Executive Summary
Overview
I. Snapshot of the Federal Research Portfolio
II. Gaps in the Knowledge Base: Examples of Research Opportunities
III. A Key Element of the Research Enterprise: Links to Policy Makers and Service Providers
IV. Next Steps: Options for Phase Two of the Children's Initiative
Endnotes
Appendix A: Subcommittee on the Children's Initiative
Appendix B: Methodology
Appendix C: Selected Bibliography
Appendix D: Examples of Successful Research-Policy or Research-Services Linkages Submitted by Agencies
Numerous indicators of the well-being of our children and families paint a mixed picture of successes and shortcomings. Our national infant mortality rate is declining rapidly and is at a record low, but is still higher than that of many other countries. Our children's test scores in reading and science are improving but still trail those of several other industrialized nations. Our school dropout rate is unacceptably high, costing over $250 billion each year in lost earnings and foregone taxes, as well as lost human potential. Our teenage pregnancy rate is declining slightly, but is still the highest in the developed world. Our national vaccination coverage is the highest ever, but in many communities less than 50 percent of two-year-olds are adequately immunized. A similar picture of gains and unmet goals exists with respect to youth violence, child poverty, smoking, and other substance abuse.
Much of the progress achieved in these and other areas is the result of critical research efforts that have advanced our understanding of how children and youths develop into healthy and productive individuals. Research has helped to inform policy decis ions and program development, track outcomes, and identify strategies that work and those that do not. The Federal investment in research has clearly paid dividends in terms of improved outcomes for children and a healthier and brighter outlook for the entire Nation. Despite such important achievements, much remains to be done: Significant gaps persist in our understanding of how children grow up to be healthy, well-educated, and responsible members of society. Given the profoundly changing nature of our communities and Nation, strengthening the Federal research enterprise on child and adolescent development and expanding its role in shaping relevant policy are especially crucial to serving national goals.
Given the complexity of influences on child and adolescent development, improved connections between researchers and those who develop policies and programs concerning the future of young people must be an essential part of the Federal research strategy. These connections should be thought of in terms of a continuing feedback system, with multiple entry points for feedback and modification in the decisionmaking process at the Federal, State, and local levels. Such a strategy would enable researchers not only to inform initial policy and program development, but also to monitor and evaluate the implementation of these policies and programs -- and their effects on child, adolescent, and family status -- on an ongoing basis. Sustained research could provide knowledge that is essential in our effort to further shape and refine policies and programs so that they more effectively address the problems facing our children and Nation.
Increased multi-agency collaboration and coordination of research on national priorities related to children's health, education, and well-being are essential steppingstones to success. Just as linkages should cut across public and private sectors and span all governmental levels, the Federal Government's collaborative approach should also strive to tap the knowledge and experiences of the private sector, including foundations and private industry. Strategic partnerships with interested public and private sources will be instrumental to addressing the current and emerging needs for relevant data and knowledge concerning children and adolescents.
A specific linkage issue is how the Federal research investment in child and adolescent development can be more effectively used to inform our Nation's domestic policy. Two fundamental questions are involved. The first is how to create and strengthen the linkage between two key councils within the Executive Office of the President -- the National Science and Technology Council (NSTC) (which coordinates the diverse parts of the Federal research and development enterprise) and the Domestic Policy Council (DPC) (which oversees the development and implementation of the President's domestic policy agenda), in a way that fosters important research and uses the results of that research to guide policy development. The second is how to use this linkage between NSTC and DPC to create effective collaboration among Federal agencies that support research on children and adolescents.
Our Nation has a clear stake in ensuring that all of America's children grow up to be healthy, educated, productive, and contributing adults. Doing so requires removing barriers to achieving their full potential, including the barrier of insufficient knowledge. Scientific research is and will continue to be a catalyst for achieving that goal; it serves as a fundamental tool to gain knowledge needed for informing, developing, implementing, and refining policies and programs that address the urgent needs of children and adolescents. As such, research must be at the forefront of the highest level of decisionmaking. The Federal Government is faced with an opportunity to embark on a path that will lead to creating and sustaining conditions that optimize human development. It is time to take that first step -- to establish a coordinated multi-agency research approach that emphasizes partnerships among the public and private sectors and linkages between the research and policymaking communities. We owe our children, our families, and our Nation nothing less than this sound investment in our future.
At the same time, too many of our children, adolescents, and their families face obstacles that obscure that bright future, including poverty, violence, child abuse, inadequate education, and substance abuse. Addressing these challenges to their future and investing in opportunities to ensure that all children reach their full potential is a central priority of the Administration. The devastating economic and social costs of not responding to these challenges for both individuals and society are indisputable.
The Administration's commitment to children and youth was demonstrated in its first term. It launched a number of initiatives critical to children and youth, including increasing Head Start enrollment by almost 200,000 in 1997, curbing the sales and marketing of tobacco to children (the Children's Tobacco Initiative); reducing teen pregnancy rates; providing safer food and drinking water; and expanding opportunities for children to improve their skills, maximize their potential, and prepare for the 21st century workplace (the Educational Technology Initiative, the America Reads Initiative).
