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For most young children, early experiences—sensitive, responsive parents, stable child care situations, and generally supportive emotional experiences—provide the kind of nurturing and stimulation that enables them to develop age-appropriate emotional and cognitive competencies. But there is also a group of young children for whom emotional development does not proceed smoothly, placing the children at risk for poor cognitive, social, and behavioral outcomes. To date, there has been very little systematic attention paid to how to develop policies and practices to promote healthy emotional development in these children. This guide is for policymakers and community leaders who want to craft such policies and improve practices. It paints a portrait of the kinds of young children and families who are in need of preventive, early intervention, or treatment services; highlights why policymakers should invest in such services; describes emerging principles and strategies for what are often called early childhood mental health services; and offers concrete tips from early leaders in these efforts, as well as more general recommendations.

Since the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), the major welfare reform legislation of the late 20th century, there have been dramatic reductions in welfare caseloads. Attention is now turning to how to meet the needs of those adults who are currently unable to enter the work force successfully and are thus likely to face time limits and sanctions. This issue brief focuses on a subset of this population, those who experience, either singly or in combination, domestic violence, substance abuse (including alcohol, drugs, and other substances), and serious mental health issues, including depression, and who are parents of young children. For these families, both common sense and research suggest that treatment and other interventions to help the adults become ready to work are crucial. But so, too, are interventions to address parenting issues and to promote resilience in their children—the ability to adapt and thrive even in the face of especially difficult circumstances. States are beginning to address the first challenge. This issue brief addresses the second, often ignored, challenge. It is organized in three sections. The first section highlights the dimensions of the challenge. The second section highlights service strategies to: (1) promote resilience, social competence, and school readiness in the children of the most vulnerable parents; (2) repair (or prevent) damaged parent-child relationships among young children whose parents face severe risks; and (3) ensure the safety of the children while helping parents meet the work-related goals of PRWORA. The third section suggests steps that policymakers, service providers, private funders, and advocates might take to improve outcomes for and investments in young children in high-risk families.

Early childhood is a time of great opportunity. State policymakers recognize this and some are trying to use resources strategically to promote healthy development and school readiness in young children. This report, based on findings from NCCP's Improving the Odds for Young Children project, highlights key findings from NCCP's database of state policy choices that provides a unique picture of early childhood policies across the states. The report summarizes emerging patterns and can be used to stimulate a dialogue, both within the states and nationally, about how to make more strategic, coherent investments in young children.

Early childhood is a time of great opportunity. State policymakers recognize this and some are trying to use resources strategically to promote healthy development and school readiness in young children. This report, based on findings from NCCP's Improving the Odds for Young Children project, highlights key findings from NCCP's database of state policy choices that provides a unique picture of early childhood policies across the states. The report summarizes emerging patterns and can be used to stimulate a dialogue, both within the states and nationally, about how to make more strategic, coherent investments in young children.

This document is part of a policy series intended to improve social, emotional, and learning outcomes for young children. Building on NCCP's work over the past several years (see Promoting the Emotional Well-Being of Children and Families series, at www.nccp.org), Resources to Promote Social and Emotional Health and School Readiness in Young Children and Families—A Community Guide builds on NCCP's earlier work to describe effective programs, highlight policy opportunities, and offer fiscal strategies to promote the emotional health of young children and their families. The analyses in this series will help state officials, community leaders, and advocates take action to ensure the healthy development of children and their families. This report describes targeted interventions that can help parents and other early care providers, such as home visitors and teachers, be more effective in promoting healthy relationships and reducing challenging behavior in infants, toddlers, and preschoolers. The companion document, Spending Smarter: A Funding Guide for Policymakers and Advocates to Promote Social and Emotional Health and School Readiness, focuses on strategies to maximize existing funding streams by building on federal programs.

This document is part of a policy series intended to improve social, emotional, and learning outcomes for young children. Building on NCCP's work over the past several years (see Promoting the Emotional Well-Being of Children and Families series, at www.nccp.org), Spending Smarter describes effective programs, highlights policy opportunities, and offers fiscal strategies to promote the emotional health of young children and their families. The analyses in this series will help state officials, community leaders, and advocates take action to ensure the healthy development of children and their families. Spending Smarter focuses on strategies to maximize existing funding streams by building on federal programs. The companion document, Resources to Promote Social and Emotional Health and School Readiness in Young Children and Families—A Community Guide, describes targeted interventions that can help parents and other early care providers, such as home visitors and teachers, be more effective in promoting healthy relationships and reducing challenging behavior in infants, toddlers, and preschoolers.

