Raising Children: Emerging Needs, Modern Risks, and Social Responses

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Raising Children

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Raising Children Emerging Needs, Modern Risks, and Social Responses

EDITED BY JILL DUERR BERRICK AND NEIL GILBERT

1 2008

3 Oxford University Press, Inc., publishes works that further Oxford University’s objective of excellence in research, scholarship, and education. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With ofﬁces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam

Copyright ª 2008 by Oxford University Press Inc. Published by Oxford University Press, Inc. 198 Madison Avenue, New York, New York 10016 www.oup.com Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Raising children : emerging needs, modern risks, and social responses = edited by Jill Duerr Berrick and Neil Gilbert. p. cm. Includes bibliographical references and index. ISBN-13: 978-0-19-531012-2 (pbk. : alk. paper) 1. Child rearing—United States. 2. Parenting—United States. I. Berrick, Jill Duerr. II. Gilbert, Neil, 1940HQ769.R1695 2008 306.8740973'09045—dc22 2007024285

9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper

Table of Contents

Contributors

vii

Introduction

1 Part I.

1.

Children in Families

The Past Is Not a Foreign Country: The Historical Education of Policy 9 Paula S. Fass

2.

From Private to Public: Paying Grandparents as Caregivers Jill Duerr Berrick

3.

Supporting Fathers’ Engagement with Their Kids Philip A. Cowan, Carolyn Pape Cowan, Nancy Cohen, Marsha Kline Pruett, & Kyle Pruett

4.

Can Women Have Careers and Babies Too?

81

Mary Ann Mason

5.

Motherhood, Work, and Family Policy

98

Neil Gilbert

6.

Child Support: How Much Is Just Right? Ira Ellman & Tara Ellman

116

44

27

vi

Table of Contents

Part II. 7.

Outside Forces: Shaping Health and Education

Framing Public Interventions with Respect to Children as Parent-Empowering 151 Stephen D. Sugarman

8.

Childhood ADHD: Biological Reality or Social Construction, with Policy Implications 167 Stephen P. Hinshaw

9.

Do Immigrant Children Have a Fair Chance?

183

Sylvia Guendelman & Kate Cosby

10.

Nonacademic Needs of Students: How Can Schools Intervene? 201 Susan Stone

11.

Families and Schools Raising Children: The Inequitable Effects of Family Background on Schooling Outcomes 221 W. Norton Grubb

Conclusion Index

257

250

Contributors

Jill Duerr Berrick Professor of Social Welfare; Co-Director, Center for Child and Youth Policy, University of California, Berkeley Kate Cosby Program Associate, Maternal and Child Health Program, University of California, Berkeley Nancy Cohen Program Director, Cancer Lifeline, Seattle, Washington Philip A. Cowan Professor of Psychology Emeritus, University of California, Berkeley Carolyn Pape Cowan Professor of Psychology Emerita, University of California, Berkeley Ira Ellman Willard H. Pedrick Distinguished Research Scholar and Professor of Law, Arizona State University; Visiting Scholar, University of California, Berkeley Tara Ellman Economic Consultant, Tempe, Arizona Paula S. Fass Margaret Byrne Professor of History, University of California, Berkeley

vii

viii

Contributors Neil Gilbert Chernin Professor of Social Welfare; Co-Director, Center for Child and Youth Policy, University of California, Berkeley W. Norton Grubb David Gardner Chair in Higher Education, University of California, Berkeley Sylvia Guendelman Professor and Chair, Maternal and Child Health, School of Public Health, University of California, Berkeley Stephen P. Hinshaw Professor and Chair, Department of Psychology, University of California, Berkeley Mary Ann Mason Professor of Social Welfare, University of California, Berkeley Kyle Pruett Clinical Professor of Child Psychiatry, Director of Medical Studies, Yale University School of Medicine Marsha Kline Pruett M. B. O’Connor Chaired Professor, Smith College Susan Stone Assistant Professor of Social Welfare, University of California, Berkeley Stephen D. Sugarman Roger J. Traynor Professor of Law, University of California, Berkeley

Introduction Jill Duerr Berrick & Neil Gilbert

Over the past half-century, technological and medical advances, shifting patterns of employment, the loosening of marital bonds, changing social norms, and the women’s rights movement have dramatically altered the landscape of family life. In this new terrain, parents struggle with balancing the demands of work and child care responsibilities, selecting the right schools, and sorting through a bewildering array of medical and psychological nostrums. As mothers and fathers strive to nurture and protect their children, public ofﬁcials are under increasing pressure to formulate policies that assist parents to meet the challenges of child rearing in contemporary society. This book examines some of the most pressing issues in health, education, and family life that affect child rearing in modern times, and it critically assesses alternative policy responses to these developments. The percentage of women who work is on the rise, increasing from 38% in 1960 to 60% in 2002. Women with very young children have not exempted themselves from this dramatic change. In 1980, 44% of married women and 45% of single women with children under the age of 6 were in the labor force; by 2002, those ﬁgures climbed by roughly 50% (to 61% and 71%, respectively). Women struggle with the transition to the workforce—particularly when their children are young. Many are haunted by worries about who will care for their children in their absence, along with concerns about their appropriate role as provider versus parent. While some employers have attempted to make the workplace more ‘‘family friendly,’’ the reality is that signiﬁcant public policy has been developed to make families more ‘‘work 1

2

Raising Children

friendly.’’ Child care programs, after-school programs, ﬂexible work schedules, and telecommuting are all innovations that, at their heart, are designed to increase women’s (and men’s) capacity to be fully engaged in the workplace. In addition to emerging needs created by the changing work patterns of American families, the family itself is undergoing change. Fertility rates have declined, as has family size. Between 1976 and 2002, the proportion of women over 40 years of age who had either no children or one child increased by 80%; at the same time, the proportion of women in that age group with three or more children declined by 50%. The most recent U.S. census suggests that the fastest growing family-group pattern in the United States is the ‘‘noparent family’’: children raised in relative-headed households with no mother or father present. While traditional students of the family may celebrate that rates of single parenthood are ﬁnally stabilizing and that marriage rates have nudged up a bit, the more recent trends in children’s living arrangements are startling, if not alarming, and suggest undercurrents in family life that are profoundly unstable. On the new terrain of family life, children face myriad risks to their wellbeing, whether from unstable families, exposure to poor-quality child care, attendance in substandard schools, violence in the neighborhood, or coping with chronic health conditions. While some families manage to protect their children against these risks better than others, even mainstream middle-class Americans worry regularly about protecting their children from harm. And in struggling to raise their kids, many subgroups across America—immigrants, gay and lesbian couples, teenage parents, and low-income adults—experience heightened vulnerability. Raising Children offers a fresh perspective on the most troubling concerns of modern family life and raises provocative questions about the beneﬁts and hazards of policy alternatives designed to alleviate these issues. Take, for example, the rapid expansion in the number of children now being reared by their grandparents instead of their parents. While child welfare professionals praise grandparents for stepping in to care for these children, it is easy to forget that children have lost something important in the transition to Grandma’s house— their parents. How these fundamental changes in living circumstances affect children’s well-being is little understood. Asking whether policies that promote kinship care are desirable challenges conventional wisdom in this realm. Drawing on the disciplines of history, law, education, psychology, and social welfare, this volume frames the emerging needs and new risks that have an impact on child rearing, addressing issues such as the following:

Why do some men become positively involved with their young children while others remain at a distance? What are the beneﬁts for children if their fathers develop strong, nurturant relationships with them? How can we create programs that promote fathers’ active participation in the daily lives of their children? Neither the child on whose behalf support payments are made nor the parent charged with making them are likely to live alone. Can the law of child

Introduction

3

support continue to pretend they do? Do we want child support to insure the child’s welfare or to ensure that each parent pays a fair share of the child’s expenses? With the surge of media attention and controversy over Attention-Deﬁcit= Hyperactivity Disorder (ADHD) as a diagnostic category (and medication as a major treatment), what are the facts and what are the myths? To what extent is ADHD a social construction devised to manage children’s challenging behavior? Do family-friendly policies such as daycare and parental leave harmonize work and family life or create incentives for both parents to enter the workforce— and intensify the daily struggle between the demands of work and child rearing? Are some families better served by family-friendly policies than others? Who are the women with fast-track careers? What happens when they face the challenge of balancing childbirth and infant care with the high-pressure demands of professional life? Are recent efforts to provide health and psychosocial services in schools likely to beneﬁt students? How do families and schools raise students together? Must public-health policies aimed at reducing drinking, smoking, and obesity among children be seen as overriding parental authority in the ‘‘best interests’’ of children, or can they be formulated as measures that enable parents to exercise better control over their children? How does the U.S. health-care system serve immigrant children, most of whom live in working poor families? What practical solutions can be implemented to reduce barriers to care for immigrant children?

In addressing these issues, the volume is divided into two parts that focus on how children are affected by modern circumstances inside and outside of family life. To place these developments in a broader perspective, Part I begins with a historical overview of the problems and issues of child rearing in American families. Chapter 1 reminds us that although contemporary concerns are not exactly the same as past concerns, social anxieties about the fragility of family life are not unique to the twenty-ﬁrst century. The subsequent chapters in this section analyze the needs and risks of children raised under various settings of modern family life. Children raised by grandparents or teenage mothers face a new environment of adaptation as they fashion a normative childhood in the context of ‘‘other.’’ Millions of children are being cared for by their grandparents, often at public expense. Chapter 2 examines the recent trends and social implications of government support for kinship care of children. Over the past several decades, research on family life has generated increasing interest in the role of fathers in child rearing. Chapter 3 looks at how fathers’ positive relationships with children foster the children’s well-being and what can be done to promote such relationships. While fathers are encouraged to become more actively involved with their children, mothers struggle to balance the responsibilities of raising children and working outside the home. And, as parents have increasingly left home for work, varied provisions have been made to supply the daily care of children.

4

Raising Children

Chapters 4 and 5 explore the form and substance of ‘‘family-friendly’’ measures to help balance work and child rearing over the life course of women in occupational positions ranging from high-powered professional careers to middle- and working-class jobs. When families break up, questions arise concerning the fair division of responsibility for the support of children. Chapter 6 probes the complex realities of child support arrangements, the fundamental conﬂict between the core purposes of child support, and how to ameliorate this perplexing situation. In Part II, the focus shifts to the forces outside of family life that affect a child’s physical, psychological, and educational well-being, particularly those emanating from medical and academic institutions and the state. A bewildering array of modern drugs and medical technology has generated rising expectations for longer and healthier lives. At the same time, parental anxieties are fueled as diagnostic advances uncover new childhood disorders and ailments, the cost of medical care continues to rise, and children engage in behaviors that may be detrimental to their health. Heightened concerns about children’s health are matched by a growing sense of the need for an adequate education to prepare children to work and ﬂourish in an increasingly competitive global market. The chapters in this section consider how schools are changing to meet the evolving needs of children and their parents, the risks of overpathologizing normal variations in children’s behavior, the role of the state in shaping health-related behaviors among children, and the need to extend health care to vulnerable populations. Although public intervention is often thought to substitute for or undermine parental responsibility, Chapter 7 formulates an approach that emphasizes framing social policies in such a way that they are seen as strengthening rather than limiting parental authority in family life. This analysis shows how proposals to deal with controversial issues such as childhood obesity and school choice can be understood as measures to empower parents. Along with concerns about the growing problem of childhood obesity, many parents struggle with what to do about the increasing diagnosis of ADHD in children— a condition that is poorly understood. Chapter 8 illuminates the myths and facts about ADHD, the behaviors that deﬁne the disorder, controversies surrounding medication and psychosocial treatments, and the need to understand the stigmatizing implications of the condition. While all parents sometimes worry about maintaining their children’s health, these anxieties are particularly intense in the absence of insurance for care. Examining the wellbeing of children from this perspective, Chapter 9 surveys the access to care for children of the working poor, among whom immigrant children are most likely to lack health-insurance coverage and least likely to receive medical care. Children’s physical and psychological ills are not only handled within the purview of medical institutions. Over the past few decades, schools have increasingly been called upon to provide not only for the education but also for the heath and mental health care of children. Chapter 10 questions how well these nonacademic needs of children are being met by school programs and

Introduction

5

whether, in fact, such special interventions provide added beneﬁts in wellfunctioning schools. Finally, Chapter 11 reminds us that although forces emanating from institutions outside the family inﬂuence the well-being of children, it is rarely a case of either=or—parents are always in the equation. When it comes to education, parents and schools raise children together. This ﬁnal chapter analyzes the impact of family characteristics on a child’s educational achievement and suggests how school reforms can address the problem of low-performing students. Beyond a wide-ranging examination of various needs and risks tied to raising children in modern times, the chapters in this volume illustrate the importance of perspective and context in understanding and responding to these issues. The opening chapter places the issues of child rearing in a historical context that suggests that the problems encountered today are more of an ongoing struggle occurring over generations than what might feel to some to be a unique crisis of modern times. This tempers our outlook and sets a tone for policy recommendations that seek adjustments and changes that are ameliorative rather than transformative. The needs of children with ADHD are not only examined according to their substantive character but also framed in the larger context of the stigmatization of mental health patients. The health care of immigrant children is assessed in the broader context of children of the working poor. The recent practice of public subsidies for grandparents serving as caregivers of young children is appraised against the larger backdrop of informal kinship care in the privacy of family life. The struggles of caring for children by mothers in working-class, middle-class, and high-level professional jobs are seen from a life-cycle perspective. The involvement of fathers in raising children is seen as affected by the context of other important relationships in which the father–child relationship is embedded. State interventions that affect children are framed as measures designed to empower parents. The conventional method for determining child support is reframed, shifting the calculation from the marginal expenditures of an intact family to more nuanced considerations of the competing purposes of support. Children’s educational achievement is examined from the perspectives of both family background and school-based programs. In each case, the context and perspective on these issues inform policy recommendations that address essential features of the modern challenge to raising children. Of course, the policies suggested in this volume offer no grand, utopian solutions. Rather, they are mostly incremental in nature, and all of them are debatable. Looking at these needs and risks from different perspectives and in alternative contexts would elicit other policy responses. Our objective is not so much to resolve the issues as it is to open avenues of understanding and to stimulate debate about where they might take us.

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PART I CHILDREN IN FAMILIES

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1 The Past Is Not a Foreign Country: The Historical Education of Policy Paula S. Fass

The American imagination is peopled by rugged individuals. From John Henry to John Wayne, we have pictured ourselves as a nation of self-sufﬁcient men and (occasionally) women who set off on Walt Whitman’s Open Road, pursue Huck Finn’s Western territory, inhabit Emily Dickinson’s lonely soul, or hunt the seas for a great white whale. American literature and popular culture have always been replete with such images. How do we ﬁt into this picture a regard for society or, in less grandiose terms, an ability to live with other people and create an effective sense of social connection and responsibility? Traditionally, Americans have assigned this task to the family, the one institution that they trust to devise controls on individual impulse through effective child rearing, provide a means to convey laws and regulations to all its members, and be counted on to wrestle individual selﬁshness into safe directions without entirely taming the emphasis on a self-deﬁned destiny. Since colonial days, the burden on the family has been large, and whatever the family’s real achievements or failures along these lines, the family has been regarded with considerable awe precisely because we as a society have invested it with so much freight as the one institution we entrust with our commitments for both maintaining social order and protecting the individual. In a society that has historically rejected many of the strong agents of control common elsewhere, such as a powerful central state and an established national church, and which has depended on voluntary bonds for its rich associational life, the family alone is viewed as a stable force for order and a reliable source of authority. Indeed, the family has historically been intimately 9

10

Children in Families

involved in the protection of individual rights, as Martin Guggenheim1 recently pointed out, and parental rights in the United States have traditionally been regarded as a vehicle for and expression of individual rights. In this chapter, I offer suggestions as to how this reliance on the family as the source of social life has created special anxieties about family stability. As a result of those anxieties, family change is often not viewed realistically, while we cling to earlier family forms with fervor. I also suggest ways that policy makers can use a realistic understanding of our historical commitment to advance more effective policies regarding children.

The Family as an Approved Social Space When we use the word family today, we usually have a very particular concept in mind—a small, nuclear unit composed of a married couple and its children. In fact, however, this deﬁnition of family is largely a Victorian invention.2 Until the middle of the nineteenth century, when Americans spoke about families they often meant households, rather than the nuclear units that we are likely to imagine when we use the term today. A seventeenth- or eighteenthcentury ‘‘family’’ could be composed of a variety of individuals, many of whom we would hardly recognize as belonging to the family today, including servants (often indentured for a period of years); apprentices (under contract); dependent parents or parents-in-law; and sometimes other individuals, including other people’s children, who might have been placed in the home by public authorities as dependent paupers or orphans. Even prisoners could be inserted into households during the colonial period.3 In the South (and, far less frequently but more often than we imagine, in Northern states as well), a household could include slaves (as household servants, skilled workers, or as part of a plantation gang). By the mid-nineteenth century, many of these unrelated individuals had disappeared from households, leaving mostly related family members. Some of these households=families still contained unmarried spinster aunts, aged single parents, fostered children who had been placed out, and, occasionally in poor urban households, boarders not capable of or willing to maintain their own residences. The household together with its family represented a living unit, and it was also the basic form of social interaction. It was this variously composed family=household (not to be confused with a truly extended family) that was looked to in the colonial period for a large number of social functions, including ﬁnancial support, vocational training, operations of law and social control, and dispensing of community assistance. In a society such as that of the United States in the nineteenth century, in which people moved often and immigrants left familiar institutions behind, the ‘‘family’’ was an indispensable institution. It ordered the life of the individual in a nation that was constantly renewing itself and, in newer western regions especially, was often lacking in other forms of social life. Even many older regions of the country were still undergoverned and underserviced.

The Historical Education of Policy

11

By the mid-nineteenth century, the more intimate, domestic family of the Victorian period no longer provided the array of services that the colonial family had, and during the second half of the century it began to emphasize (and, indeed, to create) special family events such as birthday and holiday celebrations in order to deﬁne itself around these personal affairs rather than its older links to the social order. Above all, the domestic family began to concentrate on child rearing as it turned increasingly inward, especially in the privacy-seeking middle class. In so doing, it lost some of its more obvious social markings. As it turned toward private life, the family became more obviously the center of personal and emotional sustenance, which is how we recognize it today. But for most nineteenth-century families, especially in rural areas (which were dominant until the early twentieth century), the family continued to provide economic and other services to its members, and it remained symbolically the institution everyone looked to as a reminder of the fact that, even in the United States, the individual lived in and depended on group supports. This does not mean that all people lived in families. Throughout American history, some people have lived alone, as frontiersmen, fur trappers, and woodsmen—beloved in our cultural myths—and as city bachelors, sailors, and students. They have also lived in groups such as religious and secular communes; lumbering, mining, and other labor camps; army encampments; school dormitories; orphanages; and prisons. None of these were ‘‘households’’ as I have deﬁned them, although they did provide social linkages. But, throughout most of American history, the social connection to others usually came from within some kind of family-based household. Even slaves, who could not legally marry or form families, belonged to households—those of their masters. Despite the central importance of the family=household, Americans have also viewed this social unit as peculiarly vulnerable. And just as Americans have come to rely on its services, they have also very much, even disproportionately, feared its dysfunction or dissolution. This is the paradox of American family history: in a land of individuals, where other social forces were often weak, the family has seemed always to be both deeply necessary and perceived to be in peril. This was true to some extent even before the formation of the nation; thus town governments in seventeenth-century Massachusetts appointed tithingmen to guard their households in order to make certain that they performed their functions fully. It is interesting that commonlaw marriage remained a legal option throughout most of the nineteenth century in many American states, longer than in most European countries—a sign, perhaps, of the need for deﬁning institutions, even in the absence of observed rituals.4 Throughout our history, American family life has been under some kind of ‘‘nervous microscope.’’ I suggest that part of this is the result of the fact that family life has been constantly changing as it adapts to other social forces and factors, while our images of what families are have often remained constant, as if families exist outside of time and history. In the seventeenth

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Children in Families

century, while families adapted to ‘‘New World’’ conditions, Puritans enforced a static biblical view of the family and the way in which it was supposed to operate. In the twenty-ﬁrst century we are apt to enforce an idealized image, often drawn from a static and media-driven view of what families were like in the mid-twentieth century.5 Thus, while families successfully change and adapt, our images of families are much less elastic, and this disconnect can cause considerable anxiety. If Americans have worried long and hard about families, they have also worried about the children these families raise. In no other place in the world are so many child-rearing books and manuals available and sold. And this growth industry is not new: child-rearing experts began to provide parents— ﬁrst fathers, then mothers—with advice in the nineteenth century. By the early twentieth century, this advice and those who dispensed it, almost all now addressing themselves to women, became the basis for a small industry. So widespread was the interest in obtaining up-to-date advice that pediatricians such as L. Emmett Holt and psychologists such as John Watson became celebrities. Beginning in the early twentieth century, the U.S. Children’s Bureau distributed pamphlets that guided parents in rearing their children properly.6 Founded in 1912, the bureau distributed 4.5 million copies of its bulletin between the time of its founding and 1925. These pamphlets were addressed to ‘‘the average mother of this country.’’ Each year, the bureau received about 125,000 letters from these ‘‘average mothers.’’7 From these letters, it is clear that the readers were hardly all middle class; rather, they represented a large cross-section of American mothers who were hungry for advice about everything from infant formula feedings to discipline and schooling. Watson was so worried about this average mother’s trustworthiness that he warned her to follow his conﬁning regimen strictly, so that she might avoid the pitfalls of other mothers and (potentially) raise happy children.8 By the 1950s, the American home bible was Baby and Child Care, and millions of mothers turned eagerly to Dr. Benjamin Spock, their new guru, for advice. This hunger for advice is a sign of the desire of Americans to achieve successful, wholesome family life. It is also a sign of the anxiety Americans bring to this task. While Europeans have begun to recognize their own child care advisors, I doubt whether any other nation’s insecurities about child rearing and family relations have been quite so blatant as those in the United States. The American search for ideal ways to raise children is also an indicator of how much the family has changed from the earlier household, where all kinds of work and social services were being provided to the members. A midnineteenth-century domestic adviser such as Catherine Beecher spent most of her time instructing women about household management—for example, how to arrange their kitchens and hire servants. Today, child rearing and caregiving, and their associated emotional and psychological tasks, have become the center of gravity of concern in family life.

The Historical Education of Policy

13

Family Policies In the ﬁrst full century of national life, the nineteenth century, Americans attempted to create very few explicit social policies that operated directly on the family, although laws of many forms regarding marriage, divorce, adoption, and custody were created by states throughout the Union.9 The one exception was the strong movement to create schools and enforce school enrollments on all students, starting in the 1840s and 1850s in the North and Midwest and progressing somewhat later in the century in the South and West. Although we do not often view schooling as a form of family or social policy, in fact schools took authority from the family in its most intimate sphere, its control over children.10 The American common school was the most deeply and widely inﬂuential nonfamily social institution in nineteenthcentury America, not only because it required all members of the republican community to have some schooling but because it acted apart from the family and directly on the individual child.11 In so doing, the school inherited the possibility of becoming the other institution of choice—as an alternative to the family—for channeling innovative policies in regard to children. During the nineteenth century, public schools became a familiar part of the social scene, and it was largely through the social institution of the school in the early twentieth century that a variety of publicly desirable policies regarding health, nutrition, civic education, and vocational preparation, among others, were attempted. Throughout most of the nineteenth century, however, most schooling was local and brief (most children attended for 4 to 6 years), and the facilities were rudimentary. It was only in the twentieth century that schooling became a much more long-lasting, centralized, and potent form of social intervention.12 As the United States joined other industrial societies, in the late nineteenth and early twentieth centuries, in seeking to address a range of matters that related to the welfare of its population, and as the state enlarged its own powers in these arenas, it was through these two institutions—the family and the school—that most of these attempts took place. Families were regarded with ever more heightened concern, and the apparatus of the state provided a powerful position from which to observe families; it was also capable of establishing enforceable norms about family life. Once the state began to channel resources to families, it also began to monitor and supervise the ways in which families were deﬁned. One of the results was that the informal concerns regarding family life, existent in the nineteenth century and even earlier, became, in the twentieth century, an almost uninterrupted discourse of declension and anxiety. Thus, even as the accelerating interest in child-rearing advice was demonstrating the attempts by families to improve, the new observer=experts of the family seemed to be charting its steady decline. Starting in the early twentieth century, as state governments created institutions such as the juvenile court to oversee family relations and mother’s

14

Children in Families

pensions to provide assistance to poor children, and as schools were augmented with a variety of welfare services, the parallel (and related) development of social science disciplines (such as sociology, education, and child study= psychology) provided information about the workings of family life. These observations made their way into the media, as well as into government councils such as the White House Conferences on Child Welfare. What had previously been diffuse concerns about the family voiced by ministers, journalists, or other observers now took on a sharper, and more systematic, edge that continued to deﬁne American plaints about family life throughout the twentieth century. When I lecture on the modern American family to undergraduates in my American social history class, I always begin with two long quotes, one from a New York Times article published in the 1970s13 and the other from sociologist Ernest Mowrer’s 1932 book on the family.14 I ask students to identify which is which, a difﬁcult task, as (apart from subtle changes in language) they are very much alike in content and tone. Both view the family as a fundamental social institution in which the society invests its hopes, and both argue that the family is at a crossroads, assaulted by social changes that have rendered it increasingly unstable and vulnerable. Unfortunately, too often we imagine that as families face various crossroads, it doesn’t matter much which path they follow: their voyage always lands them in trouble. Over the 40 years between the writing of these two quotes, worries about the decline of family life have not diminished, while much has actually changed both in the larger society and in families’ adjustments to societal changes. This persistence of concern about the family in the twentieth century, I tell my students, is its most obvious feature. In fact, probably one of the few things we can predict with some certainty about the family in the near future is that it will remain an object of public concern and anxiety. Another striking consistency is that in both the 1920s and the 1970s (and even today), when Americans thought about families they had in mind the Victorian institution of the married couple and its children that, as I suggested earlier, became the deﬁning center of the urban household only in the mid-nineteenth century. This family form, which some seem to think has been in place since time immemorial, was really a new kind of family, adjusting to its time and place. But much had changed in the society, and families were adapting to those changes. Today, the family remains a social unit that binds individuals to each other and to the larger society, but it is no longer necessarily composed of either married couples or of those couples and their many children.

Observing Families in Motion To understand this relentless concern, the appropriate initial point of historical departure, as in many matters related to social policy, is the social and political landscape of the very late nineteenth and early twentieth centuries, which became the site for progressive agitation and policy proposals.15 That landscape

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contained a complex jumble of problems associated with the rapid expansion of urban life and its associated disorder, both perceived and real. The cities were chaotic, dangerous, and ﬁlthy, and they were rapidly ﬁlling with an enormous population of recent immigrants from many European countries. The strangeness and foreignness of these people’s lives in these tumultuous places called forth ﬁrst indignation and then, as more and more thoughtful people came to observe the scene, proposals for solutions. Initially, these observers were journalists, novelists, artists, charitable visitors, and settlement-house workers. Academic social science and the policies it inﬂuenced also grew out of observations about this troubled urban scene, and the attendant analysis was deeply inﬂuenced by the larger social complex in which it appeared. These groups began to urge that the chaotic and often unsavory lives of the people they observed had to be understood not just as a result of poverty, lack of hygiene, and the increasing precariousness of industrial work but also as the result of the kinds of families people came from and these families’ inability to cope with and survive the onslaughts of city life. Some of this literature was deeply racially tinged, and some of it became the basis for eugenics policies. But many of the most thoughtful analysts, who were eager to understand poverty as a result of poor environments, unemployment, and bad luck, also turned to explanations that saw families as implicated in the equation. Robert Hunter, 16 for example, in his important study titled, simply, Poverty, distinguished those families whose unfortunate circumstances led to impoverishment from those whose very ﬂawed nature predisposed them to a kind of poverty he called ‘‘pauperism.’’ The early sociological literature on families reinforced the emphasis on family dynamics as a prerequisite for effective solution to the problems posed by new economic conditions. The ﬁrst really important examinations tended to emphasize the special fragility of family life for migrants from the countryside. Perhaps the best-known example of this form of analysis is the multivolume investigation by William I. Thomas and Florian Znaniecki,17 The Polish Peasant in Europe and America, which quickly became a sociological classic. But there was a sizable literature on all aspects of this problem pouring out from what became known as the Chicago School of Sociology. Members of this school identiﬁed various parts of the city geography with greater or lesser instability and ascribed stable and unstable social structures, including families, to this geography. Greater instability led to more disorganized personal styles of life and personality structures and was associated with all manner of antisocial behavior. While the close association between geography and instability was a deep Chicago School ﬁxation, the broader point—that traditional families were buffeted by rapid change to which they could not adequately respond—was a view that was more generally held in the profession, and it reached far beyond the academy. Change itself became a threat— change associated with economics, with geography, and with culture. But, while all these were culprits, the city was the one category that contained all of these destabilizing elements.

