BEND — After a free screening at Healthy Beginnings in Bend revealed that a Central Oregon couple’s child was ready for preschool by all measured health and developmental milestones, the parents were relieved.

The couple confided to the nonprofit’s executive director Diane Murray-Fleck that the family was in a financial crisis, living in a hotel and struggling to get back on its feet.

That was an epiphany for Murray-Fleck.

“I thought, ‘We’ve missed it,’” she said. “Serving children requires that we serve the parent. When the parents have all their needs met, they naturally want to love on their kids and want the best for their kids.”

The Bend-based organization runs a mobile screening program designed to check kids age 5 or younger for problems that could pose barriers upon entering school, such as hearing, vision, behavior and speech. Their experts offer helpful referrals or, as in this case, peace of mind. The program has screened more than 10,000 children across three counties in the past 25 years.

This year, Healthy Beginnings added a new target client to give children under age 5 a better start in education, health and life: parents.

Healthy Beginnings is one of many organizations trying to better serve young children by expanding their focus to the key adults in their lives. The approach is dubbed two-generation. It focuses on building parenting and career skills in tandem with learning and development in children.

Healthy Beginnings now has a station to screen parents with an experimental adult resilience measure. “We’re asking the questions: How are you doing? What’s going on with your family? Do you need more support?” Murray-Fleck said. “The dream is being able to offer adult referrals — to therapists, to housing, to food. Because we know if we can strengthen and empower the parent, they naturally will have a fuller tank to take care of their children.”

In some ways, the two-generation idea is not exactly new, but support for parents usually has been separated from the core focus on the child and often limited to advice and information. Now, the concept has become embedded in policies and programs as people seek to improve the access and quality of early learning programs, including childcare.

“The way science proceeds, we always try to accumulate stronger evidence and test more rigorously,” said Shannon Lipscomb, who leads human development and family sciences at Oregon State University-Cascades and who developed and is testing the adult resilience measure at Healthy Beginnings. “The renewed or expanded awareness is based on the science of how critical adults are as caregivers.”

The two-generation solution is showing up in different ways across Central Oregon. This year, for example, a kindergarten teacher Lindsey Kealey quit the classroom to coach local teachers on a program she developed that helps students learn to manage their own emotions and make responsible choices about their behavior.

On Nov. 20, she’s piloting the first session focused on parents’ needs. The three-part series at Buckingham Elementary School will brief parents on the social and emotional learning of children and how they can support that at home.

“The goal is to equip families with strategies and tools to be a seamless supportive environment for children to grow up in,” Kealey said.

Meanwhile, MountainStar Family Relief Nursery of Bend, which serves high-risk families, offers classes for parents and home visits in addition to its classroom-based services for children ages 0 to 5.

“At MountainStar, we often talk about getting parents to ‘like’ their children as a huge safety factor,” Tim Rusk, MountainStar executive director, wrote in an email. “’Love’ is virtually always guaranteed. ‘Like means a whole new set of actions — reading to them, getting on the floor to play with them, talking to them, making children feel special, nurtured and securely attached to their caretaker/parent. It is the basis for a child’s emotional health.”

Proponents assert the two-generation approach can help whole families lift themselves out of poor health and poverty more effectively and efficiently than focusing on the child alone.

The idea is that, even if infants and children are given optimal early childhood learning and daycare experiences, they often return to families without adequate food, housing, health care, security and stability, and sometimes to parents or other caregivers who may be severely depressed, traumatized, inattentive or abusive. It’s a cycle that can repeat through generations.

Decades of research have established the importance of early childhood brain development for health and wellbeing in life. Now, emerging neuroscience suggests another window of opportunity — in a parent’s brain.

So far, there is not much evidence about how well a two-generation approach will work, but the idea has an intuitive appeal that has generated broad support across the public and private sectors of society.

Early childhood learning experts hope it will help more children and families. Business leaders see it as a way to boost the return on investment in early learning programs and forge strong local economies. Policymakers see efficiencies in coordinating services.

“These are words and concepts that have grown up around what’s been happening for a long time,” Rusk said. “You can’t have healthy children without healthy families. But big stressors — community safety, safe housing — are beyond the scope of early childhood education. The wisdom of two-generation solutions to complex social problems is not new, but it has now become an irrefutable call to action. ”

Treating trauma

“It really comes back to the science of early childhood development,” Lipscomb said. “Young children’s brains are growing and evolving really rapidly. It sets the foundation for future development.”

