Health « Preschool Matters… Today!

A Life Devoted to Healthy Development for All: J. Fraser Mustard

November 28, 2011

The Toronto Star recently reported the sad news that Canadian physician and researcher Dr. James Fraser Mustard died in his home at age 84. In addition to being a part of the research team that discovered aspirin could help reduce the likelihood of heart disease, Dr. Mustard studied early childhood development with his research influencing his home province’s education policy. His Early Years Study was used by the Ministry of Education in Ontario when it established a program to offer full-day kindergarten throughout the province. His broader body of work influenced early childhood policy around the globe.

Dr. Mustard was a strong global disseminator of the science base for public investments in early childhood development. He was expert in tying together diverse research from medicine, neuroscience, and social science so as to make clear to virtually any audience the connections and implications. Dr. Mustard had a keen understanding of the impacts of early brain development on later outcomes including adult health. He also understood the importance of showing policymakers and the public that the relationship between socio-economic background and human development is a gradient—a smooth continuous slope—and that the level and steepness of these slopes varies considerably across nations depending on their public policies. As he wrote in 2010:

“Results from developmental neurobiology studies and animal and human studies provide strong evidence that early neurobiological development affects health (physical and mental), behaviour and learning in the later stages of life. Countries that provide quality universal early development programs for families with young children tend to out-perform countries in which the early development programs are chaotic.”

Mustard was born in Toronto, Ontario and attended the University of Toronto. He later conducted postgraduate study at the University of Cambridge before returning to the University of Toronto as a research associate. He was also involved with the National Heart Foundation of Canada, the Canadian Heart Foundation, and the Royal College of Physicians and Surgeons of Canada, amongst others. Dr. Mustard was a founding member of both the McMaster Medical School and the Canadian Institute for Advanced Research, a multidisciplinary nonprofit that has conducted research on topics such as economic growth and policy, experience-based brain and biological development, human-environment interactions, human development, population health, and successful societies.

Beginning in the 1980s, Dr. Mustard became more involved with research on early childhood development and learning. He became the head of the Founders’ Network, a group dedicated to studying economic and social impacts on health and human development, with an emphasis on early childhood. Dr. Mustard’s research work produced the 1999 report on the Early Years Study commissioned by the government of Ontario and follow-up reports in 2002 and 2007. Collectively, the reports criticized Canada’s commitment to preschool learning and called for national early childhood development initiatives on par with K-12 education as a means to promote lifelong healthy outcomes. In 2004, Dr. Mustard co-founded the Council for Early Childhood Development, an organization whose goals include promoting the message of the Early Years Study and further studying early childhood development.

We are heartened that Dr. Mustard’s work proceeds on. Less than a week after his death, a third report based on the Early Years Study was published, recommending that children as young as 2 years old should have access to voluntary prekindergarten education. And, the full-day kindergarten initiative in Ontario continues to roll out, with final implementation slated for September 2014.

- Steve Barnett, Director, NIEER

- Jen Fitzgerald, Public Information Officer, NIEER

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Eating Right, Learning Right

October 10, 2011

The important link between children’s health and their education is being highlighted this week with the celebration of National School Lunch Week. This year’s theme is “School Lunch – Let’s Grow Healthy,” as part of a three-month long campaign by the School Nutrition Association to highlight the importance of school lunch programs. Common sense tells us that children with empty stomachs can’t concentrate on classroom learning or homework. With this in mind, schools and pre-K programs often offer snacks and meals throughout the day to make sure children are fully prepared to learn and excel. The federal Child & Adult Care Food Program (CACFP), administered through the United States Department of Agriculture (USDA), provides guidelines for serving nutritious meals and snacks in child care centers and afterschool programs. In addition, providing nutritious meals to children is a key component of the federal Head Start program’s services to low-income children and families.

Each year, NIEER gives state pre-K initiatives a rating based on meeting 10 quality standards benchmarks, which address a variety of quality components including services such as meals. As we stated in The State of Preschool 2010, “these items are included because children’s overall well-being and success in school involves not only their cognitive development but also their physical and social/emotional health.” In order to meet our benchmark on meals, state programs must require by policy that all programs, regardless of hours of operation, offer at least one meal each day.

