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By Deborah Merrifield

I’d like to share the results from a 10-year review I did in 2003 as commissioner of Social Services, looking back at child fatalities in Erie County from 1993 through 2002 due to child abuse or neglect.

There were 28 deaths, with 89 percent of these children 3 years old and younger. Sadly, 57 percent were 6 months and under. What I have concluded is that most children didn’t have a chance to be known to the Child Protective Services system because they were so new to the world.

Even for those families who had past reports against them, their latest children may not have been reported to the CPS Hotline because they were not seen regularly outside the home unless they were in kindergarten, day care or another early childhood education program. Days and weeks could go by without anyone seeing them outside the home.

I have hopes that New York State will make universal prekindergarten and kindergarten mandatory, because these settings provide a great opportunity to reach children and their parents early, before things spiral out of control, resulting in abuse or neglect.

The analysis of 10 years of child fatalities and my own 34 years of child welfare experience lead me to recommend using a public health prevention model with priority given to children from birth to 3 years and their parents, and to teens who are the community’s soon-to-be parents. A comprehensive public health approach could be very powerful in a partnership with schools, early childhood education providers and primary care doctors, especially pediatricians. These are the settings where there is the most potential access to all families with young children and to teens.

A review of current science and many studies strongly point to the first three years of life plus the child’s experience in the womb as a highly changeable time for the brain, when our neurological, immune and endocrine systems are just getting set up chemically and physically. The roots of later violence and/or physical and mental health conditions can often begin during this stage of human development.

We have very little help for the mental health of children from birth to 3. There are emerging approaches, but we have a long way to go. With the changes going on in health care and health care coverage, I see a key role for insurers, public and private, who have a major stake in the health and mental health outcomes of all children. They have the same stake in the wellbeing and skills of parents who are essentially the frontline managers and protectors of their children’s health and mental health on a daily basis.

Deborah Merrifield, past commissioner of the Erie County Department of Social Services, is executive director of the Family Help Center and chairwoman of WECAN, Western New York Ending Child Abuse and Neglect.