Early Childhood Development:
Building Blocks for Life
Briefing Paper
Greater Twin Cities United Way
Research & Planning
July 2010
Contact:
Elizabeth A. Peterson, Ph.D.
petersonl@unitedwaytwincites.org
1
Table of Contents
Why it Matters…………………………………………………………………………………2
Brain Development…………………………………………………………………………...2
 Early Care and Attachment
 Developmental Prime Time
External Factors: The Impact of Poverty………………………………………………….6
 Prenatal Care
 Health Care
 Food Insecurity
 Environmental Pollutants
 Family Relations and Stress
 Neighborhood Effects
Emergent Literacy: Key to Lifelong Success……………………………………………14
Where the Kids Are: Demographics & Other Data……………………………………...15
Best Practices…………………………………………………………………………………18
 Home Visiting Programs
 Quality Childcare and Education
References………………………………………………………………………………..……24
2
Early Childhood Development:
Building Blocks for Life
What the best and wisest parent wants for his own child, that must the community want
for all its children. –John Dewey
I. Why it Matters
Early childhood is a critical time. These early, formative years serve as the foundation for
all of life’s later endeavors. If, as a society, we fail to meet the needs of our young
children, it is not just the children who suffer. We as a society suffer as well. Their
success is our success.
A recent report puts the cost of each high school dropout at $292,000 (Sum, Khatiwada,
McLaughlin, & Palma, 2009). Dropping out of high school is not a singular event, but
rather a culmination of many factors, beginning in early childhood. Supporting children
and parents in these early years will have impacts into elementary school, high school,
early adulthood, and beyond. Even officials of the
Investment in human capital
Federal Reserve Bank are weighing in—from a financial
breeds economic success not
perspective. They argue that early childhood
only for those being educated,
development programs should be viewed as economic
but also for the overall
development initiatives because the data around its
economy.
return on investment (ROI) is so compelling (Grunewald
--Art Rolnick (Federal Reserve)
& Rolnick, 2006; Rolnick & Grunewald, 2003).
There are many factors that affect child development, resilience, and ability to thrive.
Ensuring these are in place will improve the likelihood of positive outcomes despite
challenging or threatening circumstances. These factors include emotionally responsive
caregiving, a well-organized home environment, and well-developed intellectual and
language capabilities. The best way to support children’s healthy development and longterm success is to reduce the level of stress they experience and provide support to the
family (Shore, 1997).
II. Brain Development
Much has been made of all the advances in brain research in the last decade or so.
Most of what has been learned serves to confirm what was already known and further
build on it.
We know that the first years of life are very important. The experiences that children
have in the first 10 years influence how their brains will be wired as adults. By age 2, a
child’s brain is as active as an adult’s and by age 3 the brain is more than twice as active
as an adult’s—and stays that way for the first 10 years of life. Not only are children’s
brains more active, they also have higher levels of neurotransmitters which assist in the
formation of synapses. This and other attributes of the early brain (e.g., synapse density,
glucose utilization) suggest that young children are primed for learning—particularly as
infants and toddlers (Shore, 1997).
3
Early Care and Attachment
The ways that parents, families,
Brain research has also shown the critical role that
and other caregivers relate and
early caregiving plays. This care has a long-lasting
respond to young children, and the
ways that they mediate their
impact on development, including ability to learn
children’s contact with the
as well as capacity to regulate emotions. Babies
environment, directly affect the
thrive when they receive warm responsive care,
formation of neural pathways.
and there are biological mechanisms responsible
--Rima Shore
for babies’ positive responses to attentive
caregiving. When parents mimic and reinforce their infants’ positive emotional responses
(e.g., smiling, laughing. babbling), they are influencing the development of patterns of
connected neurons.
A strong, secure attachment to a parent or other nurturing caregiver has a lasting
protective function. This protective factor helps to “immunize” infants against the adverse
effects of stress and trauma they will certainly experience at some point in their lives.
Research has found that children respond to stress by releasing cortisol, a steroid
hormone. Children with chronically high levels of cortisol are likely to experience more
developmental delays than other children. But children who receive warm, responsive,
nurturing care in the first year of life are less likely to respond to stress by producing
cortisol. This early attachment and the attending protective factor has a long-term effect.
Elementary school children who experienced strong attachment as infants are less likely
to exhibit behavior problems when they encounter stressful situations. In general, babies
with secure attachment tend to thrive and show more resilience throughout their lives,
including greater self-reliance, greater capacity for emotional regulation, and stronger
social competence, including empathy (Sroufe, 2005).
Indeed, few things are of greater importance than attachment in early childhood.
According to Alan Sroufe (2005), a University of Minnesota professor who has studied
attachment for many years:
It [attachment] is an organizing core in development that is always
integrated with later experience and never lost. . . . Infant
attachment is critical, both because of its place in initiating
pathways of development and because of its connection with so
many critical developmental functions—social relatedness,
arousal modulation, emotional regulation, and curiosity, to name
just a few. Attachment experiences remain, even in this complex
view, vital in the formation of the person. (p.365)
Shore (1997) reports that the kind of attachment infants form with their primary caregiver
by age 1 can predict:

Teacher ratings of child performance

Behavior problems

Quality of relationships with peers in preschool

Social competency in a summer camp setting

School achievement at age 16
There are three commonly used attachment classifications: secure, anxious-avoidant,
and anxious-resistant. Simply put, a child with secure attachment behaves in a manner
that reflects a trusting relationship with the caregiver. The caregiver is viewed as a
reliable source of love: The infant is unhappy when she leaves and comforted when she
4
returns. A child with anxious-resistant attachment typically is not comforted by the
caregiver. For example, if picked up, the child may resist by biting, screaming, whining,
and arching his or her back. A child with anxious avoidant attachment tends to behave
as if the caregiver isn’t present (Gopnik, 2009; Shore, 1997; Sroufe, Egeland, Carlson, &
Collins, 2005).