In the first few years of life, more than 1 million new neural connections are formed every second, according to the Harvard University Center on the Developing Child.

By the time a child turns 1, the pathways are laid for basic vision and hearing. Early language skills and higher cognitive functions are well underway. Neural connections proliferate and are pruned along the way. Later, more complex brain circuits build upon the earlier, simpler circuits.

“They have a phrase in neuroscience: ‘What fires together wires together,’” said Rusk about how high-stress family lives affect vulnerable children. “Neural sequences become patterns. Then you are left with a child in elementary school who is good at scanning for safety and power, but not at paying attention to teachers.”

Adults play a major role in this developmental process through the “serve and return” relationship between children and their parents and other caregivers in the family or community. It’s easier and more effective to influence a baby’s developing brain architecture than to rewire parts of its circuitry in the adult years.

“Young children naturally reach out for interaction through babbling, facial expressions, and gestures, and adults respond with the same kind of vocalizing and gesturing back at them,” according to a science explainer on the Harvard center’s website. “In the absence of such responses—or if the responses are unreliable or inappropriate — the brain’s architecture does not form as expected, which can lead to disparities in learning and behavior.”

Healthy development can be derailed by toxic stress in early childhood. The excessive or prolonged activation of stress response systems in the body and brain can have damaging effects on learning, behavior and health across the lifespan.

To put the importance of adults in context, chronic neglect, exposure to violence or the accumulated burdens of economic hardship without a supportive adult to buffer the child is worse than the stress of a natural disaster, such as a fire or earthquake, or death of a loved one. If those severe difficulties are buffered by adult relationships, that can help the child adapt and allow the brain and other organs to recover.

Traumatic events add up, points out ACESTooHigh, a research news site about adverse childhood experiences. The list includes physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s dependent on alcohol, opioids or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s incarcerated and witnessing a mother being abused, as tallied by the Centers for Disease Control-Kaiser Permanente Adverse Childhood Experiences Study. Other types of trauma have been added to the list, including racism, witnessing violence outside the home, bullying, losing a parent to deportation, living in an unsafe neighborhood and involvement with the foster care system.

To help children overcome multiple traumatic events there’s a wave of solutions in Oregon designed to boost early childhood development, but they are not reaching all the children who need them.

The new parent brain

Science has shown how childhood adversity influences health in part by affecting what genes are turned on and off (through a mechanism called epigenetics), which can pass health risks of chronic disease from one generation to the next. But research also shows that brains and bodies can heal from the effects of toxic stress.

The Aspen Institute, a non-partisan think tank in Washington D.C., is a major proponent of the two-generation approach. Parents not only are critical agents of change for the child, according to an Aspen two-generation report, but they are also individuals who can benefit from the window of opportunity presented by parenting.

Decades of science shore up the rationale for early childhood programs, and now newer research suggests parenting is another distinct and important sensitive period for adults, the report stated. There is evidence of major structural and functional changes in the brains of new moms and dads that are supportive of positive parenting. The same window puts parents at risk too. Importantly, chronic stress, mood disorders, substance abuse, and their own childhood traumas may short-circuit this supportive biology.

“Without this supportive biology, new parents face an even more challenging task, and this co-occurs with the infant’s first and most important sensitive period,” concludes report authors. “Well-designed two-generation approaches during the transition to parenting—particularly when new parents have a legacy of risk—can build a cycle of opportunity for parents as people and for parents as agents of change for their children by capitalizing on these shared sensitive periods.”

A new analysis shows that the effects of a high-quality preschool with parental involvement can spill into the next generation.

Sixty years ago, an experiment called the Perry Preschool Project enrolled just over 100 kids ages 3 and 4. Researchers wanted to test if parental education and partnership, home visiting and child-centric early learning could raise IQs of poor African-Americans living in a dicey neighborhood outside Detroit.

The main question was a bust. Any IQ boost didn’t last long. And other results were more compelling. The grown children had better employment, health, cognitive and social and emotional skills and, for males, less criminal activity, especially violent crime, compared to other children in the neighborhood who didn’t participate in the project. The original preschoolers are now in their 50s.

Fast-forward to their adult children. Strikingly, those children also were better educated, healthier, better employed and more likely to stay stably married, especially if they were boys born to preschool-educated fathers.

Or, as one headline put it, “sending your boy to preschool is great for your grandson.”

The original preschooler’s children also grew up in the same or worse neighborhoods. The researchers concluded that the home environment and family life matters more than the neighborhood when it comes to promoting positive outcomes.

