Maternal and Child Health Library

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October 12, 2007

1. FRAMEWORK COMBINES ADVANCES IN SCIENCE AND PROGRAM-EVALUATION RESEARCH TO INFORM EARLY CHILDHOOD POLICY DECISIONS

A Science-Based Framework for Early Childhood Policy: Using Evidence to Improve Outcomes in Learning, Behavior, and Health for Vulnerable Children combines scientific knowledge about early childhood and early brain development with findings from four decades of program evaluation research into a unified framework to guide policy decisions on behalf of young children and their families. The report, published by the Harvard University Center on the Developing Child, builds on a process of systematic analysis that began with the publication in 2000 of a landmark report by the National Academy of Sciences titled From Neurons to Neighborhoods: The Science of Early Childhood Development, followed by the ongoing work of the National Scientific Council on the Developing Child and the National Forum on Early Childhood Program Evaluation, both of which are based at the Center on the Developing Child at Harvard University. The authors describe the process by which brain architecture is formed in very young children and integrate this scientific knowledge with the identification of factors from the program-evaluation literature that appear to offer the best course toward positive outcomes for children. Factors identified include the following: strengthening the family environment, serving children in out-of-home environments, combining support for vulnerable families with direct services for children, family economics and maternal employment, and the vulnerability of the young brain. An executive summary, references, and selected background readings are included. The report is available at http://www.developingchild.harvard.edu/content/downloads/Policy_Framework.pdf.

• Compared with women who gained 15-25 lbs. during their pregnancies, those who gained less weight had significantly lower risk of preeclampsia, cesarean delivery, and LGA births, but higher risk for SGA births.
• Results were similar for each obesity class, but at different amounts of gestational weight gain.

• Seventy-two percent of parents (n=68) reported that their child had received either school and/or community services following the crisis intervention.
• More severe depressive symptoms, parental perceived need for services, and being non-Latino predicted community mental health service use following YSPP contact.

• A total of 593 (77%) of the infants received some BM during their NICU hospitalization, and 180 (23%) received none.
• Across quintiles of BM feeding, a general pattern emerged of better outcomes associated with increased BM feeding. Overall, differences across quintiles were significant for Bayley Mental Development Index (MDI) scores, Bayley behavior score percentiles for emotional regulation, and re-hospitalization between discharge and 30 months.
• For every 10 milliliters per kilogram per day increase in BM ingestion, the MDI increased by an estimated 0.59 points, the Psychomotor Developmental Index by 0.56 points, and the total behavior percentile score by 0.99 points.
• The odds of any re-hospitalization between discharge and 30 months decreased by 5% for every 10 mL/kg per day of BM ingestion during the NICU stay. Additional analyses indicated that the reduction in re-hospitalization was accounted for by respiratory illness that occurred in the first 2 years of life.