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Improving Early Childhood Development

Promising Strategies for States and the Health Care System

A Workshop for State and Local Health Officials


Children's early development is critical to their long-term health and well-being. Opportunities exist within the health care system to promote young children's physical and emotional health, their cognitive development and language function, and to support positive parenting that nurtures the child's development. Because health care is the one system that virtually all parents use in a child's early years, health care providers and State agencies administering health programs have great potential for providing child development service and addressing child and family psychosocial concerns as part of primary health care.

The following is a summary of a workshop on improving early childhood development cosponsored by the User Liaison Program (ULP), the Centers for Medicare and Medicaid Services (CMS), the Commonwealth Fund, and the American Academy of Pediatrics. It was held in Jacksonville, Fl, on January 30-February 1, 2002.

About the Workshop Sponsor.


Workshop Objectives

By the end of the workshop, participants were expected to be better able to:

  • Understand early childhood development services within the context of the health care system.
  • Use the research evidence supporting positive outcomes of early child development services.
  • Identify promising strategies to provide early childhood development services and opportunities for collaboration with other systems of care.

Key Workshop Questions

Why This Focus?

Recent research in early brain development has given us a better understanding of the importance of early experiences and relationships to a child's development. The need to nurture early brain development requires a comprehensive approach of prevention and early intervention strategies, targeted at both parents and children.

Effect on Policy

Many mental health problems and developmental delays begin early in a child's life and many of these go unrecognized until school begins. The pediatric provider is in a strategic position to assess the development of the child and address potential problems through the provision of ongoing well-child care, preventive services, and acute care. Pediatric providers can take steps to improve the delivery of developmental services by redesigning their practices to incorporate developmental services.

Parent and Provider Satisfaction

Parents of most children are satisfied with their children's care, but wish their providers also addressed cognitive, family and community issues and risk factors. Pediatricians tend to agree that such developmental assessments are important but they lack the time to do assessments. Some States are beginning to use standardized tests to report parent perceptions of preventive developmental services to report on and improve the quality of care for children.

What Are These Services?

Developmental services for young children can be grouped in four major categories:

These services can be provided within the pediatric setting to promote optimal early development and improve developmental outcomes.

Impact of Parental Depression

Depression is the most prevalent mental disorder and has been found to have a significant impact on children's emotional and behavioral functioning. By including parent-child relationships and the impact of parental mental health in their assessments and interventions pediatric providers have the opportunity to substantially improve the functioning of children in these areas.

What States Can Do

States can take administrative steps to improve the delivery of early child development services by weaving early childhood development into the fabric of medical care and health care financing in the State through:

Federal and State Initiatives

A number of Federal and State programs and national initiatives are examining early childhood development from a more comprehensive perspective and seeking linkages with the agencies and providers that have an impact on children:

Financing Services

There are a number of Federal programs that fund early childhood development services. Together with the use of State funds, collaborative interagency approaches and integration of services, State agencies can strengthen the delivery, coordination, and cost effectiveness of early child development services thereby maximizing these funding sources. In addition, cost and outcome analyses have demonstrated possible cost savings of early childhood development programs by themselves; these may apply for both children and parents, and they may have positive effects in the long-term.


AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.

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