[Senate Hearing 111-1149]
[From the U.S. Government Publishing Office]
S. Hrg. 111-1149
STATE OF THE AMERICAN CHILD: WHAT'S WORKING FOR CONNECTICUT'S CHILDREN
=======================================================================
FIELD HEARING
BEFORE THE
SUBCOMMITTEE ON CHILDREN AND FAMILIES
OF THE
COMMITTEE ON HEALTH, EDUCATION,
LABOR, AND PENSIONS
UNITED STATES SENATE
ONE HUNDRED ELEVENTH CONGRESS
SECOND SESSION
ON
EXAMINING THE STATE OF AMERICAN CHILDREN, FOCUSING ON WHAT'S WORKING
FOR CONNECTICUT'S CHILDREN
__________
JULY 26, 2010 (New Haven, CT)
__________
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COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS
TOM HARKIN, Iowa, Chairman
CHRISTOPHER J. DODD, Connecticut MICHAEL B. ENZI, Wyoming
BARBARA A. MIKULSKI, Maryland JUDD GREGG, New Hampshire
JEFF BINGAMAN, New Mexico LAMAR ALEXANDER, Tennessee
PATTY MURRAY, Washington RICHARD BURR, North Carolina
JACK REED, Rhode Island JOHNNY ISAKSON, Georgia
BERNARD SANDERS (I), Vermont JOHN McCAIN, Arizona
ROBERT P. CASEY, JR., Pennsylvania ORRIN G. HATCH, Utah
KAY R. HAGAN, North Carolina LISA MURKOWSKI, Alaska
JEFF MERKLEY, Oregon TOM COBURN, M.D., Oklahoma
AL FRANKEN, Minnesota PAT ROBERTS, Kansas
MICHAEL F. BENNET, Colorado
CARTE P. GOODWIN, West Virginia
Daniel Smith, Staff Director
Pamela Smith, Deputy Staff Director
Frank Macchiarola, Republican Staff Director and Chief Counsel
______
Subcommittee on Children and Families
CHRISTOPHER J. DODD, Connecticut, Chairman
JEFF BINGAMAN, New Mexico LAMAR ALEXANDER, Tennessee
PATTY MURRAY, Washington JUDD GREGG, New Hampshire
JACK REED, Rhode Island JOHN McCAIN, Arizona
BERNARD SANDERS, (I) Vermont ORRIN G. HATCH, Utah
SHERROD BROWN, Ohio LISA MURKOWSKI, Alaska
ROBERT P. CASEY, Jr., Pennsylvania TOM COBURN, M.D., Oklahoma
KAY R. HAGAN, North Carolina PAT ROBERTS, Kansas
JEFF MERKLEY, Oregon MICHAEL B. ENZI, Wyoming (ex
TOM HARKIN, Iowa (ex officio) officio)
Tamar MagarikHaro, Staff Director
David P. Cleary, Minority Staff Director
(ii)
?
C O N T E N T S
__________
STATEMENTS
MONDAY, JULY 26, 2010
Page
Dodd, Hon. Christopher J., Chairman, Subcommittee on Children and
Families, opening statement.................................... 1
Zigler, Edward, Ph.D., Director Emeritus, Edward Zigler Center in
Child Development and Social Policy, Yale University, New
Haven, CT...................................................... 8
Prepared statement........................................... 11
Horan, James B., Executive Director, Connecticut Association for
Human Services, Hartford, CT................................... 12
Prepared statement........................................... 14
Lowell, Darcy, M.D., Executive Director, Child First CT,
Bridgeport Hospital, Bridgeport, CT............................ 17
Prepared statement........................................... 19
Keck, Douglas B., D.M.D., M.S.H.Ed., Connecticut State Leader,
AAPD Head Start Dental Home Initiative, Madison, CT............ 22
Prepared statement........................................... 23
Dolliver, Abby I., Superintendent, Norwich Public Schools,
Norwich, CT.................................................... 27
Prepared statement........................................... 29
Papa, Tammy, Director, Bridgeport Lighthouse, Bridgeport, CT..... 30
Prepared statement........................................... 32
Day, KellyAnn, Executive Director, New Haven Home Recovery,
Manchester, CT................................................. 34
Prepared statement........................................... 36
Edwards, Doug, Founder and Programs Director, Real Dads Forever,
Manchester, CT................................................. 41
Honigfeld, Lisa, Ph.D., Vice President for Health Initiatives,
Child Health and Development Institute of Connecticut, Inc.,
Farmington, CT................................................. 43
ADDITIONAL MATERIAL
Statements, articles, publications, letters, etc.:
Debra P. Hauser, Ph.D., M.S.W................................ 64
William B. Wickwire, Attorney................................ 69
(iii)
STATE OF THE AMERICAN CHILD: WHAT'S WORKING FOR CONNECTICUT'S CHILDREN
----------
MONDAY, JULY 26, 2010
U.S. Senate,
Subcommittee on Children and Families,
Committee on Health, Education, Labor, and Pensions,
New Haven, CT.
The subcommittee met, pursuant to notice, at 9:30 a.m. in
the Donald J. Cohen Auditorium, Yale Child Study Center, 230
South Frontage Road, Hon. Christopher J. Dodd, chairman of the
subcommittee, presiding.
Present: Senator Dodd.
Opening Statement of Senator Dodd
Senator Dodd. The committee will come to order. I guess I
have a gavel. That is what the gavel is here for.
Let me welcome all of you here this morning. I see a lot of
familiar faces and friendly faces out in the audience. I thank
you all for being here this morning to be a part of this series
of conversations we are having as the Health, Education, Labor,
and Pensions Committee, the Subcommittee on Children and
Families, which I have either chaired or been the ranking
member of, for over the last 25 or 30 years.
We have done a lot of work together with many of you in the
room on children's issues and family issues. And as I am
wrapping up the next 6 or 7 months of my seat in the U.S.
Senate, I thought it would be worthwhile to conduct a series of
hearings on the status of the American child and to look at
where we are today, what we have accomplished, and where we
need to go.
We have had hearings already, led off by Alma Powell,
General Colin Powell's wife, who has been very involved in
children's issues for a long time, along with others. We are
here today to talk about some solutions, things that
Connecticut has done well over the years, although we all
recognize we have a lot of work to do.
But I have always been very, very proud--a lot of the ideas
that I have championed over the years as the chairman of the
Subcommittee on Children and Families have come from this
State, come from this very building. In fact, people like Ed
Zigler, who have been just remarkable as a tutor and a guide
for me over the years in dealing with children's issues. I have
been very, very grateful to many others of you here today as
well. And so, I have utilized the experience in Connecticut to
try and help develop some national standards and ideas as well.
We will have a hearing later this week, Thursday, back in
Washington again, to start talking about national ideas and
solutions as well, with representatives from the major Cabinet
officers that are coming together. And it will be wrapping up
as well with some ideas on the establishment of a permanent
council on the status of children, much as we have done here in
Connecticut, along with the ideas of establishing something
along the lines of a report card on an annual basis so we have
a regular basis by which we have a structure in place to make
determinations as to how we are doing, sort of tracking this
without having to go back over and over, over the years.
I wanted to begin, I should have at the very outset here,
to express my condolences--and all of you, I am sure, will join
me in this--to remember the two firefighters in Bridgeport, by
the way, who lost their lives over the weekend--Lieutenant
Steven Velasquez and Michael Baik. They died while fighting a
fire in Bridgeport on Saturday, and I know all of us want to
express our condolences to their families and their brother and
sister firefighters in Bridgeport and around the country.
What they do every single day, a remarkable group of people
are firefighters. So I know all of us, we share in those
thoughts.
Let me start with some opening remarks. I will introduce
our panel, which is a very distinguished panel. I presume many
of you in the audience know the people at this panel as well as
I do and respect them immensely. But I wanted to share some
opening comments and thoughts, and then we will begin this
conversation about Connecticut and some solutions and ideas.
I would like to welcome all of you here this morning to our
second in a series of hearings on the state of the American
child. The first hearing, as I mentioned, in this series was
held in June in Washington, DC, and we were lucky enough to
have as our witness Elaine Zimmerman, with the Connecticut
Commission on Children. And I look forward to hearing from
additional Connecticut experts not only today, but in the weeks
coming.
It is fitting that we have come together at the Yale Child
Study Center, where so much good work has been done to
investigate the problems that children face and to discover
solutions to meet their needs.
I would also like to take a moment to thank Dr. Fred
Volkmar, the head of the Yale Child Study Center, for hosting
us this morning, and for all of the tremendous work he is doing
for children in this State and around the country.
I would also like to thank Dr. Robert Alpern, Dean of the
Yale School of Medicine, and President Rick Levin for their
hospitality as well.
I have had the privilege of working on many of the
different issues on behalf of the people of Connecticut for the
last 35 years. But as I have said before, the most rewarding
work, without any question whatsoever, that I have been
involved in has been issues affecting children and their
families.
And while it comes to helping each American child reach his
or her potential, a lot falls on the shoulders obviously of
parents, as I have come to learn as the father of a 5-year-old
and an 8-year-old over the last several years. I decided to
have my own grandchildren is what----
[Laughter.]
But as parents, we all recognize parents can't do it alone,
and the welfare of children in this country depends heavily on
having education, healthcare, and economic policies that give
families the resources and the support that they need.
We have learned a lot about what children need to succeed
during my time in the Congress, and I am proud of the progress
we have made in many areas. We have helped a generation of
young children prepare for school through the Head Start
program. We have worked to provide quality childcare facilities
and afterschool programs to ensure that learning can truly be a
lifelong pursuit, not just something that happens during the
school day.
We have freed millions of parents from having to choose
between the job they need and the sick children they want to
care for through the Family and Medical Leave Act. And we have
strengthened children's healthcare by reducing the number of
uninsured children through the CHIP and Medicaid programs,
preventing tobacco companies from treating our children as
customers-to-be, spreading awareness of food allergies, and
reducing premature births.
Most recently, as a result of a provision I worked closely
on in the Patient Protection and Affordable Healthcare Act, an
estimated 41 million American children and their families will
receive preventive care, such as routine immunizations, regular
pediatrician visits, and breast and colon cancer screenings at
no cost.
But the fact remains that too many children are left behind
at the starting gate through no fault of their own and through
no fault of their parents. And as the chairman of the Senate's
only body specifically focused on children and families, I have
embarked on a series of hearings to examine where we are
falling short and devise a strategy for improvement that can
endure even after I have left the Congress.
We have recently learned that, tragically, nearly one in
five American children live in poverty and that by the year
2012, it will be one in four, the highest rate since the 1960s.
Right here in Connecticut, one of the wealthiest States in our
country, 1 in 10 children grows up in poverty. In the city of
Hartford, nearly half of all children live below the poverty
line.
As we struggle to emerge from this devastating recession,
the economic gap between the haves and have-nots is only
growing. Even though Connecticut can rightly brag about its
above-average performance on standardized tests, we have one of
the country's highest achievement gaps as well. The two gaps
are, of course, related. One survey of kindergarten teachers
found that three in four children who couldn't go to preschool
arrived at kindergarten lacking basic language, literacy
skills, and basic fundamental math skills.
And while we have made great strides in keeping our
children healthy, Connecticut manifests many of the problems
with low birth weight and childhood obesity that plague our
Nation as a whole. And like many cities, our neighborhoods and
homes put children at higher risk for asthma.
In many ways, Connecticut is a good example of the problems
we face nationally. Even in a relatively well-off State, too
many children face overwhelming, even insurmountable,
disadvantages.
And while we need to identify and talk about the problems,
today I want to talk about solutions. I want to talk about what
we need to do to build a framework for evaluating the efficacy
of those solutions. Connecticut has lessons to teach the Nation
in that regard as well.
Today, we have convened a panel of experts from around our
State on different aspects of child development. We are going
to hear about programs helping families who have lost their
homes to foreclosure to find stable and affordable housing.
We will hear about an innovative program that works with
high-risk children and families to help avoid the incidence of
emotional disturbances, developmental problems, abuse, and
neglect.
And we will learn about collaborations between Connecticut
dentists and Head Start programs, initiatives for fathers, and
a program that provides children with safe and stable
environments after school and over summers. We will hear from a
school superintendent working to address the varied needs of a
low-income population in her city.
These programs have proven effective in our State. And if
we can take the lessons that these leaders have learned and
make them part of the national agenda and approach to
children's issues, then I think we can make a difference.
This is just a selection, obviously. There are many
brilliant and talented people who have done incredible work
over many, many years, working for our children. I want to
thank some of them who are here today.
Here at Yale, we have Dr. Walter Gilliam and Dr. Steve
Marans--have I pronounced that correctly?--creating and
evaluating innovative programs to prevent behavior problems in
very young children and address childhood trauma. Dr. Scott
Rivkees, who is doing tremendous work for children's health as
the director of the Yale Child Health Research Center.
Edith Karsky and the Connecticut Association for Community
Action are on the front lines working to prevent childhood
poverty. And Jeanne Milstein, my great friend, and the Office
of the Child Advocate, providing oversight and accountability
on behalf of our children as well.
We are constantly learning new things about children and
about what they need to reach their full potential. And we are
constantly adjusting our policies to try and meet those needs.
It is critical that we regularly and carefully examine the
progress of children in America, so that we can assess our
progress as policymakers as well.
That is why, at the very first hearing in this series, I
announced plans to introduce legislation to create a national
council, a permanent council on children to do just that. This
body would gather data, analyze trends, issue an annual report
on the state of the American child, and make policy
recommendations for improving child well-being. We need a
national and permanent body at the Federal level whose top
priority, whose only priority are children and their families,
improving their lives and looking at their needs in a
comprehensive manner.
It has been more than 20 years since the last comprehensive
report on the status of children. That report made a
significant contribution to the well-being of children and
their families.
In fact, I was going back and looking and just saw the
child tax credits, the SCHIP program, forerunner of the CHIP
program. There were many ideas that the Clinton administration
took from those recommendations, 1989 and forward, that became
the law of the land and made a difference in children's lives.
But it has been more than 20 years since we really had such a
commission established and thus the idea to establish a
permanent one.
On Thursday of this week, we will be back--this hearing
will be back in Washington for the next hearing in our series
on the state of the American child, which will look at the
impact of Federal policies on children. We will have witnesses
from the Departments of Labor, Health, and Education, as well
as an economist team from the White House. And I look forward
to taking the lessons we may learn from the innovative
Connecticut programs back down to Washington, to working with
my colleagues to turn those good ideas, I hope, into action.
So I thank all of you again for being with us here today.
Now let me briefly introduce our panel, and then I am going
to ask them in the order that I introduce you to share some
thoughts and comments with us. Then we will begin the
discussion on some of these ideas and thoughts you bring to the
table.
We have nine witnesses today, which is a lot of witnesses
at a hearing. But I am very grateful to all of them. It is a
big group, but everyone brings an important and unique
perspective to the topic of today's hearing.
I will briefly introduce each of you, but given the time
constraints, my comments will be rather brief. In introducing
you, I don't want to shortchange you in terms of your wonderful
contributions over the years. I will include the full
biographies in the Congressional Record. How is that?
[Laughter.]
After I complete the introductions, what I will ask you to
do is if you can each take 3 to 5, or 6 minutes or so--I am not
going to gavel anyone down--to share your thoughts. Your full
comments, any supporting data, and many of you included data
with your testimony, I will make a part of the permanent record
as well for the hearing room.
That way, we can get to the Q and A and the conversation
with ourselves, and we may invite the audience as well to raise
some questions and thoughts as we go forward. Not something we
normally do with a congressional hearing, but this was sort of
a different type of a setting anyway for us to be conducting
this along the way.
We will keep the record open for 10 days, 2 weeks. I will
make it 2 weeks. My other colleagues on the committee may have
some questions as well to submit to people, and I ask you to
respond to them.
Dr. Ed Zigler, my good friend, Director Emeritus, Edward
Zigler Center in Child Development and Social Policy at Yale,
has been involved in early children issues for decades, as all
of us in this room, I hope, are aware. And we all owe him a
tremendous debt of gratitude for the incredible work that he
has done on behalf of America's children.
Dr. Zigler's work has improved the lives of innumerable
families, and we are honored to have you once again, Ed, with
us here today to talk about childhood development and preparing
children for school and success in life and the solutions he
has implemented, beginning with Head Start, Early Head Start,
whole school reform, and many other efforts over the years.
Jim Horan is the executive director of the Connecticut
Association for Human Services in Hartford, CT. Jim is here to
talk about child poverty and the solutions he has fought for as
executive director of the Connecticut Association for Human
Services to end child poverty, as well as to work as an Annie
E. Casey KIDS COUNT grantee.
Jim has led the effort to better connect low-income working
families with the services. And I was pleased to join him last
March at one of the free tax preparation clinics that the
Association for Human Services conducted, enabling parents to
claim the earned income and child tax credits.
Dr. Darcy Lowell is the executive director of Child FIRST
Connecticut of Bridgeport Hospital, which I had the privilege
of visiting--where are you? There you are, over there. Visited
not long ago. I spent an afternoon at the hospital, a great
facility.
She is here to talk about preventing mental illness,
developmental learning problems among kids, as well as child
abuse and neglect and the solutions she has proven effective
with Child FIRST, a model program in Bridgeport that brings
pediatricians, teachers, and other community leaders together.
And we thank you for your work as well.
Dr. Doug Keck is with the American Academy of Pediatric
Dentistry's Head Start Dental Home Initiative in Madison, CT.
Dr. Keck is here to talk about the oral health among low-income
children and the solutions he is part of by leading
Connecticut's Dental Home Initiative for children enrolled in
Head Start.
This innovative program aims to develop a Connecticut
network of pediatric dentists to provide quality dental homes
for Head Start, Early Head Start children and train teams of
dentists in optimal oral healthcare practices. He also serves
on the clinical teaching staff at the Yale-New Haven Hospital
and the Yale School of Medicine.
Abby Dolliver is the newly appointed superintendent of the
Norwich Public Schools, Norwich, CT. And she is here to
highlight the programs that meet the academic, physical, and
social needs of the students in her district. I might point out
Abby is, truth-in-advertising, the daughter of my long-term
person around my office, Stanley Israelite. And in
Connecticut--for those who know Stanley, and Abby is the
superintendent of schools in Norwich today.
I lived in Norwich for a number of years, as my parents did
as well, in a town of around 40,000 people, and you have all of
the complex issues of a major urban area. And Abby will talk
about what it is to grapple as a superintendent of schools
today with all of the issues that are identified here and
trying to see that they get the proper education of how
important that school setting is.
Before accepting the position of superintendent, Abby
worked as a special education director, creating programs for
students on the autism spectrum. Her understanding of the
importance of developing the whole child stem from her work as
a social worker for some 13 years prior to that as well.
Tammy Papa is the director of the Bridgeport Lighthouse
Program. I have worked for many years with this program. Talk
about afterschool education and the solutions that she has
discovered through the Lighthouse Program. She has been
actively involved in planning and implementing afterschool
programs for 17 years and has done a remarkable job. Her
dedication to the issue was acknowledged in 2005 when she was
awarded the Children's Champion Award from the Connecticut
After School Network. She also acts as an appointee member of
the Connecticut After School Advisory Committee and co-chairs
the Bridgeport After School Network.
Kellyann Day is the executive director of the New Haven
Home Recovery in New Haven, CT, here in the city. She is here
to talk about child homelessness and the solutions she has
worked on with New Haven Home Recovery. She has worked with
homeless children and families for 20 years, giving her key
insights into what works and what doesn't. And again, when you
read or hear her testimony today, the statistics are just
daunting when it comes to the issue of what happens to children
who are homeless.
She has served on numerous boards throughout the State,
including New Haven Early Childhood Council, the Connected
Coalition to End Homelessness, New Haven Mayor's Task Force on
AIDS, South Central Behavioral Health Network, the city of New
Haven's 10-Year Plan to End Homelessness, and many others.
Doug Edwards is the founder and program director of Real
Dads Forever, Manchester, CT. This program teaches fathers the
importance of home environment in child development and
challenges them to examine their commitments to their families,
themselves, and their personal success. He has consulted with
Connecticut's Department of Social Services, Department of
Education, Department of Children and Families, the Department
of Public Health, and many other organizations. And we thank
him.
Dr. Lisa Honigfeld--did I pronounce that correctly?
Ms. Honigfeld. Yes, you did.
Senator Dodd [continuing]. Is the vice president for Health
Initiatives for the Child Health and Development Institute of
Connecticut, CHDI, in Farmington, CT. She oversees CHDI's
efforts to strengthen the quality and accessibility of primary
and preventive healthcare for children and families. In
addition to numerous positions in health services research and
pediatric primary care, Dr. Honigfeld also has a faculty
appointment at the University of Connecticut School of
Medicine.
Well, that was a lot to go through with all of you here.
And as I said, that is the abbreviated version of their
resumes. I spared you.
[Laughter.]
I mentioned earlier, just going back, and I kept a note on
this. But just looking at some of the stuff that happened on
that earlier commission on children that started in 1987,
didn't get underway until 1989, was charged with assessing the
status of children and families. And from that blueprint, the
Clinton administration enacted policies including the earned
income tax credit, the child tax credit, the State Children's
Health Insurance Program, and many others. Out of all that,
came one blueprint. So it was very, very valuable that that
worked some 20 years ago.
Well, again, I thank all of you for being here. Ed, we will
begin with you and your thoughts and comments. Then we will
move down in the order that I have introduced people, and then
we will start the conversation.
Ed, thank you. You are going to have to pull this closer.
STATEMENT OF EDWARD ZIGLER, Ph.D., DIRECTOR EMERITUS, EDWARD
ZIGLER CENTER IN CHILD DEVELOPMENT AND SOCIAL POLICY, YALE
UNIVERSITY, NEW HAVEN, CT
Mr. Zigler. Thank you, Senator.
On behalf of all my colleagues at Yale, allow me to welcome
you to Yale. I want to take 10 seconds of personal privilege
and speaking not to you, but rather to your constituents here
in the audience.
I know many of you, and as many of you know, I have worked
in some capacity as a consultant to every administration since
that of Lyndon Johnson. Over that 45-year period, I have
witnessed a great number of Senators and members of the House,
and I would just like to state for the record that in my own
lifetime, I have never met a Congressperson who has been a more
effective, active, and dedicated advocate for children and
families than our own Senator Dodd, and I would like to
congratulate him on that record.
Senator Dodd. Thank you.
[Applause.]
Mr. Zigler. Now let me put on my professorial hat. I have
been studying human development now for 55 years, and I have
come to the conclusion that there are four major systems, all
in interaction, so they are synergistic, four systems that are
the primary determinants of the child's growth and development.
The first, and by far the most important, is the family.
Then there is the health system, then the education system the
child experiences, and finally, the childcare, where the
majority of children spend the first 5 years of their life
prior to school entry.
The family today is experiencing so much stress that it has
difficulty in performing its primary child-rearing
responsibilities. Thanks to Federal legislation like SCHIP, the
health system has improved for children but is still far from
perfect.
We have known that the education system in this country is
far from excellent ever since the publication many years ago of
``The Nation at Risk.'' Our Nation's non-childcare system
actually harms millions of children, as I documented in my
recent book, ``The Tragedy of Childcare in America.''
This morning, I would like to acquaint you with a whole
school reform model that my colleague Matia Finn-Stevenson and
I have now successfully put into place in this country. These
new schools have been named Schools of the 21st Century.
However, the 60 schools in Connecticut, mounted originally
through the efforts of John Larson, and the statewide system of
schools in Kentucky are called Family Resource Centers.
The purpose of these schools was to positively impact each
and every one of the four systems that we know largely
determine the child's development. Given my long involvement
with our Nation's groundbreaking Head Start program,
unsurprisingly, the theoretical principles underlying the 21C
school model are similar to those of Head Start. The schools
adopt a whole child approach through which we attempt to
positively impact the child's cognitive development, social-
emotional development, and the child's mental and physical
health.
Thus, like Head Start, our schools provide comprehensive
services that go far beyond the standard provision of academic-
focused education alone. Like Head Start, parents are viewed as
the most important determinant of their children's growth, and
parents are deeply and actively involved in each and every
School of the 21st Century and Family Resource Center. This
aspect of Schools of the 21st Century is very similar to that
of the very successful Child-Parent Centers now to be found
throughout the city of Chicago.
A particularly innovative aspect of 21C schools is that the
child is enrolled in the neighborhood school as close to the
child's conception as possible and no later than birth. Upon
the birth of the child, the school sends a home visitor to the
home, and these home visits continue for 3 years and employ the
parents-as-teachers home visiting model, which has been
implemented in every school in the State of Missouri.