16

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In the background of most of these portraits of instability was the image of a rural countryside, which many academics viewed as the ‘‘natural’’ place for human habitation and stable family development. From this perspective, the problem began when families moved from this grounding environment. Theodore Roosevelt, who was not only a president but also a historian and a vocal social observer, set the tone for this perspective when he noted, ‘‘It is not a good thing to see cities grow at disproportionate speed relatively to the country.’’18 In the view of many, the farm provided an environment in which families worked together and each member had a job and a purpose. The family’s economic function anchored its interdependence, ensuring its stability and trustworthiness. Work and play were natural expressions of rural life, and the family was stable, meaningful, and coherent. Many also imagined that this family was the locus for multigenerational interdependence, with innumerable grandparents and other family members joining parents and children in family solidarity; but even without this imagined sense of family structure, parents and children were thought to be bound to each other and to the natural stability of the hearth.19 From this perspective, the shift to cities itself was problematic, eroding the economic functions of the participants and dissolving the family’s glue-like connectivity within itself and with other stabilizing institutions in the local community. Immigrants suffered from all of these problems to a heightened degree because many not only came from the farms but had the additional and special disadvantage of cultural dislocation, and by relocating they lost all their connections with familiar community supports. Jane Addams,20 who was deeply sympathetic to immigrants, wrote a series of essays, The Spirit of Youth in the City Streets, that captured many of these issues and articulated them effectively enough to engage the public mind. Distilling this social analysis into a series of vivid portraits of the consequences for city youth, she offered up a picture of America’s children stranded in industrial cities with few meaningful aspirations and connections, whose vitality and sexual drives left them prey to commercialized forms of leisure and vice. John Dewey’s21 vision of the modern school drew upon this perspective as well, because for him urban schooling needed to create proxies for this rural-based experience. Oscar Handlin22 incorporated this perspective into his Pulitzer Prize–winning portrait of American immigration, The Uprooted, which he proposed as the master narrative of modern American life, portraying the immigrant torn from the soil and his children alienated and vulnerable in the modern world. From presidents and sociologists to social agitators, philosophers, and historians, the founding visions of family afﬂiction during the ﬁrst half of the twentieth century were signiﬁcantly derived from this compelling conceptualization. All or most of the problems of the twentieth century could thus be traced to the basic social transformations of industrial and urban life, complicated by immigration, and all of it was expressed in forms of family pathology. Early in the twentieth century, the portrait pivoted on a belief in the loss of the family’s economic function. In part, of course, families over the course of

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the nineteenth century did lose many of the economic functions once belonging to households that also functioned as workshops and places of apprenticeship and training. The remaining domestic unit in the nineteenth century was more loosely connected, as mothers replaced fathers at home and children were increasingly taught by state schools rather than by their fathers or masters. Industrialization did alter family ties and the meaning of households. But family analysts somehow missed the point by measuring (after the fact) the present against a past standard, while family life itself not only adapted to but facilitated economic change, with children in working-class industrial households deployed in a new version of the family economy.23 Most analysts missed the successful transition that was taking place and began to worry that as households lost their obvious economic enterprises, individual members were being released from their secure places and from their responsibility to each other in the most fundamental social institution. Contemporary observers believed that social stability and personal competence were dependent on their own historically derived visions of family interdependence. Many believed that what they saw in the chaos of early-twentiethcentury industrial cities, with their poverty and despair, were the palpable consequences of families’ being made irrelevant and rendered fragile. This image of the relationship between urban poverty and family fragility and the association between urban economics and family malfunction continued to inﬂuence American visions well into the twentieth century. It became so familiar, so ‘‘naturalized,’’ that one now has to work hard to understand its historical speciﬁcity as a form of diagnosis. This set of associations has also meant that for much of the twentieth and twenty-ﬁrst centuries, American public discussions have rarely taken note of the deep-seated and pervasive existence of rural poverty and the needs of rural families.24 It took Michael Harrington’s25 tract of the 1960s to make this seem obvious. Rural families, as imagined within the paradigm of city disorder, are naturally resilient, interdependent, and selfsufﬁcient. Similarly, it is not true that the change from rural to urban life, or the consequences of migration, or the change from preindustrial to industrial existence, has doomed urban families, even in the inner city; this is true for both those moving from European villages and those leaving American cotton ﬁelds. On the contrary, migration often leads to new aspirations, new kinds of interdependence, and new opportunities.25 There is no doubt that some urban families did not function well, but neither did many rural families. Despite the clear resilience of most families in the context of urban change, American policies regarding poverty have often taken this analysis as a point of departure, and they have developed particular ways of dealing with it. One of these is to imagine that recreating traditional family cohesion is itself a form of solution; another is to create policies around the maintenance of particular kinds of families that many assume are better suited to social living and provide better environments for children. By the 1920s, the newly professionalized ﬁeld of scientiﬁc social work had incorporated these views and values and took the family as its primary unit of

18

Children in Families

treatment. As Linda Gordon26 has demonstrated, the case-work method assumed that the individual problems social workers were called on to treat reﬂected some kind of family pathology. Their aim was not simply to provide relief from suffering at any one moment but instead to deal with a family’s unfolding problems—problems assumed to be based in family dynamics. Government aid was also guided by this view. Shoring up the family was the basis for the creation of mother’s pensions by states early in the twentieth century and became the basis for Social Security payments during the New Deal. Indeed, during the Great Depression, as the problem of poverty ballooned to include a huge proportion of a normally hard-working population, relief was imagined and dispensed in terms of families, not individuals. Not only was there widespread fear that spreading poverty would destabilize families,27 thus releasing children into the streets and onto boxcars, but work relief was usually offered with families in mind. The Civilian Conservation Corps (CCC) illustrates this well, but it was also true of other programs such as the National Youth Administration (NYA), a part of the Works Progress Administration (WPA). Through employment by these agencies, young people were given federal beneﬁts in order to help support and stabilize their families. Recipients were assumed to be responsible for each other’s welfare within the family unit. A CCC recruit automatically had his wages sent home, and employment in other agencies was often family-, rather than individual-, speciﬁc, with no two members of the same family employed at the same time.12 The economics of the family has remained a fundamental unit of calculation in part because Americans, despite their beloved mythology of the ruggedly independent individual, have continued to imagine that this is the natural basis of social authority.28

From Family Economy to Family Affection The growing fears about the family’s potential fragility and the accompanying social diagnosis were not the result only of perceptions about lost family functions. Even though the early Chicago School sociologists left a deep imprint on the way we think about the family in an urban environment, family life was not altogether given up because it was no longer rural and multigenerational. By the 1920s, many social theorists had managed to reinvest the family with a new basis for authority and signiﬁcance as they renegotiated the substance of family relationships, from the economic to the emotional. William Ogburn,29 a prominent Columbia University sociologist, concluded, ‘‘It does not seem probable that the family will recover the functions it has lost. But even if the family doesn’t produce thread and cloth and soap and medicine and food, it can still produce happiness.’’ This perspective seemed to give the modern urban family a new lease on life, although many still imagined that this required the family to remain a coherent unit deﬁned by the marriage of a man and a woman, a unit available

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to provide succor to its adults and effective socialization to its young. Studies that measured family quality in terms of sentiments and emotions even gave the urban family an edge because middle-class families, at least, relieved of the problems of precarious economics, seemed to be providing their children with far more emotional sustenance than either the rural family or the more hardpressed urban working-class family. In the early 1930s, the White House Conference on Child Health and Protection (commissioned by Herbert Hoover before the depression) discovered that urban families had a more effective form of emotional integration: children conﬁded more readily in their parents, and parents were able to guide and induce their children toward behavioral regularity through positive emotions, rather than by using stricter methods of discipline and control. Ogburn and many others, including a new generation of Chicago sociologists such as Ernest Burgess, deﬁned families as groups organized around affective relationships, bound together through emotion rather than economic obligation. Burgess30 was even led to question whether the family was a social institution at all: ‘‘Historically, as other institutions have evolved, the family has lost one by one its original collective activities until the question may be raised whether the modern family is any longer an institution: Is it now anything more than a mere unity of interacting personalities?’’ This question still echoed with the anxiety of the Chicago School perspective on families, but it also facilitated the new emphasis on the importance of stable personalities nurtured in good family relations, which developed during the 1930s and especially the 1940s as new psychologically attuned views focused on the problems of children in wartime.31 The childrearing literature had also been turning its attention from judging children’s well-being in terms of physical health toward measures of emotional health and psychological well-being. This was especially notable in Spock’s psychodynamic viewpoint and his unquestioned position as the dominant post– World War II children’s expert. Also beginning in the 1930s, the new turn to emotional and affective issues resulted in efforts to prepare young people for their roles as parents in a modern world. Popular sociologist Ernest Groves was especially well known for these efforts as a founder of the parent-education movement, which sought to establish special curricula to train youth for their roles in fulﬁlling family lives.32 A new family required members more fully aware of and better prepared for the demands of marriage and child rearing. This redeﬁnition of the family as an emotion-based unit never entirely replaced the earlier fears about modern urban families as fragile institutions, but it opened another realm of action, as the monitoring of affection became a concern to family specialists. If the new family order was dependent on warm feelings and positive affect, this did not remove the onus from families or lessen their need for stability, though it did redirect the conversation. While social workers had once been able to deem families who abused or neglected their children untrustworthy, this new deﬁnition, with its focus on the quality of family relations, made even the middle class—once imagined to be largely

20

Children in Families

immune to the destabilizing forces of poverty and disorder—subject to scrutiny and concern. As Ernest Groves’s attempts to instruct elite college students in the ﬁne art of family harmony suggest, the anxiety over family life was now moving steadily toward the evaluation of middle-class family dynamics, where fragile relationships between husbands and wives and unpredictable childrearing practices were demanding new attention and becoming the source of new worries.32

A House in the Suburbs The movement to the suburbs is not a recent phenomenon. Since the nineteenth century, those who could afford the carfare moved to the outskirts of cities, where the air was fresher and the trees and grass created an illusion of country life. Suburban life became a staple of the early twentieth century, and by the 1920s it was ﬁrmly part of the American imagination.33 Not the least of its enticements by that time was the possibility of carefully nurturing personalities in a private domestic unit not buffeted by urban turmoil. In fact, well before that time the ideal of a life in the country had been part of family policy in regard to orphans and waifs, who were transported to life outside the city as workers, foster children, and summer campers.34 After World War II, this American romance became a fundamental social process, as suburban migration was magniﬁed by an increasingly prosperous society with an expanding middle class eager to raise its larger post-Depression and post-war families away from the disintegrative forces of urban life. The suburbs became part of the American dream, and the individual single-family house became an expression of family harmony and autonomy. One should not discount the degree to which the beliefs about the corrosive inﬂuences of city life had penetrated into the popular imagination; Americans intent on raising their Baby Boom–inﬂated families ﬂed from environments they associated with dangers to family life. But the suburbanization of American families was above all the result of policy decisions by federal agencies now willing to support singlefamily home ownership through veterans’ beneﬁts, federally insured home loans, and various taxing policies.35 The suburbanization of America in the 1950s was a public response to a view of families as needing not only an escape from the city but also a locale for effecting positive interpersonal relations. Even the suburbs could not insulate families from a new set of fears, or quell the anxieties of family analysts about the future of the family. In fact, in the second half of the twentieth century, observers of the family added the suburbs to their list of areas with potential for disintegration and deep disturbance. If the assault on the families on the margins—immigrants, the poor, and racial minorities—resulted from the belief that such families were inadequate to the challenges of moving to cities, middle-class families seemed to be imploding from within as the family became a new battleground of emotion. The initial detonator came not from economics but from unhappiness, and it came be-

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cause in families now deﬁned by affection instead of function, lack of emotional fulﬁllment and harmony was a trigger for divorce. Burgess’s proposal of the 1940s—that families would likely stay together just because of elective afﬁnity—seemed not to be holding up. Divorce was already well recognized on the public radar by the early twentieth century, when some observers, especially Protestant ministers, began to watch the up-tick in the divorce rates with gloom.36 Indeed, divorce was often looked to as a primary indicator of widespread family trouble, a signal of the disintegration that academic sociologists most feared. After World War II and into the 1950s, the divorce rate continued to rise, so that by the end of the 1950s about one-quarter of all marriages ended in divorce. After the 1960s, however, the American divorce rate seemed to run out of control, shattering family unity, as the lack of personal fulﬁllment became sufﬁcient grounds for dissolution. By the last third of the twentieth century, as the level of divorce reached 50% and stayed there (more or less), the family— in the suburbs, the city, and the countryside—seemed once again to be visibly in peril. Some, such as feminist spokeswoman Betty Friedan,37 saw this as the necessary result of the shattering of 1950s suburban dystopias. Others blamed new sexual mores brought about by the sexual revolution of the 1960s and the feminist revolution that Friedan had helped to midwife. By the 1970s and 1980s, economics and ideology together had created a growing population of two-career or two-job households in which the pressures of jobs and emotions created a volatile mixture that seemed to destabilize previous gender roles and other family dynamics. Today, these pressures are often at the heart of concerns about family life and the welfare of children. Thus, seven decades after the original images of urban working youth out of control in inner cities had been enshrined as a basis for family policies by progressive reformers, a new portrait of youth—now suburban, leisured, and middle class—has become another stimulus for addressing the need for action regarding families. Starting in the late 1970s, our image of young people being victimized or inadequately supervised by their harried or unhappy parents began to ﬁll popular magazines and books. This time the families could be of any class: the perceptions of family trouble had spread to all parts of the society. No place was immune, and everyone was vulnerable. Even prosperity became a culprit, as goods became suspect as a substitute for the affection that was supposed to serve as the glue of family life. Whether it was single mothers trying to hold tight to middle-class status and working two jobs while neglecting their children, or divorced fathers kidnapping their own children in custody disputes, middle-class family life seemed to be in disarray.38 And the American media heightened our obsessive concern with family failure by focusing on young people who ran away; who were strung out on alcohol, music, and video games; or who were having sex by age 15 and being bullied into selfloathing by peers. Today, the children of Columbine as seen on NBC, not the children of Chicago as portrayed by Jane Addams, have become the signal of family inadequacy.

22

Children in Families

The image of children out of control with which we like to berate ourselves as a society is as old as the tradition of the Puritan Jeremiad, where each new generation of ministers agonized about a falling-away from a golden age of piety and rectitude by decrying the misbehavior of the young. In fact, our society is very different, and our families are very different, from those of those early, anxious Puritans. Unlike them, we no longer live in small, coherent communities where we watch each other’s children (and each other’s morals). The family is a private terrain, and our families no longer provide every kind of social resource, from nourishment, education, and religion through the sinews of law enforcement. Our twenty-ﬁrst-century families are also very different from those who caused such anxiety when they ﬁrst moved to cities and adjusted to industry a century ago. Having adapted to a long century of new technologies involving reproduction and household maintenance, as well as myriad other social changes, our families are no longer patriarchal units in which wives obey and children serve the larger good of the household. Today, we have families of all kinds, even in the suburbs. Some are composed of the traditional husband and wife with their children, others of second or third spouses and their blended children; still others are unmarried single parents or same-sex couples with children. These households still provide various social goods, although their varied constitutions may not ﬁt everyone’s image of a family. So, the family has changed a great deal. But our view of the family as a basic joist of social order has not been much revised, and as a result we still worry endlessly about whether it can be depended on. In the early twentieth century, many of those who diagnosed the problems of the cities were surely looking back to a golden age that might have still comforted the Puritans, a world of cohesive communities with responsible, hierarchical families. Our own recent past is neither rural nor based in such tight-knit communities, although we still seek a golden age. Today, the golden age is likely to be sought in some version of the mid-twentieth-century dream of a stable, two-parent, singlewage-earner, domestic family that was itself ﬁrst created by nineteenthcentury Victorians, and we tend to reify this model as the only one that can provide social stability and personal satisfaction. Because this family now approximates a kind of golden historical ideal, it has recently reappeared in the press as former career women ‘‘opt out’’ to return to domestic duties that approximate the tone of this earlier family form.39 As we contemplate the multiple kinds of families today, it is tempting to apply older standards as a way of escaping contemporary difﬁculties. But these standards were themselves never more than historical inventions. I do not want to give the wrong impression. Our fears about family have not stayed exactly the same as even this brief review has suggested, and the new anxieties about the middle classes have certainly not entirely displaced our worries about the poor, the immigrant, and the nonwhite. Nor do I think that we live in the best of all possible worlds. Our families and our children have lots of problems, and problems of many kinds, and there is much that could be

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done to help family life and individuals within it. Still, it is hard to avoid the conclusion that worrying about families is both an American tradition and contagious. But a number of matters can be clariﬁed simply by recognizing how much our current perspectives participate in a long historical tradition and then using that historical understanding to inform our approach to policy. First, American families have been changing since the nation’s ﬁrst founding, and they will continue to change. Worrying about families is also likely to continue—it is in our national genes. But worrying about keeping them just as they were before is hardly a good basis for policy or an effective response to change. Americans need families, and they need to implement policies that make families better at what they do, but these policies need to be realistic and socially responsive. There are a number of quite positive lessons that this history also yields. Americans worry about their families because they assume they are important, and while they disagree about approved forms of family life, they have long been accustomed to making families the basis for social welfare policies. Unlike other societies, such as those of Germany and Britain, which introduced social welfare policies largely to protect workers, Americans created values of social welfare around families and children. Americans also seek out the best possible expert advice about their children when they can, and while the inconsistency and excess of that advice can sometimes overwhelm and frustrate them, they can be expected to view thoughtful and ﬂexible policies that look to their children’s best interests with favor. Even individualistic Americans understand their stake in their own children’s future. Today, our children seem to be surrounded by risks, and much of the heightened concern we experience is related to our perception of these risks and the feeling that families are not quite up to dealing with them. Drugs, bad schooling, obesity, sexually transmitted diseases, popular culture, and popular media are among the things that parents seem to need to deal with. At the same time, parents are overwhelmed and overworked. As the essays in this volume suggest, different families and different individuals have responded in various ways to these challenges, just as families have responded in the past to the challenges of their day. In seeking ways to assist in the creation of better families and better parents, it is the task of academics and policy makers to recognize not only that family life itself has a history but also that the improvement of families is something in which we have historically had a deep stake as Americans have sought a better future.

Notes 1. Guggenheim, M. (2005). What’s wrong with children’s rights? New York: Harvard University Press. 2. For the invention of the modern family, see Gillis, J. (1996). A world of their own making: Myth, ritual, and the quest for family values. New York: Basic Books.

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3. Rothman, D. J. (1971). The discovery of the asylum: Social order and disorder in the new republic. Boston: Little, Brown. 4. Friedman, L. M. (2004). Private lives: Families, individuals, and the law. Cambridge, MA: Harvard University Press. 5. Coontz, S. (1992). The way we never were: American families and the nostalgia trap. New York: Basic Books. 6. For a history of the Children’s Bureau, see Lindenmeyer, K. (1996). A right to childhood: The U.S. Children’s Bureau and Child Welfare, 1912– 46. Urbana= Chicago: University of Illinois Press. 7. Hulbert, A. (2003). Raising America: Experts, parents, and a century of advice about children (p. 99). New York: Alfred A. Knopf. 8. For information on Watson, see Fass, P. S. (1977). The damned and the beautiful: American youth in the 1920s (pp. 100–107). New York: Oxford University Press; Hulbert, A. (2004). Raising America: Experts, parents, and a century of advice about children (Chapter 3). New York: Alfred A. Knopf. 9. Grossberg, M. (1985). Governing the hearth: Law and the family in nineteenthcentury America. Chapel Hill: University of North Carolina Press. 10. For a similar view, see Cohen, M. (2005). Reconsidering schools and the American welfare state. History of Education Quarterly, 45, 511–537. 11. Cutler, W. W., III (2000). Parents and schools: The 150-year struggle for control in American education. Chicago: University of Chicago Press; Schultz, S. K. (1973). The culture factory: Boston public schools, 1789–1860. New York: Oxford University Press; Kaestle, C. F. (1983). Pillars of the republic: Common schools and American society, 1780–1860. New York: Hill and Wang; Cohen, M. (2006). Children’s rights, mother’s rights, labor rights. Paper presented at The Century of the Child: Children’s Rights and the Nation-State in the U. S., France and Sweden, 1900– 2000. Columbia University, New York, May 24–26, 2006. 12. Fass, P. S. (1989). Outside in: Minorities and the transformation of American education. New York: Oxford University Press. 13. ‘‘Few doubt the family’s capacity to survive; it has withstood the challenges of a changing society since the Industrial Revolution ﬁrst took people from the isolation and self-sufﬁciency of the farm. It will no doubt, do so again. . . . Still, as American men and women attempt to shape new relationships, the family is being challenged as never before, from within and from without. Experts intensely debate the social implications of this dual challenge, with some envisioning the dawn of an enlightened, creative society while others are deeply disturbed by what they see as a loss of values, a burgeoning instability that may have dire consequences for democratic institutions. . . . The new challenge and the new relationships that have spawned it have made this the age of the fragile family, the family in transition.’’ Nordheimer, J. (1977). The family in transition: A challenge from within. New York Times, November 27, p. 1. 14. ‘‘No problem in modern life so challenges the attention of thoughtful students of society as does the family crisis, if we may interpret the tenor of recent writings upon the subject. One group heralds the present situation as the beginning of a new day in which all the old restraints of family mores will be thrown aside, and the other group is alarmed lest the most treasured of institutions may disappear and bring havoc upon modern civilization. Both, however, agree that the family is at a turning of the way.’’ Mowrer, E. (1932). The family: Its organization and disorganization. Chicago: University of Chicago.

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15. Rodgers, D. T. (1998). Atlantic crossings: Social politics in a progressive era. Cambridge, MA: Harvard University Press. 16. Hunter, R. (1904). Poverty. New York: Macmillan. 17. Thomas, W. I., & Znaniecki, F. The Polish peasant in Europe and America. First published in ﬁve volumes between 1918 and 1920. Boston: Badger. The book is best known in its two-volume edition, published in 1927 (New York: Alfred A. Knopf). 18. Quoted in Hulbert, A. (2003), Raising America: Experts, parents and a century of advice about children (p. 34). New York: Alfred A. Knopf. 19. Even as sophisticated a modern historian as John Gillis still adopts some of this picture when he portrays preindustrial pre-nineteenth-century families. See A world of their own making (Gillis2). 20. Addams, J. (1909; reprinted 1972). The spirit of youth in the city’s streets. Champagne-Urbana: University of Illinois Press. 21. For Dewey, see Fass,12 1989. 22. Handlin, O. (1951). The uprooted: The epic story of the great migrations that made the American people. Boston: Little, Brown. 23. On the subject of the industrial family, see Anderson, M. (1971). Family structure in nineteenth century Lancashire. Cambridge, UK: Cambridge University Press; Hareven, T. (1982), Family time and industrial time: The relationship between the family and work in a New England industrial community. Cambridge, UK: Cambridge University Press. 24. Jones, J. (1992). The dispossessed: America’s underclasses from the Civil War to the present. New York: Basic Books. 25. Harrington, M. (1993). The other America: Poverty in the United States. New York: Simon and Schuster (originally published in 1962); Fass, P. S. (2005). Children in global migrations. Journal of Social History, 38, 937–954. 26. Gordon, L. (1988). Heroes of their own lives: The politics and history of family violence. New York: Penguin Books. 27. Komorovsky, M. (1940). The unemployed man and his family: The effect of unemployment upon the status of the man in ﬁfty-nine families. New York: Dryden Press for the Institute of Social Research. 28. This is in sharp contrast with Sweden, where the individualistic ideal has led to distinctly non-family-based policies, such as separate taxes for husbands and wives. 29. Ogburn, W. F. (1928). The social heritage and the family. In M. E. Rich (Ed.), Family life today (pp. 38–39). New York=Boston: Houghton Mifﬂin. 30. Burgess, E. (1928). The family and the person. Publications of the American Sociological Society, 22, 133. 31. Tuttle, W. M. (1993). ‘‘Daddy’s gone to war’’: The Second World War in the lives of America’s children. New York: Oxford University Press. 32. Ernest Groves was one of the main proponents of parenting education, and he set up the ﬁrst course of its kind at the University of North Carolina. He also summarized the state of education for parenting regularly in the American Journal of Sociology. See, for example, Groves, E. (1929). The family (changes in 1928). American Journal of Sociology, 34, 1099–1107. Others also followed this trend, such as Helen Merrill Lynd ([1960]. Parent education and the colleges. Annals of the American Academy of Political and Social Science, 160, 197–204) and Laura Winslow Drummond ([1942]. Youth and instruction in marriage and family living. New York: Bureau of Publication, Teachers College, Columbia University).

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33. Peter Stearns notes the close relationship between a newly intensive emphasis on child rearing and carefully nurtured personalities and suburban life in his 2003 book, Anxious parents: A history of modern childrearing in America (p. 10) (New York: New York University Press). 34. For camps and camping as an escape from the city, see Paris, L. (2008). Children’s nature: The rise of the American summer camp. New York: NYU Press. This did not occur only in the United States but also in France and other societies where poverty was associated with industrialization. 35. Jackson, K. T. (1985). Crabgrass frontier: The suburbanization of the United States. New York: Oxford University Press. 36. O’Neill, W. (1967). Divorce in the progressive era. New Haven: Yale University Press. 37. Friedan, B. (1963). The feminine mystique. New York: W. W. Norton. 38. For information on parental kidnapping, see Fass, P. (1997). Kidnapped: Child abduction in America (Chap. 5). New York: Oxford University Press. 39. Flanigan, C. (2006). To hell with all that: Loving and loathing our inner housewife. Boston: Little, Brown.

2 From Private to Public: Paying Grandparents as Caregivers Jill Duerr Berrick

The 1990 U.S. Census revealed a 44% increase over the previous decade in the number of children living with their grandparents in the United States.1 In one-third of these families, neither of the parents was present.2 The trend has continued, and today more children are living in grandparent-headed households than ever before; in fact, grandparent-headed households appear to be the fastest growing demographic group in the United States. The most recent ﬁgures suggest that in 2001, about 9% of all U.S. children lived with at least one grandparent—almost double the number and percentage from just 5 years earlier. About 1.4 million of these children were living in grandparent-headed households with no parent present.3 The majority of children in no-parent households are poor, and African-American and Hispanic children are overrepresented.3,4 About half of the relative caregivers are two-grandparent families, and the other 45% of families are headed by a grandmother.5 Some of these grandparents are quite elderly, dealing with their own health complications and other challenges, but as of 1997 over half (55%) were under age 55, and 19% were younger than 45.6 The family constellation of grandparent or other relative and child has been referred to by various authors as kinship care, relative care, and skipped-generation care. It refers to the full-time parenting of children by individuals related by blood, law, or marriage. In some contexts, it also includes care provided by ‘‘members of [a] tribe or clan, godparents, stepparents, or other adults who have a kinship bond with a child,’’7 although these caregivers are more widely referred to as ‘‘kith.’’ While gaining increasing contemporary attention in 27

28

Children in Families

social-policy circles, the practice of rearing a relative’s child is ancient and global. In early Hawaiian cultures, for example, paternal grandparents typically claimed the ﬁrst-born son, and maternal grandparents the ﬁrst-born daughter, as their own.8 In many African nations, kinship care has been widely practiced for decades,9 and in colonial America children who lost their parents to death or incapacity were typically reared by grandparents or other relatives.10 Today, kinship arrangements largely occur within the private context of the family. These intensely personal decisions are made to promote the safety, security, and well-being of children,11 and they usually come about as a result of signiﬁcant problems in a parent’s capacity to care for a child, such as economic disruptions or parental health problems including HIV=AIDS, substance abuse, incarceration, or maltreatment.12 Sometimes the arrangements are temporary; other times they are permanent.4 While the large majority of kinship arrangements are private and voluntary,13 an increasing number of children are now cared for by relatives with ﬁnancial support from government sources. Shifting public policies promoting the use of kin as substitute and=or supportive caregivers have blurred the lines between private and public, and they raise questions about the future of the American family and children’s care. In this chapter, I examine four domains of social policy where kin care dominates: foster care, welfare, guardianship, and child care. Taking a critical perspective on current developments in these areas, I analyze the limits and beneﬁts of the shifts from private to public involvement. The ﬁnal section raises questions about the appropriate role for government in supporting extended families.

