179 - Cynthia Osborne: Translating Evidence Into Early Childhood Policy

0:00Adani:Welcome back to the Stanford Psychology Podcast. I'm Adani and for this week's episode I had the pleasure of chatting with Cynthia Osborne. Professor Osborne is the founder and executive director of the Prenatal to Three Policy Impact Center at Vanderbilt University, Peabody College of Education. She completed her PhD in Demography and Public Affairs at Princeton University after studying public policy, education, economics and psychology. Her research spans social policy, poverty and inequality, family and child well-being, and family demography. Under her lead, the Prenatal to Three Policy Impact Center reviews and translates evidence from these varied domains to inform how society can best translate science into effective solutions for infants, toddlers, and their families.

0:51Adani:I loved learning all about what it takes to bridge research with policy at the state level and beyond, and I hope you do too. Without further ado, here's our conversation. Thank you.

1:26Adani:I'm really excited to have you with us today. Thank you so much for joining us. I'm really glad to be here. Thanks so much for the opportunity. The audience has already heard a little bit on what you do more generally as a researcher and also as the director of the center that you run. But nevertheless, I want to ask you just how would you describe what you do at this prenatal to three policy impact center, but also more generally as a professor and researcher? How would you describe that? Well, so I'm a professor of early childhood education and policy at Vanderbilt. And I'm in the Peabody College, which is actually a school of education and human development.

2:06And my work is really about kids before they get to school. I'm actually a former teacher, taught sixth grade for several years and really thought of education as the kind of key to greater equality, greater opportunities for everyone. And the more and more that I both taught and then went back to do additional graduate work, I learned that although what's happening in the schools is incredibly important, it's so important what happens both outside of school, even among our school age kids, as well as what happens before they actually get to school and start kindergarten or even pre-K. And so my work has been, as both a scholar and now the director of the center, has really been focused on how families and communities and policy can really create those environments in which all of our children are thriving right from the start.

3:23Adani:there's a lot in there and i'm also really curious to ask you more about your teaching experiences maybe later on we can circle back on that so i think perhaps a lot of people who had some explore well all of us i guess had some exposure to preschool environments and obviously family environments and so forth and all of us had various experiences that shaped us during that time and there's a lot of evidence out there speaking to the importance of those early years still, I want to ask you, why exactly do we focus, or is it worthwhile focusing so heavily on these prenatal to three years? And also, actually, secondly, it seems to me that a lot of the work you do is focusing on the state level, but you've also worked on national programs before.

4:02Adani:So maybe that's two pieces, like why focus on prenatal to three? Why focus on the state level? And what kinds of promising things do we see there? Yes. So why prenatal to three? For decades, developmental psychologists have been really telling us how important these earliest years are to shaping all of our subsequent development. And in the last 20 years, especially in the last decade, we've really been able to start to actually image what's happening there. Neuroscientists have shown us what is going on in the brain. And the brain is the only organ in our body that is not fully formed when we are born.

4:48So every other organ, your heart, your liver, your kidneys, these are all just kind of small versions of what they will ultimately become, but they're operating in just the same way that they will across your lifespan until obviously you start to damage it as you get older and so forth. But your brain is actually expecting input from its environment. Think of like this supercomputer that is kind of waiting to be wired in certain ways to be most effective in psychology, we call it adaptive, to our environment. And we know that having nurturing interactions between a loving caregiver and a child is really that key to shaping your brain in those earliest years.

5:42That the part of the brain that is really going to set us apart from all other mammals is what we call our prefrontal cortex. It's the part of the brain where decision-making and relationships and delayed gratification and critical thinking, all of those life skills are really kind of regulated by that part of our brain are things like executive functioning, getting along, paying attention, all those things in school that actually make you pretty successful, make you successful at work, make you successful in friendships and in life. and so about 90 % of all of that development that's going to happen over your lifespan is happening in those first three years.

6:31We call this a period that is both a rapid period of development and a sensitive period of development, meaning that your brain's expecting all of that input by the time you're age three. And if it doesn't get it, it's not that you can't ever learn these skills. It's just a lot harder. And we haven't really figured out a way to teach them very well. And so what we know is that we're born kind of primed and ready for folks to help us understand who are our people, what's our language, what's safe in this world, what's scary, and how do I operate through it? And our brains are paying attention, and their environment's going to teach us how to be, how to survive.

7:21Like, that is biologically what it is wired to do. And we know that if we expose it to environments that are nurturing and safe and stable, with limited exposure to really bad things or adversity, that our prefrontal cortex is developing in a way that will literally have lifelong consequences for our health and well-being, and they will be positive. If instead our children are born into environments in which they have no money, the parents don't know where they're going to sleep that night or how they're going to feed their children or whether they're going to pay their electric bill, how they're going to get to work, all of those stressors, and especially things like violence or other acute stressors, your brain is actually learning how to survive in that environment, but it's not developing those life skills that make you reach your optimal potential.

