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Ideas We Should Steal: Infant Caregiver Project

Pre-K is great. But helping parents of even younger kids might be even better

Pre-K is great. But helping parents of even younger kids might be even better

In all the debate about Mayor Kenney’s proposed Soda Tax, there has been one thing that everyone seems to agree on: That good, universal pre-K is a boon for Philadelphia. And no wonder. High-quality pre-K has shown to help even the playing field for poor children, making them better prepared for kindergarten, which in turn helps them succeed in elementary school.

But what no one seems to have considered is whether pre-K is early enough to make a real difference in the lives of the most at-risk children. Mary Dozier, the Amy E. du Pont Chair of Child Development at University of Delaware, doesn’t think it is. Over the last several years, Dozier has implemented a 10-hour in-house coaching program for parents of babies and infants that is helping to shape their brains for success from their earliest days—well before they walk into a pre-K classroom.

“A child’s environment as a baby can make a real difference,” Dozier says. “What happens early is especially important because of the developing brain and the developing behavioral systems. You don’t want to have to make up for what came before, even in pre-K.”

University of Delaware’s Mary Dozier has implemented a 10-hour in-house coaching program for parents of babies and infants that is helping to shape their brains for success from their earliest days. Those 10 hours have resulted in the development of grit and resilience that reflect their more secure peers.

Dozier’s Infant Caregiver Project is based on a series of randomized trials she has conducted over the last several years with babies and toddlers in the child welfare system, either in foster care or with their parents. (One study was in Philadelphia.) It works like this: Parenting coaches spend one hour a week, for 10 weeks, helping caregivers with three concepts: Soothing their child when he’s upset, which creates what researchers term a “secure attachment” to their parents; following the child’s lead during play, like picking up a ball when she does; and avoiding frightening behavior, like yelling or glaring.

Just those 10 hours have resulted in the development of physiological characteristics—what have come to be called grit and resilience—that reflect their more secure peers, and that Dozier says are “more important than knowing your numbers and letters.” This, in turn, leads to better success in schools. In Helping Children Succeed: What Works and Why, writer Paul Tough notes what this looks like in practice: “the ability to understand and follow directions; to focus on a single activity for an extended period; to interact calmly with other students; to cope with disappointment and persevere through frustration.” (Tough’s book, excerpted in an essay in Sunday’s New York Times, came out on Tuesday.)

The work of the Infant Caregiver Project addresses an issue that is a reality of every urban school district in America: That children who live in poverty, especially those in foster care or otherwise unstable homes, often come to schools ill-equipped to learn. In Philadelphia, where 40 percent of children live in poverty, 87 percent of public school students are economically disadvantaged. Around 3,000 kids every year go into foster care here; some 13,000 are in the child welfare system.

More and more, researchers are using the phrase “chronic trauma” to describe what happens to these children, and many others who live in neighborhoods rife with violence, joblessness and poverty. That constant trauma shapes children’s brains, putting them on constant alert—a fight or flight response that can lead to disruptive behavior, attention problems and other obstacles to learning. And research has found that income differences account for the gap in success between white and black children who have both attended quality pre-Ks.

The Infant Caregiver Project doesn’t ameliorate all the effects of trauma. But a seemingly small tweak in interaction might be a big shift in attitude, and can have ripple effects. Dozier says what she calls Attachment and Biobehavioral Catchup (ABC) can change lives, maybe even generations. For many people, parenting is learned behavior; they raise their children, intuitively, the way they were raised. Dozier says she’s had subjects who balk at too much nurturing because, they say, they want their kids to be tough—not realizing that making them feel secure at home is the best way to make them resilient for the outside world. “Having parents who are nurturing to children is related to children being more independent in preschool,” Dozier notes.

In the last year, the Infant Caregiver Project has trained more than 220 parent coaches in 15 states; in Minnesota and North Carolina, counties throughout the state use the program. And in New York City by 2019, the home-visit program will reach every foster family of babies in all five boroughs. Sometimes, as in the case of Minnesota and New York, funding for the initiative comes through government agencies; other times, it’s run by a private organization.

For many, parenting is learned behavior; they raise their children, intuitively, the way they were raised. Dozier says she’s had subjects who balk at too much nurturing because, they say, they want their kids to be tough—not realizing that making their kids feel secure at home is the best way to make them resilient for the outside world.

Training for each coach—two days, plus two years of video conference check-ins—costs $5,000, which goes to running Dozier’s program out of Delaware. Those coaches, mostly from private organizations, work with anywhere from a handful to 40 children a year. Dozier says no one from Philadelphia has yet signed up for training, though the research she has done here clearly showed a benefit.

There are other programs that touch on aspects of Infant Caregiver Project—like nurse home visits to at-risk first time mothers, up to two years of a child’s life, or child parent psychotherapy, a program which offers 50 weeks of intervention. Dozier’s program, though, is unique in at least two regards: It is one of the best supported by evidence, and it is among the shortest in duration. In those 10 hours, coaches comment on parents’ actions at least once a minute; it is intensity and direction, not duration of the program, that has shown to matter.

Like with universal pre-K—something first proposed on a national scale by then-Senator Walter Mondale in 1971, before being vetoed by Pres. Nixon—it’s hard not to dream of a world in which all families who need it have access to something like the Infant Caregiver Project. And Dozier says she can envision a scenario in which all at-risk families—perhaps even all those on public assistance—are offered the service, the way we hopefully will be able to offer pre-K. What would that world look like? It would not be free of any of the countless traumas we inflict on children and their developing brains. But maybe it would be a world in which opportunity isn’t just about the luck of birth.

Dozier says she has seen the results of her project on myriad children, in myriad situations, both immediately and a few years after. In particular, she recalls one displaced family, living in a motel room for the duration of the study. At first, their 8 month old baby spent most of the day fairly listless, barely moving or reacting. After the intervention, that baby was engaged, smiling, wiggling arms and legs. “The parents’ interactions with the child had changed, even though their circumstances hadn’t,” Dozier says. “And that baby’s whole world changed, too.”

Photo Header: Pixabay

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