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New federal grant invests $4M to improve early childhood development

Tuesday, September 10, 2019
Debra Best, MD; Karen Carmody, PhD

Positive social-emotional development in early childhood is essential for lifelong health and well-being. When children have safe environments and secure relationships with parents or caregivers, their bodies and brains are fully able to develop complex skills like self-regulation, empathy, resilience, and curiosity that are the building blocks for learning and growth. For children who experience trauma or chronic adversity, though, those developmental processes are interrupted, increasing their risk for a range of negative outcomes from dropping out of school to developing diabetes and other chronic illnesses in adulthood.

The compelling data on the power of early social-emotional development to drive key life outcomes consistently bring elected officials, policy makers, and other institutional leaders to one conclusion: anyone who serves young children in our community should be equipped to support healthy social-emotional development and to identify children with developmental concerns. Building such a comprehensive system is an ambitious, long-term undertaking, but a new five-year grant of $4 million will help Durham County make meaningful progress toward that vision.

The grant has been awarded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to the Center for Child and Family Health (CCFH), a Durham-based nonprofit with expertise in trauma-informed approaches to early childhood development. As the coordinating grantee, CCFH will bring together partners in early care and education, pediatrics, family support, mental health, and homeless services in a unified strategy called Responsive Early Access for Durham’s Young Children (READY). Other funded agencies include Child Care Services Association, Duke Children’s Primary Care, Exchange Family Center, and Families Moving Forward. Project evaluation will be conducted by the Duke Center for Child and Family Policy.

The primary goal of the READY project is to foster the healthy development and wellness of all young children in Durham County, preparing them to thrive in school and beyond. This includes expanding the use of evidence-based practices for preventing mental, emotional, and behavioral disorders and for identifying and addressing behavioral concerns before they develop into serious emotional disturbances. While the project is designed to meet the needs of all children ages 0-8 in the county, it will give particular attention to those affected by racial disparities, substance abuse, homelessness, and parental military deployment.

Specific project activities include:

  • Identifying behavioral and developmental concerns early through increased screening and assessment in primary care, early intervention, and early childhood education programs with linkages to appropriate services.
  • Training parents, guardians, and other caregivers to create healthy, safe, and secure relationships and environments in which young children can learn and grow, and to address identified problems.
  • Expanding use of evidence-based integrated behavioral healthcare for families of children ages 0-3 at Durham’s largest pediatric clinic along with training for the clinic’s primary care providers to support the social-emotional needs of young children.
  • Equipping early childhood education providers to create learning environments that are responsive to social, emotional, and behavioral concerns through training and in-classroom mental health consultation.
  • Providing general training to a broad range of professions on the effects of trauma and toxic stress on brain development and strategies to buffer children from those effects.

Through these strategies, CCFH estimates that 7,000 families will be screened during the course of the project and 4,000 families will receive prevention and mental health services. Nearly 1,000 child-serving professionals will receive training. The project is also expected to improve coordination across child- and family-serving systems and to raise public awareness about local resources to promote healthy social-emotional development in early childhood.

The year-long planning process was led by Karen Carmody, PhD, director of early childhood prevention programs at CCFH, who points to long-standing collaboration among the project partners as a compelling factor in the application to SAMHSA. “This community has a long history of close coordination in the early childhood arena,” she says, “and there have been remarkable steps taken in recent years to help families here secure a good start in life.” With such a strong foundation of working relationships already in place, she believes the project is aptly named: “Durham is truly ready for READY!”

Debra Best, MD, associate professor of pediatrics in the Duke University School of Medicine, will oversee the project’s expansion of evidence-based integrated behavioral healthcare at Duke Children’s Primary Care. “We are thrilled to be a partner in the READY initiative,” she says. “By increasing screening, improving pediatric capacity to address social-emotional development needs, and building new linkages between systems, we have an exceptional opportunity here to strengthen the continuum of care and improve health outcomes for young children in Durham County.”

A kick-off celebration for the READY project will be held Tuesday, September 24, 3:30 pm to 5:00 pm, at the Durham County Administration Building II (201 East Main Street, Room 461). Staff from child- and family-serving agencies in Durham County are encouraged to attend to learn how they can participate in the project. More information and registration for the kick-off is available at

The Center for Child & Family Health (CCFH) is a multi-disciplinary behavioral health agency in Durham,
North Carolina, specializing in evidence-based interventions for childhood trauma and supports for early
childhood development. Through its outpatient clinic, home visiting programs, and other family services,
CCFH meets the needs of more than 2,500 children in Durham and surrounding communities each year.
CCFH’s practitioner-trainers also teach hundreds of child-serving professionals each year, steadily
improving the trauma-informed care available to thousands of children throughout North Carolina and