Search reports, ask a question, or jump to a page.
Reports
Reports gathered from around the world, newest first.
14,075 reports · page 605 of 1408
Journal Article
Wandera, Susan Nduta, Akala, Winston Jumba, Imonje, Rosemary Khitieyi
Journal Article
Fernandes, Michelle, Stein, Allan, Newton, C. R. et al.
Student Reflection on CCFP Careers Series Talk “Many Sectors. Many Roles.” The post Student Reflection on CCFP Careers Series Talk “Many Sectors. Many Roles.” appeared first on Duke Center for Child & Family Policy.
Sarah Brantley
Journal article
Mabwa, Shirley Ofuyo, Ongaro, Kennedy, Yugi, Philemon
Abstract Life course epidemiological research demonstrates the importance of early childhood as a sensitive period where experiences can shape long-term health and well-being. Early childhood policies and programmes grounded in life course theory—including economic policies, educational and parenting programmes, and place-based initiatives—show promise; however, effectively translating findings into large-scale impact remains challenging. There is a need for interventions to more explicitly link their theories of change to key health outcomes and causal pathways. Cross-sector collaboration and coordination could also help develop multilevel, innovative solutions. With a focus on testing theories of change and understanding heterogeneity in effectiveness, evaluations can optimize existing approaches and inform policies aiming to reduce health inequities over the lifespan.
Natalie B. Slopen, Jack P. Shonkoff
The early childhood field is at a critical inflection point in a changing world. In the wake of a devastating pandemic that has exacerbated longstanding inequalities and disrupted vital services, the demand has intensified for fresh thinking about how to strengthen the foundations of healthy development in the face of significant adversity. In this context, the current framework for early childhood policies and programs across the globe is guided by three core concepts of development: (1) the impact of early experiences on brain architecture; (2) the importance of responsive, ‘serve and return’ interactions between young children and the adults who care for them; and (3) the disruptive effects of toxic stress on the developing brain and early learning. Building on this strong knowledge base, the rapidly moving frontiers of the biological sciences now underscore three additional concepts that offer a deeper and broader framework for science- informed investment in the early years of life. (1) Connecting the brain to the rest of the body. Extensive evidence of the interactive effects of excessive adversity on multiple biological systems (e.g., neural, immune, metabolic), beginning in utero, underscores the highly interrelated origins of early development and lifelong health. The time has come to move beyond coordination of services across sectors as an endpoint and to design policies and programs to strengthen the early roots of effective learning, adaptive behavior, and both physical and mental health informed by a common, integrated, science framework. (2) Variation in Sensitivity to the Environment. Science confirms what caregivers know—all children have similar basic needs but respond differently to adversity and support, even in the same family. At a population level, children who experience significant adversity are at greater risk for later problems in development and health, but long-term predictions for individuals based solely on adverse experiences are highly inaccurate and can lead to false labeling. (3) Timing and critical periods. Research on sensitive periods in developing immune and metabolic systems, as well as in brain circuits, calls for greater attention to the prenatal period and first 2-3 years after birth. All policies and programs that affect well-being during pregnancy and infancy present opportunities to promote a lifetime of well-being. Advances in our understanding of the complex interactions among genes, environments, and developmental timing provide a compelling opportunity for leveraging 21st-century biology to inform more effective strategies for promoting early childhood development. Aligning that rapidly moving science with the lived experiences of families and decision makers across a diversity of sectors and cultures offers a powerful pathway forward in the quest for healthier and more equitable contexts in which families raise young children.
Jack P. Shonkoff
Learning how to cope with adversity is an important part of healthy child development. The field of early childhood intervention stands at an important crossroads. An exciting new era in early childhood policy, practice, and research lies at the convergence of these two agendas—an era driven by science, creativity, and pragmatic problem-solving in the service of building a more humane present and more promising for all young children and their families. Science tells us that early childhood is a time of both great opportunity and considerable risk. A strong foundation in early childhood lays the groundwork for responsible citizenship, economic prosperity, healthy communities, and successful parenting of the next generation. The science explaining the phenomenon is grounded in the basic biological principle that the immature organism "reads" salient environmental characteristics in the service of developing its capacity to adapt to the environment in which it "expects" it will live.
Jack P. Shonkoff
The rapidly moving frontiers of neuroscience, molecular biology, and epigenetics—combined with extensive research in the behavioral and social sciences—are dramatically expanding our understanding of how children develop, how that process can be disrupted, how to get it back on track when it does get derailed, and how to keep it from going off track in the first place. The challenge for educators, other practitioners, policymakers, and change agents across sectors lies in our collective ability to transform cutting-edge knowledge into design principles and concepts that can inform an actionable game plan. The first step in addressing this challenge is the need to identify the most important factors that affect individual variation in learning and behavior—a task that demands recognition of the inextricable interaction between environmental influences and genetic predispositions. Building on this foundational understanding, progress toward substantially better life outcomes for all children will require attention to three objectives: (1) making complex science understandable and accessible for strategically targeted audiences; (2) making credible knowledge usable for educators, other practitioners, parents, policymakers, and civic leaders; and (3) leveraging continuing advances in science to build an R&D platform that drives innovation across multiple sectors within a dynamic ecosystem. The opportunities to leverage scientific insights to catalyze fresh thinking and test new ideas in practice and in policy are plentiful and growing, while the barriers to progress remain formidable. The time to seize the opportunities and overcome the barriers is now.
