Protecting the Building Blocks of Early Learning: An Urgent Priority.

Protecting the Building Blocks of Early Learning: An Urgent Priority.

For those who missed it on May 26, here is the webinar recording and slide deck for Protecting the Building Blocks of Early Learning: An Urgent Priority. 

Hosted by The Campaign for Grade Level Reading, this webinar features our own Elena Rivera, senior health policy and program advisor at Children’s Institute.

Here’s the summary from GLR:

In this special GLR webinar, Dr. Jacqueline Jones of Foundation for Child Development moderated a conversation exploring the impact of the COVID-19 pandemic on young children and strategies and resources that can help support children’s emotional well-being.

Dr. Pamela Cantor, the Founder of Turnaround for Children, discussed the “COVID paradox” in which the physical distancing that keeps us and others safe can threaten the social connections that help us manage stress and build resilience. She explained the impacts that stress — and the resulting cortisol — can have on brain development but emphasized that positive relationships — and the resulting oxytocin — can protect children and help them manage stress and build resiliency. Cantor underscored the importance of context on brain development and explained how, to be effective, our education system needs to support the whole child and the learner inside that child. She outlined the five non-negotiables for whole-child design: Positive Developmental Relationships; Environments Filled with Safety and Belonging; Integrated Supports; Intentional Development of Critical Skills; Mindsets and Habits; and Rich, Instructional Experiences for Children. She discussed the Building Blocks for Learning framework and explained how the three R’s — Relationships, Routines and Resilience — can support healthy development, learning and stress management, both while children are at home and when they return to school.

Dr. Philip Fisher of the Center for Translational Neuroscience at the University of Oregon shared how he launched Rapid Assessment of Pandemic Impact on Development – Early Childhood (RAPID-EC) to gather and share real-time information about the challenges facing families of young children during this crisis. A weekly survey of a nationally representative sample of over 1,000 households with at least one child under age 5, RAPID-EC has uncovered significant increases in caregiver stress and decreases in family income with many respondents also reporting difficulties in paying for basic necessities and delays in seeking health care services. While the effects of the COVID-19 pandemic are widespread, Fisher shared how low-income households and those in which a child has a disability are reporting much higher rates of mental health difficulties. Survey reports are posted each week to help inform public and private responses to the crisis. While many of the issues underlying the survey responses predate the pandemic, Fisher suggested that the findings can help leaders transform the early childhood system, making quality care and supports more accessible.

Elena Rivera of Children’s Institute shared her reflections on the presentations, highlighting the themes of the importance of families and relationships, the existence of disparities that must be addressed and an urgency to act now. She explained that this crisis offered the opportunity to “build back better” by holding families at the center, focusing on equity and taking action now. She encouraged webinar participants to lift up both stories and data to make the case for change, to connect with people through action and to build a movement to advance systems change for young children and their families.

Dr. John Kitzhaber on Health Care Transformation

Dr. John Kitzhaber on Health Care Transformation

In this episode of the Early Link Podcast, we speak with Dr. John Kitzhaber, a physician and previous governor of Oregon, about ways to improve our health systems and re-frame the national healthcare debate.

Dr. John Kitzhaber is well known in Oregon and across the country for his expertise on health care and health policy. He has practiced as an emergency physician, served for 14 years in the Oregon legislature, and completed three terms as governor of Oregon. Through his service, he authored the Oregon Health Plan and was the chief architect of the state’s Coordinated Care Organizations.

The Oregon Health Plan (OHP) provides health care coverage for low-income Oregonians from all walks of life. This includes working families, children, pregnant women, single adults, seniors, and more.

Coordinated Care Organization (CCO) is a network of all types of health care providers who are working together in their local communities to serve people who receive health care coverage under the Oregon Health Plan (Medicaid). CCOs integrate physical, mental, and dental care with the goal of better health, better care, and lower costs. CCOs focus on prevention of illness and disease and improving care. This helps reduce unnecessary emergency room visits and gives people support to be healthy.

Additional Resources

Children’s Institute Health and Learning Initiative

Reframing the 2020 Health Care Debate by Dr. John Kitzhaber

CCO Health Innovations Support Early Learning Goals

Early Mental Health Support Is Vital

Early Mental Health Support Is Vital

Writing in The Oregonian today, CI’s Senior Health Policy & Program Advisor Elena Rivera argues for the importance of programs and services to support early childhood mental health.

Research tells us that children who suffer from abuse, neglect or trauma—especially those facing additional barriers such as poverty—are more susceptible to mental health issues. Early intervention is effective and shows lasting benefits.

Expanding early screening for mental health issues; providing adequate training for people who work with infants, toddlers and their families; integrating mental health consultation and programming into child health and education services; and making sure insurance policies include mental health treatment for our youngest are all ways we can improve the network of support for our youngest children.

5 Things to Know About Infant and Early Childhood Mental Health

5 Things to Know About Infant and Early Childhood Mental Health

Advocates for children’s mental health envision a comprehensive network of supports for children and families that begins with mothers at the prenatal stage and continues throughout an individual’s lifetime. That’s reflective of continuing research which demonstrates that children who enjoy good health—including mental health—are better prepared for school and life.

Yet, general understanding of infant and early childhood health is still at an emergent stage. That’s partly because diagnostic classification of mental health and developmental disorders in children under 5 did not exist until 1996. While treatment and payment protocols have been established in Oregon since then, more work is needed to integrate infant and early childhood mental health into the larger array of available services and supports for families and children.

