Objective 3.2: Strengthen early childhood development and expand opportunities to help children and youth thrive equitably within their families and communities

HHS invests in strategies to strengthen early childhood development opportunities to help children and youth thrive equitably within their families and communities.  HHS fosters the physical, emotional, intellectual, language, and behavioral development of children and youth while supporting their families and caregivers.  HHS implements interventions and multidisciplinary programs to enhance and support early childhood development and learning.  HHS also focuses its efforts to improve early childhood development programs, systems, and linkages through the application of data, evidence, and lessons learned.

Objectives represent the changes, outcomes and impact the HHS Strategic Plan is trying to achieve.  This objective is informed by data and evidence, including the information below.

• According to data from 2017–2018, about five in 10 children ages three to five are developmentally (early learning skills, social emotional development, self-regulation) on track to enter school.  (Source:  Comparing the National Outcome Measure of Healthy and Ready to Learn with Other Well-Being and School Readiness Measures)
• Head Start programs cumulatively served 1,047,000 children ages birth to five and pregnant women throughout the 2018–2019 program year.  Head Start served a diverse group of children, families, and pregnant women.  Thirty-seven percent identified themselves as Hispanic/Latino, and 30 percent were Black/African-American.  (Source: Head Start Program Facts: Fiscal Year 2019)
• Prior to COVID-19 in March 2020, 41 percent of parents used child care services outside their home.  Since the onset of the pandemic, six in 10 of these parents experienced disruptions to their child care.  K–12 school closures have created challenges for families.  (Source: Report on the Economic Well-Being of U.S. Households in 2020 - May 2021)
• Parents of color, particularly Black women, whose labor force participation is higher than other women, face the double challenge of seeking childcare while having lower earnings to pay for it.  Compared to other women, Black women maintain high work hours regardless of the presence of young children.  At the same time, 47 percent of Black families report having no difficulty finding childcare, compared to 53 percent of White families.  Black families are also more likely to cite cost as a factor in child care compared to White families (38 percent vs. 27 percent).  (Source: Child Care, COVID-19, and our Economic Future)
• A national survey of child care providers conducted in late June found that across the U.S., 18 percent of child care centers and 9 percent of family child care homes remained closed, and for those that were open, the vast majority (86 percent) of them are serving fewer children than before the pandemic.  Costs of care have increased for 70 percent of businesses, who are facing additional staff, cleaning, and equipment costs.  (Source: Child Care, COVID-19, and our Economic Future)
• The percentage of all children in foster care who experienced maltreatment while in care decreased by 10.3 between 2015 and 2019.  There was a 26 percent decline in young children placed in group homes or institutions from 2015 to 2019.  Nearly 90 percent of children exiting foster care were discharged to a permanent home in 2019.  (Source: Child Welfare Outcomes Report Data)

Contributing OpDivs and StaffDivs

ACF, ACL, ASPE, CDC, CMS, FDA, HRSA, IHS, OASH, NIH, OGA, and SAMHSA work to achieve this objective.

HHS OpDivs and StaffDivs engage and work with a broad range of partners and stakeholders to implement the strategies and achieve this Objective.  They include: the Adolescent Brain Cognitive Development (ABCD) Project and United States Interagency Council on Homelessness, Interagency Autism Coordinating Committee (IACC), and Interagency Working Group on Youth Programs.

Strategies

Foster the physical, emotional, intellectual, language, and behavioral development of children and youth while supporting their families and caregivers

