Starting Right: What We Owe Children Under Three

In the mid-1990s, newsstands across the country brimmed with magazines touting new research on brain development, and the science of early-childhood development was championed from the East Room to the hearing room, from the boardroom to the living room. Yet almost a decade later, there is still a significant gap between what we know about the earliest years of life and the public policies that support families with infants and toddlers in the United States.

Why the gap? There is no simple answer; rather a combination of factors has left this country without a coherent family policy -- and lagging far behind virtually all other advanced nations when it comes to support for families with children under age 3. Perhaps the strongest influence has been the cultural tradition that considers the care of very young children the sole responsibility of their parents. Any attempts to develop policies that are perceived as interfering with this responsibility have been taboo. Even a policy to give parents time off during the critical first year of a baby's life has been stubbornly hard to win.

Yet the sense that parents must go it alone is not the only thing that stands in the way of change. Traditional thinking on education still has not fully embraced the concept that children are born learning, despite compelling evidence from the newest brain research. Similarly, our policies do not fully reflect what science teaches about the vitally important contribution of parents and caregivers to a child's education. Education reform has focused much more on what goes on inside the school building and much less on what goes on at home and in the community.

Strategies to promote the healthy development of and early education for our youngest children -- starting well before school age -- should be the next frontier of education reform. We need a more cohesive set of policies that can support the earliest forms of education while respecting the range of choices parents make for their families. Along with access to prenatal and early health care, such policies would address parental leave and preparation for parenthood for all families; improved child care for working families; and access to comprehensive early-childhood services for expectant parents, babies, and toddlers at greatest risk.

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It is widely recognized that parents need time and support to be with their newborn baby to establish the strong early bonds that lead to positive and healthy relationships. Indeed, while most industrialized countries guarantee paid parental leave, the United States is not among them. The closest we've come to a national response -- the Family and Medical Leave Act of 1993 -- provides 12 weeks of unpaid leave and covers only about 60 percent of private-sector employees, and only about 45 percent are both covered and eligible.

Predictably, low-income working families are least likely to benefit because they can rarely afford to take unpaid leave, have jobs with the least flexibility, and have the hardest time finding quality infant care and reliable transportation. Welfare reform in the 1990s only compounded the problem, allowing states to require women with children under age 1 to participate in work activities, while funding for child care in the past few years has failed to keep up with demand.

In recent years, advocates for family and medical leave have turned to the states. In 2002, California became the first state in the nation to enact paid family leave, expanding the state disability insurance program to provide up to six weeks of partial wage-replacement benefits to workers who take time off to care for a new baby or seriously ill family member. According to the National Partnership for Women and Families, five states (and Puerto Rico) have state-administered Temporary Disability Insurance systems (or require employers to offer them). Such systems provide partial wage replacement to employees who are temporarily disabled for medical reasons, including pregnancy or birth-related medical reasons. Efforts to enact paid leave have been introduced in more than two dozen states.

One innovative solution, the At-Home Infant Care (AHIC) program, was pioneered by Minnesota and Montana in response to the lack of good infant care. AHIC gives low-income families a partial subsidy so they can remain home to care for their very young children. Minnesota families could participate if they were eligible for child-care assistance and had children under age 1. In Montana, eligibility was set at 150 percent of poverty for families with children under age 2. Parents reported both developmental and financial benefits. Despite the promise and interest in this model, though, tight budgets have hampered its progress.

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Most children under age 3 have working parents. It is well-established that the quality of the infant and toddler care on which millions of these parents depend each day can affect a child's well-being. Despite this knowledge, affordable, high-quality care remains out of reach for many working parents -- particularly low-income ones, whose children could benefit most from the enrichment a good program might provide. Families with very young children have the fewest child-care options and pay the highest price for care. Quality is stretched thin due to low wages, high turnover, and limited training opportunities for providers. Child-care resource and referral agencies across the country receive more calls from parents seeking affordable, quality infant care than any other type of child care. Even when child-care assistance is available, it most often does not cover the full cost of quality care.

In an effort to address this national need, Congress has appropriated an additional $100 million each year since 1998 to improve the quality of infant care through the nation's main child-care program, the Child Care and Development Block Grant (CCDBG). With these funds, states have been launching new strategies, creating innovative training and credentialing for infant- and toddler-care providers, expanding family child-care networks, and developing supports for family, friends and neighbor care -- the type most often used by parents of very young children and by low-income families. While all these efforts are important, they are only initial steps forward; much more is needed to make high-quality infant care the national priority it deserves to be.

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The early Head Start program was designed with this challenge in mind. Added to the Head Start program in 1994, it was designed to offer comprehensive health, family-support, and education services to expectant parents and infants and toddlers living in poverty. In fiscal year 2003, Early Head Start served nearly 62,000 children under age 3 in more than 650 programs across the country. Services are delivered through home visits, center-based programs, or a combination of the two.

So far, the results have been promising. A rigorous evaluation of Early Head Start has shown positive impacts on children's cognitive, language, and social-emotional development -- and, importantly, solid effects on their parents, too. Results were stronger when programs started during pregnancy and when standards were carefully implemented.

As is too often the case, though, too few are helped: Early Head Start still serves only 3 percent of the more than 2 million poor children under age 3 nationwide. And with poverty among very young children growing, expansion of services to infants and toddlers is more important than ever. With more and more states investing in preschool programs, the logical next step for Head Start is to expand downward. Because we know that most children enter the program already behind in language development and other skills important for school readiness, we simply can't afford to wait to start them on the right road.

There are more than 11 million infants and toddlers living in the United States. If we are indeed committed to making top-notch education a priority, it must start well before they reach the preschool door. And it must bridge partisan and ideological differences that have impeded progress for far too long. The next Congress and administration can start by expanding the Family and Medical Leave Act to provide benefits to more families, and by providing incentives to states to experiment with paid leave and programs like the At-Home Infant Care model. Reauthorization of both Head Start and the CCDBG provide important opportunities for change, too. The funding set aside for infants and toddlers in the CCDBG should be authorized and expanded, and each state should be required to have a plan to ensure better care for babies and toddlers. Head Start programs across the country should be allowed to serve expectant parents and children under age 3 if that is what their communities need.

These steps can lay the foundation of a compassionate agenda, can lead to long-term benefits, and are the most basic elements of a comprehensive approach to education reform -- a goal that everyone can embrace.

Joan Lombardi is the director of The Children's Project in Washington, D.C. She served as a deputy assistant secretary for children and families and the associate commissioner of the Child Care Bureau during the Clinton administration.