RALEIGH, N.C. -- COVID-19 is affecting children's social and emotional health, but experts say there's a gap in data when it comes to understanding what factors influence how children manage their emotions and build relationships.

Mary Mathew, collaboration and policy leader for the North Carolina Early Childhood Foundation, says measuring children's social-emotional health at the population level is complex.

Her organization has released a set of recommendations for helping the state figure out ways to do so.

She adds that research shows healthy social and emotional skills help children manage stress and stay resilient in challenging times.

"COVID-19 is one of those challenging times, and it's really going to have an impact on children's social-emotional health," Mathew states. "In order for North Carolina to really know how to best support children and families and their children's social-emotional health, what they really need to know is how children in North Carolina are doing in this area of development."

The NC Early Childhood Action Plan, put in motion by Gov. Roy Cooper and the state Department of Health and Human Services in 2018, has set a target for developing a reliable set of measures for young children's social-emotional health by 2025.

Dr. Debra Best, a Duke University pediatrics professor, says pediatricians can be a resource for families when it comes to gauging a child's social-emotional health, noting that health care providers see children at least 13 times by their third birthday.

"One in four children are at risk for developmental delay, and so the universal early childhood screening that we do within a pediatric practice really provides an opportunity to identify delays early and to intervene with appropriate supports during what really is the most critical period of child development," she states.

The state's criteria should take into account differences across racial, cultural and socio-economic lines, according to Sheresa Blanchard, an assistant professor of human development and family science at East Carolina University. She says a child's behavior is closely linked to his or her home environment.

"We may be measuring something that a child has not been exposed to, or that may not be valued by that child's family or culture," she points out. "And so, you have to think about what the norm is for your community."

The report released by the North Carolina Early Childhood Foundation calls for an investment in resources that minimize racial and cultural bias in screening, and for creating tools that better describe children's social-emotional strengths, and not just focus on deficits.

An increase in child-care subsidy reimbursement rates up to 58% of market rate is being hailed as a big win for providers in Missouri.

Sarah Gould is the early-childhood director for Community Support Services of Missouri, which primarily cares for children with special needs in Jasper County.

She said the rate increase, which was signed in June by Gov. Mike Parson, helps families be able to afford child care.

"There's more stability for them," said Gould, "and they're able to use those resources that they would have put in child care to pay for additional utility costs or food costs, because we know those have all gone up in the last several years."

American Rescue Plan stabilization funds and some emergency aid through Congress for early-childhood education expired at the start of October, and Missouri child-care providers are looking for long-term solutions.

Missouri often is referred to as a state with many child-care deserts, and any loss of subsidies can be straining.

Casey Hanson, director of outreach and engagement for Kids Win Missouri, said it's important to come up with permanent solutions.

"So there's a little bit more relief money that will get pumped into the system," said Hanson, "but a lot of those opportunities that providers have used to keep their doors open over the last couple of years are going away. And that's why we're so focused on making sure that as a state, we're making investments that are more sustainable."

Hanson said it's important for families and parents to talk to elected officials and leaders about the needs for reliable, safe child care and also for child-care providers to be vocal about the impact of rate increases and how it helps their organizations.

The coalition known as "Think Babies Michigan" has advocated for more than $36 million in funding to offer grants to child-care providers for infants and toddlers.

Families with young children from across Michigan have joined the coalition to advocate for improvements in early child care, in terms of quality and affordability. But many of those care providers are struggling to keep their doors open.

Sacha Klein, senior director of policy and advocacy for the Early Childhood Investment Corp., underscored the dire need for this funding from the American Rescue Plan Act.

"Those child-care providers increase the quality of care that they are able to offer families," she said. "It'll enable them to pay their staff a living wage for the work that they do, and reimburse them as 'brain builders,' which is the way we think of early-learning staff."

The Think Babies Michigan collaborative is made up of more than 30 groups and numerous parents. Klein said it intentionally prioritizes having parents co-lead and co-design the policy agenda-setting process.

Although the coalition focuses primarily on making policy changes, Klein said it can also help families find the direct services that are available to support them around caring for their babies.

"We have secured greater public investment for early-on services, which enable families to get the services that they need," she said, "to intervene early if their baby shows signs of developmental delay or disability."

She said Think Babies Michigan aims to increase access and enrollment in high-quality child care and home-visiting services, along with early intervention and postpartum care for low-income families with children from birth to age three.


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For many in Nebraska's child-care industry, which was struggling even before the pandemic, the "Child Care Stabilization" funds in the American Rescue Plan Act made a huge difference. The money must be disbursed by Sept. 30, causing concern about a "funding cliff" for child care.

Catherine Huddleston-Casas, Ph.D., associate director of workforce planning and development at the Buffett Early Childhood Institute at the University of Nebraska, said the pandemic shone a light on the "poverty wages" many child-care workers receive. She said some found they could make better money in less-demanding jobs.

"The knowledge and expertise that is developed through the process of working under a seasoned child-care provider - all of that is going to be lost if we don't do something to try to keep our providers in their positions," she said.

The Nebraska Department of Health and Human Services distributed the stabilization funds in a variety of ways, including stipends to employees at licensed child-care centers, and grants to center owners and staff to help pay down school loans. In a survey of Nebraska providers, 87% reported receiving some COVID relief money in the previous year, and most had used it for rent and utilities. Today, Nebraska has 10% fewer child-care programs than before the pandemic.

Grants also helped centers expand their capacity. Ninety-one-percent of Nebraska counties have a shortage of licensed child-care slots, and 11 counties have no licensed providers.

Susan Sarver, Ph.D., director of workforce planning and development at the Buffett Institute, said the way funds were disbursed may help the state experience a less severe "funding cliff" than it might have.

"Some states are still maintaining centers, so they're paying wages through those pandemic funds," she said, "and when that money disappears, those are the places that are going to have the biggest drop."

Sarver acknowledged that only when there's data to examine will it be possible to evaluate the sustainability of Nebraska's approach.

Huddleston-Casas authored a recent study showing the gap to fully fund Nebraska's early-childhood care and education grew from 51% in 2017 to 57% in 2021. She said there won't be any quick fixes, but examination of the current system is crucial, including the way it's funded. She considers this especially important because of what we've learned about child development.

"They're not just passive recipients; there's a lot going on in a baby's brain," she said. "But in what ways does the system we have give us the opportunity to do better? Or are we stuck with a system that doesn't know how to accommodate the developmental needs of children?"