Child care deserts

One of the Perry study authors is James Heckman, a Nobel Prize-winning economist at the University of Chicago. His research shows that high-quality programs for disadvantaged children birth to age 5 can deliver a 13 percent per year return on investment.

Some state and national business organizations see a major value proposition in providing high-quality care to children younger than 5. They cite two main goals, to free up a productive workforce now and to train one for the future.

“If you’re working and can’t afford childcare, what do you do with the child when you need to go to work?” Asked early learning advocate Martha Brooks, the Oregon-based regional director for Council for a Strong America. “Childcare is more expensive than a college degree at OSU or UO. Yet, people have to pay for that at the time of their lowest income in life.”

A report Brooks submitted to the Oregon governor and legislature last year defines childcare in the title as “a two-generation solution for boosting Oregon’s workforce.”

In late September, the U.S. Chamber Foundation Center for Education and Workforce took their sales pitch to invest in early childhood education on a roadshow of events with Oregon chambers of commerce, including Madras-Jefferson county, Prineville-Crook county, Redmond and Bend.

Yet, in Oregon, high-quality childcare is so scarce that all families with infants and toddlers ages 0 to 2 live in a “childcare desert.” It’s not much better for families with preschool-age children ages 3 to 5, which face similarly limited options in 25 of 36 counties. That’s the finding of a January 2019 report by OSU researchers for the Oregon Division of Learning. A childcare desert was defined as a community where two-thirds or more of children do not have access to a regulated child care slot.

Deschutes and Crook counties are childcare deserts for children ages 3-5. Jefferson, on the other hand, is one of nine counties in the state with at least one childcare slot for every three children younger than 5. Thirty-four percent of Jefferson County’s young children have a child care spot available, compared to 20 percent in Deschutes County and 14 percent in Crook County.

Even if they can find childcare, parents may not be able to afford it. Public funding plays a big role. Statewide, 19 percent of regulated child care slots are publicly funded, while more than half of the child care slots in Jefferson County are publicly funded.

Expanding early learning

In Oregon, about half of all children are born to families in poverty who qualify for Medicaid. “That’s a pretty big low-income population,” said Sara Mickelson, chief of staff for the Oregon Early Learning Division. “We know those children have the hardest time accessing early education. With the exception of a few programs, it’s the family’s job to pay for early childhood education until children enter school.”

More than half of kids ages 3 and 4 are not in preschool, according to the 2019 Kids Count Profile by the Annie E. Casey Foundation. Two-thirds of them are not proficient in reading by fourth grade, nor in math by eighth grade. Nearly one-third of high school students in Oregon are not graduating on time.

The state exceeds the U.S. rate for children living in poverty (22% or 141,000 kids), children whose parents lack secure employment (36%), and children living in households with a high housing cost burden (45%).

A surge of new funding will flood into the education system next summer from the Student Success Act, passed this year by the state legislature. Of the $1 billion in funding estimated to be collected annually, 20% or $200 million is earmarked for early learning.

The funding will 10,000 new slots for a total of 25,000, which leaves about 50,000 children of low-income families without access to early childhood education.

The money will expand the variety of high-quality early childhood education programs, such as Early Head Start and Head Start. In Central Oregon, Brenda Comini, director of the regional early learning hub, is leading a needs assessment to develop priorities for the state funding. She’s looking at what seems to be working and not working and why, as well as areas that are not being served.

“We are really going to take advantage of conversations around childcare and the workforce and economic development,” Comini said. The two-generation concept will show up as “family engagement” in program design.

Other two-generation solutions for providing positive early childhood experiences are literally breaking ground in Central Oregon. In Redmond, for example, a multi-generational housing community will be part of the new Maple Meadows subdivision being built by Hayden Homes. Most of the 44 units are affordable housing for foster kids living with their forever families and for elders 55 or older.

“Everyone gathers for one cause, to support children to live vibrant lives,” said Derenda Schubert, executive director of the project Bridge Meadows. Two such housing communities are located in the Portland metropolitan area. “We believe in using intergenerational solutions,” she said. All communities have a therapist on-site to support community efforts.

“The ultimate goal is that every family enters the school years ready to contribute and thrive with no barriers toward the health and development of the child and of the family as a unit,” said Murray-Fleck. “Once you enter the school years, if there is a delay in discovering what’s wrong, it gets very expensive. If you can do that in the first few years of life, you can prevent a lot of heartaches.”