Due in part to these efforts and the President's commitment to "cherish our children and strengthen the American family," the Nation has taken some modest but significant steps toward addressing these daunting challenges. Progress in these areas must often be measured incrementally. Solutions and knowledge of their effects and influence often take years or even generations to emerge. Still, it is important to acknowledge our successes. For example:
Infant Mortality2 | |
What We Have Accomplished: | The infant mortality rate reached a record low of 7.5 infant deaths per 1,000 live births in 1995, a 6 percent decrease from the previous year. |
Challenges that Remain: | The U.S. still has one of the highest infant mortality rates of any developed country; in some urban areas it exceeds some developing countries. From 1985 to 1994, the rate of low birth weight babies steadily increased. Low birth weight infants account for nearly two-thirds of all deaths under 28 days of age; those babies who survive are at increased risk of suffering severe physical and developmental complications. |
Education3 | |
What We Have Accomplished: | American fourth graders outperformed students from all other nations, except Finland, in the latest International Assessment of Reading, while American eighth graders have demonstrated rising math and science scores in recent years. |
Challenges that Remain: | Despite our national goal of being first in the world in math and science by the year 2000, U.S. eighth graders scored below the average of 41 countries in the math portion of the 1995 Third International Mathematics and Science Study (TIMSS). In science, students in nine countries outperformed U.S. eighth graders. In 1994, 40 percent of fourth graders failed to attain the basic reading level, while 70 percent did not attain the proficient level (i.e., competency with challenging reading materials). Poor reading performance is an important predictor of school dropout. Each year's class of dropouts will, over the course of its lifetime, cost the Nation about $260 billion in lost earnings and foregone taxes, in additional to lost human potential. |
Teen Pregnancy4 | |
What We Have Accomplished: | The teen birth rate declined in 1995 for the fourth straight year, while the unmarried birth rate has decreased for the first time in nearly two decades. |
Challenges that Remain: | The teen birth rate is still higher than it was 20 years ago and the U.S. rate remains the highest in the developed world. Every year about one million adolescents become pregnant, most of whom are unmarried teens. |
Immunization 5 | |
What We Have Accomplished: | In 1995, three-quarters of all two-year-olds were fully immunized -- a historic high. The incidences of Haemophilus influenzae type b invasive disease, symptomatic hepatitis B, and measles among infants in the highest-incidence groups have been reduced by over 95 percent. |
Challenges that Remain: | Vaccine coverage among the economically disadvantaged in inner-city areas is about 50 percent. Public health measures require an immunization rate of 80 to 90 percent of all children to prevent the spread of outbreaks. |
IMMUNIZATION |
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Youth Violence6 | |
What We Have Accomplished: | The juvenile crime arrest rate decreased approximately 3 percent in 1995, while the juvenile murder arrest rate dropped more than 15 percent, marking the largest one-year decrease in more than a decade. |
Challenges that Remain: | Our Nation can do better. In 1995, the cost of maintaining our prison system reached about $50 billion; in some States, prison system costs exceed the cost of supporting the State's higher education system. It is less costly to educate than to incarcerate. |
Child Poverty 7 | |
What We Have Accomplished: | Since 1993, the child poverty rate has declined from approximately 23 percent to 21 percent - the biggest two-year drop since 1968. And with the recently passed Personal Responsibility and Work Opportunity Reconciliation Act of 1996, the stage is set for a fundamental reconstruction of the welfare system, giving States increased flexibility to move families off welfare. |
Challenges that Remain: | Much more progress is needed to reduce poverty and its short- and long-term impacts. Children living in poverty more often are inadequately nourished, live in overcrowded and unsafe environments, and experience academic underachievement, violence, and greater unemployment of adult family members. |
OVERCOMING ADVERSITY: IT CAN BE DONE8 |
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Smoking and Substance Abuse9 | |
What We Have Accomplished: | Beginning in the early 1980s, the number of teens who smoked, used marijuana, or consumed alcohol declined or remained flat - for about a decade. |
Challenges that Remain: | While use has not returned to peak levels of the 1970s, teenage tobacco and drug use has continued to climb over the last several years, and alcohol use remains unacceptably high. More than five million of today's underage smokers will eventually die because of tobacco-related illnesses and if current patterns of teen smoking persist, their health needs will cost about $200 billion in health care alone. Alcohol and drug use is a major factor in injuries - in particular, motor vehicle injuries, which are the leading cause of death for persons every age from 6 to 27 years, again exceeding rates for every other developed country. |
Alcohol-Impaired Driving | |
What We Have Accomplished: | Young drivers age 15 to 20 have historically represented a high risk group, involved in more fatal crashes per licensed driver than drivers of any other age group. Alcohol has been a major factor in these fatal crashes. Efforts to reduce the alcohol-related fatal crash rate for young drivers have proven successful: from 1982 through 1995 these fatalities for young drivers declined by 59 percent, while adult alcohol-related fatalities dropped by 28 percent. |
Challenges that Remain: | While this is good news, other reports are disturbing. How long can this decline continue when drinking and drug use are on the rise? Even if the current rate holds, population increases among adolescent drivers will mean increased fatalities in coming years. Zero tolerance laws for underage drinking drivers and more active enforcement of underage drinking laws are essential. We need to support efforts by various sectors of the community and young people themselves to curb underage drinking and impaired driving. |
Much of the progress achieved in these and other areas is grounded in critical research efforts that have advanced our understanding of how children and youth grow into healthy and productive adults. Research has helped to inform policy decisions and program development, track outcomes, and identify strategies that work and those that do not. The Federal investment in research has clearly paid dividends in terms of improved outcomes for children and a healthier and brighter outlook for the Nation as a whole.
Consider, as examples, the pivotal role research has played in the development of early childhood education, the reduction and prevention of childhood lead exposure, the reduction and prevention of childhood injuries and iron deficiency anemia, the identification of protective factors that help children overcome adverse conditions such as poverty, and the understanding of how child nutrition contributes to health and educational attainment (see box).
EARLY CHILDHOOD PROGRAMS: THEY CAN MAKE A DIFFERENCE10 |
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Despite such important achievements, the Federal emphasis on research must be sustained. There continue to be significant gaps in our understanding of how children grow up to be healthy, well-educated, and responsible members of their communities and nation. Coordination across the Federal Government as well as among Federal, State, and local governments needs to be improved. Linkages between researchers and policymakers must be strengthened. And changes in policy must be informed by policy-relevant research and assessments. These challenges must be addressed if our Nation is to develop policies and programs that meet the complex needs of today's children and youth. Strengthening the Federal research enterprise on child and adolescent development and its role in shaping relevant policy is especially crucial given the changing nature of our communities and Nation.