These home visits focus on the parents' knowledge of human
development, as well as in motivating parents to become as an
effective first teacher of the child as possible. At the age of
3, the child physically begins attending school in a high-
quality, 2-year preschool program rather than the 1-year
preschool program that has become so commonplace in our Nation.
The preschool day is as long as the work day of mothers and
fathers, rather than the usual half-day program or school day
program, which usually ends around 2:30 p.m. or 3 p.m. Thus,
one of our schools in Bridgeport is actually called the ``6 to
6'' school. This allows children to receive both preschool and
afterschool care.
Thus, our preschools provide not only preschool education,
but childcare as well. This before and afterschool care
continues in the school until the child is approximately 12
years of age. Each school also mounts a health education
component for parents and health services for children, which
include improved nutrition practices.
Many of the children in the schools' catchment area are
attending private childcare. Our schools are aware that these
children will eventually come to the school at age 5. Thus, the
schools provide outreach and training to these independent
childcare centers, thus improving the childcare experience of
these non-school enrolled children.
Our schools also act as brokers for human services that
already exist in the community. Thus, each school is also a
resource and referral center in order to satisfy the other
needs that the school's families have.
From age 3 to age 12, 21C parents have the childcare they
need for their children. This should reduce the stress that
parents experience in dealing with the childcare problem, and
our research shows that it does reduce stress in parents.
Research clearly indicates that the more parents are
involved in their children's education, the better the child's
educational performance. Like Head Start, parent involvement is
a basic pillar of the Schools of the 21st Century. This model
has grown exponentially since its introduction some 20 years
ago.
It began originally in Independence, MO, with two schools.
Thanks to John Larson, we began with three schools here in
Connecticut, and we now have 60 in this State. Interestingly,
when Governor Rell recently wanted to cut Family Resource
Centers from the budget, parents of these schools rose up and
demanded that the Family Resource Centers continue, and that is
now the case.
These schools can now be found in over 20 States. This
model has now been embraced by over 1,300 schools, making it
the largest whole school reform model in America.
The primary catalyst for this program has been parents
themselves. Once they become aware of a School of the 21st
Century in the next district, they demand to have one in their
own district. Kentucky has now gone statewide with this model,
and Arkansas is also moving to a statewide program, having
already put into place over 160 21C schools.
I am both a pragmatist and empiricist and a strong believer
in accountability. Thus, from its inception, we have included a
strong evaluation component into the Schools of the 21st
Century.
The evidence of the value of these schools is contained in
a series of positive findings associated with them. In addition
to lower stress levels, we have found much less vandalism in
our schools, and studies conducted both in Missouri and
Arkansas showed students in 21C schools had superior
performance across a broad array of academic abilities than did
the comparison children.
For example, in the Independence School District of fourth
grade students, over 70 percent of them had proficient scores
or better on literacy tests, whereas the national average in
this entire country is only about 33 percent.
In a recent unpublished study, we found that child abuse in
the Independence district was reduced by two-thirds in
comparison with another comparable school district in Missouri.
Since child abuse is primarily a stress phenomenon, stress
impinging on parents, this is not surprising since we
discovered much earlier that 21C schools reduce the stress
level of parents.
I conclude my testimony with a single recommendation. The
Department of Education of this country should spend some of
its school reform funds in bringing the 21C model to the
attention of the Nation and provide grants to schools to
provide the seed money necessary for startup activities.
I will conclude my testimony where I began. I would like to
express to Senator Dodd my own personal deep gratification at
having the opportunity to work closely with him and see all of
his accomplishments over several decades.
Thank you.
[The prepared statement of Mr. Zigler follows:]
Prepared Statement of Edward Zigler, Ph.D.
There are four major synergistic systems that are the primary
determinants of the child's development. The first and most important
is the family. Then there is the health system, the education system
the child experiences and finally child care where the majority of
children spend the first 5 years of their life prior to school entry.
The family today is experiencing so much stress that it has difficulty
in performing its primary child rearing responsibilities. Thanks to
Federal legislation the health system has improved for children but is
still far from perfect. We have known that the education system is far
from excellent ever since the publication of The Nation at Risk. Our
Nation's non-child care system actually harms millions of children as I
documented in my recent book The Tragedy of Child Care in America.
This morning I would like to acquaint you with a whole school
reform model that my colleague Matia Finn-Stevenson and I have now
successfully put into place in this country. These new schools have
been named Schools of the 21st Century. However the 60 schools in CT
(mounted originally through the efforts of John Larson) and the
statewide system of schools in KY are called Family Resource Centers.
The purpose of these schools was to positively impact each and every
one of the four systems that we know largely determines the child's
development.
Given my long involvement with our Nation's groundbreaking Head
Start program, unsurprisingly the theoretical principles underlying the
21C school model are similar to those of Head Start. The schools adopt
a whole child approach in which we attempt to positively impact the
child's cognitive development, social emotional development and the
child's mental and physical health. Thus like Head Start our schools
provide comprehensive services that go far beyond the standard
provision of academic-focused education only. Like Head Start, parents
are viewed as the most important determinant of their children's growth
and parents are deeply and actively involved in each and every School
of the 21st Century. This aspect of Schools of the 21st Century is very
similar to that of the very successful Child Parent Centers in the city
of Chicago.
A particularly innovative aspect of 21C schools is that the child
is enrolled in the neighborhood school as close to the child's
conception as possible and no later than birth. Upon the birth of the
child the school sends a home visitor to the home and these home visits
continue for 3 years and employ the Parents As Teachers home visiting
model which has been implemented in every school in the State of
Missouri. These home visits focus on the parents' knowledge of human
development as well as motivating parents to become an effective first
teacher of the child as possible.
At the age of 3 the child physically begins attending school in a
high quality, 2-year preschool program rather than the 1-year preschool
program that has become so common place in our Nation. The preschool
day is as long as the work day of mothers and fathers rather than the
usual half-day program or school-day program which usually ends around
2:30 p.m. or 3 p.m. Thus one of our schools in Bridgeport is actually
called the ``6 to 6'' school. This allows children to receive both
preschool and afterschool care. Thus our preschools provide not only
preschool education but child care as well. This before and afterschool
care continues in the school until the child is approximately 12 years
of age. Each school also mounts a health education component for
parents and health services for children which include improved
nutrition practices. Many of the children in the schools catchment area
are attending private child care. Our schools are aware that these
children will eventually come to the school at age 5. Thus the schools
provide outreach and training to these independent child care centers
thus improving the child care experience of these non-school enrolled
children.
Our schools also act as brokers for human resources that already
exist in the community. Thus each school is also a resource and
referral center in order to satisfy the other needs that the school's
families have. From age 3 to age 12 the 21C parents have the child care
they need for their children. This should reduce the stress that
parents experience in dealing with the child care issue and our
research shows that it does. Research clearly indicates that the more
parents are involved in their children's education the better the
child's educational performance. Like Head Start parent involvement is
a basic pillar of Schools of the 21st Century.
This model has grown expedientially since its introduction some 20
years ago. It began originally in Independence, MO with 2 schools.
Thanks to John Larson we began with 3 schools here in CT and we now
have 60. Interestingly when Governor Rell recently wanted to cut Family
Resource Centers from the budget, parents rose up and demanded that the
Family Resource Centers continue and that is now the case. These
schools can now be found in over 20 States. This model has now been
embraced by over 1,300 schools making it the largest whole school
reform model in the Nation. The primary catalyst for this program has
been parents themselves. Once they become aware of the Schools of the
21st Century in the next district they demand to have one of their own.
Kentucky has now gone statewide with this model and Arkansas is also
moving to a statewide program, having already put into place over 160
21C schools.
I am both a pragmatist and empiricist and a strong believer in
accountability. Thus from its inception we have included a strong
evaluation component into the Schools of the 21st Century. The evidence
of the value of these schools is contained in a series of positive
findings associated with these schools. In addition to lower stress
levels, we have found much less vandalism in our schools and studies
conducted both in MO and AK showed students in 21C schools had superior
performance across a broad array of academic abilities than did the
comparison children. For example in the Independence school district,
4th grade students over 70 percent had proficient scores or above
whereas the national average is about 33 percent. In a recent
unpublished study we found that child abuse in the Independence
district was reduced by two-thirds in comparison with another
comparable school district in MO. Since child abuse is primarily a
stress phenomenon this is not surprising since we discovered much
earlier that 21C schools reduce the stress level of parents. I conclude
my testimony with a single recommendation. The Department of Education
should spend some of its school reform funds in bringing the 21C model
to the attention of the Nation and provide grants to schools to provide
the seed money necessary for startup activities.
Senator Dodd. Thank you, Ed, very, very much.
[Applause.]
Jim Horan. Jim.
STATEMENT OF JAMES P. HORAN, EXECUTIVE DIRECTOR, CONNECTICUT
ASSOCIATION FOR HUMAN SERVICES, HARTFORD, CT
Mr. Horan. Good morning, Senator Dodd and distinguished
guests. Thank you for the opportunity to testify on the state
of the American child.
I am the executive director of the Connecticut Association
for Human Services. This year, CAHS celebrates 100 years of
advocacy to improve the lives of children and families in
Connecticut, with a focus on policies and programs that create
family economic success. I will summarize the written testimony
that I have submitted.
First, thank you, Senator Dodd, for championing big-picture
issues like healthcare and financial reform and issues that
directly affect kids, like Head Start and Childcare and
Development Block Grants. We will really miss your leadership.
Second, I want to emphasize the importance of timely,
accurate data. As the Annie E. Casey Foundation's KIDS COUNT
grantee, we know how important this is and what is now lacking.
Thank you for sponsoring legislation to expand the National
Survey of Children's Health and the Measuring American Poverty
Act.
The Casey Foundation releases the National KIDS COUNT Data
Book tomorrow. It includes data up until 2008, and it shows
that improvements in the condition of children that began in
the late 1990s stalled even before the current recession began.
Three data points on the current state of children in
Connecticut. Child poverty was rising before the recession,
from 10.5 percent in 2004 to 12.5 percent in 2008. That is
despite Connecticut having the Nation's first child poverty
target.
We know what to do to reduce poverty, including modeling
that was done by the Urban Institute of top recommendations of
the State's Child Poverty and Prevention Council. But the
Governor and the legislature never made the necessary
investments to reduce poverty.
On education, only 40 percent of Connecticut fourth graders
are reading proficient, according to NAEP scores. That is the
second-best in the Nation, but we need to raise proficiency for
all kids. Connecticut is making modest progress in reducing the
huge achievement gap between whites and kids of color, but it
is not good enough.
The news is better on health, where SCHIP--HUSKY in
Connecticut--has reduced the percentage of uninsured kids to
just 5.4 percent, about half the level for adults. And this
trend should continue with the passage of CHIP reauthorization;
national health reform, which you led efforts on; and universal
healthcare legislation in Connecticut.
Given the recession and indicators that are moving in the
wrong direction, what do we do now? At the Federal level, we
urge you to help extend Federal earned income tax credit, SNAP,
and FMAP; reauthorize the Child Nutrition Act; focus on job
creation. These investments will pay off.
In Connecticut, with a new Governor after November, we will
try again to create a State earned income tax credit to reward
low-wage work. On education, CAHS will soon release a report on
reading success in the early grades, and we are working to
expand the State's successful School Readiness program and to
create a true system of early care and education in
Connecticut.
We have created a New England consortium to reduce child
and family poverty, working with our colleagues, and child
advocates across the region to advocate for change at the
Federal level. Since the recession began, CAHS has stepped up
efforts to improve access to the Federal earned income tax
credit, like the VITA site you visited in Bridgeport last year;
food stamps, now called SNAP; and other benefits.
We use an electronic screening tool called EarnBenefits
Online and work with partners and communities across the State.
Last year, we started the Connecticut Money School, the
country's second statewide financial education project with
potential to become a national model. Information on all of
these efforts is on our Web site, www.cahs.org.
Good results can come about if we all work together and
engage those most affected by poverty and poor-quality
education. We need the political will to make the changes that
data and evaluation demonstrate will work.
You mentioned, Senator Dodd, that we are headed for the
highest child poverty rate since the 1960s. Poverty rates at
that time led to President Johnson creating the war on poverty.
Poverty at that time in that year had decreased by 50 percent
nationally. And even though the war on poverty is often
considered a failure, in fact, many of the gains that we made
at that time have been sustained.
You mentioned the council in the late 1980s and the
recommendations that the Clinton administration helped to
implement. There was a 25 percent reduction in child poverty
during the 1990s. But those gains have not been sustained. We
need a focused effort like the one you are talking about to
help make good things happen, and we appreciate your
leadership.
[The prepared statement of Mr. Horan follows:]
Prepared Statement of James P. Horan
Good morning, Senator Dodd. I am Jim Horan, executive director of
the Connecticut Association for Human Services. Thank you for the
opportunity to testify at the second hearing in this series on the
State of the American Child. This year, CAHS celebrates 100 years of
advocacy to improve the lives of children and families in Connecticut,
with a focus on policies and programs that create family economic
success.
CAHS and other child advocates have long admired and appreciated
your leadership in the Senate not only on financial and health reform,
but on issues directly affecting children, including Head Start, Child
Care and Development Block Grants, and Family and Medical Leave.
You have been a champion on children's issues throughout your
distinguished tenure in the Senate, and these hearings help lay the
groundwork for continued progress on issues critical to children,
including the potential for a national Commission on Children, even
after you leave the Senate. Connecticut's Commission on Children has
done such important work over the past 20 years.
As the Annie E. Casey Foundation's KIDS COUNT grantee in
Connecticut, CAHS gathers and releases data on child and family well-
being to inform policymakers and our own advocacy work at the State
Capitol in Hartford and in Washington. Therefore, CAHS understands the
importance of timely, accurate data. We thank you, Senator Dodd, for
your current sponsorship of legislation to expand the National Survey
of Children's Health, and your lead sponsorship of the Measuring
American Poverty (MAP) Act. We are very pleased that the Obama
administration is working to address the latter issue with the
Supplemental Poverty Measure (SPM).
The most recent available data is outdated. Right now, that means
that we lack current data on the impact of the recession on children
and families. Patrick T. McCarthy, president and CEO of the Casey
Foundation, recently noted:
``the reality is that we can only go so far without needed
improvements to our data collection systems. None of us has a
good grasp on the conditions facing America's children because
State and Federal agencies collect data too infrequently, and
often do not measure what really matters for kids.''
The Casey Foundation will release the national Kids Count data book
tomorrow. The most recent data available, from 2008, shows child
poverty rising both nationally and in Connecticut. Overall improvements
in child well-being that began in the late 1990s stalled in the years
before the current recession began, both nationally and in our State.
Of course, the statewide picture of Connecticut does not tell the
full story. Often, Connecticut looks better than other States in
national rankings on the well-being of children. But when data is
disaggregated by community and by race, it is clear that kids in
Connecticut of color and in our larger cities fare poorly. That is why
it is important to increase the sample size of the American Community
Survey (ACS), to provide more precise data for urban neighborhoods, as
well as rural communities.
I would briefly like to look at data trends in three areas, to show
what is happening to children in Connecticut, including areas where
government actions are helping, and where they were failing to do so,
even before the recession began.
Poverty in Connecticut was rising before the deep economic
downturn. The child poverty rate was basically flat from 2000 to 2004,
and then rose from 10.5 percent to 12.5 percent in 2008. This is
especially disappointing since following the passage in 2004 of a State
target to reduce child poverty in half, by 2014. This legislation, the
first in the Nation, created good recommendations but practically no
investment from the Governor and legislature. The increase of 13,000
kids in poverty will rise with the recession, as many parents have lost
their jobs. And as previously noted, the relatively low rate of child
poverty statewide masks the disturbing rates of child poverty in many
urban communities. Hartford's child poverty rate of 46 percent in 2008
is among the highest of any city in the Nation, an increase from 41
percent in the 2000 census.
In Education in 2009, Connecticut had the second highest
level of fourth grade reading proficiency in the Nation, behind only
Massachusetts, according to the National Assessment of Educational
Progress (NAEP). Despite the high national ranking, only 40 percent of
Connecticut fourth graders were proficient, compared to 32 percent
nationally, showing how poorly Connecticut and all States are doing.
And again, the data is worse when disaggregated. NAEP data show 53
percent of White Connecticut fourth graders were proficient readers,
compared to 22 percent of Blacks and 15 percent of Hispanics. A small
piece of good news in these distressing data is that the gap between
Black and White students narrowed in recent years, due to gains by
Black students between 2003 and 2009.
On Health, there is encouraging news that despite the
decline in insurance provided by employers, the number of uninsured
kids in Connecticut declined in recent years because of HUSKY, the
State Children's Health Insurance Program. More kids were covered in
2009 than in 2003, and only 5.4 percent were uninsured, about half the
rate of adults. The positive trends on children's health should
continue, with the reauthorization of CHIP last year, and the passage
of national health reform that you helped to shepherd through Congress
earlier this year, Senator Dodd. Connecticut's passage of universal
health care legislation in 2009 puts the State in a very good position
for implementation of Federal health reform.
While the news is positive on health care, a lot more needs to be
done to reduce poverty and improve education for children in our Nation
and State. These are critical factors for children that underlie many
other indicators, and affect them throughout their lives. We know what
needs to be done to create better outcomes for children and families.
We just need the political will and leadership to make it happen, in
Washington, in Hartford, and in our communities.
With the indicators headed in the wrong direction, poverty is the
toughest nut to crack. The American Recovery and Reinvestment Act
(ARRA, the stimulus) stopped the recession from deepening. It also
expanded SNAP (formerly food stamps) and the EITC, expansions that
should be made permanent. While ARRA prevented the loss of millions of
jobs, it has not yet resulted in the creation of many new jobs to
replace those lost. This is crucial for poverty reduction. Congress
must have the courage to continue stimulus measures, including
additional FMAP Medicaid funding for States to avoid a $265 million in
the current Connecticut budget. And new stimulus funding is needed for
schools, to prevent significant local teacher layoffs, like those we're
seeing in New Britain and towns across Connecticut. Pending
reauthorization of the Child Nutrition Act, with more money for
healthier school meals and after-school programs, will also help.
On education, Race to the Top prompted State education reform
legislation this past year. More needs to be done, especially to close
the achievement gap between whites and kids of color. Action is needed
not only to ensure that every child achieves his or her full potential,
but also so that Connecticut and the United States can compete in the
global economy with a highly-educated workforce.
At CAHS, in partnership with our funders and other nonprofit
organizations, we're taking action to improve the well-being of kids,
with some positive results. To reduce child poverty, CAHS led efforts
in 2006 and 2007 to create a State Earned Income Tax Credit, modeled on
the very successful Federal EITC. This was a top recommendation of the
Connecticut Child Poverty and Prevention Council, but Gov. Rell vetoed
it twice. In 2008, CAHS was launching a broad-based ``Opportunity and
Prosperity Campaign.'' As the economy tanked, that no longer seemed
viable. CAHS shifted gears to expand our Federal EITC and SNAP
(formerly food stamps) outreach. Earlier this year, we launched
EarnBenefits Online, a screening program that can complete applications
for up to 13 State and Federal benefits, including SNAP, HUSKY, and the
EITC. We are working with 13 community partners in five cities, with
support from six foundations, using a tool developed by Seedco, a New
York-based nonprofit.
Last year, CAHS started the Connecticut Money School, which offers
financial education classes. This partnership with the United Way of
Connecticut and nonprofits in our three largest cities is only the
second statewide financial education project, and a potential national
model. CAHS also started a multi-faceted family economic success
program in Bridgeport with the support of the local United Way and
banks.
On education, our primary focus is to close the achievement gap
while raising the performance of all students, from early childhood
through post-secondary. With support from the Graustein Memorial Fund,
CAHS is working with advocates including the Connecticut Early
Childhood Alliance, Connecticut Voices for Children, and Connecticut
Parent Power, to regain Connecticut's former status as a national
leader. New investments are needed, especially to expand the State's
successful School Readiness program to more children in low-income
communities, and to create a true system of early childhood education.
CAHS has a forthcoming report with recommendations on how to help all
students become reading proficient by the end of third grade. This is a
major focus of the Annie E. Casey Foundation, which is partnering with
philanthropies across the country, including the Graustein Memorial
Fund in Connecticut. And last year, CAHS published a report on
strengthening the role of Connecticut's community colleges in educating
adult workers--because kids need parents who earn wages that can
support their families.
This work is not enough to reverse negative trends for kids in our
State and country. Continued leadership at the Federal level is
critical. Most recently, CAHS has teamed up with Connecticut Voices for
Children and our Kids Count and Voices for America's Children
counterparts across the region to create the New England Consortium to
reduce child and family poverty. We're working together on data, policy
solutions in our States, and an emerging Federal agenda. With our
strong regional congressional delegation, we think this may be where we
can make the greatest difference, and create a model for advocates
nationally. You can check out our collective work at
www.endpovertynewengland.org. We are moving beyond strengthening the
safety net to creating real pathways to opportunity for children and
their families.
The State of the American Child in 2010 is fragile and
unacceptable. But there are actions the Federal Government can take, as
it has done in the past and is doing now on health care, to improve
child well-being, especially with regard to poverty and education. And
there is a role for all of us--in State and local government,
nonprofits, education, as parents and community leaders. We need to
engage everyone, especially those most effected by the negative
consequences of poverty and poor quality education, to make the
necessary changes. Maintaining the status quo has serious negative
consequences for these children and for the economy. As Harry Holzer
and his colleagues at Georgetown University and the Urban Institute has
written, child poverty has lifelong impacts on workforce productivity,
crime, health, and ultimately on our Gross Domestic Product.
The challenges to improving child well-being seem daunting,
especially in the midst of the Nation's most serious economic downturn
since the recession. But the economy will recover, and we need to
ensure that everyone will share in it. Working together, with good data
and a clear focus on improving the future for our children, we can
adopt policies and make investments that ensure that our country's
brightest days are ahead of us.
Thank you for holding this hearing, Senator Dodd, and inviting CAHS
to testify. We look forward to continuing to work with you on this
important initiative.
FPL is Federal Poverty Level. Data for 2000 are from the Decennial
Census, Summary File 3, Table P87, Poverty Status in 1999 by Age. Data
from 2002 are from the American Community Survey (ACS), Table P114,
Poverty Status in the Past 12 Months by Sex and Age. Data for 2004,
2006, 2008 are from ACS, Table B17001, Poverty Status in the Past 12
Months by Sex and Age.
Senator Dodd. Thanks, Jim, very, very much.
[Applause.]
Dr. Lowell.
STATEMENT OF DARCY LOWELL, M.D., EXECUTIVE DIRECTOR, CHILD
FIRST CT, BRIDGEPORT HOSPITAL, BRIDGEPORT, CT
Dr. Lowell. Good morning.
Senator Dodd and esteemed colleagues, I am extremely
honored to be here testifying today. Senator Dodd, I want to
thank you for all of the hard work you have done on behalf of
children and families. It has made an incredible difference,
and we will sorely miss you.
I am a developmental behavioral pediatrician. My name is
Dr. Darcy Lowell. I am an associate clinical professor here at
Yale School of Medicine and the executive director of Child
FIRST Connecticut. I have been working with young children and
families for over 25 years in this State.
I have been asked to focus my testimony on our work of
Child FIRST, which is a new and innovative model and an
approach to the extreme challenges that our children and
families are facing today.
Child FIRST specifically targets the most vulnerable young
children and families, prenatally through age 5 years, and
these are children who have early behavioral and developmental
problems. And we target the highest-risk families who suffer
from maternal depression, substance use, domestic violence,
poverty, homelessness, among many other risks. Our goal is to
prevent emotional and behavioral problems, developmental and
learning disabilities, and abuse and neglect.
We identify children at the earliest possible time, both
through formal screening as well as through referrals from over
70 agencies in the greater Bridgeport area because of the
strength of our collaborative process. Especially, when they
come from pediatrics, from early care and education, from the
schools, and from our Department of Children and Families.
We then provide a home visiting intervention to the child
and entire family with an expert clinical team. Our approach is
based on the most current scientific research on brain
development, which has made it very clear that extreme stresses
in the environment are toxic to the architecture of the
developing brain. They cause damage that result in not just
short-term, but long-term impairment in mental health, in
learning, cognition, and in physical health as well. This does
not go away.
Therefore, our intervention takes a two-pronged approach.