Recent research on early brain development and on-going research on the effects of comprehensive programs for young children and families point to the importance of investing in efforts to improve the well-being of young children and families. This report profiles what states are doing to promote the well-being of America's youngest children and families. Map and Track asks and answers six core questions: 1. Are there statewide strategies to enhance the development of infants and toddlers? 2. Are there statewide strategies to promote early learning and well-being among preschool-aged children? 3. Are there statewide strategies to support families with young children as they face the challenges of parenting? 4. Are states linking comprehensive programs for young children with welfare reform implementation? 5. Are there strategies to mobilize community leadership around an agenda for enhancing the life chances and opportunities of America's youngest citizens? 6. Is there high-level leadership, vision, and a coherent framework around which the state can develop and sustain a bipartisan commitment to its young children over time?

In 1994, the Carnegie Corporation of New York issued a report titled Starting Points: Meeting the Needs of Our Youngest Children. Calling its findings "a quiet crisis," the report urged the federal government, states, community leaders, educators, health care decision-makers, service providers, business, leaders, parents, and the philanthropic community to actively work toward four broad goals: promoting responsible parenthood, guaranteeing child care choices, ensuring good health and protection, and mobilizing communities to support young children and their families. Heeding its own call, in January 1996, the Carnegie Corporation made the first awards for the Starting Points States and Communities Partnership for Young Children Grants, a four-and-a-half year, $7 million initiative. Focusing on program improvement, policy development, and public engagement and awareness, the aim was to serve as a catalyst to seed activities to spur both short and long-term systems change within selected states and communities. In 1999, the National Center for Children in Poverty (NCCP) was asked to undertake an assessment of Starting Points to document the variations in context, structure, activities, and accomplishments across the 11 sites that were funded throughout the initiative, including four city sites: Baltimore, Boston, Pittsburgh, and San Francisco; and seven states: Colorado, Florida, Hawaii, North Carolina, Rhode Island, Vermont, and West Virginia. The cross-site assessment focused on the following questions: • What were the variations in the structure, auspices, and leadership across the sites? • How did the demographic, policy, economic, and political contexts vary across the sites? • What was the range of activities and accomplishments across the sites? • What were the most common positive and negative mediating factors across the sites? • How did the sites perceive the strengths and limitations of the Starting Points initiative? • What were the collective lessons and implications for future multisite early childhood systems change initiatives? Findings from the assessment, based on reviews of written materials, interviews and debriefing of key informants, and analysis of the data, are highlighted below. The full report is available on the Internet at www.nccp.org and in paper from the Publications Department of NCCP. Profiles of the individual Starting Points sites are also on NCCP's Web site.

In 1994, the Carnegie Corporation of New York issued a report titled Starting Points: Meeting the Needs of Our Youngest Children. Calling its findings "a quiet crisis," the report urged the federal government, states, community leaders, educators, health care decision-makers, service providers, business, leaders, parents, and the philanthropic community to actively work toward four broad goals: promoting responsible parenthood, guaranteeing child care choices, ensuring good health and protection, and mobilizing communities to support young children and their families. Heeding its own call, in January 1996, the Carnegie Corporation made the first awards for the Starting Points States and Communities Partnership for Young Children Grants, a four-and-a-half year, $7 million initiative. Focusing on program improvement, policy development, and public engagement and awareness, the aim was to serve as a catalyst to seed activities to spur both short and long-term systems change within selected states and communities. In 1999, the National Center for Children in Poverty (NCCP) was asked to undertake an assessment of Starting Points to document the variations in context, structure, activities, and accomplishments across the 11 sites that were funded throughout the initiative, including four city sites: Baltimore, Boston, Pittsburgh, and San Francisco; and seven states: Colorado, Florida, Hawaii, North Carolina, Rhode Island, Vermont, and West Virginia.