The quality of attachment is based primarily on the quality of care the child receives—
most particularly caregiver responsivity in the first year. Mothers of securely attached
infants are consistently more cooperative and sensitive when interacting with their
infants in feeding and play situations. They are more responsive to their baby’s cries and
they tend to hold their baby in a more affectionate manner (Sroufe et al., 2005).
Developmental Prime Time
Much attention has been given in the last few
For the vast majority of kids in normal
years to “critical periods” for development, with
homes, all they will need in order to
the implication that if it doesn’t happen now, the
develop strong brain architecture is the
child is lost forever. In fact, the brain has
kind of rich experience they will get
from everyday interactions.
amazing plasticity and ability to compensate for
--National Scientific Council on the Developing
injury or lost opportunity. With few exceptions,
Child
the window of opportunity remains open for
years (National Scientific Council on the
Developing Child, 2007; Shore, 1997; Wilder Research, 2008).
Developmental
Domain
Visual &
Auditory
Development
Window of
Opportunity
0-5 years
Components
Vision, 0-6 months


Hearing, 0-6 months


Language
Development
0-10 years
Learn language, 0-3
years
Physical & Motor
Development
0-12 years
Large motor skills
Fine motor skills
Emotional &
Social
Development
0-12 years
Emotional attachment
Emotional intelligence




Children Need….
Objects in a variety of shapes and
colors, at varying distances.
Movement.
A variety of sounds.
A language-rich environment—
talk, sing, and read to them.
Respond to their babbling.
Opportunities for gross and fine
movements: balls, blocks,
crayons.
Patient caregivers.
Early nurturing to learn
empathy, happiness, hopefulness,
and resiliency.
Children are born ready to learn and will learn whatever comes next in their
developmental continuum. They’re like little (and growing) learning machines. It is
important to point out that there is no specific point in time where children are “ready to
learn.” Instead, readiness falls along a continuum throughout childhood and the school
years, rather than at any single point in time. There is a prolonged neurodevelopmental
timetable throughout childhood and adolescence in which the brain exhibits a gradual
development (Peterson, 1994). Readiness is a process, with many phases, rather than a
singular event, or switch (i.e., ready, not ready).
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III. External Factors: The Impact of Poverty
The negative effects of poverty are pervasive, cumulative, and increase with age (Shore,
1997). Children who are raised in poverty show a negative impact even when they are
born healthy and free of medical problems. They tend to show gradual declines in
mental, motor, and socio-emotional development; they have poorer quality relationships
with their caregivers; and they are more likely to exhibit anxious attachment. In
preschool, they are more likely to have problems getting along with other children and
functioning on their own. By the time they start school they are more likely to need
special education services and as they progress through school they are more likely to
be held back.
Everyone is well aware of the achievement gap between white students and students of
color (i.e., African Americans, American Indians, and Hispanics). This achievement gap
is highly correlated to parental education and family income. When these two
demographic variables are examined, much (though not all) of the variation between
racial/ethnic groups is explained. What many people do not realize, however, is that the
gap is already in place before children enter kindergarten (Fryer & Levitt, 2004, 2006).
Numerous studies have found that most of the inequality in cognitive skills and
differences in behavior come from family and neighborhood sources rather than from
schools (Berliner, 2009).
Evans and Schamberg (2009) provide evidence that living in poverty results in
chronically elevated physiological stress, which in turn affects working memory. Working
memory is essential to language comprehension, reading, and problem solving; it is a
critical prerequisite for long-term storage of information. The longer the period of
childhood poverty, the higher the stress load is during childhood, the greater the longterm effect on working memory.
Children growing up in poverty are, as a rule, exposed to more risk factors than children
growing up in middle-income households. Evans and English (2002) report that
exposure to one risk factor generally has a negligible impact on children, while exposure
to two or more risks has a cumulative, adverse psychological impact. Not surprisingly,
the environment of poverty is characterized by exposure to cumulative, adverse,
physical and social stressors. The housing is noisier, more crowded, and of lower
quality. People living in poverty experience elevated levels of family turmoil, greater
child-family separation, and higher levels of violence.
According to Dearing (2008), the economic costs of childhood poverty in the United
States could be as high as $500 billion a year—about 4% of the U.S. gross domestic
product. The impact of poverty manifests in many ways, including the avenues of
prenatal care, health care, food insecurity, environmental pollutants, family relations and
family stress, and neighborhood characteristics. Each of these factors is discussed in
turn.
6
Prenatal Care
Disparities based on poverty begin even before birth. For example, preterm infants are
born to African-Americans 58% more frequently than they are to Whites and very
preterm infants are born to African-Americans 246% more frequently. In contrast,
Hispanics, who have poverty and uninsurance rates comparable to African-Americans,
typically have longer gestation periods and infants that often weigh more at birth than
their white counterparts (Berliner, 2009). This is sometimes referred to as “the Latina
Paradox.” Researchers in the public health field (McGlade, Saha, & Dahlstrom, 2004)
attribute the positive outcomes to informal systems of prenatal care, composed of family,
friends, community members, and lay health workers. They suggest that “this informal
system confers protective factors that provide a behavioral context for healthy births” (p.