No. 1, we connect families with comprehensive, well-
coordinated, community-based services and supports, using all
the rich kinds of services we have in our communities already.
This system of care approach directly decreases the
environmental stress and provides the growth-promoting
experiences for young children.
So we get parents, if they need it, substance abuse
treatment. If they need to find new homes, if they need job
training, that is the kind of thing we get the parents. And for
children, we will get them involved, of course, in early care
and education, so critical, but in special ed services or
birth-to-3 services, as necessary.
And then, No. 2, we provide parent-child therapeutic
intervention to promote a nurturing, responsive parent-child
relationship. The important thing is that this relationship has
been documented to buffer or protect the developing brain from
what Jack Shonkoff terms ``toxic stress'' and promotes strong
social, emotional, and cognitive development.
Furthermore, our team also works in early care and
education and the schools. So we take a very comprehensive
approach. Now, how do we know this works? We have been working
on this model for over 10 years, and we have conducted a
randomized control trial, which is the gold standard for
scientific research.
We have 12-month outcomes that have demonstrated that Child
FIRST children had a very significant decrease in aggressive
and defiant behaviors and improvement in language development.
Mothers reported significantly less stress, depression, and
anxiety. There was a significant decrease in referral to DCF
for child protective services, and the Child FIRST intervention
families were able to access 91 percent of desired services, as
opposed to 33 percent in our usual care controls. These
outcomes will significantly contribute to closing our
achievement gap.
Based on the strength of this research, the Robert Wood
Johnson Foundation has provided $3.2 million toward funding a
public-private partnership with Connecticut State government
and philanthropy to replicate the Child FIRST model. We are now
in five cities across Connecticut, including some of our most
challenged--Hartford, New Haven, Waterbury, and Norwalk.
From a cost-benefit perspective, if we just compare the
cost of Child FIRST services for a single family, which is
$5,000 to $6,000, with the cost for psychiatric hospitalization
for a single child for a year, which is well over $700,000, our
return on investment is very clear. Child FIRST is a very
promising, evidence-based model that can address ethnic,
racial, and socionomic disparities with a goal of closing the
achievement gap.
We have the knowledge. We must now develop the will to
restructure systems and target our resources so that our most
vulnerable children and families can succeed.
Thank you so much.
[The prepared statement of Dr. Lowell follows:]
Prepared Statement of Darcy Lowell, M.D.
Senator Dodd and esteemed colleagues, I am extremely honored to be
testifying today on efforts to improve the lives of the most vulnerable
young children and their families in Connecticut. My name is Dr. Darcy
Lowell. I am a developmental and behavioral pediatrician, executive
director of Child FIRST CT, an Associate Clinical Professor of
Pediatrics and the Child Study Center here at the Yale University
School of Medicine, and Section Chief of Developmental and Behavioral
Pediatrics at Bridgeport Hospital. I have been working with high risk,
very young children and their families for 25 years.
Many of Connecticut's young children and families are suffering.
With the recession, greater numbers are not only experiencing poverty,
but the number and complexity of accompanying environmental risks
appear to be rising rapidly. We need to be alarmed. Those children who
make up the largest proportion of the achievement gap in our State are
precisely those whose home environments have multiple, recurrent, and
unrelenting challenges. The most current neuroscientific research has
made it clear that stresses in the environment, like maternal
depression, substance use, domestic violence, homelessness, and child
abuse and neglect, are toxic to the architecture of the developing
brain, causing damage that results in lifelong impairment in mental
health, learning, and physical health. It is therefore imperative that
we intervene as early as possible with comprehensive, intensive
approaches based on scientific knowledge and proven outcomes.
CHILD FIRST MODEL
Throughout the country, policymakers and providers have been
struggling to find models to address the needs of our highest risk,
most vulnerable, and most costly children and families. Today, I am
going to speak briefly about a model intervention system developed in
Greater Bridgeport, CT, called Child FIRST. This stands for Child and
Family Interagency, Resource, Support, and Training. Child FIRST
specifically targets the most vulnerable young children, prenatally
through age 5 years, and their families to prevent emotional and
behavioral problems, developmental and learning disabilities, and abuse
and neglect. By identifying these children at the earliest possible
time and providing comprehensive, intensive, home-based intervention,
we hope to address the racial and ethnic disparities in health and
education and help close the achievement gap.
Child FIRST developed from the ground up, based on community need,
first beginning approximately 12 years ago. Children with developmental
and emotional problems were ``falling through the cracks.'' Families
wanted to do their best, but had overwhelming challenges and were not
getting the services or supports they needed. Providers delivered
quality services, but they were narrow and categorical, without
resources to attend to--or even recognize--the intensity and breadth of
family problems. It was clear, however, that one could not address the
needs of the child without attending to the challenges and stresses
experienced by the whole family. Only then could parents be available
to nurture and support the development of their children.
Child FIRST is a new model for an early childhood intervention
system. It has two essential components, which are based on what we
know about the developing brain:
(1) Comprehensive, integrated services and supports are wrapped-
around the child and family. This ``system of care'' approach directly
decreases the environmental stress (e.g., through housing assistance,
domestic violence intervention, substance abuse treatment) and provides
growth promoting experiences for the child (e.g., through early care
and education, early intervention for developmental delays);
(2) Direct intervention with the child and parents to promote a
nurturing, responsive, parent-child relationship. This relationship has
been documented to buffer or protect the developing brain from ``toxic
stress,'' at the same time that it leads to strong social-emotional and
cognitive development.
Children in need of Child FIRST intervention may be identified
directly by caregivers or by any child or adult community provider
(e.g., Department of Children and Families, early care and education,
pediatrics, domestic violence shelter, adult mental health provider)
serving either children or their parents. Families are usually referred
because a child has emotional, behavioral, or developmental problems or
because the family is struggling with serious challenges that interfere
with the ability of the parent or caregiver to nurture and support the
child's development. These challenges include maternal depression and
anxiety, substance abuse, domestic violence, child abuse and neglect,
homelessness, unemployment, illiteracy, cognitive limitations, food
insecurity, health problems, single and teen parenting, incarceration,
among many others. About 95 percent of these families have evidence of
poverty (e.g., TANF, HUSKY, SNAP), and approximately 90 percent are of
ethnic minority. In addition, Child FIRST in Bridgeport has established
more formal screening in the Bridgeport Hospital Pediatric Primary Care
Center and in Head Start.
Identified children and families are referred to the Child FIRST
home-based intervention, which consists of weekly home visits by a
multi-ethnic, multi-lingual team of a licensed, Master's level
developmental and mental health clinician and a Bachelor's level care
coordinator/case manager. Our families are often extremely wary and
mistrusting of the social service system. Our approach is different. We
believe that parents want the best for their children. Our initial goal
is to engage our parents and build trust and mutual respect. Without
building that relationship, no work can be done. A comprehensive,
assessment of the strengths, priorities, culture, and needs of the
family leads to a collaborative, family-driven plan of care, which
includes services and supports for all members of the family. Our care
coordinator provides hands-on assistance to help families connect with
services and problem solve with them if there are barriers to access.
These services are extremely broad, including early care and education,
early intervention, special education, pediatric providers, nutrition,
dental providers, adult medical specialists, substance abuse providers,
adult mental health providers, domestic violence providers, parenting
groups, home visiting, family resource centers, housing, shelters,
HUSKY, WIC, SNAP, SSI, food pantries, clothing, job training, literacy
providers, etc.
Most of our children and families need parent guidance and parent-
child psychotherapy. This is to build the protective buffer of the
secure, nurturing parent-child relationship, which is so often missing.
This is not surprising, as so many of our parents were abused,
neglected, or suffered from violence or extreme stress in their own
lives. It is through the expert interventions of our clinical staff
that we are able to begin to repair these early relationships, leading
to healthy social-emotional development, strong language and cognitive
development, and physical well-being. In addition, we work in the early
care and education classrooms to help the teachers understand the
child's behavior and develop strategies to promote healthy social-
emotional development not only for the identified child, but frequently
extending to other children in the classroom as well. The Child FIRST
home-based intervention usually lasts between 4 and 12 months, but it
is entirely driven by the unique needs of the child and family.
Collaboration among community agencies (both State and local) is a
key component of our Child FIRST system of care model. Our goal is to
help community providers understand and recognize the broad challenges
of the children and families that they serve, and for them to seek help
from Child FIRST if the needs of the families are beyond their unique
expertise. At the same time, Child FIRST uses the strengths of the many
community resources as the source of services for the children and
families. Through collaboration, we can ensure that a seamless array of
comprehensive, well-integrated services and supports is provided to the
family. An Early Childhood Community Council provides community
oversight for the model.
CHILD FIRST RANDOMIZED TRIAL
Child FIRST has conducted a randomized controlled trial to
determine the effectiveness of our model, funded as part of the
Substance Abuse and Mental Health Services Administration's Starting
Early Starting Smart--Prototype. Families who participated had multiple
challenges, which included receiving public assistance (93 percent),
unemployment (64 percent), lack of high school diploma or GED (53
percent), unmarried (67 percent), maternal depression (54 percent),
family substance abuse history (44 percent), and history of
homelessness (25 percent).
Data was analyzed by an independent team of doctoral level,
university-affiliated psychologists. Results of the comparison of
outcomes between the Child FIRST Intervention and the Usual Care
Controls demonstrated the strong positive impact of the Child FIRST
Intervention at 12 months. In Child FIRST children, there was a very
significant decrease in aggressive and defiant behaviors (Odds ratio =
4.8), and improvement in language development (Odds ratio = 4.2).
Mothers reported significantly less stress and fewer depressive
symptoms, anxiety, and other mental health problems. There was a very
significant decrease in referral to the Department of Children and
Families (DCF) for child protective services, as reported by mothers
(Odds ratio = 4.1), which was further documented by DCF records at 3
years (Odds ratio = 2.1). Intervention families were able to access 91
percent of desired services as opposed to 33 percent in Usual Care.
The results of this research were accepted for publication in Child
Development in a special issue: ``Raising Healthy Children: Translating
Child Development Research into Practice.''
CHILD FIRST REPLICATION
As a result of the strength and consistency of these outcomes, the
Robert Wood Johnson Foundation provided $3.195 million toward funding a
public-private partnership with Connecticut State leadership (including
the Early Childhood Education Cabinet and the Department of Children
and Families) and 12 other Connecticut philanthropies to replicate the
Child FIRST model. An intensive training through a Learning
Collaborative and on-site supervision is ensuring fidelity to the
model. Five Connecticut cities, including Hartford, New Haven, Norwalk,
Waterbury, and New London County, now have Child FIRST models, with the
intention of further replication in each DCF area office throughout
Connecticut.
COST-BENEFIT ANALYSIS
A cost-benefit analysis is currently being conducted, but there
appears to be clear and immediate cost savings in special education,
protective services and foster care, and parental productivity. Future
savings in mental health services and juvenile justice are likely to be
enormous. The Child FIRST intervention costs an average of about $5,000
for a family of four. When compared to conservative estimates of
$96,000 per year for a level two group home for a child with serious
emotional disturbance, over $450,000 per child per year for the State
juvenile training school, and over $700,000 per child per year for
psychiatric hospitalization, the tremendous return on investment is
very clear.
POLICY IMPLICATIONS
Policy implications are very extensive. A few of those most
pressing include:
(1) Medicaid and EPSDT (Early Periodic Screening and Diagnosis and
Treatment): Child FIRST is the only early childhood home-based
intervention in CT to receive Medicaid reimbursement for diagnosed
children. However, we cannot and should not wait until a child has a
diagnosable disorder before offering treatment. The opportunity to
identify and prevent later disability is enormous. One has only to look
at the known consequences of maternal depression or violence exposure--
including serious emotional disturbance, academic failure, and abuse
and neglect--to know that it is essential to treat before the symptoms
are severe. EPSDT is part of Medicaid law specifically enacted to
provide children with medically necessary treatment in order to
identify, prevent, and intervene before serious problems develop. Full
utilization of EPSDT, consistent with the intent of the law, could
provide significant Federal funding for Child FIRST implementation. In
addition, EPSDT could fund screening for emotional and behavioral
problems, mental health consultation services in early care and
education, and services for maternal depression within the home.
(2) CAPTA (The Child Abuse Prevention Treatment Act): CAPTA
requires that infants and toddlers who are victims of substantiated
child maltreatment be referred by child protective services (DCF) to
early intervention services funded under Part C of the Individuals with
Disabilities Education Act (IDEA). The children in DCF are our highest
risk young children. Surprisingly, while the numbers of substantiated
children have not increased in CT during the recession, the severity of
the needs of the children and families appear to have increased. CAPTA
gives us an opportunity to ensure that this very vulnerable, already
identified population receives the developmental assessments and
intervention that are needed. If these children have emotional,
behavioral, or relationship challenges, they can then be referred to
Child FIRST with its unique expertise. It is imperative that States
fully enact this law so that our highest risk children can be served.
(3) Early Childhood System of Care: While there are many excellent
early childhood services in CT, they are fragmented and categorical.
Many have no evidence-base. We need to build a comprehensive system,
developed from interlocking, well integrated services and programs
within and across State agencies and at the local and regional level.
This would create an infrastructure that could provide direct,
individualized, and seamless assistance to all families.
Child FIRST is a new and innovative, home-based model that
addresses the most vulnerable children and families at the earliest
possible time. It combines comprehensive, integrated, family-driven,
community-based services with parent-child intervention to facilitate
the nurturing relationship. The strength of the neuro-
scientific literature and the Child FIRST randomized trial establishes
Child FIRST as a very promising model that can address ethnic, racial,
and socioeconomic disparities with the goal of closing the achievement
gap. We have the knowledge. We must now develop the will to restructure
systems and target resources so that our vulnerable children and
families can succeed.
Thank you very much!
Senator Dodd. Thank you very much, Doctor.
[Applause.]
Doctor, thank you.
Dr. Keck.
STATEMENT OF DOUGLAS B. KECK, D.M.D., M.S.H.Ed., CONNECTICUT
STATE LEADER, AAPD HEAD START DENTAL HOME INITIATIVE, MADISON,
CT
Mr. Keck. I have a pretty loud voice. So thank you, Senator
Dodd and the Subcommittee on Children and Families.
I am pleased to have the opportunity to testify at this
hearing to describe an exciting project that is helping to
improve children's oral health in the State of Connecticut. I
am a practicing pediatric dentist in New Haven and Madison, and
I teach part-time at the Pediatric Dentistry Residency Program
at Yale-New Haven Hospital.
I am testifying today in my role as the Connecticut State
leader of the American Academy of Pediatric Dentistry Head
Start Dental Home Initiative. The American Academy of Pediatric
Dentistry believes that every child deserves a healthy start in
life and that good oral health is integral to the healthy
development of all children.
This may come as a surprise, but dental caries is the most
common chronic disease of childhood, much greater than asthma,
and low-income children are three to five times more likely to
have untreated tooth decay compared to children of more
affluent families.
National statistics indicate that 28 percent of all
preschoolers between the ages of 2 and 5 suffer from tooth
decay. However, in Head Start programs, decay rates often range
from 30 to 40 percent in 3-year-olds and 50 to 60 percent for
4-year-olds. Head Start has reported that access to oral health
services is the No. 1 health issue affecting Head Start
programs nationwide.
In October 2007, the American Academy of Pediatric
Dentistry signed a 5-year contract with the U.S. Office of Head
Start that hopes to improve the access to care for the over 1
million children that are enrolled in Head Start and Early Head
Start programs annually throughout the United States. Through
this partnership, we are developing a network of pediatric and
general dentists to provide dental homes to children in Head
Start across the Nation. A dental home means that each child's
oral healthcare is provided in a comprehensive and ongoing way
by a dentist.
Here in Connecticut, approximately 9,000 children are
enrolled in Head Start programs each year. Through the efforts
of our regional oral health consultants and State leaders,
which is my role in Connecticut, we are capitalizing on the
willingness of dentists to improve access to quality dental
care for underserved children. In Connecticut, I have recruited
over 40 dentists to partner with Head Start programs across the
State directly.
Since most Head Start children are eligible for Medicaid,
it is important that Medicaid dental programs are adequately
funded and properly administered. Over the past 2\1/2\ years,
the number of providers that treat Medicaid recipients in our
State has increased from 300 providers to approximately 1,100.
I would be remiss not to mention that the key driver in these
Medicaid dental program improvements was the 2008 increase in
payment for Medicaid services to market-based rates as a result
of settlement of litigation against the State.
An example of how my State leader role helps move the
initiative forward is that I work closely with the New Haven
Board of Education Head Start grantee and its delegate, LULAC.
I have met with the superintendent of schools of New Haven, the
grantee, and its delegate in order to finalize a program for
Yale's pediatric dentistry residency program that will provide
dental homes to all the New Haven Head Start students that need
one.
This project is slated to reach nearly 1,000 students and
their families, while providing a tremendous learning
experience for our dentistry residents at Yale-New Haven
Hospital.
Once again, I would like to thank Senator Dodd for allowing
me the opportunity to testify, and I look forward to answering
any questions about the program.
[The prepared statement of Mr. Keck follows:]
Prepared Statement of Douglas B. Keck, D.M.D., M.S.H.Ed.
I am pleased to have the opportunity to testify at this hearing to
describe an exciting project that is helping improve children's oral
health in the State of Connecticut. I am a practicing pediatric dentist
in New Haven and also teach part-time at the pediatric dentistry
residency program at Yale/New Haven Hospital. I am testifying today in
my role as the Connecticut State leader for the American Academy of
Pediatric Dentistry-Head Start Dental Home Initiative.
The American Academy of Pediatric Dentistry \1\ believes that every
child deserves a healthy start in life and that good oral health is
integral to the healthy, physical, social-emotional and intellectual
development of all children. Unfortunately, many children in America
suffer from poor oral health and lack access to quality oral health
care. In the U.S. Surgeon General's 2000 Report on Oral Health in
America, it was noted that not only is dental caries the most common
chronic disease of childhood, but that low-income children are 3-5
times more likely to have untreated tooth decay compared to children of
more affluent families. National statistics indicate that 28 percent of
all preschoolers between the ages of 2 and 5 suffer from tooth decay.
However, in Head Start programs, decay rates often range from 30
percent-40 percent for 3-year-olds, and 50 percent-60 percent for 4-
year-olds. These decay rates are common for children of low-income
families. In fact, Head Start directors, program specialists, staff and
parents have reported that access to oral health services is the No. 1
health issue affecting Head Start programs nationwide!
---------------------------------------------------------------------------
\1\ Founded in 1947, the American Academy of Pediatric Dentistry
(AAPD) is a not-for-profit membership association representing the
specialty of pediatric dentistry. The AAPD's 7,700 members are primary
oral health care providers who offer comprehensive specialty treatment
for millions of infants, children, adolescents, and individuals with
special health care needs. The AAPD also represents general dentists
who treat a significant number of children in their practices. As
advocates for children's oral health, the AAPD develops and promotes
evidence-based policies and guidelines, fosters research, contributes
to scholarly work concerning pediatric oral health, and educates health
care providers, policymakers, and the public on ways to improve
children's oral health. For further information, please visit the AAPD
Web site at www.aapd.org.
---------------------------------------------------------------------------
In October 2007 the American Academy of Pediatric Dentistry (AAPD)
signed a 5-year contract with the U.S. Office of Head Start (OHS) to
confront the oral health challenges that Head Start children and Head
Start programs have faced for over 30 years. This contract represents a
partnership with OHS to improve access to care for the over 1 million
children enrolled in Head Start and Early Head Start programs annually
throughout the United States.
This partnership represents years of hard work by both the dental
community and Head Start centers across the country to improve the oral
health of children who have struggled for far too long to obtain care
that many Americans take for granted. Through this partnership, we are
developing a network of pediatric and general dentists to provide
dental homes to Head Start children. A dental home means that each
child's oral health care is provided in a comprehensive, ongoing,
accessible, coordinated, family-centered way by a dentist. This
partnership also empowers parents, caregivers and Head Start staff by
providing the latest evidence-based information on how they can help
prevent tooth decay and establish a foundation for a lifetime of oral
health.
Early Head Start and Head Start are comprehensive child development
programs which serve children from birth to age 3 (plus pregnant women)
and 3 to 5, respectively, and their families. In addition to providing
educational services, Head Start grantees also provide parent education
and case management services. Services are provided for parents and
caregivers to enable them to provide safe and nurturing environments
for their children that support each child's physical, social-emotional
and intellectual development, and emphasize opportunities for parent
involvement.
Head Start recognizes that every child must be healthy and well-
nourished to learn and develop to his or her full potential. Preventive
health services are central to Head Start's comprehensive array of
services. Head Start also understands that oral health is vital to
overall health and well-being. In recognition of the fact that poor
oral health can interfere with a child's ability to learn and develop,
the Office of Head Start has made oral health a priority. Over time,
OHS has provided funding to support a variety of oral health
initiatives and programs to address barriers to oral health care for
Head Start children. The current partnership with the AAPD holds great
promise to overcome the greatest unmet health care need for Head Start
programs across the country, because this initiative is all about
linking dentists to Head Start programs. See the attached fact sheet
for more information about the national scope of the initiative.
Here in Connecticut, approximately 9,000 children are enrolled in
Head Start programs each year. Through the efforts of our Regional Oral
Health Consultants and State Leaders--which is my role in Connecticut--
we are capitalizing on the willingness of dentists to improve access to
quality dental care for underserved children. In Connecticut, I have
recruited over 40 dentists to partner with Head Start programs across
the State, increasing both access and utilization of dental services
for families who have traditionally struggled to obtain dental
services.
Since most Head Start children are eligible for Medicaid, it is
important that Medicaid dental programs be adequately funded and
properly administered. Over the past 2\1/2\ years, the number of
providers that treat Medicaid recipients in our State has increased
from 300 to approximately 1,100. This is due to the efforts of the
Connecticut State Dental Association, the Department of Public Health,
the Department of Social Services, the Connecticut Dental Health
Partnership (ASO), and--with a little help from me. As State Leader for
the AAPD-Head Start Dental Home Initiative, I work closely with the
Connecticut Department of Public Health, WIC and various Boards of
Education to enhance public awareness of the importance of oral health
for our State's most vulnerable children. But I would be remiss not to
mention that the key driver in these Medicaid dental program
improvements was the 2008 increase to market-based rates as a result of
settlement of litigation against the State.
Let me provide one example of how my State Leader role helps move
the initiative forward. I work closely with the New Haven Board of
Education Head Start grantee and its delegate LULAC, as a member of
their Health Advisory Team. I will be meeting next week with the
Superintendent of Schools of New Haven, the executive directors of the
grantee and its delegate, as well as the Health Managers of both
programs, to finalize a new program for Yale's pediatric dentistry
residency program to provide dental homes to all the New Haven Head
Start students that need one. This project is slated to reach nearly a
thousand students and their families. In addition, it will provide a
tremendous learning experience for our pediatric, as well as general
dentistry residents, at Yale-New Haven Hospital.
The AAPD, through this initiative, is also empowering parents and
Head Start Staff through the development of educational materials.
These materials, which include videos, will provide them with solid,
evidence-based information about early childhood caries and how they
can protect their children from this disease.
I want to thank Senator Dodd for allowing me the opportunity to
testify, and look forward to answering any questions about this
exciting initiative.
Attachment.--American Academy of Pediatric Dentistry
HEAD START DENTAL HOME INITIATIVE
Creating partnerships between the dental community and Head Start
to provide dental homes for Head Start children across the United
States.
Every child deserves a healthy start on life, but when it comes to
oral health many children face significant challenges. Young children
in low-income families tend to have higher rates of tooth decay and
have greater difficulty accessing ongoing basic dental care. Key points
that highlight the severity of the problem include:
Tooth decay is the most common chronic childhood disease--
five times more common than asthma--and the #1 unmet health care need
among Head Start children.
Twenty-eight percent of all preschoolers between the ages
of 2 and 5 suffer from tooth decay, but decay rates often range from 30
percent-40 percent of 3-year-olds and 50 percent-60 percent of 4-year-
olds in Head Start programs.
Dental care for children in Head Start generally is
covered by Medicaid, however dentists' dissatisfaction with Medicaid
programs often results in low levels of dentist participation and
limited access to comprehensive dental care for Head Start children.
Challenges that Head Start programs face in securing access to
quality dental care include those related to the availability of dental
services as well as community, family and cultural factors:
Reluctance by many general dentists to provide services
for preschool-age children;
Dentists' lack of familiarity with HS/EHS program goals,
objectives and resources;
Transportation, language and cultural barriers; and
Educating parents about oral health and motivating them to
follow up with treatment their children need.
