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Saving All Children: The Strategy and The Commitment

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November 1, 2016

We have massive learning gaps between groups of children in far too many schools in our country today. Efforts to close those gaps over the past two decades have very consistently failed.

We have an economic reality where minority Americans have an average net worth that is less than 30 percent of the average net worth for White Americans. Unemployment levels are far higher for African American, Hispanic, and Native Americans.

We imprison more people than any country in the world by a wide margin, and we disproportionately imprison minority Americans.

We actually have more African American males in jail today than the total number of male slaves at the beginning of our Civil War. If the current trends continue, roughly 30 percent of the African American males in this country will spend time in jail.

That compares to less than 2 percent of White Americans who will spend time in jail.

When you look at who is actually sent to jail, it is clear there are huge differences in incarceration rates that relate directly to high school drop out rates. That is true for people from every racial and ethnic group. Dropouts from every group are much more likely to go to jail.

Roughly 60 percent of the African American males in their 30s who dropped out of school are in jail today. Roughly 80 percent of the African American males who dropped out of school will spend time in jail.

That compares to roughly 5 percent of the African American males who graduated from high school who are in jail today.

African American high school dropouts are 12 times more likely to end up in jail than African American high school graduates.

The path to prison actually begins significantly before kindergarten. Education does not begin at kindergarten. Education begins at birth — literally at birth.

What we need to understand as a society in looking at those high school learning gaps, drop out numbers, and those massive economic challenges, is that we can predict with more than 80 percent accuracy by age three which children will be going down the path that leads to jail.

Education does begin at birth. Learning ability development begins in the first weeks and months of life — and that is true for children from every race, ethnicity, culture, and economic status. All children go through the same processes in the same time-frames. To close our learning gaps we need to help every child, and we need to begin that help as soon as each child is born.

The first years are hugely important. The first three years of life are the years when the neurons that connect in each child’s brain determine whether or not each child will be learning ready when they get to school. Multiple studies have shown with painful clarity that the children who have fallen behind by age three, relative to the neuron connectivity levels in their brain, do not tend to catch up.

The children who actually have had their brains exercised in those first months and years of life tend to have stronger and bigger brains, and those children who have had that initial level of exercise do better in school. Exercising muscles builds strong muscles. Exercising brains in those first months and first years very similarly builds strong brains.

By age four, the golden time of neuron connections is over, and we need to do different things after that time to add educational value for each child. We should continue to help every child and children will obviously benefit from that help, but we all need to understand that it is much harder to achieve major learning-capability benefit from the same kinds of basic biological triggers and interactions that connect neurons by the millions and billions for each child in those first months and years. We should and must continue to help every child, but it is much more difficult to achieve the same levels of benefit and the same growth in ability after age three.

High school is too late. The proof for that statement exists at many levels. Many schools have tried very hard and very sincerely to close the learning gaps for school age children — and those schools have had only marginal success in closing those gaps. The biological reality for children from every racial and ethnic group is that you can’t really close the most important learning gaps at 15 years. You need to close them at 15 months.

It is entirely possible to close those gaps for every child from every group in those months and years. Modern research and a growing body of science and wisdom has given us new insights into the actual functioning tools that work to transform the lives of children.

The tools that work are basic and they can be used in any setting. The tools that work to close the gaps and strengthen the brains are to talk, read, sing, and interact directly with every child.

Talking directly to a child is actually the single most powerful and effective brain-building tool. That is new science — and it is extremely important knowledge because it tells us very clearly what we need to do to help each child. We now know that talking directly to a child creates billions of neuron connections in a child’s brain, so we need to be sure that someone is talking to every child.

The new research is showing us children react in very direct and powerful ways when trusted adults talk directly to them and interact with them in direct ways. Literally billions of neurons connect when adults talk directly, in loving ways to a child, and that is true in even the first weeks and first months of life.

The brain science programs at Harvard, Stanford, The University of Washington, Columbia, UCLA, and a number of other rapidly learning and focused research sites know that science and those time frames well. New science from multiple sources about what happens in those key time frames for each child points us in extremely important directions. The knowledge exists. But we have failed to a massive degree in using that science and that functional knowledge to help children across our country.

