Sydney Hans and Karen Freel have been part of a revolution. Over the past 30 odd years, our understanding of early childhood development has been turned upside down, as social science and neuroscience have given researchers a much richer picture of the importance of the first years of an infant's life. Both women have been involved in this work over the last three decades.
Sydney Hans, the Samuel Deutsch Professor at SSA, has conducted studies focusing on the development of young children whose parents use illicit substances, suffer from major mental disorders, have experienced traumatic events, and/or live in conditions of extreme poverty. She is particularly interested in using research to develop interventions and public policy that will benefit infants, young children, and their families.
Karen Freel is the vice president for research and evaluation for the Ounce of Prevention Fund, a partnership between private donors and the state of Illinois to give children who are born into poverty a chance for success in school and in life. She oversees the organization's evaluation activities and leads the Ounce's efforts to build an early childhood mental health system in Illinois. In September, the pair sat down to talk about Freel's work as a graduate assistant on the groundbreaking work of SSA's Samuel Deutsch Professor Emerita Dodie Norton, what infants need from their parents, how early development policies can make a difference, and more.
Freel: We know each other's work pretty well. I don't know that I have a question for you. [laughs]
Hans: Karen and I have worked together since she was a graduate student here at the University, which is how I met her. And you met Dodie Norton as well around that time, too, I think, right after she came to the University. I remember you talking in those days about what you were observing in the Infant Development Project.
Freel: We wanted to see what the natural environment for a baby looked like. We started out videotaping the mother with the baby in the hospital right after the baby was born, and we went back to the home every six weeks. We told the mother you just do whatever you do. We were there for four hours. People can't pretend for four hours, so we really did start to see the natural environment. I was learning how to be a researcher, so I was out there listening to babies cry and not picking them up. That was really hard. But I did my job: We just watched what was going on.
Hans: And you produced all this data on how many hours a day children are sitting in front of the television screen and how many hours sleeping, documenting what really happens in the life of a child.
Freel: Right, and then Dodie and the people on our team needed to figure out what to focus on with all this information. She eventually landed on language: what's the language like and what kind of language is the baby hearing, and how is that going to be related to later school success or later outcomes. Dodie was also one of the first to recognize it is terribly important how families think about routine and time.
Hans: Dodie was really one of the pioneer scholars to take seriously what kinds of environments babies are exposed to. Her work is a part of a bigger body of research showing that experiences during the first years of life have implications for how well kids are doing in school and how resilient they will be to a variety of life stressors later on. In the research Karen and I did together, we learned from mothers who were in treatment for substance abuse. It was one of the very first studies to examine the implications of mother drug use on children's longer-term development. We followed those kids from before birth until early adolescence. When the children were ten years old, we were looking at which children had mental health problems, which children were engaging in disruptive behavior. The one thing that was most strongly predictive was not their parents' history of drug use. It was how responsive their parents were to them when they were young children. We were kind of blown away by this actually. It fit very well with our theories about development and intervention, but after ten years, we didn't expect to see such strong effects.
Freel: I think people thought that the drug effects would be the deciding factor in those kids' lives. But it wasn't. It was whether when the baby cried, the mother picked it up. It was whether when the baby was interested in something, the mother followed that child's interest and affirmed what the child was all about.
Hans: There's a wonderful quote from William James—one of the founders of the field of psychology—about how babies process information. He said that they live in a "blooming, buzzing confusion," basically meaning that babies can't make sense out of anything. And if you truly believe that, what difference does it make what kind of experiences you provide babies with? But we've learned a lot in the last three decades about early childhood, and now we know it's amazing what babies learn and understand from birth. In the late 1960s, early '70s, there was an explosion of techniques for studying young children. We learned how to get better information about what children were thinking by observing their attention and behavior in very careful ways and by monitoring their physiological responses. There's just so much knowledge now about the importance for young babies to be in environments with adults who help them to feel safe and secure. If kids don't have an enriched and caring environment during those early years of life, it will be a challenge later.
Freel: Absolutely. There was a faculty member when I was at the University, Kenneth Kaye, who talked about the dance between mothers and babies and how important that was, how they learn conversation styles, and how the baby learned that "yes, I can communicate and somebody will listen to me and respond to me."
Hans: In those early days, we thought it was mostly about providing kids with cognitive stimulation—that they needed to have the right toys, they needed to learn their ABCs, they needed to learn their colors. But probably more important than those things is a solid socio-emotional grounding. Family support programs can help parents provide children with that foundation, help parents become more focused on their children's emotional needs. Early childhood education can help children learn to express their feelings appropriately and be curious and take pleasure in the learning process. That's been a real change in how we think about what's important in early development.
Freel: It really is. It's been amazing. And it's sometimes really hard to get that across to policymakers about how important socio-emotional development is, because it's so soft and it sounds like something that just sort of happens naturally, but it really doesn't. It has to be encouraged and supported. But certainly it is also true in early childhood that everything is so interconnected that it's really hard to separate it all out. So going back to language, if a parent is saying more words, they're having more interactions and there is more opportunity for the child and the mother to be looking at the same thing, talking about the same thing, and for that child to feel safe and feel that someone's interested in them. As you're focusing on socio-emotional development, you can be very intentional about building language, about building numeracy. You want those kids to come into kindergarten and know what it means to sit still and to share, how to work independently, how to be curious and ask questions and wonder.
Hans: And from an intervention perspective, it's best to give the kids what they need early on rather than to try to help them to catch up later on. We want our kids to be coming to school ready to participate in learning situations so that they can get the most out of those experiences.