• Support state and local government agencies, tribes, non-governmental organizations, and other community partners in promoting comprehensive, culturally competent, two-generation, community-based, developmentally appropriate, trauma-informed services that strengthen economic security, promote protective factors, advance learning, and reduce stress on families, fostering environments that support children, youth, pregnant and expectant persons, and parents.
• Identify and address barriers to maximizing children’s physical, emotional, cognitive, language, and behavioral development, while ensuring knowledge of and access to comprehensive behavioral health services for children, parents, and families.
• Promote programs and leverage strategic family, early learning, school, healthcare, and community-based partnerships to improve early identification of children with developmental delays and disabilities, including mental, behavioral, and developmental disorders, and facilitate linkages to appropriate treatment and services, including IDEA Part C early intervention services for children (aged birth to 36 months) and IDEA Part B services for school-aged children (aged three through 21 years of age).
• Advance strengths-based approaches and models to promote protective factors, positive youth development approaches, and evidence-informed programs focusing on improving the physical, social, emotional, cognitive, language, and behavioral health of adolescents, including engaging parents and caregivers, ensuring access to teen-friendly services, and coordinating adolescent- and family-centered services.
• Improve growth and development prospects of children, including enhanced dietary quality and reduction in risk factors for preventable non-communicable disease, through the promotion of healthy eating and dietary guidelines, nutrition education and standards, physical activity, oral health and hygiene, and other feeding and nutrition programs or collaborations aimed at supporting children and families, especially in rural, low-income, and other high-risk areas.
• Coordinate federal interagency efforts and target resources aimed at improving environmental health and healthy development in children by reducing exposure to environmental health risk factors—including food contaminants, foodborne pathogens, lead, mold, toxic chemicals, and potent allergens—and their effects, such as asthma, poisoning, and other health conditions.
• Provide interagency leadership to effectively implement the Administration’s early childhood agenda, including overseeing the implementation of existing and proposed new investments in early childhood and facilitating interagency early childhood working groups and public-private partnerships for cross-program collaboration.
• Expand access to comprehensive and inclusive sexuality education for young people to ensure accurate and complete information about sexual and reproductive health and rights, and to support child protection.
• Collaborate and coordinate with state, tribal, local, territorial, and other key partners to increase awareness of adverse childhood experiences, build capacity to implement prevention and response policies, programs, and practices based on the best available evidence, provide targeted, culturally appropriate trainings and technical assistance, and use data to inform program planning, implementation, and evaluation of adverse childhood experiences prevention and response strategies.

Support services and programs to improve the social well-being of unaccompanied homeless youth, children and youth who cannot remain in their homes, and refugee children and youth

• Provide street outreach, emergency shelters and longer-term transitional living and maternity group home services and programs to serve and protect runaway and homeless youth.
• Bridge child welfare experience with expertise in refugee resettlement to improve outcomes for minors who have undergone forced migration and traumatic experiences with foster care placement and services and support the caregivers and community members involved in nurturing their physical and emotional well-being.
• Provide services to facilitate the school performance, psychosocial adjustment, integration, and goal-setting of refugee children and youth, and extend complementary supports to their family members, to strengthen overall family well-being.

Implement interventions and multidisciplinary programs that enhance and support early childhood development and learning

• Promote systems and practices of assessment and intervention, anchored in primary healthcare, that support holistic early childhood development and learning, and child and youth well-being, inclusive of physical, socio-emotional, behavioral, intellectual, cognitive, and language development.
• Align eligibility and program requirements across family-serving health and human service systems, and provide family navigation supports, to reduce burden and gaps in services.
• Improve access to stable and affordable high-quality early care and education settings and participation in early childhood programs of underserved communities and populations and the replication and application of lessons learned from successful programs focused on inclusion practices.
• Develop effective and culturally-informed training and technical assistance informed by evidence and best practices to improve the quality of early childhood and prenatal care services and education programs, including those offered by tribes and faith-based and community initiatives.
• Invest in early childhood development, learning, and care by building the capacity and increasing the compensation of the staff and workforce supporting the programs and services provided to children and families in these sectors, including programs serving low-income communities and populations.
• Stabilize the early care and education sector to address decreased revenues and increased costs resulting from the COVID-19 pandemic and build back a high-quality supply of programs and providers, particularly in low-income communities, and equitably deliver services across a variety of program settings that meet the needs of families.
• Develop short- and long-term interagency strategies to address the early childhood education workforce shortages by urging states, communities, and local programs to invest ARP funds, other sources of COVID-19 relief funding, and existing funding to address the current ECE workforce shortage and provide support to child care and early childhood education providers.
• Develop interagency partnerships and cross-program initiatives with programs for Native American families to leverage existing federal resources to prioritize early childhood and help implement their tribe’s vision for a stronger system of high-quality early care and education at the tribal community level.