2062). They further note that Latinas in the United States are losing this protection and
suggest it could be maintained through community-based informal care systems.
Birth weight is important because children born at low birth weight (< 2500 g), very low
birth weight (< 1500 g), and extremely low birth weight (< 1000 g) are more likely to
have cognitive and behavioral problems—especially those born at very low or extremely
low birth weights.
Part of the problem may relate to higher use of alcohol and cigarettes frequently found in
poor neighborhoods—the most consistent findings of impairment in children are those
related to mothers who smoked and drank throughout pregnancy (Berliner, 2009).
Alcohol intake during pregnancy is one of the most common causes of brain damage
before birth. Even one drink a day is discouraged, as there are no known safe alcohol
intake levels during pregnancy (CDC, 2009; U.S. Department of Health and Human
Services, 2005).
Alcohol can cause a wide range of damage to the gestating child, resulting in many
different disorders (referred to as the fetal alcohol spectrum disorder). The damage
varies depending on the amount of alcohol consumed as well as the particular time in
the pregnancy. Mild damage includes decreased intellectual function, visual problems,
and high pain tolerance. Prevalence is difficult to estimate, though some studies indicate
that up to 20% of children are exposed to alcohol prenatally. Epidemiological studies
estimate an overall fetal alcohol incidence of 1 in 500 births, occurring in 2-6 births per
1,000 Caucasians; 6 per 1,000 African-Americans; and up to 20 per 1,000 American
Indians (Minnesota Department of Health, 2005).
In addition to preterm births and alcohol use, maternal obesity can affect the gestating
baby, and weight problems are more prevalent in low-income populations, as are stress
and anxiety during pregnancy. Mothers who are anxious, depressed, or both tend to
have children with a higher rate of sleep disturbances and temperament and attention
disorders (Berliner, 2009).
Other prenatal conditions can affect the long-term health and ability of the child as well:
If flu shots are not free, poor people do not receive them as often as higher income
people. Influenza during pregnancy is associated with higher rates of schizophrenia, and
influenza in the first trimester is associated with rates of schizophrenia seven times the
normal rate in the population (Berliner, 2009).
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Health Care
Families living in poverty are much more likely to have unmet health needs. Not
surprisingly, health coverage is highly correlated to income: Families with higher
incomes are much more likely to have health insurance than low-income families.
Income is also highly correlated with race, and as can be seen in the accompanying
graphic, American Indians, Blacks, and Hispanics have uninsurance rates two to three
times higher than Whites and Asians.
Source: Minnesota Department of Health, 2010.
People lacking health care coverage are much more likely to forego needed medical
care because of the cost—including not filling prescriptions or seeing a doctor when sick.
This problem has been exacerbated in the current economic downturn: A September
2009 survey conducted by the Kaiser Family Foundation found that over half (56%) of all
households (not just those uninsured or underinsured) are putting off medical care
because of costs.
Dental care is an area of critical importance. Children in households at or below poverty
are much less likely to obtain annual dental care—more than 1 in 3 had not seen a
dentist in the last year, a rate 2.5 times greater than children in upper income
households. This is important because untreated dental cavities interfere with learning
(Berliner, 2009) as pain interferes with focus and dampens concentration. If cavities go
untreated, more serious conditions could evolve, resulting in school absenteeism.
Children from lower income households are also more likely to have undiagnosed vision
problems. However, even when vision problems are identified, follow-up care is less
likely. Berliner (2009) reports that low-income families follow up on problems uncovered
in school vision screenings at about half the rate of more affluent families.
The bottom line is: Children in low-income families are six times more likely to be in less
than optimal health compared to their higher income peers, and are more likely to
experience a wide variety of illnesses and injuries (Berliner, 2009). These illnesses and
injuries can impact development, learning, and the long-term trajectory of the child.
8
Food Insecurity
Proper nutrition is critical, most especially in the first few years of development. A
nutritious diet early in life results in greater intellectual functioning and higher levels of
education later in life (Berliner, 2009). The United States Department of Agriculture
published a report in September of 2009, focusing specifically on food insecurity in
children.
According to the USDA (2009), food insecurity is associated with numerous negative
outcomes for children, as detailed below:
Impact of Food Insecurity on Children
Poorer health
More stomach aches, frequent headaches, and colds
Higher hospitalization rates
Iron deficiency anemia
Behavioral problems
Lower physical functioning
Poorer psychosocial functioning and psychosocial development
Higher rates of depressive disorder and suicidal symptoms
More anxiety and depression
Larger numbers of chronic health conditions
More “internalizing” behavior problems
Lower math achievement and other achievement gains in kindergarten
Lower math and reading gains from kindergarten to third grade
Lower arithmetic scores and higher likelihood of repeating a grade
The USDA study found an average food insecurity rate for children of 8.7% nationally and
5.7% in Minnesota. The organization Feeding America (2009) did further analyses of the
USDA data and developed estimates of food insecurity specifically for children under age 5.
They estimate that 17.3% of
children under 5 are food
Food Insecurity (2007)
insecure nationally and the
17.3%
rate in Minnesota is estimated
at 13% (with a range from 10%
13.0%
to 16% when standard error is
11.0%
9.5%
taken into consideration).
8.7%
Nationally, food insecurity
5.7%
increased to 14.6% in 2008
from 11.0% in 2007 (USDA,
2008, 2009). Updated data are
not available for children, but it
All Households
Children under 18
Children under 5*
is likely their food insecurity
U.S.
