The BUILD Initiative is a national effort that advances state work on behalf of young children (prenatal-five), their families, and communities. BUILD staff partners with early childhood state leaders focused on early learning, health, mental health, and nutrition, child welfare, and family support and engagement to create the policies, infrastructure, and cross-sector connections necessary for quality and equity. BUILD provides consultation, planning, and tailored implementation assistance, learning opportunities, resources, and cross-state peer exchanges. These efforts help state leaders improve and expand access to quality and promote equitable outcomes for our youngest children.

BUILD partners with state leaders to create the infrastructure for quality and equity and to connect programs and services for young children that may have functioned in isolation, at cross-purposes, or without sufficient resources to meet critical needs. The BUILD Initiative works to ensure young children can start school healthy and prepared for success.  One of the strategies is the QRIS National Learning Network, a community of state leaders focused on early learning cross sector system building. The linkages between state early childhood system building leaders and an important initiative such as Help Me Grow can provide connections across early learning, health, mental health, and family support.

Currently, developmental monitoring represents a key strategy to ensure that young children with developmental concerns are identified and linked to services. Such linkage maximizes the opportunity for vulnerable young children to reach their optimal developmental trajectory. Settings in which to conduct developmental surveillance and screening include, for example, the pediatric primary care office, where providers perform developmental screening as recommended by the American Academy of Pediatrics (AAP). However, exclusive reliance on the pediatric primary care setting to ensure universal developmental surveillance and screening has proven challenging, and there is thus a need to consider other settings that serve a high proportion of young children and may therefore be a critical partner in ensuring early detection, referral, and linkage to services. Due to their high utilization by families and frequent interactions with children, early learning providers, whether they be center-based or home-based, have an opportunity to impact and monitor children’s development, unique from other professionals such as home visitors or pediatricians. By engaging early learning leaders in the family and community outreach component of the HMG model, it is ensured that local early learning leaders are informing systems change efforts and are integrated with providers and initiatives across the community.

The early learning setting is at the focus of the recent AAP Policy Statement, ‘Quality Early Education and Child Care from Birth to Kindergarten’, which recognizes the critical influence of children’s experience in early education and child care settings on children’s development. Early care in family- and center-based settings provided in a healthy and safe environment, which promotes developmentally appropriate learning and play, positively influences children and families. State-level efforts to ensure the availability of high-quality early care settings to young children and families often include establishing state quality rating (or recognition) and improvement systems (QRIS), with QRIS efforts currently implemented in more than 75% of states. QRIS methods focus on implementing measurable standards of quality in early care settings, such as developmental assessment, that ensure the provision of comprehensive, high quality care. The QRIS systems also focus on continuous improvement and supports for meeting standards and best practices such as professional learning opportunities, technical assistance, and financial supports for providers.

There is both recognition of the importance of and a process to assess early care efficacy in contributing to early detection of developmental concerns. However, the focus on developmental assessment and linkage to services in early care settings is recent, and family- and center-based settings often face barriers to addressing child development, such as a lack of access to training. Innovative approaches led by HMG affiliates in other states offer the opportunity to strengthen the capacity of early care to 1) engage in developmental assessment, by providing training and resources to early care sites, and 2) link children to HMG and subsequent referral pathways in the presence of concerns, by promoting awareness and leveraging available technology.

A Community of Practice initiated by the Help Me Grow National Center in September 2018 seeks to diffuse an HMG-EL Integration innovation to other communities within the HMG and QRIS networks, to expand the degree to which early care settings across the country have capacity to address the developmental needs of young children.

This project is generously supported by the W. K. Kellogg Foundation.