Improve early childhood development programs, systems, and linkages through the application of data, evidence, and lessons learned

• Facilitate and foster cross-sector partnerships and collaboration across HHS and non-HHS agencies at federal, state, tribal, territorial, and local levels to better integrate planning, programs, policies, financing, and data systems aimed at addressing social determinants of health, integrating family services, reducing disparities, and supporting strong families and communities in equitable ways.
• Empower children, youth, and families with opportunities to engage and have their voices heard in the planning, implementation, and assessment of programs and systems they rely on for care, learning, and other health and well-being supports.
• Promote evidence-based community engagement, dissemination, and implementation of healthcare and human services best practices among underserved populations to leverage reach and reduce gaps in services.
• Leverage research opportunities and access to data, evaluations, and evidence to better inform the development and execution of policies and programs that affect the health, well-being, and livelihoods of children, youth, adolescents, and their families and communities.
• Invest in providing technical assistance to states, tribes, and localities to support the implementation of policy, programs, and approaches, and enhance their capacity to identify, monitor, and address children’s learning and developmental needs, including supports for mental health.
• Foster the dissemination and utilization of user-friendly tools to strengthen the enrollment and participation of vulnerable youth in postsecondary education, apprenticeship, and career technical assistance opportunities.
• Utilize an integrated approach to understand the environmental factors and hazards that present a barrier for maximizing program improvement for the benefit of improved health outcomes, safety and resilience, and healthy learning environments for children.
• Conduct and support innovative research, evaluation, and surveillance of adverse childhood experiences to build the evidence base and guide prevention, identification, and response efforts.

Performance Goals

The HHS Annual Performance Plan provides information on the Department’s measures of progress towards achieving the goals and objectives described in the HHS Strategic Plan for FY 2022–2026.  Below are the related performance measures for this Objective.

• Reduce the proportion of Head Start grantees receiving a score in the low range on the basis of the Classroom Assessment Scoring System (CLASS: Pre-K)
• Increase the percentage of Head Start preschool teachers with an AA, BA, or Advanced degree in early childhood education or a related field
• Maintain the proportion of youth living in safe and appropriate settings after exiting ACF-funded Transitional Living Program (TLP) services
• Number of 0–8-year-old children screened for mental health or related interventions
• Number of participants served by the Maternal, Infant, and Early Childhood Home Visiting Program

