Health and School Readiness in Early Childhood Douglas Tynan, Ph.D.

1. Health and School Readiness inEarly ChildhoodDouglas Tynan, Ph.D. May 27, 2009

2. The World of Children Has Changed Families are changing • More… • Single parent births > 40% • Parents are working • Women in workforce> 65% mothers • Back to work 6 weeks • Lack of good childcare • Medicaid-eligible children>24% • Fewer… • Engaged fathers • Community connections

3. Three Decades of Increases Source: SECPTAN Source: U.S. Census

4. School Readiness Domains • Physical well-being and motor development • Social and emotional development • Approaches to learning • Language development • Cognition and general knowledge

5. Mother Education & Readiness

6. Poverty & School Readiness

7. Early Childhood Education & Health Health, mental health and education responses are changing • More… • Demand on all providers in health, education, child care, mental health to address developmental, emotional and behavioral problems • Less… • Access to effective screening tools or access to effective help for parents and families

8. Education and Health: Changing Risk Factors Out-of-home care is changing • More… • Children in non-parental childcare • Time spent daily in out-of-home care • Much day care is poor quality • And in care, teachers have less… • Opportunities for professional development or for working full time • Adequate compensation and benefits

9. Risk Factor: Disruptive Behavior in Early Childhood Surveys in Delaware: • 30% of low-income preschool children have emotional and behavioral problems by parent and teacher rating • 40.2% of Delaware child care providers asked family to withdraw a child from their care • Delaware ranks fifth nationally for expelling children from state-funded Pre-K • Nearly one out of five parents in Delaware reported having a child with some level of emotional or behavioral difficulty, similar to national numbers • Lack of effective and available mental health services

10. Risk and Opportunity • Children are exposed to many types of risk: Within child, within family, within child care, within community • Nearly all young children birth to five share exposure to risk • As risks increase, chances for problems increase • Opportunities: • many adults and systems have a hand in raising young children • work with child care, primary care, community organizations and with parents to reduce risks and offer effective solutions

11. Public Spending Priorities Do Not Match Research Findings Source: RAND Corporation

12. Promising Approaches in Early Care and Education • Quality ratings systems • Teacher compensation • Parent support (e.g. Triple P, Help Me Grow) • Early childhood mental health consultation • Early childhood professional development and technical assistance • Parent engagement

13. Status of Quality in Child Care Source: SECPTAN Source: Midwestern Child Care Study

14. Preschool Teacher Income, 2007

15. Promising Approaches in Primary Care Opportunities: • Shifting the model for transforming primary care • Screening • Surveillance • Anticipatory guidance (brief counseling) • Parent approach