AAPD and Head Start are partnering at the national, regional, State
and local levels to develop a national network of dentists to link Head
Start children with dental homes. A dental home means that each child's
oral health care is delivered in a comprehensive, ongoing, accessible,
coordinated, family-centered way by a dentist.
A national network of pediatric dentists and general dentists is
being created to: provide quality dental homes for Head Start (HS) and
Early Head Start (EHS) children; train teams of dentists and HS
personnel in optimal oral health care practices; and assist HS programs
in obtaining comprehensive services to meet the full range of HS
children's oral health needs. Regional consultants are assisting State
leadership teams in development of collaborative networks throughout
each State. Local networks engage local dentists and HS personnel as
well as other community leaders to identify strategies to overcome
barriers to accessing dental homes. This partnership also provides
parents, caregivers and HS staff with the latest evidence-based
information on how they can help prevent tooth decay and establish a
foundation for a lifetime of oral health.
The 5-year plan relies on five key components:
Providing project leadership, administration and
organizational support;
Providing oral health expertise and technical assistance;
Developing networks of dentists to provide access to
dental homes;
Training dentists to enhance their capability to meet the
oral health needs of young children and their understanding of HS/EHS
programs; and
Enhancing HS/EHS oral health staff training and parent
education programs.
For additional information contact: Jan Silverman, AAPD Head Start
Dental Home Initiative Project Manager at [email protected] or visit
http://www.aapd.org/headstart/.
SUCCESS STORIES
Formalizing Relationships
North Dakota State Leader Brent Holman on facilitating discussions
between Head Start Centers and IHS clinics: I was amazed that just by
scheduling a meeting with IHS Dental staff and HS staff, they very
quickly start discussing common problems and solutions for the benefit
of better care for their HS kids. We mostly listened and guided them in
developing strategies to solve their problems. Although they
communicated previously, this was an opportunity to talk about issues
that were only informally discussed after a problem with a particular
case. It was inspiring to see their commitment to their mission despite
the many challenges.
Parent Empowerment
Connecticut State Leader Doug Keck on talking with parents: At the
Health Advisory Committee, parent representatives of the local Head
Start were amazed from a consumer standpoint that there are differences
between dentists and how it is important to seek better oral health
care than what they are accustomed to.
Recruiting Providers
North Dakota State Leader Brent Holman: Surveys have been sent out
to ND dentists to determine their willingness to see HS kids and/or
serve on HS Advisory Committees. The early returns have been amazing
with most dentists expressing their eagerness to serve in any capacity.
We also helped an HS program ``re-recruit'' a dentist that decided to
quit seeing HS kids, in an area that had few other dentist options.
Telamon Migrant and Seasonal Head Start, TN: Dr. Pitts Hinson, TN
State leader has been working closely with the Head Start State
Collaboration Director and individual Head Start grantees to identify
dental homes for Head Start children throughout Tennessee who did not
previously have access. According to J. Davis, State Director, Telamon
Corporation,
``The initiative is working throughout the State--not just
here. The whole idea of dentists talking to each other is
phenomenal--we're seeing it work. This has changed everything.
All five Telamon programs traditionally have had a hard time
finding dentists. For the first time in over 20 years, all five
centers have partnerships with dentists.''
New York State Leaders, Dr. Amr Moursi & Dr. Courtney Chinn have
recently created a NYC Pediatric Oral Health consortium for Head Start.
This consortium has support from 14 of the 15 pediatric dental
residency programs in the NYC area. The consortium will link
participating dental residency programs with Head Start programs.
Collaboration
Maureen Short, RN, Assistant Head Start Director, UCAN Head Start
on regional collaboration meetings sponsored by AAPD HS Dental Home
Initiative State Support Grants: The Southern Oregon Regional Meeting
was a wonderful opportunity to begin lasting relationships between Head
Start, pediatric dentists and the dental health organizations. The
relationship building will be the foundation for many future positive
experiences, this is a huge success. . . . Maureen Short RN.
Michael E. Jones, executive director, Oklahoma Association of
Community Action Agencies on collaborating with the Pediatricians:
Active and key pediatrician involvement in the HS DHI State Leadership
Team was accomplished this quarter. The representatives of the medical
community have the capacity to influence physicians' decisions to
participate in cross-sector education and training opportunities to be
made available through the HS DHI support grant.
Senator Dodd. Very excited about your project.
[Applause.]
Abby, thank you for being here.
STATEMENT OF ABBY I. DOLLIVER, SUPERINTENDENT, NORWICH PUBLIC
SCHOOLS, NORWICH, CT
Ms. Dolliver. Thank you. I want to thank you, Senator, for
inviting me and giving me this honor to testify on such a
critical topic for our State and our country.
I know that you know that I have watched you throughout
your career, making decisions that have improved the lives of
our children and their families, and I thank you for that.
Senator Dodd. Thank you.
Ms. Dolliver. As a fairly new superintendent, I don't see
myself as the voice for all of my colleagues. However, I will
speak to you about some of our programs and services. I can't
really do that without also addressing some of our needs. I am
sure that our story mirrors that of many of our cities and
towns in Connecticut.
Norwich is an urban center now. We weren't probably when
you lived there before, but we are of about 38,000 citizens.
Our median household income is about $48,000, based on 2009
data.
Our district is 3,800 Pre-K to 8 students, with the
majority of our high school students attending Norwich Free
Academy, which is our designated high school. We do have our
own Alternative High School and Clinical Day Treatment
Programs, which are the types of programs that are helpful and
important to the success of many of our high school students.
Not all students benefit from a comprehensive high school
experience.
Our schools are very diverse. There are 29 languages spoken
there. We house five bilingual centers within our schools.
These centers are critical for the success of our students with
English as a second language. Many of our students arrive in
school without speaking any English. There are 465 students
with English as a second language throughout our district.
We are fortunate to be part of a program as a partner with
UCLA in California called Project Excell. This program teaches
our teachers strategies for our classrooms and dealing with
students who do not speak English. We have also had several
years of training for staff in a program called Courageous
Conversations, which gave us the opportunity to have
discussions about items related to race, our feelings about the
differences, and how to manage them in a very diverse
environment.
Seventy-nine percent of our students qualify for free or
reduced meals in school. This federally funded program is
critical to our district, as we feed our students breakfast,
lunch, and snacks. Without this, many would be hungry, and we
know how adversely hunger affects our students' abilities to
focus in school.
During last summer, 2009, we provided 11,185 breakfasts and
21,654 lunches throughout our community, and I expect that this
year's numbers will be higher. Our students and their families
need these programs.
Norwich has 845 students who meet the criteria for special
education services. While we know that many of the mandates for
special education have not been ever fully funded, we were able
to provide specialized programs for students on the autism
spectrum, and I know that there is much research going on
currently about autism, and the numbers of students who qualify
for these programs continues to grow.
In addition, older students also are required to have
programs now that transition them to be able to be successful
and independent after high school. We are able to use some of
our ARRA funding to support both of these important
initiatives, as well as others. We do need to provide these
programs in the future.
We provide several integrated preschool opportunities.
These are all possible through Title I, School Readiness, and
IDEA funding. We also have Family Resource Centers in several
of our schools. Even with limited space, we are committed to
finding ways to keep these centers in our schools. They provide
affordable before and afterschool care and supports for
families. We all know how important early intervention is to
future student success.
Increasing parent involvement is one of our goals. We
provide opportunities to partner with them to work together for
student success. One example is the FAST Team, which is
Families and Schools Together. This grant came through the
Connecticut Parent Advocacy Center, and they helped us to focus
on opening doors and bridging communication gaps with our
parents. Each of our schools finds ways to engage parents who
are very busy and hard-working.
Since 2007, we have expanded afterschool opportunities to
our K to 8 students with a 5-year 21st Century Learning Center
grant award. We were able to serve over 450 students from
afterschool until 5 p.m. This had a positive impact on
students, with enriched academic and cultural opportunities,
service learning projects, and recreational activities. During
the summer months, we were able to provide service learning,
enrichment, and structured recreational activities for
students, bringing academic success from one year to the next,
a very necessary bridge.
After school tutorial programs through grant funding
enriches students' math and literacy skills. Learn and Serve
America funds support community partnerships with students.
Community pride and involvement is critical to student and
community success.
Three school-based health clinics offer students and
families access to essential health and counseling services.
This program has helped students with obtaining physicals and
immunizations and ongoing healthcare. We have a wellness
committee that oversees initiatives for healthy staff and
students. We take advantage of a fresh fruit and vegetable
grant so that we set the example for students on healthy eating
and lifestyles.
The Positive Behavior Support Program is being implemented
in our schools to address school climate and culture. We have
seen a significant decrease in disciplinary referrals as a
result of this program.
This is all part of our Scientifically Research Based
Intervention Programs that provide tiered interventions to
address both academic and emotional and behavioral needs of our
students. Several of our schools have developed Character
Counts initiatives, which provide positive reinforcement for
good citizenship.
Those programs that I have mentioned are just a sampling of
all that we do. I am proud to say that we are making progress.
Even with a nearly flat-funded budget for the third year in a
row and with having to close two schools this year coming up
and laying off 70 staff, we are making progress.
We have not closed the achievement gap. We are one of the
districts in need of improvement in Connecticut. Yet with all
of these program opportunities and our committed staff, we open
the doors to our students and their families with programs and
services that address their academic, social, and health needs.
Providing emotional and academic support is critical to student
success, and we need this success as the foundation for our
future.
[The prepared statement of Ms. Dolliver follows:]
Prepared Statement of Abby I. Dolliver
I want to thank you Senator Dodd, for providing me with the honor
of testifying today on such a critical topic, Connecticut's Children. I
am proud to say that I have watched you throughout your career making
decisions that have improved the lives of our children and their
families, and I thank you for that.
As a fairly new Superintendent, I don't see myself as the voice for
all of my colleagues; however I will speak to you about some of our
programs and services. I can't really do that without also addressing
some of our needs. I'm sure that our story mirrors that of many of our
cities and towns in Connecticut.
Norwich is an Urban Center with about 38,000 citizens; our median
household income is $48,000 a year based on 2009 data. Our district has
3,800 Pre-K to 8 students, with the majority of our high school
students attending Norwich Free Academy, our designated high school. We
do have our own Alternative High School and Clinical Day Treatment
Program which are the types of programs that are helpful and important
to the success of many high school students. Not everyone benefits from
a comprehensive high school experience.
Our schools are very diverse. There are 29 languages spoken there.
We house five Bilingual Centers. These centers are critical for the
success of our students with English as a second language. Many of our
students arrive in school without speaking any English. There are 465
students with English as a second language throughout our district. We
are fortunate to be part of a partner program with UCLA in California,
Project Excell. This program teaches our teachers strategies for their
classrooms for our students who do not speak English. We have also had
several years of training for staff in a program called Courageous
Conversations. This program discussed issues related to race, our
feelings about these differences and how to manage them in a very
diverse environment.
Seventy-nine percent of our students qualify for free or reduced
meals in school. This federally funded program is critical to our
district as we feed our students breakfast, lunch and snacks. Without
this, many students would be hungry and we know how adversely hunger
affects students' abilities to focus in school. During the summer of
2009 we provided 11,185 breakfasts and 21,654 lunches. I expect that
this year's numbers will be higher. Our students and families need
these programs.
Norwich has 845 students who meet the criteria for special
education services. While we know that many of the mandates for Special
Education have not been fully funded, we are able to provide
specialized programs for students on the autism spectrum. I know that
there is much research going on currently about autism and the numbers
of students who qualify for these programs continues to grow. In
addition, older students also are required to have programs that
provide a transition for them to be able to be successful and
independent after high school. We are able to use ARRA funds to support
both of these important initiatives as well as others.
We provide several integrated preschool opportunities. These are
all possible through Title 1, School Readiness, and IDEA funding. We
also have Family Resource Centers in several of our schools. Even with
limited space we are committed to finding ways to keep these centers in
our schools. They provide affordable before and afterschool care and
supports for families. We all know how important early intervention is
to future student success.
Increasing parent involvement is one of our goals. We provide
opportunities to partner with them to work together for student
success. One example is the FAST Team (Families and Schools Together).
This grant through the Connecticut Parent Advocacy Center helped us to
focus on opening doors and bridging communication gaps with our
parents. Each of our schools finds ways to engage our very busy and
hard-working parents.
Since 2007 we have expanded afterschool opportunities for our K to
8 students with a 5-year 21st Century Community Learning Center grant
award. We are able to serve over 450 students from the end of the
school day until 5 p.m. This has had a positive impact on students,
with enriched academic and cultural opportunities, service learning
projects and recreational activities. During the summer months we are
able to provide service learning, enrichment, and structured
recreational activities for students, bringing academic success from
one year to the next, a very necessary bridge.
After school tutorial programs through grant funding enriches
students' math and literacy skills. Learn and Serve America funds
support community partnerships with students. Community pride and
involvement is critical to student and community success.
Three school-based health clinics offer students and families
access to essential health and counseling services. This program has
helped students with obtaining physicals and immunizations. We have a
Wellness Committee that oversees initiatives for healthy staff and
students. We take advantage of fresh fruit and vegetable grants so that
we set the example for students on healthy eating and lifestyles.
The Positive Behavior Support Program is being implemented in our
schools to address school climate and culture. We have seen significant
decrease in disciplinary referrals as a result of this program. This is
all part of our Scientifically Research Based Intervention Programs
that provide tiered interventions to address both the academic and
behavioral needs of our students. Several of our schools have developed
character count initiatives which provide positive reinforcement for
good citizenship.
Those programs that I have mentioned are just a sampling of all
that we do. I am proud to say we are making progress. Even with a
nearly flat funded budget for the third year in a row and with having
to close two schools and lay off 70 staff, we are making progress. We
have not closed the achievement gap yet but with all of these program
opportunities and our committed staff, we open the doors to our
students and their families with programs and services that address
their academic, social and health needs. Providing emotional and
academic support is critical to student success and we need this
success as the foundation for our future.
Senator Dodd. Very good, Abby. Thanks so much.
[Applause.]
Tammy.
STATEMENT OF TAMMY PAPA, DIRECTOR, BRIDGEPORT LIGHTHOUSE,
BRIDGEPORT, CT
Ms. Papa. Good morning. On behalf of our partner agencies
and the children and families we serve, I would like to thank
you for the opportunity to submit testimony today on what is
working for Connecticut's children.
A very special thank you to you, Senator Dodd, for all that
you have done for Bridgeport children. We truly appreciate it.
The Lighthouse Program serves approximately 2,700 children
a day in 24 public schools, and we know we are impacting the
whole child when we hear from a teacher who tells us,
``My students were doing poorly in math, struggling
with basic math concepts. Since participating in the
Lighthouse mathematics program, the girls have come a
long way and are now doing so well that they are
helping other students.''
Or when student Amanda Lopez writes, ``The Lighthouse
Program has helped me in so many ways, but most importantly, it
helps me stay out of trouble after school.''
And yet another student, Cecily Morales, writes,
``Lighthouse has given me opportunities for new things like
ballroom dancing. For me, this has helped me be more
confident.''
Or when a parent from Edison School comments that,
``The Lighthouse Program treats each and every child
like a member of its own family. I feel comfortable
leaving my child there on a daily basis. It is a
wonderful program, and I see a big change in my son's
behavior.''
Through tutoring, partnerships with local universities,
regular contact with daytime teachers, state-of-the-art
curriculum in reading and math, as well as activities that
focus on critical thinking skills, the Lighthouse Program is
making strides to close the achievement gap.
Our latest independent evaluation, conducted by Dr. Phil
Zarlengo of MRM, former director of the Lab at Brown
University, reports that,
``2009 findings for Lighthouse participants are
significant for reading, writing, and math when
compared to the rest of the district. The average CMT
mathematics score of Lighthouse students exceeded the
district score in grades 3 through 8, and the average
reading and writing score exceeded the district score
in grades 3, 5, 7, and 8.''
We address the physical, social, and emotional well-being
of Bridgeport children by offering them activities in a
judgment-free zone in which pressure to perform is taken out of
the equation. Through various partnerships for extracurricular
activities, the Lighthouse Program is working with some of the
district's most challenged students, and daytime teachers are
reporting positive changes in behavior.
They indicate that, ``72 percent of students had good to
excellent relationships with peers, and 83 percent had good to
excellent relationships with teachers.'' Furthermore, ``86
percent of Lighthouse participants are rarely or never referred
to the office for disciplinary reasons, and 79 percent rarely
or never require in-class discipline,'' resulting in fewer
disruptions and more time on task.
Through these activities, the Lighthouse Program is also
addressing the serious obesity rate among our young people.
Joseph Mahoney, Ph.D., associate professor of psychology at
Yale University during the time of the research--he has since
moved--and at the time under the direction of Dr. Zigler, noted
that ``childhood obesity is a significant problem in this
Nation and in the city of Bridgeport. When the children in this
study were only 5 years old, nearly one quarter of them were
clinically obese. However, over time, children participating in
afterschool programs showed a less marked increase in their
body mass index and lower rates of clinical obesity.
``In particular, by the second year of the study, 33
percent of children who did not participate in
afterschool programs were obese, compared to only 21
percent of those who did.''
His study further concluded that
``Children in Bridgeport's afterschool program had
higher expectations of success and more socially
acceptable behavior when compared to children in self
care, parent care, or relative care.''
And that,
``For those children exposed to high rates of crime
and violence in their neighborhoods, participation in
the afterschool program appeared to buffer them from
exposure and significantly reduce the likelihood of
developing academic and behavior problems in school.''
In a city like Bridgeport, where 95 percent of public
school students are considered economically disadvantaged, we
need to do all we can to assure that children are productive
during their out-of-school time. We need to appeal for more
funding that provides children, who tend to suffer greatly
during tough economic times, with opportunities to participate
in quality afterschool and summer programs because we now know
that they work.
We need to make sure that current sources of funding, like
the 21st Century Community Learning Centers program, remain
intact and that the funds for such are not diverted.
While we have been fortunate over the years to grow the
city's Lighthouse Program, we still have much to do to ensure
that every child that wants or needs access has it. As program
providers, we appreciate opportunities in which we can share
our successes and humbly ask that we continue to safeguard the
future of every American child by continuing to support high-
quality afterschool and summer programs like Bridgeport's
Lighthouse Program that partners with the school district and
our community-based organizations to help students learn,
succeed in school, become college- and career-ready, and thus
productive members of society.
Thank you.
[The prepared statement of Ms. Papa follows:]
Prepared Statement of Tammy Papa
Good morning. My name is Tammy Papa and I am the director of the
city of Bridgeport Lighthouse Before, AfterSchool and Summer Program.
On behalf of our partner agencies and the children and families we
serve, I would like to thank you for the opportunity to submit
testimony today on what is working for Connecticut's Children. A very
special thank you to you Senator Dodd for all you have done in support
of our program over the years. Without your leadership along with
Senator Lieberman, former Congressman Christopher Shays, and
Congressman Himes, we would not have been in a position to serve over
2,700 children per day for the past 17 years.
History: Partnership that began in 1993 between the city of
Bridgeport, Board of Education, and numerous faith and community-based
organizations, as well as institutions of higher education at a time
when our young people were being shot and killed on our streets in
broad daylight, afterschool, and within yards of our public schools.
Then Mayor Joseph Ganim along with former Superintendent James Connelly
called upon some of the larger non-profits and faith-based
organizations within the city to work together on a solution to curb
the violence. The city was coming out of bankruptcy and was only able
to contribute a small amount. Other agencies did what they could as
well. With approximately $100,000 in seed money, three schools in
critical neighborhoods and a few community centers extended their
hours. With the start of the new fiscal year in July 1993, an influx of
Education Cost Share funding allowed the city through the Board of
Education to expand programming into 17 summer and afterschool sites.
The program was scaled back to 11 sites the following year maintaining
a budget of approximately $850,000 where it remained until receiving
its first 21st CCLC grant in 1998 and an increase of $400,000 from the
city. Former Mayor John Fabrizi and current Mayor Bill Finch have both
maintained the city's investment in afterschool which today totals
$1,350,000 annually. From 11 afterschool sites, the program has grown
to 24 sites and the need to open two additional schools in the fall and
spring of 2010 and 2011 respectively is evident. The program receives
Federal, State, local, private foundation, and parent fees. It's 2010-
11 budget totals $4,000,000.
Currently Serving: 2,700 Bridgeport children daily in grades K-8
during the school year from 3 p.m.-6 p.m. and during the summer for 5
weeks from 9 a.m.-5 p.m. employing over 300 individuals.
Percent of Public School Student Population Served: Approximately
12 percent for the 2009-10 school year.
In addition to providing a safe place for children who might
otherwise go home to an unsupervised setting, the Lighthouse Program
also addresses the following issues:
Achievement Gap--Through tutoring, partnerships with local
universities, regular contact with daytime teachers, state-of-the-art
curriculum in reading and math as well as activities that focus on
critical thinking skills, the Lighthouse Program is making strides to
close the achievement gap. Our latest independent evaluation conducted
by Dr. Phil Zarlengo, former director of the Lab at Brown University
reports that:
``2009 findings for Lighthouse participants are significant
for Reading, Writing, and Math when compared to the rest of the
district. Students in all but 5th grade are performing at
proficiency or above in reading and math. The average CMT
Mathematics score of Lighthouse students exceeded the district
score in grades 3-8 and the average Reading and Writing score
of Lighthouse students exceeded the district score in grades
3,5,7, and 8.''
This evidence is further backed by the research conducted over a 2-
year period by Deborah Lowe Vandell, University of California, Irvine
and her team titled, ``The Study of Promising Practices,'' which
Bridgeport's Lighthouse Program was part of. She found that ``those
elementary school students who regularly attended the high-quality
afterschool programs demonstrated significant gains.'' We are hopeful
that subsequent evaluations will show further growth and anticipate the
completion of the 2010 report shortly. In the meantime, we continue to
research new, innovative, and cost-effective approaches that engage
children in activities that promote learning.
Physical, Social and Emotional Well-Being--By offering
children activities in a judgment free zone in which pressure to
perform is taken out of the equation, they adapt and rise to the
occasion. Through partnerships with the Kennedy Center, the Lighthouse
Program is working with some of the districts most challenged students
during afterschool hours and daytime teachers are reporting positive
changes in behavior. Activities that encourage team approaches like
those offered through First Tee, USTA's Quick Start, and Cal Ripken's
Healthy Choices, Healthy Students among a host of other activities like
ballroom dancing, chess, organized basketball clinics, drama, etc.
indicate Lighthouse children's physical, social, and emotional needs
are being met. Daytime teachers reported that ``72 percent of students
had good to excellent relationships with peers and 83 percent had good
to excellent relationships with teachers.'' Furthermore, ``86 percent
of Lighthouse participants are rarely or never referred to the office
for disciplinary reasons and 79 percent rarely or never require in
class discipline'' resulting in fewer disruptions and more time on
task. Through these varied activities, the Lighthouse Program is also
addressing the serious obesity rate among our young people. Joseph
Mahoney PhD. Associate Professor of Psychology at Yale University
during the time of his research on the Lighthouse Program, noted that:
``Childhood obesity is a significant problem in this Nation
and in the city of Bridgeport. The condition is known to
predict a range of serious health problems. When the children
in this study were only 5-years-old, nearly one-quarter of them
were clinically obese. However, over time, children
participating in afterschool programs showed a less marked
increase in their body mass index and lower rates of clinical
obesity. In particular, by the second year of the study, 33
percent of children who did not participate in afterschool
programs were obese compared to only 21 percent of those who
did participate in afterschool programs.''
By providing Lighthouse children with healthy snacks, rotating them
from activity to activity, and encouraging a minimum of 20 minutes of
exercise per day, the program is making strides to curb this most
serious epidemic. Dr. Mahoney's study further concluded that:
``children in Bridgeport's afterschool program had higher
expectations of success and more socially acceptable behavior
when compared to children in self care, parent care or relative
care.''
This is especially critical because all the research shows that
student expectations of his or her performance have a direct
correlation to his or her rates of success.
Community Violence--Research shows that exposure to
criminal activity over time can hinder one's ability to focus in school
and most often times creates problem behavior. With the rise of gang
activity on our streets it is critical that we keep our children in
supervised settings and away from danger until a parent or guardian can
be there. We use this time productively to help build relationships
between local law enforcement and students. Raising awareness about the
negative impact of joining gangs and what to look for in their
community is reducing their risk of becoming involved in illicit
activities or being victimized. In his study of Lighthouse Program
participants over 4 years, Dr. Mahoney concluded,
``for those children exposed to high rates of crime and
violence in their neighborhoods, participation in the
afterschool program appeared to buffer them from exposure and
significantly reduce the likelihood of developing academic and
behavior problems at school.''