We have done a completely inadequate job of teaching that science to parents and to the families of newborn children, and we have done an equally inadequate and intellectually inexcusable job of teaching that science to the people who run our schools and our public programs, and even to the caregivers who need that information to do their jobs well with the patients and families they serve. We have not built that science into our care settings or into our public policy functions and strategies.

We will be damaged as a nation as the result of that failure to use that information in meaningful ways.

More than 50 percent of the births across this entire country next year will be to Medicaid families. And more than half of the Medicaid families do not have a single book. Reading strengthens brains and builds learning ability levels. We have far too many homes of young children who do not have a single book.

There is a major speaking deficit as well. Children’s brains grow when adults speak directly to them. Direct speaking to children in the first years of life literally causes billions of neuron connections. We have not taught that information to every American family. We have major differences today in the number of words spoken between groups of children. We now know children in the lowest income families hear millions of fewer words spoken directly to them by the time they enter school.

Talking is free and talking can have a great effect in any setting, but we have not taught the value of talking to far too many low-income homes, and parents don’t know how much value is created for their children by simply talking constantly in an interactive way with their child.

We need to create a culture of parenting for our country that is very intentionally and deliberately anchored in that knowledge and science. Lower-income families often have children with much lower levels of interactions from adults by the time they get to school, and no one is teaching the low-income parents about the value of those interactions. It is extremely disrespectful to low-income parents, and it is clearly dysfunctional for low-income-family children when we do not to teach that information to every family in every setting.

We can change that knowledge level for every family, and we can change each of those interaction realities. We can get every home into a more effective level of support for each child. We can teach the huge brain-development potential of talking to a child to every mother and to every father of every new child in America. We can encourage those key behaviors that change lives, and we need to do exactly that because we know those behaviors will have impact and we know that information will be used in many settings to help children because parents love their children, and parents from every group and setting very much want their children to succeed.

We have failed in the past in teaching those realities to most parents. Some groups have parenting practices that take better advantage of those time frames. We need to share that knowledge about those opportunities with every group and every parent. We have failed in that teaching process as a country, and we need to correct that failure. We have not systematically, clearly, and consistently given all parents the knowledge about those processes that will truly enhance their children’s likelihood of success, and there are parents who are not providing that support to their children in those key time frames because we have not taught those parents the value and opportunity that those interactions create.

This needs to be a massive, intentional, and high-priority public health campaign for America.

We need to begin by doing what we need to do to build a basic intellectual understanding of these issues with every relevant person in America. We need our relevant caregivers to all understand those realities. We need our educators to understand those realities. We need our planners and our economists to understand those realities.

Any economist looking at the future of our overall economy who does not understand the inevitable impact of having more than half of our babies born into families with very few books and relatively low levels of words spoken to the babies, is an economist who is missing a massively relevant and foundationally important set of data about our future.

If we don’t correct the trajectory we are on, far too many children will lead damaged lives, drop out of school, and go to prison — and our cities will have very large and growing numbers of people who have no effective functional chance of economic success.

We need to act now to change that direction for America. Every single minute children are born and then swept down grim pathways to extreme difficulty, and almost inevitable, perpetual failure at several important levels if we fail to intervene in each of their lives right now, with the right sets of interactions.

We need to begin the intervention by making every single effort to compel every relevant person in America understand this reality. Because those first years determine whether or not children will succeed in school — and because they determine whether or not they will be employable after their school years — and because we now know from extensive research into the physical and medical long-term consequences of Adverse Childhood Experiences (ACES), that those very first years also have a massive impact on each persons’ lifelong levels of future health — we need our educators, community leaders, caregivers, economists, public planners, law makers, and our public program administrators to clearly understand those sets of issues, and to factor those realities into our actions as a society to help children today. We need to educate our educators and teach our teachers about the real reasons their schools have failed to close those gaps in so many settings, even in spite of their sometimes-heroic efforts. We need every family to learn how to give the new members of their families the best chance to succeed, and to support each other in helping their children receive the needed support and interactions.

The people who make our laws, and create and govern our public programs need to know how different the lives are for people who do get the help they need in those first key years, in comparison to people who do not receive that support in that time frame.

We need mayors in every city to understand those issues and we need them to teach that information to their cities. We need governors to understand the future success for their states depends on helping children today in those key time frames. And we need a President of the United States who understands our country will fail in key ways if we end up continuing to impair and damage high and growing percentages of our children by not helping them in those first key months and years, when help has massive impact.