Minnesota
rates have increased on a
parallel track.
*Analysis conducted by Feeding America, 2009.
Not surprisingly, food insecurity is much more prevalent among low-income households
than in moderate- or high-income households. In addition, compared to the general
population, food insecurity is nearly three times as common in households with children
headed by single women; twice as common in Black households; and almost twice as
9
common in Hispanic households (Berliner, 2009). This is a critical issue for the
community. Food insecurity can have serious, long-term consequences for babies and
toddlers, putting them at risk for poor health, increased hospitalizations, and
developmental delays. For children under age 3, it is likely that nutritional deficiencies
will affect their entire school career as well as their employment experiences (Berliner,
2009). According to Dr. J. Larry Brown (Brown, Beardslee, & Prothrow-Stith, 2008), from
the Harvard School of Public Health and Founding Director of the Center on Hunger and
Poverty:
There exists no “safe” level of inadequate nutrition for
healthy, growing children. . . . . When children attend
school inadequately nourished, their bodies conserve the
limited food energy that is available. Energy is first
reserved for critical organ functions. If sufficient energy
remains, it then is allocated for growth. The last priority is
for social activity and learning. As a result, undernourished
children become more apathetic and have impaired
cognitive capacity.
Environmental Pollutants
Environmental pollutants do not affect all people equally. The two major sources of
mercury in the environment are coal-fired power plants and municipal waste incinerators,
and poor communities are much more likely to be located near these two mercury
emitters than middle- or upper-class communities. Mercury contamination results in
cognitive and behavior problems, including hyperactivity and loss of focus (Berliner,
2009).
Impact of Lead Poisoning
Lead is one of the most well-known
pollutants affecting children.
Deteriorated lead paint and leadcontaminated house dust are found in
approximately 4.5 million homes with
young children (Berliner, 2009). These
older buildings (built before 1950) are
now home to large numbers of poor
and minority children. There is no safe
level of lead in the human body. Lead
poisoning, even at low levels, can have
lifelong effects and is associated with
negative outcomes for children,
including impaired cognitive, motor,
behavioral, and physical abilities,
including learning disabilities, attention
deficit disorder, lower IQ, antisocial
Source: Olympio et. al., 2009
behavior, headaches, and seizures
(Binns, Campbell, & Brown, 2007;
Olympio, Gonçalves, Günther, & Bechara, 2009).
10
Also of concern are PCBs (associated with decreased cognitive function in early
childhood) and pesticides. Air quality is also an issue and is reflected in increased
hospital admissions for asthma. Inner cities, where the poor are most frequently
concentrated, tend to have the highest levels of smog, which in turn affects the health of
these community residents to a much greater extent than is experienced in the wealthier
suburbs (Berliner, 2009).
Family Relations and Stress
Violence
It is estimated that some sort of serious family violence occurs annually in 10 to 20
percent of families. This violence is more likely to be directed against females than
males and it correlates with poverty such that it is more common in lower income
households (Berliner, 2009). This is not to say that violence does not occur in higher
income families, but rather that it is more prevalent in lower income families. Nor is this a
surprising finding, given the multiple stresses that families in poverty experience.
Family violence, even if not directed at children, has a strong effect on children. Parents
in a violent, volatile relationship are less able to nurture the development of their
offspring. Parental victims of violence may be emotionally withdrawn (which with infants
could impede attachment). Children who grow up in violent families frequently have
social and emotional problems, including higher rates of depression, aggressive
behavior, and anxiety, and as they enter school are more likely to have lower social
competence and poorer academic performance. Exposure to household violence has
also been found to impact children’s physical health, putting them at greater risk for
allergies, asthma, gastrointestinal problems, headaches, and flu (Berliner, 2009).
Mental Illness and Maternal Depression
Familial mental illness can also have a negative impact on child development. Maternal
depression, in particular, has been found to have significant effects on development.
Mental Illness & Poverty
Research has found that mental illness is more
prevalent in low-income households than in wealthy
households. While the base rate of mental illness is
around 3% in wealthier communities, it is more than
twice that (7%) in low-income communities. It is not
only that mental illness tends to make people poor
(increased medical costs as well as potential difficulty
getting and keeping a job) but poverty on its own has
been found to be a causal factor in making people
mentally ill.
--David C. Berliner
In fact, infants as young as 3 months
of age are able to detect depression
in their mothers, potentially
compromising the infant’s social,
emotional, and cognitive functioning
(Weinberg & Tronick, 1998).
According to Knitzer, Theberge, and
Johnson (2008), maternal
depression is a significant risk factor
affecting the well-being and school
readiness of children.
Maternal depression is relatively widespread, and like mental illness in general (see
textbox), is disproportionately represented in low-income households across all
ethnicities.
Maternal depression affects parenting in two primary ways: It impedes the development
of healthy relationships and it compromises the ability of the mother to perform basic
parenting functions.
11
The impact of maternal depression on children varies according to the child’s age when
it occurs: Maternal depression during infancy has a greater impact on a child’s
development than depression at later ages. The impact on the child is also dependent
on the severity and length of the depression (Knitzer, Theberge, & Johnson, 2008).
The negative effects of maternal depression on the developing child can start even as
early as pregnancy. Maternal depression is linked to poor birth outcomes such as low
birth weight, prematurity, and obstetric complications. Maternal depression while the
child is an infant predicts increased cortisol levels at preschool ages, and as previously
discussed (see ”Early Care and Attachment”) high cortisol levels are associated with
anxiety, withdrawal, and decreased social competence (Knitzer, Theberge, & Johnson,
2008).
