Screen Time

Juliette Price, Director of The Albany Promise

A group in Albany, New York is promoting early childhood developmental screenings as a way to boost educational outcomes years down the road.

Without early intervention, very young children who show signs of developmental delays tend to enter kindergarten less ready than their peers. Children who lag in kindergarten readiness tend to be less likely to read on grade-level by the end of third grade, and those who do not read on grade level by third grade are four times more likely to drop out of high school. And high school dropouts face a wide array of negative outcomes, including drastically lower lifetime earnings than people who finish school.

The Albany Promise – a cross-sector, cradle-to-career partnership between business and industry, k-12 districts, higher education, philanthropy, community-based organizations, health care, early childhood, and government in Albany, New York – is taking aim at the first link in this chain. By increasing early screening for developmental delays, the group hopes, the region will see a ripple effect throughout kids’ educational careers.

“Everything science tells us about brain development says that 85 percent of development happens during those first three years, and that’s when kids aren’t in the education system,” says Juliette Price, director of The Albany Promise. “We don’t have a way to systematically support those kids in those early years, because they’re not in one place. We can’t reach them.”

To solve this problem, Price’s organization is partnering with the state Medicaid program, local pediatricians, Albany City School District and Albany County Early Intervention program to increase screening of developmental delays in children aged 0-3. While the American Academy of Pediatrics recommends that such screenings take place at nine, 18, and 30 months, Price says that available data of a sample of kids who attended their well-child visit showed that about 1 percent of kids were actually being screened at those intervals.

“Just like with any medical condition, the earlier that developmental delays are identified, the easier it is to provide support and intervention,” Price says. “But again, if we’re not seeing them until they’re five, a lot of time has gone by, the brain has really started to solidify, and we have a harder and harder time remediating those delays.”

While it’s not a new idea that early childhood interventions have a higher return-on-investment than programs administered to older children, Price says that healthcare is an often-overlooked route for providing such services. “Our line of thinking was that pediatricians get to know the child, get to know the family, and they’re really helping children build healthy foundations for the rest of their lives,” Price says. “But if they’re not part of a larger effort that monitors the child’s development – and they’re not keeping an eye on brain development and skill development – five years goes by, and then a child enters kindergarten, and for the first time, they’re in a formalized education system. The bottom line is we needed pediatricians at the table—they’re a key part of getting this right for students and families.”

Pediatricians were selected to participate in the program late last year, and implementation is just now getting underway. Pediatrician offices will administer a standard developmental screening tool to assess children’s progress toward milestones such as sitting up, pulling themselves up, talking, and walking, and will provide referrals and warm handoffs for kids who are significantly behind schedule. The agencies who will then provide the interventions will then create timely feedback loops with pediatricians to ensure they are always in the loop and know how the child is progressing.

The team hopes to have some early data about screenings in the coming months, and plans to track outcomes like kindergarten readiness and third-grade reading scores over time to assess impact. “Our first goal is to get that screening rate up, and then we’ll look at what impact that has,” Price says. “Are there more kids needing services than we previously knew about? Do we have service shortages? Can we better coordinate care between the pediatricians, the early intervention specialists, and the school district to benefit the student? Do we see an increase in kindergarten readiness? The little improvements become stackable.”

Price says she’s hoping to see “small, sustainable progress” from the project, rather than dramatic results. Improving educational outcomes is a complex ecosystem, she notes, and she hopes that people will look to this initiative as an example of how people from outside the education sector can contribute.

“You don’t have to be a pre-K teacher to help solve this problem,” Price says. “You can be a pediatrician; you can be an economic development organization that decides that they’re going to really push for employers to have childcare subsidies.”

“Everyone can contribute,” Price adds. “It’s going to look different for everybody, but that doesn’t take you off the hook. Absolutely everybody can contribute to ending this problem.”

Juliette Price serves as the director of The Albany Promise, a cross-sector collective impact partnership in Albany, NY that facilitates the improvement of educational outcomes for the city’s most vulnerable students using a shared vision, collective action, and rigorous continuous improvement. The partnership focuses its efforts on six key outcome areas including kindergarten readiness, third grade reading, eighth grade math, high school graduation, post-secondary enrollment, and post-secondary completion, and is a part of the national StriveTogether network of cities across the nation leading the field of collective impact. The Albany Promise convenes over 100 institutions to engage in systems change to create a new civic infrastructure to best serve children and families, with a special focus on eliminating racial disparities. Juliette was awarded the White House Champion of Change award in 2016 for her work in this field.

At SXSWedu 2017, Juliette served as an expert panelist during PCG’s
Kidonomics: 2 + 2 = 6 session, which explored the need for cross-sectoral collaboration to address the issues of early childhood development and exponentially increase future opportunities for our youth.