We need to start by making sure that information is taught to the parents of every single newborn child. We need all parents of new children to know their children will fall far behind very quickly if people are not interacting directly in caring ways with each child, and we need parents to know they can provide great value for their child by helping the child in those key weeks, months, and years when that help has the greatest impact.

We need to very intentionally create and roll out a massive public health campaign to teach that information to every adult in America — because we will have a much better chance of helping every child if all relevant adults in all relevant settings know how much value is created for each child and all children from those first months and years of direct interactions and support.

We need a strategy for the country that involves both Surround Sound and Trusted Messengers on those issues. We need our obstetricians and midwives teaching that information to each mother before each baby is born — and we need our pediatricians, family doctors and all other relevant nurses and physicians teaching that information to all mothers and families after the birth of each child. We need the family of every child who goes home from the hospital after being born to receive information from the hospital about the importance of key parental interactions in the first days, weeks, months, and years for the developmental success of each child.

We need all day care settings to also understand that information — and we need our babysitters and child support settings to know the importance of those positive interactions with each child in those key months and years.

We also need all the health plans and programs that provide health insurance to our infants to understand those issues, and to support the caregivers in teaching that information to each parent. The data is clear that Adverse Childhood Events tend to significantly increase overall health care costs for individual people — and we need to do proactive things that reduce the number of those events for each child. Health plans and government programs that provide health coverage and care should promote and support those proactive interactions.

We need every WIC program in America supporting those agendas. WIC is a highly beneficial federal program that provides both nutritional counseling and food purchasing support to the vast majority of Medicaid parents. Nearly 80 percent of Medicaid parents use the WIC program, and those parents each interact directly with the WIC counselors. It is relatively easy to add coaching and counseling about brain development issues and approaches to that current counseling about food and basic health for WIC participants, and it is possible to systematically and directly reach a large percentage of the lowest-income mothers who will benefit significantly from learning that information.

In addition to the WIC program, we currently have a program called Nurse/Family Partnerships that reaches about 10 percent of the Medicaid homes. That program has also helped children deal with this set of issues. The children whose homes received nurse family partnership support have had significantly lower learning gaps, and significantly lower numbers of incarcerated young people. That Nurse/Family Partnership program could be redesigned to deal more explicitly with early brain development issues — and some pilots have indicated that a more focused program with a higher emphasis on early learning issues could achieve significantly positive results with lower expense levels than the current program.

The existing Head Start programs that begin with 4-year-old children have many benefits, but the research shows us those basic Head Start programs have had a fairly minimal impact on reducing the learning gaps in the school. They have not closed those school learning gaps because they start with 4-year-old children — and the greatest opportunities for neuron connectivity happen before those years — in the first two and three years of life for each child. However, the variation on that program, Early Head Start, is focused on children at a much earlier age — and those Early Head Start programs that begin closer to birth have an excellent record of reducing the learning gaps for the children they serve.

States should extend Early Head Start to more low-income children in any places where money allows that extension.

We definitely need to teach this science — early brain development promoted by talking and reading — to every day care setting in America, and we should require day cares for very young children to have books for their children. More than half of the day cares for the lowest-income children did not have a single book. Providing books should be a requirement for both licensure and for any government cash flow to those settings. Parents should demand and expect their day care settings to provide both books and appropriate interaction times and settings.

We also need to distribute books to all low-income families. Several studies have shown that higher-income homes average more than 12 books per child, and studies have shown that more than half of the lowest-income homes do not own a single book. Books are very inexpensive, and books provide great value when read to children. We need a variety of programs to get free or low-cost books to low-income families. Every community and every care site should make that goal a priority, and every community should facilitate access to books for every low-income family.

We also need our faith-based organizations to share this information about helping their children with all of their members. Making information about brain development in children available by faith leaders at the time of marriage, and any time relating to birth and early learning, would be a blessing to many parents and children. Supporting those teaching agendas for all faith-based school settings has its obvious benefits. We need both trusted messengers and surround sound on those issues. Few people are more trusted than faith leaders. We need faith leaders and faith-based organizations to share this information with all of their relevant members.

