The Early-Childhood Intervention That Can Make Even Congress Stop Fighting

Political support for evidence-based home visiting programs is so broad-based that Congress approved a funding extension earlier this spring.

Darnell Bowen Sr., Markita Logwood and thier 18-month-old son Darnell Bowen Jr. The family has participated in a Memphis-based Parents as Teachers program operated by a local nonprofit, Porter-Leath, since Markita was 12 weeks pregnant. The couple say the program has given them a new way to think about parenting. 
National Journal
May 9, 2014, 11:22 a.m.

MEM­PH­IS, Tenn. — De­mat­rise Givens knows her fam­il­ies. With­in seconds of pulling in­to the park­ing lot out­side the sun-rav­aged blue pub­lic-hous­ing com­plex in South Mem­ph­is where 18-month-old Dar­nell Bowen Jr. is liv­ing with his par­ents this month, Givens is out of her car, col­lect­ing the day’s es­sen­tials. 

There isn’t, it seems, a mo­ment to waste.

“Ms. De,” Dar­nell Bowen Sr., 22, an­nounces while hold­ing open the fam­ily’s front door. Bowen starts talk­ing be­fore the 4-foot-10½-inch Givens’s hur­ried stride hit the side­walk. “I’ve got news.”

Givens, 41, is a par­ent edu­cat­or cer­ti­fied in the Par­ents as Teach­ers meth­od — a 30-year evid­ence-based home vis­it­ing pro­gram with a cur­riculum de­signed to en­cour­age the kind of day-to-day par­ent­ing that sup­ports chil­dren’s in­tel­lec­tu­al, so­cial, and emo­tion­al de­vel­op­ment dur­ing the crit­ic­al first five years of life. That’s a peri­od when chil­dren’s brains have a sin­gu­lar ca­pa­city to gain found­a­tion­al skills needed to ex­cel at school, on the job, and in life.

Givens is vis­it­ing Bowen, baby Dar­nell, and his mom, Markita Log­wood, 25, to talk par­ent­ing skills, brain-build­ing activ­it­ies, and ba­sic life coach­ing. She’s armed with a black bind­er and what looks like a half-ream of work­sheets. The mul­ti­colored zip-top bag she car­ries in­to the apart­ment is stuffed with over­sized, con­nect­able plastic blocks that are ir­res­ist­ible to tod­dlers.

Twice each month, Givens and thou­sands of oth­er par­ent edu­cat­ors with Par­ents as Teach­ers vis­it the homes of low-in­come or oth­er­wise at-risk fam­il­ies in all 50 states and sev­er­al coun­tries. They, and oth­er out­reach work­ers in­clud­ing nurses and so­cial work­ers, work with fam­il­ies that have chil­dren un­der the age of 5 and are vol­un­tar­ily en­rolled in the evid­ence-based home vis­it­ing pro­gram.

Forty-five per­cent of U.S. chil­dren live in fam­il­ies with in­comes that meet the of­fi­cial defin­i­tion of poverty or earn in­comes just above it, ac­cord­ing to Columbia Uni­versity’s Na­tion­al Cen­ter for Chil­dren in Poverty. Even those slightly more well-off fam­il­ies of­ten struggle with in­stabil­ity, in part be­cause they make too much money to qual­i­fy for as­sist­ance but not enough to live com­fort­ably. In the worst cases, chil­dren in these fam­il­ies face peri­od­ic food in­sec­ur­ity, fre­quent moves, and of­ten home­less­ness. Many have lim­ited ac­cess to the kinds of books, par­ent­al in­ter­ac­tion, and oth­er ex­per­i­ences that help to de­vel­op young brains. By the time chil­dren start school, that kind of poverty of­ten pro­duces low test scores, lim­ited vocab­u­lar­ies, and even so­cial and emo­tion­al de­fi­cits.

Since the 1990s, Ten­ness­ee and a col­lec­tion of oth­er states have op­er­ated a vari­ety of home vis­it­ing pro­grams that tar­get first-time par­ents, low-in­come fam­il­ies, house­holds with his­tor­ies of ab­use or neg­lect, and chil­dren with de­vel­op­ment­al delays and dis­ab­il­it­ies. They’ve been fun­ded with a com­bin­a­tion of state and loc­al gov­ern­ment dol­lars, fed­er­al funds, and private dona­tions. The in­ter­ven­tions seemed to make a dif­fer­ence in the lives of the chil­dren they reached, but their scope was lim­ited.

