COLUMBUS, Ohio - New research has found that the majority of Ohio's children are not on track in cognitive development by the third grade, and the number is even lower for children living below the poverty level. According to a report released today by the Annie E. Casey Foundation, in Ohio almost half of children under age 8 are from low-income families.

Renuka Mayadev, executive director, Children's Defense Fund Ohio, said that is where they see the lowest skill development and social emotional growth.

"Children who don't meet the key developmental milestones, they struggle to catch up in school, they struggle to graduate on time, and they're less likely to achieve the kind of economic success and stability necessary to support themselves and their family," Mayadev said.

The report found that high-quality early childhood programs that include supports for families can have a lasting impact. Ohio has made progress by recently adding 2,500 additional preschool spaces for low-income children, but Mayadev said it's not nearly enough. According to the report, more than 60 percent of low-income Ohio children ages 3 and 4 are not enrolled in a preschool program.

Laura Speer, associate director for policy reform and advocacy with the Casey Foundation, said federal, state and local policies can help parents effectively provide and care for their children.

"Having the flexible work schedule - it's so important. Also things like providing paid sick leave for parents could make a huge, huge difference," Speer said.

While Ohio's Third Grade Reading Guarantee is a good standard to have in place to keep children on track, Mayadev said it cannot work if a child lacks adequate developmental and education opportunities in the early years.

"You can't have third graders having to meet standards if you haven't developed children's cognitive abilities and emotional and social abilities before third grade," Mayadev explained.

For children to succeed, classroom learning should be integrated with other aspects of child development, such as social, emotional and physical development, Mayadev added.

The report is available from the Casey Foundation at www.AECF.org.




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Child-abuse prevention specialists in South Dakota and elsewhere say a new study underscores the need to protect kids from traumatic situations to avoid long-term physical health issues. International researchers have found a 14% increase in heart failure among adults who experienced one form of childhood maltreatment.

Those with three to five types of maltreatment had a 43% increased risk.

Brooke Jones, a child-abuse pediatrician based in Sioux Falls, said these events place stressors on the body.

"If you've heard of the term 'fight or flight' - if you're having constant adversity in your childhood, you might be in a constant flight stage, meaning that you don't have any down regulation or you're not getting out of that constant stress environment," Jones said.

And that constant stress can leave its mark in multiple ways, including cardiovascular disease, as these kids transition to adulthood. Jones said parents or caregivers can reduce the impact by providing a nurturing environment as the child grows.

She said it can involve simple things, such as reading to them or finding ways to let them know they are in a safe space.

Shakira Suglia, director of epidemiology at Emory University, chaired a 2017 American Heart Association report that tied adverse childhood experiences to adult health risks, including heart disease. She said the new study adds to evidence that the mental and physical health effect go hand-in-hand when peeling back the layers of trauma.

"There might be development of depression or anxiety disorders that may make someone more prone to then cope with substances," she said. "For example, the uptake of smoking is also another thing that people tend to use to cope with stress."

Suglia echoed calls for policymakers and community-level organizations to do anything that supports stronger family relationships, especially in situations where trauma has surfaced in a household. She said outside of the home, schools and care centers can be on alert for children who have dealt with trauma and should try to emphasize a welcoming environment in those settings.

Ohio's child-welfare system is plagued by a shortage of mental-health professionals. Experts said having consistent access to therapists, counselors, psychologists and psychiatrists could change the trajectory for kids who otherwise would be placed in institutions, increasingly lacking the space for them.

Theresa Lampl, CEO of The Ohio Council of Behavioral Health and Family Services Providers, said to offset the community consequences of lack of access to care, mental health should be viewed as a persistent health condition, and treated on par with heart health, diabetes or other chronic diseases. She said that requires creating value to attract more people to the profession.

"Really creating incentives for people to come in, because these jobs offer relatively low pay, yet require in many cases, bachelor's or master's degrees, in order to provide services," Lampl said.

She said the state could implement tuition-reimbursement programs, paid internships and loan-forgiveness opportunities to jump start the behavioral health workforce pipeline. According to state data, more than 2-million Ohioans live in communities without enough behavioral-health professionals.

Melissa Flick, protective services manager of South Central Ohio Job and Family Services, said the state's rural regions lack intensive behavioral health services that are more readily accessible in cities. She provided an example of a 12- year-old girl with a long history of trauma, and was hospitalized for several weeks.

"She's doing some self harming by ingesting different items," Flick said, "so whatever she can get her hands on, she will try to ingest to harm herself. And she is currently placed in an acute-care hospitalization type facility. Those types of facilities are supposed to be very short term."

The agency has exhausted every resource in the state, and those facilities are either completely full or they are unable to meet her specific needs. Flick believes better resources early on may have addressed the trauma to set the child on a path toward healing.

Nationwide, mental-health crises among young kids are on the rise. According to the CDC, mental health-related Emergency Department visits jumped by 24% for children ages 5 to 11 and 31% for 12 to 17-year-olds in 2020, compared with the year prior.

Ohio families are experiencing greater mental-health challenges coming out of the pandemic, and social services workers emphasized it makes it more difficult to place kids who need help in appropriate facilities.

According to a report published earlier this year by the Public Children Services Association of Ohio, 89% of counties experienced placements of youths whose needs were primarily behavioral health-related.

Deanna Nichols-Stika, executive director of Wayne County Children's Services, explained caseworkers had options for residential placement and could select the provider who best met the needs of a child a decade ago. Now, she noted, it is now rare to find basic long-term housing and care.

"It is not uncommon for us to make over 40 phone calls to different providers in the state of Ohio, just looking for an available bed," Nichols-Stika pointed out. "Not even having the opportunity to really look at available services matching the needs of the child."

According to an Ohio Council of Behavioral Health and Family Services Providers report, demand for behavioral-health treatment in the state spiked by 353% between 2013 and 2019, likely worsened by the pandemic. Agencies said the increased demand for youth mental-health services, in particular, is having a substantial impact on wait times.

Scott Boone, director of Knox County Job and Family Services, said families are struggling with increasingly complex, interconnecting issues compared to previous generations. As a result, kids are dealing with trauma and resulting behavioral and mental-health issues traditional foster homes and even therapeutic foster care, are not equipped to manage.

"We're finding that a lot of kids are developing these types of behaviors where they're self harming, and they're running away," Boone observed. "They've been exposed to every kind of abuse that you can think of."

Boone cited a recent example of trying to place a teenage girl who had been in a detention facility. He recalled staff worked desperately with the local probation department and contacts throughout the state for nearly three months trying to find placement.

"And we were turned down by over 100 providers until finally we found a location in Cincinnati," Boone recounted. "You can imagine that the cost of that is around $400 a day."

Nichols-Stika added despite the challenges, there is a collaborative spirit among people working to stabilize and care for children coming out of the worst circumstances.

"There is such a passion for this, of people in this profession, child welfare, behavioral health, mental health, to help people," Nichols-Stika explained. "That's why we got into this profession. We just need additional resources to help us do better."