We also need both employers and government organizations to support parental leave policies for all new parents. The first 90 days of life involve epigenetic processes for children that shape many aspects of their lives — and having parents available for loving and direct interactions with their children in those first weeks and months can be a major biological and emotional asset for each child. Every other industrialized country in the world provides support for parenting in that key time period. We are unique in not supporting our parents for that extremely important period of time. We clearly need to change those support levels — and we need to make that change in alignment with the kind of parental education and coaching that will optimize that time for the babies.

To change the trajectory from growing numbers of schools where far fewer than half of the children reach basic learning levels in either reading or mathematics, to a future where the vast majority of our children do well in our schools, we need support from our communities at multiple levels. Mayors and Governors are natural leaders for these efforts. We need those leaders to be teaching their communities those realities, and we need both Governors and Mayors to be leading team-based efforts in each city and setting. We need the League of Cities to support Mayors and cities in those efforts. We need the National Governors Association to be helping Governors down those paths.

We also need the Academy of Medicine and each of the professional medical associations to be part of that agenda. The Academy of Medicine has done some brilliant research on those topics — beginning with the great study Neurons To Neighborhoods — but the Academy has been relatively silent and a non-participant on the public policy relevance of their learning and their science. We need the Academy to re-engage on those issues as guidance for the country. They did that with great success on issues relating to Hospital Safety, and we need them to take a similar role on childhood brain development.

The Academy of Pediatrics is now beginning to do important work in that area. We need that work to continue and expand.

We need the major foundations and think-tanks for the nation to make helping children in those age categories a major priority. We need the Robert Woods Johnson Foundation, The Gates Foundation, The California Foundation, and all of the other organizations who steer and fund public policy development to make this issue a priority, and we need them to help communities do the right things for their children in those key months and years.

We need the economists at the think-tanks and the various academic institutions to understand how badly our country will do in the future if we don’t change those most negative trends. The University of Chicago, with Nobel Laureate James Heckman, has been a leader in that thinking. We need more economists to understand and deal with those issues.

We also need manufacturers and distributors of child-relevant products educating parents about early brain development within their advertising, product designs, and materials. Talking to babies while changing their diapers is a science-based parenting best practice — and a well structured and functionally-focused education process would call for coaching to parents on that practice to actually be printed on each diaper.

We also need the people who run Medicaid to support those processes, and we need each state to support those processes. Medicaid is extremely important as part of the solution strategy for helping our children. Medicaid can have a massively positive impact very quickly. Medicaid is our single biggest structural and functional opportunity to make a difference in the lives of children who most need our help. More than half of all births in the U.S. this year will be to Medicaid Mothers.

To be enrolled in Medicaid, people are, by definition, very low-income. More than half of the births in this country will be to low-income families supported by Medicaid. That gives Medicaid a great opportunity to have direct and extremely timely interactions with those parents.

The research shows us low-income people are much less likely to talk to their children and low-income people much less likely to read to their children than higher income families. The average working family reads to their children roughly 1,500 hours per child from birth to kindergarten. The average Medicaid family reads fewer than 30 hours to each child — and more than half of the Medicaid homes do not own a single book. The lower-income children also tend to have fewer words spoken directly to them by adults. By some measures, the difference in the total number of spoken words heard by each child exceeds 20 million words between the higher-income homes and the lowest-income homes.

That does not need to be the pattern we face in the future. Medicaid is involved in all of those births — and Medicaid can require its own network of caregivers to teach both the science and the proven and effective parenting practices to every parent. We have done a terrible job of teaching low-income mothers the benefits and value of speaking directly to their children. Medicaid can simply and directly change that reality by having its contracted caregivers teaching those issues to parents both before and immediately after birth.

There are very good reasons for Medicaid to take on that role. We need to modify some existing patterns of parenting for some of the people served by Medicaid. We now know some sets of people both directly and indirectly discourage mothers from speaking in baby-talk to very young children. Mothers are told that talking in baby-talk is not good for the mother or the child. We need Medicaid caregivers and all of the other trusted messengers for young mothers to communicate the more effective information on that issue.

Similarly, some numbers of people served by Medicaid believe children should not be read to until they have reached the age of four or five. We know those practices exist, and we also now have great science telling us that children who are not given direct interaction and reading time before the age of four tend to be at least a year behind children who are receiving those interactions in those first years.

