A Healthy Early Childhood Action Plan: Policies for a Lifetime of Well-being


A Healthy Early Childhood Action Plan: Policies for a Lifetime of Well-being highlights more than 40 policy target areas that are key to achieving national goals of reducing toxic stress and Adverse Childhood Experiences (ACEs) and improving the lives of millions of children.

Living with prolonged stress and/or adverse experiences can significantly increase a child’s risk for a range of physical, mental and behavioral problems – increasing the likelihood for hypertension, diabetes, heart disease, stroke, cognitive and developmental disorders, depression, anxiety and a range of other concerns.

Currently, around one-quarter of children ages 5 and younger live in poverty and more than half of all children experience at least one ACE.  According to research from the Centers for Disease Control and Prevention (CDC), more than one-quarter of children experience physical abuse (28.3 percent) and substance abuse in the household (26.9 percent) while sexual abuse (24.7 percent for girls and 16 percent for boys) and parent divorce or separation (23.3 percent) are also prevalent.

“More and more studies show investing in early childhood pays off in a lifetime of better health and well-being,” said Jeffrey Levi, PhD, executive director of TFAH.  “There are dozens of policy levers we can and should be pushing to ensure all children have high-quality preventive healthcare; safe, stable, nurturing relationships, homes and communities; good nutrition and enough physical activity; and positive early learning experiences.”

The report calls for increased public health engagement in early childhood areas, with a series of recommendations including to:

Build beyond the traditional healthcare system by integrating health and other social supports, including accountable health communities for children, by:

  • Ensuring every child has access to high-quality and affordable healthcare;
  • Building systems to help identify and provide support for children’s needs beyond the traditional medical system, but that have a major impact on health;
  • Focusing on a two generation approach to healthcare – and social service support;
  • Modernizing and expanding the availability of mental health and substance misuse treatment services – for both parents and children;
  • Expanding the focus of a trauma-informed approach across a wider range of federal, state and locally supported services; and
  • Improving services and care coordination for Children and Youth with Special Healthcare Needs (CYSHCN).

Promote protective, healthy communities and establish expert and technical assistance backbone support to help spread and scale programs nationally and in every state, by:

  • Improving the collection, analysis and integration of child health, well-being and services data to better assess trends and target services and programs;
  • Strengthening the role of federal, state and local health departments as the chief health strategist in communities; and
  • Establishing a support organization in every state that provides expertise and technical assistance.

Increase investments in core, effective early childhood policies and programs, by:

  • Making programs and services that promote early childhood well-being a higher priority to ensure they can be delivered on a scale to help all families (ranging from home visiting programs to child welfare services to increasing economic opportunity for families to child care and early education); and
  • Better aligning systems and financial resources to improve the effectiveness and efficiency of health, social services and education services.

The report includes a series of maps showing the status of different states on key trends and policy areas and case studies of evidence-based and model programs, organizations and initiatives—which are putting these recommendations into action—including the Nurse Family Partnership, Family Check Up Models, Abriendo Puertas/Opening Doors, Good Behavior Game, Child-Parent Center Program, Crittenton Children’s Center at Saint Luke’s Health System, Wholesome Wave, Community Asthma Initiative at Boston Children’s Hospital and many others.

“If we work together across sectors – bringing together the collective energy and resources of diverse partners – we will have a better chance of achieving the common goal of a healthy start for all of America’s children,” said Gail Christopher, chair of TFAH’s Board of Directors and vice president for policy and senior advisor at the WK Kellogg Foundation.  “This report shines a light on many promising policies and programs.  But the question remains whether we can garner the public will to turn the potential into the promise that improves the lives of our next generation.”

The report was supported by a grant from the Robert Wood Johnson Foundation.

Source: Trust for America’s Health

Available at: http://healthyamericans.org/report/123

Promising Practices for “Learn the Signs. Act Early.” 


What works in helping communities to learn the signs and act early?

This is a collection of locally inspired models and ideas that have been implemented and evaluated to varying degrees in programs and communities.

A promising practice helps spread the reach of the campaign and has the potential to positively impact families with young children and the organizations, health care professionals, and early care and education providers who serve them.

Many of the activities in this collection represent the work of Act Early Ambassadors and State Systems grantees who found creative solutions for implementing Learn the Signs. Act Early. with greatest potential impact using very modest resources. We hope their work will inspire you to think about how you can adopt and adapt activities in your local programs and communities to promote awareness of the importance of tracking developmental milestones and acting early on concerns.

