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The earliest intervention is reading at home to children before they reach Kindergarten

From the Associated Press today: When her son Dylan was just 6 years old, Kristen Wahlmeier noticed that he had to be bribed to read: A surfing trip here or a pair of new shoes there before he'd pick up a book. Worried as she watched him struggle, a gnawing fear crept into her stomach: Her only son, with big blue eyes and the jones for Star Wars, might be headed for a special education classroom. Instead, teachers at his suburban Portland school intervened immediately, putting him into extra reading and vocabulary tutoring every day before school. It paid off. Now, officials in districts across the country are rapidly adopting similar early intervention programs, hoping that steering a child away from expensive special education classes later will pay off for them, too, in cost savings.

The Center for Urban Child Policy released a policy brief earlier this year about literacy rates in Memphis and Shelby County among low-income parents. Among our findings were that low-income parents do many things right when it comes to preparing their children for school - and a lifetime love of reading - like telling stories, singing songs, playing games and counting numbers. These "in-kind" pre-literacy activities are very important to children's developing minds. However, when it comes to the most important pre-literacy activity - reading to children - low-income parents in Shelby County lag far behind parents nationwide.

More from the AP: Traditionally, children haven't been identified for special education until third or fourth grade. They end up costing roughly twice as much, or about $12,000 a year, to educate an average student, including about $11 billion in federal dollars every year.

These findings fit nicely with a very troublesome headline in today's Commercial Appeal:
City council may cut funding for Memphis City Schools

The Memphis City Council is considering withholding some or all of the $93.5 million requested by the city school district, a controversial move that could provide city residents with a tax break instead of a tax hike.

This triad of issues - Special Education, Early Literacy and School Funding - are critically important to see as inter-related in our community. Fourth-grade reading scores are both evidence of the past and a window to the future: they are evidence of early literacy experiences and predictors of future experiences. (Prison analysts use 4th grade reading scores to determine projected prison populations...)

• 1 in 7 students (14%) are categorized as Students With Disabilities.
• 4 in 5 students (82%) are categorized as Economically Disadvantaged
• 1 in 3 people in Shelby County are functionally illiterate - meaning they have difficulty reading street signs, newspaper headlines, prescriptions and job applications

Too few parents and young children are reading together regularly. Too many children have learning difficulties which are costly for them and for us, the taxpayers. Too often, children are the last priority of policymaking and the first to be considered for budget cuts.

Things we can do that will help:

1. Invest in early literacy experiences for children. Access to Books from Birth, access to public libraries and to quality time spent reading with parents and caregivers is critical to initiate a love of reading.
2. Help parents read to their children. Parents may be insecure about their reading ability. The Memphis Literacy Council can give parents with difficulty reading tools to improve their skills and quality time with their kids and books.
   
3. Understand the connections between poverty/low-income status, learning disabilities and school finance. Short-sighted budget cuts that affect children will not improve the quality of our city now nor in the future. What gets cut now, we will all have to pay for later.
   
4. Make children a priority from the start - not an afterthought at the end.
   

The SCHIP Saga Continues

Uninsured children may still have a chance under SCHIP, the public health insurance program that is jointly financed by federal and state governments.

According to a New York Times report today:

The Bush administration violated federal law last year when it restricted states’ ability to provide health insurance to children of middle-income families, and its new policy is therefore unenforceable, lawyers from the Government Accountability Office said Friday.

Under the Aug. 17 directive, states cannot expand the Children’s Health Insurance Program to cover youngsters with family incomes over 250 percent of the federal poverty level ($53,000 for a family of four) unless they can prove that they already cover 95 percent of eligible children below twice the poverty level ($42,400).

Moreover, in such states, children who lose or drop private coverage must be uninsured for 12 months before they can enroll in the Children’s Health Insurance Program, and co-payments in the public program must be similar to those in private plans.

Moreover, now while the debate has been revived, the public should weigh in on the appellation SCHIP to reframe the issue in such a way that it is an undeniable children's rights issue. S-CHIP as it stands sounds like a computer or technical problem, akin to the Y2K frenzy, not an issue of utmost importance pertaining to the rights of children to medical care.

The name SCHIP gives no indication that the bill is fundamentally about protecting children by assuring that they have access to quality health care, that they have a reliable medical home, that they have a well-coordinated team of health care providers and reliable adults overseeing their medical well-being. This name does not invoke public sentiments of empathy and protection as it should. Other states - like Minnesota's Badger Care or Tennessee's TennderCare - are catchy and sticky.

Some suggestions (others welcome):
The Defense of Children's Health Act
Protecting Children's Health Act
Health Coverage for Children Act

The working poor

The New York Times is reporting today on the effect of the economic downturn on America's working poor - the bootstraps folks who are self-employed, the entrepreneurs who teach music lessons and do handiwork, the fabric of the country who work for themselves and who hold jobs that once gave them ample overtime hours that gave their family a cushion of income, a buffer that gave them a sense of security which is eroding paycheck by paycheck.

Says the New York Times, "The gradual erosion of the paycheck has become a stealth force driving the American economic downturn. Most of the attention has focused on the loss of jobs and the risk of layoffs. But the less-noticeable shrinking of hours and pay for millions of workers around the country appears to be a bigger contributor to the decline, which has already spread from housing and finance to other important areas of the economy."