The United States is experiencing significant changes in the racial and ethnic diversity of its population, fundamental shifts in the structure of families, and an increasingly global economy that demands a highly skilled workforce to achieve an adequate standard of living. At the same time, our society is undergoing changes in longstanding social policies; these changes include the devolution of responsibility for income support programs (e.g., welfare) from Federal to State Governments and the restructuring of our health care financing system. Our Nation has learned how to invest in and profit from research; now we must extend those efforts to meet the challenges of the next century.
To achieve meaningful progress, research on children and adolescents must be used more effectively to inform our Nation's domestic policymakers. This means the scientific community must better communicate and disseminate significant research findings to policymakers. Policymakers, too, must work with researchers to help identify key questions concerning children, youth, and families that need to be addressed through research.
Understanding the forces that shape young people's development and using that knowledge to influence public policy and service delivery should be a cornerstone of the Federal Government's research enterprise. An example of the successful potential of this process is described in the box in this section. To neglect this fundamental building block risks compromising national goals of security, economic prosperity, and high quality of life for all.
THE UNITED STATES EXPERIENCES DRAMATIC DECLINES IN CHILDHOOD IRON DEFICIENCY ANEMIA11 |
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While Investing in Our Future: A National Research Initiative for America's Children for the 21st Century provides several examples of important research issues concerning children and adolescents, a dynamic research framework and agenda is needed that would involve partnerships among research and policy groups in the Federal Government, in collaboration with non-governmental researchers and practitioners. This report should be considered the first phase of a sustained effort directed towards that end.
Section II, Gaps in the Knowledge Base: Examples of Research Opportunities, provides examples of research needs in understanding children's biological, cognitive, and social development, and a basis for establishing research priorities.
Next, Section III, A Key Element of the Research Enterprise: Links to Policymakers and Service Providers, discusses the need for establishing stronger links among researchers, policymakers, and service providers to develop policies and programs that meet the needs of children and adolescents.
The report concludes with Section IV, Next Steps: Options for Phase Two of the Children's Initiative, which provides recommendations for building on the work of this first phase.
ABOUT THE CHILDREN'S INITIATIVE SUBCOMMITTEE |
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ABOUT THE DATA ANALYSIS |
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The CTI analysis aimed to estimate the Federal portfolio; it is not a comprehensive, in-depth examination of each Federal R&D project related to child and adolescent development.
CTI found that, in fiscal year (FY) 1995, the Federal Government spent an estimated $2 billion on R&D directly related to children and youth. These funds were distributed among 12 Federal departments including eight agencies within the U.S. Department of Health and Human Services (HHS) and 21 funding components within the National Institutes of Health (NIH) and three independent Federal agencies. The National Institute of Child Health and Human Development (NICHD), the National Institute of Mental Health (NIMH), and the Department of Education (ED) account for about half of the research. However, each of the 15 Federal departments and independent agencies has a specific mission for its R&D efforts, which is often linked closely to its service programs, and provides valuable findings to enhance the knowledge base about children and adolescents. A key challenge lies in collecting, analyzing, and synthesizing what this knowledge base tells us about what the Nation can do to ensure the healthy development of all American youth.
There are several ways to put in perspective the estimated $2 billion Federal R&D investment in children and youth. One way is to compare this investment to the total Federal R&D budget, which includes research on defense, energy, health and other topics. Such a comparsion shows that Federal R&D on children represents less than three percent of the total Federal research investment of $71 billion, and about six percent of the $33 billion non-defense R&D budget (Chart 1).
It is equally important to place children's R&D in the context of the Nation's total R&D expenditure--including all levels of government and the private and nonprofit sector. The private and nonprofit sectors provide more total R&D funding than the Feder al Government--an estimated $100 billion in FY95. However, little of this private and nonprofit research is directed toward research on children (excluding product-oriented marketing research). Foundations spent an estimated $75 million on research for children in FY95, and the remaining nonprofit sector and State and local governments probably contributed less than $300 million. Thus, the share of total national R&D directed toward children is less than 1.2 percent.
Unlike other areas of research, the Federal Government bears almost total responsibility for R&D on children. For instance, the private sector provides over 50 percent of health and energy R&D funding and over 90 percent of transportation R&D. In contra st, the Federal Government provides approximately 90 percent of children's R&D. Thus, it is even more essential that the Federal research portfolio be well coordinated across agencies and adequate to address the critical social, educational and health is sues facing children.
A second way to consider the investment in R&D for children is as a proportion of total expenditures on children. The U.S. investment in R&D is between 2 and 3 percent of national expenditures (Gross Domestic Product, or GDP). In the areas of health, en ergy and transportation, the Nation invests between 2 and 3 percent of expenditures in R&D. This R&D commitment of 2 to 3 percent is directed toward making the expenditures in each area more effective and efficient.
In contrast to the 2 to 3 percent commitment in other areas, less than three-tenths of a percent of the expenditures on children is spent for R&D on children. Total government expenditures for children and youth in FY1995 were an estimated $555 billion, almost two-thirds of which was devoted to K-16 education. Most of the remaining funds were allocated for social welfare (including AFDC, Medicaid, Head Start, WIC, and Food Stamps), criminal justice (including police, courts, and prison expenditures), health care, and other programmat ic expenses (Chart 2). Private sector expenditures for children are far larger than public sector expenditures, so our total R&D commitment to children of $2 billion to $2.4 billion is certainly less than three-tenths of a percent of public and private expenditures for children.
Given these comparisons, an obvious question is whether the Nation's investment related to child and adolescent R&D is consistent with our research investments to solve other social, economic, energy, transportation and health problems. Put another way, the estimated $2 billion investment is aimed at understanding the growth and development of 30 percent of the Nation's population--over 80 million children and adolescents under age 21. The lack of dramatic progress on some youth-related problems may stem from having limited R&D funding that must be spread across the spectrum of developmental prob lems arising during the first 20 years of life.