How were Promising Practices identified?

The collection includes activities from the beginning of the campaign (2005) through 2014. We established criteria to assess each activity and determine which to include in the collection. Criteria were informed by program values that broadly define what we consider to be a successful and promising activity. Each year we will review partner activities and apply the criteria to them so we can continue to update and add promising activities to the collection.

What about activities not captured here?

Some activities contain more detail than others, and some activities may have been excluded because we did not have sufficient information to score them. In the years to come, we plan to:

  • Improve our ability to gather as much information as we can about our partners’ important work to promote and integrate Learn the Signs. Act Early. within programs and communities across the country,
  • Expand evaluation studies of promising activities, and
  • Use this collection to raise awareness among partners about their role in sharing their important work with us and collecting process and outcome data to demonstrate impact.

If you have questions or suggestions about the collection or any of the specific activities, please contact ActEarly@cdc.gov and include “Promising Practices” in the subject line.

Source:  Centers for Disease Control and Prevention

Available at: http://blogs.cdc.gov/actearlypromisingpractices/

The Well-Visit Planner for Families


The Well-Visit Planner for Families

The Well-Visit Planner is an Internet-based tool (www.wellvisitplanner.org) developed to improve well-child care for children 4 months to 6 years of age. Information in this tool is based on recommendations established by the American Academy of Pediatrics Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition. The tool helps parents and caregivers to customize the well-child visit to their family’s needs by helping them identify and prioritize their health risks and concerns before the well-child appointment. This means that parents and health care professionals are better able to communicate and address the family’s needs during the well-child visit.

The Well-Visit Planner and Head Start

The Child and Adolescent Health Measurement Initiative (CAHMI) has worked with the Office of Head Start National Center on Health to expand the Well-Visit Planner through age 6 years and has prepared materials to help Head Start and Early Head Start programs use this tool with the families they serve. Knowing that school readiness begins with health, Head Start and Early Head Start programs are committed to supporting the health and well-being of every child enrolled in a program. The Well-Visit Planner has been tested in several programs, and staff have found it helpful for encouraging parents to complete well-child visits and become familiar with what is expected at each visit. The tool also reinforces the role of parents as the experts for their child’s needs—including those related to health.

Using the Well-Visit Planner in Head Start and Early Head Start Programs

In partnership with the National Center on Health, CAHMI has prepared a number of tools and resources to help programs assess their readiness to begin using the Well-Visit Planner as a standard part of their work with parents and children. There is also an implementation toolkit that helps programs with step-by-step implementation of the Well-Visit Planner within the program, including materials to help promote the use of the tool among parents. Materials are also there to help reach out to local health care professionals to help prepare them for the use of the Well-Visit Planner by their patient families.These materials will be housed on the Early Childhood Learning & Knowledge Center but are currently available at http://www.cahmi.org/projects/wvp/, the implementation-portal.

How does the Well-Visit Planner help families?

Completing the tool, which takes about 15 to 20 minutes, will help empower parents and caregivers to identify priorities for a child’s upcoming well-child visit; it will also prepare them for what to expect at that visit. The content of the Well-Visit Planner is different based on the age of the child. It is developed to be used before each well-child visit through age 6 years. The Well-Visit Planner also includes educational materials about topics such as a child’s growth and development, language development, and safety. The educational materials address the topics of most importance for each age.

After parents use the Well-Visit Planner, they can save or print a summary or Visit Guide of the needs and priorities for the visit. They will take this summary with them to help prioritize their time with the child’s pediatrician or primary health care professional. Parents can print a copy to leave with the physician or send a copy prior to the visit if the child’s physician has a secure e-mail address. The summary can also be discussed with the parents and the family service worker and integrated into the family partnership agreement.

Additional Background

The tool was developed and is maintained by CAHMI to engage parents as partners to improve well-child care services as a part of a project supported by the US Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Research Program (R40 MC08959). Continued development and implementation of the Well-Visit Planner is supported by CAHMI and volunteer advisors and through support from HRSA/Maternal and Child Health Bureau through Cooperative Agreement U59-MC06890.