Unfortunately, in the 2009-2010 school year, only 24 of 52 state-funded pre-K programs met the benchmark of at least one meal being required in state policy. (See Table 1 for a list of the programs meeting the benchmark for required meals.) Twenty of these 24 programs specifically mention lunch in their meal requirements.

Table 1. State programs requiring at least one meal in all pre-K classes

Alabama	Louisiana LA4	Oregon
Alaska	Louisiana NSECD	Pennsylvania HSSAP
Arkansas	Maryland	Rhode Island
Delaware	Minnesota	South Carolina CDEPP
Georgia	New Jersey Abbott	Tennessee
Iowa Shared Visions	New Mexico	Washington
Kentucky	North Carolina	West Virginia
Louisiana 8(g)	Oklahoma	Wisconsin Head Start

However, only five programs – Pennsylvania EABG, Pennsylvania K4 & SBPK, Vermont Act 62, Vermont EEI, and Virginia – reported that no meals or snacks are required by state policy. The remaining 23 programs either reported that snacks were required and/or that meals are required for full-day programs but not half-day programs.

For the 2009-2010 school year, we also asked states to report on whether meals and snacks need to meet nutritional guidelines and found that all but 10 programs require this. (See Table 2 for a list of those programs not requiring programs to use nutritional guidelines.) Of those meeting nutritional guidelines, all were using federal nutrition guidelines set by the United State Department of Agriculture (USDA).

Table 2. State programs not requiring the use of nutritional guidelines

Florida	Pennsylvania K4 & SBPK
Illinois	Pennsylvania Pre-K Counts
Nevada	Rhode Island
New Jersey ELLI	Vermont Act 62
Pennsylvania EABG	Vermont EEI

The federal Head Start program’s nutritional guidelines play a role here as all five state programs that are Head Start supplements met the benchmark for meals. This is particularly noteworthy in Pennsylvania and Wisconsin, where the states’ other pre-K initiatives do not meet the meal requirement benchmark while the Head Start supplements do.

As with any other of the quality standards we report on in the State Preschool Yearbook series, it is important to remember that we are discussing policy here and not necessarily practice. While not every state policy requires that all programs offer at least one meal, some, or perhaps even all, of those programs may exceed the policy and do so. Still, with only 24 state pre-K programs on the record with a commitment to providing their students with at least one meal a day, we have a long way to go before we can truly celebrate school nutrition.

Child nutrition is of increasing concern as childhood obesity rates increase while food insecurity also spreads. President Obama’s proclamation of this week pointed to the need for collaboration throughout communities to bring students healthy food every day at school, a goal toward which we still work. At a time when Sesame Street has created a new Muppet to address the issue of food insecurity—the 17 million children in families who don’t know where their next meal comes from—it is clear that providing nutritious, consistent meals to children in school can go a long way to improving their daily lives.

- Jen Fitzgerald, Public Information Officer, NIEER

- Megan Carolan, Policy Research Coordinator, NIEER

2 Comments | Child Development, Federal policy, Head Start programs, Health, Preschool, State-funded programs | Permalink
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Childhood Obesity: A Growing Problem

September 27, 2011

Obesity, especially beginning in childhood, has become a growing problem in the United States. The rate of childhood obesity has been increasing at a breakneck speed so that currently a third of children are obese (16.4 percent) or overweight (18.2 percent), according to a recent report from the Trust for America’s Health. Childhood obesity is linked with numerous negative effects that can follow a person throughout their lifetime, including greater risk for other health problems such as asthma, cancer, diabetes, heart disease, and high blood pressure. Given the risk of these negative outcomes, early intervention is seen as paramount by many. With that in mind, President Obama made a proclamation on August 31^st, declaring September to be National Childhood Obesity Awareness Month. To that end, the federal government’s Let’s Move! initiative encourages children and families to make healthier choices regarding exercise and meals. But as President Obama noted in proclamation, “Everyone has a role to play in preventing and reversing the tide of childhood obesity.” This does not exclude preschool programs and, indeed, in the past research has found that a preschool program’s choices of daily activities and menu selection could play a role in reducing childhood obesity. For more on the role of preschool in promoting healthy lifestyles, stay tuned for NIEER’s upcoming brief on health policies in pre-K.