The science of those direct interactions and its impact on both individual children and groups of children are clear to the researchers — but that science is not known to the families and parents of those children. We need to change that reality.

The people in those cultures and settings all want their children to do well — but those parents who do not do baby talk and who do not read at very early ages to their children simply do not know that talking and reading to their children in those key months and years are the easiest and most effective pathways to success for their children.

Simply talking to a baby in the first year of life can create billions of neuron connections. Babies don’t need books in those first months of life, but babies do need parents and adults who talk directly to them and who respond to their sounds and attempts at communication with words and responses. We have not taught that information to low-income mothers — and their babies have not received the interactions that build both security and learning skills as a result.

We need every mother and family to know the huge impact that talking to and with a child has in the first months and years. We need to add books to the parenting mix by the end of the first year, with either parents or family members or day care settings reading at least some books to their children during that time. Talking is free — and books can be made affordable and accessible — and we should do whatever we need to do to make those interactions a reality for each child.

Obstetricians, midwives, pediatricians, and nurses who handle Medicaid care delivery should all incorporate coaching to parents about the early growth tools for their children. Medicaid can and should make that a requirement for all Medicaid care deliverers.

The Internet should also be used widely and extensively to both explain those issues and the Internet should be used to demonstrate to parents and families various ways that parents and families can meet those needs for their children. We need role models and we need various Internet support tools. The Internet gives us a wonderful tool to do this work in ways that did not exist before.

Texting to new parents has also been used with major success to coach parents, and to remind them to interact with their kids instead of interacting with devices alone. One program showed a texting approach that simply reminds parents regularly to interact with their children, which resulted in only one year with children who were three months further advanced in their learning ability than the children who’s parents had not received those same reminder texts.

Texting also can have its unintended negative consequences. Parents who ignore their children because they are texting can actually damage their children by that lack of interaction. That seems to be happening in some settings. For some groups that had very high reading scores only a couple of years ago, there have been some decreases in children’s ability that seems to be happening with the groups and sets of mothers who spend the most time texting other adults and not focusing as much direct time on their children.

We can make life better for many children if we just do some basic strategies to support parents in their interactions with their children. We need surround sound to exist on the need for having those interactions with children. We need all parents to know both the science and the tools. We need all community leaders, legislators, and caregivers to know both the science and the tools.

We need all of the great research programs that are figuring out the best science of development for our children — like the Center for The Developing Child at Harvard, and The Center for Early Brain Development and the Science Learning Laboratory at the University of Washington in Seattle — to continue and expand their work. We need the great brain and behavioral scientists, like, Patricia Kuhl, John Schonkoff, Ross Thompson, Beatrice Beebe, and the teams at the Institute of Medicine and the Zero to Three Coalition — to be expanding their work and sharing their findings more effectively with the world.

We need a collective commitment to save this generation of children — and we need to do the things that the commitment calls for us to do to save each child. If we allow the learning gaps to continue, we will face growing problems as a country. As an example of those problems, we just had a number of highly visible protests, demonstrations and community action campaign in the City of Milwaukee. The news media pointed out that there are major economic problems and major employment problems for minority members of the Milwaukee community. Arrest rates were disproportionate, and the articles mentioned that there were significant numbers of minority people from Milwaukee in prison and jail.

What the articles written about those problems generally did not mention is that when the new national reading tests were taken last year by the students in the Milwaukee schools, only 15 percent of the children in those schools were reading at proficient levels. A high percentage could not read at all.

That should not be acceptable to any of us. We need a program in Milwaukee today to teach this basic science about the importance of the neuron connectivity processes In the first months and years to every family and every parent of a new child in that city. While we work to correct the other major problems of that community, we need to start now by giving each child born this week a better trajectory into the future. That better trajectory for those children being born today in that city will not happen if we don’t make it happen.

We need a similar trajectory changing agenda for the country. We need to make this issue of early brain development for all children a top priority or we will face a grim and divided future and all of our communities will end up losing in significant ways.

That should not be the future we choose for ourselves.

Let’s choose the pathway that gives all children the best path for success. Let’s understand the overall issue, and then we all need to figure out how to make those realities relevant to our lives and our communities.

We need collective creativity to happen — and that will only happen if we share the science and build the wisdom about how to use it in the best ways. Knowledge is power. We need that power and we need it now.