The Case of Foster Care Foster care is designed to serve children who can no longer live in their parents’ homes, usually due to problems associated with child maltreatment. The care offered is often temporary while parents attempt to resolve the problems that resulted in the child’s removal from the home.14 The long history of foster care has sometimes favored children’s placements in institutions, sometimes in free boarding homes, and, in the past century, in the homes of foster parents— strangers to the children who elect to provide care with modest subsidies offered by the state.15 Since the mid-1980s, the foster-care census in the United States has risen dramatically. In 1985 there were 276,000 children living in out-of-home care, but after the turn of the century that number doubled to over 560,000 children.16 At the same time that foster care caseloads were rising, the number of foster parents available to serve children declined precipitously. Some estimates suggest that nearly one-third of foster parents left the ﬁeld in the decade from 1980 to 1990.17 The imbalance in supply and demand and the pressing need for care providers left state ofﬁcials with few choices: expand care provided in institutional settings (an alternative that would raise costs

Paying Grandparents as Caregivers

29

considerably and clash with philosophical sentiments about the best interests of children) or develop alternative placement settings. As relatives had long provided care to children outside of the auspices of the child welfare system,18 they were turned to as a potential placement resource. Parallel to these developments, legal precedent changed. In 1979, the U.S. Supreme Court ruled that kin could receive federally funded foster care payments under speciﬁed conditions.19 Although various states interpreted the decision to different effects, many states opened opportunities for kin to become kinship foster parents, albeit without many of the same training requirements and licensing standards associated with regular foster care.14 In fact, in California and many other states, kin were required to pass a criminal background check only; the suitability of others in the home was not necessarily considered, and other health and safety concerns were often passed over.20 The inclusion of kin into the foster-care system has had profound effects on the child welfare system overall. In the 1990s, kinship foster care became the fastest growing service funded by the child welfare system.21 From 1986 to 1990, the proportion of children served in kinship foster care grew from 18% to 31% of the total foster care caseload,22 and in some states the rapid expansion of kinship foster care continued thereafter. In California, the utilization of kin peeked in 1998, with 45% of all children placed in kinship foster care23; Illinois showed similar trends, with approximately half of their child welfare population placed with kin.24 Since the late 1990s, utilization of kin has declined somewhat and stabilized. In 1997, the federal government introduced the Adoption and Safe Families Act,25 recommending kinship foster care whenever possible but limiting federal funding to those kin meeting state licensing requirements for foster care.13 Today, kinship foster care accounts for roughly one-ﬁfth of all placements nationwide, although it still predominates in many large states.26 Prior to placement, a kin caregiver is assessed for suitability as a care provider, and the home is reviewed to ensure that it meets basic health and safety standards for licensure. Those who qualify receive a modest monthly subsidy to pay for the child’s care, ranging nationally from approximately $200 to $700 per child per month. In California, the average foster-care payment is approximately $500 per child per month, and the payment is graduated based on the age of the child.27 If the child has special needs, monthly rates may vary from about $800 to $1200 per month.28 Children in kinship foster care qualify for federally supported health insurance (Medicaid), mental health services, and other services as needed, although some evidence suggests that kin-care children actually receive fewer services and fewer contacts with social workers than do children in regular foster care.29,30 Some caregivers eventually adopt the children in their care, and others may elect for legal guardianship, but many children placed with kin remain in foster care for extended periods of time. Some evidence suggests that while the likelihood of reuniﬁcation with birth parents is similar for children placed with

30

Children in Families

kin as it is for those placed with foster parents, the speed with which reuniﬁcation is achieved is slower for children living in kinship foster care. Further, it appears that the amount of the foster care payment may effect reuniﬁcation, with higher payments resulting in a lower likelihood of reuniﬁcation and a higher probability of the child’s remaining in kinship foster care in the long term.31 One can only speculate as to what would be the circumstances of children and their families if government supports were withdrawn from kin caregivers. Federal and state funding for kinship foster parents has allowed large numbers of children who would otherwise have been cared for by strangers to remain in their family of origin; to preserve cultural, religious, community, and linguistic ties; and to maintain more frequent and more informal contact with other family members, including birth parents and siblings.32 Although it would be difﬁcult to argue that the availability of kinship foster care has acted as an incentive to move children from the homes of parents into the homes of grandparents (as there are a number of formidable gatekeepers to the child welfare system, such as social workers, lawyers, and judges, who presumably act to separate children from their parents only in severe circumstances), it appears, nevertheless, that subsidized kinship foster care, in some circumstances, may dampen the likelihood that children will be reunited with their birth parents, or at least that they will do so in a timely fashion.

The Case of Welfare If foster care has fundamentally changed with the inclusion of kin into the child welfare system, changes in welfare have been just as signiﬁcant. Welfare, or cash assistance, is available to low-income parents and their children. Most frequently, the head of household is a single mother with two children.27 In 1996, the federal government overhauled the cash-assistance system in the United States, developing the Temporary Assistance to Needy Families (TANF) program.33 TANF diverges from its predecessor program, Aid to Families with Dependent Children (AFDC), in several important respects. Most notably, TANF is time limited (varying by state from 21 months to 60 months),34 work requirements are imposed in exchange for the continuation of beneﬁts, and a variety of ﬁnancial sanctions can be imposed by the state if parents do not comply with program regulations. Although these rules apply to most birth parents, the law is variable with regard to others who may be caring for a child under the welfare program. Speciﬁcally, when relatives designated as the head of household provide care to low-income children, TANF requirements in some states are relaxed.35 For example, in nine states, heads of household aged 60 or older are exempt from time limits.34 Twenty-nine states exempt grandparents from work requirements, although the exemption applies only for older grandparents ranging in age from 55 to 65 years, depending on the state.36 In California, grandparents

Paying Grandparents as Caregivers

31

aged 60 and older are exempt from both time limits and work requirements; others can be excused from these requirements at worker discretion based on their ‘‘caregiving burden.’’37 Grandparents caring for child relatives may collect public aid via one of two routes: a family grant or a child-only grant. Grandparents who themselves meet income-eligibility requirements can collect a family grant.38 As mentioned, some work- and time-limit restrictions may apply. Family grant amounts range from $96 to $551 for a family of two, depending on the state.39 As family size increases, the grant amount rises incrementally.40 Families are eligible for health insurance (Medicaid) and may be eligible for Food Stamps, assistance with heating, and assistance with housing. Grandparents whose income and=or assets are too high may collect a ‘‘child-only’’ grant, again with variation across states.41 Like family grants, child-only grants are incremental relative to family size, children are eligible for Medicaid, and the family may be eligible for Food Stamps. Neither time limits nor work requirements apply. Most research suggests that growth in grandparent-headed TANF households is high. In a study conducted by Berrick, Needell, and Minkler,37 California’s welfare caseload was examined using state data. Due to limitations in the dataset, the researchers could consider the characteristics of the ‘‘head of household’’ but could not determine the relationship of the head to the child. Using an age cutoff of 50 years or older, they found growth in the welfare caseload among older caregivers was considerable in the years prior to reform. From 1990 through 1996, for example, while the AFDC caseload grew among all age groups, households headed by older caregivers more than doubled. The study has yet to be replicated since welfare reform was implemented. Nationwide, the proportion of TANF children who live with a grandparent who serves as head of household climbed from 6.2% of the total caseload in 1998 to 8.4% in 2001, and the share living in a parent’s household declined from 90.3% to 85.7%.27 Growth in the child-only caseload also has been pronounced, particularly as a proportion of the total caseload. From 1969 to 2001, the proportion of child-only families more than tripled to 37.2% of all aid cases.42 The childonly caseload is made up of two major groups: (1) children living with parents who are not counted in the assistance unit (because the parent has been sanctioned off of TANF, the parent is collecting Supplemental Security Income, or the parent is ineligible for TANF due to immigration status43) or (2) children living with an adult other than the parent. Today, about half of the child-only TANF caseload comprises children living with their relatives,44 and of these relatives about two-thirds of adults are grandparents to the children. Although there are few differences between parents and grandparents collecting child-only grants, there are more subtle differences between parents and grandparents collecting full family grants. Among grandparents eligible for a TANF grant, monthly subsidies are similar to those allocated to parents. However, the TANF policy environment, including work requirements, time

32

Children in Families

limits, and behavioral regulations, may make relative-headed households more economically secure for children than parent-headed households. The workand time-limit exemptions were designed to shelter older caregivers from a labor market that is reluctant to embrace older workers.45 But they were also intended to honor relatives for fulﬁlling a social obligation toward family members. Indeed, as an alternative to foster care, relative care is desirable both economically and socially. However, as an alternative to parental care, kinship caregiving has its limits. The welfare-policy landscape that makes kinship care more economically secure for children may also unintentionally serve as an incentive for parents to move their children into their relatives’ homes.

The Case of Subsidized Guardianship As policymakers begin to recognize the needs of relative caregivers and their increasing role in child welfare and welfare programs, new initiatives have been developed in some states that resemble a hybrid between foster care and welfare. Some kinship programs are designed for children who previously lived with their parents but who have been deemed at risk for maltreatment; others are designed for non-needy relatives (regardless of the reason for the child’s living arrangement), with grant amounts about midway between foster-care and welfare payments.44 Another handful of states have developed subsidized guardianship programs as a means of encouraging relatives to assume a legal custodial relationship with the child for whom they are caring. Up until recently, grandparents or other relatives were free to petition the courts to assume custody of their relative children when parents were unable or unwilling to care for a child. Custody was a private, family matter, and courts were involved only to the extent that the legal change in relationship needed state sanction. Following the change in custody, however, the role of the state faded. The new subsidized guardianship programs are funded with Federal IV-E funds (through state waiver requests), through TANF, or with state funding46 and are designed principally as a diversion from foster care or as an exit alternative for children who have been living in foster care with their relatives. Some states limit guardianship based upon the age of the child (e.g., age 10 or older),47 while other states restrict the program only to those caregivers who have provided foster care to their relative child for some period of time (e.g., 12 months or longer). Depending on the state, payments are made at or near the basic foster-care rate and Medicaid services are continued. Other services, including case management, are terminated, and court oversight of the case is withdrawn. Subsidized guardianship allows children to experience the security of a legal relationship with their kin caregivers in addition to the affective relationship they likely enjoy. It gives children living in kinship foster care a way out of the child welfare system, as many kin are reluctant to adopt their relative chil-

Paying Grandparents as Caregivers

33

dren,48 and it allows relatives to continue caring for children into adulthood without the intrusion of social workers and others monitoring their parenting and their children’s well-being. Once legal guardianship has been established, however, it is unlikely most parents will see their children return to their care. Parents can petition the courts to have their children returned, but they have to show signiﬁcant improvement in their behaviors and=or living conditions for a guardianship to be overturned. Court and legal fees can be substantial44 and may mitigate low-income parents’ opportunities to assert themselves in the judicial system. Further, children who do return to low-income, welfare-reliant households will see their assistance income fall (from the basic foster-care rate to the TANF rate) and their income insecurity rise. The economic incentive for grandparents to return children to these economically unstable households is thus slim.

The Case of Child Care Social-policy changes relating to kin have largely centered on substitute-care arrangements when parents are unable or unwilling to provide for their children. Yet kin have also played an increasing role as supportive-care providers during daytime, evening, and weekend hours, when mothers have been called to work. With the advent of welfare reform, an increasing number of children now need care while mothers work part and full time. In most states, parents collecting public assistance are required to enter the labor market shortly after the birth of their child. In 44 states, no exemptions are given for the birth of a baby, while in the other states mothers can stay home for up to 12 months before they are required to return to work.34 While mothers work or look for work, someone must care for their child, and government funds for subsidizing care are now more plentiful than ever before. Prior to welfare reform, federal funding for all child care programs combined equaled about $10 million. The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA)33 ushered in a substantial increase in child care funding, with a $15 million block grant and an additional $7 million discretionary fund. Federal funding for child care was also streamlined from several categorical child care programs into a single Child Care and Development Fund (CCDF).49 Federal subsidies are available to help pay for care,50 and parents are given signiﬁcant latitude to choose the type of care that best meets their child’s and family’s needs. Although child care funding and availability have expanded since welfare reform, low-income women moving from welfare to work must make child care decisions within tight time constraints, often with little knowledge about the formal child care system51; many parents choose relatives or close friends to care for their child. Relatives have always been the caregivers of choice for low-income women with young children,52 yet these informal child care arrangements were

34

Children in Families

previously made and paid for privately among family members.53 In 1990, however, federal law changed with the introduction of the Child Care and Development Block grant, ushering in a new perspective on public funding for child care services that aligned with parents’ priorities. License-exempt care— unlicensed child care provided by a relative or close friend—was thus included in the subsidized child care delivery system, with discretion given to the states to determine regulations for allowing public funds to ﬂow to these caregivers. But policies surrounding license-exempt care were not developed based only on parental preference. Cost for license-exempt care is signiﬁcantly lower compared with formal child care, and with the large-scale entrance of lowincome women into the labor market following welfare reform, the supply of formal child care was recognized as wholly inadequate for meeting demand.54 The beneﬁts of license-exempt care are clear: care provided by a relative is likely to be culturally and linguistically consonant with the needs of the child; it is likely to be more accessible than center-based care (particularly for families living in rural communities); and it is more often available during odd hours, weekends, and evenings, when TANF recipients returning to the labor market are more likely to work.55,56 But license-exempt care is not without limitations. Because it is exempt from licensure, care providers need not abide by any standards typically set for daycare environments. Health, safety, and quality concerns prevail, particularly among child care researchers who point to the social, interactional, educational, and structural beneﬁts afforded by center-based care.57 Safety concerns may indeed be an issue: license-exempt care providers in California who are not relatives to the child (kith care) are required to submit to criminal background checks, but, as with kinship foster care a decade previously, no other requirements or standards for care are imposed. Relatives providing license-exempt care have no requirements imposed at all except for age requirements (at least 18 years old)—even their relative status is self-reported.54 Since the introduction of subsidies to license-exempt care, growth in this sector has been dramatic. A decade after its introduction, 44% of all children receiving subsidized care in California were cared for in license-exempt care.54 Today, more than half of all children in subsidized care in that state are with kith or kin.58 Nationwide, the numbers are somewhat smaller, but grandparents are still the predominant child care providers for preschoolers receiving subsidized care.59 Relatives receiving these subsidies are paid hourly, weekly, or monthly based on regional market rates set annually by the government. In California, monthly rates for full-time care range from about $425 in rural counties to $680 in urban counties, with care for younger children set at a higher rate.58 Subsidized license-exempt child care has made public what was once private. As in other aspects of children’s care, grandparents have taken on a large role in supporting low-income families and have won public trust at a time when public support for parental care for children has waned. Indeed, prior to welfare reform, parents in California received an AFDC payment of about

Paying Grandparents as Caregivers

35

$500 per month to provide care for their children. Since welfare reform, these same women have been urged to enter the labor market while their welfare checks have been essentially transferred to grandparents who watch over their children.

A Policy Approach to Soften Incentive Effects In foster care, welfare, guardianship, and child care, recently developed public policy has favored grandparent-headed households, sometimes to the disadvantage of parents. Table 2.1 reviews these four major programs and outlines the ﬁnancial and service supports offered kin, the standards for care, and restrictions on aid. For example, in kinship foster care, ﬁnancial support is generous compared with welfare payments for low-income parents, services are rich compared with the few services available for parents, and standards for care are relatively high compared with the practical absence of standards of care for parents.60 Once children are placed in kinship foster care, incentives to return them to resource-poor, unsupported care environments may not be strong. In the case of TANF family grants, ﬁnancial support and standards for care are similar for both parents and grandparents, yet parents face more restrictive policies in terms of work and time requirements, making grandparent-headed households more ﬁnancially secure for children whose mothers do not succeed in a welfare-to-work environment. In the case of subsidized guardianship, ﬁnancial support may be more generous to grandparents than to low-income parents, and parents must petition the court to regain custody of the child. Similar to kinship foster care, once legal guardianship is established, incentives to return children to parents do not prevail. The case of child care is somewhat different because there is no incentive for a full-scale transfer of children from parents to grandparents; yet low-income parents on welfare are largely compelled to place their children in others’ care as they enter the labor market, and the care they often select is that provided by grandparents or other relatives. In this instance, the incentive is to place children with grandparents rather than in center-based settings, even though the quality of care children receive may be highly variable. The incentive effects described here are speculative in some cases; information from parents and grandparents about their personal lives and decisions would be necessary to answer the question qualitatively, and large-scale administrative data necessary to answer the question empirically.61 But modest adjustments to policy in each of these areas would likely have a neutralizing effect on the current implicit incentives (described brieﬂy in the ﬁnal column of Table 2.1). Development of services and supports for children, regardless of their living arrangements, and additional supports to parents upon reuniﬁcation with their children following kinship foster care would allow families to feel more comfortable about children’s transitions back to the birth-parent’s home when mothers were ready to assume full-time care. In the case of welfare,

Table 2.1. Financial and Service Incentives for Grandparent Care Financial Support

Services to Grandparent

Kinship Foster Care

Varies by state from $200 to $700 per child per month

Child and family assessment Service plan= case plan Medicaid Clothing and school supplies

TANF— Family Grant

EmploymentVaries by state based services from $170 for adult(s); to $923 per no services month for a for child family of three; Medicaid. incremental

36

Type of Care=Support

Policies or Programs to Mute the Incentive Effect

Standards Imposed on Grandparent

Restrictions Placed on Grandparent or Parent

Foster care licensure Criminal background check Home-suitability assessment

Disincentive Visitation with to return birth parent may child to parent be supervised or restricted Parent must show compliance with case plan Grandparent may be encouraged to adopt or assume guardianship after 18 months

Provide services to child that follow child, whether placed in or out of care Offer family stabilization grants to parents when children return home Offer clothing and school-supply allowances to parents

Income and assets test

Work and time restrictions may apply

Eliminate time limits

Incentive Toward No-Parent Care

Incentive to move child to relative when parents face time limits

TANF— Child Only

$60 to $513 per month; incremental

Subsidized Varies by state; Guardianship may be set at TANF child-only rate or at basic foster care rate

No services for adult or child Medicaid Medicaid

37 Child Care

$425 to $680 per child per month

None

Show relationship to child (self-report)

No restrictions Aid available until child turns 18

Neutral

None

Aid available Varies by state; until child for children turns 18 already in kinship foster care, Parent must petition the the suitability court to return of the home must child match that assessed previously through foster care for children ‘‘at risk’’ of maltreatment

Disincentive to return child to parent

Periodic monitoring to ensure child still resides with relative and home situation is safe Do not provide subsidized guardianship as a diversion to foster care

None

Incentive toward daily (not full-time) relative care

Require ‘‘certiﬁcation’’ including basic training, background checks, home inspections, etc.

Varies by state; available while mother works, until mother’s income rises, or based on time limits

38

Children in Families

elimination of time limits would shift the focus away from parents and toward children’s needs for ﬁnancial security, and it would allow children to remain with their parents except in dire circumstances. Subsidized guardianship should be retained for children exiting kinship foster care, although legal guardianship practice could be altered to include periodic, unannounced social-worker visits to verify that children are still living with the relative and to ensure the health and safety of the caregiving situation. As a diversion from foster care, however, subsidized guardianship should be reconsidered. During a child’s stay in kinship foster care, parents are given supports and services to promote their reunion with their child. If children are transferred directly to guardianship without the protection of the foster-care system, parents will lose an important opportunity to reunite with their children, and efforts to regain legal custody will fall entirely on the shoulders of parents who may not have the ﬁnancial or other resources necessary to bring their children home. Finally, public funding for private child care will continue to promote informal relative care, but efforts to develop basic certiﬁcation processes, similar to those devised in other, western European countries,62 will ensure that minimum standards for children’s care are met.

Policy Reforms to Support Parental Care Grandparents caring for children in skipped-generation households may be one of the poorest and therefore most disadvantaged groups in the United States.6 Yet much policy in the area of kinship care has been reactive and contradictory,63 in some cases restrictive and in others generous regarding kinship care standards, services, rights, and responsibilities. A new approach that focuses squarely on children’s needs, regardless of their living circumstances, would likely balance parents’ and grandparents’ opportunities and rights in addition to better safeguarding children’s well-being. It is clear that children in record numbers have left the home of their parents to live with or be cared for by their grandparents and other relatives. Although in previous years relatives offered such care to children through a private system of social obligation and reciprocity, their support likely placed severe ﬁnancial pressures on these relatives, potentially jeopardizing the wellbeing of children. With the advent of public subsidies for foster care, welfare, guardianship, and child care, relatives have been able to extend themselves to their relative children, cushioned from the economic strains imposed by the exercising of their social obligations. But have the effects of public subsidies been entirely benign? Surely some children are now more economically secure living in the homes of their grandparents than they were with their parents. Yet is it possible that the availability of public payments has unwittingly contributed to the decline of the parent-child family and to the rise of the noparent family?

Paying Grandparents as Caregivers

39

While relatives have long played a role in supporting parents in their caregiving function, the signiﬁcant rise in grandparent-headed households has paralleled the rise in public funding for such care. Have public-policy makers responded to an increasing demand for services and supports from relative caregivers, or have newly available supports instigated the transfer of more children from parents’ homes to relatives’? Ungerson’s62 theory of the commodiﬁcation of care suggests that relatives—principally women—are inﬂuenced by market demands, and government-based payments for care serve to pressure women to act on their sentiments of obligation toward family members. Publicly available payments, therefore, serve the purpose of insuring a sufﬁcient supply of caregiving settings for children, particularly when demand for caregiving services rises. One could argue, however, that as payments for care rise, the tipping point in each family’s consideration of their economic best interests must be reassessed, and in some cases public payments for informal care may actually increase demand. The result not only signiﬁes a shift in children’s care arrangements but also yields a subtle, and important, message to low-income women: public support is greater for grandparents than for parents when it comes to providing protection and care to children. Public-policy makers generally appreciate the role of relatives in the lives of children; without their assistance, many children might otherwise be forced into the arms of the state and=or strangers for custody and support. Yet efforts to afﬁrm grandparents’ labors in a no-strings-attached policy environment, where parents are tacitly discouraged from raising their children, may have unwittingly contributed to the development of social trends in family patterns and unregulated care for children that is less than ideal. Instead, acknowledgment of the role grandparents play in the lives of children can be balanced by a combination of social recognition, ﬁnancial support, and modest bureaucratic regulation. The more generous the ﬁnancial support, and the fewer obligations attached to the funding, the greater the concern that such assistance may create opportunities for and pressures on parents to move children into more economically stable environments in the homes of relatives. Further, the care that is provided at public request can assuredly be variable in quality if it operates entirely outside of basic standards and regulatory controls. The case of foster care is instructive in this regard. Although kinship foster care grew at an unprecedented rate prior to 1997, with the introduction of basic licensing requirements growth in kinship foster care leveled, and relatives offering low-quality care were screened out of the system. Public policies that support parents and extended family members in caring for children should be encouraged, but they should be introduced primarily to promote parents in their efforts to exercise their duties toward their children. Relatives, a critical safety net for children’s care and protection, can play an important role in children’s upbringing, but public policy should guard against their supplanting the role of parents, particularly with the tacit support of the welfare state.

40

Children in Families

Acknowledgments The author thanks Chelsea Neel for her assistance with this chapter. This chapter was previously presented as a paper at the European Social Policy Analysis Network (September 22, 2005, Fribourg, Switzerland).

Notes 1. Saluter, A. F. (1992). Marital status and living arrangements: March 1991. Current Population reports (Series P-20 No. 461). Washington, DC: U.S. Government Printing Ofﬁce. 2. Please see Note 1. 3. Kreider, R. M., & Fields, J. (2005). Living arrangements of children: 2001. Washington, DC: U.S. Department of Commerce, U.S. Census Bureau. Retrieved August 25, 2007, from http:==www.census.gov=prod=2005pubs=p70–104 .pdf. 4. Simmons, T., & Dye, J. L. (2003). Grandparents living with grandchildren: 2000. Washington, DC: U.S. Department of Commerce, U.S. Census Bureau. 5. Kleiner, H. S., Hertzog, J., & Targ, D. B. (2005). Grandparents acting as parents. Washington, DC: Grandparents United. Retrieved August 25, 2007, from http:== www.uwex.edu=ces=gprg=article.html. 6. Casper, L. M., & Bryson, K. R. (1998). Co-resident grandparents and their grandchildren: Grandparent maintained families. Washington, DC: U.S. Census Bureau. 7. Child Welfare League of America (CWLA). (1994). Kinship care: A natural bridge. Washington, DC: CWLA North American Kinship Care Policy and Practice Committee. 8. Luomala, K. (1987). Reality and fantasy: The foster child in Hawaiian myths and customs. Paciﬁc Studies, 10(2), 1– 45. 9. Hegar, R. L. (1999). The cultural roots of kinship care. In R. L. Hegar & M. Scannapieco, Kinship foster care: Policy, practice, and research. New York: Oxford University Press. 10. Trattner, W. (1994). From poor law to welfare state: A history of social welfare in America, 5th ed. New York: Free Press. 11. Silk, J. B. (1987). Adoption and fosterage in human societies: Adaptations or enigmas? Cultural Anthropology, 2(1), 39– 49. 12. Caputo, R. K. (2001). Grandparents and coresident grandchildren in a youth cohort. Journal of Family Issues, 22(5), 541–556. 13. Geen, R. (2003). Kinship care: Making the most of a valuable resource. Washington, DC: Urban Institute Press. 14. Berrick, J. D. (1998). When children cannot remain home: Temporary foster care and kinship care. Future of Children, 8(1), 72–87. 15. Simmel, C., Lim-Brodowski, M., Goldberg, S., & Austin, M. J. (1997). Foster parent recruitment, retention, and rate setting. Berkeley: University of California at Berkeley, BASSC. 16. U.S. House of Representatives, Committee on Ways and Means. (2000). Green book 2000. Washington, DC: U.S. House of Representatives.

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17. National Commission on Foster Family Care. (1991). A blueprint for fostering infants, children, and youths in the 1990s. Washington, DC: Child Welfare League of America. 18. Burton, L. M., & Dilworth-Anderson, P. (1991). The intergenerational roles of aged black Americans. Marriage and Family Review, 16(3– 4), 311–330. 19. Miller v Youakim (1979). 440 U.S. 125. 20. Shlonsky, A. R., & Berrick, J. D. (2001). Assessing and promoting quality in kin and non-kin foster care. Social Service Review, 75(1), 60–83. 21. Gleeson, J., & Craig, L. (1994). Kinship care in child welfare: An analysis of states’ policies. Children and Youth Services Review, 16(1–2), 7–31. 22. Kusserow, R. P. (1992). State practices in using relatives for foster care. Washington, DC: U.S. Department of Health and Human Services, Ofﬁce of Inspector General. (No. OEI-06–90– 02391). 23. Needell, B., Webster, D., Armijo, M., Lee, S., Cuccaro-Alamin, S., Shaw, T., et al. (2005). Child Welfare Services Reports for California. Retrieved August 11, 2005, from http:==cssr.berkeley.edu=CWSCMSreports=. 24. Wulczyn, F., & Hislop, K. B. (2001). Multi-state foster care data archive. Unpublished report. Chicago, IL: Chapin Hall Center for Children. 25. Adoption and Safe Families Act of 1997, Pub.L.No. 105–89, 111 Stat. 2115. (1997). 26. U.S. Department of Health and Human Services, Administration for Children and Families, Administration of Children, Youth and Families, Children’s Services Bureau. (2005). AFCARS Report #10. Retrieved August 11, 2005, from http:==www .acf.hhs.gov=programs=cb=publications=afcars=report10.htm. 27. U.S. House of Representatives, Committee on Ways and Means. (2004). Green book 2004. Washington, DC: U.S. House of Representatives. 28. Smith, C. (August 15, 2005). Personal communication. San Mateo County Children and Family Services. 29. Chipungu, S., Everett, J., Verduik, M., & Jones, J. (1998). Children placed in foster care with relatives: A multi-state study. Washington, DC: U.S. Department of Health and Human Services. 30. Gebel, T. (1996). Kinship care and non-relative foster care: A comparison of caregiver attributes and attitudes. Child Welfare, 75(1), 5–18. 31. Berrick, J. D., & Needell, B. (1999). Recent trends in kinship care: Public policy, payments, and outcomes for children. In P. A. Curtis and G. Dale (Eds.), The foster care crisis: Translating research into practice and policy. Lincoln, NE: University of Nebraska Press. 32. LeProhn, N. (1994). The role of the kinship foster parent: A comparison of the role conceptions of relative and non-relative foster parents. Children and Youth Services Review, 16(1–2), 65–81. 33. Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). P.L. 104–93. 34. Urban Institute. (2005). Welfare rules databook. Retrieved August 22, 2005, from http:==www.urban.org=UploadedPDF=411183_WRD_2003.pdf. 35. Mullen, F. (1998). Grandparents and the Welfare Reform Act. Washington, DC: American Association of Retired Persons. 36. Mullen, F., & Einhorn, M. (2000). The effect of state TANF choices on grandparentheaded households. Washington, DC: Public Policy Institute, AARP.

