1. Message from the Chairperson Judy Romano, MD, FAAP

2. New Reports

3. New State Policy Reports

4. New Resources

5. Chapter Child Care Contact Corner

6. Upcoming Events

7. Funding Opportunity

1. Message from the Chairperson Judy Romano, MD, FAAP:

Dear Members of the Section on Early Education and Child Care:

Welcome to the September issue of our Section Newsletter! I think you will be pleased with the breadth of information offered.

Children's health issues have never been HOTTER, with lots of opportunities for us to make an impact!

I hope everyone is following the health care reform debate and making your voices heard. For more information on health care reform, visit the Member Center and click on the “Health Care Reform” icon on the right side.

Also, please work with your state AAP chapter to check on the status of the development or progress of a State Advisory Council on Early Childhood Education and Care. Pediatric input is crucial.

Lastly, for those of you attending the NCE, click here for a schedule of early education and child care related events. We are particularly looking forward to networking with our Chapter Child Care Contacts – I hope many of you will take advantage of the Medication Administration training. The section program also promises to be highly interesting and interactive. We hope to see you there!

Sincerely,

Judy Romano , MD, FAAP, Chairperson
AAP Section on Early Education and Child Care

2. New Reports:

Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States
This new report from the National Academy for State Health Policy and the Commonwealth Fund explores how states can play an important role in improving care coordination and case management and strengthening linkages between primary care providers and other child and family service providers to promote and support the healthy development of young children. The report spotlights the roles states can play to facilitate and support improved linkages by: 1) maximizing the use of personnel; 2) undertaking quality improvement initiatives; 3) supporting data, information, and technology; and 4) supporting individualized care plans and cross-systems planning.

An International Comparison of Early Childhood Initiatives: From Services to Systems
It can be argued that much of the evidence generated in the US on the importance of early childhood to future health and attainment has had a greater effect on the national policies of other countries than it has in the US, which lacks a national policy agenda for young children. However, the US is not the only country to struggle with the direction early childhood policy should take: England, Canada, and Australia all started with similarly fragmented early childhood services, and have tended to favor market-based solutions with limited reliance on the welfare state.

This report describes some of the components of all four countries’ efforts to develop policies that produce lasting gains for their youngest citizens. The authors also consider the implications of experiences in England, Canada, and Australia for the development of early childhood policy in the US.

The Physician's Role in Reducing SIDS
"If physicians are uncomfortable with their fund of knowledge about SIDS (sudden infant death syndrome), they may be reluctant to discuss it with families," state the authors of an article published in Health Promotion Practice online. In spite of a 13-year public education campaign aimed at reducing the risk of SIDS, it remains the leading cause of postneonatal death and the third leading cause of infant death. The primary modifiable risk factor for SIDS is prone sleeping, but physicians, nurses, and other health professionals have been reluctant to stress the importance of putting infants to sleep on their backs, perhaps because of inadequate or incorrect knowledge or skepticism. Studies have shown that health professionals have substantial influence on parental choice of sleep position. This article reports on a study conducted to test the hypothesis that physicians in central New York were not adequately educated on SIDS and were not sufficiently emphasizing risk-reduction strategies with parents.

• Almost all (88.8 %) of health professionals were unaware that 2 to 4 months is the age range associated with the highest incidence of SIDS
• Fifty-seven health professionals (27 %) were not able to identify the American Academy of Pediatrics recommended supine position as the safest infant sleep position.

For AAP resources on safe sleep, click here.

Impact of Training on Child Care Health Consultant Knowledge and Practice
This article reports on an evaluation of a pilot training of nurse child care health consultants, child care directors, and community teams in Connecticut, and the effect of the training on (a) nurses' and directors' perceptions of the health consultant role, (b) nurses' knowledge and activities as health consultants, and (c) child care health and safety policies and practices. The findings from this study support the importance of preparation for the health consultant role and increasing evidence of the positive effect of health consultation on the health and safety of child care programs.