Jack P. Shonkoff
This supplement issue on racism in the early years is coming out at a critical inflection point in the history of early childhood policies and programs, and the knowledge base on which they sit. From a research perspective, there is a compelling need to revisit previous studies and critique emerging work through a racial equity lens to identify potential bias in research designs, data analyses, and reported findings. Equally important is the need for actionable knowledge that reflects the lived experiences of a broad diversity of racially and ethnically marginalized families with young children, many of whom bear enormous hardships imposed by structural inequities.
Iheoma U. Iruka, Jack P. Shonkoff, Stephanie M. Curenton
Despite growing recognition of the foundational importance of the early childhood period, the persistence of significant socioeconomic, racial, and ethnic disparities in school readiness remains a challenge.1 This challenge is reflected in decades of program evaluations across multiple sectors revealing modest effect sizes, limited replication of promising interventions, and minimal evidence of significant impact at scale.2,3 In this issue of Pediatrics, Chamberlain et al4 address an important question facing pediatricians: What can be done in a primary care practice to strengthen the building blocks of literacy for children who are not reached by other programs? The contributions of this article fall within two categories. The first includes the findings of the TipsByText (TbT) evaluation. The second, and arguably the more instructive, includes the questions that the study leaves unresolved.The premise for this investigation is based on the proposition that young children’s access to primary health care in the United States is near universal, thus offering an opportunity to engage families who are difficult to reach through other services (eg, preschool). The rationale for testing an existing intervention that is easy to incorporate within the health care setting is well founded, and the positive overall impact of TbT on children’s knowledge of literacy fundamentals is encouraging.Although the potential benefits of text messaging for isolated families are promising, a more important contribution of this article is the opportunity to consider the questions it is unable to answer. Namely, what is the value of a statistically significant mean difference between a treatment and control group that is not embedded in an explicit theory of change that connects the intervention to the measured outcome? When that precision and linkage are missing, what are the implications of the findings for either practical application or further investigation?More specifically, the theory of change for an intervention that uses text messages to empower parents to improve their child’s early literacy skills assumes that the messages will (1) be received and viewed by parents; (2) inform and motivate them; and (3) lead them to engage in greater interactivity in language exchanges with their children, which in turn will improve early literacy skills. The lack of data in this report on program take-up and parental empowerment, combined with null impacts on parents’ self-reported reading and literacy interactions with their children, generates more questions than answers about the mechanisms through which the intervention affected children’s literacy knowledge.Similarly, although Chamberlain et al do take the important step to examine subgroup differences in outcomes, the absence of a conceptual framework to guide these analyses makes their interpretation challenging. What meaning can be attributed to the relatively larger intervention effects associated with first-born status, 2-parent families, English-speaking caregivers, and children >48 months of age, with no differences on the basis of caregiver education? Without hypothesized causal mechanisms, how can pediatricians be expected to modify their practice in response to potential variation in intervention effectiveness?5The challenges faced by Chamberlain et al in explaining how and why the TbT program led to stronger versus weaker impacts on child literacy are not unique. Indeed, in a recent systematic review of 277 high-quality early childhood program evaluations spanning 5 decades, we found that information on program take-up was reported in fewer than half of the studies, whereas process outcomes and tests of moderation were each reported in fewer than 20%.6 Collectively, this lack of consideration for whether programs are used by intended recipients, how and why they work, and for whom they are most effective has led to more questions than answers about how to maximize both impact and equity in early childhood intervention.In summary, although its average effect was confirmed, the conclusion that parent-directed texting produced “three months of literacy gains” in young children without any evidence of take-up, impact on parenting behaviors or parent-child interaction, or explanation of subgroup heterogeneity makes it difficult to identify the active ingredients and, in turn, generalize the stated conclusions about the TbT program. Significant mean differences between treatment and control groups on outcomes that are not linked to the intervention through a clear mechanism to explain the changes limits our understanding of how to match services to children and parents who will benefit from them.The most important contribution of this instructive article is not its recommendation for text messaging to improve early literacy in the context of pediatric primary care. Rather, its power lies in the opportunity it provides to underscore a fundamental challenge faced by early childhood services broadly for half a century. Reporting average effects and subgroup differences without exploring causal explanations in programs that target child development is a major limitation affecting many similar studies. The entire early childhood field would benefit substantially from confronting this important challenge, which impedes our ability to develop efficient and effective interventions that can be targeted to those who would most benefit. Although the TbT program was found to lead to some improvement, we need further studies designed explicitly to elucidate the complex mechanisms underlying its reported effects on early literacy to achieve sustainable, population-level impacts.
Jack P. Shonkoff, Dana Charles McCoy