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37. Berrick, J. D., Needell, B., & Minkler, M. (1999). The policy implications of welfare reform for older caregivers, kinship care, and family conﬁguration. Children and Youth Services Review, 21(9/10), 843–864. 38. This is true for all except three states (Alabama, South Dakota, and Wisconsin), where grandparents are excluded from the assistance unit.36 39. Figures reﬂect only the continental United States—aid payments are higher in Alaska and Hawaii. Figures are reﬂective of 1999. 36 40. Twenty-two states also impose a ‘‘family cap,’’ disallowing any incremental adjustments to the family grant for children born after the implementation of PRWORA. 41. Monthly payments range from $60 in Mississippi to $452 in California. 42. Although the proportion of child-only cases has increased, the absolute number has remained relatively constant in recent years (approximately 780,000). 43. Of parent-headed child-only cases, 10% include parents who have been sanctioned, 42% include parents who are receiving Supplemental Security Income, and 32% include parents whose citizenship status disqualiﬁes them from aid (16% other). These ﬁgures vary signiﬁcantly by state, depending on the size of the state’s immigration population.44 44. Gibbs, D., Kasten, J., Bir, A., Hoover, S., Duncan, D., & Mitchell, J. B. (2004). Children in Temporary Assistance for Needy Families (TANF) child-only cases with relative caregivers. RTI Project No. 07147.018. Research Triangle Park, NC: Research Triangle International. 45. Minkler, M., Berrick, J. D., & Needell, B. (1999). Impacts of welfare reform on California grandparents raising grandchildren: Reﬂections from the ﬁeld. Journal of Aging and Social Policy, 10(3), 45–64. 46. National Conference of State Legislatures (NCSL). (2000). A place to call home. Denver, CO: NCSL. 47. Cornerstone Consulting Group, Inc. (2001). Guardianship: Another place called home. Houston: Cornerstone Consulting. 48. Burnette, D. (1997). Grandparents raising grandchildren in the inner city. Families in Society: The Journal of Contemporary Human Services, 5, 489–501. 49. Meyers, M. K., & Heintze, T. (1999). The performance of the child-care subsidy system. Social Service Review, 73, 37–64. 50. In California, child care subsidies are available to women collecting TANF, who are required to attend assessment or training activities. Subsidies are also available for up to 24 months after exiting cash assistance, or until their family income reaches 75% of the median income. Subsidies are available for children under the age of 12, and not all families eligible for subsidies receive them due to funding limitations. 51. Knox, V. W., London, A. S., Scott, E. K., & Blank, S. (2003). Welfare reform, work, and child care: The role of informal care in the lives of low-income women and children. New York: MDRC. 52. Brown-Lyons, M., Robertson, A., & Layzer, J. (2001). Kith and kin—informal child care: Highlights from recent research. New York: Columbia University, National Center for Children in Poverty. 53. Galinsky, E., Howes, C., Kontos, S., & Shinn, M. (1994). The study of children in family child care and relative care. New York: Families and Work Institute.

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54. Whitebook, M., Phillips, D., Jo, J. Y., Crowell, N., Brooks, S., & Gerber, E. (2005). Change and stability among publicly subsidized license-exempt child care providers. Retrieved August 16, 2005, from http:==repositories.cdlib.org=iir=cscce=. 55. Henly, J. R., & Lyons, S. (2000). The negotiation of child care and employment demands among low-income parents. Journal of Social Issues, 56(4), 683–706. 56. Kisker, E. E., & Ross, C. M. (1997). Arranging child care. The Future of Children, 7(1), 99–109. 57. Fuller, B., Kagan, S. L., the Growing Up in Poverty Project. (2000). Remember the children: Mothers balance work and child care under welfare reform. Berkeley: University of California at Berkeley. 58. California Department of Social Services. (2005). Child care monthly report— CalWORKs families. Retrieved August 15, 2005, from http:==www.dss.cahwnet .gov=research=caldatatables=CW115.htm. 59. Smith, K. (2002). Who’s minding the kids? Child care arrangements, Spring 1997. Washington, DC: U.S. Census Bureau. 60. Except for egregious lapses in parenting signaling a child abuse report. 61. Subsidized guardianship is still new where it is available, and federal data on relative-headed child-only cases were not collected before 2000. National data on license-exempt care is not available. 62. Ungerson, C. (1995). Gender, cash and informal care: European perspectives and dilemmas. Journal of Social Policy, 24(1), 31–52. 63. Geen, R., & Berrick, J. D. (2002). Kinship care: An evolving service delivery option. Children and Youth Services Review, 24(1–2), 1–14.

3 Supporting Fathers’ Engagement with Their Kids Philip A. Cowan, Carolyn Pape Cowan, Nancy Cohen, Marsha Kline Pruett, & Kyle Pruett

For the past two decades, some American politicians and conservative social commentators have been urging citizens to rediscover their ‘‘family values.’’ The core assumption is that many of the current problems with children, youth, and families could be solved if all of us would become less self-centered and more motivated to preserve family relationships. Because the problems are blamed on lack of motivation, the solutions involve each citizen’s resolve to change his or her family goals and behaviors. From a ﬁscally conservative point of view, this perspective is optimal because, if it worked, we would not need costly government programs for family support. Recently, both the U.S. Congress and the Bush Administration have concluded that more than a change in motivation may be required to strengthen families. In a surprising turn of events, the Deﬁcit Reduction Act of 2005 (Temporary Assistance to Needy Families [TANF] reauthorization) provided funding of $150 million each year for programs to promote healthy marriage and responsible fatherhood. In response to the congressional mandate, the Administration for Children and Families (ACF) launched the Promoting Responsible Fatherhood Initiative in 2006 with the goal of ‘‘funding programs that support healthy marriage activities, promote responsible parenting, and foster economic stability. The initiative will enable fathers to improve their relationships and reconnect with their children. It will help fathers overcome obstacles and barriers that often prevent them from being the most effective and nurturing parent possible.’’1

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The justiﬁcations for this new thrust in family policy targeting fathers can be summarized in ﬁve arguments: 1. Father involvement is a critical factor in the development and well-being of children. 2. Fathers today are less involved with their children than fathers used to be, and this is contributing to a decline in the quality of family life and an increase in problems for children and youth. 3. Points 1 and 2 support a need for programs to promote fathers’ becoming more involved in children’s lives. 4. Because the primary factor in men’s lack of involvement is self-centeredness and low motivation, policies and programs to promote father involvement ought to focus on changing men’s outlook and increasing their motivation to become more engaged with their children. 5. A secondary factor in men’s lack of involvement is to be found in family structure. Men are much more likely to be involved fathers if they are married. Therefore, programs and policies to promote involved fatherhood should encourage marriage.

This chapter examines some points of connection and disconnection between research on father involvement and the features of programs designed to enhance it. Our review of the literature suggests that only the ﬁrst point above is clear and relatively free of controversy. Although the vast majority of children growing up in single-mother households fare quite well, it is also true that positive father involvement is generally beneﬁcial for children and for the family as a whole. The second point has raised some controversy. We show that there is substantial disagreement about the direction of social change in fathers’ family roles, with some indications that father involvement is increasing rather than decreasing, especially for dads in intact-couple relationships. Despite the argument put forth in point 3, the need for programs to enhance fathers’ engagement in their children’s daily lives does not rest on the direction of historical trends: even if fathers were more involved than they used to be, we would need to be concerned about the sizeable proportion of fathers who were not engaged with their young children and=or at risk of becoming increasingly disengaged over time. In this chapter, we describe a number of existing programs designed to enhance father involvement. Most of these programs focus on men as individuals, and many attempt to persuade them to become ‘‘responsible fathers’’ or discourage them from becoming disengaged fathers by persuading them not to have children until they are ready, through abstinence, birth control, and abortion counseling. Other programs, sponsored primarily by government agencies, favor deterrents and punishments in the form of coercive child support policies. Still others seem to be based on the notion that exhorting men to be good fathers in small groups or mass meetings will produce the desired outcome. We also describe several programs that attempt to provide men with parenting and job skills so that they can become more effective in

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their parenting role. In addition to their focus on fathers as individuals, a similarity among these programs is that they have not been planned with reference to scientiﬁcally accepted research designs. With the exception of a handful of university-based experimental programs, we do not know whether most fatherhood programs are effective, because they have not been subjected to systematic evaluation research with a comparison or control group. Furthermore, many program designs ignore a large body of research on father involvement, which reveals systemic risk factors that lower the probability of father involvement and positive factors that increase the likelihood that fathers will play a central, positive role in their children’s daily lives. This chapter attempts to bridge the disconnect between research studies and intervention studies focusing on fathers’ family engagement. We summarize a ﬁve-domain systemic model that includes the characteristics of fathers as individuals, the quality of their relationships with their children, the quality of their relationship with the child’s mother, their family-of-origin relationships, and stresses and supports from outside the family, all of which affect whether fathers become positively engaged with their children. The central lesson to be learned from this research is that simply addressing men’s motivation to behave responsibly or punishing fathers for failure to provide child support are not likely to be the most effective approaches to encouraging fathers’ involvement with their children. Research on risk factors that affect father involvement leads us to conclude that improving the quality of the relationship between fathers and mothers can go a long way to helping men to become and stay engaged with their children. We describe two new approaches to father involvement that focus on the relationship between the parents. One involves attempts to develop policies that encourage couples with children to marry, with the hope that this will result in increases in father involvement and children’s well-being. This approach, with new programs funded through the Deﬁcit Reduction Act, remains to be tested. The second approach, focusing on strengthening the relationship between the parents, offers interventions for groups of couples— both married and unmarried—that are designed to strengthen their relationships in ways that will foster fathers’ engagement with the children and provide beneﬁts for the children as well. The question is whether it is the state of being married or the quality of the relationship between the parents, married or not, that holds most promise for affecting the well-being of children. Finally, we present a set of recommendations for programs directed toward fathers, based on current research. Our aim is to bring the research and intervention literatures together, with a view to formulating a more differentiated and effective set of policies and programs for enhancing fathers’ engagement with their children.

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Father Engagement: Deﬁnitions, Beneﬁts for Children, and Social Trends The Diversity of Fathering Arrangements

It is impossible to summarize the meaning of fatherhood in a single example, picture, or deﬁnition. Some fathers live with their children (co-resident), whereas others live in different households (nonresident). Some fathers are married to their child’s mother, some are divorced, and others have never been married to the child’s mother. Among never-married, nonresident fathers, some are romantically involved with the mothers and some are not. In addition to biological fathers, there are stepfathers, adoptive fathers, foster fathers, grandfathers, and family friends, all of whom may function as ‘‘psychological fathers’’ living with or separate from their children. The literature on father involvement makes further distinctions between low-income and middle-income fathers and between fathers of different ethnic=racial groups. Despite the fact that each of these distinctions may affect the conclusions drawn, it is not possible in a brief review of the literature to take all of these variables into account. We focus on some of the major differences among fathers: married, divorced, and never married; resident and nonresident; European American, African American, and Hispanic. We mention the diversity of fatherhood here to highlight the fact that there is an inherent tension in the fatherhood-research ﬁeld, where diversity reigns, and the fatherhood-policy ﬁeld, in which politicians make laws that apply to entire populations and design services for large constituencies. Involvement versus Engagement

Until relatively recently, the issue of whether fathers have contact with their children was summarized under the heading of ‘‘father involvement,’’ with authors focusing on whether or not fathers are in the home and married to the child’s mother. From our point of view, involvement that refers primarily to fathers’ presence or absence leaves out some of the most important ingredients of the relationship between a father and his child. Fathers are involved with children in many ways. They provide direct care, such as dressing younger children or helping older children complete homework; play=recreation activities, such as roughhousing or going to the movies with children; indirect care=responsibility, such as preparing meals, arranging for medical care, and keeping an eye on children; and ﬁnancial support, including child support from divorced or separated fathers and cash or in-kind contributions toward children’s food, clothing, shelter, education, and other needs.2,3 These activities represent the traditional approach to deﬁning fathers’ involvement with children—in essence, a quantitative account of the amount of the time fathers spend with children, the number of activities they engage in, or the resources they provide.

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Critics of the ‘‘time and activities’’ approach to studying fathers make several important points. For example, Parke4 and Lamb5 argue that traditional research deﬁnitions are restrictive, are narrow, and underestimate the amount of time in which fathers are actually involved in child rearing. Palkovitz6 suggests that by focusing on only behavioral, ‘‘task-related’’ activities, researchers have ignored central internal aspects of fatherhood such as ‘‘thinking, planning, feeling, caring, monitoring, evaluating and praying.’’ Because the research on trends in father involvement almost never takes this multidimensional view of father involvement into account, we do not know, for example, whether contemporary fathers are more active in some speciﬁc domains and less active in others than fathers used to be. In this chapter, we emphasize the term ‘‘engagement’’ to convey the broad view rather than the narrow view of how fathers are involved in their children’s lives. The Beneﬁts of Fathers’ Engagement

It is usually assumed that a high level of father engagement is better for children than a low level or total absence. From countless studies, it is clear that the quality of fathers’ engagement is associated with negative or positive outcomes for children.7 Positive paternal engagement8—fathers’ warmth, closeness, and responsiveness to their children—is consistently associated with the children’s advanced cognitive skills, academic achievement, and emotional adjustment.9–12 Similarly, when the father-child relationship is positive, children are less likely to engage in maladaptive, problematic behaviors or to receive diagnoses of serious mental health problems as deﬁned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV ).13–18 Fathers’ maladjustment, including depression, personality disorder, and psychosis, is consistently correlated with a variety of negative outcomes for children that include learning problems, aggression, shyness, low self-esteem, and depression.19–21 Links between fathers’ poor adjustment and children’s outcomes appear to come from the fact that fathers’ psychological problems interfere with the quality of parenting rather than with the amount of engagement. Fathers with high scores on psychological symptoms on standardized questionnaires22 or formal psychiatric diagnoses23 tend to have more laissez-faire or harsh and intrusive parenting styles, which, in turn, are related to children’s poorer adaptation; the Fendrich et al.23 study found that parental depression had a more negative impact on children than did schizophrenia. Because primary physical custody of the child almost always remains with the mother after marital dissolution,24 the long-term negative consequences of divorce are often attributed largely to fathers’ absence, but there are problems with this interpretation. Until recently, investigations of divorced parents and children’s development began after parents separated or divorced. It is reasonable to assume, and there is some evidence to suggest, that there may be a selection factor operating, in that parents who eventually divorce have been experiencing serious relationship difﬁculty prior to the divorce.25 Because we

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know that couple conﬂict often affects parent-child relationships as well,26,27 it may be the cumulative impact of the parents’ conﬂict rather than the divorce itself that has negative effects on the children’s development.28 Studies of children of divorce tend to pose an undifferentiated research question: ‘‘Does divorce hurt children—yes or no?’’ Amato suggests a more differentiated approach: ‘‘Divorce beneﬁts some individuals, leads others to experience temporary decrements in well-being, and forces others on a downward trajectory from which they might never recover fully. Understanding the contingencies under which divorce leads to these diverse outcomes is a priority for future research.’’29 Are there beneﬁts for children of having a man in the home who is not the biological father? On this question, the evidence is mixed. McLanahan and Sandefur30 argue that the presence of stepfathers or live-in boyfriends may raise income levels but does not increase positive outcomes for children. Several authors point to the increased risk of physical and sexual abuse for children in households with these arrangements.31 On the other hand, there is some evidence that the engagement of stepfathers and ‘‘social fathers’’ may be positive for African American children.32,33 Based on our reading of relevant studies, we cannot draw general, deﬁnitive conclusions about this from current evidence. Studies of father absence are open to two important methodological criticisms. First, too many studies equate nonresident fathers with father absence. We believe that it does an injustice to nonresident fathers to describe them as ‘‘absent’’ when some are a clear presence in their children’s lives. Second, the problem in drawing conclusions about the impact of fathers’ engagement in all of these studies is that it is impossible to trace children’s adaptation directly to the father. For example, whether children do well may be explained by whether the parents are in conﬂict or collaborative34 or by the life circumstances surrounding the particular family arrangements (e.g., whether declining income associated with divorce is responsible for the negative effects on children). Is Father Engagement Increasing or Decreasing?

One view of the current state of affairs in the United States with regard to father engagement is apparent in the title of a book by Blankenhorn, 35 Fatherless America: Confronting Our Most Urgent Social Problem. Blankenhorn’s review of family-demography research led him to the conclusion that fatherlessness is a growing trend in America: a ‘‘good family man’’ is a vanishing ﬁgure, men’s motivation to focus on families is waning, and children are suffering. Popenoe36 surveyed similar research studies and came to similar conclusions. Both authors use these social-trend data as the foundation of their argument in support of new programs to encourage father engagement. In contrast with the view that fathers are disappearing from the family, other scholars assert that today’s fathers are more actively involved with their

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children than ever before, especially in the earliest months of their children’s lives.6,9,37Fathers are typically in the delivery room when their babies are born. A small but substantial number of married fathers are caring for children while mothers are at work. Thousands of men meet in stadiums to afﬁrm their commitment to their families, while other men meet in small groups to address their concerns about parenting. An increasing number of single fathers have asked for and been granted custody of their children. Large-scale survey data suggest that the proportion of time fathers spend with their children relative to mothers increased sharply from the 1960s to the 1990s. For every hour fathers spent with their children in the 1960s, mothers spent 5 hours. In the 1990s, for every hour that fathers spent with their children, mothers spent 2 hours.38 It was not that mothers were doing less, on average, but that fathers were more involved than they used to be. From a comprehensive review of research ﬁndings, we believe that several differentiated statements can be made about trends in the quantity of father engagement. First, not surprisingly, the amount of father engagement varies with the structure of the family and the household: fathers are more involved when they live with their children,39 and incarceration rather than lack of commitment separates many fathers and children, particularly in African American families.40 Second, compared with mid-century fathers, fewer contemporary fathers live with their children, but those who do are more actively involved in children’s daily care than fathers used to be.9,41 Third, the ﬁndings are open to wide differences in interpretation: some observers take a ‘‘glass is half empty’’ approach, while others see the glass as half full. Some view it as deplorable that only 20% to 33% of never-married fathers have regular contact with their 5-year-olds, while others ﬁnd it remarkable that up to onethird of these fathers see their children regularly.42 Fourth, and most important, substantial numbers of divorced fathers43 and never-married fathers44 not only maintain regular contact with their children but also provide consistent ﬁnancial support for them. Finally, there are methodological reasons to think that the quantity of engagement of nonresident fathers has been underestimated. Most data concerning fathers’ presence and frequency of visitation are obtained from mothers. Surveys of ‘‘single mother’’ households rarely obtain accurate information about whether there is a father or father ﬁgure in the home. Not surprisingly, divorced fathers report more frequent contact with their children than their ex-spouses report.45 Several longitudinal studies tracking nonresident fathers’ engagement with their children over time ﬁnd that more fathers are involved over the course of their children’s lives than are captured by the vast majority of studies asking about father engagement at one point in time.43,46 This may be because some fathers who are initially involved with their children become less involved over time, whereas others with low early levels of engagement become more involved. Taken together, the ﬁndings suggest that in a large proportion of families, nonresident fathers are involved with their children at some point in the children’s lives. We need to learn

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more about individual differences to understand (a) the conditions that increase the probability of fathers becoming engaged with their children and (b) the barriers that keep them from remaining engaged; we explore both of these issues next. The Case for Fatherhood Interventions

If this evidence of increasing father engagement with children represents a valid historical trend, why are large-scale interventions to encourage fathers’ family involvement needed? Our answer, to be elaborated upon in this chapter, is that both the fathers-are-disappearing and fathers-are-increasinglyinvolved views miss the mark when it comes to discussing the need for new policies and new programs. Blankenhorn and Popenoe are rightly concerned, we believe, about the need for programs and policies to foster fathers’ family engagement, but they are seriously limited in their analysis of why substantial numbers of men fail to play an active role in their children’s lives. They argue that the issue is primarily that men lack motivation to be ‘‘responsible fathers’’ and that what we need are programs addressed at increasing their motivation. Blankenhorn’s36 recommendations include a pledge signed by men that they will live their lives according to the principle that every child deserves a father; an annual report by government agencies on the state of fatherhood; and consideration of all domestic policies in terms of whether they strengthen or weaken the institution of marriage, actively promote marriage, and give preferences to married families (e.g., in housing). Faith-based and community agencies are urged to promote marriage and responsible fatherhood through information and persuasion programs. All of these recommendations are consistent with the assumption that the state of marriage encourages active fatherhood and that men need to change their priorities and motivations to become involved fathers. So far, there is little or no evidence for these positions. Rather, a survey of a substantial body of research on the factors associated with both low and high levels of father engagement reveals that there are multiple, systemic barriers to father engagement independent of men’s motivation, and that active interventions at various levels of the social system may be needed to overcome them. In recent years, public discussions of hot-button family issues have become polarized, with a tendency to assume that those who advocate a particular position necessarily endorse it in its extreme form. We refer here to the assumption that those who argue for the importance of fathers and the desirability of programs to facilitate their engagement with their children are espousing the view that fathers are essential for children’s development—that children who grow up without the direct engagement of a father in their lives are necessarily at risk for a number of economic and emotional difﬁculties. Ample research demonstrates that this is not the case.47– 49 What we discuss in this chapter is the proposition that when a father is available to take an active, positive role in his child’s life, the child and the family as a whole can reap the beneﬁts.

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Existing Programs to Promote Positive Father Engagement Before we move to a discussion of how to think about new programs to promote positive father engagement, we present a brief description of the kinds of programs already available. Our survey is not exhaustive, but it does provide a sample of the current array by describing three types of programs with very different goals: preventing premature parenthood; supporting the father’s role as economic provider; and encouraging men to take an active, positive role in their children’s lives. Programs to Prevent Early Parenthood

One way of promoting positive approaches to fatherhood is to persuade men not to become fathers until they are ready to become involved. Some intervention programs directed primarily toward young men attempt to reduce the risks of uninvolved fatherhood by encouraging unmarried teens to abstain from sex or use birth control. Most of these programs recruit female participants, and few direct attention to the women’s partners. One exception is the Teen Fathers Collaborative Project,50 initially designed to prevent teen pregnancies by changing young men’s perception of responsible fatherhood and increasing their social capital, especially their job skills. Data from 10 years ago show that teen pregnancy has been declining in recent years.51 While the U.S. Department of Health and Human Services has attributed this decline to their pregnancy-prevention programs,52 there is no direct evidence to suggest that men’s or women’s participation in any speciﬁc program contributed to these national trends. Programs to Buttress the Father’s Role as Economic Provider Child Support Programs: Sticks and Carrots from the Government

The initial focus of many government programs to encourage fathers’ engagement was an effort to get nonresident fathers to pay child support. Mincy and Pouncy53 point out that these programs were originally designed to punish ‘‘deadbeat’’ dads who were usually middle class, divorced, and unwilling to pay. For this population, the programs showed a small but signiﬁcant effect in increased contributions to the support of the child. Child-supportenforcement programs were also applied to ‘‘dead-broke,’’ usually never-married fathers who were unable to pay for the support of their children and then were denied access to them. Some of the men were imprisoned for failure to follow new laws and regulations that set payment requirements far beyond their ability to pay. To the extent that the programs were interested in encouraging fathers’

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engagement with their children, the outcomes appeared to have had the opposite effect, because they reduced men’s motivation to provide, and incarceration physically prevented them from being involved directly in their children’s lives. By and large, these programs have been focused on a single outcome criterion (payment of child support), with a narrow range of content and a mild to extreme level of coerciveness. With the notable exception of strategies such as child support being paid automatically from nonresident parents’ paychecks, most of the Ofﬁce of Child Support Enforcement’s efforts are ‘‘downstream’’ interventions, instituted after problems with payment of child support have surfaced, rather than preventive programs designed to capitalize on unmarried fathers’ early investment in their relationships with the mother and the child.54 Economic Programs to Increase the Social Capital of Low-Income Fathers

A more positive preventive approach to father engagement was stimulated after the U.S. Congress passed the Family Support Act in 1988 and began to fund father access and visitation projects—to provide mediation between contentious divorced parents, monitor visitation orders, and offer classes for fathers. Some programs attempt to increase low-income, nonresident fathers’ participation in the labor force, based on the idea that unemployed nonresident fathers have less money and fewer personal resources to contribute to their children’s maintenance.55 These programs have proved challenging to implement56 and, based on the evaluations currently available, they have had small, if any, effects on fathers’ employment or payment of child support.57–60 Programs to Nurture Father Engagement

A number of quite different programs to encourage fathers to become engaged and stay involved with their children can be summarized as having one of two basic orientations. The ﬁrst type of program directs efforts at increasing men’s motivation to take an active role in their children’s lives (to be ‘‘responsible fathers’’), and the second attempts to provide men with interpersonal and job skills to enable them to become more effective and satisﬁed parents and partners. Motivation Enhancement

There are a number of national programs attempting to change institutional and societal values, policies, and programs in order to promote, encourage, and support active father engagement for men at all levels of income and all stages of family development. These programs are less likely to be professionally run or to be evaluated than the university-based experimental interventions described below. Some of the programs provide direct services to fathers, whereas others reach out to service providers to help them become more sensitive to fathers and their concerns.

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The Fatherhood Project,61 one of the oldest national fatherhood programs in the United States, works with businesses, government, and community organizations to promote policies and practices that encourage fathers to become more involved with their children. The primary clients are not the fathers themselves but the institutions in which fathers live and work and service providers who work with fathers. The National Center for Fathering (NCF), the National Center on Fathers and Families (NCOFF), the National Center for Strategic Nonproﬁt Planning and Community Leadership (NPCL), and the National Fatherhood Initiative (NFI) are examples of organizations that provide technical assistance to states, communities, and occasionally individuals to help men become more involved, responsible fathers. The NCF62 began with faith-based institutions but extended its work to venues similar to those in the Fatherhood Project.62 Some programs in the ﬁeld of father engagement function as social movements. Faith-based organizations, such as The Promise Keepers, a Christian organization that holds large conferences and rallies in American cities, and the 1995 Million Man March on Washington, D.C., are designed to raise men’s consciousness about father engagement and family responsibility. The program examples cited in this section attempt to promote a change in cultural values about the role of fathers, even though they differ on the speciﬁcs of fathers’ ideal role. Further, some programs focus on obstacles to father engagement, such as workplace policies or how child care center staff treat fathers, whereas others focus on fathers’ personal values and motivations. It is remarkable that so much time, effort, and money have been spent on these programs without systematic research using control or comparison groups to evaluate whether they work and whether the central assumptions about the importance of motivational change are warranted. Skills Enhancement

Several experimental efforts have attempted to teach fathers about parenting young children or encourage men’s direct participation in child rearing and children’s early education.63,64 These programs provide group or individual interventions for fathers on a one-time or short-term basis. For example, a few parenting programs offered fathers with newborns65 or new fathers and mothers66 the opportunity to watch as the Brazelton Neonatal Assessment Scale67 was performed on their babies. The control groups received either no intervention or verbal feedback on the Brazelton results but no opportunity to watch the procedure. Observations made 1 to 3 months later showed that, compared to control-group parents, intervention fathers’ behavior with their infants was more positive, and the men perceived their infants as less difﬁcult temperamentally. Other small pilot programs, most with an information– education approach that attempt to increase fathers’ knowledge and skills as parents, are described in an edited volume by Fagan and Hawkins,63 but as yet we have very little evidence about whether and how these programs work.

