Ensuring Strong Foundational Supports for Children and Families
June 30, 2026
Early childhood experiences and relationships set the foundation for lifelong health and well-being, shaping how children’s brains and bodies develop. Providing quality care is essential, which relies on caregivers — parents, guardians, or those who provide support outside of family (e.g., home visiting professionals, child care providers, early childhood education providers) — having strong education and training to support children in a way that is developmentally appropriate and socially/emotionally competent. Families may struggle to provide or access quality child care due to a lack of knowledge or parenting skills, mental/physical health concerns, child care deserts, or financial issues.
As children and adolescents enter school (K-12), they may also benefit from ongoing resources and support within or attached to the school system, which should provide a safe and supportive environment for them to learn, make responsible decisions, and achieve positive goals. Further, whether in school or other settings (e.g., outside of school time programs), children and adolescents can benefit from greater access to opportunities that help them build skills to navigate life’s challenges.
The approaches detailed in this action guide are key to strengthening foundational supports for children and families, with an abundance of research demonstrating they are at the intersection of preventing adverse childhood experiences, suicides, and overdoses. Effective implementation of each takes:
- Convening and partnering with organizations that can support education efforts.
- Collecting and disseminating data on opportunities for and benefits of these prevention mechanisms.
- Raising awareness in communities and reducing barriers for families and those providing these critical services.
On This Page
Enhancing Early Childhood Supports for Ages 0-8
Expand Access to Home Visiting Programs
Home visiting programs are often a two-generation approach, providing services to both parents/caregivers and children under five in the home. While programs can differ widely, they typically involve trained providers (nurses, social workers, or community health workers) who deliver services, including:
- Using standardized screening tools to identify physical or mental health concerns among children or families.
- Providing case management to ensure families access medical and social services.
- Providing tailored counseling or skills development training to parents/guardians to meet their own needs and the needs of their children.
There is one primary federal funding source that supports evidence-based home visiting programs: the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, administered by HRSA, which provides grants directly to states on an annual basis following application. The Administration for Children and Families also provides specific home visiting support to tribal communities.
States often supplement funding for home visiting programs with Title V Maternal and Child Health Services Block Grant, Medicaid, Temporary Assistance for Needy Families, or other state-/local-funded child welfare investments.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of home visiting programs include state government agencies, social services, and existing organizations (e.g., Zero to Three) that already provide these services. In addition, pediatricians and child care agencies are key communicators of families’ eligibility for this support and play an essential role in enrollment. Home visiting programs that coordinate and align with other services and family supports can help state and local agencies develop strong early childhood systems of care.
Education
Key Data
Focus on sharing information about how investing in home visiting programs offers various cost benefits, can improve children’s developmental outcomes, decrease child welfare involvement/foster care placement, and reduce household stress. Collect and showcase home visiting program participation rates in your jurisdiction, including those who are eligible for services but are not enrolled. States often conduct their own assessments of home visiting, so additional, more granular data may be available in state-level datasets.
Local Stories
Source stories directly from home visitors and families who have been positively impacted by home visiting programs, highlighting how they have supported their child’s development and the family’s ability to support their child’s needs.
State Assessment
To help inform decision-makers how expanding home visiting programs could enhance local family stability and improve children’s health, determine:
- Which agencies are utilizing MIECHV funding.
- Which agencies are delivering services to families, including state or locally developed programs that vary in evidence of effectiveness criteria.
- Whether there are other state-or local-level investments to expand access to home visiting programs.
- If there are any adjustments to MIECHV or other funded programs that would enhance the reach of home visiting programs (e.g., Durham Connects provides universal in-home visits to any parents of newborns who live in their county).
Raising Awareness and Reducing Barriers
For families: Support informational campaigns about home visiting programs to the public and those who might be eligible. Ask policymakers to allocate resources to improve outreach and ensure that groups already supporting lower-income families provide them with information about these programs and involve families in the conversation (e.g., Raising Children Colorado).