Disparities in Early Learning and Development: Lessons from the Early Childhood Longitudinal Study – Birth Cohort (ECLS-B)
Education and business leaders and the public at large have grown increasingly concerned about the achievement gap between children from at-risk backgrounds and their more advantaged peers. Very little research has used nationally representative data to explore whether disparities are found within the first year of life, and whether disparities are evident across a wide range of developmental outcomes. The data and analyses presented in this brief, however, indicate that disparities are apparent in infancy, with the gap widening in toddlerhood. Policy makers and early childhood professionals therefore need to take into account the entire period from birth to 5 years, including targeted interventions to address the developmental needs of at-risk children ages 0 to 3.

What About the Babies: A Focus on Infants and Toddlers in State Advisory Councils
As part of the Head Start reauthorization bill passed into law in 2007, federal lawmakers required the creation of State Advisory Councils on Early Childhood Education and Care. This paper from ZERO TO THREE provides an overview of states’ current coordinating and governance structures and lessons learned from analyses done by leading organizations. It describes the new requirements for State Advisory Councils and related decisions to be made by states. The paper offers guidance to states on including a focus on infants and toddlers as they make decisions about the formation of State Advisory Councils and the activities of those Councils. The State Advisory Councils in four states—Connecticut, New Mexico, Ohio, and Virginia—are profiled as examples of varying approaches taken to meet the requirements in the Head Start reauthorization law.

Infant Sleep Environments Depicted in Magazines Targeted to Women of Childbearing Age
The authors of this study, including SOEECC member Rachel Moon, MD, FAAP, evaluated pictures in magazines widely read by women of childbearing age, for adherence to AAP guidelines for safe infant sleep practices. Results showed that more than one third of pictures of sleeping infants in magazines geared toward childbearing women demonstrated infants in an inappropriate sleep position, and two thirds of pictures of infant sleep environments were not consistent with AAP recommendations. Messages in the media that are inconsistent with health care messages create confusion and misinformation about infant sleep safety and may lead inadvertently to unsafe practices.

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3. New State Policy Reports:

Two new state policy reports offer encouraging and helpful information for AAP chapters and their members who are advocating for early education and child care issues in the states.

Early Care and Education State Budget Actions FY 2009
The first report from the National Conference of State Legislatures (NCSL) Early Care and Education State Budget Actions FY 2009 notes that although states faced significant economic challenges as they developed their FY 2009 budgets, a number of early care and education programs continued to enjoy expanded investment.

Appropriations generally increased for child care, prekindergarten, home visiting, and other early learning initiatives from FY 2008 to FY 2009. Total increases were $651 million across the states. Legislators continued to support early education and child care programs even as two-thirds of states were addressing budget gaps that had emerged in 2008.

Although all states did not provide data from each of the last 3 fiscal years, many reported increases from year to year. In child care, 17 states that increased appropriations from FY 2008 to FY 2009 also increased funding in the previous fiscal year. In prekindergarten, 21 of the 23 states reporting an increase in FY 2009 also showed funding increases in the previous fiscal years. In home visiting, 9 states that increased funding from FY 2008 to FY 2009 also increased funding in the previous year.

With the state budget gap continuing to grow in 2009 because of poor state revenue performance, FY 2010 budgets will be a challenge. NCSL estimates the FY 2010 budget gap at $84 billion.

Although some funds from the American Recovery and Reinvestment Act are directed to early care and education, some states may be utilizing these funds to fill FY 2009 shortfalls. As such, it is unclear whether states will be able to maintain or increase funding to these programs in FY 2010.

Beyond the School Yard: Pre-K Collaborations with Community-Based Partners
The second report from PreK Now, a program of The Pew Center on the States, examines strategies to expand access to prekindergarten programs through community-based partnerships. The report highlights the benefits and challenges of establishing preK partnerships with community-based programs, such as Head Start, child care centers, and faith-based organizations. Community-based collaborations create an opportunity for states to reach and support the early learning needs. The report offers five recommendations for addressing as well as policy recommendations for states to support community-based preK collaborations.

The AAP Division of State Government Affairs is available to provide you and your chapter with consultation on these and other state advocacy issues and initiatives. Please contact us at 1-800-433-9016, x7799 or stgov@aap.org for assistance.