8:29So I know that was kind of a long answer to why prenatal to three, but hopefully, you know, you can see that it's such an important developmental period because it really does set the stage for lifelong learning and health and well-being. And we also know that that's when the brain is most malleable, when we can do the most. So you also asked, why do we focus on state level policy rather than only on national policy. And at the center, we focus on the policies that are the closest to the families, if you will. And nearly all of our policies are implemented by states, even if they're federal policies.

9:19So something like SNAP, which is our nutrition program, is a federal policy, but it's implemented by the states. And so how easy it is to get access to it, all of those things are really influenced at the state level. And then we have a lot of policies that only states are actually implementing, that we don't have a federal policy. So something like a paid family medical leave program, where you get time that's paid after having a child, or when you're ill or a family member is, we have only a handful of states, 13, that have implemented those policies. And we have, we're the only wealthy nation that doesn't have a federal policy.

10:05We have an unpaid federal policy. So, again, we look to states because there's this huge variation right now in what our kids have access to based on just the state in which they're born. In fact, when we combine a set of policies together and we say, all right, well, if you lived in each state, what would you actually have access to when we think about minimum wages and out-of-pocket child care and tax credits and nutrition benefits and paid leave? this year that family if they lived in colorado a mom with an infant and a toddler would have nearly 57 000 in resources if they lived in north carolina they would have fewer than 21 000 in resources all full-time working families so state policies make a big difference even even if it's in the implementation or federal or in their decisions about their policies alone

11:09Adani:yeah this is really striking and we'll also share the links to the policy calculator that you just mentioned so that people can go have a look themselves i actually really appreciate how visual it is to the outputs you get from the calculator and you can see for yourself like again as you say that with the same income how much of a difference it can make depending on the state i'm curious um so so we've we've talked a little bit about this variability between states and nevertheless there being common things that probably families in all states will benefit from And one of the signature publications that I heard about from your center is this sort of prenatal to three state policy roadmap where you outline different things that all spades can do, right?

11:46Adani:That would be very beneficial for these early years and the families that have children in those early years. Can you tell us a little bit about some of the things? There are a lot of different things. Maybe we can't cover all of them, but just curious which ones you would want to highlight or talk about it. Sure. Well, so on our roadmap, it really is a combination of these broad-based economic and family supports, like having access to health insurance, paid family medical leave, higher wages, tax credits, as well as more targeted interventions that really meet those specific needs of families.

12:21So things like early intervention services that help children with developmental delays or access to doula services for women during the prenatal labor and postnatal periods. And we are looking to add new policies and strategies all the time. And the way that they get on our roadmap, so we update our roadmap annually, is as researchers, like I said, we're not at all neutral to the goal that families and children live in environments that children can thrive. But what we are neutral to is what the policies are that get us there. So we started with kind of a blank slate, if you will, and said, let's review every state level policy that has been evaluated and see if it actually improves health and well-being and economic security and learning opportunities for infants and toddlers and their parents.

13:31And we cast a wide net. So again, looking at things that are not typically thought of as early childhood policies. So Medicaid expansion, for instance, for adults, but it has huge impacts on birth outcomes, as well as family economic security. And when parents are not eligible for Medicaid, they often think their children are not eligible for Medicaid. So it affects children's take up as well. to things like tax credits, which are often paired with federal tax credits, but many states now implement their own version. And these policies put money into families' pockets to be able to spend on things that they need for keeping their children healthy and themselves healthy.

14:23But they also incentivize work and they lead to better health outcomes and so forth. And then we also look at things like child care subsidies, for instance, that are really crucial to allow families with lower levels of income to work. Child care costs more than in-state tuition in most states at this point. And, you know, you have 18 years to save your kid to go to college. You have 18 seconds before you have to get them on a wait list for child care. So we looked at every policy that we could, and we really honed in on causal evidence. So studies that we could draw causal inference between implementing that at a statewide level and improvements in the health and well-being, economic security, learning of infants and toddlers and their parents.

15:18And so that's how we narrowed it down. Initially, we have 12 on there. We've added five more this past year that not many states are really implementing. So we're trying to figure out what the state levers are there. And then we'll be adding more as we continue to do more research and more things are evaluated. But it really is a range, which is important because although it is a guide for all states, each state is going to choose its own path. right? It's a choose-your-own-adventure, if you will. And there's really something in it for every state because some states are never going to change their minimum wage.

16:06And we know higher minimum wages are better for lots of outcomes for parents and children. But they will use Medicaid to support doula services or to expand Early Head Start in their state, for instance. So So there's something on there for lots of states, depending on the goals that they have. Right.