This research investment in children must address not only all developmental issues (social, emotional, cognitive and health) from before birth to age 21, but also a wide range of social issues (such as education, social services, and delinquency). In a ddition, this research seeks not only to address the developmental issues and problems which arise during childhood, but also to uncover the origins of health conditions that are manifested later in life but have their genesis and best hope prevention in childhood. The annual health care cost of four such conditions alone (atherosclerosis, osteoporosis, diabetes, and obesity) exce eds $100 billion.
Younger Americans may benefit from programs for which they are not specifically a target group. The funding for these programs, such as those directed toward general health and family research, is not included in the estimate of the amount directed expli citly at child research.
During discussions to identify illustrative research issues, the Children's Initiative Subcommittee considered the following criteria: the nature and importance of an issue's impact on children, youth, families, and larger society; the degree of public concern about the issue; the extent to which the scientific community is prepared to advance knowledge of this issue; and the potential for improved research understandings to effectively inform policy (i.e., does a "policy window" of opportunity exist?).
Working from the above cross-cutting themes and principles, the Children's Initiative Subcommittee identified six research opportunity areas concerning the development of children and adolescents that merit further exploration in the next phase. These six areas are: (1) influence of families and communities on child and adolescent development, (2) health and behavior, (3) children and environmental hazards, (4) understanding learning, (5) policy research, and (6) longitudinal studies. An overview of each area follows, outlining current knowledge in this area, topics that need to be explored further, anticipated benefits of advancing the knowledge base, and suggestions for which Federal agencies could work together to act on these research opportunities. Taken together, the six research areas create a functional path that enables us to look at all facets -- biological, cognitive, social, and emotional -- of children's development.
These six research opportunity areas should be considered illustrative starting points for thinking about the Federal research investment strategy. They are not meant to be the final word on the Federal research agenda, nor do they represent an exhaustive list of all research questions that will inform policies and programs regarding young people's development. For example, two of the six issue areas -- policy research and longitudinal studies -- cut across the other four areas.
Research leading to reliable, useful indicators of child and family well-being is a key element of any research enterprise; however, this initiative did not address this element because it concluded that there was sufficient current activity in this area by the Federal Interagency Forum on Child and Family Statistics, Partnerships for Stronger Families, and the NICHD Child and Family Well-Being Research Network. Improved communication among these and other related public- and private-sector research efforts should be established to further enhance the knowledge base about children and adolescents.
Research has established that a number of personal behaviors are major determinants of long- and short-term health outcomes in children and youth. For instance, the initiation of unhealthy or risky behavior such as substance abuse (including tobacco use), drinking and driving, early or unprotected sexual intercourse, poor nutritional choices, lack of exercise, violence, not wearing safety belts, and not using bicycle and motorcycle helmets is related to poor outcomes during early adolescence and beyond. Given this knowledge, the Federal Government collects information to indicate the general health and well-being of children and youth. The Youth Risk Behavior Survey, for example, monitors serious health-risk behaviors (e.g., unintentional and intentional injury, tobacco, alcohol and other drug use, sexual behaviors, dietary behaviors, physical activity) that contribute to the leading causes of mortality, morbidity, and social problems among young people.
RAISING THE AGE FOR DRINKING |
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What We Need to Know. Major strides have been made during the past few decades in understanding how health problems of children and youth develop, but the following gaps in our knowledge, while not an exhaustive list, remain:
How Federal Agencies Conducting Research Could Work Together in this Area. The NIH Office of Behavioral and Social Sciences Research is playing a major coordinating role across the NIH to assure that the behavioral aspects of health are well integrated into the Nation's health research enterprise. The National Science Foundation (NSF) supports disciplinary research on the cognitive and decision-making underpinnings of risk perception and behavior. At the same time, other agencies of the Federal Government such as the CDC, ED, USDA and the U.S. Department of Transportation (DOT) are engaged in efforts to promote health and prevent disease and injury. The U.S. Department of Justice (DOJ) supports programs and approaches to prevent and treat violence, now considered a major threat to public health.
Research findings have now established that problematic outcomes in child and adolescent health do not occur in isolation from one another. Health-compromising behaviors, such as poor diet, smoking, and inadequate exercise and fitness, tend to cluster in the same individual. Likewise, health-enhancing behaviors, such as regular use of seat belts, and avoidance of harmful substances such as tobacco, also tend to cluster. This line of evidence indicates that child and adolescent health and behavior initiatives in the future must involve agencies, that, heretofore, have focused on specific health outcomes.
REDUCING CHILDHOOD LEAD POISONING: SIGNS OF PROGRESS14 |
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The Federal Government (including the Environmental Protection Agency (EPA), the National Institute of Environmental Health Sciences (NIEHS), the CDC, the Consumer Product Safety Commission (CPSC), the Agency for Toxic Substances and Disease Registry (ATSDR), and the Department of Housing and Urban Development (HUD)) has made important contributions to answering some of the questions concerning the effects of environmental hazards on children. These activities range from basic research to systematic evaluations examining whether environmental protection efforts are adequately safeguarding children's health. The EPA has recently proposed new pesticide and chemical testing guidelines to more completely identify neurological, developmental, and reproductive effects on children.
What We Need to Know. Through research on the risks associated with exposure to environmental hazards, significant gains concerning the health and well-being of children and adolescents have been made. Yet much more can be done to protect children from environmental health hazards. Questions that require further exploration include:
Also, children face physical hazard susceptibility regarding motor vehicle-related injuries because they have smaller bodies, and because adults may direct where they sit and may decide whether safety devices are used. Motor vehicle-related injuries are the major cause of death for those ages five to 27.
How Federal Agencies Could Work Together in this Area. Effective partnerships are required to achieve a healthy environment for children. Federal agencies charged with protecting public health and the environment must work together to achieve desired outcomes for young people. One such collaborative effort might be the development of public health guidelines on environmental issues to improve children's health. The ATSDR provides a written series for this purpose. The EPA develops testing and risk assessment policies for environmental pollutants.