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Supported by funds from various government agencies and private foundations, Fair Share68 was a well-worked-out example of a program to promote nonresident fathers’ engagement with their children. This program offered men assistance in securing and improving employment and negotiating the child-support system, group sessions for peer support, and mediation for fathers and mothers about visitation. A multisite experimental evaluation, using random assignment to different conditions, found that participation in the program increased men’s employment and earnings but achieved mixed results in terms of fathers’ visitation and engagement. Although there were no overall differences between the experimental and control groups, fathers who were initially least involved with their children and who participated in the program increased their engagement signiﬁcantly. There were also some increases in parental conﬂict over child-rearing decisions, and some restrictions on fathers’ access to the children by mothers. It seems that the relative lack of positive effects on family relationships may stem from the decision to recruit fathers some years after they had ceased to be involved with the children—by which time the mothers were less likely to welcome them back into the family. A number of father-involvement programs have been sponsored by community organizations (e.g., Joe Jones’ Center for Fathers, Families and Workforce development in Baltimore), states (e.g., Connecticut’s Department of Social Services Fatherhood Initiative [[email protected] .ct.us]), and the National Early Head Start program.69 All of these programs focus on men and attempt to provide education about fathering, and most also address issues of employment or unemployment. Because many of these programs include men who are long estranged from the mothers of the children, they ﬁght an uphill battle in trying to help men take a more active role in their children’s daily lives. The array of pregnancy prevention, economic programs, motivation enhancement, and fathering-skills programs we have described here represents only a small proportion of those that exist now, but it would be wrong to conclude that what is needed is already available. First, we know very little about whether any of these programs are effective in producing the results they seek because there is almost no well-designed evaluation research. In the few cases where empirical studies have been done, the results are not encouraging, and there is a suggestion that coercive child support programs may turn fathers off rather than draw them into the family. Second, it seems clear that most fatherhood programs recruit men long after they have drifted away from their families. Even the most skilled caseworkers are in a position of trying to offer too little too late. Third, as we have seen, current programs tend to focus almost entirely on men as individuals.36,37 The president’s 2002 budget proposal,70 in justifying the need for more ‘‘responsible fatherhood programs,’’ asserted that men who are self-involved and do not value family life are absent or less involved with their children, whereas men who value children and family life are more involved. This view places the blame for

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father absence and disengagement on the men themselves. Because we found no systematic studies that tested this hypothesis, we cannot conclude that men’s level of motivation is the primary source of their level of engagement. After more than three decades of studying families and reading the literature, we are more inclined to take a family-systems approach to understand why some men become highly involved with their children, while others do not.71

What Facilitates or Interferes With Father Engagement? A key tenet of prevention science72 is that interventions to prevent distress and promote well-being are more likely to be effective when they are directed at risk factors known to be associated with distress and maladjustment and at positive factors known to be associated with competence and adaptation. We need to pay attention to what is known about naturally occurring factors that lead some men to be more involved with their children than others. Based on our reading of the research, we believe that father engagement is an outcome of a dynamic set of interrelated factors in ﬁve central aspects of fathers’ lives: (1) individual characteristics of fathers and children that might inﬂuence men’s engagement, including fathers’ demographic characteristics (age, resources, race, and location), personal adjustment, self-concept, and beliefs, as well as the children’s sex and age; (2) father–child relationship quality, including fathers’ parenting skills, the father–child bond, and the types of activities fathers engage in with their children; (3) father–mother relationship quality, including the status of the relationship, the extent to which pregnancies are welcomed, and the quality of the parents’ interaction as a couple; (4) three-generational factors—fathers’ early and current experiences with their families of origin; and (5) outside-the-family factors, including stress and support from extended family, friends, neighborhood, workplace policies, child custody procedures, and child support policies and enforcement. This multidomain model posits ﬁve types of risk and protective factors that increase or decrease the likelihood that fathers will become positively involved with their children. Our assumption is that the relationship between a father and his child is a dynamic product of all ﬁve dimensions. That is, father engagement affects, and is affected by, the context of other key relationships in which the father–child relationship is embedded. The connections are bidirectional, consistent with the family-systems assumption that causality is interactive and circular rather than linear. Thus, we are not claiming that the quantity or quality of fathers’ engagement is necessarily the primary engine driving the system that shapes children’s development. Individual Characteristics of Fathers

Studies of whether fathers with certain demographic characteristics, such as older or younger age, are more or less involved have not emerged with clear-

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cut conclusions.73 Married fathers who earn less, work fewer hours, or have incomes that constitute a smaller proportion of total family income appear to spend more time in caregiving activities.42,74,75 By contrast with the literature on married fathers, studies ﬁnd that divorced fathers with higher education, employment, and income provide more ﬁnancial support for their children and have more contact with them.76–78 Research on fathers from different ethnic groups is beginning to yield interesting ﬁndings. African American fathers appear to be more involved with children than their white and Hispanic counterparts,79,80 even when controlling for whether mothers work outside the home. In two-parent families, Hispanic fathers monitor their children less than African American and European American fathers do, but both Hispanic and African American fathers describe having more responsibility for child rearing than European American fathers do.81 Although parents in all ethnic groups regard family as important, there is a cultural focus on the centrality of family life in African American and Hispanic communities82 that appears to encourage men to spend more time with their children. Nevertheless, we are far from being able to make ﬁrmly grounded generalizations, and even if the data seem to support such generalizations, we know that there is substantial variability within each ethnic group. Father–Child Relationship Qualities

There is a circularity to the father–child relationship factors that predict father engagement: the more fathers are involved, and the earlier they become involved with their children, the more they stay involved.55,83 Researchers and clinicians have focused on children’s emotional bonds with their mothers, but it is clear that children make primary attachments to their fathers as well.84,85 Although secure attachment—deﬁned as the child’s tendency to use the parent as a secure base in times of threat or stress—is often thought of as a characteristic of the child, it is actually an assessment of the quality of relationship between the adult and child. The clearest evidence for this assertion is the fact that the same child can show a secure attachment to one parent and an insecure attachment to the other, so that attachments to mother and father are uncorrelated or independent.86 For our purposes here, it is important to note that secure attachments do not appear to be a product of the amount of time fathers spend with their children87 or are engaged in hands-on caretaking.88 When there is high conﬂict between the parents, the more time the father spends with the child, the less likely the child is to have a secure attachment.89 There is mixed evidence about whether the quality of father-child relationships prior to divorce is linked with fathers’ maintenance of engagement after divorce. Some studies ﬁnd that fathers who were more closely involved with their children prior to divorce are more likely to pay post-divorce child support and maintain contact with the children.90 Furstenberg and Harris91 found that the older children are when parents separate, and presumably the

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more time fathers and children have had to develop emotional connections, the slower the rate of decline in fathers’ contact over time. The question of whether there is continuity between predivorce and post-divorce father–child relationships is difﬁcult to answer because studies begin after the divorce has occurred, when it is difﬁcult to get accurate information about fathers’ engagement prior to the divorce. The Couple Relationship

It has become clear over the last two decades that whether and how a father is involved with his child depend in large part on the quality of his engagement with the child’s mother.92,93 Among ethnically and socioeconomically diverse samples of married, divorced, and never-married men, fathers’ engagement with children is consistently associated with the quality of the couple relationship9,45,55,94,95—the more satisfying the couple relationship, the greater the father’s engagement. This is true as well in the relatively few studies of never-married but cohabiting parents’ relationship satisfaction and interaction: the closer and more harmonious the relationship between the parents, the greater the father’s engagement.96,97 Whether fathers become involved and stay involved with their infants depends in part on how couples make the decision to become pregnant or carry the pregnancy forward. Consistent ﬁndings from studies of ethnically diverse populations of both married and never-married couples suggest that when pregnancies are unplanned and not welcomed, fathers are less likely to be involved.61,98 Married, never-married, and divorced mothers often play a ‘‘gate-keeping’’ role in facilitating or discouraging fathers’ engagement with their children.99 Mothers deﬁne the times and conditions under which fathers will be engaged in children’s care when the mothers are not present, and in some cases they determine whether a father will spend any time with the child. Despite the claims of many married women that they wish their partners would be more involved in taking care of the children, about half the mothers in one study of ﬁrst-time parents did not want their husbands to be more involved with their preschool-age children than they currently were.100 Are there some families in which the couple relationships are so strained or violent that father engagement can be detrimental to children? There is no question that exposure to domestic violence constitutes a risk factor for children.32,101,102 An estimated 10% of divorced couples experience conﬂict that is sufﬁciently severe and intractable that it may not be beneﬁcial for the children to have contact with their noncustodial parent.103 Three-Generational Factors

Fathers’ early experiences with their own parents and families can have consequences for the amount and quality of engagement they have with their

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children. Two contrasting possibilities exist. The ﬁrst is consistent with the continuity hypothesis from social learning theory,104 which suggests that patterns observed in one generation tend to be repeated in the next. The second is consistent with a compensation hypothesis, which suggests that men who feel deprived of a positive relationship with their fathers strive to create more positive relationships with their children. Some researchers and clinicians have observed that family-of-origin relationships provide a template of what to expect in family relationships, so parents tend to repeat their experiences of being parented in raising their own children.105,106 Highly involved fathers are more likely to have sons who become highly involved fathers.107 There is also some evidence for the compensation hypothesis, in which married and never-married fathers who report having been dissatisﬁed with the quality of their relationship with their own father while growing up become relatively more involved with their children.61,108,109 Still other studies ﬁnd no link between fathers’ childhood relationships with their own fathers and engagement with their children.45,110,111 These contradictory ﬁndings may reﬂect different ways of assessing earlier relationships or the presence of different mechanisms in different families—social learning and compensation—which might lead to an overall ﬁnding of no clearly signiﬁcant patterns. Factors Outside the Family

Although fathers’ social support has not been well studied, there is some evidence that men’s social networks—extended families, friends, workmates, acquaintances, and society in general—affect their engagement with their children.112 One study found that among married, two-earner couples, fathers having supportive ‘‘non-kin allies’’—mostly friends who also had children— participated in signiﬁcantly more of the direct and indirect care of their children.113 Several other studies found that men’s social networks tend to encourage fathers to be involved with children in stereotypical and limited ways, and some friendship networks actively discourage fathers from spending time with their children.8,9,114–116 The workplace environment may play a major role in men’s level of engagement with their children. First, the atmosphere at work can spill over into home life; the level of stress117,118 or enjoyable experiences at work74 affect the quality of interactions between fathers and children at home. Second, workplace policies have an impact on the extent of fathers’ engagement in family life. Although utilization is on the rise, few fathers take advantage of formal parental-leave policies.8 The more generous the employers’ familyleave policies, the more days fathers take off for family duties or events.119 More liberal family-leave policies seem to communicate to fathers that their workplace has positive attitudes about fathers’ engagement in the family, leaving men more comfortable about taking time off to care for newborns and young children. The results of these work and family studies seem to suggest

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that, when given the opportunity, both fathers and mothers act to spend more time with their children, although in countries with substantial provisions for family leave around the birth of a child mothers are more likely to stay home than are fathers.120 In divorced families, agreements concerning paternity, child support, custody, and visitation are not always negotiated at the same time or as part of the same legal document. The types of agreements governing how nonresident parents care for their children, and the processes by which parents come to these agreements, are associated with nonresident fathers’ engagement with their children in both the short and long run.121 There is some evidence that when divorced or never-married parents’ agreements about how to care for children are reached voluntarily and by mutual consent rather than being court-ordered, fathers provide more ﬁnancial support,122 and children’s interests are best served.123

Programs Based on a Couple or Family Model In sum, ample evidence exists that each aspect or domain of fathers’ lives— individual, parent-child, couple, three-generational, and outside-the-family factors—contains both supports and barriers to fathers becoming and staying engaged in their children’s lives. Factors that support men’s engagement with children include their mental health and psychological characteristics; their ability to establish a positive relationship with their child; the child’s mother; and their parents, kin, peers, and social institutions outside the family. Conversely, pressures or difﬁculties in any of these domains act as barriers to fathers becoming and staying involved with their children in positive ways. The fatherhood interventions we have described tend to focus on the men as individuals, or on the connection between fathers and large-scale institutions. There has been very limited focus on changing intergenerational patterns, and until very recently almost none of these programs have focused on strengthening the relationship between father and mother.124,125 Two kinds of programs that do place the couple relationship at the center of the intervention have emerged recently. The ﬁrst, embodied in the TANF reauthorization mentioned at the beginning of this chapter, provides money for programs promoting marriage on the assumption that married families are more stable and keep fathers involved. Studies to test this assumption are in progress. The second approach involves interventions to strengthen couple relationships, based on the assumption that healthier couple relationships will be more satisfying to both parents, encourage more nurturant father–child relationships, and foster children’s well-being. The examples that we are aware of involve university-based programs or, in one case, a state program (California) with substantial university faculty involvement in both intervention planning and evaluation.

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Hawkins and colleagues126 conducted a ﬁve-session couples group in which participants discussed their family roles in attempts to encourage fathers to take a more active role in both household and child care tasks. The program did lead to signiﬁcantly more participation by fathers, and satisfaction with the arrangements increased for mothers. Although the authors were aware of the evaluation issues in not having a control group for comparison, they chose not to include one on the basis of values about denying services to untreated controls. A program directed to divorced fathers was mounted by Braver and colleagues.125,127 An 8-week program with behavioral-skills training focused not only on parenting skills but also on the co-parenting relationship that the divorced fathers continued to have with their ex-wives. Using a random-assignment design, the investigators found that in comparison with nontreated fathers in the control group, the fathers who had participated in the intervention engaged in more positive parenting and less conﬂictual communication with the mothers. Pruett and colleagues34 also focused on divorced fathers, using a group for men along with individual and couple meetings. Compared to families in the control group, those in the intervention showed greater cooperation, less conﬂict around custody and visitations, and more frequent and positive involvement of fathers with their children. Results of two intervention studies of working- and middle-class families at two different family transition points support the hypothesis that strengthening the relationship between the father and mother fosters fathers’ positive engagement with their children and has beneﬁts for the couples, the children, and the fathers themselves. In the ﬁrst study, couples making the transition to ﬁrst-time parenthood were randomly chosen to participate in a couples group led by male-female pairs of mental health professionals meeting for 24 weeks or a no-treatment control condition.128 Longitudinal follow-up results revealed that the intervention prevented the typical slide in fathers’ and mothers’ marital satisfaction documented in many other longitudinal studies without interventions.129 Compared to fathers in the control group, men participating in the couples-group intervention became more psychologically engaged in their role as fathers in the early years of parenthood, and they and their partners maintained their level of satisfaction with their couple relationships over the next 5 years as their children made the transition to school. The second study focused on couples whose ﬁrst child was making the transition to elementary school26 and used a similar random assignment design: parents were invited to participate in either a couples-group meeting for 16 weeks before their ﬁrst child entered elementary school or a control group, which involved an optional short consultation with the same clinically trained staff. The curriculum was similar in all the couples groups and focused on the ﬁve aspects of life we described above. In addition, during the open-ended part of each evening, when group members discussed their own issues and dilemmas, the leaders of half of the groups helped parents pay particular attention to issues in the parent–child relationships, and in the other half of the groups they focused more on issues in couple relationships.

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The groups that paid particular attention to parent–child issues produced a signiﬁcant increase over a 1-year period in the warmth fathers showed to their children, as observed during a 40-minute visit to the project playroom. Groups that focused more on couple-relationship issues stimulated increases in the quality of both father–child and mother–child relationships in the following year—and those couples maintained their marital satisfaction for 5 years, until the children had completed fourth grade. The promising results of these programs led to a new intervention project focused speciﬁcally on father engagement in 300 low-income Mexican American and European American families. Now in progress in four California counties,130 the Supporting Father Involvement project design contrasts a one-time information session for couples (the control condition) with a 16week couples group or a 16-week fathers group focusing on all ﬁve domains in our family risk model. Preliminary analyses suggest that, compared with the single-session control condition, the 16-week intervention groups are producing signiﬁcant positive effects on both couple and father–child relationships. Participants in both variations of the 16-week groups (for couples and for fathers only) maintained their relationship satisfaction from before to 2 months after the 16-week intervention, whereas the marital satisfaction of the parents from the control group declined over the same period. Fathers who had participated in a fathers-only or couples group had increased their engagement with their children—by their own and their partners’ descriptions— whereas fathers and mothers from the control group described no change in the fathers’ involvement in the care of their children. Even more preliminary ﬁndings at a third assessment almost a year after the intervention ended suggest that the positive effects of the intensive group interventions are holding up, whereas reports from the parents assigned to the control group show no change or more negative change. All the study families are being followed for an additional year to assess any longer-term effects of this work with fathers and mothers. In sum, a small couples group with the goal of discussing more shared family roles, post-divorce interventions that address co-parenting conﬂict, and group-based interventions for low-income fathers and couples provide evidence that addressing issues in the quality of couple relationships, for both married and divorced couples, may help to create more positive engagement of fathers with their children. At the time of this chapter’s writing, the fathers’ project had just recruited a ﬁfth site in which the two group interventions would be randomly offered to parents in primarily African American families, hoping to foster the fathers’ engagement with their young children and strengthen the relationships between fathers and mothers.

Recommendations for Father Engagement Programs The programs we have described above are relatively new. Based on the results so far, and on the more voluminous research on father engagement, we sum-

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marize some lessons learned about programs designed to enhance fathers’ role in the family. Doherty and colleagues2,131 suggested that father-engagement interventions should focus on multiple family domains. This Minnesota group based their recommendations on a family-systems model similar in many respects to the one we present here and suggested that interventions focused on fathers should include mothers and pay attention to intergenerational issues. From our experience in conducting several of these intervention studies, we agree that focusing on the multiple factors that contribute to fathers’ engagement in their families makes most sense. What follows are some speciﬁc suggestions for translating the multidomain family risk model into effective father-engagement programs. Orienting Principles

Adopt a prevention perspective. Our approach to designing interventions to promote father engagement is guided by the central principles and strategies of prevention science,73,132 and we feel it is best to intervene at early stages of fathers’ relationships with their children, before problems have surfaced or become intractable. Focus on normative and nonnormative transitions. Because transitions involve changes in family members’ sense of self, roles, and relationships,133 periods of major life change are likely to be times when old ways of coping are not sufﬁcient and new strategies are necessary. Fathers and their partners may be more motivated to seek information and assistance, or to accept it when offered, when faced with signiﬁcant feelings of vulnerability around family transitions. Becoming a parent for the ﬁrst time, having a preschooler enter the larger world of the school, or dealing with the challenges of adolescence or children ‘‘leaving the nest’’ are optimal times to consider interventions to maintain and enhance fathers’ engagement with children. In addition to thinking about these normative developmental and family transitions, times when families are undergoing stressful change, such as during the illness of a child or parent, the loss of a job, or the parents’ divorce, provide conditions when fathers are more open to interventions focused on helping their children maintain healthy development. Provide systematic evaluations of programs. The lack of program evaluation is pervasive. The Fatherhood Web site of the ACF (http:==fatherhood .hhs.gov) includes an eloquent document about the importance of evaluating fatherhood programs and a report by The Lewin Group134 describing the desiderata in such programs. But neither in that report nor in any other document on the Web site is there an example of a program that goes beyond collecting data on participation, qualitative interviews with clients and staff, and a discussion of the beneﬁts provided. Standardized questionnaires are rare; observational data are rarer still. With the exception of a handful of university-based programs, control groups are not included, so we cannot tell whether any of the changes described for the intervention group might also have occurred in fathers not involved in the program. From the point of view

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of those who deliver family services, we understand the feeling that it is difﬁcult, if not unethical, to deny services to a control group. But we believe that it is important to raise the issue of whether it is reasonable or ethical to devote extensive public funds to untested programs that may not have the desired effects. Programs with adequate research-evaluation designs might consider offering a ‘‘low-dose’’ intervention rather than a no-treatment control condition as a way of providing some service to people who might need help while providing a rigorous test of program effectiveness. Note the physical environment of family agencies. As we have become more involved in the father engagement ﬁeld, we have observed a pervasive barrier to father engagement at the level of community institutions—a barrier that seems invisible to most service providers. Family-service agencies are rarely ‘‘father friendly.’’ A quick visit to an agency typically reveals waiting rooms with pastel-colored walls, pictures of mothers and children, women’s magazines, and brochures describing programs for mothers. Appointments are typically offered during the day, when fathers and many mothers are at work. The staff— almost all women—rarely ask if the father will participate, or they readily accept the mother’s declaration that he’s not interested or not willing to come to discuss family matters. Home visitors rarely invite fathers into conversations about the child and the family even when they are home. In this way, the climate of the agency can create a self-fulﬁlling prophecy in which men are not invited to participate in major decisions or interventions affecting the child or family, and are then referred to by agency staff as uninvolved.

Addressing Each of the Five Domains of the Family Systems Model Although one cannot draw deﬁnitive conclusions based on correlational research, it is reasonable to assume that interventions are more likely to have an effect on positive father engagement when they target multiple risk factors associated with father disengagement and multiple positive factors associated with father involvement. We propose that interventions to enhance fathers’ family engagement address each of the aspects of life in our family systems model. Build on Men’s Strengths as Individuals

Include intervention modules that support fathers’ employment and education, regardless of the intervention focus. Because nonresident fathers’ personal resources are linked to engagement with their children, it makes sense to help men take steps to increase their incomes. This approach has been more challenging to implement than expected with low-income fathers. Working with child support systems to develop reasonable options for lowincome fathers will be necessary to father-engagement efforts because lowincome fathers who owe large amounts of child support face incarceration. It is

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worth noting that evidence from longitudinal studies indicates that when nonresident fathers become more involved with their children, they also become more involved in the labor market.135 That is, men’s engagement in their children’s lives may increase their motivation to provide for children in ﬁnancial as well as emotional terms. This sequence suggests that some interventions could begin with a father-engagement emphasis and shift to employment, rather than the more usual, reverse direction. Consider integrating brief treatment for fathers suffering from depression. We noted earlier that parental depression is associated with ineffective parenting and negative child outcomes. Most interventions to promote father engagement could integrate components to identify and treat fathers’ depression, or refer them for treatment, thereby increasing the potential for more effective relationships with the children’s mother and more positive engagement with their children. We emphasize depression because it is both ubiquitous136 and treatable in the context of individual and couple treatment.137 We are not as optimistic about reaching out to men with antisocial personalities, who are difﬁcult to treat and whose engagement with children is less likely to be beneﬁcial.137 Focus on the Couple Relationship and Co-Parenting

Help couples make pregnancies intended and wanted. Planned and welcome pregnancies are associated with greater father engagement, both because fathers are more positively involved with babies they wanted and because fathers are more likely to live with them. Consequently, efforts to ensure that pregnancies are intended and welcomed can also serve as father-engagement efforts. Improve the quality of the relationships between fathers and mothers. One consistent ﬁnding from research is that better-functioning couple relationships are linked to, and more likely to lead to, greater and more positive father engagement—for parents who are married, divorced, or have never married. We recommend that programs to enhance couple relationships be designed for (a) married couples, (b) unmarried couples in romantic relationships, and (c) unmarried couples parenting children together. We have noted that the ACF has begun to fund large-scale programs with elaborate research designs to accomplish these goals. Interventions for couples who are separating and divorcing also show promise. Often, nonresident fathers’ engagement with their children is at a high point as the couple relationship dissolves; they are going through a complex process of learning to parent from a separate residence or to co-parent with mothers with whom they are no longer romantically involved, sometimes in the context of a romantic relationship with a new partner. The formats would have to be different from the interventions for married and cohabiting couples, but it has been shown that separate group meetings for fathers or mothers have a good chance of helping to improve the children’s well-being after divorce.139,140

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Consider and address couple violence. Intervention work must proceed with caution in cases of families in which the parents are experiencing high levels of conﬂict or domestic violence. Program staff must be clinically skilled in recognizing these relationship dangers and able to refer parents for additional professional help. At the very least, they should be prepared to make decisions about screening for such information before interventions begin, in order to proceed cautiously with everyone’s safety in mind. Help parents identify and adjust mothers’ gate-keeping and fathers’ helper roles. Mothers often play a gate-keeping role with their children by controlling their children’s experiences and dictating who has access to them. Fathers often play a more passive helper role, assisting with children’s care as directed or allowed by mothers. Gate-keeping can often be seen clearly when children and mothers live apart from fathers, but many parents who live together follow these patterns, too. Given evidence that fathers are competent caretakers of children when given the opportunity, interventions to foster father engagement might encourage parents to experiment with fathers providing some solo care for children so that they can develop their own effective ways of caring and share the burden of children’s care with mothers. Focus on the Quality of Father–Child Relationships

Promote both direct and indirect engagement in children’s care. When fathers provide considerable amounts of direct and indirect care for their children, from helping with homework to getting them up, dressed, and fed in the mornings, the engagement is more meaningful for fathers and children alike, which makes their involvement more likely to continue over time. It may be particularly important for nonresident fathers to be involved in at least some of children’s everyday routines.141,142 Father-engagement interventions can help fathers and mothers think about the range of care that children require, help parents plan which parent will do what, and work toward a division of labor that is effective and satisfying to both parents. We know that satisfaction with ‘‘who does what’’ is linked with satisfaction with the overall couple relationship, and that both are linked with children’s well-being.128 Take Intergenerational Relationships Into Account

Help fathers reﬂect on and, as necessary, make up for their own less-thanideal experiences of being fathered. Fathers’ experiences of being fathered are related to their level of engagement with their children. Although interventions cannot change fathers’ childhood experiences, they can encourage men to consider how their own early experiences may be inﬂuencing their behavior with their children and help them consider how to create more positive experiences for their children. They can be helped to identify positive examples of fathering from their fathers or other men they know, who can teach them about the skills to sustain engagement with children. Sensitive male

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staff in some of the interventions we described have proven very important to fathers who lacked successful male models as they were growing up.128,143 Address parents’ relationships with extended family. It is important for fatherhood interventions to recognize that extended-family members help shape fathers’ engagement with children—supporting or hindering it through their expectations, attitudes, and offers of help. Interventions can choose to address parents’ current relationships with extended-family members directly, for example, by working with parents to consider how their parents (the grandparents) may facilitate or hinder fathers’ efforts to be involved with children. Fathers and mothers can be encouraged to talk with each other and the grandparents in ways that will gather support for handling their family relationships in more nurturant and supportive ways. When parents are relatively dependent on the grandparents for their children’s care, interventions might involve extended family members in the program to facilitate fathers’ engagement. For example, grandparents may be part of teen parents’ agreements about fathers’ visitation by receiving or delivering children when the parents cannot act civilly in front of the children, or by giving single parents the concrete support, conﬁdence, and motivation they need to care for their children. Address Stresses and Supports Outside the Family

Consider fathers’ choice of social networks. Family members, friends, acquaintances, and coworkers in fathers’ social networks have beliefs and attitudes about how involved fathers should be with their children—some that are supportive and others that can hinder men’s actual engagement. Interventions can take these patterns into account in their work with fathers, for example, by helping men identify their perceptions of how various groups expect them to act as fathers, consider how those expectations ﬁt with their own desires, and explore how to develop new social connections that might be more supportive of their family goals. Help parents and employers increase work and family compatibility. Many fathers struggle with meeting the twin demands of their jobs and being involved with their children. Father-engagement efforts might help parents identify ways in which stress from work spills over into their family lives and suggest approaches for easing that strain. More family-friendly workplace policies, such as time off around children’s births and ﬂextime to care for a child who is ill, seem to allow fathers to become more involved with their children. Some father-engagement efforts might facilitate the identiﬁcation by both workers and employers of workplace changes that would make it easier for parents to be involved with their children. Reorient agencies to make them more ‘‘father friendly.’’ Although it is important to consider the physical characteristics of agencies serving families with a view to making fathers feel welcome, it is necessary to go beyond changing the pictures on the walls. Agency staff often need help to reorient their perceptions

