Updated: September 2023

Author: Early Childhood Program, Vermont Department of Health

The National Survey of Children’s Health (NSCH) is sponsored by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, and is conducted by the U.S. Census Bureau. The NSCH is a national survey that provides rich data on multiple, intersecting aspects of children’s health and well-being – including physical and mental health, access to and quality of health care, and the child’s family, neighborhood, school, and social context. The NSCH is designed to produce national and state-level data on the physical and emotional health of U.S. children <1-17 years of age. Each year, prospective participants are mailed an invitation to complete a household screener and then a child-level questionnaire either by mail or online. Parents respond to questions regarding their child’s or adolescent’s health and development. The criteria used for measuring family resilience are based on a composite measure of the 4 survey items: “When your family faces problems, how often are you likely to do each of the following?” (a) Talk together about what to do, (b) Work together to solve our problems, (c) Know we have strengths to draw on, and (d) Stay hopeful even in difficult times.

Childhood and early adolescence is a critical time that provides the greatest opportunities to influence the trajectory of a child’s life. Early experiences, relationships and environments have a deep and lasting impact on development and lifelong health. When parents struggle to meet basic needs, their stress can affect their child’s emotional and physical health. Furthermore, when parents or caregivers experience adversity, either past and current (e.g., poverty, domestic violence, depression, a substance use disorder, or childhood trauma), their distress can impact their parental responsiveness, attachment, bonding, ability to provide appropriate discipline, and overall relationship with their child or adolescent. Growing research shows that children who grow up with prolonged, or toxic, stress face significant health, well-being, and economic challenges as young adolescents and adults.  In Vermont, seven out of every ten children have one or more factors that place them at risk for a developmental or behavioral delay (risk factors include maternal depression, parental stress, linguistic and cultural diversity, poverty and rural isolation, etc.). 

Supporting parents and caregivers to create a protective home environment mitigates family adversity and promotes healthy child development and family well-being. Engaging families in better understanding child development, including social and emotional skill development across early, middle, and late childhood is an evidence-based strategy that:

•     Increases family stability

•     Addresses toxic (long-term persistent) stress

•     Enhances child development

•     Reduces the risk of child abuse and neglect

National partners include the Maternal and Child Health Bureau. State partners include:

• Department of Mental Health, Child, Adolescent, Family Unit
• Designated Mental Health Agencies
• Building Bright Futures State and Regional Councils
• Early Childhood Educators adn School Districts
• Strong Families Vermont Nurse and Family Support Home Visiting Programs and Children's Integrated Services
• Help Me Grow Vermont
• Parent Child Centers
• Vermont Child Health Improvement Program

•             Change social norms to support parents and positive parenting

•             Strengthen economic supports to families

•            Provide quality care and education early in life

•             Enhance parenting skills to promote healthy child development

•             Intervene to lessen harms and prevent future risk

When faced with serious adversity, families are more likely to demonstrate resilience, or an adaptive response to serious hardship, when they are supported with protective experiences. When families have someone to turn to for emotional support and know where to get help in their community, the effects of hardship are reduced. When parents and caregivers have responsive exchanges and supportive relationships with children, they help children build the adaptive and emotional skills they need to manage stress and cope with difficulties. Families demonstrate resilience when, faced with problems, they talk together about what to do, work together to solve them, and know they have strengths to draw on while staying hopeful. These criteria support family well-being and mitigate the effects of adversity on young children and adolescents. Adverse family experiences are less likely to affect children’s/adolescent’s school engagement, academic success and ability to thrive if they develop social and emotional competence. Resilience moderated the effect of three or more Adverse Family Experiences (AFE’s) on a child’s engagement in school and their ability to complete all homework. Research shows that having at least one supportive adult in the child’s life can make a tremendous difference in helping a child develop resiliency. Additionally, when families have strong connections and supportive communities, children often demonstrate increased resiliency. Find more information about what works at:

https://developingchild.harvard.edu/

https://www.cdc.gov/violeneprevention/pdf/can-prevention-technical-package.pdf

https://www.cdc.gov/violenceprevention/pdf/yv-technicalpackage.pdf

https://www.cdc.gov/violenceprevention/pdf/ipv-technicalpackages.pdf

Vermont supports programs and communities to build five protective factors that are the foundation of the Strengthening Families Approach[1]:

•   Support Parental Resilience: Managing stress and functioning well when faced with challenges, adversity, and trauma

•   Create Social Connections: Feeling connected with constructive, supportive people, and institutions

•   Improve Knowledge of Parenting and Child Development: Understanding parenting best practices and developmentally appropriate child skills and behaviors

•   Provide Concrete Support in Times of Need: Identifying, accessing and receiving needed adult, child, and family services

•   Increase the Social and Emotional Competence of Children: Forming secure adult and peer relationships; experiencing, managing, and expressing emotions in healthy ways

When the protective factors are well established in a family, parental stress is lower and, as a result, family stability increases, the likelihood of child abuse and neglect diminishes, and the child’s emotional and physical health is protected. Promotion of protective factors encourages parents/caregivers to support children’s and adolescent’s learning and the development of social and emotional skills which better prepare children and adolescents for school and lifelong success. Building Flourishing Communities, Help Me Grow Vermont, Early Multi-Tiered Systems of Support (Early MTSS), Positive Behavior Interventions & Support (PBIS), universal high-quality child care, and screening for social determinants of health and promotion of protective factors in Medical Homes are Vermont strategies to strengthen families and mitigate adversity.

Data is based on 2 years of pooled data due to small sample sizes. No data is available for 2018 due to a change in methodology between 2017 and 2018.

The Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB) provides the primary funding and direction for the National Survey of Children’s Health. More information can be found here: https://mchb.hrsa.gov/data/national-surveys. Households received a mailed invitation asking an adult in the household who is familiar with the child’s health and health care (usually a parent) to complete a short screener questionnaire (via web or paper). The screener asked participants to identify all children ages 0-17 living in the household.

• If a child (or children) was reported to live in the household, participants who chose to respond online were immediately directed to a more detailed, age-specific topical questionnaire for one randomly selected child.

• Participants could also request a paper copy of the screener and topical questionnaire if they did not wish to complete it online.

• For more details about individual surveys, see 2016 NSCH Survey Sampling and Administration Diagram, 2016 Methodology Report, 2017 NSCH Survey Sampling and Administration Diagram, and 2017 Methodology Report.