Effective Services for Young Children

Report of a Workshop

Lisbeth B. Schorr, Deborah Both, and Carol Copple, Editors

National Forum on the Future of Children and Families

National Research Council

Institute of Medicine

National Academy Press
Washington, D.C.
1991



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Effective Services for Young Children: Report of a Workshop Effective Services for Young Children Report of a Workshop Lisbeth B. Schorr, Deborah Both, and Carol Copple, Editors National Forum on the Future of Children and Families National Research Council Institute of Medicine National Academy Press Washington, D.C. 1991

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Effective Services for Young Children: Report of a Workshop NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Frank Press is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Samuel O. Thier is president of the Institute of Medicine The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Frank Press and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council. Library of Congress Catalog Card No. 91-62826 International Standard Book Number 0-309-04579-7 Additional copies of this report are available from: National Academy Press 2101 Constitution Avenue N.W. Washington, D.C. 20418 S-440 Printed in the United States of America

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Effective Services for Young Children: Report of a Workshop NATIONAL FORUM ON THE FUTURE OF CHILDREN AND FAMILIES STEERING GROUP JULIUS B RICHMOND (Chair), Harvard Medical School, Harvard University WILLIAM S. WOODSIDE (Vice Chair), Sky Chefs, Inc., New York HENRY AARON, The Brookings Institution, Washington, D.C. DREW ALTMAN, Henry J. Kaiser Family Foundation, Menlo Park, California ALAN K. CAMPBELL, The Wharton School, University of Pennsylvania JAMES P. COMER, Child Study Center, Yale University JANE L. DELGADO, National Coalition of Hispanic Health & Human Services, Washington, D.C. FELTON J. EARLS, School of Public Health, Harvard University DONALD M. FRASER, Office of the Mayor, Minneapolis, Minnesota ROBERT E. FULTON, Oklahoma Alliance for Public Policy Research, Oklahoma City EUGENE E. GARCIA, Board of Education, University of California, Santa Cruz ROBERT J. HAGGERTY, William T. Grant Foundation, New York MARGARET C. HEAGARTY, Department of Pediatrics, Columbia University RUBY HEARN, Robert Wood Johnson Foundation, Princeton, New Jersey FRED M. HECHINGER, Carnegie Corporation of New York, New York DAVID HORNBECK, Education Adviser, Baltimore, Maryland JUDITH E. JONES, National Center for Children in Poverty, Columbia University JEROME KAGAN, Department of Psychology, Harvard University RONALD B. MINCY, The Urban Institute, Washington, D.C. MARTHA L. MINOW, Harvard Law School, Harvard University ANNE C. PETERSEN, College of Health and Human Development, Pennsylvania State University HAROLD A. RICHMAN, Chapin Hall Center for Children at the University of Chicago ALLAN ROSENFIELD, School of Public Health, Columbia University LISBETH B. SCHORR, Harvard Medical School, Harvard University CAROLE SIMPSON, ABC News, Washington, D.C. PATRICIA A. PLACE, Project Director DEBORAH R. BOTH, Senior Research Associate DRUSILLA BARNES, Administrative Secretary

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Effective Services for Young Children: Report of a Workshop Preface The Workshop on Effective Services for Young Children, held November 1 and 2, 1990, was one in a series of events that the National Forum on the Future of Children and Families has sponsored on current and emerging child and family policy issues. A joint project of the National Research Council's Commission on Behavioral and Social Sciences and Education and the Institute of Medicine, the forum was established in 1987 to promote an ongoing dialogue among scholars and experts in children and family issues and leaders in government, business, philanthropy, and the media. The forum provides a neutral setting for discussion of problems affecting children and families and the development of policy options and strategies to improve their health and well-being. Its mission is to enhance the policy-making capacity of the public and private sectors on behalf of children and families. The forum's Working Group on Effective Services organized the workshop in response to evidence of a growing consensus that: The nation has an enormous stake in reversing the alarming deterioration of the circumstances in which poor and otherwise disadvantaged children grow up. Many past efforts to reverse unfavorable trends in damaging outcomes such as school failure, adolescent childbearing, substance abuse, and violent crime have been relatively ineffective. Much new knowledge on how to improve the institutions and programs that are meant to strengthen children and families is now available but is not being used.

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Effective Services for Young Children: Report of a Workshop Most of the difficult unsolved problems call for remedies that cut across multiple systems and disciplines. The forum is well situated to bring together the range of individuals and interests needed to sort through and extract from current knowledge and activities the options and strategies that could achieve major improvements in services for young children and their families. Accordingly, the forum convened a two-day workshop involving 60 invited participants to assess the state of current knowledge and to identify strategies for action. Participants included many of the nation's leaders in current efforts to improve services for children and families and many who are at the forefront of attempts to understand these efforts in the context of current experience, theory, and research. A list of participants is included in the appendix. The presentations and discussions that took place during the two-day meeting, together with the background papers, enriched participants' understanding of available options and steps that could be taken to improve the well-being of the nation's children and their families through more effective services. Needless to say, however, not all important aspects of the provision of effective services for children were covered in this initial workshop. With this summary of our workshop deliberations, we hope to reach a wider audience of policy makers, administrators, and practitioners. We hope that this summary and the background papers will inform future efforts to ensure that all American children and their families will benefit from the high-quality education, social services, health care, and family support services that are within the nation's capacity to provide. The forum is grateful for the contributions of the impressive array of workshop participants and to the authors of the background papers. We are also grateful to the Carnegie Corporation of New York, which provides general support to the forum, and to the Foundation for Child Development, which has provided funding for the publication and dissemination of this report. We extend our thanks to Carol Copple, a valued consultant and one of the drafters of the summary. In addition, we wish to express appreciation to Deborah Both, the forum's senior research associate, and Drusilla Barnes, administrative secretary, for their dedicated efforts in organizing the meeting and for producing this report. Lisbeth B. Schorr, Chair Forum Working Group on Effective Services for Young Children Julius B. Richmond, Chair National Forum on the Future of Children and Families

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Effective Services for Young Children: Report of a Workshop Contents PREFACE   v REPORT OF THE WORKSHOP   1     Effective Services for Young Children,   3     Attributes of Effective Services,   4     Lessons of the Past and Strategies for the Future,   6     Strategies to Encourage Systems Change,   8     Conclusion,   19 BACKGROUND PAPERS   21     Attributes of Effective Services for Young Children: A Brief Survey of Current Knowledge and Its Implications for Program and Policy Development Lisbeth B. Schorr with Deborah Both   23     Effective Services for Children and Families: Lessons From the Past and Strategies for the Future Peter B. Edelman and Beryl A. Radin   48     State Financing Strategies that Promote More Effective Services for Children and Families Frank Farrow   65     The Challenges of Services Integration for Children and Families Drew Altman   74

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Effective Services for Young Children: Report of a Workshop     The Role of Training and Technical Assistance in the Promotion of More Effective Services for Children Douglas W. Nelson   80     Collaboration as a Means, Not an End: Serving Disadvantaged Families and Children Olivia Golden   84     Outcomes as a Tool to Provoke Systems Change David W. Hornbeck   105 APPENDIX: Workshop Agenda and Participants   109

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Effective Services for Young Children: Report of a Workshop Effective Services for Young Children

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