One woman's monthly income has decreased by one-quarter - while she once could depend on $600 per week, she now makes do on $450 per week. Trips to the store are rationed. Families visit parks instead of museums. Parents take their children to thrift stores instead of the mall. (Heck, I'm shopping at ICB on Jefferson these days...) This decline has brought her salary from $31,000 to $23,000 - where once she was middle-income, she is now considered low-income, a phenomenon described in The Missing Class, a book about America's near poor.

According to the February 2008 Tennessee Labor Report, 20,000 people in Memphis City are unemployed (6.7%) - and this might be a conservative figure given that this only measures people who have actively sought work in the past few weeks. What about other people who have given up looking for work?

People who could once make it on one income are now taking part-time jobs to supplement what they've lost in earnings. This means more children spend less time with their parents, more families are stressed by financial worries, more families have fewer buffer resources to fall back on in case of emergencies or special occasions - a sick child, a flat tire or a prom.

New Calculator Factors Chances for Very Premature Infants

One of the most difficult questions about the survival of premature babies is how to best help them. Babies are now able to survive life outside the womb much earlier than before because of advances in medicine about how to best treat neonates. And now, doctors and researchers have come up with a formula for determining a baby's chances for survival and potential complications later in life.

The New York Times reports today that the new method uses an online calculator developed for such cases factoring in traits like birth weight and sex as well as gestational age and whether or not the baby was a multiple birth. (Incidentally, baby girls born early have a better chance for survival than do boys.)

In theory, at least, the calculator would seem to favor treating girls, because, all else being equal, their odds for survival are better.

From the New York Times article: The study included 4,446 infants born at 22 to 25 weeks at 19 hospitals in the Neonatal Research Network; 744, generally the smallest and most premature, did not receive intensive care, and all died. The babies were assessed at birth, and the survivors were examined again shortly before turning 2. Over all, half the infants died, half the survivors had neurological impairments, and half the impairments were severe. Many survivors spent months in the hospital, at a typical cost of $3,400 a day. The researchers estimated that if all babies born at 22 to 23 weeks received intensive care, for every 100 infants treated there would be 1,749 extra hospital days and zero to nine additional survivors, with zero to three having no impairment.

What is most compelling about this study is that based on this data, researchers are able to make projections about what kind of future these children will face, and what the social cost will be to care for them long-term, not only medically, but educationally as well. We know that low birth weight children face many more educational obstacles and often need special attention in school, and that students with disabilities - including those with Individualized Educational Plans - cost the school system and community more.

These problems are especially relevant for our community since Memphis has an exceptionally high rate of low birthweight babies and infant mortality - a well-known problem that was publicized in a Commercial Appeal article in 2005.

One of the researchers - Dr. Nehal Parikh - said the following about how the new formula will help parents decide what is the best treatment option for their child: “We lay out the facts, rather than our own opinions,” Dr. Parikh said, “because we’re not the ones taking these babies home.” This is only partly true. The choice of treatment for a child is an individual decision, but the implications for society are far-reaching, especially considering the care and cost associated with children with disabilities throughout their lifetimes - not only the family's personal cost but society's investment in their future.

An element of forward thinking which is not covered in the article is the root causes of pre-term births, low birth weight and infant mortality. Prenatal care - including access to and use of health care and routine doctor's visits - and proper nutrition are essential to growing and delivering healthy babies, and the community at large must take a more proactive role in promoting healthy pregnancies.

We need to intervene in the lives of the children before they are delivered early, and before we have to make the decision whether 22 weeks or 23 weeks is a viable gestational age for a child. We need to intervene in the lives of the children in utero - investing in the mothers and assuring that they have routine, quality, available medical care and proper nutrition so that their babies are healthy from the start.

The Child Well-Being Data Book written and published by The Urban Child Institute has more information about the health conditions of infants and children in Memphis and Shelby County.

New report from "Every Child Matters" on key geographic differences in child well-being

Every Child Matters has issued a new report, Geography Matters: Child Well-Being in the States, which shows wide gaps in key indicators of child well-being from state to state.

The report:
* Describes critical components of the 'grid of opportunity' that needs to be intact in order to support the well-being of children and families, and makes clear that for too many children, that grid has broken down.
* Supports the idea that the well-being of children is a 'path dependent' process. In other words, the start kids get in life sets them on the path that will take them to school and will prepare them for life.
* Supports the idea that the best way to insure the well-being of families and communities later on is to invest in the well-being of young children today.
* Focuses on the critical relationship between the environment in which children are raised and their well-being in school and life. As recent studies suggest, for example, children living in high crime neighborhoods can be a full year behind their peers when they reach school.

Among the key findings of the report:
Children in the lowest ranked states for each indicator are:
• Twice as likely to die in their first year as children inthe highest ranked state.
• Three times more likely to die between the ages of 1-14.
•Roughly three times more likely to die between the ages of 15-19.
• Three times more likely to be born to a teenage mother.• Five times more likely to have mothers who received late or no prenatal care.
• Three times more likely to live in poverty.
• Five times more likely to be uninsured.
• Eight times more likely to be incarcerated.
• Thirteen times more likely to die from abuse and neglect.