A potential opportunity for collaboration within HHS is a recently established Subcommittee on children and environment. The subcommittee, convened by the HHS's Environmental Health Policy Committee, is charged with coordinating the activities of relevant HHS agencies conducting work in this area. Other agencies such as EPA, the Department of Energy (DOE), and CPSC have been invited to be liaisons to this activity.
Another potential coordinating point is EPA's Children's Environmental Health Initiative. One EPA proposal is to fund academic institutions to advance the understanding of how children are exposed to environmental hazards and children's susceptibilities and vulnerabilities to environmental hazards. The EPA has committed to establish two national Centers of Excellence on Children and Environmental Health in academic institutions. Such an endeavor could be undertaken as a partnership by several Federal agencies. For example, the USDA provides data to the EPA to help monitor and establish estimates of exposure to pesticide residues in foods. The agencies are currently working together to obtain additional data specific to infants and children.
An existing hub for research coordination is the NSTC CENR. The Subcommittee on Risk Assessment has provided a powerful stimulus to standardizing and coordinating the approaches of all Federal agencies to health and environmental risk assessment, and assessment-related research. The CENR Subcommittee on Toxic Substances coordinates research on these topics.
The ATSDR Child Health Initiative, launched in 1996, has focused the agency's programs and public health actions on reducing the adverse effects of toxic substances on the health of infants, children, and youth. This initiative is intended to (1) place a special emphasis on child health issues, (2) implement new projects that benefit children and their families, and (3) solicit input and disseminate information through other government agencies, professional organizations and child advocacy groups.
Currently, the NSF, the ED, and the NIH all support research related to cognitive development and learning. Enhanced research investments that build upon the convergence of concepts, models, and technologies used in many related disciplines have the potential to yield significant benefits for learning research. Disciplines that contribute to the study of learning in natural and artificial systems, and to the techniques and methodologies for supporting enhanced learning include the social and behavioral sciences, mathematics and the physical sciences, and education and cognitive sciences. An interagency research focus could build on all of the strengths of different participating agencies, capitalizing on ongoing research efforts, fostering cooperation, and highlighting interdisciplinary approaches that offer the highest potential to serve our Nation's education and human resource needs.
What We Need to Know. Science has already demonstrated that the importance of learning and creativity in the first two decades of life cannot be underestimated, yet our knowledge base is limited. Many questions still remain.
The examples cited here are not meant to be exhaustive. They represent research needs that could be more capably addressed through interdisciplinary approaches. The unique contributions and research strengths of each agency are important to address these issues.
GAINING ACCESS TO LEARNING THROUGH TECHNOLOGY |
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Many other problems and issues associated with supporting and maximizing learning potential similarly require interdisciplinary approaches and understanding. Research on basic cognition, approaches to learning, and limits and enhancements to learning abi lity will be generalized to other educational and workplace challenges individuals face into adulthood.
How Federal Agencies Could Work Together in this Area. Different agencies of the Children's Initiative have unique capabilities and strengths with respect to research on learning. Working together, the potential for advances in theory and application is heightened. Transferability of data and methods to classrooms and other learning sites will also be improved.
The NSF has unique capabilities with respect to interdisciplinary research in this area since it supports basic research on all of the science and engineering fields involved in the study of learning. In 1996, NSF initiated an activity, Learning and Inte lligent Systems (LIS), that will fund high-risk, multidisciplinary basic research and technology development on the learning processes in humans, and in artificial systems. Though LIS does not focus specifically on children, the initiative contributes di rectly to the understanding of learning and cognitive development generally, including the development of prototype technologies to support and enhance higher-level learning. The research methods employed will also have broad applicability to other resea rch on children. NSF has focused this activity on integrating technology with research and on exploring unifying concepts in the many disciplines that contribute to the study of learning and intelligent systems. LIS's research focus recognizes that advan ced information and communication technologies are radically transforming the way people will live, learn, create, and work in the 21st century, and responds to the need to provide supportive technologies that enhance the human ability to learn and create . In addition to the LIS program, NSF also supports basic research in social and behavioral sciences, biology, and other related fields. Through enhanced support, large-scale testing and implementation projects could be initiated; research initiatives c ould be accelerated.
The NIH also has unique capabilities for funding and conducting research on all aspects of the health sciences, including neurosciences and environmental health effects. Basic research on brain function, pathways, and brain disorders is ongoing at NIH la bs and through research grants. With respect to research on learning disabilities, NICHD-sponsored research on dyslexia has recently resulted in new techniques for diagnosing and treating the disorder. Other interdisciplinary, large-scale, and collabora tive research projects would be more feasible with enhanced support and cooperation with other agencies.
The ED funds research targeted specifically at education and learning, including process evaluation and models, methods and technologies for learning. Direct involvement of the ED in basic and applied research on learning promises rapid advances in both theory and application. Working together with other agencies of the Children's Initiative which focus on more basic research understanding, the ED has much to offer and gain from interdisciplinary and collaborative efforts.
The Department of Defense (DoD), with both its research and educational programs, could be an important partner in such an effort, given its work in information technology as well as human capital development. The DoD also is expert in the applicability of advanced simulation and presentation techniques, such as virtual reality, to other instructional settings. This work could be applied in the transportation sector for example, the applicability of simulator technology to driver education.
Research involving infants, for example, is identifying how their interactions with responsive caregivers (parents and other adults) provide the foundations for developing a healthy sense of self, forming trusting relationships, and taking pleasure in lea rning and exploring the world.
Research also is documenting the importance of children's direct interactions in middle childhood and adolescence with their parents as well as with mentors and peers. Findings are shedding new light on important variations in parents? and other adults? abilities to structure and influence children's access to and use of resources -- human and institutional -- in their communities. Such adult mediation of the community influences children's involvement in positive experiences or in high risk behaviors s uch as substance abuse and violence.
