- Letter from the President
In the early 1960s, Dr. Caldwell showed us that poor children seem to develop normally until about a year of age and then diverge in their progress from their less poor peers. We now know that this divergence may appear even earlier. At the Pediatric Academic Societies meeting in May, work was presented by Laura Betancourt, Ph.D., and her colleagues that showed the increased parental stress and less enriched home environments that poor infants experience already led to differences in cognitive and language scores at 12 months of age.
Dr. Caldwell partnered with Julius B. Richmond, M.D., FAAP, to create the Head Start program. It was based on her groundbreaking work at Syracuse University, which created enriched early childhood programs combining education and nutritional support for children with help for parents on parenting skills. At that time, Dr. Richmond was chair of the Department of Pediatrics at Syracuse and was recruited to start the Head Start Program as part of the Office of Economic Development Opportunity under Robert Sargent Shriver as part of the War on Poverty in Lyndon Johnson’s administration. In fact, Drs. Caldwell and Richmond wanted the program to start earlier in the life of the child, a program we now call Early Head Start, but couldn’t get traction for its adoption. Early Head Start was finally funded in the 1990s, although the funding is small compared to the need. Head Start, however, has helped more than 30 million children since its inception in 1965.
Perhaps most importantly, Dr. Caldwell taught us about parenting and the importance of the home environment in changing the developing brain in young children. From the beginning, she understood that parents were their children’s first teacher in the context of a loving and supportive home. She viewed early childhood education as a supplement, not a substitute, for good, effective parenting. She understood the consequences of excessive parental stress, a concept we talk about frequently today. And as a researcher, she developed the Home Observation for Measurement of the Environment (HOME) inventory that measures the home environment through direct observation and questioning at a home visit. The HOME is the gold standard in all research that seeks to measure or control for the impact of parenting and is widely used across the world today.
My personal experience with Bettye Caldwell was in the 1990s, when my colleagues and I were developing an office-based questionnaire to capture the same elements of the home environment that the HOME measured. We were developing the measure, StimQ, as part of a research project looking at the effects of low-level blood lead on child development and wanted to control for the effects of parenting. It is sad that we are still concerned about low-level lead exposure today. In the case of Flint, Mich., we are starkly aware of the potential effects of the combination of exposure to lead and a poorly resourced home environment.
I had long conversations with Dr. Caldwell about her thoughts on parenting, the home environment for young children, as well as asking her permission to use the HOME as the model for our new scale. She was generous, gracious, collaborative and wise. StimQ is now used wisely as a tool to measure the home environment when home visits cannot be made. I will be forever grateful for her wonderful help and guidance.
Bettye Caldwell was interviewed in 2013 and was asked what children need. “They need to be loved,” she said. “They need to be spoken to, all the time. They need opportunities to explore. They need to be safe and to feel safe. They need stable figures in their lives. They need new experiences. They need to repeat experiences they enjoy.”
The voice of Dr. Caldwell so beautifully mirrors the mission of the AAP, our agenda for children and many of our policies.
Dr. Caldwell was a psychologist and an educator, not a pediatrician. Her partnership with Dr. Richmond, a pediatrician, changed the lives of millions of children. We must continue to reach out to our partners in education and child development and to all those who care for and care about children. If we do that, together we too can change the world.
Bettye Caldwell, 1924-2016. We celebrate you!