Then, in 2010, a pro­vi­sion of the Af­ford­able Care Act changed the game. Sud­denly, a pot of $1.5 bil­lion fed­er­al dol­lars be­came avail­able to states will­ing to im­ple­ment one or more of 14 evid­ence-based home vis­it­ing pro­grams. In the years since, even states that have loudly re­jec­ted core fea­tures of the ACA — such as the Medi­caid ex­pan­sion — have jumped at the money, vol­un­tar­ily de­vel­op­ing or ex­pand­ing a range of in­ter­ven­tions.

Some of the pro­grams send nurses in­to the homes of first-time moth­ers and wo­men with his­tor­ies of de­liv­er­ing pre­ma­ture or low-birth-weight ba­bies to mon­it­or their health closely dur­ing preg­nancy and help moth­ers ad­dress everything from high blood pres­sure to the causes of el­ev­ated stress. Oth­ers de­ploy so­cial work­ers and less-cre­den­tialed com­munity-out­reach work­ers to fam­il­ies liv­ing in com­munit­ies where poverty and its of­ten-in­dis­tin­guish­able causes and symp­toms — low-qual­ity schools, crime, drugs, un­em­ploy­ment, and in­car­cer­a­tion — have shaped gen­er­a­tions.

A cor­nu­copia of data ana­lyzed by child de­vel­op­ment ex­perts, eco­nom­ists, and child ad­voc­ates af­fil­i­ated with Har­vard, Yale and Cor­nell Uni­versit­ies as well as the Uni­versity of Chica­go may ex­plain why. Re­search­ers have con­firmed that these pro­grams boost child health, re­duce ab­use and neg­lect, boost par­ti­cip­at­ing fam­il­ies’ eco­nom­ic well-be­ing, and help chil­dren ar­rive bet­ter pre­pared for school.

To sup­port­ers, home vis­it­ing pro­grams are the Swiss Army knives of so­cial policy and should be a key fea­ture of any plan to make Amer­ica more com­pet­it­ive and re­duce in­equal­ity. Polit­ic­al sup­port for evid­ence-based home vis­it­ing pro­grams is so broad-based that in March, the na­tion’s fre­quently dead­locked Con­gress ap­proved a six month fund­ing ex­ten­sion. The move will keep the pro­grams op­er­at­ing un­til next year.

In Mem­ph­is, just whom that fund­ing might reach is clear. “Juice, juice, juice,” Dar­nell Jr. chants as Givens enters the apart­ment. There’s none of the tell­tale middle-class clut­ter of fam­il­ies with young chil­dren. There are no clusters of toys, no rub­ber play mat or shelves over­flow­ing with books or baby equip­ment.

Givens put the zip-top bag on the liv­ing room cof­fee table, near the spot where Dar­nell Jr. is busy test­ing the lim­its of his sippy cup. Tak­ing a seat on the couch, Givens opens her bind­er and spreads out a few work­sheets.

“Ok, let’s hear it,” Givens says.

“I got a job,” Bowen tells her, smil­ing broadly.

“You know we couldn’t wait to tell you Ms. De,” says Log­wood, Bowen’s girl­friend of six years. “You are like fam­ily.”

Dur­ing the ex­change, Dar­nell Jr. aban­dons the sippy-cup pro­ject and be­gins shak­ing the bag.

“Oh my good­ness,” says Givens. “That is just great! I knew it would hap­pen.” She switches seam­lessly from en­cour­age­ment to ob­ser­va­tion. “Now, Mom, Dad, do you see what Ju­ni­or is do­ing? This is the kind of activ­ity that builds his aware­ness of sounds and lets him work on those gross and fine mo­tor skills that a curi­ous and in­creas­ingly mo­bile 18-month-old needs.”

Re­turn­ing her at­ten­tion to Bowen, Givens says, “Okay, now, Dad. Tell me about it. What kind of job?”