For agencies providing home visiting programs: Ensure caseworkers providing home visiting services are qualified and appropriately compensated. Also, assess other states’ legislation related to home visiting programs, workforce development, and governance, by using the National Conference of State Legislatures’ Early Childhood Legislation Database, and determine if similar legislation would support improvements in your state.
Help Working Families Access Quality Care for Young Children
Quality child care supports working caregivers, which is essential to a strong start for children. It allows parents or guardians to work or go to school while also providing young children with early educational, developmental, and emotionally supportive opportunities to learn and succeed. However, it can also be one of the biggest challenges for families with young kids due to the often high costs. Fortunately, child care subsidies can help working caregivers enter and remain in the workforce while their children receive quality, stable child care from licensed providers.
To address the need for subsidies and improved quality of care for children in low-income families, two federal funding sources in the Child Care and Development Fund (CCDF), as well as Temporary Assistance for Needy Families (TANF) funding, are available to U.S. states:
- The Child Care and Development Block Grant is the primary federal funding source to help low-income families access child care and improve quality and supply. The amount of these funds is discretionary, meaning Congress decides annually what to provide.
- The Child Care Entitlement to States, the secondary funding source, is mandatory and determined by pre-established payment formulas.
- TANF is a separate block grant for low-income families and children to support economic stability.
While CCDF is a federal program that sets standards for eligibility and quality of care, states make additional decisions on eligibility, provider payment and family payment rates, and provider licensing and quality requirements. States set their own plans for every three years of funding, which vary widely.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of subsidizing child care for low-income families include state government agencies, social services, and child care providers serving these families. In addition, pediatricians, schools, child care agencies, unhoused service agencies (e.g., family shelters), and home visiting programs are key communicators of families’ eligibility for this subsidized care.
Education
Key Data
Focus on sharing information about how subsidizing child care can reduce financial stress in households, which improves the health of children and families. Collect and showcase child care subsidy participation rates in your jurisdiction, including those who are eligible but have not received the subsidy and are waitlisted (with national estimates suggesting that only 16% of those eligible receive the subsidy).
Local Stories
Source stories directly from families who have been positively impacted by accessing child care subsidies, highlighting how it has supported their child’s development and allowed them to spend additional money on other household priorities.
State Assessment
To help inform decision-makers how expanding CCDF subsidies could enhance local economic stability and improve children’s health, determine your state’s three-year plan and assess how the state-level program is structured. This includes:
- Whether state or local counties set eligibility requirements, and what these are.
- Which programs or services it invests in (the fund also goes to early learning programs).
- Which providers CCDF funds cover and their licensing requirements.
- Payment rates for providers.
- Quality standards within the state that set requirements for providers.
- Co-payments required by families and any sliding fee scales used to access the subsidy.
Determine which CCDF program structures are most appropriate for potential changes at the state level. In addition, determine whether there are other state- or county-level investments to subsidize child care in your state, and determine if any additional investments could be adjusted. If additional programs do not exist, consider whether an investment in additional child care subsidies might be feasible.
Raising Awareness and Reducing Barriers
For families:
- Ensure parents and caregivers have access to skills development trainings so they can create a safe and supportive home environment for children.
- Support informational campaigns about child care subsidies to the public and those who might be eligible. Ask policymakers to allocate resources to improve outreach and ensure that groups already supporting lower-income families provide them with information about these programs.
- Promote co-located services and partnerships so eligible families can learn about and enroll in a variety of assistance programs during one visit.
- Create online tools designed to streamline multiple benefit applications, with easy checks for eligibility (e.g., MyFriendBen).
- Align enrollment requirements and processes (e.g., recertification periods) across assistance programs, which often have independent and sometimes lengthy enrollment and renewal requirements/procedures.
For child care providers:
- Enhance the state’s quality rating and improvement system to ensure that children who use licensed child care services are receiving quality care.
- Create or enhance financial incentives and technical assistance to support child care agencies in increasing the quality standards they meet.
- Ensure child care providers are qualified and appropriately compensated.