Three years have passed since the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) restructured the nation's welfare system. During that time, caseloads have dropped 40 percent, and many former welfare recipients have found employment. Yet, while some families are better off financially, others are spending more time in work activities with no financial gain. Because of low wages, many employed parents continue to struggle to pay their rent and provide food for their families. Lack of affordable child care and health care continues to threaten job stability for many as well. A portion of those who remain on welfare will require substantial assistance to prepare for work, while others will be unable to handle employment because of poor health, substance abuse, domestic violence, or other challenges. The changes in welfare have also had unanticipated effects on other social welfare programs. Medicaid and food stamp caseloads have dropped more than expected, suggesting that some eligible families are not being enrolled. Policymakers at all levels of government are taking note of these changes. They have begun to debate what steps are needed to help families make lasting transitions to employment and to ensure that work pays more than welfare. Missing from much of the debate, however, is a discussion of the implications of welfare reform for children and the opportunities that it holds to strengthen child outcomes. Children comprise 70 percent of all welfare recipients, and more than one-third of them are younger than age six. When welfare reform is viewed from the perspective of young children's needs, the policy picture changes. Although children may benefit from policy efforts to promote work and increase family income, additional steps are needed to ensure their healthy growth and development and to see that welfare reform helps and does not hurt them. Like all young children, those growing up in low-income families need regular health care and positive early learning experiences. They also need nurturing relationships with their parents and other adults who care for them. To provide for these basic needs, all low-income parents transitioning to employment need access to high-quality health care for their families and high-quality child care and child development programs for their young children. Some parents need additional services, such as family support or parent education, to help them meet the complex demands of work and parenting. A significant proportion of low-income parents with young children need intensive services, such as substance abuse treatment or mental health services, for themselves and their children. Still others need access to shelters to exit abusive relationships. In short, if policymakers are concerned about improving young children's health and development as a way to impact their immediate well-being as well as outcomes for the next generation of families, the policy debate about welfare reform must be broadened beyond employment and income. Policymakers need to focus on the full array of basic and specialized supports required to enhance the well-being of low-income young children and their families. This means that in addition to efforts to promote employment and increase family income, deliberate policy, program, fiscal, and collaborative strategies are needed to: ■ Strengthen basic supports (e.g., access to health care and child care); ■ Promote young children's health and development (e.g., high-quality child care, comprehensive early childhood programs, and family support activities); and ■ Address specialized child and family needs (e.g., mental health, substance abuse, and domestic violence interventions for children and their parents). As the title Beyond Work suggests, this issue brief focuses on non-economic strategies to promote child and family development in the context of welfare reform. It is based on interviews with directors of child development and family support programs, statewide early childhood initiatives, state and local partnerships between early childhood and welfare programs, and Starting Points initiatives (a multisite effort to support young children and families funded by Carnegie Corporation of New York). The first section discusses why it is important to integrate child and family development perspectives with welfare reform implementation. The second section describes specific strategies and provides examples from initiatives and programs across the country.

This issue brief reflects NCCP's continuing commitment to ensuring that every low-income child enters school with the skills to succeed, and that policymakers have access to the very best research to create policies that use public resources in the most effective, smartest way. It is based on a meeting convened through NCCP's Project THRIVE to identify and promote solutions to emerging issues that impact young children's healthy development and school readiness. The brief is being jointly published by Project THRIVE, through which NCCP serves as a resource to the Maternal and Child Health Bureau-funded State Early Childhood Comprehensive Systems (ECCS) systems program and Pathways to Early School Success, NCCP's on-going project to help policymakers, program administrators and practitioners address barriers that get in the way of reducing the achievement gap for young low-income children.

Very young children are the fastest growing segment of the child welfare population. Over the past decade, the number of children under age five has increased by 110 percent in contrast to a 50 percent increase for all children. Over 30 percent of all children in foster care are under age five. Infants comprise the largest cohort of the young child foster care population, accounting for one in five admissions, and they remain in care twice as long as older children. Ensuring healthy development and permanency for these young children, given the range of risks they face, is a complex challenge that requires a unique mix of resources and strategies. Yet, there has been relatively little attention focused on linking child welfare practice with health care, early intervention, and other strategies that could effectively address the risks that these young children face and strengthen their families. This policy paper is intended to be a wake-up call—to challenge communities all over the country to attend to the needs of children in or at risk of foster care placement. It is about what child welfare agencies, courts, and other partners can do to improve the physical, developmental, and emotional health of young children in foster care. It highlights the special risks these children face and identifies strategies that service providers, courts, policymakers, and advocates can use to enhance the healthy development of young children in foster care and promote their prospects for permanency—whether that means reunification with their families or adoption.

Drawing on lessons from six case studies, this policy paper highlights the most innovative approaches states and communities are currently using to finance early childhood mental health services and explores what else might be done to mix, match, and leverage all available resources. The focus is on prevention and early intervention services to not only help children directly, but equally important, to help their families and other caregivers address the social and emotional challenges children face. The case studies are based on interviews with policy and program leaders in the states of Florida, Indiana, Ohio, and Vermont, as well as two metropolitan areas—San Francisco and Cuyahoga County, Ohio (where Cleveland is located).