16:29Adani:Yeah, I mean, as I was listening to you describe all of these things, and you explicitly mentioned there's really this broad range of things that you cover. There's sort of two things I would love to dig a bit deeper into. The first is, you know, what it takes for a team like yours to tackle this wide range of things to evaluate and to think through. But before we get to that, the thing I wanted to ask you about too is, so you've put in tremendous work to produce all of these resources, to do all this research, all of these evaluations and produce these guidelines. And I'm wondering what you've observed as being the main bottlenecks for policymakers in different states to actually implement things.

17:07Adani:Is there any aspect of this where people almost feel overwhelmed with all of the different options that they have? if there's like an analysis paralysis kind of thing? Or is it that they actually don't know about these resources? Or what are you kind of seeing playing out in that sense? Yes. Well, every state is in a different position. So it's hard to speak too broadly about this. But we've had to learn how to be effective at getting this information into the hands of folks who can use it. as researchers i'm my team and myself we know how to review evidence and tell you whether it's rigorous or not and whether things are effective we learned how to pull those things that are effective together on a roadmap and create this tool if you will but how do you get that in the hands of people who are going to use it that's not something you're taught even in i have a phd and a master's in policy, but that's not really what you're taught.

18:07And so we have had to kind of learn lots of different strategies. One, we had to be able to identify what our comparative advantage is. What sort of information do we have that others may not that is useful to those who either make or influence policy action. And for us, having a good scan of what is actually happening across the U.S., these landscape scans, are really important because probably one of the questions I get asked the most by lawmakers and others is, well, what are other states doing in this area? How are other states that are kind of like me, my state, fixing the child care crisis?

18:56What are they doing to promote work and so forth? How are they helping reduce their maternal mortality? So we can answer that question for them. Another way that we've found that we kind of have a comparative advantage is we, our expertise extends to data analysis and we do benefit cost analyses for states to help them to really understand what the return on investment will be, how much it's gonna actually cost them, who will benefit the most, that in addition to kind of what should we do, the well, how much is it gonna cost and how will we pay for it are the questions that lawmakers ask the most, right?

19:43And so we've created tools for states that kind of span where the state is based on the policymaking process. So there are some states that really need information to just learn what the policy is even, right? They're in the kind of education coalition building stage. Their advocates will often turn to us and say, we've got to do something about our child care crisis or we've got to do something about X, Y, or Z. We need convincing to help. We need to help convince folks that the earliest years are important. So we'll go and do presentations or sit with a smaller group and answer their questions.

20:30And really, what's the problem? What are the policy solutions? There are other states that have decided we want to craft a paid leave bill. And so we and other national partners, too, can work with them to say, well, here are some of the things that you need to consider. What's your reimbursement rate? Who's going to be eligible? How long? And then you have states that are kind of in that walking the hall stage where they have a piece of legislation and people have introduced it, but now they need enough votes to get it over the finish line. So they ask us for things like benefit cost analyses or testimony or to walk the halls with them as the expert.

21:13So we've had to learn how to bring the right information to the right people in the right format at the right time. and sometimes it's directly to lawmakers, other times it's through advocates and it really is to address the needs that they have specifically at that time.

21:31Adani:Yeah, I think there's something really interesting in there. So earlier you said a lot of the ways in which you navigate these things is not something you're explicitly taught even if you go to school for public policy and so one thing I would love to speak about a little later is for students who are interested in this kind of thing. Like, how do they actually get started on getting involved and learning the skills necessary? But one adjacent thing to that that I wanted to ask you about is you talked a bit about the comparative advantage you see yourself having at your center and specifically like the expertise you have that extends to data analysis, like these cost benefit analyses you just mentioned.

22:05Adani:And people should go look at the website of your center. But one thing that struck me looking at it is you have a really big team, right? And you have a lot of different sub teams within it. You have the data team, the research and evaluation team, the policy team. And so I'm just curious what it's like for you to run this operation and what you see as some of the core aspects of what it takes to make this endeavor work well in the ways that you just described. Well, I have an amazing team. That's really the secret to success. I have an amazing deputy director who really is responsible for the way that the team operates together.

22:44I spend a lot of my time raising money and sharing our expertise and our knowledge, kind of guiding the big thinking that's going on. And I have a deputy director who is just someone that everyone loves and trusts and is able to help the teams to work together really well. And then I have a set of directors that are over each of these teams. And we have five teams because we also have an operations team that is responsible for making sure that we have the money and the resources and the people to do everything. But I think of our teams in a diamond shape, if you will, where on either side of the diamond, we have these content-based folks.

