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 PRB’s Policy Seminar series to discuss how to take what is known to work for early childhood development 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.


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. Ramey’s research has focused on the effects of the environment on behavior, including longitudinal studies of the effects of early experience on children “at risk” 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.


Sharon Ramey spoke with PRB before the policy seminar.


What are the basics of care and support that all young children need to thrive?


Children simultaneously need four areas addressed: Health and safety…Daily stimulation of language and basic cognitive function, what we call language and learning…They 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 it’s becoming more complex to meet this, is that the family…needs to really be in productive, effective partnerships with all the other people touching that child’s 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, there’s lot of mobility, and people don’t even have a common language sometimes, much less common values…that communication can be a very big deal.


Can you describe some of the major challenges confronting American families in terms of early child care and support?


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 children’s needs. It’s not all people in poverty, it’s 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 they’re 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 20…is at great risk of having secondary lifelong problems and disabilities that are totally preventable if they get what they need early on.


A third group…are 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 don’t know if we should spend any public time or energy to help them since they’re “ahead of the game.” Well that’s not true. Many of the young, exceptionally talented children really don’t 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 they’re poor and talented, they’re going to get overlooked and that’s a real loss of human capital.


A fourth group are the children who have problems that emerge that are probably going to be temporary and time-bound—a period of illness or a period where a learning difference becomes a disability in a school that expects you to be highly organized and you don’t look like you’re highly organized, but you’re really quite intelligent. So these are children who don’t have a major disability, they’re not extremely poor…but they have differences that could place them in jeopardy. If those differences aren’t understood and responded to well, those kids can go off trajectory and they’re kids who will be much more likely to take undue risk when they become adolescents, kids who detach, and don’t 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. It’s not a large number of children, but it’s still too many who fall into this temporary category.


What are the demographic impacts on family care and young children in the United States? How do income, racial, or regional differences affect the resources and abilities of families?


What I see is that the demography, the social variables like your ethnicity, language, family income, and size—these all are markers for more interactional, proximal variables. But they’re 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, I’m often interested in why there isn’t a direct match between the demography. Demography helps us identify places to concentrate either research or resources to maximize what we can learn…but we need to move beyond that. Some of my work has looked at what’s 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.


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?


It is very sad that we’ve gotten into a blaming game. Teachers blame parents, parents blame teachers…a young child doesn’t know actually who’s my real parent vs. who’s someone paid to take care of me. So for a young child, there’s a functional family of people who love and care for the child so that’s one way to think about family. And then of course there’s the…everyday, which isn’t always the legal family…For 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 doesn’t get good transition-to-adulthood support, that parent may not be able to negotiate the educational, social, and health systems very well…Then 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 threatened…and 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.


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?


I think this is the most important, because if we know that much and we’re not putting it into action, to me, it’s 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 that’s structural and easy. We like to say “Oh—child care giving will have certain ratios and we’ll make sure everyone has a certain level of education or a certain number of in-service training hours.” And then you think, “Phew—that’s high quality!” Here’s 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 children…We need more of our scientists to get help about communicating and working in partnership with policymakers and practitioners and we need to be sure that policymakers get more science background so they can collaborate.


So do you think policy tends to have a narrow focus?


I work a lot with people who shape and determine policy and often they take exception, (saying) “Well we just have to make it simple.” But I say, “How do you know you have to make it simple? That’s the way you’ve been doing it but how about we put forward a policy where in general you do this, but if you can’t meet these ratios—if you’re in a rural area, the ratios for staff to children or the educational levels aren’t feasible—you offer alternative routes.” You offer solutions that people don’t have to request a waver for. If they can prove they can deliver what’s needed for a child through a different route, you’ll 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.


Eric Zuehlke is an editor at the Population Reference Bureau