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Advocates for Children of New Jersey (ACNJ) is proud to be publishing the third Trenton Kids Count Data Book in over 20 years, a one-stop source for child well-being data on the state's capital city. Trenton Kids Count includes the latest statistics, along with data trends, in the following areas: demographics, family economic security, child health, child protection, child care, education, and teens. "Trenton Kids Count 2023" looks a bit different compared to previous data books. In particular, due to data quality concerns, the U.S. Census Bureau did not release American Community Survey (ACS) 2020 one-year estimates. For this reason, tables using ACS one-year estimates do jump from 2019 to 2021. [Funding for this report was provided by The Burke Foundation, the Princeton Area Community Foundation, and the Smith Family Foundation. For "Newark Kids Count 2022: A City Profile of Child Well-Being," see ED621268.]

Since 1997, Advocates for Children of New Jersey (ACNJ) has published the Newark Kids Count Data Book, a one-stop source for child well-being data on the state's largest city. Newark Kids Count includes the latest statistics, along with five-year trend data, in the following areas: demographics, family economic security, child health, child protection, child care, education, and teens.

Children develop fastest in their earliest years, and the skills and abilities they develop in those years lay the foundation for their future success. Similarly, early adverse experiences can contribute to poor social, emotional, cognitive, behavioral, and health outcomes both in early childhood and later life. Children who grow up in families with lower incomes tend to be at greater risk of encountering adverse experiences that negatively affect their development. One approach that has helped parents and their young children is home visiting, which provides individually tailored support, resources, and information to expectant parents and families with young children. Many early childhood home visiting programs aim to support the healthy development of infants and toddlers, and work with families with low income, in particular, to help ensure their well-being. In 2010, Congress authorized the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, which also appropriated funding for fiscal years 2010 through 2014. Subsequent laws extended funding for the program through fiscal year 2022. The initiation of the MIECHV Program began a major expansion of evidence-based home visiting programs for families living in communities that states identified as "at risk." The legislation authorizing MIECHV required an evaluation of MIECHV in its early years, which became the Mother and Infant Home Visiting Program Evaluation (MIHOPE). The overarching goal of MIHOPE is to learn whether families and children benefit from MIECHV-funded early childhood home visiting programs as they operated from 2012 through 2017. In addition, MIHOPE includes a cost analysis to estimate the cost of providing evidence-based home visiting to families. This report describes local programs' home visiting costs for the year after families begin receiving services and how those costs are allocated between meeting specific families' needs and other home visiting program activities. The analysis presented in this report has two main goals: (1) Examine the allocation of resources at MIECHV-funded programs in the MIHOPE cost analysis sample; and (2) Estimate the cost for each family served in MIHOPE and investigate how these costs differ across families, local programs, and evidence-based models.

For 25 years, Advocates for Children of New Jersey (ACNJ) has published the Newark Kids Count Data Book, a one-stop source for child well-being data on the state's largest city. Newark Kids Count includes the latest statistics, along with five-year trend data, in the following areas: demographics, family economic security, child health, child protection, child care, education and teens. [For "Newark Kids Count 2020: A City Profile of Child Well-Being," see ED616481.]

This publication presents the challenges and opportunities confronting early childhood development in vulnerable urban contexts, derived from specialised research by Arup and the Bernard van Leer Foundation (BvLF). The data is clear: vulnerable urban areas such as refugee and informal settlements house a growing population in critical need, and the number and size of these areas will only increase in the coming decades. Living in these contexts has particularly significant negative impacts on young children aged 0 to 5. At present, governments, development and humanitarian organisations, and urban practitioners devote little attention to the specific needs of the 0-5 age group in projects aimed at improving conditions in informal and refugee settlements. This age group's needs are different than those of older children but are often 'lumped in' with them from a planning and policy perspective, or worse, go entirely unrecognised. In addition, the complexity of vulnerability in these contexts makes it difficult to design and implement effective early childhood development solutions that consider the influence of the built environment. Arup and BvLF have partnered to help bridge this gap. The Proximity of Care approach was developed to better understand the needs and constraints faced by young children, their caregivers, and pregnant women in informal and refugee settlements; and to ultimately help improve their living conditions and well-being. [This report was co-produced by Arup.]

