The Baby & Toddler Takeoff’s Scope and Scale: What We’ve Reported, and Why
The 2010 Census tells us that roughly 6 percent of New York City residents—more than half a million of us—are under the age of 5. Nearly a third of these very young children belong to households that are, by Federal standards, impoverished.
The everyday stresses of this poverty can have powerfully corrosive effects on the crucial early years of their lives. (Many thousands more New York City children living in conditions of near poverty face quite similar hardships.) An array of publicly funded social, educational, medical and other services – in day care centers, Head Start programs, pediatric clinics, Family Courts and other settings—exists to offset these disadvantages. Together, they make up New York City’s broad and varied early childhood services.
Traditionally—and for good reason—the top priority of these programs has been safeguarding the physical health and safety of these especially vulnerable children. Today, however, a concern about infant mental health is also rising to the top of their agenda. It’s driven by an emerging consensus about the destructive effects that particularly intense poverty-related stresses, such as homelessness, neglect or family violence, can have on the ability of young children to grow and learn, cognitively and emotionally. It’s also informed by hopeful evidence that efforts by early childhood service providers to reach both small children and their parents—including through the interactive psycho-social work known as dyadic therapy—can prevent or counteract such harmful consequences.
For many researchers and practitioners who have long worked in early childhood development, these concerns and findings are familiar. What’s new, however—and for that reason, what’s the focus of this report—is the growing attention they’re receiving in a wide range of agencies in city and state government, and in the community-based programs that they fund and work with. And the significance of that new awareness is magnified by the fact that government’s ability to reach people needing help typically far exceeds that of even the most ambitious private or philanthropic undertaking.
In this report, we focus on initiatives that receive funding by the city or state, or with whom the city and state has partnered. We are also looking almost exclusively at efforts that have launched or expanded their vision over the past two years. (We did not, for instance, include the Nurse Family Partnership program because it is long-established.) Most of these new programs are quite modest in size—especially measured against the vast unmet needs they confront.
While it’s impossible to say with certainty how many very young children in the five boroughs are experiencing toxic developmental stresses, the best guess is that the number is likely to be in the tens of thousands. In the face of that daunting challenge, programs such as, for example, one designed to help young children involved in one Family Court in the Bronx are small-scale indeed. We also have heard reservations from those in the field that without greater coordination and communication, the reach and impact of these new policies and programs will be needlessly hampered.
Other of the initiatives we report have the potential to impact a large number of families; a good example is a planned reform of how the state Medicaid program pays for infant mental health services, which could greatly increase diagnosis and treatment of early childhood social-emotional problems. Finally, while “siloing” certainly threatens to keep the Baby & Toddler Takeoff on the runway, we have seen signs that city and state policymakers recognize that danger and are working to overcome it, which we will report on in the coming months. The landscape of programs and possibilities is what this installment attempts to map.