- Jen Fitzgerald, Public Information Officer, NIEER

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Forget the Tea Party — The Milk Party Has Arrived!

December 9, 2010

Think the Children’s Movement of Florida is just another garden variety advocacy effort? You’re likely to think again after watching what could be the most compelling 15 minutes of video ever produced making the case for putting children at the top of our priority list. It incorporates five issues of the movement’s focus, the 4 ½-minute “I Am Florida” video, a portion of the CNN national story seen by millions of people, and highlights from the Milk Party rallies in which 15,000 Floridians participated.

Anyone who has worked with David Lawrence, Jr., the children’s advocate, retired publisher of The Miami Herald, and spark plug behind the movement knows he is an able executive. Here we see Lawrence and his fellow advocates crisscrossing the state aboard the smartly decked out Children’s Movement bus that served as a mobile command center for the milk party tour. The milk party designation the group chose was an inspired move. It speaks both to the grassroots nature of the movement and the impressive momentum Lawrence and his associates built as they pulled into town after town to the enthusiastic support of large crowds. Some have wondered if the milk party might spread to other states — possibly even become a national movement. Only time — and the actions of other advocates and concerned citizens across the country — will tell.

Leave a Comment » | Child Development, Early Childhood, Early Education, Economics, Health, Preschool, State-funded programs | Permalink
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Health Care Reform: Early Learning Challenge Fund Dropped but Home Visitation Survives

March 26, 2010

We were bitterly disappointed to learn that the Early Learning Challenge Fund didn’t survive the rough and tumble of the health care reform effort. It represented much that was good about the Obama approach to education. Using competitive grants to fund better quality, better-coordinated services for children from birth to age 5, as the program proposed, would go a long way toward addressing the many deficiencies in our early childhood system.

We hope the administration finds another way to meaningfully fund the challenge grant concept for the early childhood years but can’t help wondering if this will actually happen. Obviously, it didn’t help that Congress had to resort to the reconciliation process for passage and that the amount saved from reforming the student loan program was revised downward. One worry is that the costs of health care reform, war, and other big budget items will simply squeeze early childhood programs out of the budget. In any case, this session in Congress will be a test of the early childhood community’s clout on the Hill.

The news wasn’t all bad for the early childhood community, however. The health care reform legislation does contain a $1.5 billion federal grant program for evidence-based home visitation for new and expectant families. Engaging families at home to deliver parenting education and child development guidance is not new. Programs like Parents as Teachers (PAT), Home Instruction for Parents of Preschool Youngsters (HIPPY) and Even Start have been around since the 1980s. They use home visits to deliver parent education intended to promote better cognitive and socio-emotional development of at-risk children. In the 1990s, programs like Healthy Families America and Healthy Start began using home visits in an effort to prevent child abuse.

For years, these programs have been plagued with questions about how well they work. The quality of research on them is mixed, as are the findings. For the most part, when positive effects have been found, they have tended to be modest. One exception is the Nurse Family Partnership. Begun in the 1970s, it targets low-income, first-time mothers with visits from trained nurses. Randomized trials have found the program produced positive outcomes that, among other things, included fewer childhood injuries, fewer subsequent pregnancies, and improved school readiness among the children of parents visited.

If a major expansion of home visitation is to be effective, policymakers need to realize that success with this service delivery model depends heavily on the quality of the intervention. As with high-quality preschool education, much depends on the quality of the professional doing the teaching and the pupil — in this case the home visitors and parents.

A good deal more high-quality research needs to be done on home visitation to identify what works for given sets of circumstances and to inform various aspects of the policy process. Among those calling for that is John Schlitt who directs the Pew Home Visiting Campaign at The Pew Center for the States. His initiative is looking at what each state is doing in this arena and will publish initial findings this year. It is working in partnership with states that take different home visitation approaches in order to better develop scenarios from which other states may benefit. Meanwhile, a number of states are funding programs that don’t have much in way of compelling evidence that they are working. That needs to change.