Over the past three years, the Boston Birth to Eight Collaborative has convened more than 200 individuals and organizations from across the early childhood field--center and family-based providers, pediatricians, public health researchers, hospitals, family engagement organizations, and parents--to ensure all children are ready for sustained success. The inaugural "State of Early Education and Care" report brings together for the first time data from the Boston Public Schools, Boston Public Health Commission, Massachusetts Department of Early Education and Care (EEC), U.S. Census Bureau, City of Boston Census and the United Way DRIVE Initiative. This report focuses on supply, demand and gaps in child-care seats (availability, quality and affordability). It also explores disparities based on child and family characteristics, including child/family demographics, and maternal/adult and child health. This first "State of Early Education and Care in Boston" aims to provide policy makers, philanthropists, and early education and care practitioners with information about gaps and opportunities around supply and demand of early education and care in the city. It will guide the Boston Opportunity Agenda and Birth to Eight Collaborative's citywide plan and will help to identify where additional child-care slots are needed, areas for quality improvement, and what other family supports are necessary. [This report was produced by the Birth to Eight Collaborative.]

Located on the U.S.-Mexico border, Webb County is an international trading center, bursting with culture and opportunities. But the county's future success depends on whether every Webb County child has access to opportunities that help them reach their full potential. Ensuring the well-being of all Webb County's children--across neighborhood, income, immigration status, race and ethnicity--is essential for each child's well-being and that of the community. Unfortunately, Webb County is not doing as well as Texas overall on many indicators of children's health, education and financial security--revealing a pattern of underinvestment in children's futures. This Webb County report is part of a larger series of reports in the Texas Kids Count project that focuses on equity in child well-being across Texas and in several of its major metro areas. [Texas Kids Count is a project of the Center for Public Policy Priorities. Additional funding for this paper was provided by Methodist Healthcare Ministries of South Texas, Inc.]

This edition of "The State of the World's Children" report examines children, food and nutrition. It seeks to deepen understanding around the causes and consequences of children's malnutrition in all its forms and to highlight how governments, business, families and other stakeholders can best respond. Chapter 1 examines the changing face of children's malnutrition. Chapter 2 investigates malnutrition across the life of the child, from development in the womb to the point where a young person is entering adulthood. Chapter 3 explores malnutrition in a changing world. Chapter 4 examines the current state of responses to children's malnutrition, including the increased attention -- at the global and national level -- to the importance of addressing malnutrition across multiple systems, with particular emphasis on the food system in synergy with the health, water and sanitation, education and social protection systems, and on how different stakeholders are responding. Finally, Chapter 5 sets out an agenda to put children's nutrition rights first. A Perspectives section includes: (1) Upholding a child's right to food and nutrition (Hilal Elver); (2) Why is addressing children's nutrition important for a country's broader economic development? (Sania Nishtar); (3) Women lead the way in community-based child nutrition in rural Tanzania (Scholastica Nguli); (4) Sesame Workshop's Raya teaches children healthy habits (Sherrie Westin and Raya); (5) The food industry must accelerate action to tackle the global nutrition crisis (Inge Kauer); (6) Grassroots activism in Mexico battles childhood obesity (Alejandro Calvillo Unna); and (7) Working together to deliver healthy people and a healthy planet (Peter Bakker).

This summary presents highlights of the "Minnesota Early Childhood Risk, Reach, and Resilience Report." The report describes potential risks to the healthy development of young children and the extent of coverage of publicly-funded services to meet their early learning, health, and basic needs. It also includes new and emerging indicators of risk, reach, and resilience. Finally, this 2018 report reviews and notes changes since the 2015 Minnesota Early Childhood Risk and Reach report in the indicators of early childhood well-being and the availability and accessibility of key services from a county-level perspective. [For the full report, see ED612386. For the 2015 summary, see ED612383.]