4. New Resources:

Building Your Medical Home Toolkit
Brought to you by the AAP/MCHB/National Center for Medical Home Implementation, the Building Your Medical Home toolkit is a new (and free!) resource that supports the primary care pediatrician's improvement of a pediatric Medical Home. The toolkit also contains materials and resources for a pediatric office to use as part of applying for and potentially meeting the National Committee for Quality Assurance (NCQA) Physician Practice Connections Patient Centered Medical Home (PPC-PCMH) Recognition program requirements.

This toolkit can help a practice assess and improve its medical home capacity with resources and downloadable tools organized into the following implementation areas:

• Care Partnership Support
• Clinical Care Information
• Care Delivery Management
• Resources and Linkages
• Practice Performance Measurement
• Payment and Finance

Improving the Health of All Americans by Focusing on the Early Years of Life
A new fact sheet from the Robert Wood Johnson Foundation Commission to Build a Healthier America is available and provides facts and figures, cost estimates, and background on the policy environment surrounding early childhood development.

For additional fact sheets, click here.

Final Newsletter from the Healthy Child Care Consultant Network Support Center
The work that our partners have done at the Healthy Child Care Consultant Network Support Center (NSC) ended August 14th. NSC worked towards strengthening statewide networks of child care health consultants, and provided resources and support to help CCHC networks promote the healthy development of children in early education and child care. Please enjoy their final newsletter, which is particularly helpful for pediatricians who serve as child care health consultants and have questions about funding and working with child care providers.

Materials from the California Childcare Health Program
The California Childcare Health Program received funding from the CJ Foundation to develop written materials and continuing education workshops to child care providers in several California counties on safe sleep practices and SIDS risk reduction. The materials are available in English and Spanish on their Web site:

• Safe Sleep Policy for Infants in Child Care
• Tummy Time for Infants
• Reducing the Risk of SIDS for Infants in Our Care

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5. Chapter Child Care Contact Corner:

Do you live in Delaware or West Virginia? Are you looking to become more involved in early education and child care? If so, we have an opportunity for you! We are looking for an AAP Chapter Child Care Contact (CCCC) in Delaware and West Virginia. If you or someone you know is interested in this position, please see the CCCC job description and/or email Stephanie Nelson at snelson@aap.org.

NCE 2009 – CCCC Meeting
Mark your calendars to attend the AAP National Conference and Exhibition (NCE) in Washington, DC October 17-20, 2009. The CCCCs and SOEECC members are invited to attend a training/discussion on the new medication administration curriculum and the small grant program to support the implementation of the curriculum. The training will be held on Sunday, October 18th from 8:30am-11:30am. If you are interested in attending the training/discussion, please RSVP to snelson@aap.org by October 2nd and pick up your badge at the registration booth.

***NCE registration is not required to attend this event, but you do need to register to attend the educational sessions***

Educational Outcomes Based on Ethnicity Can be Changed
Thomas A. Clark, MD, FAAP, is the CCCC for Georgia and has submitted an article about his experience in organizing an early childhood development symposium in Savannah. Dr Clark hopes to raise the high school graduation rate in Savannah by duplicating the Harlem Children’s Zone project.

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6. Upcoming Events:

AAP 2009 National Conference and Exhibition October 17 – 20, 2009, Washington, DC Please join us at the section educational program on Sunday from 1:00pm to 5:00pm. For a schedule of events taking place at this year’s NCE related to early education and child care, click here.

National Association for the Education of Young Children Annual Conference & Expo November 18 – 21, 2009, Washington, DC More than 20,000 early childhood professionals from around the world attend the NAEYC Annual Conference & Expo to discuss the everyday issues of our work with young children and families. An Afternoon with the American Academy of Pediatrics Friday, November 20th, 12:30 – 5:00 PM - Reducing the Risk of Sudden Infant Death Syndrome (SIDS) - Fighting the War on Germs: Spit Happens! - Promoting Healthy Behaviors in Young Children.

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7. Funding Opportunity:

Build-A-Bear Workshop, Inc.
Deadline: Rolling

Build-A-Bear Workshop, Inc is accepting grant applications as part of its annual giving program. The Build-A-Bear Workshop and its charities support children's health and wellness, literacy and education, animal causes, and the environment.