Maternal depression is also linked to negative relationships in early childhood as well as
reduced language ability (which is key to early school success): Depressed mothers lack
the energy to carry out consistent routines such as reading to their children. In addition,
their ability to have fun with their children, performing the simple but critically important
elements of singing, playing, and cuddling, is severely compromised (Knitzer, Theberge,
& Johnson, 2008). It is thus, perhaps, not surprising that 3-year-old children whose
mothers were depressed in their infancy perform more poorly on cognitive and
behavioral tasks.
Maternal depression is also linked to health and safety concerns: Depressed mothers
are less likely to breastfeed, and even when they do breastfeed they tend to do so for
shorter periods of time. Depressed mothers are also less likely to follow the back-tosleep guidelines for prevention of SIDS, and are less likely to use basic safety
precautions such as socket covers and car seats. They are also less likely to follow
routine preventive health practices and are more challenged when managing chronic
health conditions such as asthma.
The impact of maternal depression should not be underestimated. It carries a stronger
risk of child behavior problems than many other risks that are frequently tracked,
including smoking, binge drinking, and emotional as well as physical domestic violence
(Knitzer, Theberge, & Johnson, 2008).
As mentioned, mothers in low-income households are more likely to experience
depression. Overall, about 5% of children in 2004 had a parent with some depressive
symptoms. That increases to about 15% in families receiving food stamps, and to 20%
for families receiving Temporary Assistance for Needy Families (Child Trends Data
Bank, 2009).
Often women suffering from maternal depression are reluctant to seek treatment
because of the stigma associated with depression and seeking help. There is also a
general distrust of mental health agencies, and to further complicate things, they are
often reluctant to take medications because they fear it will interfere with their parenting
(Knitzer, Theberge, & Johnson, 2008).
12
Neighborhood Effects
Where you live affects how well you learn.
Living in a severely disadvantaged
Research studies have confirmed that
neighborhood reduces the later
neighborhood economic status is strongly
verbal ability of Black children on
average by ≈ 4 points, a magnitude
associated with children’s acquisition of skills in
that rivals missing a year or more
general and language in particular (Berliner,
of schooling.
2009; Sampson, Sharkey, & Raudenbush, 2008;
--Sampson, Sharkey, & Raudenbush
Sastry & Pebley, 2008; Sharkey, 2009). In fact,
poverty results in about a quarter of a standard deviation loss in verbal ability.
Residing in neighborhoods of concentrated poverty (bottom quartile of income) has a
cumulative and negative effect on verbal development and achievement. Studies
suggest that living in a low-income neighborhood may have a greater effect on inequality
in school test scores than coming from a low-income family (Berliner, 2009). It appears
that the primary factor is the absence of more affluent neighbors rather than the
presence of low-income neighbors.
For children whose family income is in the top three quintiles, growing up in a highpoverty neighborhood versus a low-poverty neighborhood (e.g., a poverty rate of 25%
vs. 5%) increases the chances of downward mobility by 52% (Sharkey, 2009). There is a
strong racial component here—only a small percentage of White children live in highpoverty neighborhoods while a majority of Black children do: Approximately two-thirds of
Black children grow up in these high-poverty neighborhoods compared to about 5% of
White children.
Even health is affected by neighborhood location (see “Environmental Pollutants”). Why?
In part it is due to the lack of opportunities found in poor, racially segregated urban
neighborhoods. Schools are often underfunded, and residents of poor neighborhoods
have less political influence than residents of affluent neighborhoods. The quality of
public amenities is poorer, the effectiveness of the police is compromised by a number
of factors including distrust, and there is much greater exposure to violence, gangs, toxic
soil, and polluted air (Sharkey, 2009).
Additionally, poor neighborhoods are often stressful and hazardous. Parents may be
more focused on their children’s safety than their cognitive development. The children, in
turn, are less likely to be exposed to well-educated, successful, adult role models who
provide examples of the value in verbal, reading, and problem-solving skills. Children’s
cognitive and verbal skills may also be affected by the language environment to which
they are exposed in their neighborhood: In concentrated poverty neighborhoods,
children may be less exposed to adults and peers who speak standard English and also
less exposed to hearing language in general due to the restrictions in social interaction
imposed by parents concerned about safety (Sastry & Pebley, 2008).
13
IV. Emergent Literacy: Key to Lifelong Success
Learning to read starts a child on the long pathway to success. It is particularly important
that a child is able to read by grade 3, since that is the turning point when schools begin
to expect children to read to learn. But
From the child’s first, halting attempts to
learning to read begins much earlier than
decipher letters, the experience of reading
third grade or even kindergarten. As soon as
is not so much an end in itself as it is our
an infant can sit on a caregiver’s lap, the act
best vehicle to a transformed mind, and,
of learning to read may begin. Sitting on a
literally and figuratively, to a changed
lap, surrounded by love, being read to: This
brain.
--Maryanne Wolf
is the beginning of a long process called
emergent or early literacy.
Children are not born knowing that there is a name, or label, for everything in the world.
But children gradually begin to name the parts of their world—typically beginning with
the people who care for them. The “aha!” moment that everything has its own name
usually comes at around 18 months of age.