Source: Early Childhood Learning and Knowledge Center, National Center on Health

Available at: http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/physical-health/satf/well-visit-planner.html

Welcome to OHS Health Talks


A Health Talk is a pre-recorded video or podcast that allows health managers to explore deeper into specific health topics.The Health Talks include two series:

  • Health Chats: Listen, as new tools and strategies are discussed to improve health outcomes for children.
  • Ask the Experts: Get answers to frequently asked questions from pediatricians, dentists, psychologists, and other health professionals.

Health Talks offer an easy way to learn more about some of the health issues that concern the early childhood community. Health professionals, technical assistance providers, and other early childhood health and safety staff share information on a variety of topics. The topics are chosen based on questions and suggestions submitted from the field. Send your suggestions for the next Ask the Expert or Health Chat presentations to nchinfo@aap.org.

What is a Health Chat

  • Digging Deeper into Safety and Injury Prevention Data
  • Using Stepping Stones and Compliance with Care to Support Infants and Toddlers
  • Identifying and Reporting Child Abuse and Neglect

Ask the Expert

  • What is Ask the Expert
  • Head Lice
  • Head Start and the Medical Home
  • Nurturing Health and Wellness in Early Childhood: Nurturing the Brain, the Environment, and the Nurturer

Source: Early Childhood Learning and Knowledge Center, National Center on Health

Available at: http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/health-services-management/program-planning/health-talks.html

Mother To Baby

MotherToBaby, a service of the non-profit Organization of Teratology Information Specialists, is dedicated to providing evidence-based information to mothers, health care professionals, and the general public about medications and other exposures during pregnancy and while breastfeeding. Talk directly to the experts behind the most up-to-date research!

Source: Mother To Baby

Available at: http://mothertobaby.org/

Measles – What Early Childhood Programs Should Know


Childhood diseases like measles can cause children pain and discomfort. They can result in doctor visits, hospitalization, and even premature death. Nothing protects young children better from serious diseases, like measles and whopping cough, than immunizations.

The Administration for Children and Families’ Office of Head Start (OHS) and Office of Child Care (OCC) believe it is critical that all children in Head Start and child care programs are vaccinated according to the Center for Disease Control and Prevention (CDC) vaccination schedules.

Vaccination requirements for children entering child care programs vary by state. The CDC School and Childcare Vaccination Surveys page has information on each state’s vaccination requirements.

In addition to state entrance requirements for child care, Head Start programs are required to help all children in their care in getting up to date. These efforts have resulted in 97 percent of Head Start children being current on their immunizations.

It is important to note, that to be fully immunized, children need all doses of the vaccines according to the recommended schedule. Not receiving the full number of doses leaves a child vulnerable to catching serious diseases.

Source: Early Childhood Learning and Knowledge Center, National Center on Health

Available at: http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/health-services-management/program-planning/measles.html

Head Start Health Services Newsletter: Stronger Connections between Head Start and the Medical Home

Children learn best when they are healthy. Head Start and Early Head Start programs have a unique chance to give families the information and skills they need to effectively engage their child’s pediatrician or other health care provider. See the full edition of this month’s newsletter for important information on working with medical homes. It includes a new resource designed just for parents to help them prepare for each preventive care visit for their children age 6 and under.

Topics in the newsletter include:

  • Tips for collaborating with local medical homes
  • Using your health services advisory committee to engage health care providers
  • Ways to identify local pediatricians
  • New tool to support families in engaging their child’s pediatrician
  • Resources for more information

Who Will Benefit?

Head Start health managers and program staff are encouraged to use the information and resources in this issue. They can be used to increase collaboration with health care at the program level as well as to help families become more engaged with their child’s health care providers.

Access the Newsletter

Select the link to view this month’s newsletter. Find previous issues on the Early Childhood Learning and Knowledge Center (ECLKC).

Contact Us

The National Center on Health welcomes your feedback on this newsletter, as well as suggestions for topics for future issues. Please forward your comments to nchinfo@aap.org or call (toll-free) 1-888-227-5125.

Subscribe to receive more information on health, school readiness, and other early childhood topics.

Strong Connections for Strong Kids: Working Through the Challenges of System Collaboration

Wednesday, Nov. 19, 2014
1 – 2 p.m. EST

Join the Head Start National Center on Health (NCH) for a webinar that brings together health care and Head Start experts. Learn to address the challenges that can arise when multiple systems are caring for children and families. The webinar will highlight the differing requirements for each system. It will also explore ways that communities have worked through them to provide the best support to children.