The physical, social, and economic health and well-being of adults and society are strongly influenced by experiences in early childhood. The most cost-efficient time to build foundational skills, to assure the healthy development of all young children, to break the cycle of disadvantage for vulnerable children, and to prevent achievement and health inequities is in the very early stages of development. This report describes potential risks to the healthy development of young children and the extent of coverage of publicly-funded services to meet their early learning, health, and basic needs. It also includes new and emerging indicators of risk, reach, and resilience. Finally, this 2018 report reviews and notes changes since the 2015 Minnesota Early Childhood Risk and Reach report in the indicators of early childhood well-being and the availability and accessibility of key services from a county-level perspective. It is intended to be a resource for all early childhood stakeholders in order to guide and inform resource allocation and policy. [For the summary, see ED612388. For the 2015 report, see ED612381.]

Across America, in living rooms and classrooms, in houses of worship and community centers, on street corners and in parks, families are doing their best to care for their children. Sometimes, parents and caregivers need extra support along the way, especially when they are living in adverse conditions marked by poverty, homelessness, violence and substance misuse. At the 2017 Winter Meeting of the National Governors Association (NGA), attendees were inspired by a plenary session that highlighted the importance of the early years of childhood development. In response to governors' interest in early learning, NGA focused on the role that governors can play in supporting children from birth to age 3 and their families. Following the winter meeting, staff from several governors' offices reached out to NGA for additional information. The NGA Center for Best Practices' (NGA Center) education, health and human services divisions collaborated to support the governors' requests. NGA Center convened an expert roundtable conversation in June 2018 to review the latest research and learn about current state efforts in this space. This report includes the vision statement that emerged from the roundtable, and the essential elements for integrated prenatal to age 3 policies were defined.

Each year, the Interagency Autism Coordinating Committee (IACC) releases a list of scientific advances that represent significant progress in the field. The "2017 Summary of Advances" provides short, plain language summaries of the top research breakthroughs selected by the IACC from a pool of research articles nominated by the members. The 20 studies selected for 2017 have provided new insight into potential biomarkers to predict risk of autism spectrum disorder (ASD), developmental trajectories of children with ASD, and the impact of various prenatal exposures on ASD risk. The advances also include studies that investigated treatments and interventions for both ASD and co-occurring conditions, the impact of policy changes on ASD health care spending, patterns of injury mortality, and prevalence differences across demographic groups. Articles in the "IACC Summary of Advances" are grouped according to the topics represented by the seven questions of the "2016-2017 IACC Strategic Plan for ASD": (1) How Can I Recognize the Signs of ASD, and Why Is Early Detection So Important? (2) What Is the Biology Underlying ASD? (3) What Causes ASD, and Can Disabling Aspects of ASD Be Prevented or Preempted? (4) Which Treatments and Interventions Will Help? (5) What Kinds of Services and Supports Are Needed to Maximize Quality of Life for People on the Autism Spectrum? (6) How Can We Meet the Needs of People with ASD as They Progress into and through Adulthood? and (7) How Do We Continue to Build, Expand, and Enhance the Infrastructure System to Meet the Needs of the ASD Community? Citations for the articles selected for the Summary of Advances, as well as a complete listing of those nominated, are included at the end of the document. [For the 2016 Summary, see ED589773.]

KIDS COUNT has used data to help call attention to emerging trends impacting kids in communities across the state. This year, the Colorado Children's Campaign marked the 25th birthday of KIDS COUNT in Colorado! by exploring this important question: What has changed for Colorado kids in the past 25 years? Long-term trends are not possible for every indicator, but a few success stories have emerged. Colorado's infant mortality rate in 2016 was nearly half of what it was 25 years earlier. The teen birth rate plummeted by nearly 70 percent, and our uninsured rate for kids reached a record low in 2016. The number of available spaces in early learning programs like the Colorado Preschool Program climbed steadily, and the share of Colorado kindergartners enrolled in a full-day program increased five-fold. Behind each of these numbers are real children who are better off as a result of policy decisions that contributed to these trends. The data in this report also shows where Colorado has work to do. For example, in 2015, the state's teen suicide rate--consistently one of the highest in the nation-- reached a rate not seen in the previous 25 years. Although infant mortality rates have declined overall, they remain high for some demographic groups. The school funding system has not been updated in nearly a quarter of a century and reading scores of fourth graders have been stagnant for nearly a decade.