23:29We have one that does our original research and evaluation work that we do for states or nonprofits or communities. And the other is our policy team. They're evaluating the research. They are monitoring what states are doing. They're helping us to connect with states and build partnerships. And then the base of that diamond is our data team. They are the ones that are really feeding both teams the information that they need. It works both ways where our teams are giving the data team stuff to analyze and so forth, but they're really feeding the team that way. And then we have a comms team that I think on top of this diamond that is really helping us to spread it to the rest of the world.

24:14And over time, we have gotten better at understanding the needs of each of those teams and how to hire for those and how I obviously teach students. And you can see that there are some folks who are really great at data and love to sit with code all the time and others who want to talk with folks and learn what they're doing and others who want to develop great surveys and so forth. So we really learned to pair the right skills with the right teams to everyone works very hard, but we try to break it down into digestible pieces. So everyone plays a really important role in keeping this whole thing moving forward.

25:04Adani:That's very interesting. I haven't heard about this diamond shape setup before. It really makes a lot of sense. Exciting to think about. So you mentioned you work with students currently, but also at some point you first got involved in all this. And I'm very curious if you could just tell us a little bit about what it was like for you to first get into this space? Like my understanding is you've been researching families and children's well-being as a general topic for many, many years now, since the early 2000s, I think. Maybe not quite with the same focus that you have now, but still this core interest seems to be stable.

25:34Adani:And so I'm curious how you first got interested in what it was like for you to dive into the space and learn the things that you know now and that you sort of on to your team? Well, so really started as a teacher. I actually started my beginning of my career. I worked for an economic consulting firm and loved the work, but my heart just didn't show up to the office. And I was really interested more in why it is that some kids work so hard and still struggle, whereas other folks seemingly kind of succeed or make it with very little effort. And I was convinced based on my own experiences that our education system was the key to success, like I mentioned earlier.

26:20And that's why I wanted to teach for a while and really understand what's going on in our schools that facilitate this or create barriers. and probably the first week, but certainly the first month or first year, I saw that what was happening outside of my students' classroom experience had a much bigger impact on their lives overall than what I was doing in the classroom with them. And this was a neighborhood that was mostly free and reduced price lunch students, mostly Latino, many immigrant families, and a community that was marginalized from opportunity. And I knew then that I wanted to dig in further to understand how the family and communities and policies could really support kids and make it so it's just easier for everyone to succeed.

27:25and so I started working on a study it was called then the fragile family study it's now called the future of family study that for the first time was really giving us insight into what families who have low levels of income and especially families that are unmarried what they're experiencing, what their needs are, what the needs of their children are. And this study interviewed about 5 ,000 women in the hospital when they gave birth and then followed them and re-interviewed them and as many of their partners as possible when the child was 1, 3, five, nine, 15, 21, and they're now getting not just the kids that were born in 2000, 1998 to 2000, but now those kids' kids, so the grandkids of the parents, right?

28:25So that study really helped us to understand the conditions in which families are thriving, the conditions in which families are struggling. And my degree is in demography as well as public affairs. And so demography means I study how populations change, what affects both our birth rates, our death rates, our marriage rates, all those things. But my policy hat means that I'm really interested in what we as a community, what we as a society are investing in, and whether it's working to meet the public good. And so when I first started as an assistant professor, I was at the University of Texas at Austin, and I had the opportunity then to start to work with the state of Texas to evaluate lots of its programs in child welfare and child support and home visiting and child care and so forth.

29:31And that was when I really, we developed this kind of understanding of how states operate and how they implement policies and how research can help to inform that. And then it was 2019 that we got the opportunity to start to think on a national level about, Well, what are the policies that states should be implementing, not just the implementation of them that have already been decided on, but can we be part of the conversation about what states can actually do in a big P and little p policy way to influence well-being? So kind of a long story, but that was my transition, how I kind of moved through it and did this applied work rather than the traditional kind of social science research that I started doing.

30:22Adani:Yeah, that's fascinating. I mean, for one, it sounds like you just had a very multifaceted trajectory. You've done a lot of different things. I'm curious, especially since you mentioned at the very end there, your experience working with the state of Texas, when you train students now as a professor, you interact with students, you train students, you probably teach classes too. I'm curious if you feel like there really is just a good proportion of, you know, is there a good proportion of things involved in the kind of training you would need to work on issues like that, that really just comes from practically working with states on policies and so forth?

30:59Adani:Or is there still a certain part of that can be taught in classrooms or working on teams like yours? Like, how do you see that playing out? And how do you feel like students can involve in these spaces if they're interested. Yeah. There is a whole field of public policy, and I wish that the actual practical politics worked that way, but it doesn't always work that way. But it is important to have that foundation, that understanding of, especially in the U.S. democratic context, of who gets to make what decisions and how are they made and so forth. I teach public policy, basically public policy 101, and we start with the Constitution.