Dispatches from the field: Family-centered policies help children thrive

“All our work builds on the science of the developing child. That science is very clear that the experiences during the prenatal period of the developing fetus, as well as the mom and of all the caregivers in that expected child’s life, are central to a healthy start. And we know the most rapid and sensitive period of development is in that prenatal and first three-year period. Our work with states is built on the premise that if they want to get the most from their investments in children’s development, they should invest when children are developing the most.” – Dr. Cynthia Osborne

Interview with Dr. Cynthia Osborne

Tell us about the work you do and the journey that brought you to where you are today.

I’m a professor of early childhood education and policy at the Peabody College at Vanderbilt University. I’ve always wanted the work I do to have an influence on actual people’s lives. My research has been very applied, with the goal of trying to understand more about how families, communities, and policies can intersect to improve the wellbeing of children, and of course parents and other caregivers as well. I’m a former teacher and I chose teaching because I was convinced it was the schools that would be the great equalizer. I’m from a very working-class background and the opportunities I had in school provided me a path forward that I wouldn’t have been able to find on my own. I thought, “well, that’s the answer then for kids.” But I saw very quickly there was so much more going on in children’s lives than what was happening in the schools. That’s when I decided I wanted to look at how schools, medical institutions, childcare, and social services all intersect within our community and with our public policies and how they can create more equitable outcomes for children.

Once you came to this decision, how did you pursue this field of inquiry?

I decided to study public policy and went to Harvard’s Kennedy School. This was in 1997, right after the welfare reform legislation of 1996. Many of the folks who had resigned to protest President Clinton signing that bill were teaching at the Kennedy School and I wanted to be part of the conversation and learn about how our social policies could benefit families. Then I did a doctorate at Princeton with Sara McLanahan, who was launching the Fragile Families and Child Wellbeing Study at that time. As a student, I was able to work on that project, which was an incredible experience.

You run the Prenatal-to-3 Policy Impact Center housed at Vanderbilt University. Why have you chosen to focus specifically on this time period?

The Prenatal-to-3 time period was chosen not because it’s the only time period that matters, but when the Center began it wasn’t something that everyone else was focusing on. A lot of organizations were looking at what was happening from the time of birth until children reach preschool age, a lot of folks were focused on three- and four-year-olds, and a lot were focused on K-12. All our work builds on the science of the developing child. That science is very clear that the experiences during the prenatal period of the developing fetus, as well as the mom and of all the caregivers in that expected child’s life, are central to a healthy start. And we know the most rapid and sensitive period of development is in that prenatal and first three-year period. Our work with states is built on the premise that if they want to get the most from their investments in children’s development, they should invest when children are developing the most. That’s why we chose to focus there. It’s not that we don’t think that the subsequent age ranges are important. They’re absolutely important.

Since you’ve been in the field, what would you say are some of the most significant changes you’ve seen in research or practice?

One change I have seen in the field is much greater understanding that there is not one policy or program or institution that can do it all to support families. I have seen a lot more coordination and collaboration and thinking across systems. This is happening within states. Policies that were traditionally not thought of as ”early childhood,” like minimum wage, Earned Income Tax Credits, or paid family leave are being accepted in the early childhood space — in addition to things like childcare and home visiting — as important policies that affect families of young children.

What do you think led to this collaboration and coordination across systems?

Our old way was clearly not working, and folks had to finally admit they need to work with others. Folks have been able to understand that it’s not only parenting skills, but it’s also food, housing, and social networks that families need. I think there’s been recognition from folks who implement programs that by working collaboratively and centering the family they can better serve families and meet their needs. The facilitator in this regard has to be the funders, meaning that the federal and state governments have to support this coordination and even require it. In the past, they inadvertently put up barriers preventing systems from collaborating. If we could start to think about how healthcare systems, childcare systems, schools, social services, religion, and other social networks all coordinate to better meet the needs of the children and families then we can think of how funding can reflect that.

Are there other shifts you’ve seen in the field?

The other fundamental shift in the field is a focus on equity from both a research and implementation perspective. In the past, we often thought we were doing work with an equity lens. We were controlling for race/ethnicity and we were taking into consideration the voices of folks benefiting or living with these policies. But now we have a much better and growing understanding of what it means to do research with an equity lens, including thinking about how racism leads to different outcomes. This means understanding the history of our policies and how that history lingers and creates different experiences today. It’s important that scholars lay out a theory of change that incorporates racism.  As researchers, we also must be mindful of the burden we often place on communities and families in an effort to hear from them and incorporate their lived experience. Their understanding play a critical role in how we shape our research questions and methods, so we need to treat them as the content experts they are and pay them as we do any other consultant.

How does the Prenatal-to-3 Policy Impact Center’s Equity Initiative grapple with these questions?