Since the Lighthouse Program is not exempt from the current
recession, it has become even more critical that we constantly measure
our success and look for new ways to engage not only our K-8
population, but also our high school youth who suffer greatly from a
lack of employment opportunities. There can be no time, effort, or
money wasted on unsuccessful activities as needs grow during tough
economic times and tend to have a devastating effect on the young and
elderly alike. Therefore, in addition to our annual independent
evaluation which collects both quantitative and qualitative
information, we are conducting additional site visits, asking site
coordinators to conduct periodic self assessments, keeping in regular
contact with principals, and asking for community feedback. In this
manner, we are poised to attract additional funding opportunities that
will enable us to bring current programs to scale and replicate
services throughout the district.
The Impact of AfterSchool on Bridgeport and the Region
Economic Development
Employs over 300 certified teachers, para-
professionals, college students, youth, and adults.
Allows approximately 1,800 families to work full
days.
Higher employee productivity levels.
Incentive for company relocations.
Higher Test Scores
Reading, Writing, and Math.
Lower Crime Rates and Less Exposure to Crime
Transition from Early Childhood Initiatives
Lower Obesity Rates
Reduced health care costs.
Improved Self Esteem.
Less Discipline Referrals
Higher Attendance Rates
Again, thank you for the opportunity to speak before you today.
Senator Dodd. Thank you.
[Applause.]
Kellyann.
STATEMENT OF KELLYANN DAY, EXECUTIVE DIRECTOR, NEW HAVEN HOME
RECOVERY, MANCHESTER, CT
Ms. Day. Good morning, Senator Dodd, and distinguished
guests. It is an honor to be here, and thank you for inviting
me to speak.
Contrary to the stereotype of men sleeping in doorways or
pushing overloaded shopping carts, families now comprise 40
percent of the homeless population in the United States. The
percentage is closer to 50 percent in the State of Connecticut.
I have submitted many pages of information in my written
testimony for your review, but I just want to emphasize one
thing. Of the 130 children that we sheltered this past year, 35
percent were between the ages of 6 and 12, and 45 percent were
under 6.
Of the 15 programs that New Haven Home Recovery operates, I
would like to highlight two. The first is the Family School
Connection, funded by the Connecticut Children's Trust Fund. It
operates out of the Fair Haven K-8 School, which has the
highest number of homeless families in the city.
The FSC is an intensive home visiting program that provides
parent education and student advocacy. Children who are at risk
of neglect because of excessive tardiness, truancy, or academic
and behavioral challenges are referred to the program. Young
children who are frequently tardy, absent, and disconnected
from school are likely to be living in circumstances where
family issues are interfering with their participation and
opportunity to learn and achieve.
The outcomes of our program this year, to name a few, a
significant drop in DCF referrals were made by the school, an
increase in parental involvement was documented, and a 15
percent increase in grades for the students who were enrolled
in the program was shown.
On a cold morning in March during the CMTs, the FSC staff
received a phone call from the school requesting assistance.
When staff arrived, they found a third grade boy was selling
his Christmas toys to classmates to help his dad pay for rent
and food.
A backpack full of food, a Stop and Shop gift card,
toiletry items, warm clothing were all provided to the child
that day to bring home. Subsequently, the family was informed
about the program and enrolled. As of today, dad is employed,
engaged with the school, and accessing community resources. The
child is excelling socially and academically.
This is a highly successful program, and we have many
families on the wait list.
The second program is the Homeless Prevention and Rapid Re-
Housing Program, funded by HUD. The program provides financial
assistance to people lining up for shelter beds or for those
that are in the shelter.
For example, Jack and Diane were evicted from their home of
5 years. Jack is a self-employed contractor. Diane is a stay-
at-home mother of six. Upon eviction, the family moved into a
local homeless shelter, but one of their children's asthma
became so severe that they needed to move to a motel.
After two apartments fell through, the family finally found
a house to rent. Unfortunately, the timing was off. They had
reached their limit on their credit card at the motel and were
being put out on the street. Their only choice was to sleep in
their car. HPRP prevented this from happening by providing
funding for the motel for a few days and ultimately relocating
them to the home.
Lastly, Juan and Julia, both college graduates, moved to
New Haven from Puerto Rico in order to seek medical care for
their son. Their 1-year-old was ill and had recently undergone
open heart surgery at Yale-New Haven Hospital. In addition, the
boy was recovering from liver disease and other infections.
The family was living at the Ronald McDonald House during
the baby's hospitalization but had no place to live upon
discharge. A stay at a shelter would have compromised the boy's
fragile health. They considered going back to Puerto Rico, but
funding was limited, and they needed to remain close to
necessary medical care.
HPRP was able to assist them in finding housing, paying for
security deposit and rental assistance. The family is stably
housed, and Juan and Julia are currently looking for work.
Thank you for allowing me to tell you about these families,
and thank you for all the work that you have done.
I know I did submit lots of facts and figures in my written
testimony.
Senator Dodd. They were great.
Ms. Day. And I would be happy to talk about those after.
[The prepared statement of Ms. Day follows:]
Prepared Statement of Kellyann Day
Good morning Senator Dodd and distinguished guests, it's an honor
to be here. Thank you for inviting me to speak and thank you for great
work on family and children's issues.
Contrary to the stereotype of men sleeping in doorways or pushing
overloaded shopping carts stuffed with their worldly belongings,
families now comprise 40 percent of the homeless population in the
United States. The percentage is closer to 50 percent in the State of
Connecticut.
Just 30 years ago, child and family homelessness did not exist as
it does today. The numbers of homeless families in the United States
are increasing at a rapid rate. According to the National Alliance to
End Homelessness' Web site,
``Approximately 3.5 million individuals experience
homelessness each year--about 600,000 families and 1.5 million
children. An additional 3.8 million adults and children are
residing in doubled-up, overcrowded, or otherwise precarious
housing situations.''
CT Faces a significant and growing challenge of family
homelessness, with a steadily increasing number of homeless families
with children. We saw a 13 percent increase in homeless families from
2007 vs. 2008 and a 33 percent increase between 2008 and 2009!
Available shelter and housing for homeless families is decreasing.
There is a rising demand for shelter and housing at a time when State
and local government are unable to support the operations of shelters
and are cutting budgets. The development of affordable and supportive
housing has slowed significantly. Public housing authority lists are
long and rarely open for new names.
In 2007, the nationwide average shelter stay for a homeless family
was 5 months. With the economy worsening in 2008 and 2009, the length
of stay has been increasing. At NHHR we have seen a 17-percent increase
in the number of days a family is living at the shelter.
In a nationwide survey, 87 percent of homeless families cited a
lack of affordable housing as the primary cause of their homelessness.
Although most homeless families are headed by a single parent, families
in 36 of the 50 States must work at least two full-time jobs in order
to afford Fair Market Rent for a two-bedroom unit.
Overcoming homelessness is almost impossible without
steady employment.
Over two-thirds of homeless parents are unemployed.
Fifty-three percent of homeless mothers do not have a high
school diploma.
In 17 of 50 States, households must earn over $16/hour to afford
the Fair Market Rent for a two-bedroom unit. According to the National
Center on Family Homelessness' Stat Report Card, the minimum wage in CT
is $8.25. The average wage for renters is $16.53, but the hourly wage
needed to afford a two-bedroom apartment is $21.11. That means someone
working full-time at minimum wage earns only 39 percent of what is
needed to afford the average two-bedroom apartment.
Homeless children have less of a chance of succeeding in school.
This year 35 percent of the 130 children sheltered in NHHR shelters
were between 6 and 12 years old and attending school.
Homeless children are more likely than housed children to
be held back a grade.
Homeless children have higher rates of school mobility and
grade retention than low-income housed children.
Frequent school transfers are the most significant barrier
to the academic success of homeless students.
Homeless families are more vulnerable to serious health issues.
While homeless, children experience high rates of acute and chronic
health problems. The constant barrage of stressful and traumatic
experiences also has profound effects on their development and ability
to learn.
Children experiencing homelessness are:
Four times more likely to show delayed development.
Twice as likely to have learning disabilities as non-
homeless children.
Sick four times more often than other children.
Have four times as many respiratory infections.
Have twice as many ear infections.
Five times more gastrointestinal problems.
Four times more likely to have asthma.
Go hungry at twice the rate of other children.
Have high rates of obesity due to nutritional
deficiencies.
Have three times the rate of emotional and behavioral
problems compared to non-homeless children.
Violence plays a major role in the lives of homeless children.
By age 12, 83 percent had been exposed to at least one
serious violent event.
Almost 25 percent have witnessed acts of violence within
their families.
Homeless parents and their children are more likely to
have experienced violence.
Domestic violence is the second most frequently stated
cause of homelessness for families.
One out of three homeless teens have witnessed a stabbing,
shooting, rape, or murder in their communities.
Among youth aging out of foster care, those who subsequently
experience homelessness are more likely to be uninsured and have worse
health care access than those who maintain housing.
Over 50 percent of all homeless mothers have a lifelong mental
health problem.
Homeless adults in family shelters, when compared to the general
adult population, have three times the rate of tuberculosis and eight
times more HIV diagnoses.
Homeless parents and their children are more likely to be separated
from each other. Homelessness is the most important predictor of the
separation of mothers from their children.
Thirty-four percent of school-aged homeless children have
lived apart from their families.
Thirty-seven percent of children involved with child
welfare services have mothers who have been homeless at least once.
Sixty-two percent of children placed in foster care come
from formerly homeless families.
The deck is clearly stacked against homeless and the unstably
housed. How do we focus on education when we don't have a stable place
to sleep? Forty-five percent of the homeless children sheltered at NHHR
shelters were under 6 years old. We have new born babies at the
shelter, often!
Of the 15 programs that NHHR operates I'd like to highlight two.
The first is the Family School Connection (FSC) program, funded by
the CT Children's Trust Fund. It operates out of the Fair Haven K-8
School, which has the highest number of homeless families in the city.
FSC is an intensive home visiting program that provides parent
education and student advocacy. Children who are ``at risk'' of neglect
because of excessive tardiness or truancy and/or academic or behavior
challenges are referred to the program.
Young children who are frequently tardy, absent, and disconnected
from school are likely to be living in circumstances where family
issues are interfering with their participation and opportunity to
learn and achieve.
Outcomes:
: Significant drop in DCF referrals by the School
(comparable to last year).
An increase in parental involvement.
Fifteen percent increase in grades for students enrolled
in the program.
On a cold morning in March, during the CMT's the FSC staff received
a call from the school requesting assistance. When staff arrived, they
found that a 3d grade boy was selling his Christmas toys to classmates
to help his Dad pay for rent and food. A back pack full of food, a Stop
and Shop gift card, toiletry items and warm clothing were provided to
the child to bring home that day. Subsequently the family was informed
about the program and enrolled. As of today, Dad is employed, engaged
with the school and accessing community resources. The child is
excelling socially and academically. This is a highly successful
program and we have many families on the wait list.
The Family School Connection program conducts universal screening
of all its families. The program is prevention-based, and therefore,
screens clients to make sure the State Department of Children and
Families (DCF) is not involved with the family. The program also
screens children for social and emotional development and refers those
at risk for help.
The vision of Family School Connection is that every child will be
raised within a nurturing environment that will ensure positive growth
and development.
The mission of the Family School Connection (FSC) program is to
work in partnership with parents of children ages 5 to 12 years old who
are frequently tardy, absent or disconnected from school in order to
strengthen the parent-child relationship, home-school relationship and
the parent's role in their child's schooling.
GUIDING PRINCIPLES
Young children who are frequently tardy, absent, and
disconnected from school are likely to be living in circumstances where
family issues are interfering with the child's participation and
opportunity to learn and achieve.
Developing a trusting and productive relationship between
the program staff and the family is the foundation for strengthening a
vulnerable family.
Consistent and reliable contacts are the most effective
way of establishing a supportive and helpful relationship between the
program staff and the family.
The goals of the Family School Connection program are to:
Enhance nurturing parenting practices.
Reduce stress related to parenting.
Increase parental involvement in the child's education.
The program works to achieve these goals by meeting the following
objectives:
Increase primary caregiver's parenting skills, attitudes,
and behavior.
Increase primary caregiver's ability to use community
resources.
Increase communication between primary caregivers and
school personnel.
Increase primary caregiver's involvement in the child's
education and presence in the school.
A growing body of intervention evaluations demonstrates that family
involvement can be strengthened with positive results for children and
their school success. To achieve these results, it is necessary to
match the child's developmental needs, the parent's attitudes and
practices, and the school's expectations and support of family
involvement. Three family involvement processes for creating this match
emerge from the evidence base:
Parenting consists of the attitudes, values, and practices
of parents in raising young children.
Home-School Relationships are the formal and informal
connections between the family and educational setting.
Responsibility for Learning Outcomes is the aspect of
parenting that places emphasis on activities in the home and community
that promote learning skills in the young child.
The Family School Connection Program encompasses these processes in
the design and structure of the program through three components aimed
at reducing the risk of child abuse and neglect and increasing positive
results for children and their school success.
HOME VISITATION
Home visiting based on the concept of ``family-centered'' practice
is the foundation of the Family School Connection program. This
practice is designed to engage families as partners and is essential to
the success of the program. Research has found that parents enrolled in
the home visiting component experienced less stress, developed
healthier interactions with their children, and became more involved in
their children's academic lives during the time they participated. The
program results also suggest that this home visiting is a promising way
to decrease child abuse and neglect in families with school-aged
children.
Program participants are offered weekly home visits for as long as
the family feels the visits are beneficial or until the child ages out
of the program. At any time the frequency of the visits can be changed
based on the family's needs and preferences. The first objective of the
home visitor is to establish a relationship with the family. Often this
is accomplished by addressing immediate and concrete needs identified
by the family such as employment, child care, transportation, basic
necessities, and other issues that might be making it difficult for the
parent to attend to the child's need to be in school.
The second objective is to establish a plan for assisting the
family. The home visitor works with the family to create and implement
a Family Action Plan that draws on the family's strengths, community
resources, and the skills of the home visitor to:
strengthen parent-child relationships;
create linkages for the family to community resources;
support the parent in meeting their family's basic needs;
support the parent in attaining their own aspirations and
needs; and
support the overall social-emotional needs of the parent
and child.
The Clinical Supervisor works with the home visitor to assess the
family's needs and support the home visitor and parent in the creation
and implementation of the family action plan. The Clinical Supervisor
can also provide clinical intervention for the family if the need
arises.
HOME-SCHOOL TEAM
The program supports families by helping both the parent and child
make a positive connection with the child's school. Program staff help
the family connect with a host of school and community services.
Program staff also work with school personnel to help the school better
understand and support the needs of the family. Parent school
involvement is an essential piece of the program and is encouraged by
program staff at every opportunity.
FAMILY LEARNING
Traditionally, school officials have found it challenging to get
parents involved, especially in areas that have a large non-English
speaking, immigrant population. This has been due, in large part, to
language and cultural barriers experienced by non-English speaking
parents. In order to accommodate this population, parent engagement
strategies are modeled after those used by Brein McMahon High School in
Norwalk, CT, where there is also a large immigrant population.
Communication is also crucial to getting parents involved. Parents may
not get involved because they lack direct and helpful information.
Information needs to be provided consistently and in different formats
to ensure the information is delivered in a clear and supportive style.
Resources should be provided to parents who want to learn more about
their children's education and activities. The FSC staff aid school
staff trying to increase involvement by implementing these strategies.
Program staff work with families help them understand and take
responsibility for their children's learning outcomes. This is the
aspect of parenting that places emphasis on activities in the home and
community that promote learning skills for children. Responsibility for
learning outcomes in the elementary school years falls into four main
areas: supporting literacy, helping with homework, managing children's
education, and maintaining high expectations.
Program staff work in partnership with the school, community
organizations, and arts and cultural institutions to engage families in
family learning opportunities. Family learning opportunities can range
in scope and service but are all intended to extend to help the parent
understand and under-take their role as the child's first and most
important teacher. The home visitor works with the family to enroll
them in a family literacy program, before and afterschool programs,
tutoring services or parent workshops on topics that support and extend
a child's learning to the home and community.
Highlights this year:
Between October 2009 to May 2010, 316 books were read by
FSC enrolled students.
The FSC program was able to purchase school uniforms for
children within the FSC program. FSC has become an active investor of
Fair Haven School's ``uniform is unity'' policy.
FSC families participated in New Haven Home Recovery's
holiday program, Adopt-a-Family, were 32 FSC families were adopted and
given Christmas gifts this holiday season.
The FSC program co-sponsors the RIF program with The
Fairhaven School to promote reading as well as connect families with
the school. FSC staff and families participate in this school-wide
presentation.
The FSC program participated in the Fair Haven School
Advisory Program (Grades 7-8). The advisory program is an arrangement
whereby one adult and a small group of students have an opportunity to
interact on a scheduled basis in order to provide a caring environment
for guidance and support, everyday administrative details, recognition
and activities to promote citizenship. The purposes of advisory are to
ensure that each student is known well at school by at least one adult
who is that student's advocate (the advisor), to guarantee that every
student belongs to a peer group, to help every student find ways to be
successful, and promote coordination between home and school.
The FSC program had six target children graduate from the
Fairhaven K-8 and all are registered to attend high school in the fall.
In addition, as a result of FSC involvement, parents reported school
successes with their children.
All FSC families participated in the Homework Contract
campaign. This assists families with becoming involved in their
children's academics and build on parent-child-school relationships.
During the fiscal year ending, June 30, 2009, FSC families
participated in a series of family field trips with transportation and
admission sponsored by NHHR. The field trips include: Duckpin bowling,
Movie night Lake Compounce, Roller Magic Rink, Beauty and the Beast at
the Chevrolet Theatre, Lighthouse Park, Norwalk Aquarium and Beardsley
Zoo.
FSC annual data:
107 Families have been referred.
53 Families were enrolled.
85 Children participated.
211 People total.
The Second Program is the The Homeless Prevention and Rapid Re-
housing program, funded through the American Recovery and Reinvestment
Act provides funding and services to families and individuals. NHHR
serves families who are at imminent risk of homelessness, or who are
literally homeless. Examples of assistance that may be provided
include:
Financial Assistance
Rental assistance, including back rent.
Security and utility deposits.
Assistance with utility payments, including utility
arrearages.
Moving cost assistance (not furnishings).
General Assistance
Referrals to other agencies/shelters when appropriate.
Legal services to assist appropriate person's to stay in
their housing (not assistance with mortgages).
Populations To Be Served
Programs will target people who would be homeless ``but for this
assistance.''
Rapid Re-Housing: Includes people who are literally
homeless (ex: living in a shelter, a motel, a car, etc.) who require
more permanent housing.
Prevention with Re-location: Includes people who are at
imminent risk of becoming homeless (ex: notice to quit, in the process
of an eviction, institutional discharge, housing has been condemned,
etc.), who are unable to repair their current housing situation and
will need to relocate.
Prevention In Place: This includes people who are at risk
of becoming homeless (ex: behind on rent, temporary loss of income,
etc.), but who intend to stay in their current housing situation.
The following is the program breakdown of those served through
HPRP:
HPRP
------------------------------------------------------------------------
Total in
Households Household
------------------------------------------------------------------------
Admitted......................................... 15 56
Discharged....................................... 40 41
In progress...................................... 183 569
----------------------
Total.......................................... 238 766
Denied........................................... 138 438
------------------------------------------------------------------------
For example, Jack and Diane were evicted from their home of 5
years. Jack is a self employed contractor. Diane is a stay at home
mother of six children. Upon eviction, the family moved into a local
homeless shelter, but one of their children's asthma became so severe
they were forced to move to a motel. After two apartments fell through,
the family finally found a house to rent. Unfortunately the timing was
off and they had reached their limit on the credit card at the motel
and were being put out on the street. Their only choice was to sleep in
their car. HPRP prevented this from happening by providing funding for
the motel and ultimately relocating them into a home.
Mike and Gina were being evicted on the day they came to NHHR for
help. Gina is pregnant and was recently laid off from her job. The
couple has three young boys and Gina's elderly, disabled mother living
with them. Dad was working and Gina had found an apartment to rent but
they did not have the security deposit. The CT Department of Social
Services has closed the security deposit guarantee program. NHHR's HPRP
program was able to pay the security deposit and part of the first
month's rent into order to avoid this family moving into a shelter.
Lastly, Juan and Julia, both college graduates, moved to NH from
Puerto Rico in order to seek medication care for their son. Their 1-
year-old was ill and had recently undergone open heart surgery at Yale
New Haven Hospital. In addition the boy was recovering from liver
disease and other infections. The family was living in the Ronald
McDonald House during the baby's hospitalization, but had no place to
live upon discharged. A stay at a shelter, would have comprised the
boy's fragile health. They considered going back to Puerto Rico, but
funding was limited and they needed to remain close to necessary
medical care. HPRP was able to assist them in finding housing, paying
for security deposit and rental assistance. The family is stably housed
and Juan and Julia are currently looking for work.
These two program are examples of excellent programs that need to
and should continue.
Please feel free to contact me with any questions or concerns
regarding this testimony.
Senator Dodd. No, they were great. I would just say I wish
others would look at the testimony, but just the statistics on
housing, on healthcare, on education, I am just alarmed. I went
the other night to--Nancy Pelosi's, Speaker Pelosi's daughter
Alexandra made a movie which HBO supported, and we went to it
at the Press Club. I introduced it the other night.
And it is about children, homeless children living in
motels outside of the gates of Disneyland in California and
just what their lives are like and what they go through. But
the statistics, the numbers are just breathtaking and growing.
Ms. Day. From 2007 to 2008 here in Connecticut, family
homelessness increased by 13 percent.
Senator Dodd. Yes.
Ms. Day. Between 2008 and 2009, it was 33 percent.
Senator Dodd. Yes. There is about a 20 percent increase in
kids in school who are homeless, and one quarter--only one
quarter of homeless children graduate from high school
nationally.
Mr. Edwards.
STATEMENT OF DOUG EDWARDS, FOUNDER AND PROGRAMS DIRECTOR, REAL
DADS FOREVER, MANCHESTER, CT
Mr. Edwards. Thank you, Senator Dodd. It is a pleasure to
spend some time with you and with the rest of the members of
the panel.
Approximately 40 to 60 percent of children in Connecticut
go to bed without a dad at home at night. Father absence is
connected to high out-of-wedlock birth rates, the inability of
some men to form an emotional connection to their children, and
high levels of separation and divorce among parents, which has
been exacerbated by high unemployment and the recession.
Research shows us that children who are securely attached
to their fathers have better outcomes socially, emotionally,
and academically. Fathers, the proverbial ``bread winners,''
get their self-worth largely from performance, and in the
absence of work, psychosocial dynamics wreak havoc with their
relationships, even with their children.
The recession has triggered an increased emphasis on job
preparation, education, training, job retention, and the
development of relationships with employment resources. In
addition, programs have found ways to support fathers trying to
navigate their relationships with their children in the present
difficult environment.
Connecticut formed the Fatherhood Initiative as a result of
legislation in order to ``promote the positive involvement and
interaction of fathers with their children.'' There are
presently six sites in the State that have passed a rigorous
certification process in 2006 and are currently in the process
of recertification. Five more sites have applied for new
certification. Connecticut is the only State in the country
that has a certification process for fatherhood programs.
Representative John S. Martinez, who passed away in 2002,
was the deputy majority leader serving New Haven's 95th
Assembly District. He was especially instrumental in sponsoring
the Fatherhood Initiative of Connecticut legislation, which was
passed by the legislature in 1999. In his honor, on July 9,
2003, Public Act 03-258 was signed into law and is now--the
Fatherhood Initiative is now called ``The John S. Martinez
Fatherhood Initiative of Connecticut.''
The six fatherhood sites provide comprehensive fatherhood
program services to low-income, noncustodial fathers, including
preparation for the legal, financial, and emotional
responsibilities; the establishment of paternity at childbirth;
fostering their emotional connection to and financial support
of their children; workforce skills development; and father
support services.
There are 30 to 40 other fatherhood programs in Connecticut
in Head Start schools, prisons, churches, and communities that
provide one or more of the services mentioned.