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The Benefits of Investments in Early Development Around the Globe

November 13, 2009

Worldwide, a huge source of human potential is lost as children grow up without the benefit of effective investments in their early development. More than 200 million children under 5 years of age are not reaching their full mental, physical, and social developmental potential, says a recent report from The Open University based in the United Kingdom.

Many people associate early interventions to support child development with preschool education. That is only a part of the story in countries where problems like growth stunting, hunger, disease and extreme poverty necessitate early investments that focus on directly improving nutrition and health as well as care and education. With wide variations in the approaches to investments in early development and in children’s environments in the international arena, policy makers around the globe are asking, “How effective are the various programs in improving the development of children and does this vary across countries with very different economic conditions?”

To help answer that, NIEER recently conducted a meta-analysis of studies that looked at 30 interventions with varying approaches in 23 countries in Europe, Asia, Africa and Latin America. What NIEER found is encouraging: Regardless of the type of program, all had moderate positive effects in all domains of child development. The size of the long-term effects is similar to that found in a comprehensive meta-analysis of the U.S. studies. On average, they were about one-quarter to one-third of a standard deviation, with cognitive effects at the higher end, which translates to a gain of about 5 points on an IQ test. Studies that evaluated effects at older ages showed positive effects being sustained through adulthood.

Policymakers want answers to questions like what types of programs are most cost-effective, whether single-focus or combined-focus programs are best, and what treatment dosage is likely to yield the greatest gain in a given set of circumstances. While many of those answers will require further research, our findings shed some light. Interventions providing direct child care and education were more effective than other types of programs, particularly in terms of cognition. Interventions that combined education and care with attention to nutrition or health were more effective than cash transfer programs that gave money to parents in order to achieve a goal such as making sure kids get medical attention or programs that were solely nutritional in nature. Read the rest of this entry »

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A Tense Year for Flu Watchers in Early Care and Education

October 30, 2009

If you’re a parent or pre-K provider, sizing up the flu threat this year is a bit like watching that troubling pattern on the weather radar. You hope it doesn’t develop into a full-fledged storm and if it does, you hope it doesn’t blow your way. Seasonal flu has always been a worry for pre-K providers but this year the H1N1 flu virus presents a special challenge since young children are more vulnerable to it than the bulk of the population and this virus has the potential to mutate into a more deadly threat. The rapid spread of H1N1 flu prompted President Obama to declare a state of emergency this week and vaccine makers, who haven’t been able to supply sufficient H1N1 doses to meet demand, are being pushed to redouble their efforts.

Research has shown that vaccinating young children is an effective weapon not only in protecting them from flu outbreaks but also in protecting high-risk groups such as the elderly since young children are known to spread the virus to adults. Vaccinations for flu administered to kids early in influenza outbreaks have particularly high benefits for the rest of the population because the vaccine is relatively effective and the flu is highly infectious. One study simulating an outbreak found the benefit to be greater than one case of flu prevented in the rest of the population per influenza vaccination administered to a child.

Findings like this have prompted the Centers for Disease Control (CDC) to recommend that children between six months and 18 years old receive seasonal flu vaccinations. Of course, the CDC is not vested with the authority to require kids to receive them. That rests with the states. To date, only New Jersey has made it a regulation that kids must receive seasonal flu vaccinations (as well as pneumonia) as a condition of attending pre-K. Approved over the objections of the anti-vaccination lobby last year, the new regulation puts the state in a proactive position this flu season since getting kids vaccinated early is a key to containing outbreaks.

The vaccine for H1N1 flu, which requires two nasally administered doses to immunize children began arriving in October. Researchers looking at epidemiological models say that if a concerted effort is made to vaccinate 70 percent of children between six months and 18 years old for H1N1 flu first, it could lead to coverage of 70 percent of the entire U.S. population since kids are prime spreaders of the virus. Read the rest of this entry »

1 Comment | Health, Preschool | Permalink
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