To promote prenatal health and improve birth outcomes, the Centers for Medicare and Medicaid Services (CMS) developed the Strong Start for Mothers and Newborns initiative. The Strong Start initiative is assessing several enhanced prenatal care approaches, including home visiting. As part of the Strong Start initiative, CMS, in partnership with the Administration for Children and Families and the Health Resources and Services Administration, established the Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start). MIHOPE-Strong Start is evaluating the effectiveness of evidence-based home visiting for improving prenatal care and birth outcomes among women enrolled in Medicaid or the Children's Health Insurance Program. This report presents findings from a qualitative substudy of MIHOPE-Strong Start designed to summarize state efforts to promote prenatal health and improve birth outcomes, including but not limited to home visiting.

Located on the U.S.-Mexico border, the Rio Grande Valley is a place of rich culture and possibilities. However, on many indicators of children's health, education and financial security, the Valley is not doing as well as Texas overall, revealing a pattern of disinvestment in children's futures. In order to "raise the bar" in child well-being for all Rio Grande Valley area kids, Rio Grande Valley has to "close the gaps" in outcomes between children. Doing this means intentionally breaking down obstacles and creating equitable opportunities for good health, an excellent education, and economic security for every child. This is the only way to ensure the Rio Grande Valley's economic future is strong for both businesses and families. This Rio Grande Valley report is part of a larger series of reports in the Texas Kids Count project that focuses on equity in child well-being across Texas and in several of its major metro areas. [Texas Kids Count is a project of the Center for Public Policy Priorities. For the 2016 report, see ED582932.]

This policy plan offers an approach to early childhood policies that get to the roots of racial equity. It describes how to promote social, economic, health, and educational equity by broadening the current early childhood public policy focus in Minnesota on early education and service programs to also include funding efforts that promote positive early experiences; safe, stable, and nurturing relationships; and economic security and by building upon the assets and capacities of all families and communities. The interconnected components for public policy action included in this plan include supporting formal and informal multigenerational family and community support networks; investment in family and community economic development and security; the establishment of a flexible funding stream for community-led solutions; and the continuation of advancement in prenatal to age 3 holistic service and funding strategies, coordinated across systems and agencies. [Development and Training, Inc. co-produced this report.]

The California Children and Families Act of 1998 led to creation of the Kern County Children and Families Commission (First 5 Kern) to support early childhood service programs in Kern County, the third largest county in California that spread a land area as large as the state of New Jersey. In Fiscal Year 2014-15, First 5 Kern administered more than $10 million to fund 39 programs in four focus areas, Child Health, Family Functioning, Child Development, and Systems of Care. The local investment came from a state trust fund established by a $0.50 per pack tax on cigarettes or equivalent tobacco products. Following a model of results-based accountability, multilevel evaluation findings are summarized in this report to assess the annual impact of the program funding and provide recommendations for service improvement. Five chapters are included in this report. Chapter 1 highlights features of First 5 Kern support; Chapter 2 provides program-specific findings that impact children ages 0-5 and their families; Chapter 3 describes results of partnership building to strengthen the capacity of service integration; Chapter 4 includes longitudinal results from the Core Data Elements (CDE) survey and Family Stability Rubric (FSR) to describe sustainable accomplishments through ongoing improvements. This report ends with Chapter 5: Conclusions and Future Directions to review past recommendations and introduce new recommendations for next year. Quantitative and qualitative approaches have been taken to describe service outcomes in different communities, including the city of Bakersfield that has surpassed St. Louis in population size. The report includes two appendices: (1) Index of Program Acronyms; and (2) Technical Advisory Committee served in FY 2014-15.

Fort Worth is a city that prides itself on its heritage, resiliency and growth, from its birth as a small military outpost to the global city it is today. Despite the area's economic resources, the data also show gaps in children's health, education and financial security across race and ethnicity. In order to "raise the bar" in child well-being for all Fort Worth area kids, we have to "close the gaps" by intentionally breaking down obstacles and creating equitable opportunities for good health, an excellent education and economic security for every child. This is the only way to ensure Fort Worth's economic future stays strong. This Fort Worth report is part of a larger series of reports in the Texas Kids Count project that focuses on equity in child well-being across Texas and in several of its major metro areas. [Texas Kids Count is a project of the Center for Public Policy Priorities.]