- Ensure that local zoning and land-use regulations are consistent with the expansion of child care centers providing subsidized care near where lower-income parents and families live and work.
- Assess other states’ legislation related to child care, workforce development, quality standards, and governance, and determine if similar legislation would support improvements in your state.
Expand Access to Quality Early Childhood Education Programs (0-8).
Ensuring access to quality early child care education (ECE) programs builds a strong foundation for future learning and opportunity, promoting physical, social, emotional, cognitive, and language development. ECE programs also engage families of children, creating a long-term support network.
ECE programs are defined as any type of educational program offered to children, generally until they enter kindergarten, but can continue through age 8. They include, but are not limited to, Early Head Start and Head Start, which are both federally-funded programs for low-income families, as well as state-sponsored or locally-funded preschool or pre-kindergarten programs:
- Early Head Start serves pregnant women, infants, and toddlers (ages 1-3). It has increased its partnerships with licensed child care centers that meet safety requirements to streamline efforts in places that already serve the cultural and social needs of local families.
- Head Start serves preschool-aged children (ages 3-5), and also funds programs specific to American Indian and Alaska Native families and for children of farmworkers. It directly funds local organizations that qualify for federal funding so they can create locally designed services. Local organizations provide Head Start services across settings: child care, center-based (in a school or Early Head Start center), or home-based (visits to the family’s home or group activities).
- State-sponsored or locally-funded preschool: As of 2023, 44 states have state-funded preschool programs (with access and quality of programs varying widely) that primarily focus on ECE for three- and four-year-old children, with some also providing additional education to parents and families. Locally-funded programs often expand federal- or state-funded programs and services.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of free or reduced-cost ECE programs include state government agencies, social services, schools, and other ECE or child care providers that serve these families. In addition, pediatricians, schools, child care agencies, and home visiting programs are key communicators of families’ eligibility for ECE programs.
Education
Key Data
Focus on sharing information about how subsidizing ECE programs can reduce financial stress in households and support healthy adolescent development. Collect and showcase Early Head Start and Head Start participation rates in your jurisdiction, including those who are eligible but have been waitlisted.
Local Stories
Source stories directly from families who have been positively impacted by accessing free or reduced costs related to ECE, highlighting how it has supported their child’s development and allowed them to spend additional money on other household priorities.
State Assessment
To help inform decision-makers how expanding free or reduced-cost ECE programs could enhance local economic stability and improve children’s health:
- Determine which local agencies have been funded to implement Early Head Start or Head Start in your state, and whether there are other state-, county-, or city-level investments to expand access to ECE programs.
- Connect Early Head Start or Head Start programs to other state resources that could support and enhance their efforts, such as:
- Providing access to training and resources related to education and job skills, and improving quality standards within the organization.
- Offering additional skills trainings provided by other groups to parents and guardians, such as home visiting programs (e.g., Oregon Parenting Education Collaborative).
- Ensuring they are providing quality care by updating quality standards required through licensing in your state.
- Assess how other state or local programs are structured, and whether there may be adjustments that could improve programming. This might include:
- How much of an investment the state/locality is making, and if it is sufficient to support a quality program. If there is universal access to preschool for all (which reduces the stigma of accessing programs such as Early Head Start or Head Start).
- Whether additional care (before and after school) can be provided alongside the school day, to better support working families.
- Whether the quality of the programs can be improved.
Raising Awareness and Reducing Barriers
For families:
- Ensure parents and caregivers have access to skills development trainings so they can create a safe and supportive home environment for children.
- Support informational campaigns about ECE programs to the public and those who might be eligible. Ask policymakers to allocate resources to improve outreach and ensure that groups already supporting lower-income families provide them with information about these programs. (e.g., Raise North Carolina).
- Promote co-located services and partnerships so eligible families can learn about and enroll in a variety of assistance programs during one visit.
For agencies providing ECE programs:
- Ensure those who teach or support children in ECE programs are qualified and appropriately compensated.
- Enhance the state’s quality rating and improvement system to ensure that children who use licensed ECE programs are receiving quality care.