In addition to providing some of these services, my
program, Real Dads Forever, supported by the Connecticut
Department of Public Health, developed a curriculum called
Prenatal Early Attachment for dads supporting mom and the baby
during the pregnancy and after birth. We are about to begin our
second cohort, a collaboration with Fair Haven Community Health
Center, right here in New Haven, and Centering Healthcare
Institute's Centering Pregnancy in Cheshire, a group prenatal
national model, which is being evaluated by UCONN.
We have experienced very promising short-term results--
increased caring and emotional attachment to mom; more
consistent, timely prenatal visits by both mom and dad; greater
understanding of prenatal development; a commitment to
breastfeeding by mom with dad's support; an emotional
attachment by dad to his unborn child; and a dramatic increase
in communication between dad and mom, mostly initiated by dad.
Research shows us that if these elements are in place early
on, moms are healthier, babies are more likely to be full-term.
There is a better chance co-parenting will be successful for
the long-term. Our evaluation team is designing protocol to
follow up these families over time to substantiate the
research.
There is a wealth of research that underscores the value of
early prenatal father involvement, but a dearth of
comprehensive programming that specifically targets fathers
during the prenatal period. Fathers are especially vulnerable,
open to learning, and welcome the group experience along with
mom.
My work with fathers, over 5,000 of them since 1996, in
small groups over several sessions has taught me that adults
sometimes still have a yearning for that father-child
relationship embedded in their subconscious since childhood.
This--what I call ``yearning, churning, and burning''--impacts
their social/emotional development, education, and relationship
navigation for decades.
This observation of residual emotional disease led me to
want to begin to find ways to address father absence issues
from a standpoint of prevention rather than intervention,
making it essential that we start as early as possible.
DPH has succeeded in forming a collaboration of agencies,
including the Public Health Foundation of Connecticut, the
Hartford Health Department, in the 5-year HHS Federal grant to
Connecticut DPH to expand access to healthcare in Hartford for
women nearing childbirth to ensure newborns get a healthy
start. Real Dads Forever, with its Prenatal Early Attachment
Program, is one of the community partners.
Upon further evaluation, this program will be replicated
after proper training and certification of facilitators. As
part of our evaluation, we will also focus on the return on
investment of this program. At its heart, it is prevention. And
we know, especially in this challenging economic environment,
prevention is a more fiscally sound investment than
intervention.
I have also been involved as facilitator and trainer with
the Parent Leadership Training Institute, Parents Supporting
Educational Excellence, both as part of the Commission on
Children. They are two very successful programs, preparing
parents to advocate for and lead their children and to partner
with schools for school improvement.
Thank you for the opportunity to share my work, concerns,
hopes, and dreams for the present and future children of
Connecticut.
And thank you, Senator Dodd, for your many years of service
to our State. In my opinion, there is no finer way to end your
Senate career than having our children close to your heart.
Senator Dodd. Thank you.
[Applause.]
Terrific job, Mr. Edwards. Thanks very much.
Doctor.
STATEMENT OF LISA HONIGFELD, Ph.D., VICE PRESIDENT FOR HEALTH
INITIATIVES, CHILD HEALTH AND DEVELOPMENT INSTITUTE OF
CONNECTICUT, INC., FARMINGTON, CT
Ms. Honigfeld. Senator Dodd, thank you for the honor to
testify before you this morning.
As you noted, I am the vice president for Health
Initiatives at the Child Health and Development Institute, or
CHDI. CHDI is a not-for-profit organization that is dedicated
to improving the health and mental health systems for children
here in Connecticut.
As part of my responsibilities at CHDI, I have the
privilege of participating in the implementation and the
dissemination of a successful Connecticut-grown system for
identifying young children at risk for developmental delay and
connecting them to intervention services, many of which you
have heard about this morning, which will allow them to receive
services at the youngest age possible, which is when we know
that interventions are most effective.
Help Me Grow, originally developed as a pilot program in
Hartford by Dr. Paul Dworkin, physician-in-chief of the
Connecticut Children's Medical Center, brings together funding
and resources from four State agencies that address children's
developmental needs. These include the Department of Public
Health, the Department of Developmental Services, the
Children's Trust Fund at the Department of Social Services, and
the Department of Education.
Through a single point of entry, families are linked to a
variety of health and community services. Highly trained care
coordination staff at United Way's 2-on-1 Child Development
Infoline field calls, perform intake, and connect children and
families to a variety of programs, thereby facilitating access
to valuable community-based services that promote healthy
development.
Several of these services are funded through Federal
dollars, including Part B preschool special education services,
Part C early intervention services, and services for children
and youth with special healthcare needs that are funded through
the Maternal and Child Health Bureau's Title V block grant
dollars.
Child Development Infoline also integrates hundreds of
community programs, some of which we have heard about this
morning, that are part of the Help Me Grow inventory of
services. By centralizing access to all of these programs under
a single point of entry, at-risk children who are ineligible
for the federally funded, State-mandated programs can receive,
through Help Me Grow, linkage to geographically and culturally
appropriate programs and services.
Help Me Grow's statewide triage program is supported by
regional child development liaisons who locate services and
maintain regional resource inventories and facilitate access
for children and families. In addition, Child Development
Infoline educates pediatric and family medicine providers about
early identification of children at risk for developmental
delay and their connection to interventions through Help Me
Grow and Child Development Infoline.
Help Me Grow Child Development Infoline is an exemplary
model of blended funding supporting a multi-sector system that
cuts across State agencies and includes community-based
programs to ensure access to services for all children for whom
there are concerns. More than 8,000 families have used this
system over the past 4 years, and 80 percent of them have been
successfully connected to services.
When we consider that only 1 in 5 children nationally who
are identified with the behavioral health concerns receive
services, the success of Help Me Grow Child Development
Infoline is evident. Help Me Grow and Child Development
Infoline's success has led to generous support, initially from
the Commonwealth Fund and, most recently, the Kellogg
Foundation, to Connecticut Children's Medical Center for
national replication of this model system.
Two sites--Polk County, IA, and Orange County, CA--have
Help Me Grow in place. Five others--Colorado; western Oregon;
Greenville County, SC; and the greater metro Louisville, KY
area--are developing systems with technical assistance from the
Connecticut Help Me Grow team. The Help Me Grow replication
team will select 10 additional sites for replication over the
next 3 years.
All of these sites, their States, as well as the remaining
33 States, would benefit tremendously from Federal support for
Help Me Grow. More specifically, since Help Me Grow Child
Development Infoline's success depends on the blending of
Federal, State, and local resources to effectively and
efficiently address the needs of young children, we look to
Federal support of States to develop and implement Help Me Grow
systems throughout the country.
The Connecticut Help Me Grow replication center stands
ready to partner with your committee and Federal agencies in
building the capacity in all of our States to ensure that
children are connected to the services that can ensure their
healthy development and can begin school healthy and ready to
learn. As your committee considers how to support programs that
will ensure children's success, I urge you also to consider
legislation that will enable States to develop systems like
Help Me Grow for linking children to available community
opportunities.
Thank you, and if you believe that the Help Me Grow
national replication team from Connecticut can provide you with
additional information or assistance, please don't hesitate to
call on us.
Senator Dodd. That is great. What a great story.
[Applause.]
What tremendous stories here that are going on in our own
State. And with all the identifying of the problems, and yet to
hear these wonderful efforts that have been made throughout
Connecticut certainly is a source of pride as well. So I
commend all of you for your work, and I thank you immensely for
it.
I should mention, by the way, that I have some wonderful
staff who do tremendous work here, and I want to mention Averi
Pakulis. Averi is here as well. Averi, thank you for your work.
And Tamar Haro is the chief of staff of the committee. And
Tamar, thank you immensely for your work.
And Ben Nathanson is here. Ben, are you here? Yes, you are.
Ben is a new member of the staff and does a great job.
Margot Crandall-Hollick as well is at the table over there,
and Megan Keenan, is Megan here? Back in the back of the room
as well. I know Brian is here, and who am I missing--Meg
Benner.
So I thank all of them for being with us here. There are
others from the staff as well, but these are principally the
people who work on the staff of the Labor Committee.
Well, today is the 25th anniversary, by the way, of the
Americans with Disabilities Act, ADA. And so, there are some
questions we should have, I guess, about the difference the ADA
has made with children with disabilities. And maybe just to
begin right where we left off, Lisa, with you, how has the ADA
helped in all of this?
Ms. Honigfeld. Senator Dodd, the Americans with
Disabilities Act and, more specifically, the act that allows
very young children to be connected to intervention services
has an enormous potential to provide intervention at a time
when, as Dr. Lowell told us, when the developing brain is most
amenable to developing resiliency and other skills that will be
important.
And so, these services--the Americans with Disabilities
Act, as well as IDEA--for connecting the very youngest children
really call on us to ensure that children with or at risk
actually for developmental delay are identified as soon as
possible and connected to effective programs.
Senator Dodd. Well, Doctor, let me ask you as well on that
because one of the issues that strikes me is how do we identify
early on? Instead of waiting for the problem to emerge,
obviously, we can all--I mean, you don't need to have a Ph.D.
to spot that. But what does require some sensitivity is
identifying those problems as early as possible.
Dr. Lowell. Yes. I actually think that that is probably one
of the most critical things we can do because the brain is
really very malleable then and that we know that that is the
time when the architecture of the brain is developed. And that
what happens in those early experiences are going to determine
what that architecture looks like, and it is going to be there
forever.
I mean, we can hope to make changes, and it is not that we
can't in the future. But really, it forms the foundation. So
what do we do? I think that there are several things. One is
that we have to have strong collaborations in communities. We
have to have strong connections because, for instance, in
Bridgeport, where this model developed, many of the children--
actually, in the beginning, all of the children were referred
from other community providers.
And so, by educating them to understand the early signs of
problems, both within the child developmental problems, but
especially our early care and education sites were seeing
social, emotional, and behavioral problems. And so, one, we
have to be able to identify those. But I would say at least, if
not more important, is to understand what the environments
these children are growing up in and, as Dr. Zigler said, the
stresses in the environments.
Because we have a lot of knowledge now about toxic stress.
We know about maternal depression and homelessness and
substance abuse, domestic violence, and other risks that are
going to create environments where the child's brain is
actually going to be damaged by the stress they experience. So
by finding those families who are experiencing that stress
early on, we can refer them to programs which can both address
the stress and address the relationships. It is a two-pronged
kind of comprehensive approach.
The other thing we can do is have screening, much more
formal screening that we have actually established in our
pediatric primary care center. And I know actually the Child
Health and Development Institute has done a lot of work in
Connecticut around that as well, but also in our early care and
education sites. And again, the screening has to be more than
just for development. We have to look at emotional issues and
problems, and we have to look at what are the challenges that
our families are facing because that is where our
identification can be so powerful.
Senator Dodd. I wrote, along with Lamar Alexander, the
infant screening legislation, which was designed primarily to
deal with some of the--I think were eight originally. There are
a lot more now, around 32 or 34. But these are more
developmental issues that if you can pick them up early enough
and they become recessive, that actually you can avoid some of
the neurological issues----
Dr. Lowell. Right, right.
Senator Dodd [continuing]. That would develop into a
lifelong threat. In fact, there was only one facility in all of
New England, in Massachusetts, where you could do the
screenings. Now we do it here, and the resources are provided
elsewhere.
But you are talking about something else, and I am
wondering whether or not we have the capacity. I know it is
ideal to do it. Do we have the capacity to identify these kind
of developmental issues beyond the ones that we normally
associate with neurological issues?
Dr. Lowell. Yes, I think that we do have the capacity. I
think it takes education of providers to understand why it is
important and how to identify those families at risk. And it
takes will. It takes believing that if we can get there early
and work very intensely with families that we really can make a
dramatic difference and prevent not only problems for those
parents, but really prevent problems, long-term problems for
those children.
And I think that when we look at it from a cost-benefit
analysis, that we will save money even within the first year of
doing that kind of intervention because special education
itself, DCF referrals, foster care, all of this. When we get
services for families, we avoid homelessness. We avoid later on
incarceration and very serious problems with hospitalization
for psychiatric disabilities.
So we have to believe that, get there early, and prevent
many of these disabilities.
Ms. Honigfeld. Can I just add one point?
Senator Dodd. Certainly.
Ms. Honigfeld. Darcy and I have worked together on this for
a long time, and I can't overemphasize the role of formal
screening in all of this. We know from pretty rigorous studies
that child health providers, when they determine a child has a
developmental delay or is at risk for a developmental delay,
they are 95 percent correct.
However, if they used a formal screening tool, they would
identify 67 percent of children at an earlier age than if they
waited to just use their clinical judgment. So I know, Darcy,
Child FIRST has done really an excellent job in screening, and
I think that that speaks to its success, and I think that is
why the interventions have been so successful.
Senator Dodd. Dr. Keck, do you have any comments on this at
all?
Mr. Keck. Actually, I do. I learned a whole lot about Head
Start once I started this project, and Head Start facilities,
actually 10 percent of the students in each facility are
required to have either developmental delays or disabilities or
things of that nature.
And the interesting thing to note is children with special
healthcare needs is a very rough definition to actually get
your hands around because asthma could be a special healthcare
need. It doesn't need to be physical disability, developmental
disability. There is a lot of things that go into the idea of
children with special healthcare needs.
But from the perspective of being a teacher at Yale, the
facilities at Yale and the University of Connecticut I think do
a very good job at least with oral health for children with
special healthcare needs. Adults with special healthcare needs
is a different issue altogether. But I think we are doing a
good job in the State of taking care of children's oral health.
Senator Dodd. I want to come back to that. Your testimony
about the oral health of children, I want to come back to it in
a minute.
But, Ed, let me ask you, I was impressed. You got 20 States
that are now involved with 21st Century schools, and you
mentioned the number, 60 schools in this State, some 1,300
around the country that are involved. Why only 26? What has
happened? What are the obstacles that States are having?
And I was impressed that Kentucky and Arkansas have
developed school-wide systems. I mean, I say this respectfully
of Kentucky and Arkansas, but I don't normally think of them as
being so on the forefront of some of these issues. That will
probably get me in a lot of trouble now----
[Laughter.]
Senator Dodd [continuing]. That headline blaring. But they
did. They have gone ahead--to their great credit, they have
gone ahead and done this. And why not other States? What have
been the problems?
Mr. Zigler. They keep growing. California has just come
onboard. But the problem is there are so many things that could
be done that is not that visible. That is why I would say it
would need some kind of Federal push, either legislation or
some dedicated stream of money. It is the startup money that is
the only problem.
Our discussion that we have just had rings a bell with me,
too. I agree with my colleagues. Get in there, I mean, Nobel
Laureate Heckman has now pointed out that you get your biggest
payoff for any kind of a program the younger the child.
I am sure that you have helped, but the Obama
administration has been very forthcoming. For the very first
time in all these years--home visiting has been around for at
least 35 years that I have been cracking it. For the very first
time, the Obama administration has come up with a stream of
money to let home visiting take place.
There is home visiting in every one of these schools, but
one of the important aspects of home visiting pertains to your
previous question. One of the most important pieces of work
that the home visitors do is not just work with the parents,
but screen the children to pick up these kinds of mental
health, physical health problems as early as possible and act
as a broker for the services these children need.
Senator Dodd. I have used it so many times. I have said it
so many times over the past 30 years. But with Head Start, the
requirement from the earliest days, when you go back to 1965,
that your Head Start program insisted upon parental involvement
with children. And I think we get about 80 percent involvement.
These are the numbers I use. I don't know if I am right or not.
But by the first grade, the parental involvement drops
generally across the country to less than 20 percent. And so,
the importance of it, obviously, is clear. What a difference it
makes. But it does drop off, and anything that can be done to
increase that parental involvement I think is just huge.
Abby, I don't know if you want to talk about that in the
Norwich school systems. I know you talk about it. Let me say,
too, I have always sensed--and I come from a family of
teachers. My sister just retired after 41 years of teaching in
Connecticut, and my father's three sisters taught for 40 years
apiece in the public high school system of the State. There is
always some resistance, and I understand why parental
involvement, interference, teachers trying to do their job. And
all of a sudden, it is annoying parents that are showing up and
pushing, nudging, doing everything else, and their kids.
You always get this feeling that it is not a warm-fuzzy
relationship, generally speaking, between parents and teachers.
And I am curious as to how you can start to break that down. It
seems to me while you can call for it, you could require it,
but if it isn't part of the seamless relationship that that
teacher sees that child arrive, you don't see just a child walk
in the door. You see a family walk in the door.
To what extent can our educational system--and teachers,
rightfully, bemoan and say, ``Wait a minute. You trained me to
be a teacher. Now you want me to be a guidance counselor, a
minister or a rabbi. You want me to be a policeman. All of
these jobs you are asking me to do beyond trying to teach a
child. So you are loading me up as well.''
It seems to me this is pretty basic, what Mr. Edwards
talked about, and the first rule of any of these relationships
is that parental relationship, the role of fathers in this
relationship. Every one of you have mentioned, I think, to one
degree or another, the importance of that relationship. But we
don't seem to be doing a very good job of it. Now how do we do
a better job?
Ms. Dolliver. I mean, all that you talk about is what I
see. Unfortunately, it is a lot of what I see. We work really
hard to open doors to parents. But it is a culture that you
have to change that I am here to teach. You give me your kids.
They are mine. I will have them for this day, and then they go
back to you.
We are trying to do more and more programs to invite
parents in, not just to fund raise or to have activities, but
to be part of what is happening. For example, at one of our
middle schools, they have a breakfast where they honor students
quarterly. It doesn't just mean you are the top of the class.
Doesn't just mean you are on the honor roll, if you have good
conduct.
We find reasons to award kids, and we invite parents in for
breakfast to be part of that. So those kinds of things. So it
is not just the call, oh, so and so is not behaving today, or
they are failing. We are trying to do positive interventions
with parents to open doors.
Senator Dodd. Yes.
Ms. Dolliver. And really, you know, I have to model that
for the staff that you have to talk to parents. You have to
listen to them, and you have to hear where they are at and who
they are. And then it is their family who we are educating.
Senator Dodd. A lot of the times, the parents that you
wanted to reach are the ones whom themselves had bad
experiences necessarily in schools. And so, they are less than
willing to walk into an environment that was hostile in many
ways. Probably dropped out in many cases themselves.
In the case of homeless kids and so forth, they do not have
the warmest relationship necessarily. So getting that home
visiting. I mean what Ed talked about, including your
testimony--beginning with conception. I would like to know how
you figure that one out.
[Laughter.]
I can see the trouble you would be in on that one. A
Federal program here. I can see the tea party now talking about
that.
[Laughter.]
What the Federal Government is up to here requiring you to
report on those statistics.
But the idea of getting involved early on, obviously, is
important. And being at the home setting, which is the hardest
thing to do because it is labor intensive. There is sometimes
just a cultural question of walking in, what does it mean? How
good is the information you are going to get, people showing up
at a house, all the nervousness that can pose.
I mean, all of the problems, and yet I have got to believe,
having listened to a lot of people, including yourselves, there
is nothing better than if someone is familiar with that home
environment, to some extent. Anyone want to comment on that?
Ms. Day. I just wanted to comment. I think you are right. I
think the engagement of the family is critical and in a
positive way, as you were mentioning. Not just getting the
calls when something is wrong. Not just making referrals to
programs because the child did something wrong.
I also agree that we have a program in our shelters where
we advocate for students who are homeless in the New Haven
Public Schools, and what we found out is that many of the
parents were very fearful to tell the teachers that they were
living in a homeless shelter. Well, who more importantly needs
to know that that child is living in a homeless shelter than
the teacher?
Senator Dodd. Yes.
Ms. Day. But parents were afraid. They were afraid that
people were going to assume they were bad parents because they
were poor and homeless. People were afraid that they were going
to get a DCF call because they were homeless.
So I think that the connection between the school and the
family is critical, and education of the parents and outreach
to them in a positive way is very important.
Senator Dodd. Jim Horan, why don't you talk--I was curious
because you have talked about this as well in getting services
and programs, parents involved, community involved. The
recession obviously hasn't helped with more people out of work.
Mr. Horan. Yes. That is one thing I was thinking about,
listening to the other panelists right now. The recession
really has hurt this a lot. You mentioned, as superintendent in
Norwich, I think 70 layoffs. I think there are 122 in New
Britain and more in New Haven and other cities all around the
State.
I think that that really does hurt because a lot of times
school districts around the State are making cuts, and they
have to cut wherever they can. I know in West Hartford, where I
live, 2 years ago the magnet school resource officer was cut,
and part of her role was integrating the role of foreign
language speaking parents in the schools. And that was
eliminated.
Now I will say the PTO has really stepped up, and there are
parents who are translating to bring in other parents to help
them out. But that is difficult. And it is just as you said,
too. A lot of the parents who are the ones we most want to get
involved are the ones who have had poor experiences themselves
when they were students. You know, they dropped out or had
other issues in school.
So we really need to try to change the culture in the
schools, and I think that is the role starting from the
superintendent down, and it also has to be kind of from the
bottom up, with parents pushing and teachers who do feel
comfortable pushing to make that happen. But it does become
harder in a time of limited resources like we are facing now,
as districts are laying off some of the folks who were involved
in these roles.
Senator Dodd. Yes.
Mr. Edwards. If I may just add? There recently has been
funding by the Parent Trust Fund for parent leadership training
here in Connecticut. And Parent Leadership Training Institute,
which Elaine Zimmerman is involved with, and Parents Supporting
Educational Excellence are both programs that prepare parents
to have a relationship with schools.
They are taught about how schools work. They are taught
about how government works. They are taught about how to be
strategic in the development of addressing problems that relate
to their children and others and how to advocate for their
kids. They are also taught how to read reports that come out
from the schools about progress and the achievement gap.
So that is a lot of preparation that is going into working
with parents. I just recently heard from a principal who said
that her teachers--the biggest fear of her teachers is a
conversation with parents. So I think from what I hear, and I
haven't verified this, but in higher education, there doesn't
appear to be a lot of emphasis on teaching future teachers how
to develop relationships with parents.
Some teachers do it intuitively, and they do a wonderful
job. But there are others that may need a little help, just
like parents do. So if parents can be more prepared to kind of
do that dance with schools, with teachers, children will
certainly benefit from it.
Senator Dodd. That is an interesting comment. I would be
curious to know whether or not any of our schools of education
have any kind of emphasis at all, even slight emphasis on that
role. I suspect they don't.
Mr. Edwards, you seem to indicate they don't. I don't think
they would. Any further comment on this particular point? Yes?
Dr. Lowell. I just wanted to comment that you had indicated
that parents who have had bad experiences themselves are going
to be more afraid actually to engage with schools. But I mean,
even more so, they are very hesitant to engage with any kind of
social service program. So the engagement process becomes so
fundamental, the building of the relationship with the parent
so that there is really trust there.
So instead of seeing whoever this helper is as someone who
is going to take my child away or will it be a negative
consequence can see, for instance, our Child FIRST clinical
team as these are people who are there for me. These are my
partners. They are going to help me. They are going to make a
difference.
We have had parents so many times say, ``You know what, no
one ever cared what I thought before. No one ever listened to
me.'' And so, the whole move to have things that are parent
empowering, that help a parent be the one to be the driver in
terms of what kinds of services and supports are going to make
a difference makes a huge difference.
So the PLTI movement in terms of helping parents understand
this, but every single relationship that we build with parents
which helps to build them up, to empower them for their
children, becomes really very essential in terms of the long-
term outcomes, when we are no longer there for them.
The other thing I would say just about the relationships in
the schools is that we have to help teachers really have
empathy for the conditions of some of the children. Instead of
seeing children's behavior as ``bad behavior'' and, therefore,
it is the parents' fault. Instead to really try to understand
why is a child acting like that, to help them take a much more
what we call reflective stance to think about what is going on
inside the child and what is going on inside the parent. What
are the challenges they are experiencing?
So that, instead, they can feel like they can be a partner
and help the parent. That is a real shift and so that they can
be--we want them to be partners together instead of----
Senator Dodd. That was one of the things they are doing.
And again, as you are watching now, particularly in preschool
and kindergarten and first grade is having a continuum in a lot
of public schools where that teacher moves with the class. So
in these early stages, you are getting--my 5-year-old is going
to kindergarten next year in a public school in Washington, her
preschool teacher will be her kindergarten teacher next year.
Dr. Lowell. Well----
Senator Dodd. And that is great, so there is that sense of
having that same person. She is very excited about having Ms.
Burke next year.
[Laughter.]