Topics for the webinar include:

  • How the Head Start Program Performance Standards and pediatric preventive services guidelines intersect
  • Examples of communities overcoming the challenges of collaboration
  • Key Head Start and health care systems staff who can help coordinate a collaborative approach to overcoming system challenges

Who Should Participate?

This webinar will benefit an array of audiences, including: Head Start health managers and staff, center directors, and education managers; regional program managers; pediatricians and members of the medical home team; health care system leaders; and American Academy of Pediatrics chapter members and staff.

How to Register

Participation is free. Select this link to register:

After registering, participants will receive a confirmation email with information on how to join the webinar on Wednesday, Nov. 19, 2014. This presentation will be recorded and archived in the NCH portal on the Early Childhood Learning and Knowledge Center (ECLKC) for later viewing.

Certificate of Participation

Participants will receive a certificate of participation upon completion of an online evaluation. A link will be available when the webinar closes. Participants must complete the online evaluation in order to receive a certificate. Only participants in the live presentation will be eligible.


For more information, contact NCH at nchinfo@aap.org or 1-888-227-5125.

Strong Connections, Strong Kids Webinar Series: Head Start and Health Care Collaboration at the State Level

Monday, July 21, 2014
Noon–1 p.m. ET

Register Online Now!

Join the Head Start National Center on Health NCH for the second webinar in the Strong Connections, Strong Kids Series. It will offer health care and Head Start stakeholders the information they need to strengthen their collaborative efforts to support the health and development of Head Start and Early Head Start children. Panelists will highlight their own challenges and successes as they discuss the methods of collaborating at the state level. Find general guidance and specific examples to increase collaboration between these two systems.

Topics for this webinar include:

  • Identifying key stakeholders at the state level to engage in collaborative efforts
  • Understanding the challenges and benefits of Head Start and health care collaboration at the state level
  • Identifying key areas in which collaboration can be easily started and have the most impact

Who Should Participate?

This webinar will benefit an array of audience members, including:

  • Head Start and Early Head Start health mangers and program directors;
  • Pediatricians and other clinician leaders;
  • State Collaboration Office directors;
  • Health Service Advisory Committee members; and
  • Health system representatives.

We encourage you to share this email with others who may be interested this important topic.

How to Register

Participation is free. Select this link to register: https://goto.webcasts.com/starthere.jsp?ei=1037586

After registering, participants will receive a confirmation email with information on how to join the webinar on Monday, July 21. This presentation will be recorded and archived in the Health portal of the Early Childhood Learning and Knowledge Center ECLKC for later viewing.


To learn more, contact NCH at nchinfo@aap.org or 1-888-227-5125.

Source National Center on Health and the Early Childhood Learning and Knowledge Center

Literacy Promotion: An Essential Component of Primary Care Pediatric Practice


Reading regularly with young children stimulates optimal patterns of brain development and strengthens parent-child relationships at a critical time in child development, which, in turn, builds language, literacy, and social-emotional skills that last a lifetime. Pediatric providers have a unique opportunity to encourage parents to engage in this important and enjoyable activity with their children beginning in infancy. Research has revealed that parents listen and children learn as a result of literacy promotion by pediatricians, which provides a practical and evidence-based opportunity to support early brain development in primary care practice. The American Academy of Pediatrics AAP recommends that pediatric providers promote early literacy development for children beginning in infancy and continuing at least until the age of kindergarten entry by 1 advising all parents that reading aloud with young children can enhance parent-child relationships and prepare young minds to learn language and early literacy skills; 2 counseling all parents about developmentally appropriate shared-reading activities that are enjoyable for children and their parents and offer language-rich exposure to books, pictures, and the written word; 3 providing developmentally appropriate books given at health supervision visits for all high-risk, low-income young children; 4 using a robust spectrum of options to support and promote these efforts; and 5 partnering with other child advocates to influence national messaging and policies that support and promote these key early shared-reading experiences. The AAP supports federal and state funding for children’s books to be provided at pediatric health supervision visits to children at high risk living at or near the poverty threshold and the integration of literacy promotion, an essential component of pediatric primary care, into pediatric resident education. This policy statement is supported by the AAP technical report “School Readiness” and supports the AAP policy statement “Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health.”

Source: American Academy of Pediatrics

Available at: http://pediatrics.aappublications.org/content/early/2014/06/19/peds.2014-1384.abstract