Effective Implementation of Proven Practices for Children in Real World Clinical, Educational, and Community Settings
(February 2009) For over 35 years, Dr. Sharon Ramey has studied early childhood development and how to implement scientific research in policy. On Feb. 11, she participated in PRBโsย Policy Seminar series to discuss how to take what is known to work for early childhood developmentย and bring science to bear to design effective policy. According to Ramey, the failures of programs for young children are not due to a lack of funding but rather, to misplaced priorities.
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Dr. Ramey is the founding director (along with Dr. Craig Ramey) of the Georgetown University Center on Health and Education and is the Susan H. Mayer Professor in Child and Family Studies. Dr. Rameyโs research has focused on the effects of the environment on behavior, including longitudinal studies of the effects of early experience on children โat riskโ for school failure; pioneering work on prenatal care and pregnancy outcomes; studies on the dynamic changes affecting American families; observational research on the social ecology of residential and educational settings; a landmark study of the transition to school for 11,000 children from kindergarten through third grade; and a series of ongoing multisite studies to prevent child neglect. Drs. Craig and Sharon Ramey currently have launched a large-scale program of randomized clinical trials that test the efficacy of professional development programs designed to promote teaching excellence and raise student achievement.
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Sharon Ramey spoke with PRB before the policy seminar.
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What are the basics of care and support that all young children need to thrive?
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Children simultaneously need four areas addressed: Health and safetyโฆDaily stimulation of language and basic cognitive function, what we call language and learningโฆThey also need to have responsive care that gets adapted for their age and individuality that will promote social and emotional growth and development. The fourth and final, and itโs becoming more complex to meet this, is that theย familyโฆneeds to really be in productive, effective partnerships with all the other people touching that childโs life on a regular basis. The health care providers and the teachers need to be working collectively with the family. In a world where the demography is changing, thereโs lot of mobility, and people donโt even have a common language sometimes, much less common valuesโฆthat communication can be a very big deal.
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Can you describe some of the major challenges confronting American families in terms of early child care and support?
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American families as a whole actually still continue to be well-off. But what we have are three big at-risk groups of children. We have a subgroup of children living in poverty whose own families are so challenged and did not have good health and educational supports that they have difficulty meeting their childrenโs needs. Itโs not all people in poverty, itโs a subgroup that is really challenged to give their children what they need to thrive. And their communities have been marginalized and have excessive challenges and are under-resourced. Another (at-risk group) are children with disabilities for whom we know how to give an effective intervention but very often what theyโre given is a dose that is below a threshold to help them. So a child who gets two hours of therapy a week, but needs 20โฆis at great risk of having secondary lifelong problems and disabilities that are totally preventable if they get what they need early on.
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A third groupโฆare academically and artistically gifted children. We are antielitist in this country and we know we need these people, we know they are our future. But we somehow donโt know if we should spend any public time or energy to help them since theyโre โahead of the game.โ Well thatโs not true. Many of the young, exceptionally talented children really donโt fit in and have a lot of secondary emotional and social problems and some do withdraw and some just get overlooked and never deliver on their natural inclinations. Especially if theyโre poor and talented, theyโre going to get overlooked and thatโs a real loss of human capital.
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A fourth group are the children who have problems that emerge that are probably going to be temporary and time-boundโa period of illness orย a period where a learning difference becomes a disability in a school that expects you to be highly organized and you donโt look like youโre highly organized, but youโre really quite intelligent. So these are children who donโt have a major disability, theyโre not extremely poorโฆbut they have differences that could place them in jeopardy. If those differences arenโt understood and responded to well, those kids can go off trajectory and theyโre kids who will be much more likely to take undue risk when they become adolescents, kids who detach, and donโt connect and have feelings for other people. These are not pathological kids. But the way we sometimes ignore or abuse these kids by having lockstep systems can be tragic. Itโs not a large number of children, but itโs still too many who fall into this temporary category.
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What are the demographicย impactsย on family care andย young children in the United States? How do income, racial, or regional differences affect the resources and abilities of families?
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What I see is that the demography, the social variables like your ethnicity, language, family income, and sizeโthese all are markers for more interactional, proximal variables. But theyโre crude markers so we always have exceptions. So within the extremely poor in this country, there are some children who thrive and among the extremely educated and well-to-do, there are children suffering badly. As a developmental scientist, Iโm often interested in why there isnโt a direct match between the demography. Demography helps us identify places to concentrate either research or resources to maximize what we can learnโฆbut we need to move beyond that. Some of my work has looked at whatโs called the typology of poverty. We have found six major subgroups of families based on a combination of the educational and income resources, the interactions people have with their children, and their ability to relate to societal institutions.
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Can you discuss your work on the effects of the family and larger community environment on behavior, including how family and community environment affects school readiness and achievement?
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It is very sad that weโve gotten into a blaming game. Teachers blame parents, parents blame teachersโฆa young child doesnโt know actually whoโs my real parent vs. whoโs someone paid to take care of me. So for a young child, thereโs a functional family of people who love and care for the child so thatโs one way to think about family. And then of course thereโs theโฆeveryday, which isnโt always the legal familyโฆFor me as a social scientist, family has many definitions. In the conventional sense, we have a lot of parents right now who are challenged if they happen to be a teen and not in charge of his or her own household and trying to finish his or her education. A teen parent presents a high risk for neglect in the first five years of life. If the parent is a former special ed. student who doesnโt get good transition-to-adulthood support, that parent may not be able to negotiate the educational, social, and health systems very wellโฆThen there are families living in extremely chaotic residential situations where the stability of their housing, income, and food security and the relationships in their immediate environment are threatenedโฆand make it almost impossible to protect the parents and family unit at the same time they nurture every child. So the demands swamp the family system.
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There is so much research on what young children need, what a supporting and caring environment consists of, and the economic benefits of providing that to children. Yet implementing that in policy and translating research for policymakers is a challenge. How can we bridge the gap between early childhood development research and policy?
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I think this is the most important, because if we know that much and weโre not putting it into action, to me, itโs almost a public responsibility. Our research is funded publicly, we owe it back to make sure it can be understood and interpreted in terms of policy. One of the challenges is that policies often want to find something thatโs structural and easy. We like to say โOhโchild care giving will have certain ratios and weโll make sure everyone has a certain level of education or a certain number of in-service training hours.โ And then you think, โPhewโthatโs high quality!โ Hereโs the dilemma: those structural supports that often become our policies have not yet been sufficient to guarantee that children get the daily experiences or interactions. We need to have our policies get closer to what really matters for childrenโฆWe need more of our scientists to get help about communicating and working in partnership with policymakers and practitioners and we need to be sure thatย policymakers get more science background so they can collaborate.
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So do you think policyย tends to haveย a narrow focus?
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I work a lot with people who shape and determine policy and often they take exception, (saying) โWell we just have to make it simple.โ But I say, โHow do you know you have to make it simple? Thatโs the way youโve been doing it but how about we put forward a policy where in general you do this, but if you canโt meet these ratiosโif youโre in a rural area, the ratios for staff to children or the educational levels arenโt feasibleโyou offer alternative routes.โ You offer solutions that people donโt have to request a waver for. If they can prove they can deliver whatโs needed for a child through a different route, youโll accept it. We could make policies that have flexibility not in terms of guaranteeing children get important things, but in how you get there. So I think we need to have more flexibility and more experimentation when we implement programs to benefit children.
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Eric Zuehlke is an editor at the Population Reference Bureau