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and attitudes in ways that allow them reach out to fathers to acknowledge their role in the family rather than lament the fact that men are not involved. Promote nonresident parents’ legal agreements about children, including visitation and involving fathers as more equal partners. There are indications that nonresident fathers are more involved with their children when there are formal rather than informal legal agreements in place, when agreements address visitation speciﬁcally, and when agreements are more egalitarian—such as specifying joint rather than sole legal custody. Fatherengagement efforts can work to shape the systems, rules, and laws that facilitate divorced and never-married couples’ separation, in order to increase the likelihood that couples will have formal agreements that specify parents’ responsibilities for ﬁnancial support, visitation schedules, and ways for nonresident fathers to be more equal partners. Promote mediation for nonresident couples attempting to develop and adjust agreements about children. Mediation for both parents can help some couples resolve their differences and promote fathers’ engagement over the long run.144 Efforts to promote mediation may need to involve the development of strategies for packaging mediation as a desirable service. Relatively few never-married parents have legal agreements about caring for their children, and low-income and ethnic-minority communities may not view the legal system or any of its variants, such as mediation, as useful. Offering or mandating mediation when couples are splitting up might be more effective than trying to include it in father-engagement interventions later on. Try to deal with the institutional complexities of collecting child support. It is true that some middle- and upper-income fathers do not contribute adequately to the ﬁnancial support of their child, and that some systematic procedures have been developed that result in increased child support payments—wage withholding, revocation of licenses, and interception of tax refunds, for example. Such efforts need to be carefully monitored to assess the quality of father–mother and father–child relationships and the ultimate implications of those relationship qualities for the children. Increased child support payments accompanied by more strained family relationships may have a net negative effect on the children. Efforts to increase fathers’ child support payments that are accompanied by interventions to support and improve men’s relationships with the mother and child might be more successful on both counts. Another alternative would be for father-engagement efforts to explore whether increasing nonresident fathers’ contact with children might result in fathers’ voluntarily increasing their ﬁnancial support—perhaps without the increases in contact between the parents that now accompany efforts to compel fathers to pay child support. It is important to recognize the disincentives to child support payments that are embedded in some regulations of the welfare system. Some fatherengagement efforts might focus on changing the child support system to (a) increase the incentives for low-income fathers to participate, such as increasing

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the amount of the payments that get passed on to the children, even when mothers receive or have received public beneﬁts, and (b) make the amount that low-income fathers pay more equitable and tied to their actual earnings.56

Conclusion It seems odd to us, writing in the year 2007, to be summarizing evidence that positive father engagement is important for children’s development and to be recommending that some fathers may need encouragement and assistance to be the kind of father they want to be. What is clear from our survey of both the research and intervention literatures is that the factors affecting whether and how fathers become involved in their children’s lives are complex and systemic, and are not simply a matter of men’s motivation to fulﬁll their father role. Our central argument is that paying close attention to what is already known from father-engagement research could result in more comprehensive and effective interventions to support fathers. At the same time, we see that there are a great many unanswered questions. First, as we have stated repeatedly, there has not been sufﬁcient evaluation of interventions to identify the dimensions of programs that lead to positive outcomes. Most fatherhood interventions involve single-time gatherings of men in small or large groups. Can single meetings produce lasting change? There is some evidence that suggests that they can not, but this needs fuller exploration. If meetings are ongoing, what is the optimal number of sessions for producing a speciﬁc kind of family change? This question is key to those concerned with policy decisions and funding of intervention efforts. Most fatherhood interventions outside university settings do not have clinically trained staff as leaders. Does the level of training or other characteristics of intervention leaders (e.g., age, sex, race, experience) affect the outcomes programs are aiming for? The answer to this question is essential for the development and funding of responsible intervention efforts. Second, we have not identiﬁed all of the central risk and protective factors that affect father engagement, so we do not yet have a solid map of the potentially modiﬁable factors that father-engagement interventions might focus on. At the top of the list of unknowns is the extent to which programs need to be tailored to ﬁt subpopulations of fathers (deﬁned by marital status, living arrangements, age, ethnicity, socioeconomic status, and so on) or whether a generic intervention program is adequate to help different kinds of fathers become and stay involved in their children’s lives. Finally, we return to the issue of diversity that we raised at the beginning of the chapter. There is wide diversity in terms of kinds of fathers—deﬁned by race, ethnicity, national origin, and income. And there is diversity in the kinds of legal connections between fathers and their children, based on whether they are married to or living with the child’s mother. Because it is improbable that ‘‘one size ﬁts all,’’ it is essential to ﬁnd out which kinds of programs produce

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what kinds of effects on which fathers. Research to address these unknowns creates its own level of complexity. For example, if investigators were to examine the impact of any intervention on the variety of arrangements between two biological parents (married, divorced, not married but cohabiting, not cohabiting but romantically involved, not married or cohabiting or romantically involved) and low- versus high-income levels, each study would require 10 separate groups of participants. As we have seen, contemporary familymaking is even more complex than this, with some couples having children they share, others having children from one or the other’s previous or subsequent relationships, and so on. If we multiply those combinations by the number of racial or ethnic groups to be considered, the number of samples we would need to understand any signiﬁcant differences grows exponentially. Our hope is simply that each program consider some of this complexity, and that all program efforts attempt to evaluate the effects of the intervention systematically, so that in the aggregate we can begin to gather the kind of information needed by both intervention designers and policy makers to provide a more differentiated approach to encouraging fathers to become and remain positively involved with their children. It is important for us to acknowledge that our proposal to focus on the relationship between parents addresses the issues of only one segment of the diversity of fatherhood. This approach has little chance of working when the relationship between the parents has ended not only in separation but in termination, so that the father has not been involved with the mother or child for some time. In these families, a couple-focused approach may not be appropriate, but the lessons learned from our systemic model may still apply— addressing individual, familial, and outside-the-family factors that reduce chances that the father would seek out his child from the past or become involved with children in a newly established relationship. Two issues concerning the political context of establishing fatherengagement programs require further consideration. First, in our experience, despite the generally accepted ideology that father engagement is a ‘‘good thing,’’ there are two constituencies that express skepticism or opposition. In presenting ideas about the importance of father engagement, the authors of this chapter inevitably face questions from some mothers who fear that an emphasis on fathers downgrades the importance of their role in child rearing. It is always necessary to frame the inclusion of fathers as an additional central resource for fostering children’s healthy development and strengthening family relationships. Even more opposition is expressed by health and social service workers most centrally involved in dealing with the serious effects of domestic violence. We need to make clear that these programs are not for violent men but rather the majority of men whose increased presence in the family holds the potential to enhance relationship quality and children’s healthy development. Second, although we have been building an argument for creating interventions to foster fathers’ engagement, it is important to give thoughtful consideration to the question of whether the government should provide

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funding for such programs. Could the money be better spent in other ways? The most common suggestion is that income-supplementation programs could reduce family stress and increase family well-being. We are aware of no income-intervention program that has actually increased the quality of family relationships, although it is possible that such a program could be designed. The number of possible alternative uses of government funds is as large as the number of different policy initiatives designed to beneﬁt children and families. By deﬁnition, then, this debate is central to the realm of family policy— how government should allocate priorities in the spending of limited resources. We believe that there are sufﬁcient grounds in the literature we have reviewed about fathers’ importance to children’s development to give fatherengagement programs a serious try. At the time of this writing, the question of whether the government should be involved in promoting father engagement is moot. As we stated at the beginning of this chapter, based on the budget- and welfare-reform proposals by the Bush Administration, passed by Congress, the ACF at the federal level has embarked on funding programs to encourage fathers’ positive engagement with their children. We are encouraged that these plans include several ambitious studies that will randomly assign participants to one of several interventions in order to systematically establish the effectiveness of well-designed and thoughtfully staffed programs for low-income families, many based on the kinds of research ﬁndings we have described here. The results of these intervention studies will be some time in coming, but they should provide more systematic information about what works, and for whom, in terms of fathers’ engagement and the development and well-being of both parents and children. What we have described here is a ﬁeld in the process of formation and growth. Under most circumstances, fathers’ active engagement in their children’s daily lives can provide identiﬁable beneﬁts for children, mothers, and fathers themselves. We actually know a good deal about how to think about facilitating men’s positive involvement in their families, but important questions remain about whether we can do this successfully in the ‘‘real world.’’

Acknowledgments The writing of this chapter was supported by the Department of Social Services, Ofﬁce of Child Abuse Prevention, Sacramento, California. The authors are grateful to Linda Hockman and Frank Furstenberg for comments on an earlier draft.

Notes 1. Health and Human Services Web site (n.d.). Retrieved September 13, 2007, from http:==fatherhood.hhs.gov=2006Initiative=index.shtml.

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66. Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55(1), 83–96. 67. Brazelton, T. B., & Nugent, J. K. (1995). The Neonatal Behavioral Assessment Scale. London: Mac Keith Press. 68. Doolittle, F., Knox, V., Miller, C., & Rowser, S. (1998). Building opportunities, enforcing obligations: Implementation and interim impacts of parents’ fair share. New York: Manpower Demonstration Research Corporation. 69. Roggman, L. A., Boyce, L. K., Cook, G. A., & Cook, J. (2002). Getting dads involved: Predictors of father involvement in early Head Start and with their children. Infant Mental Health Journal, 23(1–2), 62–78. 70. Bush, G. (2001). A blueprint for new beginnings: A responsible budget for America’s priorities. Retrieved August 27, 2007, from http:==www.whitehouse.gov=news= usbudget=blueprint=blueprint.pdf. 71. Cowan, P. A., & Cowan, C. P. (2006). Developmental psychopathology from a family systems and family risk factors perspective: Implications for family research, practice, and policy. In D. Cicchetti and D. J. Cohen (Eds.), Developmental psychopathology (Vol. 1, 2nd ed., pp. 530–587). New York: Wiley. 72. Coie, J. D., Watt, N. F., West, S. G., & Hawkins, J. D. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 48(10), 1013–1022. 73. Jaffee, S. R., Caspi, A., Mofﬁtt, T. E., Taylor, A., & Dickson, N. (2001). Predicting early fatherhood and whether young fathers live with their children: Prospective ﬁndings and policy reconsiderations. Journal of Child Psychology & Psychiatry & Allied Disciplines, 42(6), 803–815. 74. Grossman, F. K., Pollack, W. S., & Golding, E. (1988). Fathers and children: Predicting the quality and quantity of fathering. Developmental Psychology, 24(1), 82– 91. 75. NICHD Early Child Care Research Network. (2000). Factors associated with fathers’ caregiving activities and sensitivity with young children. Journal of Family Psychology, 14(2), 200–219. 76. Cooksey, E. C., & Craig, P. H. (1998). Parenting from a distance: The effects of paternal characteristics on contact between nonresidential fathers and their children. Demography, 35(2), 187–200. 77. Furstenberg, F. F., Morgan, S. P., & Allison, P. D. (1987). Paternal participation and children’s well-being after marital dissolution. American Sociological Review, 52(5), 695–701. 78. Seltzer, J. A. (1991). Relationships between fathers and children who live apart: The father’s role after separation. Journal of Marriage & the Family, 53(1), 79–101. 79. Danziger, S. K., & Radin, N. (1990). Absent does not equal uninvolved: Predictors of fathering in teen mother families. Journal of Marriage & the Family, 52(3), 636– 642. 80. Lerman, R. (1993). A national proﬁle of young unwed fathers. In R. I. Lerman & T. J. Ooms (Eds.), Young unwed fathers: Changing roles and emerging policies (pp. 27– 51). Philadelphia: Temple University Press. 81. Hofferth, S. L. (2003). Race=ethnic differences in father involvement in twoparent families: Culture, context, or economy? Journal of Family Issues, 24(2), 185–216.

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82. Pinderhughes, E. B. (2002). African American marriage in the 20th century. Family Process, 41(2), 269–282. 83. Cowan, C. P., & Cowan, P. A. (1988). Who does what when partners become parents: Implications for men, women, and marriage. Marriage & Family Review, 12(3– 4), 105–131. 84. Greenberg, M. T., & Speltz, M. L. (1988). Attachment and the ontogeny of conduct problems. In J. Belsky & T. Nezworski (Eds.), Clinical implications of attachment (pp. 177–218). Hillsdale, NJ: Lawrence Erlbaum Associates. 85. NICHD Early Child Care Research Network. (2005). Child care and child development: Results from the NICHD study of early child care and youth development. New York: Guilford Press. 86. Main, M., & Weston, D. R. (1981). The quality of the toddler’s relationship to mother and to father: Related to conﬂict behavior and the readiness to establish new relationships. Child Development, 52(3), 932–940. 87. Cox, M. J., Owen, M. T., Henderson, V. K., & Margand, N. A. (1992). Prediction of infant-father and infant-mother attachment. Developmental Psychology, 28(3), 474– 483. 88. Solomon, J., & Biringen, Z. (2001). Another look at the developmental research: Commentary on Kelly and Lamb’s using child development research to make appropriate custody and access decisions for young children. Family Court Review, 39(4), 355–364. 89. Volling, B. L., & Belsky, J. (1992). Infant, father, and marital antecedents of infant-father attachment security in dual-earner and single-earner families. International Journal of Behavioral Development, 15(1), 83–100. 90. Lowery, C. R. (1986). Maternal and joint custody: Differences in the decision process. Law & Human Behavior, 10(4), 303–315. 91. Furstenberg, F. F., & Harris, K. M. (1993). When fathers matter=why fathers matter: The impact of paternal involvement on the offspring of adolescent mothers. In A. Lawson and D. L. Rhode (Eds.), The politics of pregnancy: Adolescent sexuality and public policy (pp. 189–215). New Haven, CT: Yale University Press. 92. Fincham, F. D. (1998). Child development and marital relations. Child Development, 69(2), 543–574. 93. Frosch, C. A., Mangelsdorf, S. C., & McHale, J. L. (2000). Marital behavior and the security of preschooler-parent attachment relationships. Journal of Family Psychology, 14(1), 144–161. 94. Braver, S. L., & Grifﬁn, W. A. (2000). Engaging fathers in the post-divorce family. Marriage & Family Review, 29(4), 247–267. 95. Orbuch, T. L., Veroff, J., & Hunter, A. G. (1999). Black couples, white couples: The early years of marriage. In E. M. Hetherington (Ed.), Coping with divorce, single parenting, and remarriage: A risk and resiliency perspective (pp. 23– 43). Mahwah, NJ: Lawrence Erlbaum Associates. 96. Edin, K., & Lein, L. (1997). Making ends meet: How single mothers survive welfare and low-wage work. New York: Russell Sage Foundation. 97. Furstenberg, F. F. (1995). Fathering in the inner city: Paternal participation and public policy. In W. Marsiglio (Ed.), Fatherhood: Contemporary theory, research, and social policy (pp. 119–147). Thousand Oaks, CA: Sage Publications. 98. Coley, R. L. (2001). Demographic, psychological, and family determinants of paternal involvement in African American and Hispanic low-income fathers. Paper presented at

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the biennial meeting of the Society for Research in Child Development, Minneapolis, MN. 99. Pruett, M. K., Williams, T. Y., Insabella, G., & Little, T. D. (2003). Family and legal indicators of child adjustment to divorce among families with young children. Journal of Family Psychology. Special Issue: Family Psychology and Family Law– Exploring the Linkages, 17(2), 169–180. 100. Cowan, C. P., & Cowan, P. A. (1987). A preventive intervention for couples becoming parents. In C. F. Z. Boukydis (Ed.), Research on support for parents and infants in the postnatal period (pp. 225–251). Norwood, NJ: Ablex Publishing Corp. 101. Osofsky, J. D. (1999). The impact of violence on children. Future of Children. Special Issue: Domestic Violence and Children, 9(3), 33– 49. 102. Yates, T. M., Dodds, M. F., Sroufe, L. A., & Egeland, B. (2003). Exposure to partner violence and child behavior problems: A prospective study controlling for child physical abuse and neglect, child cognitive ability, socioeconomic status, and life stress. Development and Psychopathology, 15(1), 199–218. 103. Johnston, J. R. (1994). High-conﬂict divorce. Future of Children, 4(1), 165–182. 104. Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall. 105. Caspi, A., & Elder, G. H. J. (1988). Emergent family patterns: The intergenerational construction of problem behaviour and relationships. In R. A. Hinde & J. Stevenson-Hinde (Eds.), Relationships within families: Mutual inﬂuences (pp. 218–240). Oxford: Clarendon Press. 106. Marsiglio, W., & Cohan, M. (1997). Young fathers and child development. In M. E. Lamb (Ed.), The role of the father in child development (3rd ed., pp. 227– 244). New York: John Wiley & Sons. 107. Williams, E. L. (1995). Father and grandfather involvement in childrearing and the school performance of Ojibwa children: An exploratory study. Dissertation Abstracts International Section A: Humanities & Social Sciences, 56(4-A), 1530 Social Sciences. 108. Barnett, R. C., & Baruch, G. K. (1987). Determinants of fathers’ participation in family work. Journal of Marriage & the Family, 49(1), 29– 40. 109. Barnett, R. C., & Baruch, G. K. (1988). Correlates of fathers’ participation in family work. In P. Bronstein and C. P. Cowan (Eds.), Fatherhood today: Men’s changing role in the family (pp. 66–78). Oxford: John Wiley & Sons. 110. Gersen, K. (1993). No man’s land: Men’s changing commitments to family and work. New York: Basic Books. 111. Radin, N. (1994). Primary-caregiving fathers in intact families. In A. E. Gottfried & A. W. Gottfried (Eds.), Redeﬁning families: Implications for children’s development (pp. 11–54). New York: Plenum Press. 112. Levine, J. A., & Pitt, E. W. (1995). New expectations: Community strategies for responsible fatherhood. New York: Families and Work Institute. 113. Riley, D. (1990). Network inﬂuences on father involvement in childrearing. In M. Cochran, M. Larner, D. Riley, L. Gunnarsson, & J. Charles R. Henderson (Eds.), Extending families: The social networks of parents and their children. New York: Cambridge University Press. 114. Lein, L. (1979). Male participation in home life: Impact of social supports and breadwinner responsibility on the allocation of tasks. The Family Coordinator, 28, 489– 497.

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115. Russell, G. (1982). Shared-caregiving families: An Australian study. In M. E. Lamb (Ed.), Nontraditional families: Parenting and child development. Hillsdale, NJ: Lawrence Earlbaum Press. 116. Russell, G. (1986). Shared parenting: A new childrearing trend? Early Child Development & Care, 24(3– 4), 139–153. 117. Repetti, R. L. (1994). Short-term and long-term processes linking job stressors to father-child interaction. Social Development, 3(1), 1–15. 118. Schulz, M. S., Cowan, P. A., Cowan, C. P., & Brennan, R. T. (2004). Coming home upset: Gender, marital satisfaction, and the daily spillover of workday experience into couple interactions. Journal of Family Psychology, 18(1), 250–263. 119. Hyde, J. S., Essex, M. J., & Horton, F. (1993). Fathers and parental leave: Attitudes and experiences. Journal of Family Issues, 14(4), 616–638. 120. Wisensale, S. K. (2001). Family leave policy: The political economy of work and family in America. Armonk, NY: M.E. Sharpe. 121. Mercer, D., & Pruett, M. K. (2001). Your divorce advisor. New York: Simon and Schuster. 122. Nord, C. W., & Zill, N. (1996). Non-custodial parents participation in their children’s lives: Evidence from the survey of income and program participation. Washington, DC: U.S. Department of Health and Human Services. 123. Lamb, M. E., Sternberg, K. J., & Thompson, R. A. (1997). The effects of divorce and custody arrangements on children’s behavior, development, and adjustment. Family & Conciliation Courts Review, 35(4), 393– 404. 124. Cookston, J. T., Braver, S. L., Grifﬁn, W. A., De Luse, S. R., & Jonathan, M. (2007). Effects of the dads for life intervention on interparental conﬂict and coparenting in the two years after divorce. Family Process, 46(1), 123–137. 125. Doherty, W. J., Erickson, M., & La Rossa, R. (2003). Parenting together: An intervention for the transition to fatherhood. Paper presented at the National Council on Family Relations, Vancouver, BC, Canada. 126. Hawkins, A. J., Roberts, T.-A., Christiansen, S. L., & Marshall, C. M. (1994). An evaluation of a program to help dual-earner couples share the second shift. Family Relations: Interdisciplinary Journal of Applied Family Studies, 43(2), 213–220. 127. Braver, S. L., Grifﬁn, W. A., & Cookston, J. T. (2005). Prevention programs for divorced nonresident fathers. Family Court Review. Special Issue on Prevention: Research, Policy, and Evidence-Based Practice, 43(1), 81–96. 128. Cowan, C. P., & Cowan, P. A. (2000). When partners become parents: The big life change for couples. Mahwah, NJ: Lawrence Erlbaum Associates. 129. Schulz, M. S., Cowan, C. P., & Cowan, P. A. (2006). Promoting healthy beginnings: A randomized controlled trial of a preventive intervention to preserve marital quality during the transition to parenthood. Journal of Consulting and Clinical Psychology, 74(1), 20–31. 130. Cowan, P. A., Cowan, C. P., Pruett, M. K., & Pruett, K. D. (2007). An approach to preventing co-parenting conﬂict and divorce in low-income families: Strengthening couple relationships and fostering fathers’ involvement. Family Process, 46(1), 109–121. 131. Doherty, W. J., & Erickson, M. (2000). Responsible fathering: An overview, conceptual framework, and recommendations for policies and programs. In M. K. Whyte (Ed.), Marriage in America: Communitarian perspectives. New York: Rowman and Littleﬁeld.

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132. Mrazek, P. J., & Haggerty, R. J. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press. 133. Cowan, P. A. (1991). Individual and family life transitions: A proposal for a new deﬁnition. In P. A. Cowan and E. M. Hetherington (Eds.), Family transitions (pp. 3–30). Hillsdale, NJ: Lawrence Erlbaum Associates. 134. The Lewin Group. (1997). An evaluability assessment of responsible fatherhood programs: Final report. Washington, DC: Administration for Children and Families. 135. Lerman, R., & Sorensen, E. (2000). Father involvement with their nonmarital children: Patterns, determinants, and effects on their earnings. Marriage & Family Review, 29(2–3), 137–158. 136. Kessler, R. C. (2003). Epidemiology of women and depression. Journal of Affective Disorders Special Issue: Women and Depression, 74(1), 5–13. 137. Anderson, P., Beach, S. R. H., & Kaslow, N. J. (1999). Marital discord and depression: The potential of attachment theory to guide integrative clinical intervention. In T. Joiner and J. C. Coyne (Eds.), The interactional nature of depression: Advances in interpersonal approaches (pp. 271–297). Washington, DC: American Psychological Association. 138. Fals-Stewart, W., Kelley, M. L., Cooke, C. G., & Golden, J. C. (2003). Predictors of the psychosocial adjustment of children living in households of parents in which fathers abuse drugs. The effects of postnatal parental exposure. Addictive Behaviors, 28(6), 1013–1031. 139. Cookston, J. T. (1999). Parental supervision and family structure: Effects on adolescent problem behaviors. Journal of Divorce & Remarriage, 32(1–2), 107– 122. 140. Pruett, M. K., & Hoganbruen, K. (1998). Joint custody and shared parenting: Research and interventions. Child & Adolescent Psychiatric Clinics of North America, 7(2), 273–294. 141. Lamb, M. E. (2002). Nonresidential fathers and their children. In C. S. TamisLeMonda & N. Cabrera (Eds.), Handbook of father involvement: Multidisciplinary perspectives (pp. 169–194). Mahwah, NJ: Lawrence Erlbaum Associates. 142. Pruett, M. K., & Pruett, K. D. (1998). Fathers, divorce, and their children. Child & Adolescent Psychiatric Clinics of North America, 7(2), 389– 407. 143. Cowan, P. A., Cowan, C. P., Pruett, M. K., & Pruett, K. D. (2007). An approach to preventing co-parenting conﬂict and divorce in low-income families: Strengthening couple relationships and fostering fathers’ involvement. Family Process, 46(1), 109–121. 144. Kelly, J. B. (2004). Family mediation research: Is there empirical support for the ﬁeld? Conﬂict Resolution Quarterly. Special Issue: Conﬂict Resolution in the Field: Assessing the Past, Charting the Future, 22(1–2), 3–35.

4 Can Women Have Careers and Babies Too? Mary Ann Mason

Recently, I spoke at a university reception where I was approached by a young woman who introduced herself as a graduate student in art history. She said she had followed our ‘‘Do Babies Matter?’’ research over the years in academic journals. ‘‘I read every new article,’’ she said, ‘‘and then I discussed it with my mom and dad. They both started out as professors, but my mother gave up her career to take care of us. I think she is unhappy,’’ explained the student. ‘‘What really surprises me is that my dad is pretty conservative, but he is beginning to understand that it’s not fair that men can have families and careers and women can’t; he thinks maybe we should change the tenure clock.’’ Clearly she felt her father was making progress, but then she added in a slightly apologetic tone, ‘‘As for myself, I’m still not sure how to make it work. I don’t think you’ve suggested when is the good time to have babies.’’ Young women today grow up in a culture that offers seriously mixed messages—you must aim high, you can be anything you choose, you can do anything that men can do, but you must be able to support yourself and help support your family for your working life—and, somehow, you have to ﬁt in motherhood. Women face a continuing series of decisions about family and work over the course of their lives. Men and women start out on their career path in law, medicine, academia, or the corporate world nearly toe to toe, but soon their tracks begin to diverge. The general rule across the male-dominated professions is that men who marry and have children are the most successful, while women who marry and have children are the least successful during their professional careers.1 Our 81

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research shows that this holds true in law, business, medicine, engineering, politics, science, and academia. Despite the growing numbers of women entering these professions, the same general pattern has held. Of course, other factors, especially persistent gender discrimination still deeply embedded in many male-dominated professions, inﬂuence women’s career trajectories. However, with the removal or reduction of most legal and ofﬁcial discrimination barriers, our research shows that family issues are a more prominent factor in career success, particularly in the early period of career formation. Differences in the lives of professional men and women extend beyond just career success—these men and women also develop different family patterns. Among highly educated, highly skilled professionals, men are more likely than women to marry, less likely to divorce, and more likely to have children. This raises a different and important question about how to deﬁne gender equity. Is equity just the ability to excel in the profession, or is equity the ability to excel in the profession without sacriﬁcing the ability to have a family?2 The divergences occur not at a single stage but rather at key points along a career path. Fast-track professions present three distinct life stages, each with different demands: an extended training period—the student and apprentice years—which begin in late adolescence and may last until about age 30; a long probationary period of the critical ‘‘make or break’’ years that fall roughly between ages 30 and 40; and the long career climb until retirement, where some, more often men than women, reach the highest pinnacles of their profession. Mothers who drop out of the most competitive tracks, usually during the ‘‘make or break’’ years, rarely leave their profession entirely. They often ﬁnd a place in the growing second tier, a female-dominated stratum in each profession that offers a more ﬂexible time commitment. This second tier is the fastest growing segment of, and most noteworthy consequence of the feminization of, graduate and professional education. It is changing, and will continue to change, the structure of the professions. Most undergraduate courses today are taught by lecturers, not professors; most primary medical care is provided by physicians who receive lower pay than in previous eras and who often work part time. These positions are disproportionately held by mothers because they can provide a more comfortable working schedule. But they are also characterized by stagnancy—there is little room for advancement in the second tier. Our ‘‘Do Babies Matter?’’ research project tracks the effect of family formation and child raising on both men and women across these life stages. Conversely, it also examines the impact of careers on family formation and tracks points at which careers help or hinder marriage and child rearing. We used a wide variety of sources: longitudinal databases developed by the National Science Foundation; the 2000 U.S. Census; and vital statistics provided by the American Bar Association, the American Medical Association, Catalyst, and others. We also interviewed dozens of women, mostly mothers, at all stages of professional life: mothers beginning their career, mothers who dropped out

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of their career, and mothers who made it to the very top of their profession. The story of how, when, and why families and careers interact is told through our scientiﬁc ﬁndings, and also through the experiences of the women grappling with these questions. It’s a complicated tale. Just as there is not one easy answer to the question ‘‘When is a good time to have a baby?,’’ there is not an easy answer to why some women succeed and others drop down or drop out. Following is the basic framework of what we know about babies and the life course of men’s and women’s careers.