There also is new evidence of the importance of building networks of relationships that provide an expanding circle of support for both child and family. Research results on early intervention strategies to promote responsive caregiving and healthy infan t development underscore the importance of focusing on both child and family development (i.e., a two-generational strategy), and attending to the role of community conditions and resources. Studies involving families with similar signs of stress indicate that lower child maltreatment rates are associated with the presence of community supports (e.g., churches, Boys and Girls Clubs, school-based community programs). In addition, findings show that parenting practices known to be effective in communities in which there are many resources and few problems are not as effective in communities in which conditions undermine parents' goals, expectations, and interactions with their children. As demographic changes bring about greater cultural diversity, studies are beginning to map both the similarities and the differences among cult ural groups in the ways that family and community influence children's lives.
This growing knowledge base is beginning to stimulate a broad range of policy approaches that emphasize working with families and communities to provide children and adolescents with the social networks and supports they require to make a successful trans ition into adult life. For instance, research has played a vital role in the design and implementation of the new Early Head Start program. Based on principles drawn from research on service delivery, Early Head Start enables communities to design flexi ble and responsive programs to provide comprehensive child and family support services to low-income families with children under the age of three. Longitudinal research is built into the program to generate knowledge that can be used both to improve ser vices and to assess impacts on children, their families, and their communities.
Further, projects supported by the National Institute on Drug Abuse (NIDA) are applying knowledge about childhood predictors of drug use to the development and refinement of preventive interventions that focus on involving schools, families, and peers. I n another example, the Centers for Disease Control and Prevention (CDC) is developing Human Immunodeficiency Virus (HIV) interventions involving at-risk adolescents and their parents based on research that shows that strengthening familial communication i ncreases the likelihood that adolescents will adopt HIV risk-reduction behaviors. Also, CDC is documenting the positive role of comprehensive school-based health education in influencing the health-risk behavior of adolescents.
What We Need to Know. Given the challenges facing our families and communities, it is essential to build on our current knowledge base and focus on how changes in families and communities can be harnessed for the benefit of children, taking into account gender and racial/ethnic variations. Here are several pressing questions for which answers are needed:
How Federal Agencies Could Work Together in this Area. Researchers and those involved in esigning preventive programs share an interest in family and community support for children and adolescents. These support systems are often referred to as ?contexts? for development to be understood in their own right and for engaging families and communities in facilitating positive outcomes in young people. Thus, a broad range of Federal research agencies is now supporting projects in this area. T he ED for instance, is providing support through (1) its research institutes that aim to connect families and communities in supporting the optimal educational achievement of children, and (2) its reorganized elementary and secondary education programs wh ich confer a greater decision-making role at the school level in exchange for accountability for higher student achievement. Other agencies involved include HHS through its research and prevention programs, including comprehensive community-based health promotion programs in substance abuse, mental health, and cardiovascular health; and the CDC through its efforts to promote health and prevent violence and diseases.
Collaborations among these research agencies, especially those that strongly connect educational and health outcomes in children and adolescents, are needed. Young people who are healthy are more likely to benefit from educational opportunities. Likewis e, research shows that children and youth who are doing well in school and have supportive families are more likely to engage in health-enhancing behaviors (and less likely to engage in those risky to their health) than are those who are doing poorly in school.
What We Need to Know. Longitudinal studies provide a mechanism for understanding what factors are most important in influencing a child's life course. Such knowledge is essential in ensuring that all children grow up to be healthy and cont ributing adults, thereby reducing significant medical and social costs associated with adverse outcomes. Here are several longitudinal studies that could help us achieve this knowledge:
A Children's Health Study involving several different cohorts could explore in greater depth the effectiveness of a number of major preventive intervention issues including: strategies to increase children's calcium intake and prevent osteoporosis, dieta ry and exercise measures to reduce the risk of adult cardiovascular disease, therapeutic and other interventions to prevent obesity (one of the most prevalent adverse health conditions in children today), effective injury prevention programs (including motor vehicle injuries), individual and community-based interventions to prevent teen smoking, identi fication and intervention programs for children with mental health disorders, and newly developed education interventions to help children with learning disabilities.
An emerging area is research on preventive interventions in areas including accidents and injury, substance abuse, adolescent pregnancy, youth violence, and obesity. Studies demonstrate that reducing substance abuse by young people requires more than pro viding information about the dangers of drugs. Information must be supported by teaching young people skills to resist peer influence and providing timely booster sessions throughout the high school years to sustain those initial sessions. Comprehensive community-based health promotion strategies that involve parents, local organizations, and the media indicate that multi-level interventions can be effective in preventing substance abuse, but must be sustained over time.
A Children's Health Study, as an analogue of the current Women's Health Initiative, is one of the best ways to provide answers in the coming decades to many of the most pressing problems facing children today and in the future. Such a study would serve a s a highly visible sign of our Nation's commitment to its children. If the research portfolio on young people does not include longitudinal studies, the timing and content of health promotion and disease prevention efforts will not be as well informed by fundamental research on child and adolescent development as they must be.
How Federal Agencies Could Work Together in This Area. Longitudinal studies would greatly benefit from multiple agency involvement. Studies of vulnerable children are of interest to the Departments of Health and Human Services, Justice, Ed ucation, Commerce, the CPSC and the National Highway Traffic Safety Administration (NHTSA). Knowledge gained from birth cohort studies would be relevant to NIH, FDA, CDC, CPSC, USDA, and other agencies. Studies of learning disabilities could build on current interagency cooperation betwee n NIH and ED, which provides a useful model for these types of studies. The NSF-sponsored Panel Study on Income Dynamics (PSID) contains data on the impact of economic variables and conditions on child development and attainment.
What We Need to Know. This is a critical time for researchers to assess how children and adolescents are affected by policy and regulatory changes. Major restructuring of longstanding social policies has the potential to affect large numbe rs of children and their families. Several reports have identified, with the participation of the research and policy communities, critical areas for policy research in income support, health care delivery, food assistance, educational attainment, and th e transition from school to work. Here are just a few cross-cutting examples of issues researchers are grappling with that have important policy implications:
One possible starting point would be to enhance the National Health Interview Survey (NHIS) to be fielded by the National Center for Health Statistics (NCHS) of the CDC next year. These surveys yield national estimates of health status derived from both physical examinations and survey questions, medical expenditures and family formation, and they can be extended to some large States. An improved statistical system on children, youth, and families could be formed by building on the NHIS nucleus.