- Create or enhance financial incentives and technical assistance to support agencies providing ECE programs to increase the quality standards they meet.
- Ensure that local zoning and land-use regulations are consistent with the expansion of centers providing ECE programs where parents and families live and work.
- Assess what other states’ legislation related to early childhood education, workforce development, quality standards, and governance, and determine if similar legislation would support improvements in your state.
Early Childhood Support Resources
- View State Profiles by Quality Compendium: Select a state profile from the map to view comprehensive data about each state operating a quality initiative.
- Supporting Home Visiting: A Guide to State and Federal Funding
by Prevent Child Abuse America: Read an overview of federal and state funding that can be used to support home visiting programs. - CCDF State and Territory Funding Allocations
by HHS: Find the CCDF federal allocations by grant year. - Early Childhood Workforce Index 2024
by the Center for the Study of Child Care Employment: Explore information for each state on child care provider wages and policies. - State Policies to Improve Early Childhood Educator Jobs
by the Center for the Study of Child Care Employment: Read recommended state policies that can improve child care provider jobs. - State Profiles
by the National Institute for Early Education Research: Find more information on state or local investments in ECE programs serving three- and four-year-olds, and the quality of these programs.
Strengthening School-Based Programs for Grades K-12
Assist Schools in Improving Their School Climate
Outside of their homes, children and adolescents spend much of their time in school. A safe and positive school climate, or the overall atmosphere of school life, creates a sense of belonging for students and their families. This enhances their connection to the school, encourages them to reach out/receive developmental support (i.e., academic, social, and emotional), and supports healthy decisions. There are five primary ways that schools foster positive school climates:
- Safety: Defined and consistently enforced rules with a strong sense of physical and emotional security among students.
- Teaching and learning: Support for academic, social, and emotional learning and growth.
- Interpersonal relationships: Positive and inclusive teacher-student and peer relationships that promote belonging.
- Institutional environment: Well-maintained physical surroundings and a sense of connectedness to the school.
- Leadership: Strong school leadership and a shared responsibility for student success.
The federal government has provided grant funding and maintains a national technical assistance hub with multiple resources for schools to improve their school climates. States vary widely in their efforts to improve school climate and have implemented legislation and utilized programs (e.g., What Works in Schools) to further help schools in developing supportive environments for students.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of positive school climates include state and local government agencies and local education agencies or schools (public, private, or other types).
Education
Key Data
Focus on sharing information about how positive school climates make children and adolescents feel safe and supported, which improves development and supports healthy decision-making. Understand how schools could improve their climate by collecting and collating school climate, disciplinary, social-emotional competency, child welfare involvement, and academic data. Showcase schools that are working to improve school climate and the success they have had.
Local Stories
Source stories directly from children, adolescent, and their families who have been positively impacted by attending a school that has a positive school climate, highlighting how it has supported their academic, social, and emotional learning and overall development.
State Assessment
Determine whether the state has funding (federal, state, or local) to support implementation of school climate improvements, and if these resources are reaching schools that might have room for improvement in their climates. Determine if these schools could use supports for these adjustments, including:
- Accessing critical funding.
- Measuring their school climate.
- Developing an action plan to improve their school climate.
Raising Awareness and Reducing Barriers
Coordinate with school districts and schools about how positive school climates can improve children’s academic, social, and emotional development. Also, encourage communication of the importance of implementing evidence-based strategies and programs, including Positive Behavioral Interventions and Supports. Support them in implementing their own school climate improvements or school policy changes and in developing community partnerships (e.g., through shared use agreements, referrals, or highlighting community groups in school presentations) that can create connections to children and adolescents in additional community spaces.
Assist Communities and Schools in Providing Extracurricular Activities
Strengthening access to extracurricular (or before- and after-school) activities can also provide expanded learning and prosocial opportunities that further support children and adolescents, allowing them to explore their interests, expand their learning, develop skills, and grow their social connections outside of the traditional school setting. However, there are many barriers to access, including limited availability of programs and affordability of program fees, associated transportation, equipment, or materials.
