as capable children become the foundation of a prosperous and sustainable society.

2. Brain architecture is constructed through an ongoing process that begins before birth and continues into adulthood. As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all the capabilities and behaviour that follow.

3. Skill begets skill as brains are built in a hierarchical fashion, from the bottom up. Increasingly complex circuits and skills build on simpler circuits and skills over time.

4. The interaction of genes and experience shapes the circuitry of the developing brain. Young children serve up frequent invitations to engage with adults, who are either responsive or unresponsive to their needs. This ‘serve and return’ process (what developmental researchers call contingent reciprocity) is fundamental to the wiring of the brain, especially in the early years.

5. Cognitive, emotional and social capabilities are inextricably intertwined and learning, behaviour, and both physical and mental health are highly interrelated over the life course. You cannot address one domain without affecting the others.

6. Although manageable levels of stress are normative and growth promoting toxic stress in the early years (e.g. from severe poverty, serious parental mental health impairment, such as maternal depression, child maltreatment and/or family violence) can damage developing brain architecture and lead to problems in learning and behaviour, as well as increased susceptibility to physical and metal illness.

7. Brain plasticity and the ability to change behaviour decrease over time. Consequently, getting it right early leads to better outcomes and is less costly, to society and to individuals, than trying to fix it later. We can pay now or we will pay more later for society’s failure to promote healthy development in the earliest years of life.

8. Effectiveness factors make the difference between early childhood intervention programmes that work and those that do not work to support children’s healthy development. These factors can be measured and can inform wise investments in effective policies and programmes.
Link to Prevention Action postResource: Jack P Shonkoff and Susan Nall Bales, ‘Science does not speak for itself: Translating child development research for the public and its policy makers’, Child Development, 82:1, February 2011, pp. 17-32 Link

Resource: Shonkoff, Investment in Early Childhood Education Lays The Foundation of a Prosperous Society, Early Childhood Encyclopedia (2009) Link

Resource: Child Development Homepage Link

Resource: Society for Research in Child Development Link
The Society is a multidisciplinary, not-for-profit, professional association with a membership of approximately 5,500 researchers, practitioners, and human development professionals from over 50 countries.

The purposes of the Society are to promote multidisciplinary research in the field of human development, to foster the exchange of information among scientists and other professionals of various disciplines, and to encourage applications of research findings. Our goals are pursued through a variety of programs with the cooperation and service of our governing council, standing committees, and members.

Monday, March 07, 2011

Resources: Gender Differences in AHT/SBS - Pediatrics

A study in the current issue of Pediatrics examines the outcomes of AHT/SBS cases involving males and female perpetrators. Link to Pediatrics.

Abusive Head Trauma in Children: A Comparison of Male and Female Perpetrators:

Several studies have examined the relationship between perpetrators of abusive head trauma and their victims. However, no study has evaluated the effect of perpetrator gender on victim presentation, victim clinical outcomes, and perpetrator egal outcomes.

This study reports significant gender differences in perpetrators of abusive head trauma in children. Male perpetrators were younger and more likely to confess and be convicted. Victims of male perpetrators had more serious acute presentations and neurosurgical intervention and suffered worse clinical outcomes.

US News and World Report HealthDay summarizes the study's findings:

The tiny victims of shaken baby syndrome are equally likely to be injured by a man or a woman, although women are less likely to be convicted of the crime, according to a new study.

Perhaps because of men's sheer strength, the babies are also more likely to suffer graver harm if their abuser is male, and male perpetrators are more likely to confess to the crime and be convicted, the researchers found.

In data collected over 10 years on 34 cases of abusive head trauma (AHT) in infants, researchers found that abusers' gender was evenly split and that female abusers were typically significantly older than males.

And, as the MSNBC coverage notes:

... the researchers expressed concern that many cases of child abuse may go unreported. They cited research from the University of North Carolina showing that more than 2 percent of mothers admit to shaking children as a form of discipline on surveys -- likely a low estimate. [Link to UNC article]

Thursday, March 03, 2011

Resource: Child Maltreatment Prevention as a Public Health Priority

Via the Doris Duke Foundation, CDC's 2009 presentation on "Child Maltreatment Prevention as a Public Health Priority" featuring Jack Shonkoff and James Mercy.
Did you know some of the worst adult health problems in the nation can be linked to the toxic stress resulting from adverse experiences in childhood?

Population health priorities, including obesity, heart disease, and diabetes are associated with harmful childhood experiences such as abuse or neglect.

The goals of this webinar are to develop a shared understanding of how the prevention of child maltreatment not only promotes optimal development but also reduces disparities in health and explore the important role public health agencies play in improving the health of children and families by preventing childhood abuse and neglect.
Powerpoint presentations from the webinar are available here, although the webinar itself is not.
Instead, please listen to this excellent thought piece, sponsored by the Cambridge Trust Company: Early Childhood Development and Public Policy: Closing the gap between what we know and what we do. downloadable .MP3 file

Jack Shonkoff, the director of the Center on the Developing Child at Harvard University talks about the impact of early experience on brain development and the policy and practice implications of new research.

Wednesday, March 02, 2011

Doris Duke/Chapin Hall Fellowships: Child Abuse Prevention

Good news from Chapin Hall at the University of Chicago...

Chapin Hall and the Doris Duke Foundation are collaborating to create 30 Child Abuse Prevention fellowships. Link to announcement

The fellowships sound encouraging: they're intended to identify and develop a new generation of leaders who will use diverse research methods and a "look over the fence" to improve child abuse prevention policy and practice.
Chapin Hall is seeking individuals with the skills, passion, and institutional support necessary for sustaining long-term professional involvement in child abuse prevention.

“We’re looking for applicants who demonstrate initiative to look over the fence and learn what is new in other domains,” said Daro. “We’re looking for those who actively engage in disseminating their findings and work to increase visibility of child abuse and neglect prevention within broader professional associations, and those who understand that research initiatives need to be developed with an eye toward influencing how program managers and policy makers do their work.”

“We hope that with its national reach and multidisciplinary approach, the Doris Duke Fellowships program will foster unique contributions that address the many opportunities and needs in child abuse prevention, a field that is gaining momentum across the country,” said Francie Zimmerman, program officer for the Doris Duke Charitable Foundation’s Child Abuse Prevention Program. “Fellows will benefit from Chapin Hall’s expertise as they participate in this robust learning experience.
Link to Chapin Hall video of Research Fellow Deborah Daro, chair of the Doris Duke Fellowships for the Prevention of Child Abuse and Neglect, talking with Anne Cohn Donnelly, Senior Lecturer at Northwestern University, about opportunities provided by the fellowships.

The next application period will open August 2011 through December 2011.

Daro is the author of an interesting 2010 issue brief "Child Abuse Prevention: A Job Half Done." Link

And Chapin Hall researchers have developed and evaluated a diverse set of programs aimed at reducing risks for maltreatment and strengthening parental capacity.
One such example is Chapin Hall’s evaluation of the Community Partnerships for Protecting Children initiative as implemented in four urban communities. You can find this and more research—including a systems approach, an epidemiological perspective, and perspectives on early childhood home visitation—in the Home Visitation and Maltreatment Prevention tab. Link
Some other Chapin Hall resources:

Progress Toward a Prevention Perspective (2009)

Epidemiological Perspectives on Maltreatment Prevention (2009)

Evidence-Based Systems of Home Visitation: Opportunities for Replication and State Innovation (2009)