Here are five answers to questions about infant and early childhood mental health in Oregon:


What does mental health in an infant or toddler look like?

Social and emotional health in the youngest children develops within safe, stable, and attached relationships with caregivers. Children who have positive and engaging interactions in their earliest years are more likely to enjoy good physical and mental health over their lifetimes. They are also better able to experience, regulate, and manage their emotions—key skills for later school readiness.

What types of mental health issues and disorders do young children suffer from?

Children who suffer from abuse, neglect or trauma—especially those facing additional barriers such as living in poverty—are more susceptible to mental health issues, including attachment and emotional regulation disorders and other developmental or psychological disorders.

Laurie Theodorou, Early Childhood Mental Health Specialist at the Oregon Health Authority (OHA), says very young children can also suffer from the same disorders that affect older children.

“Depression and anxiety can be seen even at the pre-verbal level. Though they can be harder to diagnose, young children respond well to therapy that includes their parent,” she said.

She’s also careful to note that mental health issues and disorders are not limited to situations related to maltreatment. “It’s important to de-stigmatize mental health and mental health treatment… Parents can be doing everything right and still need additional help for their child’s social emotional or behavioral problems.”

How are infant and early childhood mental health issues treated?

Proper screening and assessment are key to identifying and treating young children who are at risk for or suffering from mental health issues or disorders.

Treatment for mental health issues and disorders can be provided in a variety of home and clinical settings. Evidence-based treatments are family-centered and use attachment-focused approaches, including infant-parent psychotherapy, Parent Child Interaction Therapy, and psychoeducation.

Source: The Oregon Children’s System Advisory Council (CSAC) 2015; Early Childhood Workgroup. Adapted from TACSEI, and April 2015

What policy strategies can help improve outcomes for young children?

Researchers Joy D. Osofsky of Louisiana State University, and Alicia F. Lieberman of the University of California, San Francisco, recommend four actions to improve awareness and action on early childhood mental health issues:


  • Expand early screening for infants and toddlers to detect mental health issues.
  • Train professionals in mental health, pediatrics, early childhood education, child welfare, and other related professions to recognize risk factors; and ensure that undergraduate, graduate, and continuing professional education include content on infant mental health.
  • Integrate infant mental health consultations into programs for parents, child care, early education, well-child health services, and home-based services.
  • Address insurance and Medicaid payment policies to provide coverage for prevention and treatment of mental health issues for infants and toddlers.

How is Oregon working to improve public policy and practice for infant and early childhood mental health?

Oregon’s efforts to build a system of care for infant and early childhood mental health have been steadily building. For example, Oregon’s adoption of developmental screening as an incentive metric for Coordinated Care Organizations has increased the numbers of children identified for further assessment. The creation of a diagnostic crosswalk—a guide that aligns multiple diagnostic classification manuals—has also made it easier for providers to be reimbursed for mental health treatment.

More recent and upcoming developments include the planned roll-out of universally offered, voluntary home visiting in Oregon, and Project Nurture, an integrated model of maternity care and addiction treatment for pregnant women with substance use disorders.

A number of workforce-related efforts have strengthened the existing network of support for Oregon’s youngest children. OHA and the Oregon Infant Mental Health Association have partnered to offer an infant and early childhood mental health endorsement for early care and education and mental health professionals. An infant/toddler mental health graduate certification is available at Portland State University and the school has also introduced a new, two-year scholarship program to study rural infant mental health with funding from The Ford Family Foundation.

Raise Up Oregon, the state’s early learning systems plan, and the passage of the Student Success Act also promise to bring more attention and resources to the ultimate goal: a network of support for all children beginning at the prenatal stage which sets children up for future academic and lifetime success.



We Need a Comprehensive Approach to Childhood Adversity

We Need a Comprehensive Approach to Childhood Adversity

In the 20 years since the first study into Adverse Childhood Experiences (ACEs), health care professionals, educators, and policy makers have become increasingly aware of the long-term consequences of exposure to adversity on children’s health and development. As state lawmakers increasingly call for routine screenings of children to identify ACEs, Child Trends has released a new report cautioning about the limitations of a screening-only approach and providing recommendations to address childhood adversity that go beyond screening. 

Titled “Childhood adversity screenings are just one part of an effective policy response to childhood trauma,” the report offers the following strategies to more effectively address ACEs: 

  • Train service providers across child and family service systems in trauma-informed care.
  • Promote adversity screening only as one component of a comprehensive, trauma-informed, strengths-based approach to addressing childhood adversity.
  • Support research to develop more sensitive tools for assessing adversity exposure in young children.
  • Increase the availability and accessibility of evidence-based therapies.
  • Implement preventive strategies that reduce the likelihood of early adversity and its harmful effects on children and promote resilience in development. 

Elena Rivera, Children’s Institute’s senior health policy & program advisor, explains the connection between this new report and our health work: 

Children’s Institute believes that all children deserve the best start in life, and we are working across systems, policies, and programs to ensure all children have access to supportive early environments and relationships that prevent adversity, as well as services to address and mitigate the harmful long-term effects of adversity that children have already faced. Children’s Institute and our partners successfully advocated for a historic state investment in early childhood and family support services in the 2019 legislative session, many of which seek to address the root causes of child adversity and provide essential support to families. In addition, through our Health and Learning Initiative we are collaborating with partners to improve health care service delivery and coordination for children. Our goal is to ensure all children have access to health care that supports their physical, oral, and social-emotional well-being in the first few years of life, when children’s foundation for all future learning is being laid.

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