How Federal Agencies Could Work Together in This Area. Because effective approaches involve the delivery of services in many areas and yield multiple benefits for children and their families, Federal agencies and other groups should find it advantageous to partner in conducting new policy research on promising approaches. Where as the testing of new strategies requires funds not only to conduct research but to also develop and provide services, partnerships are likely a feasible route for overcoming the limitations of a given agency's area of authority or budgetary resources.
A multi-agency partnership effort could involve the HHS's health, social services and welfare research, the ED's research programs, the National Institute of Justice's juvenile justice research initiatives, HUD's research programs, USDA's research on food assistance programs, and education and training efforts undertaken by the Department of Labor.
Basic research is a first step -- a fundamental underpinning -- toward answering these and other questions and closing gaps in our knowledge about child and adolescent development. Indeed, theory-driven, applied and policy-related research efforts that address and build on the six opportunity areas identified in Section II are prime starting points. Advanced knowledge of family and community influences on children's behavior, for example, would help to determine what role families and communities can best play in shaping healthy lifestyle decisions regarding substance abuse, smoking, violence, nutrition, pregnancy and sexuality, and other risky behaviors. Exploring neurological and cognitive development at different ages with varying degrees and kinds of stimulation would also provide information about what kinds of learning situations facilitate optimal growth and development of the skills young people need to lead productive adult lives.
Knowledge gained in these and other areas can and should inform and facilitate action to address our Nation's urgent and costly social and economic issues. But for Federal research to be more effectively used in policy and program development, researchers must improve the ways in which they communicate and disseminate important findings to decision-makers. The scientific research community must work to establish new links and strengthen existing ones with policymakers and service providers. Likewise, policymakers and service providers, for their part, must not only assist researchers into identifying key research questions concerning children, youth, and families, but also must take responsibility for acting on relevant research findings. When successful, such connections can have powerful and beneficial results on children's well-being (see boxes in this section and additional examples provided in Appendix D).
RESEARCH-POLICY LINKAGES: LESSONS FROM COMPUTING AND INFORMATION SCIENCE AND TECHNOLOGY |
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SUDDEN INFANT DEATH SYNDROME |
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Rather than viewing research linkages with policies and services as sequential in nature, these connections should be thought of in terms of a continuing feedback system, with multiple entry points for feedback and modification in the decision-maki ng process at the Federal, State, and local levels. Such a strategy would enable researchers not only to inform initial policy and program development, but also to monitor and evaluate the implementation of these policies and programs -- and their effect s on child, adolescent, and family status -- on an ongoing basis. Sustained research could provide knowledge that is essential in further shaping and refining policies and programs so that they more effectively address the problems facing our children an d Nation.
In thinking about how to create and sustain this continual feedback system, the broader landscape in which researchers, policymakers and service providers work must be considered. The very nature of this landscape suggests that a set of conditions must b e in place if successful linkages are to occur, and entry points and feedback opportunities are to be provided. Here are three examples of such conditions that illustrate the complexity of research-policy linkages; these are by no means exhaustive.
In its effort, the Children's Initiative tackled the question of linkages from a specific perspective -- how the Federal research investment on child and adolescent development can be more effectively used to inform our Nation's domestic policy. The Chil dren's Initiative thus sought to answer these fundamental questions: How can we create and strengthen the linkage between two key agencies within the Executive Office of the President ? the NSTC (which coordinates the diverse parts of the Federal R&D enterprise) and the DPC (which overs ees the development and implementation of the President's domestic policy agenda)- in a way that fosters important research and policies? And how can this linkage create effective collaboration among and with other Federal agencies that support research on children and adolesce nts? Recommendations for how to establish and sustain such strong relationships are addressed in the next section.
Though the Children's Initiative was asked to focus solely on research-policy linkages at the Federal level, the group strongly urges similar linkages at the State and local levels.
Calls for more coordination and collaboration in research have been a consistent theme of public and private sector assessments of the research enterprise regarding children and youth. At this juncture, however, there are two compelling reasons why colla boration is even more critical than in the past.
First, the current fiscal climate requires more strategic use of existing Federal research dollars. As noted in Section I, the Federal Government currently bears primary responsibility for supporting research on children and adolescents. Yet Federal age ncies are working in an environment driven by constrained resources and public opinion that the Federal Government must scale back. Collaboration and strategic partnerships with other public and private sources are thus needed to leverage resources and m aximize their impact on research portfolios concerning children, youth, and families.
FEDERAL INTERAGENCY FORUM ON CHILD AND FAMILY STATISTICS |
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The boxes in this section on Partnerships for Stronger Families, the Federal Interagency Forum on Child and Family Statistics, and Research-Policy Linkages in Computing and Information Science and Technology provide insights and lessons for developing pro mising models of multi-agency collaboration and research-policy linkages.
PARTNERSHIPS FOR STRONGER FAMILIES |
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One thing is clear: No one Federal agency can foster the scientific advances required to strengthen our Nation's investments in its children and youth. Coordination and strategic partnerships among Federal agencies are needed to leverage resources and m aximize their impact on the healthy development of the Nation's youth. What is more, the Federal Government alone cannot achieve these results; collaboration with other public and private organizations is essential.
To meet this challenge, the Children's Initiative Subcommittee recommends that an Interagency Working Group (IWG), such as the Task Force established in the Executive Order Protection of Children from Environmental Health Risks and Safety Risks, identify activities within their research portfolios that support, inform, and facilitate the achievement of the Administration's key goals of ensuring the optimal health, education, and well-being of all American children and youth.