The Student and Apprentice Years: Ages 18 to 30 Undergraduate Degrees

One of the most remarkable events of the twentieth century was the massive entrance of women into higher education. In 1900, women accounted for 19% of U.S. bachelor’s degree recipients. The percentage rose and fell in subsequent decades; by 1960 35% of bachelor’s degrees were received by women. But in 2000, women received 57% of undergraduate college degrees.3 (Some observers believe that the balance has tipped too far in the female direction.4) Even today, however, gender variations signiﬁcantly affect future career paths. Female recipients of bachelor’s degrees in engineering remain a small minority, despite a leap from 0.4% in 1966 to 17.9% in 1996. Even more telling is their stagnant underrepresentation in mathematics and computer sciences—33%, unchanged over three decades.5 These basic degrees provide the training that has driven the computer revolution; without them, women are prevented from entering the critical arenas of research and industry. One of the rare female faculty members in a department of mechanical engineering believes the male-dominated culture in such departments continues to deter prospective female applicants: ‘‘There is a perception that mechanical engineering is for ‘gear heads.’ The ﬁeld is not set up for women and looks unattractive to women, and I think it is a problem. The ﬁeld needs to look more humanistic to entice further participation from women.’’ Some areas of science, particularly biology, have opened up to women. Soaring from 25% to 50% of all degree recipients, women are well positioned to enter medical ﬁelds and to participate in the biotech revolution. Women also now represent 50% of the social sciences, a 16% increase from 1996. Female students dominate psychology (73%) and are overrepresented in most of the arts and humanities.5 During undergraduate college years, students are still in late adolescence— their formative years. But students who plan to be physicians, lawyers, or academics make career decisions early because they have many more years of training ahead of them and must lay the foundation for these future studies.

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Mentors and role models play an important role in the career direction they will take, particularly for women. Some have postulated that one of the reasons so few women enter engineering is because nearly all the professors are men. That is no longer true for most other ﬁelds. At the early point of career choice, the question of a future family is a factor but, for most young women, it is largely a distant and abstract concern. The age at which women college graduates have their ﬁrst baby has risen dramatically. In 1970, 73% of college-educated women had their ﬁrst baby by the time they were 30; in 2000, only 36% did so in that time frame.6 This remarkable shift reﬂects, in large part, greater opportunities—as well as a greater necessity—for women to participate in the workforce. However, these impressive numbers also point to a trend identiﬁed by younger women interviewed for this book: the postponement of family decisions for career priorities. One young law student discussed why ambitious women who are focused on career success are afraid to pursue motherhood: Mommy lawyers are usually not partners; however, daddy lawyers excel. This disconnect is so common, it is like an accepted norm. For a law ﬁrm, losing a lawyer to maternity leave or a part-time track is a serious liability. Now when I hear the word ‘‘kids,’’ I think ‘‘death to my career’’—and that is sad.

Graduate and Professional Training

More remarkable than women’s high enrollment in undergraduate education is their massive entry over the past 40 years into the tough graduate training programs in law, medicine, business, science, and the academic disciplines. Inspired by the doors opened by the women’s movement and the resulting federal legislation—and sobered by the economic realities that impel women to work—women have ﬂocked to these formerly male-dominated enclaves. The numbers are stunning. Nearly 10 times as many women are entering professional schools, and 5 times as many women are entering doctoral programs, as were 40 years ago. There are, again, variations within this impressive story. Only 12% of engineering doctorates and 21% of computer and mathematics doctorates are awarded to women, reﬂecting continuing marginalization of women in these important ﬁelds.7 Overall, however, the story is one of triumph. The First Cut

In the ﬂush of graduation from professional training, a new story begins to emerge. The ‘‘ﬁrst cut’’ in career paths occurs around graduation from medical school, law school, or doctoral programs. At this point, many women veer away from their original career plans. Varying somewhat among the professional ﬁelds, graduation occurs in women’s late 20s or early 30s. Most MBA

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graduates work for several years before pursuing that degree. The average age for PhD completion is 335; medical residencies and postdoctoral appointments add years to the basic training. At some time in their late 20s, around the time they are completing their professional training, most women begin to consider children, and many have found a life partner. By the time they are in their early 30s, about 54% of men with a doctorate and 49% of women with a doctorate are married.6 Women are more likely than men to marry a fellow student, which later creates particular strains on these two-career families. They must negotiate difﬁcult career choices, such as where to locate after graduation, whose career takes precedence, and who will seek to earn more money. The prospect of future children can play an important role in this bargaining process. A signiﬁcant number of women will have their ﬁrst child while they are still students. This is particularly true for medical and science students, where the added years of residencies and postdoctoral training make women students into their 30s, the primary childbearing decade. Fifty percent of women doctors who choose to have children have their ﬁrst child while they are residents, and 25% have their second child during these years.7 Most women, however, defer childbearing during their student years. They do this because they fear they will not be taken seriously if they become pregnant and that, if they have children, their professors, mentors, and future employers will discourage them from continuing in their chosen profession. Childbirth may delay the completion of a degree and decrease access to important professional opportunities, summer internships, and appearances at professional conferences. The rigidly male model of graduate and professional education is relentlessly lockstep; one enters with a cohort and is expected to graduate with it. Any deviation from this norm is frowned on by colleagues and professors, who play a critical role in determining students’ career opportunities. Women who have their ﬁrst child near or shortly after graduation often decide to take a break. They may make compromises that they believe are temporary, but too often the compromises become permanent. For all competitors in this fast-track world, the window of opportunity closes quickly. Delaying professional advancement for more than a year or two often results in a longer-term career lag. Working part time or shifting to a low-key environment may appear to be a good choice for these women at the time because it allows them to broker a compromise between work and family and to spend time with their infant. But what they do not fully realize is that for the institution—the university, law ﬁrm, or corporation—these women’s professional degrees count for little; the gap their resume´ following their degree signals to potential employers that they are not dedicated to professional success.8 Those new mothers who do not initially take a break from their career retain the option to change direction later on to a less demanding track, usually in the second tier.

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A recent law graduate currently working as a public-interest law activist in San Francisco says the demands of work and family pull working women in many directions: I used to think I would want to start my own organization, but I am not as interested anymore. I am already so involved in my work and have such a hard time saying no to every activity I want to participate in: to drive day laborers to Sacramento for a rally or attend a workshop. Saying no is so hard because I want to do it all, but I know I really want a family and a life outside of work. The fulltime life of the activist can be a singular activity.

A divergence between men and women occurs at this juncture, based on present or future family considerations. In science and engineering, more women than men are likely to seek support jobs in industry rather than research careers at universities.9 In medicine, only a small percentage of women as compared to men pursue careers in academic medicine or the demanding surgical specialties.10 In business, women are more likely than men to start a small business rather than pursue a climb up the corporate ladder.11 In the university world, a huge leak in the pipeline occurs between graduation from doctoral programs and the successful attainment of a university position. Women who are married and women who have children are far less likely to pursue an academic research career. In contrast, single women compete toe to toe with men in getting that ﬁrst job.11 A Berkeley doctoral graduate who waited until after graduation to have children but did so before beginning her academic career says that her priorities changed after experiencing parenthood: After completing my PhD, I decided to try to get pregnant and try to have a child but keep my foot in the door; it took me longer than I thought to get pregnant, more than a year. I was lecturing and doing research and publishing, and I was only working half time. I began to think that I did not want to have a 60-hour-a-week job for the next 7 years and not be able to be part of raising my child. I think I went into it all so naively—into graduate school thinking a faculty position would be a great way to have kids, that there is ﬂexibility and open summers. As I began to see professors who had kids totally strung out and stressed out, I began to realize ‘‘Wait, I am not going to do that!’’

The Make-or-Break Years: Ages 30 to 40 For all young careerists, their 30s are their make-or-break years, but for women these are the decisive years for motherhood as well. The vast majority of women will have their children during this period if they have children at all— very few women have children after age 40. Sixty-four percent of all ﬁrst babies born to college-educated women in 2000 occurred in this critical decade.12 These are the years when women’s biological clocks collide with their

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career clocks. During this critical decade, men and women seriously diverge on their respective career tracks and family tracks—the result of the events of marriage, divorce, childbearing, and child rearing. The demands of a ﬁrst job in the fast-track, male-dominated professions are daunting. These professions are structured on a nineteenth-century competitive male model and are designed to weed out the less capable early on, during the probationary years. This model emphasizes endurance above all else, and a major measure is grossly quantitative: time spent on the job. In the legal world, the race to partnership, a track stretching from 5 to 10 years, deﬁnes the probationary period for most ambitious young lawyers. The new associate, under the supervision of a partner, must put in a workweek of speciﬁed billable hours plus an unspeciﬁed number of hours of networking with clients and partners to prove he or she is partnership material. The university world supports an arcane but enduring procedure for achieving tenure, a status that offers lifetime security. A new assistant professor must prove that she is a good teacher, that she is a good citizen in the department, and, most of all, that she is a rising star in the research world. When the time comes for deciding the fate of the acolyte, usually after 6 years, a semitransparent process occurs in which her publications, which must be numerous, are meticulously scrutinized at several anonymous levels within the university. Finally, a thumbs-up or thumbs-down is issued from on high. Medicine is different. The residency following medical school is both a continuation of the training period and a ﬁrst job. Residencies stretch from 3 to 7 years or longer, depending on the specialization, and they are famously grueling, though they may be improving somewhat. A recently enacted national regulation limits residents’ hours to 80 per week; this standard was put in effect following the death of a legislator’s child at the hand of a sleepdeprived ‘‘zombie’’ resident.16,17 Residents who perform well on this proving ground are recommended for the plum positions. Joining the faculty of top medical schools, the centers of cutting edge research, is considered by most to be the pinnacle of the profession. But a resident who takes an academic position starts as an assistant professor and, like all new faculty, must endure another 6 or 7 years on the tenure track. These hardy physicians are enduring, in effect, their second probationary period. In the corporate world, an MBA has some weight in the assessment of an individual but is not a requirement for entry or for success. In the ﬁnancial world, a broker’s success is measured by the bottom line of the portfolio he or she manages. There is no prescribed number of years to reach the next level as there are in the professions. But these dynamic meritocracies do not offer ultimate security of employment as do the professions. There is no tenure or partnership, and increasingly even venerable corporations do not honor lifetime loyalty—20-year employees can be dismissed alongside 6-month employees. In some important ways, the probationary period never ends.

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Make-or-Break Motherhood

What all of these professions have in common is that their probationary years are extremely demanding in terms of time. But these demands affect men’s and women’s personal lives differently. Simply put, the more hours a woman works, the less likely she is to have children, while the more hours a man works, the more likely he is to have children. The U.S. Census Bureau’s 2000 sample18 includes roughly 5% of American households, or about 14 million people. Survey questions included how many hours each respondent worked each week and whether there were children in their household (up to age 18). The data were striking. Among those men and women professionals who worked the fewest hours (1 to 29 hours per week), about 82% of the women had children, but only 55% of the men. At the other end of the spectrum, of those who worked 60 or more hours a week, 74% of the men had children in the household but only 49% of the women did. It is easy to understand why women who work longer hours are less likely to have children, but what about men? Why does their fertility increase with the number of hours they work? Part of the answer may be that men are still perceived as the primary breadwinners. In the professions, hours worked translate into economic beneﬁts. These beneﬁts allow men to support not only their children but also wives or partners who do not work full time. The evidence that this occurs is stunning. In the university world in 1999, 52% of male professors in the sciences and social sciences had wives who worked parttime or not at all, while only 9% of women professors had partners who worked less than full-time.19 These ﬁndings dovetail closely with the largest study of global executives, which revealed that 75% of men surveyed have a spouse=partner who is not employed at all.20 There are occasional exceptions. One young female associate lawyer reversed the roles and is the breadwinner while her husband stays home: If we had both kept working at law ﬁrms, our schedules would not have been very ﬂexible, especially if we were both in a crunch time where we had to work late. The childcare is expensive and one of our salaries would have to go directly towards it. My family is the priority, and if that means I am not going to make partner, then that means I am not going to make partner. If it came down to it I would choose family. When I ﬁrst went back to work I had a little pang of guilt, which I do not think men feel. But my sister asked me whether I harbor resentment toward our dad for working and I thought, no, I never did.

Marriage rates reveal the same paradox. The more hours a man works, the more likely he is to marry, and the less likely he is to divorce. By age 40, the end of the ‘‘make-or-break’’ years, roughly 80% to 90% of men who work 40 or more hours a week are married. Chief executives ofﬁcers are most likely to be married, and professors, least. Conversely, over age 40, only 54% to 72% of women are married, with female chief executive ofﬁcers and physicians leading the pack and female professors and lawyers trailing. Over the next 20

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years, into middle age, more men remain or become married, while women experience a higher divorce rate and more become unmarried.18 Probably few women who begin their probationary years in law, medicine, academia, and other fast-track professions have examined the 2000 Census results, but they can look around in their work setting and realize that the playing ﬁeld is not level. Because they are not the primary caretaker, men can have children and still work full-time at their careers. Some women seem able to do this as well—but they are fewer in number. So long as part-time tracks are generally seen as career graveyards, there can be little middle ground between career success and full-time devotion. Women in their make-or-break years make major life decisions with limited choices. Four main paths are available to them: they can defer or forego motherhood, they can drop out of their profession entirely, they can drop into a second tier, or they can stay the course and struggle to balance work with family life. One survey of female Stanford University MBA graduates from 1975 to the present provides a glimpse into the fastest track of businesswomen. Stanford MBAs are the young elite, groomed for the top corporate positions. These students have already shown early promise as future corporate leaders. For these women MBA holders, 60-hour weeks and frequent work-related travel are the norm. During the 1970s, there were few women in this prestigious graduate program; the number of female students climbed to nearly 40% in the 1990s. Of the women who had children in this group (about half ), 47% worked full time, 46% worked part time, and only 7% labeled themselves as ‘‘stay at home’’ (what some now refer to as ‘‘opt out’’) mothers.21 The full-time working mothers, many of them on the fastest track, expressed the highest level of contentment. They worked long hours but had little ambivalence about their career course. A mother who is a partner in a major law ﬁrm expressed her feelings about achieving success in both arenas: I don’t make the most money, but my life is my whole life. My life is my children and my work and my relationship with my husband, and all of that is ﬁne. You come to some realization of that and then it is all right and you have to stop killing yourself and beating yourself up if you are not the most this, if you are also partly that.

Mothers who professionally survive the make-or-break years—and roughly half do—are generally ambitious and diligent, and they tend to go on to full careers. But the most striking commonalities that seem to predict their longterm success are supportive partners, conﬁdence, time management skills, and a realistic understanding that they cannot ‘‘have it all.’’ Senator Diane Feinstein described for us the key role marriage security plays in career success: My personal life early on was not in order at all. I had a marriage that was not a good marriage and then I was divorced with a small child. I had very little money and I had to make my way with great difﬁculty. It really was not until I met my

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Children in Families husband, Bruce Feinstein, that I could work on my ambitions. In 1969 I ran for the board of supervisors. My family life was secure, and I had a ﬁnancial base— my husband. I do not believe I could have done it without the stability and support. I think the most important thing for a woman who wants to combine her career and family is the man she marries—that he is secure in his own right and he is proud of what she does.

Recently, the media has put across critiques of successful career mothers who ‘‘opt out.’’22 The thrust of certain coverage is that successful professional women, married to afﬂuent men, have made the choice to abandon their professions in order to stay at home with their children. This is often mentioned alongside ‘‘new momism,’’ said to be a cultural swing toward an intense focus on full-time parental participation in child rearing—and that parent is usually Mom. While the ‘‘opting out’’ story has been the focus of media attention, the larger and perhaps more important story is that many more women drop into the amorphous second tier of their profession or move into a marginalized part-time track. The Second Tier

For many women, the second tier has become the default ‘‘mommy track.’’ The second tier includes a wide range of jobs, from well-compensated positions with reduced hours in health-maintenance organizations or biotechnology ﬁrms to part-time lecturer positions that carry no security or beneﬁts. There are many virtues of a less time-consuming alternative, but in the current workplace, many of these jobs are insecure, underpaid, undervalued, and dead-end. What second-tier jobs have in common is that mothers are overrepresented in them and there is no track to the top. There is little opportunity for signiﬁcant career advancement and almost no chance to return to a fast track. The second tier is the fastest growing sector of all the fast-track professions and reﬂects larger shifts toward a more ﬂexible, less permanent work force. Recently, the American Association of University Professors declared that for the ﬁrst time the majority of undergraduate courses were being taught by parttime or adjunct faculty. The university world, following the lead of corporations, has moved toward a ‘‘ﬂexible’’ workforce with fewer tenured positions and a reliance on part-time or contract workers, who are likely to be mothers with doctorates. Many workers, both men and women, are not interested in the frantic pace that usually characterizes rising to the top of the profession. But the disproportionate number of mothers in the second tier suggests that it is not always a matter of personal ‘‘choice,’’ even when the worker believes it is. And some who ‘‘choose’’ the second tier do not always realize that there is rarely a way back. Still, for some women it is a happy compromise. One family-practice physician with a small child took a part-time teaching position and is pleased with her more limited schedule:

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Most choices I made about my career in terms of part time and being a family doctor had less to do with family and more to do with having a life outside of work. I want to do other things with my life. All my friends were overworked and over-stressed in the residency program. A good friend had two children and it was brutal. Her kids were angry at her and she was tired at work; she could do neither well.

In some cases, falling off the fast track can be creative and liberating. Some mothers take advantage of their skills and their relative freedom to create new businesses, to start new nonproﬁt organizations, or to write the books they could not undertake as media executives. ‘‘Second tier’’ does not adequately describe these innovative creators, even if they no longer garner the institutional status and income they once commanded. ‘‘Second tier’’ also does not do justice to those who choose to use their skills to create a better world in the nonproﬁt or volunteer sectors. Women in business are more likely than men to leave the larger corporate world to start or join a new business; this can be anything from a bookstore to a software company to a new line of clothing products. Perhaps the best-known woman entrepreneur, Martha Stewart, broke away from traditional publishing to start her own line of products. Women leave traditional corporate jobs for many reasons, such as a belief they are stuck in middle management limbo with no prospects for advancement, a hostile or uncaring boss or workplace, and, most prominently, ‘‘family responsibilities,’’ which may include relocating for a spouse with a corporate position. A Catalyst study of women entrepreneurs found, not surprisingly, that 82% of the group had children.14 Still, for many mothers, a part-time, adjunct, or less-than-full-partner status does not continue to be satisfying. When their children are older and they are freer, they often want to become full participants once again. One long-term adjunct faculty member described her frustration in trying to return to the fast track after she had raised her children: What was very clear to me was that for an older woman applying for a tenuretrack job, I put myself forward saying, ‘‘I know that I haven’t published, I also know that it is easy for me to do it, that I am at a time when I am not taking care of kids anymore, and that I would point myself in that direction.’’ It was also clear that they would not see me that way; they saw someone who has been in the system a long time and has not produced. It is very clear to many of us as part-time people in the academic system that it is not a good route to a tenure track position. They hire out.

Most law ﬁrms have created categories called ‘‘special counsel,’’ or nonequity partners, where lawyers work on an hourly basis but do not share in the ﬁrm’s proﬁts.23 Few ﬁnd these career options acceptable. One senior partner commented, It is a very unsatisﬁed group, holding a low status in the ﬁrm and with a confused presentation to the world. They do not have the perks of being a shareholder, but

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Children in Families they do not have the anxieties either. It is not a situation which the ﬁrm promotes; it is a ‘‘side track from the fast track,’’ and one which is a compromise rather than a viable alternative to the full time.

Why do these alternative tracks—‘‘mommy tracks,’’ as they are frequently referred to with derision—fail to provide the respected and desired choice fervently wished for by those who fought for them in the early, heady days of the women’s movement? In part, it is because they are not well supported. In one study, 60% of all respondents who worked part time reported that no one at their ﬁrm worked with them to develop their part-time work arrangement. They also reported that they were usually excluded from decision-making committees and social events. Not every ‘‘side-track’’ experience is rated negatively, but the overwhelming majority of respondents believe that the transformation of the workplace in this respect is still a distant goal.23

Beyond the Glass Ceiling: Ages 40 to 65 and Over Mothers who persevere through the ‘‘make or break’’ years arrive at the heart of their career, the 25 or more years of service before retirement. They have prepared for this stretch for nearly 20 years, through graduate school, apprenticeships, and the ﬁerce competition of the probationary period. During their ‘‘make or break’’ years, they have balanced childbirth and infant care with high-pressure career demands. By this time, most have the relative security of a good position with seniority—for example, tenured professor, chief of staff, law partner, or senior editor. Most will live out their career lives in a productive, satisfactory mode, rising in their professions to take on more responsibility and achieve greater recognition. But those women who achieve satisfying careers are far less likely than their male counterparts to have children. Roughly 60% of women at this level have children; this holds true for top women executives, tenured professors, law partners, and elite women members of the National Academy of Sciences.24 By contrast, around 75% to 85% of men in these top positions will have children. The census does not provide any data that would allow you to differentiate between individuals who have made it through the glass ceiling. Our pie charts for tenured professors included in our ‘‘Do Babies Matter? II’’ article are the closest to this.2,18,19,25 The disparity in parenthood is largely a result of the decisions made during the ‘‘make or break’’ years, when women left or were forced off the fast track. Still, this fact seriously tips the equity balance.25 The balance tips further in favor of men at the top. Some of these mothers will continue their trajectory to the very pinnacle of their profession: senator in the U.S. Congress, president of a university, dean of a medical school, chief executive ofﬁcer of a major company, member of the National Academy of Sciences. But women are far less likely to reach these top positions than are their male peers.

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What happens after those ‘‘make or break’’ years? Why do women, mothers or not, continue to lag behind men in terms of career success? And why, when they achieve a degree of success, are they not rewarded equally? In all of these professions, in addition to the lonely numbers at the very top, there is a well-documented disparity between the pay that senior men and senior women receive. Women executives receive 72 cents on the male dollar in corporate America,26 women partners in law ﬁrms take home 68 cents,24 and women physicians earn 65 cents on the dollar compared with men.27 Twenty years ago, the Wall Street Journal coined the phrase ‘‘glass ceiling’’ to describe the apparent barriers that prevent women from reaching the top of the corporate hierarchy. In 1995, the federal government’s Glass Ceiling Commission reported that women held more than half of the master’s degrees awarded in the United States and 45.7% of America’s jobs. Yet 95% of senior managers were men, and female managers’ earnings were, on average, a mere 68% of their male counterparts’ earnings. Ten years later, in 2005, women accounted for 46.5% of America’s workforce and for less than 8% of its top managers, although at large Fortune 500 companies the ﬁgure is a bit higher. Female managers’ earnings now average 72% of their male colleagues’ earnings. Since 1998, the ﬁgures have stagnated, and, overall, the trajectory is not promising.24 It is not as clear who is included among those at the very top in other professions as it is with the deﬁnitive pecking order of chief executive ofﬁcer, chief ﬁnancial ofﬁcer, and chairman of the board of a Fortune 500 company— titles that reﬂect known salary scales. Is the heart surgeon who invents new techniques and earns a large salary above the dean of the medical school? Is a Nobel Prize winner more powerful than a university president? No matter which criteria you use—fame, fortune, or power—there are relatively few women in these top positions. Only 5% of managing partners in large law ﬁrms are women28; women account for less than 10% of deans of medical schools,29 and about 10% of National Academy of Science members, the elite group that represents the pinnacle of prestige for scientists. And those women who hold respectable ranks slightly below these top positions—law partner, full professor, and chief of staff—are still a minority compared with men, and are signiﬁcantly less well paid. The usual explanation for why there are not many women at the very top focuses on the exclusionary style of the ‘‘old boys’’ network. But our research, and the research of others, reveals that family issues continue to play an important role in determining whether women rise through the ‘‘second glass ceiling’’ to the jobs at the very top. Family considerations also have a strong inﬂuence on the salary a woman commands. Keeping up with teenagers, care of aging parents, and a higher likelihood of divorce—twice as high among university professors—are signiﬁcant family issues faced by women later in their careers. Family responsibilities do not end once the children are in preschool. Many women interviewed for our study expressed a desire and need to be involved with parenting throughout the life course.

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Mobility is still a major concern at this stage, as it is for two-career couples just starting out in their professions. Advancement to the very top in the corporate world, in academia, and in science and engineering is often a question of taking advantage of the best offer. Even if the professional ultimately chooses to stay where he or she is, the threat of a move is a strategic weapon used to force the institution to make a better offer. Women are notably less inclined to negotiate on their own behalf; recent books, such as Babcock and Laschever’s Women Don’t Ask: Negotiation and the Gender Divide,30 have endeavored to teach women this valuable skill. Career advancement depends on a mix of many factors, including merit, strategy, and negotiation. The consequences for mothers are both immediate and incremental. They do not move to a better opportunity, nor do they receive credit for remaining at their positions, and, over the years, the missed opportunities and deferred negotiations cost working mothers dearly. A major factor in the gender disparity in salaries, even at the highest levels, is women’s reluctance to play ‘‘the moving game.’’ Also, the conﬁdence to say no is a critical tool in creating more ﬂexible time management and enabling working mothers to handle both careers and family life. Saying no to evening meetings and business trips is a difﬁcult but important need. Sometimes working mothers are able to handle these commitments when their employer accommodates them. The University of California is planning to offer a policy to offer travel allowances for small children whose mothers or caretaker fathers deliver papers at conferences. Such accommodations are not always available, however, and mothers must ﬁnd other ways to keep up with work. Although ‘‘gender discrimination’’ is often blamed for women’s inability to get promoted in male-dominated ﬁelds, this factor is often confused with ‘‘maternal discrimination.’’ Mothers are not expected to give ﬁrst priority to their job, and therefore they are often simply not considered for promotions. And women who adopt an aggressive, ‘‘male’’ behavior pattern are sometimes rejected because they do not ﬁt the nurturing ‘‘motherly’’ stereotype. Maternal discrimination is the basis for a new line of lawsuits brought under federal sex discrimination statutes.31 Despite some new ‘‘family-friendly’’ employment initiatives, the increased pace of work in many ﬁelds has put new strain on mothers, even when they are at the top. One long-time senior executive in the corporate world, a major player with large Fortune 500 companies such as Mobil and Phillip Morris, says increasing work pressures led her to retire early in 2002 after her children were grown: There were extraordinary dynamic changes in culture that made life very difﬁcult; the digital revolution happened in 1995, e-mail came along, and with that came a pick-up in the work. When I left in 2002 I became convinced that the pace of work was so grindingly tough with the late nights and weekends that it would be impossible to have the sort of quality of family life I had experienced

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with my kids. The prime reason for me taking early retirement was family related—I had never walked out of a work-related situation before—because I knew I would probably barely make it to my daughter’s wedding or son’s graduation if I had not done something dramatic.

The percentage of women at the very top has grown in recent years but it is by no means proportional to the numbers pouring into the ﬁelds. This is not just a time lag. As we have seen, women—mostly mothers who have been waylaid at all steps—continue to be stuck in the second tier. Nonetheless, the increase in women at the top encourages a new perspective and new initiatives regarding the structure of the workplace. The ﬁrst woman president of Princeton University, Shirley Tilghman, appointed in 2004, famously argued that the tenure system should be dropped because it is ‘‘no friend to women.’’ It makes huge demands on women at a time when many of them are already stressed out with young families.32 Generations

A striking discovery from our interviews is the strength of the generational differences. ‘‘The Pioneers’’ were the ﬁrst generation to take advantage of the opening of the professional gates to women, and they entered in great numbers. The subsequent generations, now in their 20s, 30s, and early 40s, believe their choices are unique to them and determined by personal circumstances. They have little sense of being part of a movement or of the battles that women have fought to open doors for them. The older generation, now in their late 40s, 50s, and 60s, are more aware of the cultural and economic forces that controlled, and continue to control, women’s choices. Most of the older professional women realize that they had the support of a collective movement of women who were struggling for more opportunities. A second striking discovery is that across the generations, the strategies used by successful mothers to climb to the top of their profession, whether or not they believed they were lone rangers or part of a movement, are impressively similar; so are the roads taken by mothers who drop out of the race. An interesting new trend is that the newer generation is decidedly less willing to sacriﬁce family time for work time. A recent national study by the Families and Work Institute33 reported that younger workers, both men and women, are more likely to be ‘‘family-centric’’ or ‘‘dual-centric’’ (with equal priorities on both career and family) and less ‘‘work-centric’’ (putting higher priority on their jobs than family) compared to members of the Baby Boomer generation. Both women and men have become more conscious of the personal tradeoffs they have to make in order to advance their careers. An increasing number are instead choosing to tread water in their careers, rather than continue moving up the career ladder. Young fathers are spending more time with their children than they did in 1977—more than an hour more per day than Boomer fathers.33 They are not,

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however, taking over Mom’s second shift; mothers are spending the same number of hours doing childcare and domestic duty as they always have. This may be the generation that changes the workplace by voting with their feet, insisting that the workplace accommodate families, rather than that families accommodate the workplace. This may be the generation who decides that any time is, and should be, a good time to have a baby.