Freel: We really do know a lot about what to do with children and what they need and how to help them develop. Illinois was the first state to take early childhood funds for preschool and set aside a percentage for infants and toddlers. This is critically important because we know from the literature that even by age 3, there's huge separation [in the capacities] of the kids who don't hear enough language. Most of Illinois' programs for infants and toddlers are home-visiting programs, although we think center-based programs are important too. In the pre-school age, other states have universal preschool programs, such as Georgia and Oklahoma. But we were the first one to say we're going to have universal preschool for 3, 4, and 5-year-olds. One year is really not enough. Now, we're not serving all of the 3 and 4-year-olds in our state, but that's because of budget resources. It's unfortunate that our state had such difficulties with their budget this past year, and we will have another difficult budget process this next year. But you start with the policy and program model, and then you build up the resources over time.
Freel: We know from lots of research about the importance of parents being involved with their children in school. How do we help the parents develop that? At the Ounce, we're now thinking about what we can do with parents during our home visits or when we're in center-based programs to make sure that they understand their role and how they need to be connected to what is going on with their children in school. It's easier to do that in an early childhood program because there is a lower child/teacher ratio and parents are comfortable. Public schools can feel unwelcoming for parents, but they don't feel threatened in the programs for 3-year-olds.
Illinois is considered a leader in the country on early childhood programs, systems, and resources, and in part that's because we have a unified advocacy for early childhood. My organization, Voices for Illinois Children, Action for Children, and other organizations like Fight Crime/Invest in Kids—every year we decide on a legislative agenda jointly. Each organization kind of takes a lead on some part of it, but they're all singing the same tune in Springfield. It's a united front, and the legislators find that helpful. And we have been able to enact a lot of legislation.
Hans: And we need more information [about early childhood development program's effectiveness] because that's really the ammunition that our advocates have been using. Although I must say, I think we have better data on the benefits of early childhood programs than almost any other policy area. I think our advocates have made very effective use of their data, and you would think that people would love helping babies and children. And yet we still seem to need more data to get these programs through.
Freel: I often get a little dismayed. I think that legislators or policymakers want the end result to be that you've turned all the kids in a study into A-plus students or that you've raised their IQ by 20 points. And most social service programs have much more modest results. But those modest results mean something. Deborah Darrow used to point out that the research on taking aspirin to help prevent heart disease really only affects about 1 percent of the population.
Hans: Right. But it's important because we know it makes a difference at the level of public health across the whole population.
Freel: I realize aspirin is a lot cheaper than an early childhood program. But it's the same argument: Those modest effects are helping large numbers of families have a better life than they would have had without them.
Hans: One of the things that has struck me is that this new array of programs for young children means that there are some new roles for new kinds of professionals. We're thinking about this a lot at SSA, about the new opportunities for social workers to address the needs of young children. It's an area that has not always been really visible within social work, that there's work to be done with babies.
Freel: Yes. We know that many families need programs to help them and help support the development of a child. We also know that some of these families have so many issues that social workers at those programs often find themselves at a loss and not sure what to do. And we know that mental health consultants can help those workers better understand the families and help with their own emotional turmoil when they're working with these families.
For that to happen, you have to think about who's providing the services, how are they going to get paid and where are the funding streams, and what policies put up barriers that keep people out of the field. For example, social workers are really the backbone of interventions with families. Yet social workers, up until a year ago, couldn't be reimbursed by Medicaid for any services that they provided to families if they were not connected to a health center or to a psychiatrist. And that seemed ridiculous when they were providing the bulk of the services to families. So we were able to get that changed in the legislature two years ago. It hasn't been implemented yet, but at least it's on the books.
Hans: We mentioned earlier the movement for preschool for all, and I've often thought how that's just going to provide so many changes in how we think about school social work and mental health support within schools. What's going on in Chicago and the state?
Freel: When we passed preschool for all, part of the model says programs should have access to consultants, and there are funds to provide for them. It's not universal, not every program has a consultant, but you start someplace. Again, we should be proud of Illinois for what we have put in place. Gaylord Gieseke, my former co-worker at Voices for Illinois Children, and I started working an Early Childhood Committee almost ten years ago. And there's some really smart people in the state administration who get this, and we have foundations like the Harris Foundation in Chicago, which has always been very interested in early childhood, saying if you will match our money, let's develop a consultant program.
This program is also helping to train new consultants. So new social workers coming out of school have some information, but going into consulting on early childhood programs requires some special skills that you might not get. No coursework can really prepare you for everything you need to know once you get out there.
Hans: At SSA we're really trying to respond to the need for social workers to work with families and children. Fifteen years ago, Dodie founded a program at SSA called Family Support, and every year we have about 8 to 10 second-year students who participate. Dodie worked with Bernice Weisbourd, who was on the SSA Visiting Committee and was a real leader nationally in the Head Start movement, as you well know, and other early interventions involving parent support.
It's been interesting to watch how that program has evolved. I'm the chair now. We have two classes with the students really focusing on the issues of children and supporting families so that they can support their children. We do a lot of thinking about the kinds of intervention strategies that deal with families in the home, not just the in-the-office model. The program looks at the real environments that children are in and talks about understanding the goals that parents have for their children, recognizing that it may not be the same goals that we have for their children, but that we need to help them achieve what they would like to for their children.
We've seen shifts in the kind of jobs that our graduates of that program go into. In the early days they were going more into community agencies. Now they have a lot more opportunities in the early childhood area, and many students are working with early intervention systems with children who've been identified as having risks. We have a lot of students working in hospital settings, where there's a lot of focus on early childhood, helping parents with preterm babies or children with cancer. And we're just beginning to think about how our students can become involved in emerging educational programs in early childhood. That seems to be the next big kind of growth area.