Maryanne Wolf, professor of child development at Tufts University, director of the Center
for Reading and Language Research, and author of Proust and the Squid: The Story
and Science of the Reading Brain, writes,
[T]he more children are spoken to, the more they will
understand oral language. The more children are read to,
the more they understand all the language around them,
and the more developed their vocabulary becomes. This
intertwining of oral language, cognition, and written
language makes early childhood one of the richest times
for language growth (p. 84).
Reading to a child can make a significant difference: Children who are “well-read-to” (at
least five times a week), when asked to tell a story, used more literary language than
unread to children, and they also used more sophisticated syntactic forms, longer
phrases, and relative clauses. They were also better able to understand the oral and
written language of others—an important foundation for the comprehension skills that
will develop in the coming years (Wolf, 2008).
Children who are read to are gaining vocabulary skills, but more than that, they begin to
practice the complex use of analogy (e.g., “Her cheeks were like rose petals”). Simple
similes such as those found in Curious George aid the child in performing such
sophisticated cognitive operations as size-based comparisons and depth perception
(Wolf, 2008).
Reading depends to a great degree on biological development and the brain’s ability to
connect and integrate various sources of information (visual, auditory, linguistic, and
conceptual). The speed with which this occurs depends on the sheathing wrapped
around a brain cell’s axons. For most children, this is not sufficiently developed until
school age—between 5 and 7 years. On the road to reading, however, they gradually
learn that words make up sentences, and syllables make up words, and sounds
(phonemes) make up syllables.
14
Poetry and Mother Goose rhymes help children learn phonemes. Children ages 4 and 5
are beginning to differentiate the first sounds of words—one of the reasons the Dr.
Seuss books are so popular: Go, Dog, Go! and “I do not like green eggs and ham. I do
not like them Sam I am” are catchy phrases with built-in redundancies that help children
parse phonemes. This, in turn, facilitates learning to read (Wolf, 2008).
Children who grow up without these literary advantages are already behind when they
enter kindergarten. The language and environment children grow up in has a significant
impact. A frequently cited study by Hart and Risley (1995, 2003) found huge language
differences as early as age 3: At 3 years of age, children growing up in families receiving
welfare had an average vocabulary size of 525 words. Children in working-class families
had an average vocabulary size of 749 words, and
“The importance of simply
children in professional families had an average
being talked to, read to, and
vocabulary size of 1,116 words. Extrapolating from their
listened to is much of what early
data, Hart and Risley estimate that by age 5, children
language development is all
from impoverished language environments have heard
about.”
32 million fewer words spoken to them than the
-Maryanne Wolf
average middle-class child.
Hart and Risley further found that vocabulary use at age 3 was predictive of language
skill at ages 9 and 10. Children who come to kindergarten in the bottom quartile
generally remain behind the other children—both in vocabulary growth and reading
comprehension (Wolf, 2008). According to Hart and Risley (2003), “Estimating the hours
of intervention needed to equalize children’s early experience makes clear the enormity
of the effort that would be required to change children’s lives. And the longer the effort is
put off, the less possible the change becomes.”
V. Where the Kids Are: Demographics & Other Data
There are approximately 241,000 children ages 0-5 in the nine-county area. Of those,
30,505 (12.7%) live at or below 100% of poverty, and 68,758 (28.5%) live below 200% of
poverty. (Poverty numbers do not include foster children, children in institutional group
quarters, and homeless children without shelter.)
Source: U.S. Census (2008).
15
Kindergarten Readiness
The Minnesota Department of Education conducts an annual assessment of
kindergarten readiness based on a representative sample of Minnesota kindergartners
as they enter school in the fall. They categorize children in five domains, detailed below.





Five Domains of Kindergarten Readiness Assessment
Physical development (e.g., self-care tasks, eye-hand
coordination)
The arts (e.g., participates in group music experiences, uses a
variety of art materials)
Personal and social development (e.g., interacts with others,
shows curiosity, empathy and caring, self-direction)
Mathematical thinking (e.g., beginning shape recognition,
understanding of quantity)
Language and literacy (e.g., comprehends stories read aloud,
speaks clearly, beginning understanding of concepts about print)
Each domain has a number of indicators. For each indicator within a domain, a child is
rated as Not Yet, In Process, or Proficient.
A rating of Not Yet means that a child cannot perform the indicator (i.e.,
the indicator represents a skill, knowledge, behavior, or accomplishment
the child has not yet acquired).
A rating of In Process means that the child does not yet consistently
perform the indicator, but there is some presence of the skill, knowledge,
behavior, or accomplishment. It is in development but not yet
demonstrated reliably or consistently.
A rating of Proficient means that the child reliably and consistently
demonstrates the skill, knowledge, behavior, or accomplishment.
More than 6,000 kindergartners from 96 randomly selected schools were assessed in
the 2008 assessment, representing more than 10% of the kindergartners starting the
2008-2009 school year. Overall, the large majority of children are rated either “in
process” or “proficient.” Between 4% and 13% were assessed as “not yet.”
16
Kindergarten Readiness by Domain
61%
49%
44%
49%
47%
Proficient
In Process
Not Yet
4%
35%
Physical
Development
43%
41%
43%
41%
8%
11%
12%
13%
The Arts
Personal &
Social
Development
Mathematical
Thinking
Language &
Literacy
Source: Minnesota Department of Education (2009).
As can be seen, children are most likely to be at least in process in the domain of
physical development. The largest proportion of children assessed “not yet” fell into the
language and literacy domain. These results are reasonably consistent with the findings
of prior years. There is a small trend towards an increase in students assessed “not yet,”
but the increase is not outside the margin of sampling error (i.e., it could represent
sampling error rather than an actual change from the prior years).
