Early Childhood Education and Child Health

The institutional and administrative silos that differentiate the care and wellness of children from their progress through the public education system can derail a child’s education and development if he or she has undetected sensory, intellectual, or emotional challenges or is subject to adverse childhood experiences (ACEs) and doesn’t experience regular positive childhood experiences (PCEs).

Some evident health-related issues or learning disabilities are caught in sensory and cognitive screenings at an early age by school nurses or observant teachers, but they can be missed, and the presence of an ACE in a child’s life may well go undetected for years, being perceived as “acting out” or simply as misbehavior.

Undetected and unaddressed, such issues will mean a child often fails educationally, which more and more studies show compromise their future social adjustment and employment prospects and, in too many cases, charts a course to the criminal justice system.

Today, many educational leaders frankly admit that undetected emotional, cognitive, and behavioral factors are now exceeding actual education costs.

This from the recent “Study of Vermont State Funding for Special Education”

Vermont’s special education population has the largest share of students with emotional disturbance of any state in the nation — and nearly three times the averages seen in neighboring states. The share of Vermont students with other health impairments also exceeds the national average, but is on par with neighboring states.

• Since 2013, there has been a 75% increase in the number of IEPs qualifying for extraordinary cost reimbursements from the state.
• In 2016, on average, the additional amount spent by Vermont’s supervisory unions and school districts per special education student is $21,840. This is 1½ – 2 times greater than other national and state estimates for the average excess cost per special education student.
• Spending per IEP had increased 8%, or $1,683, since FY 2014. This level of spending translates into an additional $2,971 per K-12 resident ADM.
• Increased demand and limited capacity for community-based mental health and social services has shifted responsibility for providing these services to schools. In the face of their own capacity limitations, schools have responded by either contracting with private providers or paying for students to attend special schools or programs outside the district.

Many Vermont towns are torn between the financial imperative to consolidate their shrinking student populations into larger facilities and the immensely cohesive value that these small community schools provide in their communities. We’re advocating for an alternative to closure – reinvention.

Imagine our schools as community centers focused on the physical, emotional, and intellectual growth of our children and families from birth to career. Imagine repurposing emptying schools to better reflect the connections and needs of their communities.

Combining the healthcare and education of children and young people into one institutional, budgetary, and administrative structure optimizes the chance for a child’s success as well as the wellbeing and support of their family.

We’re beginning to train and integrate pediatric paraprofessionals (school nurses, and essential early educators) to identify students at risk of ACEs and deploy early care in the form of “trauma-informed counselling.” A trauma-informed counsellor understands the full impact of ACE-generated trauma on a person’s behavior, knows how to intervene with appropriate family counseling and legal help if needed, and understands how trauma shapes a person’s capacity to learn.

We’re designing a model that integrates child health and education in one local institution and mirrors that in another location so that shared data and anecdote can be compared, interpreted, and published. The test will be small in scale so as not to galvanize those for whom change may pose a threat.

We must integrate and move upstream our healthcare and public education investments for the sake of our children and young people, building a unified cost-efficient and more successful public education system. Our success will enhance the future prospects of our children and young people and reduce the overwhelming remediation costs in “special ed,” physical and mental health care, and the criminal justice system.