Learn More About HHS Work in this Objective

• 3Ts for Reducing Lead in Drinking Water: Provides resources as an outcome of a General Accounting Office report to enhance federal agency collaboration and monitoring of lead levels of drinking water in child care facilities.
• CDC What Works In Schools Program Model: The CDC’s Division of Adolescent and School Health has established an evidence-based approach to school-based HIV and STD prevention, which includes quality sexual health education, connecting students to sexual health services, and establishing safe and supportive school environments.
• Chart Pack - Quality of Care for Children in Medicaid and CHIP: Findings from the 2018 Child Core Set: In Federal Fiscal Year (FFY) 2019 Core Set reporting, the percentage of children receiving six or more well-child visits in the first 15 months of life was only 64 percent, and the COVID-19 pandemic has exacerbated the issue of foregone care.
• Childcare.gov: Provides publicly available state and territory child care consumer education information and other resources, including COVID-19 and vaccine information for parents in English and Spanish.
• Choose Safe Places for Early Care and Education (CSPECE): Offers towns, cities, and states practices to ensure early care and education (ECE) programs are located away from chemical hazards.
• Closer to Zero: Identifies actions the FDA will take to reduce exposure to toxic elements from foods eaten by babies and young children.
• Early and Periodic Screening, Diagnostic, and Treatment (EPSDT): The EPSDT benefit provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid.  EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services.
• Environmental Influences on Child Health Outcomes (ECHO) Program: Launched by NIH in 2016 to understand the effects of environmental exposures on child development.
• Equity in Action Initiative: Through this initiative ACF is pursuing a robust approach to advance equity across programs and processes.
• Federal Fiscal Year (FFY) 2020 Statistical Enrollment Data System (SEDS) Reporting: Contains state-reported enrollment data from the Statistical Enrollment Data System (SEDS) as of June 23, 2021. The Children’s Health Insurance Program (CHIP) enrollment data consist of all children funded by title XXI (children in title XXI-funded Medicaid expansion programs and separate CHIP programs).
• FYSB Adolescent Pregnancy Prevention (APP) Program: The Exchange: The Exchange provides an interactive activation platform for Adolescent Pregnancy Prevention (APP) Program grantees, partners, and stakeholders to learn, connect, and create materials to increase the visibility and impact of their efforts to prevent pregnancy among vulnerable youth.
• Home Together: Federal Strategic Plan to Prevent and End Homelessness: Home, Together has one fundamental goal, a goal shared across federal, state, and local partners: to end homelessness in America.
• Housing and Services Resource Center: The Housing and Services Resource Center was created for people who work in the organizations and systems that provide housing resources and homelessness services, behavioral and mental health services, independent living services and other supportive services, and others who are working to help people live successfully and stably in the community.
• Interagency Autism Coordinating Committee Strategic Plan: A comprehensive review of the autism spectrum field and includes updates made by the Committee, federal agencies, and the broader autism community.
• Investigation of Co-occurring Conditions Across the Lifespan to Understand Down Syndrome (INCLUDE) Project: Investigates conditions that affects individuals with Down syndrome and the general population, such as Alzheimer’s disease/dementia, autism, cataracts, celiac disease, congenital heart disease and diabetes.
• MAT-LINK: MATernaL and Infant NetworK to Understand Outcomes Associated with Medication for Opioid Use Disorder during Pregnancy: Through funding from the Assistant Secretary for Planning and Evaluation’s Patient-Centered Outcomes Research Trust Fund, CDC’s National Center on Birth Defects and Developmental Disabilities established MAT-LINK to improve understanding of the range of maternal, infant, and child health outcomes through six years of age associated with medication for opioid use disorder during pregnancy.
• Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program: The MIECHV Program supports home visiting for pregnant women and families with children up to kindergarten entry living in communities at risk for poor maternal and child health outcomes.
• National Clearinghouse on Homeless Youth and Families (NCHYF): The purpose of NCHYF is to educate the family and youth services field—including FYSB grantees and aspiring grantees—about the research and effective practices that can improve the long-term well-being of families and youth. Additional resources that could be offered can be found here:
• National Runaway Safeline (NRS): The mission of the National Runaway Safeline (NRS) is to keep America’s runaway, homeless and at-risk youth safe and off the streets.  For 50 years, the National Runaway Safeline has been responding to youth and families in crisis, serving as the national communications system for runaway and homeless youth.
• National Youth Sports Strategy (NYSS): The first federal initiative that highlights actionable strategies to increase youth sports participation.
• OPA’s Teen Pregnancy Prevention (TPP) Program: The Office of Population Affairs' TPP Program is a national, evidence-based program that provides funding to implement effective programs and develop, test, and evaluate innovative approaches to prevent teen pregnancy across the United States.
• Refugee School Impact (RSI) Program: RSI provides grants to state and state-alternative programs to support school districts impacted by school-aged refugees and ORR eligible populations.  The central goal of the Refugee School Impact program is to strengthen academic performance and to aid the social adjustment of newly arriving refugee youth.  States are encouraged to design services according to the needs of their communities and schools through partnerships with state school officials, resettlement agencies, health and mental health providers, community-and faith-based organizations, and other local service providers.
• SAMHSA Disaster Distress Helpline: The SAMHSA Disaster Distress Helpline provides free, confidential crisis counseling and support to people in distress due to natural and human-caused disasters.  The SAMHSA Disaster Distress Helpline is available 24/7, on all days of the year, via toll-free phone at 1–800–985–5990 or text (people can text TalkWithUs to 66746).  The Disaster Distress Helpline also offers support in Spanish and several languages other than English, as well as support to people who are deaf or hard of hearing and using TTYs or a relay service.
• SAMHSA Disaster App: Allows disaster behavioral health responders to navigate resources related to pre-deployment preparation, on-the-ground assistance, and post-deployment resources.  Users can also share resources from the app via text message or email and quickly identify local mental health and SUD treatment services.
• SAMHSA Disaster Technical Assistance Center (DTAC): Provides materials, training, and technical assistance to the entire United States, its territories, and federally recognized tribes for all-hazards disaster behavioral health preparedness, response, and recovery.
• TAP 34: Disaster Handbook for Behavioral Health Service Programs: The SAMHSA TAP 34 is a preparedness resource for behavioral health providers that can be shared and promoted by SAMHSA staff at any time of the year.
• Unaccompanied Refugee Minors Program (URM): The URM program serves some of the most vulnerable minors in the world—those who were fleeing persecution, violence, or abuse, and entered the United States without a parent or custodian.  The program works with states and local URM providers to provide unaccompanied refugee minors with necessary care and services.
• Youth.gov: Provides cross-cutting federal information, interactive tools, and other resources to help youth-serving organizations and community partnerships plan, implement, and participate in effective programs for youth.
• Youth Engaged 4 Change: A cross-cutting federal website for youth between the ages of 16 and 24 to engage in change on personal, community, and national levels.