Being “in process” is not a bad thing. It is to be expected that young children will develop
at different paces, showing proficiency in some areas while others are still in process.
Greater concern and intervention is warranted for those “not yet” developing proficiency.
17
VI. Best Practices
Everyone wants a magic bullet, the perfect program, to make sure children enter
kindergarten ready and eager to learn. There is no magic bullet. The causes and
contributors to childhood problems are manifold and complex. Early Childhood
Development Programs are a good start for many children, but health care and external
environments also need to be addressed.
Early Intervention: Children from families with the least formal education generally
experience the greatest cognitive benefits from intervention programs. Importantly, the
impact of early intervention is long-lasting, especially when there is follow-up throughout
the elementary school years (Shore, 1997).
Studies of model preschool
A recent study by David Deming (2009) looked at the
interventions find dramatic
long-term benefits of Head Start programming. Deming
improvements in long-term
found that there tends to be a strong fading out in terms
outcomes among program
of test scores as children get older. However, in spite of
participants, despite rapid fadetest score fading, the long-term impacts were strong:
out of test score gains.
improved high school graduation rates, college
--David Deming
attendance, higher employment, better health, and
lower rates of teen parenthood. In fact, African-American children, who show particularly
strong fade-out on test scores also show the largest long-term gains. (Deming, 2009).
Deming concludes that test score gains are an incomplete measure of long-term benefits
and points out that the connection between test score gains and improvements in adult
outcomes is not well understood.
Home-Visiting Programs
Programs for parents of young children hold considerable promise for improving
children’s lives—in the short run as well as long term. Delivering services to families in
their own homes means that parents do not have to arrange transportation, childcare, or
take time off from work. It also provides opportunity for more whole-family involvement,
personalized service, individual attention, and rapport building (Sweet & Appelbaum,
2004). In general, home visitors focus on the parents rather than the children,
encouraging and training parents to relate to and help their children.
Home-visiting programs have been found to produce consistent and lasting results when
delivered in a manner consistent with research-based best practices. A focus on parents
and parenting is essential because hundreds of studies have found evidence of the
relationship between early prenatal care and care in the first years of life and children’s
intellectual, behavioral, and emotional outcomes. Sensitive, responsive care in the first
months of life is critically important, and home visiting can help ensure that happens.
When parents understand their infants and respond in ways that meet the baby’s needs,
children are more likely to develop secure infant attachment and exhibit better behavioral
and emotional adjustment later in life (Olds, Sadler, & Kitzman, 2007).
It is important to note that home visiting is a strategy for delivering a service rather than
a specific type of intervention. Home visiting programs differ and have been found to be
effective for different demographic groups (e.g., single teen moms, specific ethnic
groups, low-income parents); targeting different behaviors or outcomes (e.g., child
abuse, school readiness, parental employment), and vary by length and intensity of
18
services, types of services provided, methods of recruitment, and who delivers the
services.
The most effective home-visiting programs for helping parents and children are those
that start early (ideally during pregnancy), maintain visits for at least three years, visit
often—at least weekly for the first six months, and have clear, focused goals and
materials that support those goals.
The table below details the positive outcomes associated with well-structured,
professionally developed home-visiting programs as well as key components of homevisiting programs that have been found to obtain these outcomes.






























Positive Outcomes Associated with Home-Visiting Programs
Improved maternal health (prenatally and postnatally)
Improved child health
Improved parents’ abilities to manage their lives
Improved parents’ abilities to care for their children
Lower rates of involvement in the criminal justice system (parents and children)
Less harsh parenting behaviors
Lower infant mortality rates
Prevention of child abuse and neglect
Improved child safety and fewer injuries
Improved cognitive and language development
Better emotional engagement with parents
More sustained attention with objects
Less aggressive behavior
Reduced domestic violence
Fewer subsequent pregnancies and births
Increased inter-birth intervals
Increased parental employment
Increased maternal education
Reduction in reliance on welfare
Key Components of Successful Programs
Begin during pregnancy
Focus on at-risk families
Focus on prevention (of low birth weight, child abuse, reliance on public assistance,
learning delays, etc.)
Duration of at least three years (recommend 3-5)
More intensive visitation frequency at outset (weekly for the first six months)
Focus on parenting
Clear program goals with curricula and materials to support the goals
Rigorous training of supervisors and home visitors
Cultural competency
Developmental screenings for the children
Connect family to other resources in the community
Sources: Family Strengthening Policy Center, 2007; Isaacs, 2008; Olds, 2008; Olds et al., 2007; Sweet &
Appelbaum, 2004;
19
Rigorous training of home visitors is a critical element. One study found that homevisited children actually performed worse on measures of child development than their
control-group counterparts. As Olds et al. (2007) state, “In spite of our best intentions, it
is possible to harm those we attempt to help” (p.385). This is why training and cultural
competence on the part of home visitors is so important.
Home visiting generally delivers greater benefits for high-risk families than low-risk
families (Olds, 2008). This is in part because many of the benefits that accrue (e.g.,
avoiding welfare dependence, lower rates of substance abuse, less involvement in
criminal behavior) were not risk factors in the lives of lower risk (generally higher
income) groups. One study found that while the cost to implement the program was the
same for low-risk and high-risk families ($7,271), the benefits accruing to the low-risk
group totaled $9,151 while the benefits accruing to the high-risk group totaled $41,419
(Family Strengthening Policy Center, 2007).
