Early Childhood Intervention & Prevention

Beneficiaries come from all ages and all walks of life, including parents of young children (past and present) as well as infants and children themselves (present and future).  Trust beneficiaries as defined in the Trust settlement include “all persons who are past, present, and future beneficiaries of the mental health lands trust” and Trust statutes highlight prevention services and work as one of many ways Trust resources can be deployed. It is this guidance as well as the expertise of our advisory boards and other key stakeholders that provides a framework for Trust work in this area.

The sooner beneficiary families including infants and young children are identified and connect with needed supports, the better their outcomes, as proven by decades of early intervention and brain development research. The Trust’s “Bring the Kids Home” focus area initiative (2004-2012) highlighted the need for earlier identification and intervention of behavioral health supports for children and families to prevent the need for increasingly higher levels of care.

Part C of the federal Individuals with Disabilities Education Act (IDEA) provides funding to states to support early intervention systems for children age birth to three years with developmental delays or disabilities. Alaska’s eligibility threshold for early intervention services is more limiting than many other states, meaning that many young beneficiaries are not able to access these high-quality supports at the most critical time in their development. The Trust works closely with Alaska’s Part C program, also called the Infant Learning Program, to identify opportunities and improve access of these critical services for young beneficiaries and their families.

Additionally, the Trust recognizes the significance of trauma and Adverse Childhood Experiences (ACEs) and the fact that trauma is highly correlated with beneficiary groups, particularly those experiencing mental illness and substance use disorders. Alaska children are exposed to trauma early, with 1 in 3 (32%) reported to child welfare before their 7^th birthday, according to the Alaska Longitudinal Child Abuse and Neglect (ALCAN Link) study. A report of harm to child welfare is an early indicator of problems and often predict family and child social and behavioral health support needs. However, our current system does not usually intervene until children are at least school age (often late elementary) and can miss critical opportunities for optimally effective early intervention.  Precise and targeted prevention occurring before birth and throughout childhood is needed to reduce or lessen the impact of negative childhood events that result in trauma (Alaska Division of Public Health, 2020).

Intervening early in childhood can alter the life course trajectory in a positive direction (Kellam et al., 2008; Kitzman et al., 2010). Substance abuse and other problem behaviors that manifest during adolescence have their roots in the developmental changes that occur earlier—as far back as the prenatal period. While early intervention can be effective at any age, it is especially powerful when applied early in a person’s life, when development is most easily shaped and the child’s life is most easily set on a positive course. Decades of research show the highest rate of economic returns comes from the earliest investments in children – up to a 13% return on investment for birth to age 5 five programs (Heckman, 2019).

The work of the Trust aligns with Strengthening the System: Alaska’s Comprehensive Integrated Mental Health Program Plan (comp plan), that was developed in a partnership between the Trust and the Department of Health and Social Services in coordination with community stakeholders. The Comp Plan identifies priorities for the next five years to inform planning and funding decisions to meet the needs of  Trust beneficiaries. The intent is to strengthen the system of care to allow a comprehensive approach that quickly meets their needs.

Early childhood programs emerged as a primary focus in the comp plan. This priority area particularly aligns with the objectives of Goal 1.

Goal 1: Early Childhood – Programs serving young children promote resiliency, prevent and address trauma, and provide access to early intervention.

Goal 1, Objective 1.1: Promote practice-informed, universal screening efforts and early intervention services.

Goal 1, Objective 1.2: Provide ongoing support to ensure accurate identification and treatment of social-emotional needs for children and their caregivers, congruent with their cultural identification.

Goal 1, Objective 1.3: Reduce the instances and impact of Adverse Childhood Experiences (ACEs) through community engagement and by improving social determinants of health.

• Early Childhood Alaska: A Strategic Direction for 2020-2025 (Early Childhood Alaska Joint Task Force, 2020)
• 3 Principles to Improve Outcomes for Children and Families: 2021 Update (Harvard University Center on the Developing Child) 
•  Alaska Early Childhood Environmental Scan: A Baseline Report on the Condition of Young Children (All Alaska Pediatric Partnership, 2020)
• Investing in Prevention: Working Together in Early Childhood for Healthy Alaskan Children, Families, and Communities, 2015 (State of Alaska)
• Alaska Longitudinal Child Abuse and Neglect Linkage Project (ALCANLink, 2019)
• The Heckman Equation: The Economics of Human Potential (Heckman, 2020)
• Early Intervention: A Critical Support for Infants, Toddlers, and Families (Zero to Three, 2017)
• The Importance of Early Intervention for Infants and Toddlers with Disabilities (National Early Childhood Technical Assistance Center, 2011)