While there is only one federal funding source dedicated solely to creating community learning centers that provide enrichment to adolescents and families outside of school hours, additional federal and state funding exists to support these efforts. This funding has not kept pace with demand, so the responsibility for funding these programs falls on states, communities, schools, and families. Some states have implemented legislation to further support children and adolescents with access to extracurricular activities.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of having positive extracurricular activities include state and local government agencies and local school districts or schools (public, private, or other types). In addition, collaborate with community organizations that focus on out-of-school/after-school programs, who already have established trust with their communities (e.g., Boys & Girls Clubs of America and YMCA).
Education
Key Data
Focus on sharing information about how participating in extracurricular activities provides opportunities for children and adolescents to further enhance their academic, social, emotional, and workforce readiness skills. Collect and showcase community or school programs that provide these supports and what successes they have had with children and adolescents.
Local Stories
Source stories directly from children, adolescents, and their families who have been positively impacted by accessing extracurricular activities, highlighting how it has supported their academic, social, and emotional learning and overall growth.
State Assessment
Determine whether the state has funding (federal, state, or local) to support extracurricular activities within or outside of school, and if these resources are reaching low-income families facing financial restraints in enrolling their children in these programs.
Raising Awareness and Reducing Barriers
In collaboration with schools, inform local communities about how accessing extracurricular activities can improve children and adolescent’s academic, social, and emotional development. Also, communicate the importance of implementing evidence-based strategies and programs, including mentoring programs or efforts to empower girls and women, or have men and boys as allies in preventing violence and supporting victims. Support communities and schools in developing their own program that support children and adolescents outside of the traditional school setting, and in developing community partnerships (e.g., through shared use agreements, referrals, or highlighting community groups in school presentations) that can provide adolescents with extracurricular activities.
Finally, inform state and local decision-makers about how they can enhance legislation or regulations for after-school programs to improve access to high-quality extracurricular activities.
School-Based Program Resources
- Cultivating a Supportive School Climate: A “How To” Guide
by the National Center for School Safety: Review this step-by-step guide to assess school climate needs, develop strategies, and identify relevant resources to improve school climate. - School Health Index
by CDC: Use this self-assessment and planning guide as a tool to improve health promotion policies and practices in schools. - Afterschool in Your State
by the Afterschool Alliance: Explore afterschool numbers, developments, and more in all 50 states. - Resources for Mentoring Programs
by the National Mentoring Resource Center: Scan this collection of resources for guidance on implementing and developing mentoring programs. - Strengthening Prevention Work with Men and Boys
by Prevention Collaborative: Read this brief on engaging men and boys in prevention work in community settings. - Girls Equity and Empowerment Resource List
by Making Caring Common Project: Browse this website list that promotes girls’ and women’s equity and empowerment.
Providing Skills Development Training
Help Parents and Guardians Develop Skills
Skills training can provide parents and caregivers with strategies to create a safe, supportive environment for children. Parenting education can also turn challenging moments into opportunities for growth/connection with children and, in turn, lasting positive childhood experiences.
Some ECE programs and child care agencies provide training to parents and families, and home visiting programs often directly target improving the skills of parents and caregivers. The focus of these programs often covers developmentally appropriate expectations for child behavior, behavior management, problem-solving skills, safe and effective discipline, healthy relationship behaviors, and parent-child communication. Ensuring families have access to and are supported in taking skills training (e.g., time off work, transportation, and child care) is essential for creating supportive household environments for children.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of skills training for parents and caregivers include state and local government agencies, social services, local school districts or schools, or child care providers.
Education
Key Data
Focus on sharing information about how skills training for parents and families can improve communication, foster healthy relationships with children, and set a foundation for positive childhood experiences. Collect and share data on programs that provide skills training to parents/families and participants.
Local Stories
Source stories about children, adolescents, and their families who have been positively impacted by parenting or guardian skills training. Highlight how the training has supported these relationships and improved their child’s development.