The IWG will address priorities for multi-agency research activities concerning children, adolescents, and their families. Among the prime candidates for such activities emerging from the first phase are a children's health initiative to understand how c hronic health problems, which emerge in later life, can be better prevented; an effort to develop public health guidelines regarding environmental (including standards and regulations) interventions to reduce risks to safety and health among children; and a learning and technology initiative to understand how children learn in interaction with new, evolving technologies and how such technologies can be better designed to promote learning in schools and other settings.
The IWG's responsibilities should include, but not be limited to, the following:
2 Sources: Births and Deaths for 1995, (1996). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Washington, D.C.; Monthly Vital Statistics Report (June 24, 1996), U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 44(11), Washington, D.C.; Trends in the Well-Being of America's Children and Youth: 1996 (1996). U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, D.C.
3 Sources: Reading Literacy in the United States (1996). U.S. Department of Education, Office of Educational Research and Improvement, Washington, D.C.; Third International Mathematics and Science Study (1996), U.S. Department of Education, National Center for Education Statistics, Washington, D.C.; Great Transitions: Preparing Adolescents for a New Century (1995), Carnegie Council on Adolescent Development, Carnegie Corporation of New York, New York, NY.
4 Sources: Births and Deaths for 1995 (1996). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Washington, D.C.; Trends in the Well-Being of America's Children and Youth: 1996 (1996). U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, D.C.; Starting Points: Meeting the Needs of Our Youngest Children (1994), Carnegie Corporation of New York, New York, NY.
5 Sources: "National, State, and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months - U.S. June 1994-July 95," Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, Washington, D.C.; Overcoming Barriers to Immunization (1994), Institute of Medicine, National Academy Press.
6 Sources: Butterfield, F. (1995), All God's Children: The Bosket Family and the American Tradition of Violence, Knopf Publishers; "Prison Spending Hurts Schools and Black Students, Report Says," Los Angeles Times, October 23, 1996.
7 Sources: Baugher, E. and Lamison-White, L. (September 1996). Poverty in the United States: 1995, Current Population Reports, U.S. Department of Commerce, Economics and Statistics Administration, Bureau of the Census, U.S. Government Printing Office, Washington, D.C.; Trends in the Well-Being of America's Children and Youth: 1996 (1996). U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, D.C.
8 Source: Great Transitions: Preparing Adolescents for A New Century (1995). The Carnegie Council on Adolescent Development, Carnegie Corporation of New York, New York, NY.
9 Sources: Trends in the Well-Being of America's Children and Youth: 1996 (1996), U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, D.C.; "Projected Smoking-Related Deaths Among Youth - United States," (November 8, 1996), Morbidity and Mortality Weekly Report, 45(44), Centers for Disease Control and Prevention, Washington, D.C.; "Vital Statistics Mortality Data, Multiple Cause of Death Detail, 1993." (1993). National Center for Health Statistics, public-use data tapes available from the National Technical Information Service, Springfield, VA. NTIS Accession No. PB-96-501861.
10 Sources: "Long-Term Outcomes of Early Childhood Programs," (1995) The Future of Children, 5(3); Years of Promise: A Comprehensive Learning Strategy for America's Children, (1996), Carnegie Corporation of New York, New York, NY.
11 Sources: Dallman, P. (1990) in Brown, M. (ed), Present Knowledge of Nutrition (6th edition), International Life Sciences Institute, Washington, D.C.; Gerrior, S. and Zizza, C. (1994), Nutrient Content of the U.S. Food Supply, 1909-1990, Home Economics Research Report on Nutrition and Mentoring, No. 52, U.S. Department of Agriculture, Washington, D.C.; Guthrie, J. and Schwenk, N. (1996), "Current Issues Related to Iron Status: Implications for Nutrition Education and Policy," Family Economics and Nutrition Review, to be published in Fall issue; Herbert, V. (1992), "Everyone Should be Tested for Iron Disorders," Journal of the American Dietetic Association, 12; Ludwig, W. (1996), Statement before the Subcommittee on Agriculture, Rural Development and Related Agencies of the Senate Committee on Appropriations, U.S. Senate, Washington, D.C.; Oski, F. (1993), "Iron Deficiency in Infancy and Childhood," New England Journal of Medicine, 329(3); Quick, J. and Murphy, E. (1982), The Fortification of Foods: A Review, Agriculture Handbook No. 598, U.S. Department of Agriculture; Randall, B. and Boast, L. (1992), Study of WIC Participant and Program Characteristics, Prepared by Abt Associates, Inc., Cambridge, MA for the U.S. Department of Agriculture, Food and Nutrition Service; Stuart-Macadam, P. and Kent, S. (eds) (1992), Diet, Demography, and Disease: Changing Perspectives on Anemia, Aldine De Gruyter, Hawthorne, NY; Third Report on Nutrition Monitoring in the United States: Volume I (1995), Federation of American Societies for Experimental Biology, Life Sciences Research Office; Yetley, E. and Ginsman, W. (1983), "Regulatory Issues Regarding Iron Bioavailability," Food Technology; Yip, R. et al. (1987), "Declining Prevalence of Anemia Among Low-Income Children in the United States," Journal of the American Medical Association, 258(12).
12 President's FY98 Budget Submission to Congress
13 The Safety Net for Children: The Performance of the Safety Net and Changes in Federal Spending on Child Well Being. Sources: Steve Bantolome:-Hill, Allison Logie and Gary Hyzer. U.S. Department of Health and Human Services, Office of Assistant Secretary for Planning and Evaluation (Forth Coming)
14 Sources: Tesman, J. and Hills, A. (1994), "Developmental Effects of Lead Exposure in Children," Social Policy Report, 8(3); Environmental Health Threats to Children (1996), U.S. Environmental Protection Agency, Office of the Administrator, Washington, D.C.; Measuring Lead Exposure in Infants, Children, and Other Sensitive Populations (1993), National Academy Press, Washington, D.C.; U.S. Agency for Toxic Substances and Disease Registry (1996), internal correspondence.
15 Additional examples of research questions can be found in reports of the National Academy of Sciences/Institute of Medicine, Board on Children and Families.