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 health and development. Parents respond to questions regarding their child’s health and development. For children age 0-5 years, four questions were asked that aimed to capture curiosity and discovery about learning, resilience, attachment with parent, and content with life. These were captured through: (1) child is affectionate and tender, (2) child bounces back quickly when things don’t go his/her way, (3) child shows interest and curiosity in learning new things, and (4) child smiles and laughs a lot. 

Early childhood is a critical time that provides the greatest opportunities to influence the trajectory of a child’s life. With 90% of brain development occurring in the first five years of 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. Growing research shows that children who grow up with prolonged, or toxic, stress face significant health, well-being, and economic challenges as 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. Engaging families in better understanding child development, including young children’s social and emotional skill development, 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—the Child, Adolescent, Family Unit
• Designated Mental Health Agencies
• Building Bright Futures State and Regional Councils
• Early Childhood Educators
• Strong Families Vermont Nurse and Family Support Home Visiting Programs
• Parent Child Centers
• Help Me Grow Vermont
• Vermont Child Health Improvement Program (VCHIP)

• 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

Young children who develop social and emotional skills — a core characteristic of resilience — can often offset or mitigate the effects of adversity. Emotional self-control is key for predicting future success and well-being. Responsive exchanges and supportive relationships with adults and caregivers help children build the adaptive skills they need to cope with serious hardship. When families have strong connections, emotional supports, and engage in parenting practices that model positive behaviors and emotional expression, children are more likely to develop similar behaviors and coping skills, particularly in times of stress. Find more information on what works at:

https://developingchild.harvard.edu/

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

Vermont supports programs that serve children and families 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 learning and the development of social and emotional skills which better prepare children for kindergarten and lifelong success.

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.