In about a month, to go back in. So that continuum in that
early stage where they really got to know, in that public
school, Ms. Burke now knows those 21 children. She knows those
families that live in our neighborhood, in a very diverse
neighborhood in Washington. And so, it is really going to be--I
can see that already having a positive impact on the children
in that classroom and the parents.
Ms. Dolliver. Well, that is called looping, and we don't do
it a lot, but we do it a little. Now we just have to cover
classrooms with the shortage of numbers of classrooms that we
have. However, we did it in our middle school with special
education students, and it was a big deal for the teachers to
think, now I have to learn the curriculum of eighth grade if I
was in seventh, or I have to learn the seventh grade if I was
in sixth.
But we have done it for 2 years, and it has had a positive
impact.
Senator Dodd. It has had a positive impact, yes.
Ms. Dolliver. They know the kids and their needs and their
families, and they can continue the relationship. A lot of it,
so much is about relationship.
Senator Dodd. You wanted to say something, Tammy?
Ms. Papa. Yes. Just real quickly, in terms of afterschool,
because it is a less structured environment than the daytime
happens to be, we have found that we can involve parents in a
number of ways. And obviously, the most basic way is to involve
them in at least one activity throughout the course of each
semester, the fall and the spring, if you will, and ask them to
participate with us.
Most of them will do that, and they feel a little bit more
comfortable coming in in a less structured environment. But we
also require that the parents come into the school every single
day to sign their child out. So they can't beep the horn. The
kids can't run out. They have to come into the school.
So it gives our teachers an opportunity to talk to them.
Not run up to them and say, ``My God, your child today.'' But
to approach them in a more positive manner, maybe about
something great that their child has done and really focus on
words of encouragement as opposed to disappointment as to what
the child's behavior might have been for that particular day.
But we also, as part of the 21st century grant, they
encourage you to do family activities. So, monthly, we do a
regularly scheduled evening activity, where we provide dinner
and the opportunity for parents to come into the school, and
most of our principals will stay for that activity, which
really helps build the relationships. And have the afterschool
staff, along with some guest speakers, things that are critical
to families, whether it is financial literacy, or whatever it
might be.
It may be an activity that they can do with their children,
but we invite the entire family in, provide them with dinner
and an opportunity to work together on that activity. And that
has been pretty successful. In a school where maybe we serve
about 100 children, we may get upwards of 70 families that come
in for that particular event, and that happens one night during
the month.
And then, on the flip side of that, we do need to educate
our teachers a little bit more. So we provide quite a bit of
professional development on how to approach parents, how to
make the schools more welcoming. I know the State Department of
Education does quite a bit of professional development on this
topic.
So I think all those things combined will help bring
parents into the school and make teachers a little bit more
comfortable with approaching them.
Senator Dodd. Let me ask a naive question in a sense, and
it goes to what you are talking about as well, and that is I am
always struck with the fact--and again, on the Lighthouse
Program, which we have worked very closely with over the years,
and I am a great supporter of it. But it takes some initiation
on the part of parents to get in the program.
And a lot of these things we have talked about here require
parental initiation. And yet the very people we are talking
about that are the most in need are the ones where that is less
likely to occur. We are not serving but a fraction of the
population. What, at Head Start, what are we? One in four, Ed,
to this day even? One in four of the eligible Head Start
population in the United States being served by Head Start?
Mr. Zigler. The eligible population is about 45 percent.
Senator Dodd. And we are serving?
Mr. Zigler. Forty-five percent of the kids that are
eligible after 45 years of Head Start.
Senator Dodd. Yes. So, again, it takes someone to step up
and to seek to be enrolled. And many times, it is the most
vulnerable families that just don't take the step. And so, it
is always frustrating to me because the ones who, to their
great credit, do try to get into those programs, want to be in
that afterschool program, want to be in these things. And even
though they are very poor, they deserve a great deal of credit
for fighting on behalf of their children and their future.
But so much of the most vulnerable kids and families just
don't even know how to navigate this at all, and that is a----
Ms. Honigfeld. Can I make a comment to that?
Senator Dodd. Yes.
Ms. Honigfeld. I think that is absolutely true, and that is
why we really need to exploit the child health system because
every family needs to take their child to the doctor or they
are not going to go to Head Start. They are not going to go to
school. They are not going to go to camp. They are not going to
go to other childcare. And I think that is a system we really
need to exploit in terms of doing a better job educating child
health providers to encourage parents and actually to use
systems like Help Me Grow to link parents to all the programs
that are available for their engagement.
Senator Dodd. I am very impressed on how much of that has
been replicated.
Dr. Lowell. Also, I couldn't emphasize enough because the
engagement process is very difficult, and it is very costly. I
mean, I can't tell you how many children in families who
initially--who we find, who are interested, who are very high
risk, but from the time that they are identified to the time we
can actually engage them in services sometimes takes over a
month of persistence, of calls, of letters, of dropping them
notes at their door, if necessary, to before they are really
willing to have us actually come in.
And so, we are really about engaging the very highest risk
children and families. And actually, our research, one of the
things about the way we did our research, which was the
randomized trial, we actually did randomize into a control
group and an intervention group so that we could see where we
disproportionately were losing the high-risk children.
And what we found is if you are persistent and if you also
take a nurturing stance that we are there to help you, but you
have to be--I mean, it is not short-term. It is not three
strikes and you are out. You have to really be there and be
willing to keep at it. You can engage these families because
they want the best for their kids.
And when they feel like you are there for them, they are
willing to--and something about what Lisa said, just one family
comes to mind so really prominently. We had a family who came
in, a little 3\1/2\-year-old girl and a very proud mom. And
physical exam was normal, but we had done screens.
And the screen was positive only for maternal depression.
Nothing else was positive. And we had a clinician who is
embedded in our pediatric primary care center who said to this
mom after her visit, before she left the pediatric clinic, you
know, I was wondering, is there anything we can do to help you?
Because I see that you said that sometimes you feel life is so
hard you don't even know if you can continue.
And it was based on that, this mom looked at our clinician,
who is just the most warm, wonderful person, and she had dark
glasses on. She took them off, and she started to cry. And it
was that connection that never would have been made. It ended
up there was a domestic violence situation. They had an
apartment. They had no beds. They had no table. Her child was
being evicted from childcare.
I mean, there was a multiple risk family. We never would
have found them without that pediatric screening. But it took
us 6 weeks from the time she said ``yes, come'' before we
actually got in the home. So it says persistence makes a
difference.
Senator Dodd. It is labor-intensive.
Ms. Day. Well, and you also bring up a good point. I mean,
there are 1.5 million families that are homeless or unstably
housed, and those are the ones we know about. Many of them are
in motels or doubled up, and we don't know----
Senator Dodd. There is 1.5 more that is--the number is
stacked. Yes.
Ms. Day. Correct. And how can you pay attention to anything
if you don't have any food, clothing, or shelter?
Dr. Lowell. That is right. You can't.
Ms. Day. You are not going to go to the doctor. You are not
going to pay attention to whether your kid is behaving or not
behaving. The stressors on the family and the parents are so
high that that is what makes the engagement difficult, too.
I mean, I think we really need to pay attention to our
families' basic needs in order to be able to provide what Dr.
Zigler talked about, the family, health, education, and
childcare. You can't have any of that unless you have food,
clothing, and shelter.
Dr. Lowell. Stabilization. You have to have that first.
Senator Dodd. Let me jump to Dr. Keck. I want to--because I
was stunned by your statistics. Thirty percent of 3- to 5-year-
olds in Head Start have tooth decay?
Mr. Keck. I can testify to that because, as part of the
program that we are developing, last year we started examining
the Head Start children in the schools. It goes along with the
whole idea that getting active participation from the parents
can sometimes be very difficult.
So we have gone out to the schools to conduct the initial
examination. And we didn't get through all 900, but with the
150, that statistic is true. This is a national statistic, but
it holds true in the State of Connecticut.
The second thing that we have learned since starting the
project, at least in the State of Connecticut, is for the
program to work, we have done a good job about getting the
children examinations. But the follow-through to future care,
getting the cavities treated--and it is probably the same in
pediatrics--and follow-through is a big issue.
There is a person called the family service worker that is
responsible, sadly to say, for about 35 to 40 families,
students in the class that do go out and do the home
visitation. And we are trying to make it a part. We have been
educating the Head Start staff to particularly the family
service workers, when they go out to the homes, to make oral
health a part of the family health partnership agreement, as
well as several different things.
Usually you can only have so much of things on a list. I
agree that home and food and all that is important, but we are
trying to move oral health up on the list.
Senator Dodd. Well, I just want to tell you, I think it is
so important. To me, oral health, and this is such a window on
so many of the problems. And for years, it has been just so
neglected. And to me, if you had to pick at just one area, the
oral health thing is huge to me.
Mr. Keck. In my private practice, we also see Medicaid
patients, Head Start patients as well, and the amount of dental
decay is certainly not decreasing. My partners and I go to the
hospital once a week to do two or three cases a week. I know
the residency program at Yale does probably 10 cases a week of
underserved children who have multiple cavities in their mouth
and are younger than the age of 3 because they can't be treated
realistically in a normal dental environment.
Senator Dodd. Well, and I noticed the community health
centers. I was in New Britain. We have about 12 or 13 community
health centers in the State, which are great, and one of the
things we did in the healthcare bill is just expand
tremendously the number of resources to expand community health
services. And in New Britain, the facility there, they had the
mobile dental clinic that goes to schools.
Now this is not Head Start, this is----
Mr. Keck. Correct.
Senator Dodd [continuing]. I presume kids in elementary or
middle school or high schools, and that mobile dental chair to
get around was part of the student health, which I am impressed
with. I think it is impressive. But this is far beyond, what
you are talking about.
Mr. Keck. Well, the thing that we have also been trying to
carry through not just from Head Start, but through the State
as far as dentistry goes, with the increase in the number of
providers, patients that are on HUSKY A, HUSKY B aren't
necessarily relegated to go to safety net facilities anymore.
There are plenty of private providers.
And we also have to educate parents because many of them
fear going into a private practice environment other than a
safety net or a clinic, as you are talking about.
Senator Dodd. Yes.
Mr. Keck. I think education, and that is a part of this----
Senator Dodd. You have 40 dentists in Connecticut. I am
impressed you got that many.
Mr. Keck. Well, it is actually----
Senator Dodd. Connecticut magazine this month has the list
of all the 100 best dentists in Connecticut.
Mr. Keck. The list is actually greater than that. Those are
40 that I have personally gotten to work directly with Head
Start. But as I said, there are many, many dentists, both
pediatric and general, that have chosen to help and treat young
children.
Senator Dodd. Yes. Well, good. How you take that program
nationally could be very important.
Mr. Keck. The Head Start program, it is a 5-year contract,
and at this point in time, there are approximately 35 States
that it has rolled out. It has been over a 5-year period.
Connecticut was one of the six States that started this
initiative. So we are kind of well on our way, and many States,
like California, Texas, are going to have more of an issue.
Sheer size is part of it.
Senator Dodd. Let me ask, and this is something that Ed
Zigler and I have talked about over the years and the
difficulty of attracting and retaining good staff. Again, what
we pay childcare workers has been a historic set of issues,
afterschool staff. All the difficulty of how you keep people,
how you--we have upped the matter over the years to bump the
educational levels, but also the compensation for Head Start
workers and the like so you don't end up with that turnover
that we have all the time.
How do you retain your staff? How do you retain your staff
at your Lighthouse Program?
Ms. Papa. We employ just about 300 people through our
subcontracts with community agencies like the YMCA, ABCD, some
of our colleges. Professional development to really help them
do their jobs and listening to them as to what they need in
terms of professional development. I think in any given year,
we will do about 30 different workshops for staff to come to.
We do pay them well. Our certified teachers who work with
us get between $28 and $32 an hour, and the coordinators that
actually operate the program get anywhere from $32 to $36 an
hour. But I can tell you through conversations with these
individuals for going out to the individual sites, they don't
stay because of the money. They stay because they truly, truly
enjoy what they do.
And when we find somebody that is there because of the
money--and everybody needs to make a little bit of extra
money--we never begrudge anybody that. But when we find that
that is the primary reason, then we work with that person to
try and change that attitude toward his or her job.
If they don't, then they are probably really not cut out
for the type of work we need them to do because, for us, the
child does need to come first, and his or her needs need to
come first. But having said that, it is just really keeping
that open line of communication, working with principals and
other daytime staff to really determine who within the school
might be best suited for these positions. It is a long day for
people.
And we don't just recruit from within the school. But
certainly the connections that we can make within the school
and getting some of the staff from within the school really
help to build the academic portion of our program and really
help to link school day and afterschool.
But even working with our agencies, it is really recruiting
the right type of person to begin with.
Senator Dodd. Ed, you wanted to comment on that? We have
wrestled with this for years.
Mr. Zigler. Just be aware, Senator, that what you have just
heard is a model that I wish we could replicate everywhere in
the country. It is not standard. Most schools, their problem is
how do you pay these afterschool workers? Never mind what you
pay a teacher and that. Salary is a huge problem.
Let me point out to you one of the biggest problems with
the 21st century children's learning centers. And perhaps you
remember when I worked with Senator Specter, your colleague on
the Children's Caucus, to try to reverse President Bush's
attempt to cut the 21st century learning centers?
Senator Dodd. Sure.
Mr. Zigler. We were successful, thanks to Senator Specter.
But that flow of money is the only flow of money there is to
the schools to provide afterschool care. None of it is as good
as this model we have just heard about. We are delighted to
have you here.
Ms. Papa. Thank you.
Mr. Zigler. But the fact is after 5 years of getting that
money, they have to start weaning themselves away from it, and
there is no fund of money. So once you go 5 years in that
program, you are through. And so, getting money to pay people--
this is true in Head Start, too. The reason we are only serving
45 percent of eligible kids after four decades is not because
we can't--parents don't bring their kids, there isn't any money
in Head Start to serve more kids than that.
So no one knows better than you that every one of these
problems we are discussing is always a problem of money, money,
money. And you know, your new effort, you are going to find
what we already know. Compared to the rest of the world's
advanced, industrialized countries, kids in the--according to
the World Health Organization, the United States is at the
absolute bottom. Part of it is the high poverty rate, but the
bottom. And it is always a matter of money and priorities.
You spent your life trying to make children and families
the priority they ought to be in this country. But after my own
decades-long effort, we have not succeeded. It is simply a
matter of getting the Congress to provide the money for Head
Start, for afterschool, dental care, wonderful programs, every
program we have heard this morning. But where is the money to
do these? And that is the basic issue.
Senator Dodd. Yes, and we are going to face, as we look at
the arguments again, significant cost reductions in a lot of
these areas as well. So the problems are going to surmount. And
we have only really in the last, well, 45 years have been
involved in much of this at all. Up until 1965, Title I, the
Federal Government was not involved at all in education, except
on a marginal basis.
Dr. Lowell. Addressing the money issue, we have some
wonderful legislation that I think is really not used
optimally, and I would specifically talk about EPSDT, which is
Early Periodic Screening, Diagnosis, and Treatment. Here we
have talked a lot about getting children early and prevention,
and that is a law which is specifically targeted for
prevention.
It says if you can find them early enough and if you can
give them what they need, you can avoid serious problems. And
they can be health problems. They can be mental health
problems. But they really define ``health'' quite broadly in
that legislation.
And yet we have not been able to use it, both in
Connecticut and elsewhere, effectively to meet the needs of
children early, and yet that is why it was created.
Senator Dodd. Why haven't we been able to?
Dr. Lowell. Well, I think one of the reasons is States can
define what they consider medical necessity individually. We
have defined medical necessity as diagnosis. But diagnosis
means you already have a disorder.
So, in a sense, we are not using the bill appropriately. If
you look at the bill itself, it doesn't talk about you need a
diagnosis to treat. It talks about you need medical necessity
to treat.
For instance, look at children who--infants of depressed
mothers as an example. An infant of a depressed mother is not
going to be showing us symptoms until they get pretty severe,
the child is in pretty severe straits. The mom, we know--if she
is seriously depressed, we know the consequences for that
child.
So we should be able to get into that home, in the home,
not ask mom to come to an agency because she won't come. We
know that. We have lots of data that says that is not the way
to approach these moms. But we need to go in the home and treat
the mother and treat the mother and child together. Make a huge
difference.
You could use EPSDT funds to do that, and yet we don't. We
don't have the codes to be able to do that. I mean, even though
the legislation says the State does not have to have this as
part of their Medicaid policy, nonetheless, you do have to have
a way to actually do the billing. And many States have resorted
to lawsuits because of these issues.
We haven't in Connecticut. I hope we never will. But I
think we do need some changes because it is a huge possibility
for the Federal Government to be paying 50 cents on the dollar
to help us with these.
Senator Dodd. Yes. Jim, do you want to comment on this?
Mr. Horan. Yes. I will echo Dr. Lowell's support for
prevention and getting in early and saving on the back end. But
we have made some really bad decisions in public policy over
time. Just talking with a colleague before we started here this
morning. We imprison four times the number of people today in
Connecticut than we did in 1980.
We found the money to build those prisons and to pay for
the correction system over time, and yet the issues of
childcare workers and early care and education workers not
being paid adequately or not reaching all kids that qualify for
Head Start or other programs, that hasn't changed. So a lot of
it has to do with public will and the will of our elected
leaders.
We, all of us are responsible for helping to make that
happen. We are really going to miss your leadership in the
Senate because you have been terrific on these issues over the
decades, and there are not many other leaders like you.
And so, it is really up to all of us and all of our
colleagues and the people we know to get active and to get
everyone empowered to do what they need to do and to get our
leaders to do the right things. Because going back to the issue
of corrections, Connecticut is one of only two States in the
country that spends more on corrections than on higher
education. I mean, how wrong-headed is that?
And yet we have allowed that, as voters in Connecticut, to
occur over the decades. And we have to reverse that and get the
investments made in the right places if we want to see the
results for kids.
Senator Dodd. And you are preaching to the choir.
Ms. Honigfeld. Just also before we really talk down on our
State that much, I do want to say that there is tremendous
duplication in terms of services provided and ensuring people's
access to services. And it really behooves us to start looking
at the funding that we do have here in Connecticut and putting
that together in the best ways to serve families and children.
Senator Dodd. Yes. Good point.
Mr. Edwards, tell me a little bit, because I was so
impressed with what you are doing, and it seems so basic in all
of this, the role of fathers in all of this. And again, working
on the presumption that men want to be good fathers, just as
parents want to be good parents. And tapping into that very
natural instinct. It is not an adverse instinct.
Any other thoughts you have on how we can do a better job
of that? And again, we are looking at maybe thinking of it
again with Jim talking about the number of people incarcerated
and, of course, the number of--obviously, the overwhelming
majority being males, a lot of them fathers, obviously. Totally
distanced from their children.
So there are so many issues surrounding the role of fathers
and their absence in the development of a child. What
additional thoughts do you have for us?
Mr. Edwards. Well, I have done several groups with Head
Start and fatherhood programs in Head Start schools, and there
has been a wonderful reception on the part of the fathers--and
of the mothers and of the teachers--to get fathers engaged
early on, to let them realize how important they are in the
lives of their children in terms of making the connection
between father involvement and academic achievement for kids.
So we do 10 weeks of 2.5 hours each with the dads, and we
talk about all of those things. It gives them a desire to
connect with their children. We want them to be really alert to
the fact that, you know what, you are the architect of your
child's life. You are the construction manager. You are
building something. You are the custodian of your child's life.
The scary part about being a parent, you can set them up
for success, but you can also set them up for failure. So we
want to get that message into them really early on, get them
connected with the type of agencies that will provide the help.
Get them to be really, really thoughtful about their unique and
distinct way that they are as dads is very different than mom,
and what those qualities and values are as a dad.
So that their relationship with their child will continue
even if they are not in a love relationship with mom. So we
want to plant the seeds of co-parenting really, really early.
Senator Dodd. Have you tried anything with--I am curious
whether or not, for instance, where instead of having parents'
time, you just have father time. So there are only fathers
invited?
Mr. Edwards. Yes. That is mainly what we do, mainly what we
do. Most of the work with Head Start is only fathers. So, Head
Start, I may do a program for 4 weeks, 6 weeks or 8 weeks,
depending on the funding for the school. And the first week, we
start off with mom and dad because we want mom to know what is
going on with the program.
The second week is dads, and they bring their kids. And we
eat dinner for half an hour, and then we spent an hour and a
half with dad. So there is just a group of dads in the room,
and that continues on.
The last week, we bring mom back, and there is a
celebration and a dinner. And we line the dads up, and the kids
hand them their certificates of completion for the program to
celebrate. So the kids get the idea that my dad is a lifelong
learner. He went to school, and he learned something. That is
modeling.
So that is what we like to see with that. And the dads, I
hear stories from the moms about how not only has he changed in
his relationship with the child, but he has also changed as a
man in relation to mom. So it is just the more we can plant
those seeds really, really early to make dads aware of their
potential----
Senator Dodd. Well, that is Ed's point. That is Ed Zigler's
point.
Mr. Edwards. Yes, the better off we will be.
Mr. Zigler. There at conception.
[Laughter.]
Senator Dodd. He is still fighting for conception here. I
will leave that to the next Senator from Connecticut. I won't
take on that issue.
Mr. Zigler. Those first 9 months of life are such a
wonderful time because the mother and the father are totally
involved in this process and prenatal care and all the things
that you have heard about. We think birth is early enough. It
is not. It is conception on.
Senator Dodd. Yes, I agree.
Mr. Edwards. One other thing is that we also talk to them
about the first 1,000 days of that child's life and how very
important that is in terms of brain development, in terms of
lowering the risk factors, in terms of creating a wonderful,
warm, positive environment that is a rich language environment
and they are getting the healthcare that they need. That,
hopefully, will start to get them in tune to the fact that this
is a long-term commitment that I just have to do.
Senator Dodd. Yes. I literally could spend all day with
you. I can't tell you how proud I am of what goes on in my own
State, to hear these terrific things that are being done by
people here. I know the hard work and the people who work with
you and how much time they spend and the efforts they make. And
your point, Dr. Lowell, of just 6 weeks in that one family just
to get her in the door and how that magical moment occurred.
Dr. Lowell. It made a big difference.
Senator Dodd. And how hard this is to achieve, but it is
worth the effort. The future belongs 100 percent to them, and
that is why Arlen Specter and I, almost 30 years ago, started
the Children's Caucus in the Senate. We had a caucus for every
imaginable constituency in America that you could think of
except the 1 in 4 Americans who are under the age of 18.
We started with that, and over the years, we had rump
hearings. We couldn't even get funding for hearings. I was
telling a group of the interns the other day in the office, I
remember Paula Hawkins, who was my new Senate colleague from
Florida. She came to a hearing. She wanted to come and testify,
and it sounds rather routine today. But 30 years ago, to have a
woman U.S. Senator come and talk about how they were being
sexually abused as a child was banner headlines across the
country in terms of just unprecedented news.
And what she did, though, just by that and how she opened
up the door for a lot of other people to talk about what had
been going on, obviously. I mean, just things like that. We had
hearings with Bill Bradley on afterschool programs in New York
at the time. And so, it has been tremendously rewarding, and
there has been improvement.
And obviously the challenges grow, and each generation
poses new ones. But this has been tremendously helpful, and I
literally could spend all day with you. I have so many
questions to ask. But I am getting notes from my staff that I
am already approaching 3 hours of your time here this morning.
So it is running out your patience. I know you have other
work to do. But it has been tremendously helpful. And I am
going to leave the record open because I have some additional
questions we may submit to you in writing.
The testimony was terrific. I just can't tell you how
compelling it was to go over it yesterday, reading all of your
various suggestions and ideas and statistics. Particularly, I
must tell you, on the homeless, it was just breath-taking. I
was reading it to my wife this morning about 6:30 a.m. and with
our 5-year-old sitting there, talking about predilection for
separation between parents and children who are homeless. It
was a very moving number to me, very sad to see that happen.
I thank everyone who is in the room, and so many of you do
so much every day. I promised you I would let you ask some
questions, but I think we have run out of time. But if you have
some additional questions, let us know and we will try and
submit them to people here at the panel. And we will move on
and then try to build some support for this permanent council.
Again, I have talked to people at the Yale Child Study
Center about the IDEA law, maybe with Save The Children on
developing that report card so we can start looking each year
at where we are headed and when we are stepping back a bit.
That may help my colleagues and others, Ed. It may give
them some sense of this instead of having to wait every 20
years to get some report how things are to know the trim lines
because I have got to believe again--I mean, this is--again,
this ought to be an issue that transcends any ideology of
politics. I can't imagine a subject matter in which there ought
to be a greater sense of common interest than figuring out how
we do a better job with all the pressures on families that are
tremendous today.