Home visiting is also one key avenue for addressing maternal depression, which can
have devastating and long-term impacts on children.
Addressing Maternal/Parental Depression
Promote early identification and screening. For lowincome women, make treatment more accessible.
Educating parents about the effects of their
depression on their children could encourage mothers
who would otherwise be resistant to seek treatment.
Knitzer, Theberge, and Johnson (2008) point out one
potentially powerful but underutilized strategy to
address parental depression is to embed explicit
interventions into early childhood programs, most
particularly home-visiting programs. They also
recommend that efforts to address maternal
depression include the following:





Three types of strategies commonly
used to address depression in the
context of parenting young
children:
1.
2.
3.
Screening and follow up for
women, usually in ob-gyn or
pediatric practices.
Targeted interventions to
reduce depression and improve
parenting, such as home
visiting.
Promoting awareness about the
impact of maternal depression
and what to do about it. Target
audiences include general
public, low-income
communities, and early
childhood and health
practitioners.
Link services and supports for parents and
children through formal as well as informal
strategies.
Provide training and support to home visitors,
--Knitzer, Theberge, & Johnson (2008)
teachers, and childcare providers to help
families get support and treatment for depression.
Help parents address specific parenting challenges related to depression and other
difficulties.
Ensure that children in high-risk families have access to high-quality childcare
programs to reinforce social and emotional skills and provide early learning
opportunities.
Provide clinical treatment when it is needed, in settings that families trust.
Quality Childcare and Education
Educationally enriched childcare can have long-lasting effects on the cognition and
behavior of children. Quality childcare and education is particularly effective when it is
coupled with or follows on the heels of early home visiting.
20
Research has found that early childhood education is particularly beneficial to children
from low-resource families, while benefits are less clear for children from middle- and
upper-class families. Low-resource families typically have limited parental education,
very low family incomes, and/or parents unable to consistently provide high-quality
learning opportunities for normal brain and behavioral development (Wilder Research,
2008).
As more children spend more time in childcare (20-35 hours/week for most children),
concerns have arisen about the quality of care provided. There is reason for concern:
Not all childcare providers are equally skilled or trained, and at least one study found
that only 12% to 14% of children are in childcare arrangements that promote their growth
and learning (Shore, 1997).
The hallmark of quality for early childcare is not very different from quality care from
parents: warm, responsive, consistent, caregiving geared towards the needs of each
individual child. The table below details short- and long-term outcomes of successful
quality childcare and early preschool programs as well as the key components of the
kinds of programs that obtain these outcomes.













Outcomes of Successful Quality Childcare
Improved language development and literacy
Higher cognitive skills
Improved fine skills development
Higher levels of school readiness
Lower rates of special education placement
Lower rates of grade retention
Higher rates of school completion
Higher rates of college attendance
Lower incidence of juvenile arrest
Lower rates of incarceration as adults
Lower rates of child abuse and neglect
Fewer months on public aid (men)
Higher rates of full-time employment













Key Components of Quality Programs
Intensive (half- or full-day five days a week)
Multiple years
High levels of staff education and specialized training
Low staff turnover
High staff-to-child ratios
Smaller group sizes
Administrative stability
High levels of staff compensation
Educational enrichment
Comprehensive parent involvement
Instructions to parents on effective child rearing
Family support services
Health services
Sources for above: Ramey, Campbell, & Blair, 1998; Reynolds et al., 2001; Reynolds et al., 2007;
Schweinhart et al., 2005; Shore, 1997; Temple, Reynolds, & Miedel, 2000.
21
Numerous studies have examined the public and private return on investment (ROI) for
early childhood programs. The High/Scope Perry Preschool program has received
particular attention because of its extensive longitudinal nature (program participants
and controls have been tracked through age 40). Most studies have found extremely
high rates of return: Rolnick and Grunewald (2003) estimate a 16% rate of return, while
Belfield, Nores, Barnett, and Schweinhart (2006) estimate a 17% rate of return. A recent
analysis by Heckman, Moon, Pinto, Savelyev, and Yavitz (2009) applied more rigorous
and conservative methodologies but still found a rate of return ranging between 7% and
10%.
A word of caution: Perry Preschool participants were highly disadvantaged, very lowincome, African-American children with IQs between 70 and 85 (average IQ is 100), and
much of the ROI (> 90%) is based on savings from crime reduction, specifically for male
participants. Caution should be used in generalizing these data to broader populations.
Regardless of the actual size of the return on investment, it is clear that the earlier the
investment takes place, the higher the rate of return:
From: Heckman (2006).
22
Conclusion
The early childhood years are critically important: The stronger the foundation built in the
first few years of life, the greater the likelihood of long-term success and happiness.
Poverty has an insidious and pervasive impact on this development, weaving through
many areas of the child’s life: It limits their access to developmental stimulation and
heightens their exposure to stress—in their physical as well as their psychological
environment (Dearing, 2008).
It carries a cost for society as well. Dearing reports the economic cost of childhood
poverty is as high as $500 billion a year—4% of the United States gross domestic
product.
Early intervention can help. Research has found two strategies that are particularly
effective: home visiting, to educate parents; and high-quality early childcare and
education. When these two strategies are bundled and child and family support extends
through the elementary school years, long-term success is even more likely. The earlier
the intervention begins, the more likely it is to be effective and the greater the return on
investment.
23
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