"Early childhood risks" are markers of early childhood experiences that extensive research has shown to be detrimental to later academic and behavioral outcomes. In Philadelphia, evidence indicates that seven early childhood risks tracked by public agencies have negative effects on early school outcomes. These risks include low birthweight or preterm birth, inadequate prenatal care, teen mother, low maternal education, homelessness, lead exposure, and child maltreatment. The purpose of this research was to understand the early risk experiences of the entire population of children age 5 years in Philadelphia between 2008 and 2012. The specific questions were: (1) What are the prevalence rates of known early childhood risks, including low birthweight or preterm birth, inadequate prenatal care, teen mother, low maternal education, homelessness, lead exposure, and child maltreatment?; (2) What percentage of young children experienced multiple early childhood risks?; and (3) What is the geographic distribution of children experiencing multiple early childhood risks in Philadelphia? The Data Management Office (DMO) in the City of Philadelphia's Office for Health and Opportunity partnered with the Penn Child Research Center at the University of Pennsylvania's Graduate School of Education to create a data model that tracks evidence-based early risk experiences for children 0 to 5 years old. One table and three figures are appended.

This summary provides highlights from a report that describes potential risks to the healthy development of young children and the extent of coverage of publicly-funded services to meet their early learning, health, and basic needs. The report is the first attempt in Minnesota to describe indicators of early childhood development county by county. Differences and disparities by income and race/ethnicity, highlighted in other state level reports, however, are not available for every Minnesota county. The full report describes the methods in more detail, including limitations, and recommends possible improvements for future reports. [For the full report, see ED612381.]

The physical, social, and economic health and wellbeing of adults and society are strongly influenced by both positive and negative experiences in early childhood. The most cost-efficient time to build foundational skills, to assure the healthy development of all young children, to break the cycle of disadvantage for vulnerable children, and to prevent achievement and health inequities is in the very early stages of development. This report describes potential risks to the healthy development of young children and the extent of coverage of publicly-funded services to meet their early learning, health, and basic needs. It is intended to be a resource for all early childhood stakeholders in order to guide and inform resource allocation and policy. One benefit of compiling data in such a format is that these indicators can be periodically assessed for continuity, change, and integration over time. [For the summary, see ED612383.]

The U.S. is the only industrialized nation in the world without a paid leave policy for parents at or around the birth of a child. Prenatal care in the U.S. remains expensive, while virtually all other industrialized countries provide free or affordable prenatal care. While families in the U.S. pay about 80 percent of the direct cost of child care services, parents in European countries pay about 30 percent. WestEd's J. Ronald Lally says we can--and must--do better. With more than 45 years of experience developing programs and policies to improve the lives of infants, toddlers, and their families, Lally understands the urgency and necessity of supporting the healthy development of America's next generation. The latest research in brain science confirms what Lally and other child development experts and practitioners have known for decades: a healthy, nurturing, and engaging first three years are critical to babies' brain development, which supports their later success in school and life. Problems that result from inadequate care of children ages zero to three are difficult, costly, and sometimes impossible to correct. Unfortunately, the United States has a long way to go to adequately nurture its young. It currently lags far behind virtually all other industrialized countries in the support it provides to infants, toddlers, and their families. "American babies are getting inadequate prenatal care, less time at home with their parents during the first year of life, and fewer and lower-quality child care services, compared to babies in other industrialized countries," says Lally, Co-Director of the Center for Child & Family Studies at WestEd. "The United States needs to become much more strategic and farsighted in the way it supports its children during their critical first few years of life." This reality is why Lally and his colleagues launched For Our Babies, a national initiative to promote healthy development in U.S. children from conception to age three. During this period of life, a baby's brain undergoes an enormous transformation--growing from 25 to 85 percent of its adult size. The latest scientific research indicates that the actual physical structure of a baby's brain, as well as its functioning, is significantly shaped by experiences and environments in the baby's first three years. [This article was first published in WestEd's R&D Alert, Vol. 14, No.3, 2014.]

