Proposed HHS rule puts Head Start’s early health checks at risk

A Maine paediatrician warns that removing Head Start screening and healthcare requirements could leave developmental problems undetected during the years when children’s brains are developing fastest.

The first years of life are not merely a warm-up for school; they are the period when much of a child’s brain development takes shape. The Centres for Disease Control and Prevention says the first eight years help lay the groundwork for learning, health and later life success, while the National Institute of Child Health and Human Development notes that learning begins before birth and accelerates rapidly through infancy and the toddler years. In that context, Deirdre Burns Mondor, a primary care paediatrician in York County, argues that weakening Head Start would come at exactly the wrong time for children who most need stability.

Mondor points to Head Start’s long record as a programme that does far more than provide early education. Since marking its 60th anniversary last year, the initiative has reached more than 40 million children nationally, according to her account, and it combines classroom learning with health care referrals, developmental screening, nutrition support and help for parents. She says that in Maine, the programme also functions as a federal-state-local partnership that helps working families while bringing federal funding into communities across the state.

The case for that integrated model is reinforced by child-development research. The CDC says responsive, nurturing care has a lasting influence on brain development, while North Carolina’s health department says experiences from birth to age 8 shape the brain’s architecture and therefore a child’s future learning, behaviour and health. That helps explain why paediatricians often see early education and early health support as inseparable: delays in hearing, language, sleep or other developmental concerns can quickly affect a child’s ability to concentrate, participate and keep pace in the classroom.

Mondor says Head Start is especially valuable for identifying children with developmental delays or disabilities early, before small problems become entrenched. In Maine last year, 217 preschool children and 46 infants and toddlers in Head Start were newly found to be eligible for special education or early intervention services, she writes. She argues that spotting needs at age 2 rather than age 5 can mean years of additional help, and that early treatment can improve school readiness while reducing longer-term costs for schools and communities.

Her warning centres on a proposed federal rule from the Department of Health and Human Services that would remove several of the standards she sees as essential to the programme’s success. According to Mondor, the plan would eliminate requirements to screen every child shortly after enrolment, follow up when a concern is identified and confirm within 90 days whether each child has an ongoing doctor and dentist. She says stripping away those safeguards would most hurt families already facing barriers to care, and she calls on Maine’s congressional delegation to press HHS to withdraw the proposal and preserve Head Start’s standards for the state’s youngest children.