Ways to Support Low-Income, At-Risk Young Children During and After Coronavirus Disease 2019 | JAMA Pediatrics | JAMA Network
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Comment & Response
January 4, 2021

Ways to Support Low-Income, At-Risk Young Children During and After Coronavirus Disease 2019

Author Affiliations
  • 1Clinical Excellence and Research Center, Stanford University, Stanford, California
JAMA Pediatr. 2021;175(4):424-425. doi:10.1001/jamapediatrics.2020.5284

To the Editor In an issue of JAMA Pediatrics, Dooley et al1 bring up the important issue of supporting low-income children during coronavirus disease 2019 (COVID-19) and suggest that US Congress should increase investments in evidence-based programs (eg, home visiting and Head Start) and digital learning. Expanding evidence-based programs in the early intervention (EI) and preschool school systems may be more challenging than we thought, even before COVID-19. For instance, approximately 170 000 low–socioeconomic status (SES) children aged 3 or 4 years who were eligible for state-run preschools in California were not enrolled in state-run preschools. Governor Newsom wanted to expand 10 000 preschool spots2 after he took office but unfortunately did not, in part because of limited school facility capacities and teacher shortage. As a result, a large fraction of $100 million of education funds remain unused.

The EI and preschool systems for low-SES and at-risk children will face 2 challenges in the upcoming years owing to the likely repercussions of COVID-19: (1) a high rate of parent unemployment rate that contributes to family instability and (2) the need to support young children at home without the presence of a specialist/teacher owing to social distancing. To turn this pandemic crisis into an opportunity, we need to think beyond expanding existing evidence-based programs but instead ideating new ways to deliver such programs in a family-centered manner with the consideration of the larger economic environment.

One intriguing, related question is whether we can systematically teletrain and pay low-SES parents to deliver part-time preschool education or EI at home. Training and paying low-SES parents to deliver EI/part-time preschool education at home solves 2 major problems. First, it offers employment to many jobless parents. Approximately 26 million people have already lost their jobs during the pandemic crisis; many of these low-income parents are now jobless. Directly paying parents who want to and are capable of delivering EI/preschool education at home may provide a more stable environment for both the children and parents.

Second, many research studies have already shown that, with support, parents can successfully learn and implement EI strategies at home.3,4 Training parents to deliver EI and preschool curriculums for at-risk children at home could decrease the demand for space and support personnel and enable continual support for at-risk children in face of social distancing.

This is just a thought designed to prompt more creative ideas. As suggested by Dooley et al,1 we will need more creative solutions to meet the mounting needs of young children and their families during and after this pandemic crisis.

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Article Information

Corresponding Author: Venus Wong, PhD, Clinical Excellence and Research Center, Stanford University, 365 Lasuen St, Stanford, CA 94305 (vwhwong@stanford.edu).

Published Online: January 4, 2021. doi:10.1001/jamapediatrics.2020.5284

Conflict of Interest Disclosures: None reported.

Dooley  DG, Bandealy  A, Tschudy  MM.  Low-income children and coronavirus disease 2019 (COVID-19) in the US.   JAMA Pediatr. Published online May 13, 2020. doi:10.1001/jamapediatrics.2020.2065PubMedGoogle Scholar
The 2020-21 budget: early education analysis. legislative analysis office. Accessed May 14, 2020. https://lao.ca.gov/reports/2020/4167/Early-Education-Analysis-022120.pdf
Pickles  A, Le Couteur  A, Leadbitter  K,  et al.  Parent-mediated social communication therapy for young children with autism (PACT): long-term follow-up of a randomised controlled trial.   Lancet. 2016;388(10059):2501-2509. doi:10.1016/S0140-6736(16)31229-6PubMedGoogle ScholarCrossref
Baker  AJ, Piotrkowski  CS, Brooks-Gunn  J.  The home instruction program for preschool youngsters (HIPPY).   Future Child. 1999;9(1):116-133, 192-194. doi:10.2307/1602724PubMedGoogle ScholarCrossref