The Office for Civil Rights (OCR) in the U.S. Department of Education (ED) is responsible for enforcing laws prohibiting discrimination in federally assisted educational programs and activities. These laws include "Title IX" of the Education Amendments of 1972 ("Title IX"), which prohibits discrimination based on sex in education programs or activities. All public and private educational institutions that receive any federal financial assistance ("schools") must comply with this law. "Title IX" protects students in all of the academic, educational, extracurricular, athletic, and other programs or activities of schools. This includes prohibiting discrimination against pregnant and parenting students. This pamphlet has been prepared for secondary school administrators, teachers, counselors, parents, and students. The first section provides background on school retention problems associated with pregnant and parenting students. The next two sections, "'Title IX' Requirements Regarding Pregnant and Parenting Students" and "Frequently Asked Questions Pertaining to 'Title IX' Requirements Regarding Pregnant and Parenting Students," provide information on the law's specific requirements regarding pregnancy and parenthood. The final two sections, "Strategies to Assist Educators in Supporting Pregnant and Parenting Students" and "Programs Designed to Support Pregnant and Parenting Students," include strategies that educators can use and programs that schools can develop to address the educational needs of students who become pregnant or have children. Although this pamphlet focuses on secondary schools, the underlying legal principles apply to all recipients of federal financial assistance, including postsecondary institutions. [This document was first published in July 1991 and revised in June 2013.]

We consider the effects of daytime fasting by pregnant women during the lunar month of Ramadan on their children's test scores at age seven. Using English register data, we find that scores are 0.05 to 0.08 standard deviations lower for Pakistani and Bangladeshi students exposed to Ramadan in early pregnancy. These estimates are downward biased to the extent that Ramadan is not universally observed. We conclude that the effects of prenatal investments on test scores are comparable to many conventional educational interventions but are likely to be more cost effective and less subject to "fade out". (Contains 3 tables, 6 figures and 17 footnotes.)

This report sets out to estimate the total annual expenditures on children in New York City and to create a "fiscal map" to detail them. This fiscal map describes these expenditures according to a series of classifications, including age of child (early childhood, elementary, and high school); source of funding (public, tax-related, and philanthropic); level of government (city, state, and federal); and child disadvantage as measured using poverty criteria. The goal of the map, derived from analysis of budgetary data and official sources, is to depict expenditures on children in a clear and comprehensive fashion. Based on data for 2010, the authors estimate that annual fiscal spending for the average child in New York City is $15,630, which, adjusting for inflation, represents a slight decline over the period since 2005. For all 2.02 million city children, this amounts to a total of $31.5 billion, Most of that money is spent on schooling; expenditures for developmental supports for children, such as early childhood care and education and out-of-school time programs, as well as medical care and critical programs such as homeless services, amount to less than one-third of the total. Over the period, the pattern of expenditures changed significantly. The fiscal map also shows that the primary source of funding for New York City children is the city government, which provides almost half of the direct funding for programs for children. The state is the next largest source. Direct expenditures by the federal government are nearly equaled by the resource implications of rules on tax-related expenditures (such as the Earned Income Tax Credit). Notably, the map does show that public investments are disproportionately allocated toward disadvantaged children. Whereas average annual direct public spending per child is $13,340 (net of tax-related expenditures and philanthropic contributions), spending for a child who lives in a household with an income that is less than 185% of the federal poverty level is $19,280. However, the authors caution that the full amount of this spending gap should not be interpreted as a redistribution to benefit those with the greatest needs: it includes spending on rehabilitative programs and the juvenile justice system, for example, and includes very little spending that might be classed as preventive. Appended to the report are: (1) Web-Based Information Sources; (2) Programs and Services by New York City Department; and (3) Expenditures by Programs by New York City Department. [For "Providing Comprehensive Educational Opportunity to Low Income Students. Part 1: A Legal Framework," see ED573117; for "Providing Comprehensive Educational Opportunity to Low Income Students. Part 2: How Much Does It Cost?," see ED573119; for "Providing Comprehensive Educational Opportunity to Low Income Students. Part 4: What Are the Social and Economic Returns?," see ED573122; and for "Providing Comprehensive Educational Opportunity to Low Income Students. Part 5: A Proposal for Essential Standards and Resources. A Report of the Task Force on Comprehensive Educational Opportunity," see ED573123.]

