Beyond the Moon

Are we too constrained in setting goals for promoting children’s optimal healthy development? Current events suggest that perhaps we should abandon caution and be far more ambitious in our targets. For example, Congress is now poised to approve The 21st Century Cures Act, a major biomedical innovation bill that includes nearly $5 billion in dedicated funding for major research initiatives at the National Institutes of Health (NIH). Funding priorities include the Obama Administration’s Cancer Moonshot, to accelerate cancer research under the determined leadership of Vice President Joe Biden, and the Council for 21st Century Cures focused on innovative cures, treatments, and preventive measures.

Similarly, philanthropic trends also encourage us to expand our thinking beyond initiatives that yield only incremental advances. BuzzFeeds’ Natasha Tiku describes the current trend of Silicon Valley billionaires and, “wealthy young tech donors, who seek a more high-impact, transactional mode of giving.” Numerous publications and presentations, including a keynote address at The Hartford Foundation for Public Giving’s recent annual meeting, highlight the evolution of giving from the notion of charity to strategic philanthropy. In our own experiences with funders, we are impressed by the extent to which foundations and donors, alike, are increasingly seeking to leverage funding from multiple sources to achieve greater scope, scale, and impact.

What are the big ideas that will attract massive funding from increasingly engaged and strategic funders? As a senior pediatrician, I am mindful of the spectacular advances I have witnessed in our treatments of children with debilitating and life-threatening diseases, disorders, and related conditions. For example, in my professional lifetime, the emergence of successful cancer treatments offers remarkable testimony to our scientific capacity and resolve. Notwithstanding the many disorders still deserving of our attention, extraordinary advances in our understanding of early brain development, early child development, and the “biology of adversity” demand that we also focus maximum resources and efforts on the promotion of children’s optimal healthy development. In our advocacy, we speak of such promotion as a critical but often overlooked element of a tripartite systemic approach that also includes prevention and treatment. Should we be successful in advancing our advocacy for a promotion agenda, how might we reply to donors who inquire as to our priorities and needs? I am now emboldened to believe that we must be prepared to think big!

So how might we respond to the opportunity to secure prodigious funding to promote children’s optimal healthy development? I believe that the answer is informed by our experiences in early childhood system building through the work of the Help Me Grow National Center, as well as our efforts to engage all sectors so critical to achieving optimal outcomes for children through our Connecticut Children’s Office for Community Child Health. Our audacious goal is to ensure that all children have access to a comprehensive, integrated, effective system that supports developmental promotion, early detection, and referral and linkage to community-based programs and services. We must bring to scale and impact those evidence-based programs, services, and interventions that strengthen families’ capacity to promote their children’s healthy development.

Examples of such programs, services, and interventions are abundant. Consider, for example, the impact of providing all child health providers with the requisite knowledge, skills, and resources to promote children’s optimal healthy development through such strategies as the incorporation of Reach Out and Read within their practices to promote language and literacy development, or to embed staff such as Healthy Steps Specialists to engage parents in early learning activities to facilitate their children’s healthy growth and development. Training of home visitors in the use of such tools as Ages and Stages learning activities could strengthen the capacity of parents to promote their children’s development. Providing guidance to child health, early care and education, and family support providers on the process of developmental surveillance and screening would ensure the early detection of children with delays and disorders, as well as vulnerable children at increased risk of adverse developmental and behavioral outcomes. A universally-available central portal of entry would facilitate the access of all children and their families to the wide array of developmental and behavioral services, ranging from publicly-funded early intervention services to community-based programs and supports. A coordinated system of enhanced care coordination would ensure the successful referral and linkage of children and their families to culturally appropriate and geographically-accessible programs and services with a high degree of effectiveness, as well as family and provider satisfaction. The capacity to perform cross-sector data collection would identify gaps and capacity issues and inform our advocacy in support of resource development and expansion.