The con­ver­sa­tion is an ex­em­plar of Giv­en’s work with the fam­ily. She’s there to help Log­wood and Bowen un­der­stand their son’s emo­tion­al, phys­ic­al, and in­tel­lec­tu­al needs. But she also cov­ers some deeply sens­it­ive and per­son­al top­ics that can be closely con­nec­ted to fam­ily well-be­ing: birth-con­trol op­tions, fin­ances, com­mu­nic­a­tion, and ef­fect­ive dis­cip­line. To cre­ate the best en­vir­on­ment for Dar­nell Jr., Givens has helped the par­ents identi­fy fin­an­cial and oth­er goals.

For the fam­ily, the struggle for fin­an­cial solvency can of­ten get in the way of what they want and need to do to help the tod­dler de­vel­op. Log­wood, Bowen, and Dar­nell Jr. have spent much of the past year couch-surf­ing, stay­ing with fam­ily and friends. When both par­ents lost their jobs last year, un­paid rent forced them to leave their apart­ment. Each grew up in what Givens de­scribes as troubled fam­il­ies where their health, safety, and de­vel­op­ment were not con­sist­ent pri­or­it­ies.

Log­wood and Bowen each de­scribe them­selves as “af­fil­i­ated,” Mem­ph­is-speak for loy­al to but no longer con­sist­ently act­ive in gangs. They have also weathered in­ter­mit­tent waves of de­pres­sion and grief over the past few years. Long­wood’s first preg­nancy ended with a mis­car­riage at sev­en months gest­a­tion. The healthy birth of Dar­nell Jr. was an oc­ca­sion for cel­eb­ra­tion, but Log­wood’s third preg­nancy ended less than two months ago when she mis­car­ried twins.

“To me, this fam­ily is really em­blem­at­ic of what this pro­gram is all about,” Givens says back in her of­fice after the vis­it. “Their life in­cludes lots of sad real­it­ies, rolled in­to one. But the same love and hope that so many people have for their chil­dren is there. They just need the tools, a little something to get Ju­ni­or where he is per­fectly cap­able of go­ing.”

What We're Following See More »
Mueller's Team Down to 10 Lawyers
1 days ago

"Mueller’s team, once filled with 17 lawyers, will soon be down to 10. The special counsel’s office confirmed in recent days that Zainab Ahmad’s detail has ended, and Andrew Weissmann will soon be leaving for the private sector. No one has been charged by the special counsel since longtime Trump adviser Roger Stone was indicted in January for allegedly lying to Congress."

Rosenstein Not Leaving DOJ Yet
2 days ago
Prosecutors Weighing Whether to Charge Greg Craig
3 days ago

A long-running federal investigation into former Obama White House counsel Gregory Craig "is reaching a critical stage, presenting the Justice Department with a decision about whether to charge a prominent Democrat as part of a more aggressive crackdown on illegal foreign lobbying." Federal prosecutors in New York have transferred the case to Washington. ... The investigation centers on whether Mr. Craig should have disclosed work he did in 2012 — while he was a partner at Skadden, Arps, Slate, Meagher & Flom — on behalf of the Russia-aligned government of Viktor F. Yanukovych, then the president of Ukraine. The work was steered to Mr. Craig by Paul Manafort."

Feds Raided Broidy's Offices Last Year
3 days ago

"Federal authorities raided the office of Republican fundraiser Elliott Broidy last summer, seeking records related to his dealings with foreign officials and Trump administration associates, according to a sealed search warrant obtained by ProPublica. Agents were authorized to use the megadonor’s hands and face to unlock any phones that required fingerprint or facial scans."

House Approves Resolution to Release Mueller Report, 420-0
1 weeks ago

"The House on Thursday overwhelmingly passed a resolution calling on the Justice Department to make special counsel Robert Mueller’s findings and full report public and available to Congress. The 420-0 vote came after a fiery debate on the House floor, during which some Democratic lawmakers were admonished for their criticisms of President Donald Trump. Republicans said the resolution was unnecessary and a waste of time, but ultimately joined Democrats to approve it. Four Republicans — Reps. Justin Amash of Michigan, Matt Gaetz of Florida, Paul Gosar of Arizona, and Thomas Massie of Kentucky — voted 'present.'"


Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.