Our Equity Initiative has an internal and external component. Internally, we are training ourselves on the kinds of things I just discussed. We’re exploring, reflecting upon and accounting for our own biases. We’re building a diverse and inclusive workplace because we value a team that brings unique and varying perspectives to our work. For our external facing work, our goal is to better understand the different impact state policies have had and often still do have on racial, ethnic and socioeconomic groups and identify solutions that will reduce long-standing gaps. We want to understand how and why policies aimed at supporting young children and families may be impacting groups differently through a review of the most rigorous research to date and by interviewing folks in the states who are both responsible for implementing these policies and who are being impacted by them.

Through the Prenatal-to-3 Policy Impact Center’s website states can access state-specific policy roadmaps. How have you seen states use this resource?

By using the State Policy Roadmap, a state can determine the most effective policies to help them to meet their goals, how they are doing toward implementing these policies, and, ultimately, how successful they are in changing outcomes of families in their state. States are using it in myriad ways, and we are learning from them what is most helpful. A couple of states have used the roadmap as their policy agenda or to build upon their current list of priorities. They’ve also used the data to understand how current policies interact to either build upon or weaken their intended impact. We’ve also used the data to evaluate the potential impacts of new policy being considered.  As an example, we worked with partners in Pennsylvania to estimate the costs of a proposed refundable state Earned Income Tax Credit of at least 10% and up to 25% of the federal credit. We were able to illustrate that a refundable EITC in Pennsylvania at 10% of the federal credit would have a 7 to 1 return on investment.

They’re using that information as they’ve introduced legislation for an EITC. We’re just educators. We are not lobbying for any particular bill, but we are always happy when states use our information to inform policy discussions or priorities. We’re working with New Mexico now as they have just implemented a range of policy enhancements for their childcare subsidies. We want to better understand how that will help stabilize the childcare market and improve the well-being of childcare teachers, as well as improve families’ access to more affordable and higher-quality care —all of which should improve children’s outcomes over the long-term.

Once a policy is implemented, do you work with local researchers in that state to measure the impact over time?

In addition to our policy team, we have a research and evaluation team at the Policy Impact Center. Their goal is to enhance the existing evidence-base. We do program and policy evaluation ourselves. We’re also tracking evaluation work by others in the field.

We want to add more policies to the roadmap if more turn out to be effective. The child allowance is one we’ve been tracking for a while now. The United States did it for only six months, but it made a big difference in children’s food security and the levels of those living in poverty. We’re following other sorts of policy changes as well, like the introduction of community doulas on which New Jersey is leading the way.

We also track states’ adoption and implementation of policies. There are states that have wide variations on levels of generosity or reach of a particular policy. We are trying to learn from states what allows them to reach more families who are eligible for a benefit or whether families are substantially better off with higher levels of a benefit.

Your Prenatal-to-3 Policy Impact Center has been housed at two universities over time — the University of Texas at Austin and now Vanderbilt University in Tennessee. What role can higher education play in the field of child and family health?

It plays two different and important roles. One, is to facilitate new knowledge and to be flexible in how we generate and share that knowledge. Traditionally, in higher education the thinking has been, “let’s do this rigorous study and publish it in a top journal.” The findings may trickle down into the field and something might actually be of use. There is a switch at some universities in which doing research that matters is a core value. Having that in mind as to why you’re trying to advance knowledge and practice from the start is an important institutional goal.

The other way higher ed can and should advance this field is through training. Our institutions can train the next generation of folks who will care for families across the spectrum, whether in healthcare, childcare, social services, or social work. Institutions can ensure that people going into these fields understand the science, that children’s’ development is influenced by their environment, and that through their future work they will need to create the conditions in which children can thrive.

What keeps you up at night and what makes you hopeful?

One of the things I am hopeful about is that we have seen an infusion of resources and energy in the early childhood space.

The pandemic has revealed to so many that we need to care for our children. We need to care for our families. There’s been a greater understanding of what families need and how public dollars can help to support that. That said, it keeps me up at night that we aren’t making these investments permanent, and that we may have a short memory and go back to expecting families to carry this water by themselves.

One reasons folks don’t always work together is the competition for scarce resources in this field. If funding goes to home visiting, then it’s not going to Early Head Start. If it goes to one of those, it’s not going to early intervention, or we can forget about childcare subsidies.

This idea of infusing additional dollars into our system so these programs can play the important role we need them to in the lives of our children and families is really what we need. If we don’t make these investments permanent, we’re going to go back to that competition for scarce resources.

Let’s take a step back and think about the economy and national security in the US. If the economy is going south in any way, or if there’s a national security threat the government immediately steps in to help moderate any potential negative impacts. Our goal is to make sure we can provide safety for Americans and security around the globe. What if we were thinking about that with kids, and we asked, “Are the kids all right here?” It would be ideal if we thought of children with the same level of care, interest, and intentionality that we do with other important national interests.

You recently moved to Nashville. How are you enjoying your new location?

I’ve been in Nashville now for three weeks, so it’s very recent. I started at Vanderbilt in January and worked remotely until the first of May. Now, I am physically here. It’s just lovely. I am loving my new colleagues and my new university, and my new town. It’s a warm and welcoming community. We do have some work to do in Tennessee, just like we had to do in Texas and elsewhere. I like to make sure I live some place where I’m needed.