State Assessment
Determine whether the state has funding (federal, state, or local) to support skills training for parents and caregivers, and if these resources are sufficiently reaching families at risk for violence, substance use, mental health problems, and other related negative outcomes.
Raising Awareness and Reducing Barriers
Support informational campaigns about parent and caregiver skills training programs to the public and those who might be eligible. Ask policymakers to allocate resources to improve outreach and ensure that groups already supporting at-risk families provide them with information about these programs. Also, communicate the importance of implementing evidence-based programs to maximize their impact and consider funding for incentives to drive uptake.
Support Skills Training for Children and Adolescents
Skills training can help children and adolescents learn how to handle stress, resolve conflicts, problem-solve, and better manage their emotions and behaviors. Supporting organizations to implement skill-based training can help build a solid foundation for families and children to live healthy, safe lives.
Most schools, ECE programs, and child care agencies embed these skills trainings into their curriculum or include it among more traditional academic topics. The focus of these programs is often on social-emotional learning approaches, safe dating and healthy relationships, and empowerment-based training. Ensuring children and adolescents have access to skills training is essential for developing resilience and strength to make healthy, safe choices now and into the future.
How to Implement This Approach
Partnership
Key partners that can help educate the public and decision-makers about the benefits of skills training for children and adolescents include state and local government agencies, social services, local education agencies or schools, as well as child care, mental, and behavioral health providers.
Education
Key Data
Source stories about children, adolescents, and their families who have been positively impacted by children and adolescent skills training, highlighting how it has supported improving their development.
Local Stories
Source stories about children, adolescents, and their families who have been positively impacted by parenting or guardian skills training. Highlight how the training has supported these relationships and improved their child’s development.
State Assessment
Determine whether the state has funding (federal, state, or local) to support skills training for children and adolescents, and if these resources are sufficiently reaching at-risk adolescents (e.g., at risk for violence, substance use, mental health problems, and other related negative outcomes). Ensure that there is also funding to equip educators and others providing these skills trainings with the tools they need. Some states have passed legislation to support social-emotional learning uptake in schools (e.g., Illinois’ Social Emotional Learning standards).
Raising Awareness and Reducing Barriers
Support informational campaigns about children and adolescent skills training to the public and those who might be eligible. Ask policymakers to allocate resources to improve outreach and ensure that groups already supporting at-risk families provide them with information about these trainings. Also, communicate the importance of implementing evidence-based trainings to maximize their impact.
Skills Development Training Resources
- Providing a Registry of Experimentally Proven Programs
by Blueprints for Healthy Adolescent Development: Browse scientific interventions that promote healthy adolescent development. - What Is the CASEL Framework?
by CASEL: Learn about a framework that schools, districts, and states can use to support cultivating skills and environments for children and adolescents to thrive. - The Institute for Social & Emotional Learning
Understand how educators, children, and families play a role in promoting social and emotional learning in educational settings.
This resource reflects the collective efforts of many contributors, including ASTHO staff Alison Maffey, MSW, Vice President, Social and Behavioral Health; Caitlin Langhorne-Griffith, Director, Injury, Suicide, & Violence Prevention; Rachel Scheckman, Senior Analyst, Intersection of ACEs, Suicide & Overdose Prevention; and Erin Wright-Kelly, DrPH, MA, of Community Impact Partners, LLC.
Save This for Later
Learn how to download a web page for offline viewing, with these easy instructions.
Related Strategies
Strengthening Economic Supports for Families
Learn how to help stabilize families by improving financial and housing security.
Strengthening Community and Home Environments
Dive into approaches that support safe, nurturing households and neighborhoods.
Lessening the Impact of and Preventing Traumatic Experiences
Learn how to aid effective interventions when trauma occurs and reduce the likelihood of future occurrences.
Featured Resource
Addressing the Intersection of ACEs, Suicide, Overdose, and Mental Health Concerns
Explore the full Intersections Suite to learn more about these key strategies and access resources that help build core competencies.