The inability of the United States to narrow the achievement gap stems to a large extent from school reform initiatives that neglect the specific conditions in the lives of low-income students that contribute heavily to inadequate school performance. A new consensus is emerging that a more effective approach would be to prevent the achievement gap from emerging in the first place. This strategy would start with high-quality early childhood experiences and include adequate health care and high-quality after-school and summer programs, as well as school improvement. This second in a five part series, an analysis, estimates the cost of public policies to substantially narrow the achievement gap, if these policies begin early in the development cycle and build on previous success, rather than attempting to remediate past failures. The report models appropriate investments in prenatal, neonatal, infant, and early childhood development, followed by appropriate investments later to sustain the effects of such early interventions. It assumes that such a strategy could significantly inhibit development of the achievement gap in the first place, making it easier to sustain greater equality in outcomes through the school years. The full program covers a span of 18.5 years, from the beginning of the second trimester of pregnancy to 18 years of age. It would take 18.5 years to implement fully, because as each cohort matures, new services are added in each year. And each year, a new cohort is added to the model. The model is comprised of the following components: The prenatal period is devoted to ensuring that all underprivileged pregnant women receive adequate prenatal and obstetric care, increasing the likelihood that each child is born with capacity to flourish. Family (parental support) services also begin in the prenatal period and continue throughout the full 18½ years of the child's development cycle. These services include visiting nurses from the second trimester of pregnancy until the child's third birthday, parent access to continuing education from the neonatal and infancy year until the child's 18th birthday, visiting home literacy coaches for low-income children ages three, four, and five, and school-based comprehensive service coordinators. The neonatal and infancy year of the model, covering newborns to one year of age, introduces highquality early childhood care and education that continues through age two. The model provides prekindergarten for ages three and four. Also introduced in the neonatal and infancy year is routine and preventive pediatric care, and routine and preventive dental and vision care are added soon thereafter. The program models all of these costs as provided in a school-based health clinic and continuing until the child's 18th birthday, which the model assumes occurs at the end of the normal senior year of high school. The model also provides for high quality after-school and summer programs from age five (kindergarten) to age 18. The model assumes that the children eligible for these services are those who are eligible for the federally subsidized lunch program. In 2008, approximately one-third of all children in New York State were in such households. For each underprivileged family and child in New York City that takes advantage of all services recommended and modeled in this report, the estimated cumulative lifetime (to age 18) cost is about $290,000, or an average annual per child cost of about $15,700. If these costs were converted to New York State dollars, the lifetime per child cost would be approximately $256,000 and the average annual per child cost would be about $13,900. Assuming conservatively that each child would access 75% of the available services, the New York City annual cost would be approximately $11,800 per child and the New York State cost approximately $10,400. Appended to this report are: (1) Will Implementation of This Model Reduce Special Education Expenditures?; and (2) Are Services Provided in This Model Already Covered by Medicaid?. Endnotes and a bibliography are also provided. [The authors are grateful to the Smart Family Foundation, the James and Judith K. Dimon Foundation, and the Robert Sterling Clark Foundation for support of this research. For "Providing Comprehensive Educational Opportunity to Low Income Students. Part 1: A Legal Framework," see ED573117; for "Providing Comprehensive Educational Opportunity to Low Income Students. Part 3: How Much Does New York City Now Spend on Children's Services?, see ED573121; for "Providing Comprehensive Educational Opportunity to Low Income Students. Part 4: What Are the Social and Economic Returns?," see ED573122; and for "Providing Comprehensive Educational Opportunity to Low Income Students. Part 5: A Proposal for Essential Standards and Resources. A Report of the Task Force on Comprehensive Educational Opportunity," see ED573123.]