And the stress that you point out, Ed, and everyone has
mentioned here is just huge. And it isn't just on the poorest
of families. Hard-working middle-income families are all of a
sudden watching a dad at age 50, watch them lose a job and
wondering where the next one comes from, and the kind of
pressure that is associated with that, and the long-term
effects.
Ben Bernanke, the Chairman of the Federal Reserve, was
appearing before me the other day in my other hat as the
chairman of the Banking Committee, and he has written
extensively on the long-term effects of recessions like this
and beyond just the immediate loss of job, but what it does.
The long-term implications, behavioral effects that it has on
families and individuals, felt long after recessions are over
with statistically. When work comes back and people are re-
employed and the economy begins to improve, there are residual
effects of these downturns economically that are felt for years
and years and years afterwards.
So beyond all the numbers we talk about, in terms of gross
domestic product and unemployment numbers and foreclosures and
all the other things, there are other things occurring out
there that are far more difficult to calibrate on a daily or
weekly or monthly and annual basis that we are going to live
with for a long time. And we are experiencing them already.
So these issues are going to be with us for a while, and we
just need to do a better job of addressing them. And you have
been a great help this morning, and I thank all of you. How
about a round of applause for our witnesses?
[Applause.]
Thank you, Ed.
And they brought this gavel up. So I will use it one more
time.
[Laughter.]
The committee is adjourned. How is that?
[Additional material follows.]
ADDITIONAL MATERIAL
Prepared Statement of Debra P. Hauser, Ph.D., M.S.W.
I cannot convey my depth of gratitude to Senator Dodd for his
decades of enlightened leadership on behalf of children. His early
support of children and their families, years before it became chic and
before he had children of his own, exemplifies his compassion, wisdom,
and courage.
Thank you for allowing me the honor of participating in these
historic hearings on the State of the American Child and inviting me to
present written testimony.
Facts
Since 1958, infant mortality has risen to 7 percent,
doubling among minority groups.
In 2005, 2,642 Connecticut children were homeless and
34,428 people--including children--were turned away from homeless
shelters for lack of room.
As of 2006, 17 percent of children were obese and 22
percent were food insecure.
In 2007, 85,530 or 10.6 percent of Connecticut's children
under 18 lived in poverty, costing $11,800 per child per year of
poverty in lost future productivity.
On average, in the United States, only 20 percent of
children who require mental health services receive them as the result
of a profound shortage of youth therapists, prohibitive waiting lists
in community clinics, ignorance or lack of awareness of symptoms (i.e.,
seeing troubled kids as bad rather than in need of help), and a long-
standing social stigma related to mental illness.
Under our current criminal justice system, the number of
prison cells needed in the United States can be predicted by
calculating how many fourth grade boys cannot read.
Among juveniles in detention, 70 percent are mentally ill,
50 percent have been exposed to or are victims of trauma, and 90
percent cannot read above the sixth grade level.
The achievement gap puts minority youths 4 years behind
non-minority students; yet even the best U.S. students are 2 years
behind their international counterparts.
Formerly a world leader in high school graduation rates,
today the U.S. ranks 18th among the top 24 industrialized nations.
Closing the U.S. achievement gap would increase our GDP
from 9 percent to 16 percent and up to $1.8 trillion.
INTRODUCTION
The problems besetting America's children have significant negative
consequences for our Nation's overall potential and productivity. But
solving those problems is complicated by significant State-by-State
differences in how children are faring as well as a lack of a coherent
national children's policy. A national commission on children might
begin laying the groundwork to provide that vision by coordinating,
evaluating, and initiating effective public policy.
I thoroughly support Senator Dodd's proposal to initiate a U.S.
Commission on Children and America's Young People. Establishing such a
national body focused on the policy issues facing American children and
youths is an exceptional and much-needed step. I hope and pray it will
have real authority to fundamentally improve the lives of American
children. I also hope this body can be more than a study commission or
academic clearinghouse. I would like it to be given legal authority and
fiscal responsibility over U.S. domestic policy related to children and
youth. To ensure this, I suggest that the Director of this body become
a cabinet secretary with direct access to the President.
The U.S. Commission on Children and America's Young People could
establish standards of well-being for American children, coordinate
Federal policy affecting young people, and oversee program evaluation
and funding.
The following remarks address the structure, scope, and authority
of the proposed commission and outline possible directions of first-
year initiatives for the committee's consideration.
STRUCTURE OF NATIONAL COMMISSION ON CHILDREN
I recommend that the commission have a national director, who would
be a member of the President's cabinet, and five or six regional deputy
directors. Each State should have a State director responsible for
recruiting qualified people with expertise in a range of areas--people
who are also gifted, energetic, and committed to children and their
issues. State directors should be responsible for gathering and
synthesizing information about issues facing children and their
families within their States; they should also be responsible for doing
in-State program evaluations. State directors should also review
outcome data to inform future funding decisions.
As America undergoes rapid economic changes, it is imperative that
this national body has fluid bottom-up and top-down communication
capacities. It is likewise essential that the commission's leadership
and board have access to the varied perspectives of parents, educators,
physicians, psychologists, social workers, community workers, athletic
coaches, child advocates, lawyers, religious leaders and others who
have ongoing and direct contact with children and can knowledgeably
develop benchmarks for children's well-being, evaluate strengths and
weaknesses in existing services, and offer suggestions for addressing
unmet needs.
The commission would be well-served to have a racially and
culturally diverse board from a wide range of backgrounds--including
businesspeople as well as community members knowledgeable about their
regions' problems--who can help establish a policy agenda.
SCOPE OF THE NATIONAL COMMISSION ON CHILDREN
Science now acknowledges that brains in both females and males do
not develop fully until the mid-twenties. Thus, to be effective, the
age range addressed by the commission should be broad, perhaps from
birth to age 25. The length of time it takes to reach adulthood in an
advanced industrialized nation suggests that young people need to be
supported by policies through college or young adulthood. The current
legal cut-off age of support and services for youth at 18 now seems
arbitrary and out of sync with reality. Investing in the well-being of
America's young people for an extended period would likely
significantly increase their economic success.
INDICATORS OF CHILDREN'S WELLBEING
Indicators of children's well-being should include both physical
and psychological milestones. These indicators should also include
other relevant educational statistics: grade level reading; number of
disciplinary actions per year; and hours devoted to sports, creative
activities, or community involvement. Indicators should also address
rates of youth violence and crime, teen pregnancy, and high school
dropouts. Information from a number of wraparound indicators will
provide a more useful, three dimensional assessment of how children are
actually doing. It may be prudent to access milestones every 2 years in
order to stay abreast of the state of children and make policy course
corrections as needed.
The following indicators are examples of ways to think about well-
being from multiple perspectives. As a clinical psychologist, my view
of children's well-being in infancy is often demarcated by a baby's
ability to lift his or her head, learn to suckle, and form an
attachment with the primary caregiver. In toddlerhood, normal behaviors
may include brief interest in exploration away from the primary
caregiver and the capacity to play. For elementary school children,
some indicators of success could include accessing growing imagination
and school competency. Identity exploration, an ability to think
abstractly, and a preoccupation with friends could be considered
markers for teenagers, while the knowledge of one's career interest and
romantic involvement may be the notable hallmarks of the early
twenties.
TECHNOLOGY AND MILESTONES
How Are the Children Doing Today?
Investments should be made in developing the capacity to gather
information and chart how America's children are doing at a given time.
Developmental markers, once determined, need to be entered into a
centralized database. Data could be obtained from schools, mental
health settings, hospitals and doctors' offices, as well as the offices
of DCF, juvenile justice and probation. Milestones without the
technology to track and analyze the condition of America's children
will be meaningless. This need for data may also provide an impetus for
the use of electronic medical records, which should simultaneously
improve the delivery of overall health care--including mental health
care--for all children and their families.
With a databank infrastructure in place, the national commission
could evaluate wellness and the needs of American children and provide
a State-by-State report card at the end of each year, as well as an
aggregate measure of U.S. progress or failure. This national grade
could be periodically compared to other developed countries to estimate
how American children are doing compared to their global counterparts
on a number of indicators across time.
THE NEXUS OF EDUCATION, MENTAL HEALTH, AND JUVENILE JUSTICE
At five to nine times the world average, the United States has the
highest incarceration rates in the developed world. This reflects the
upside-down nature of investments whereby America over-funds its prison
programs and under-funds its education and mental health programs. This
topsy-turvy approach to setting policies is exacerbated by the lack of
a coherent frame of reference for addressing the needs of child and
youth. We have no means of coordinating young people's policy across
agencies. And previously, we seem to lack the political will to keep
all our children out of harm's way.
INVESTMENTS THE UNITED STATES NEEDS TO MAKE IN OUR CHILDREN
1. Attend to the Basic Needs of Food and Shelter First--Eliminate
hunger, food insecurity, and homelessness in America. Homelessness and
hunger must no longer ravage the lives of American children. A child
who is living with chronic instability, fear, and hunger will be unable
to develop normally or learn appropriately.
Invest in affordable housing.
Invest in universal childcare.
2. Expand Children's Health Care to Include Dental Care--Dental
care is essential to ongoing good health for children and adults.
3. Expand Children's Health Care to Include Mental Health Care--
Improve access to effective mental health services, beginning in pre-
school. Early detection and treatment of troubled students is much
cheaper than the costs of incarceration, lost wages and taxes, and
welfare.
Develop a comprehensive public education campaign, akin to the
anti-smoking campaign, to reduce the stigma connected with mental
illness, emotional problems, learning disorders, and other problems of
the human experience.
End law-and-order education policies--zero tolerance, expedient
suspensions, and drop-of-the-hat expulsions--by training school
personnel to have greater psychological awareness and by providing
administrators with abundant alternative solutions, such as access to
mental health services in schools and in the community.
Offer incentives (such as college loan forgiveness) for therapists
to learn how to treat children appropriately in order to address the
profound shortage of qualified professionals.
Stop using jail as the answer to children's social, emotional,
educational, and economic problems. Stop warehousing poor, illiterate,
and/or emotionally disturbed children in juvenile detention centers.
Give them the help they need treating their problems and remedying
their underlying causes.
Dramatically expand mental health services by increasing access,
offering incentives for college students to study child modalities,
improving quality of treatment, and disseminating information about
effective, evidence-based practices by means of publications and
electronic media in clinics and therapist's offices, and unifying
requirements for continuing education for all clinicians treating
children.
4. Expand the Definition of Trauma, Acknowledge its Ubiquity, and
Provide Early Treatment--In our increasingly violent world, trauma has
been traditionally viewed as exposure to violence, as either a witness
or a victim, that occurs in the home (domestic violence), in the
community (school or gang violence), in the context of combat or
torture, and in a natural disaster. The definition of trauma should now
be expanded to include significant losses in childhood, and appropriate
treatment should be made available. Trauma criteria should now include:
the loss of a first-degree relative due to death, illness, divorce,
military service or incarceration; threats to bodily integrity, such as
with cancer, severe illness, accidental injury or violent crime; and
the chronic deprivation of poverty, physical or sexual abuse, and
homelessness. Trauma could also be defined as any unexpected event in
which one feels overwhelmingly threatened and helpless, such as with a
sudden job loss.
There is a deeply concerning U.S. trend whereby there is at once
greater tolerance of violence and greater violence in homes and
communities. There are several well-known, but chronically ignored
studies on the desensitizing effects on children who play violent games
or watch violent electronic media, such as television or online videos.
There is little that is positive, redeeming or inspiring on mainstream
media outlets. The popularity of aggressive, so-called reality TV shows
illustrates the level of American interpersonal competition and
tolerance, even taste for aggression.
5. Support Effective and Lasting Education Reform--Develop and
implement a voluntary, consensus-driven national curriculum to ensure
consistent educational standards across State lines.
Emphasize the importance of a strong system of support and
resources that includes curriculum guidelines and professional teacher
development. Be cautioned against jumping directly from developing the
standards to administering aligned assessments.
Require U.S. students to meet international standards of learning
and student performance.
6. Give Juveniles Genuine & Age-Appropriate Justice--Treat problems
early. Small children have small problems; big kids have big problems.
Detention centers need to be rehabilitative--not punitive. Except
for those who are very ill or dangerous, the practice of keeping young
people in juvenile detention centers must be abolished.
Provide readily available alternatives to detention when necessary,
including residential treatment and respite for caregivers.
Widely expand community services and recreational facilities and
make them available from early childhood through young adulthood.
Invest heavily in after-school programs and trade school training
programs, especially for at-risk youth.
Cautionary Notes on Children
NEW MEDIA
Hillary Clinton noted that America was undergoing the largest
experiment on children in history regarding their long hours of
exposure to computers, video games, and cell phones--an exposure that
leads to addiction for some. Despite the negative effects on weight
associated with the sedentary nature of sitting in front of computer or
TV screens for extended periods, the effects of over-stimulating images
and interactions, often violent or gratuitously sexual in nature, and
the immediate gratification of computer interaction (faster and faster)
on short- and long-term physical and mental development in children are
virtually unknown and largely unexplored.
It would be in the best interest of children and young people to
have a comprehensive and rigorous series of studies examine the
possible effects of children's exposure to and interaction with
current, new, and emerging media formats and products.
Leverage the power of new media for productive uses.
As part of its policy innovation, the national commission should
find ways to promote and prevent contagious behaviors through
leveraging the viral nature of online media.
TELEVISION AND MARKETING
Since World War II, advertisers have spent trillions of dollars to
develop media campaigns to influence America's purchasing decisions and
shape our worldview. Companies and marketing agencies routinely develop
products and manipulate audiences telling us what we need to be smart,
affluent, or desirable. Consumptive marketing is pervasive in American
culture and children are bombarded with marketing images of cultural
ideals of beauty and success and relentless sales pitches for food and
products no one needs.
This leads to a ``me, me, and me'' culture of acquisition and
interpersonal competition. Relentless persuasive messages both in
online media and television must be examined and regulated. The
national commission may find it prudent to begin to develop critical
viewing or media awareness messages to help inoculate children from
shallow marketing and sales messages.
CRISIS OF YOUTH
Problems in Urban Settings
Every day, I become more certain that there is growing despair and
hopelessness in the hearts and minds of today's urban, minority youth
and it takes different forms in boys and girls. I have witnessed
firsthand the hopelessness in children's eyes living in poor urban
settings often taking the form of marijuana or alcohol abuse, teen
pregnancy, gang violence and youth murder. I have thought to myself as
I drove by a dusty playground or dilapidated soccer field that we all
like to think that if children can do well in school they can somehow
leave their family and neighborhoods, learn new social graces and make
new friends, apply and get into college and rise to the working or
middle social classes.
I am wholly unconvinced.
Doing well in urban schools is difficult, compounded by the
enormous pressures experienced in living in female headed, single
parent households. Good teachers often won't work in urban settings,
and if they do they get easily burned out by the symptoms of despair--
anger, illiteracy, and disruptive behavior in overcrowded classrooms.
Most children in urban centers, live in a female headed, single parent
household, where mother is overwhelmed and depressed, lucky if she is
working at a low-wage job. Without good parenting, high performing
schools, access to extracurricular activities and social opportunities
in safe neighborhoods the pathway out of poverty is forever blocked. I
have personally seen again and again the hardship of single mothers
raising sons, and daughters, without involvement of their fathers,
living with little income, support or security; it would take nothing
less than relentless political will, sustained and inspired leadership
combined with coordinated public policy change to lift those children
and their families out of poverty into the middle class.
Once and for all end teenage pregnancy, early parenthood, and out-
of-wedlock births. This should be a commission priority in year one. If
Madison Avenue can convince everyone, and I mean everyone, that luxury
items are a necessity and that McDonalds is healthy, with a similarly
robust and unrelenting campaign we can end this contagious and
destructive social pattern promoting poverty and harming children, both
teen parents and their babies.
In my childhood, I remember vividly the admonishments against
littering (``Don't be a Litter Bug'') and being taught the terrifying
consequences of heroin use and addiction. There has not been a
government-sponsored campaign to inoculate children from the stream of
negative messages and images in recent memory and these protective and
effective social marketing campaigns for young children need to be
urgently resurrected.
Problems in the Suburbs
The recent gang rape of a young teenage girl by several young
teenage boys in Madison, CT, an affluent suburb, represents another
kind of crisis of youth. These heinous acts occurring under the
influence of alcohol were captured on a cell phone and sent out to
friends. These were children not living in financial poverty but living
in a kind of moral poverty. Children of all ages and socioeconomic
classes are exposed to a torrent of gratuitously sexual and aggressive
messages and images in every media format. This desensitizing and
dangerous exposure combined with the disinhibition associated with
alcohol abuse leads to disaster, particularly for teenagers. Far too
many parents continue to allow teenagers to have parties in their homes
and tolerate drinking of alcohol by underage children. A national body
on children can seize this opportunity in crisis to develop educational
campaigns to better protect children against the flood of unhealthy
messages and educate parents to be more aware of the importance of
limit setting, parental supervision and legal responsibility.
ETHICS AND CHILDREN
A constant bombardment with messages urging consumption of marketed
goods helps distort children's view of themselves, their families and
their community. Before the recession, 70 percent of the GDP came from
having Americans buy goods and services. This leads to a worldview
concerned with acquisition of things and status symbols, leading to
interpersonal competition rather than interpersonal cooperation.
The U.S. Commission on Children and America's Young People--or
National Commission on Children and Youth in America--could initiate
and sustain a public education campaign to educate youth, and the
public at-large, to the virtues of an ethic of service to others.
Championing the rewards of doing for others may help to make children'
lives more meaningful, provide much-needed support to vulnerable
populations and begin to mitigate the onslaught of negative influences
of media and marketing.
SUMMARY
I thoroughly support Senator Dodd's proposal to initiate a U.S.
Commission on Children and America's Young People. Establishing such a
national body focused on the policy issues facing American children and
youths will provide fundamental direction and positive change for
American children historically not a domestic policy priority. In order
for this new commission to work, it must have legal and financial
authority in directing public policy affecting U.S. children. To ensure
this, I suggest that the director of this body be designated as a
cabinet member with direct access to the President.
The problems weighing on America's children have significant
negative consequences for our Nation's potential and productivity. With
political will and strong leadership, the national commission on
children will be able to make life altering improvements by laying the
groundwork to provide a vision for U.S. children by coordinating,
evaluating, and initiating effective public policy to dramatically
improve their children's lives.
The U.S. Commission on Children and America's Young People once
established, can set standards and follow indicators of well-being for
American children, coordinate Federal policy affecting young people,
and oversee program evaluation and funding.
Senator Dodd's vision of a national body on children is a far-
reaching, life saving initiative, one that will forever raise the
spirit of children in need and help lift all children out of harm's
way.
I am deeply grateful for Senator Dodd's compassion, wisdom and
courage on behalf of American children and would like to take this
opportunity to thank him for his 35 years in the U.S. Senate positively
impacting the lives of millions of children and families. We will miss
him as our State champion and national hero but will continue to expect
great things from this great leader and great man.
Prepared Statement of William B. Wickwire, Attorney
This statement is being presented by me, Attorney William B.
Wickwire, who was the Prosecutor for Juvenile Matters in New London
County, State of Connecticut, for 30 years. I retired on July 1, 2009,
and I am currently a sole practitioner primarily in New Haven County,
State of Connecticut. My practice of law is focused on defending
juveniles in the Connecticut Juvenile Justice System.
I will now take a child, charged with one or more delinquency
offenses through Connecticut's Juvenile Justice System, with comments
along the way, as to how the Juvenile System works today, and how it
could work better on behalf of our juvenile children. Before I do this,
it is incumbent that I mention a recent change in Connecticut's
Jurisdictional Age for Juveniles. Connecticut increased the age to 17
years of age for the prosecution of all juveniles. Adulthood now begins
at 18 years of age, instead of at 16 years of age, for two main
reasons:
1. Connecticut, as with 47 other States, now allows prosecution of
juveniles beyond their 16th birthdays.
2. Connecticut agrees with the scientific literature that a child's
brain is not fully mature at 16 years of age.
Once a child is charged with a delinquency offense, the child is
presented in juvenile court and given his/her rights and the nature of
the charge(s) against the child. However, one key difference in
Juvenile Court, as opposed to Adult Court, is that once a child enters
the courthouse, the child is assigned a probation officer. The
probation officer works with the child and parent(s) or guardian
throughout the process. Therefore, a child can receive treatment and
services early in the processing of the child's case. This must be with
the agreement of the child, the child's parent(s) or guardian and the
child's attorney (if the child is so represented). In Adult Court, a
probation officer is not assigned to a defendant until after his/her
conviction.
Juvenile Court is very treatment-oriented, with the best interest
of the child as paramount. However, Connecticut does not have enough
diagnostic and treatment facilities for juveniles. Connecticut has only
one facility that provides a comprehensive report, after a 45-day in-
patient commitment for drug issue(s). The report indicates potential
treatment options for a child's drug and/or alcohol problem(s).
Connecticut has only one residential psychiatric hospital for the
diagnosis of a child's potential mental health issue(s). Unfortunately,
many children languish in detention (lock-up) centers, because there
are insufficient beds at the two in-state facilities. Especially as to
children with mental health issue(s), the choice becomes the child's
remainder at the diagnostic hospital or return to detention (lock-up).
A child's remainder at the diagnostic hospital after the report has
been completed is not in the best interest of the child. The child is
not receiving therapeutic treatment. Furthermore, the hospital does not
have a bed available for another child.
After the child's initial presentment in Juvenile Court, the case
goes to a pre-trial. Most juvenile cases are settled at the pre-trial
level. The case then goes to a probation officer for a thorough report
with recommendations as to the best interest of the child. The
settlement of a juvenile case could result in a recommendation of
community service with no adjudication of delinquency. More serious
offenses, usually sexual assault offenses, are tried in Juvenile Court.
As to the most serious crimes, the children are transferred to the
Adult Court for handling as adult criminals. If a child is adjudicated
a delinquent after a trial, the probation officer prepares a thorough
report with recommendations.
If the recommendation(s) is probation, the terms and conditions are
entered by the Court. Problems in Juvenile Court stem from a probation
officer's recommendation that the child be placed out of the home by
DCF (The Department of Children and Families). DCF does not have enough
funding to place, in a timely manner, all of the children that require
alternative placements. Therefore, the child languishes in detention
(lock-up), until the funding is available for the child's placement.
Certain male juvenile delinquents are placed at the Connecticut
Juvenile Training School in Middletown, CT. The cost of a year's
placement is prohibitive. Not only that, but the Training School was
built and designed by the Roland Administration and was effectively an
inappropriate placement facility for children. As stated in the New
York Times article of June 25, 2004, page B5, ``One of the biggest
complaints about the facility is the cell-like rooms, which consist of
a plastic bed and a shelf.'' The cells are quite small and would be
more appropriate for convicted adult defendants. As of today, July 29,
2010, the rooms are still small and cell-like. Governor Rell tried to
create three (3) regional centers for adjudicated delinquents and hoped
to close the Training School. Her efforts failed for financial reasons,
and Connecticut male juveniles are still placed at the Training School.
Improvements have been made at the Training School, as to the treatment
of the children placed there. However, it is still an inappropriate
placement for Connecticut's children. Maybe the funding can be
appropriated to open the three regional treatment centers. Connecticut
still does not have an appropriate facility to place adjudicated
delinquent girls that need secure long-term placements.
With the influx of the 16-year-old children, and eventually, the
17-year-old children into Connecticut's Juvenile Justice System, I can
only hope that the appropriate funds can be made available to service,
effectively, all of Connecticut's juvenile delinquent children. A
delinquent child in Connecticut should have a good chance to become a
happy and productive member of society. Hopefully, this occurs.
At Senator Christopher Dodd's Connecticut Hearing on Monday, July
26, 2010 as to the State of the Child, various preventative programs
that aim to nurture and to protect Connecticut's children, all
indicated a lack of appropriate funding. Not only do we need sufficient
funding of preventative programs for children, but we also need
sufficient funding as to intervention programs, such as Connecticut's
Juvenile Justice System.
Speaking as a resident of the State of Connecticut and as a retired
Juvenile Court prosecutor, I want the best for our children.
At this time, I commend and thank Senator Christopher Dodd for his
untiring and successful efforts on behalf of America's children, who
will benefit from his leadership and dedication.
Respectfully submitted.
[Whereupon, at 11:46 a.m., the hearing was adjourned.]