Notes 1. Mason, M. A., & Goulden, M. (2002). Do babies matter? The effect of family formation on the lifelong careers of academic men and women. Academe, 88(6), 21–27. 2. Mason, M. A., & Goulden, M. (2004). Do babies matter? (part II): Closing the baby gap. Academe, 90(6), 3–7. 3. National Center for Education Statistics (NCES). (2001). The Integrated Postsecondary Education Data System (IPEDS) completion survey. Washington, DC: NCES. 4. Hoff Somers, C. (2000). The war against boys: How misguided feminism is harming our young men. New York: Simon & Schuster. 5. Hill, S. T. (1999). Science and Engineering Degrees: 1966–96 (NSF 99–330), tables 11, 18, 25. Arlington, VA: National Science Foundation, Division of Science Resources Studies. 6. National Center for Health Statistics. (2002). Vital statistics of the United States: Natality 1970, births: Final data for 2000. Retrieved September 13, 2007, from http:==www.cdc.gov=nchs=births.htm. 7. Babco, E. L., & Jesse, J. K. (2003) What does the future of the scientiﬁc labor market look like? Looking back and looking forward. Retrieved September 13, 2007, from http:==www.cpst.org=STEM=Future.pdf 8. National Science Foundation (NSF). (2003). Doctorate recipients from United States universities: Summary report 2003. Arlington, VA: NSF. 9. Hoffer, T. B., Welch, V., Jr., Webber, K., Lisek, B., Hess, M., Loew, D., et al. (2005). Doctorate recipients from United States universities: Summary report 2005. Chicago: NORC at the University of Chicago. 10. American Women’s Medical Association. (1996). Maternity leave during training. Retrieved September 13, 2007, from http:==www.amwa-doc.org=index.cfm? objectId¼0F379CED-D567-0B25-543D6436BB879B90. 11. Wolﬁnger, N. H., Mason, M. A., &, Goulden, M. (2004). Problems in the pipeline: Gender, marriage, and fertility in the ivory tower. Paper presented at the annual meeting of the American Sociological Association, San Francisco. 12. Etzkowitz, H. (1994). Barriers to women in academic science and engineering. In W. Pearson, Jr., and I. Fechter (Eds.), Who will do science? Educating the next generation. Baltimore: Johns Hopkins University Press. 13. Brundtland, G. H. (2000). The woman physician in the year 2000. JAMWA, 55(1), 3– 4. 14. Catalyst. (1998). Women entrepreneurs: Why companies lose female talent and what they can do about it. New York: Catalyst. 15. National Center for Health Statistics. (2002). Vital statistics of the United States: Births: Final data for 2000. Retrieved September 13, 2007, from http:==www.cdc .gov=nchs=births.htm.

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16. Accreditation Council for Graduate Medical Education (ACGME). (2007). ACGME duty hours standards fact sheet. Retrieved September 13, 2007, from http:== www.acgme.org=acWebsite=newsRoom=newsRm_dutyHours.asp. 17. Hoffman, J. (1995). Jurors ﬁnd shared blame in ’84 death. New York Times, February 7, B1. 18. U.S. Census Bureau. (2003). Census 2000. Washington, DC: U.S. Census Bureau. Public Use Microdata Sample (PUMS), United States. 19. Mason, M. A., & Goulden, M. (November, 2004). Marriage and baby blues: Redeﬁning gender equity in the academy. The Annals of the American Academy of Political and Social Science, 596, 86–103. 20. Galinksy, E., Salmond, K., Bond, J. T., Kropf, M. B., Moore, M., & Harrington, B. (2003) Leaders in a global economy: A study of executive women and men. New York: Families and Work Institute. 21. Zappert, L. T. (2002) Getting it right: How working mothers successfully take up the challenge of life, family and career. New York: Simon & Schuster. 22. Belkin, L. (2003). The opt out revolution. New York Times Magazine, October 26. 23. Employment Issues Committee of the Women’s Bar Association of Massachusetts. (2000). More than part time: The effect of reduced-hours arrangements on the retention, recruitment, and success of women attorneys in law ﬁrms. Retrieved August 27, 2007, from http:==womenlaw.stanford.edu=mass.rpt.html. 24. Wasserman, E. (2000). The door and the dream: Conversations with eminent women in science. Washington, DC: Joseph Henry Press. 25. [Anonymous]. (2005). The conundrum of the glass ceiling. The Economist, July 21. 26. Noonan, M. C., & Corcoran, M. E. (2004). The mommy track and partnership: Temporary delay or dead end? The ANNALS of the American Academy of Political and Social Science, 596, 130–150. 27. Boulis, M. (2004). The evolution of gender and motherhood in contemporary medicine. The Annals of the American Academy of Political and Social Science, 596, 172–206. 28. Rhode, D. L. (2001). The unﬁnished agenda: Women and the legal profession (p. 14). Retrieved September 13, 2007, from http:==www.abanet.org=ftp=pub= women=unﬁnishedagenda.pdf. 29. Coffman, D. (2005). Women deans optimistic about increasing their numbers. AAMC Reporter. Retrieved September 13, 2007, from http:==www.aamc.org= newsroom=reporter=feb05/deans.htm. 30. Babcock, L., & Laschever, S. (2003). Women don’t ask: Negotiation and the gender divide. Princeton: Princeton University Press. 31. Williams, J., & Segal, N. Beyond the maternal wall: Relief for family caregivers who are discriminated against on the job. Harvard Women’s Law Journal, 26, 77, 95. 32. Marshal, E. (2001). Shirley Tilghman: Princeton’s unconventional new chief. Science, 292(5520), 1288. 33. Families and Work Institute. (2003). 25-year trend data facts. Retrieved August 27, 2007, from http:==familiesandwork.org=site=comparedata.html.

5 Motherhood, Work, and Family Policy Neil Gilbert

During the past 30 years, the role of motherhood has contracted throughout the advanced industrialized world on three planes—(1) fewer women are having any children; (2) among women having children, more are having just one child; and (3) women having children are spending more time working outside the home.1 This trend extends well beyond the borders of the United States. Indeed, contrary to what one might expect, the birth rates in western European countries have fallen even lower than those in the United States—despite Europe’s more powerful arsenal of family-friendly policies. In this chapter, I analyze the most recent developments in the realignment of work and family life, the broader trends since the mid- 1970s, some of the reasons advanced for these trends, and several interpretations of how family-friendly policies designed to harmonize work and child rearing may have impacted these developments.

Who Is Opting Out of What? Not too long ago, caring for their children was unquestionably the most important activity that women performed in society. Prior to the 1960s, it was customary for mothers not to work outside the home—a convention acknowledged and reinforced by social policy. Thus, the Aid to Dependent Children’s (ADC) program, under the Social Security Act of 1935, gave cash grants to women who were single parents so they could stay home and care for their children.2 All this began to change after the 1960s, as normative views and 98

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policies concerning the role of motherhood shifted in response to feminist demands for social and economic equality—and, some might add, labor-force needs. By the late 1990s, women were having fewer children, and mothers were increasingly delegating child care responsibilities to others as they entered the paid workforce in historic proportions for peaceful times. Since the dawn of the twenty-ﬁrst century, however, word has been spreading that a revival of home care is underway, with women returning in droves to domestic life, leaving lucrative careers to give birth and raise their children. Reports of this trend have received considerable media attention, which crystallized in 2003 into news of an ‘‘opt-out revolution.’’ Lisa Belkin’s New York Times Magazine article3 about accomplished professional women leaving highpowered jobs to stay home with their kids foreshadowed the coming of a new era—and raised quite a commotion in the feminist community. The accounts of an opt-out revolution cite some empirical signs of a trend, such as the fact that 22% of mothers with graduate degrees are at home with their children, one in three women with an MBA does not work full time, and 26% of women approaching the most senior levels of management do not want to be promoted. Yet cross-sectional data that provide a snapshot of facts at one point in time do not tell us about how things may be changing— whether there is a revolution afoot or, if so, the direction in which it might be headed. With cross-sectional snapshots of this sort, one would need a Ouija board to detect a social trend. To what extent has the proportion of mothers with college and graduate degrees who stay home with their children varied since 1970? Belkin3 notes that 57% of mothers from the Stanford University class of 1981 stayed home with their young children for at least 1 year in the ﬁrst decade after graduation. There is no indication, however, of whether that high percentage of mothers at home has increased, decreased, or remained the same over time. And even if there has been an increase since 1970 in the percentage of women who stay home after obtaining graduate degrees from elite universities, one must bear in mind that the proportion of women with graduate degrees in 1970 was signiﬁcantly lower than it is today. The most serious evidence of change over time, as shown in Figure 5.1, is the leveling off of female labor-force participation in 1998, which turned into a slight decline of 0.8% between 2000 and 2004. Women aged 25 to 54 accounted for 69% of the female labor force in 2004. Among women in this age group, the decline in labor-force participation was 2 percentage points—much of it attributed to changing behavior of college-educated, married women with children under the age of 3.4 (The rate of decline for college-educated women with young children was 8%.) The reasons for this decline are not clear. A fraction of the change is attributed to the slightly higher unemployment rate in 2004. After carefully estimating the impact of changes in measurable characteristics such as educational attainment, marriage, childbearing, race, income, and unemployment rates, Julie Hotchkiss5 concludes that factors that economists usually rely on simply do not explain the decline in women’s laborforce participation between 2000 and 2004.

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Figure 5.1. Labor force participation rates over time. Source: Bureau of Labor Statistics.

At the moment, predictions of an opt-out revolution in the next generation lean on thin data over a limited period of time. Viewed in a broader context, the more compelling story of change illustrated in Figure 5.1 involves the long-term trends of a steady increase in the labor-force participation of women alongside the equally steady decline in the percentage of men in the labor force. Not only has there been a signiﬁcant increase in the percentage of women joining the labor force over the last generation, but these women are coming with more powerful credentials. The main difference between women in the 1970s and today is that a substantially higher percentage are currently obtaining high-status professional degrees and completing graduate education in general. Between 1970 and 2002, the proportion of all medical, law, dentistry, and business administration degrees awarded to women increased by almost 529% for medical degrees, 888% for law, 4,277% for dentistry, and over 1,000% for business.6,7As women have entered the labor force with more educational preparation, they have increasingly expressed a bent for entrepreneurial activity. Between 1997 and 2004, the number of companies owned by women climbed by 20%—twice the growth rate in the total number of U.S. businesses. Similar to most businesses, the vast majority owned by women were single-person enterprises.8 From a longitudinal perspective, the women currently opting out of jobs and professional careers in order to stay home with their children are nibbling at the margins of a profound lifestyle trend that has extended over the past several decades—a development deftly portrayed (some might say celebrated)

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in the media. After a 6-year run, the popular HBO series Sex and the City ended in 2004 with what was widely regarded as a happy ending. Each of the four heroines, in their late 30s or early 40s, found love and commitment while pursing a gratifying career. The series ﬁnale was a paean to love and individual fulﬁllment. But as for family life, these four vibrant, successful women approaching the terminus of their childbearing years ended up with only two marriages and one child between them. As a mirror of society, the media shift from kids bouncing off the walls in The Brady Bunch to the 25% fertility rate in Sex and the City several decades later clearly reﬂects the cultural and demographic trends over this period. Today, almost one in ﬁve women in their early 40s is childless. As shown in Table 5.1, that is close to double the proportion of childless women in 1976. Compared to the relatively few Ivy League law graduates who have traded the bar for rocking the cradle, the abdication of motherhood poses an alternative and somewhat more compelling answer to the question, ‘‘Who is opting out of what?’’ Women are increasingly having fewer children, and a growing proportion is choosing not to have any children at all. The increasing rate of childlessness is not unique to the United States. The proportions of childless women aged 40 in Britain, Austria, Switzerland, and Sweden are about the same as that in the United States.9 Family size is shrinking amid declining fertility rates in the advanced industrial democracies. Although the U.S. fertility rate fell from 2.48 in 1970 to 2.06 in 2000, it remains higher than those of all of the European Union countries, among which Italy and Spain have the lowest birth rates (about 1.3).10 Norway, with one of the highest fertility rates (1.8) in Europe, comes closest to the United States.11 Not only are women having fewer children, but mothers are increasingly delegating child care responsibilities to others. Both poor and nonpoor mothers

Table 5.1. Percent Distribution of Women 40 to 44 Years Old by Number of Children Year

0

1

1976 1980 1985 1990 1995 1998 2000 2002

10.2

9.6

17.9

Number of Children 2 3 or more 21.7

17.4

58.6

35.4

29.3

Source: Downs, B. (2003, Oct.). Fertility rate of American women: June 2002. Current Population Reports. U.S. Census Bureau, Table 2.

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are leaving the daily care of their preschool children to other people. Between 1991 and 2001, the proportion 3- to 5-year-old children supervised by caregivers other than their parents increased from 69% to 74%.7 A signiﬁcant number of these children spent the better part of their days in out-of-home care. According to estimates from the Urban Institute,12 41% of all children under 5 years of age whose mothers are employed are in daycare for 35 hours a week or longer (the ﬁgure rises to 52% for those whose mothers work full time.) Do the dramatic increase in childlessness—from 1 in 10 to almost 1 in 5 women—and the rise in out-of-home care for young children qualify as a social ‘‘revolution?’’ It could be said that if women have been ‘‘opting out’’ of anything, it’s reproduction. The revolt against motherhood appears to be more deep-seated than the recent decline in labor-force participation brought to the public’s attention by the media reports about professional women trading high-powered careers for child-rearing activities. Still, the ebb in labor-force participation should not be dismissed too readily—it might be the ﬁrst ripple in a sea change.

Family=Work Lifestyle Alternatives Talk of social revolutions conveys a sense of fundamental change in people’s values—a new awakening that is compelling women to substitute one type of life for another. Claims of an ‘‘opt-out revolution’’ from motherhood to the labor market, or the other way around, imply that whatever it is women really want, they all pretty much want the same thing when it comes to career and family. It may have looked that way in earlier times. Although the question of what women want has plagued men for ages, it became a serious matter for women only in modern times, and then only in the advanced, industrialized countries. Before the contraceptive revolution of the mid-1960s, biology may not have been destiny, but it certainly contributed to the childbearing fate of women engaging in sexual activity.13 Most women needed men for their economic survival before the equal-opportunity movement of the 1960s, which opened access to virtually all careers. Moreover, the expansion of white collar jobs and jobs for secondary earners since the 1960s has presented women with a viable range of employment alternatives to traditional domestic life. Taken together, these advances in contraceptive technology and civil rights, along with labor market changes, have transformed women’s opportunities to control and shape their personal lives.14 In today’s advanced industrialized world, decisions about the course of women’s lives—especially whether or not to have children and whether or not to seek paid employment—are governed less by biology and necessity than at any time in history. Thus, modern women can partake in a range of lifestyle alternatives heretofore unknown to all but a privileged few.

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What are these lifestyles? Taking family size as a powerful indicator of lifestyle alternatives, I can distinguish at least four general categories that form a continuum of work=family choices (Table 5.2). This classiﬁcation is an ideal type in the Weberian sense—an analytic frame, which encapsulates a set of essential characteristics that distinguish women’s family=work lifestyle choices. The categories are logical but by no means exhaustive,15 and, as with any typology of this sort, there are exceptions within every category. It helps to think of the categories as ‘‘usually, but not always.’’ At one end of the continuum are women with three or more children. Most of these women derive most of their sense of personal identity and achievement from traditional child-rearing responsibilities and from practicing the domestic arts. While their approaches to child rearing may differ, the constant that traditional mothers share is an abiding belief that the daily care and socialization of their children represent the most meaningful job in life—a job to which they are devoted full time and from which they draw a deep sense of personal accomplishment. Even if they do not all perform the job the same way, the time and value they attribute to it and the satisfactions derived place this work at center of their daily lives. There was a pronounced tilt away from the traditional side of the continuum as the proportion of women with three children at the end of their childbearing years sank from about 59% in 1976 to 29% in 2002. At the other end of the continuum, the number of women who are childless climbed to historic proportions, increasing almost 80% during the same period.16 In the past, high rates of childlessness have been attributed to intense poverty, poor nutrition, and the absence of men due to wars, but those conditions do not apply today, nor do modern rates of infertility explain the decline.17 Table 5.2. Family\Work Lifestyles: U.S. Women Aged 40 to 44 in 2002 Post-Modern

Modern

NeoTraditional

Family Size

Childless (17.9 %)

One child (17.4 %)

Two children (35.4%)

Three or more children (29.3 %)

Identity

Workcentered

Workoriented

Childoriented

Child-centered

Achievement

Professional and economic success

Career and socialization

Socialization and employment

Socialization, care, and household management

Policy-Oriented Interests

Employment opportunity

Employment opportunity and child care

Part-time work and caring beneﬁt

Supports for in-home care

Traditional

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This group is characterized by individualistic, work-centered women engaged in what might be called the ‘‘postmodern’’ lifestyle. Here, personal success tends to be measured by achievements in business, political, and intellectual life rather than in the traditional realms of motherhood and child rearing. Many of these women are among the high achievers in Sylvia Ann Hewlett’s book Creating a Life: Professional Women and the Quest for Children, among whom 42% were childless after age 40 (a ﬁgure that climbed to 49% among the women in her sample who earned $100,000 or more).18 The ‘‘postmoderns’’ are disproportionately well educated. An analysis of the women who graduated college in the late 1960s and early 1970s showed that 28% were childless by the time they reached 37 to 47 years of age in 1991, a rate that climbed to 50% among the women in that cohort of graduates who had active careers.19 In the middle categories, about 53% of women currently over age 40 have either one or two children. These women are interested in paid work but not so thoroughly committed to a career that they would forego motherhood. Although a bare majority, this group is often seen as representative of all women—and of the women who ‘‘want it all.’’ In balancing the demands of employment and family, women with one child normally tip the scales in favor of their careers, while the group with two children leans more toward domestic life. Thus, the women clustered around the center of the continuum are divided into two basic categories—‘‘neotraditional’’ and ‘‘modern’’—that vary in degrees from the traditional and the postmodern lifestyles. The neotraditional group contains families with two children whose working mothers are physically and emotionally invested more in their home life than in their jobs, which are often part time. Since 1976, the proportion of women over age 40 with two children has increased by 75% and currently amounts to about 35% of the women in that cohort. The modern family usually involves a working mother with one child; these women are more career oriented and devote greater time and energy to their paid employment than do neotraditional women. The proportion of women over 40 with one child has climbed by almost 90% since 1976, and currently amounts to 17% of the women in that cohort. As general types, the traditional, neotraditional, modern, and postmodern categories help draw attention to both the diversity of work and family choices and to how the size of these groups has shifted over the past three decades. Ideal types are like impressionist paintings. They portray sufﬁcient dimensions of a category to evoke meaning, but the borders are fuzzy and porous. So, let me repeat: in each group there are women who do not ﬁt the ‘‘ideal’’ type— childless women who do not work and women employed full-time with three or more children at home. Also, there are women in each group who would have wanted to be in another category, with more or fewer children than they have. Accident, illness, divorce, poor timing, and plain bad luck may have hampered lifestyle choices for some.

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Certainly some women would rather not go to work, and some would prefer to have additional children, but many of these women are compelled out of dire economic necessity to participate in the labor force and to have fewer children. For most people in the United States, however, I argue that what is often considered economic ‘‘necessity’’ amounts to a preferred level of material comfort—home ownership, automobiles, vacations, cell phones, DVDs, and the like. Poor people on public assistance tend to have as many children as the national average. Still, I grant that this point, of course, is debatable and requires more than a bald assertion to carry the case.20 For the sake of argument, however, let us accept that the tradeoff between higher levels of material consumption and a more traditional domestic life is more (although not entirely) a matter of individual choice rather than of economic survival. As noted, since the 1960s, women’s capacity to exercise choice in regard to family size was dramatically advanced by opportunities to control procreation through modern contraception, legalized abortion, and assisted reproductive technology. At the same time, their options regarding labor-force participation increased, which were followed by changes in family size and patterns of employment. This realignment of family=work lifestyles raises a question: Why does it at least appear that many women are opting out of or reducing their involvement in the role of motherhood? There are various ideas and hypotheses about the decline of motherhood.

It may be a matter of purely personal preference: Hakim14 argues that now that women are actually free to choose, there is a ‘‘normal distribution’’ among women in their preferences for motherhood—a small percentage do not want children, a medium-sized percentage want one or two children, and a small percentage want three or more children. With divorce rates high and people feeling vulnerable to unemployment and to global competition, women are increasingly insecure about the future and reluctant to start a family. Women want children as much as ever but have postponed getting pregnant in order to invest in increasing their human capital, which then makes it more costly to have a family—they wait too long and risk infertility or not being able to have more than one child. Normative expectations about what constitutes ‘‘the good life’’ are changing— with more emphasis being given to materialism and individual pleasures and less to the emotional joys and sacriﬁces of having children. The struggle to harmonize work and family life makes it difﬁcult to have children.

These possibilities are not mutually exclusive and may contribute in varying degrees to the realignment in family lifestyles. Although much could be said about each of these ideas, for now I would like to focus on the last one—efforts to harmonize work and family life—because it relates most directly to developments in social policy. In considering the struggle to harmonize work and

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family life, I will focus particularly on what we might learn from the European experience in using family-friendly policies.

Family-Friendly Policies: European Experiences Western European countries are well known for having a powerful arsenal of daycare and other family-friendly beneﬁts. For example, over 70% of the children from 3 years to school age in Belgium, Denmark, France, Germany, Italy, and Sweden are in publicly ﬁnanced child care.21 In contrast, the United States is considered a laggard in dispensing parental leave, daycare, and other public subsidies to reduce the friction between raising a family and holding a job. Since the early 1990s, however, the United States has been increasing public expenditures in child care programs. One estimate shows, for example, that between 1994 and 1999 public spending on child care climbed by almost 60%.22 Given the general direction of U.S. policy, it may be instructive to examine how motherhood and family life have fared in light of the changing levels of family-friendly beneﬁts available in the industrialized countries of the European Union. As female labor-force participation rates rose, public efforts were made in many European countries to reduce the friction between work and family life. One way to estimate the effects of these efforts is to ask, how did patterns of public spending on family-friendly services such as daycare, household services, and other family beneﬁts in kind vary with marriage and fertility rates? Although the pattern of spending on family-friendly beneﬁts rises and falls, overall the average rates of public expenditure on these beneﬁts as a percentage of gross domestic product increased from the late 1980s to the late 1990s. The average rates of spending had an inverse relationship with average fertility rates and showed a similar relation to marriage rates23 (Figure 5.2). Analyses conducted separately on each country show some variance from the overall pattern that emerges when averaging their results, particularly with regard to fertility rates, which had positive correlations with spending on family beneﬁts in 5 (4 of which were signiﬁcant) of the 15 countries. Family-friendly policies, of course, involve more than what is captured by the Organization for Economic Cooperation and Development (OECD) data on family beneﬁt expenditures. For example, over 70% of the employed women in the Netherlands work in part-time jobs that have beneﬁts similar to those of full-time employment, and Dutch children spend more days per year in school than do most elementary school students in the European Union. A thorough assessment of measures that weigh into efforts to balance work and family life would include parental leave, ﬂexible work schedules, number and length of school days, paid vacation time, and family allowances.22 Some of these beneﬁts are reﬂected in the OECD data on total public expenditures, analyses of which reveal patterns that parallel the ﬁndings noted above. That is, rates of total public expenditure between 1987 and 1997 are inversely

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Figure 5.2. Average fertility rates and family service expenditures as a percentage of gross domestic product of 15 European countries (1987 to 1997). Source: Eurostat. (1999). Eurostat Yearbook: A statistical eye on Europe (1987–1997). Luxembourg: Ofﬁce for Ofﬁcial Publications of the European Community; OECD Social Expenditure Database 1980 to 1997. (2000). Paris: OECD.

related to both fertility (Figure 5.3) and marriage rates. Still, even when total public expenditures are considered, there are many distinctions in the variety of measures that operate in different countries—which is to say that the ﬁndings that fertility and marriage rates generally declined as spending on family beneﬁts and total public expenditure have increased can only be taken as suggestive. But what do they suggest?

Believers, Skeptics, and Disbelievers Overall, these ﬁndings lend themselves to at least three broad interpretations— representing those who believe in the salutary effects of family-friendly policies, those who are skeptical, and disbelievers. It is clear in regard to the general direction of change that the increasing levels of family-friendly services did not reverse whatever forces—economic, normative, social=psychological preferences, etc.—were driving down fertility and marriage rates. Believers would argue, however, that although family-friendly policies did not appear to strengthen the formation of family life (by increasing the presence of children and marriage), in the absence of these beneﬁts the declines would have been even sharper—that is, these beneﬁts acted as a brake, slowing things up. As

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Figure 5.3. Average fertility rates and average public expenditure as percentage of gross domestic product of 15 European countries (1987–1997). Source: Eurostat. (1999). Eurostat yearbook: A statistical eye on Europe (1987–1997). Luxembourg: Ofﬁce for Ofﬁcial Publications of the European Community; OECD Social Expenditure Database 1980 to 1997 (2000). Paris: OECD.

evidence, one might point to the fact that in three of the countries—Denmark, Sweden, and Finland—that showed signiﬁcant positive correlations between fertility rates and public expenditure on family beneﬁts, the rates of expenditure were proportionately more than twice as high as that of most of the other countries. This suggests that the decline can be diminished if signiﬁcant resources are invested in family services. (One might add that Sweden also had the highest cohabitation rates, and some observers ﬁnd a general relationship between cohabitation and fertility rates.24) Invoking the mantra ‘‘Correlation is not causality,’’ skeptics ﬁnd little reason to assume that these policies are either friendly or unfriendly to families— and read the results as conﬁrming that family-friendly policies make no palpable difference. They point out that if indeed these beneﬁts served as a brake on declining rates of fertility and marriage, then one would expect to ﬁnd the lowest marriage and fertility rates in countries that lagged behind in the family-friendly beneﬁts, of which the United States is a prime example— except that the U.S. rates are higher than those of the European Union. Skeptics would no doubt refer to the history of children’s allowances in France, which were initiated under the Family Code of 1939 with the explicit goal of increasing the birthrate. Although the French birthrate increased considerably in the decades after World War II, during the same period the

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United States—with no children’s allowance—also experienced a dramatic rise in the birthrate, while the birthrate in Sweden declined despite its allowance system.25 The skeptic argues that decisions concerning marriage and family size address fundamental conditions of human existence and social expectations, which do not yield readily to the lubrications of social policy. Finally, disbelievers conclude that so-called family-friendly policies are not really friendly to family life. Rather, they argue that although the inverse correlations between expenditures on public beneﬁts offered to harmonize work and family life and fertility=marriage rates do not represent deﬁnitive explanations, they are indicative of two ﬁrm underlying realities. The ﬁrst is an unyielding tension between a life centered on family— meeting the continuous demands of marriage, child rearing, and household management—and a life centered on paid employment and meeting the continuous demands of a full-time career. As any woman who has tried it can testify, balancing paid work and family life demands extraordinary physical exertion and personal sacriﬁces on the part of most mothers during the early childhood years. Caring for young children is immensely labor intensive and relentless. A two-earner family with two children under 5 years of age hits the ground running between 6:00 and 6:30 AM; the kids have to be washed, fed, dressed, and out the door in time to get to the daycare providers well before the parents are due at their jobs. At 5:00 PM, the parents leave work and rush to pick up the kids and take them home to be fed, undressed, and put to bed. This tight daily routine can be further squeezed by jobs that require evening meetings, out-of-town travel, overtime, and take-home work. On top of the daily routine there is weekly shopping for the household, buying children’s clothes, cleaning, laundry, doctors’ appointments, haircuts, and coping with pinkeye, strep throat, and ear infections that regularly strike without warning. It does not take much for things to spin out of control—a dead car battery, a broken washing machine, or a leaky roof will do it. Although many men have increased their involvement in domestic life (whether due to genetic indisposition, poor socialization, ineptitude, or some combination thereof), their participation in traditional female duties has fallen far short of a fair share. The empirical reality is that most working mothers continue to assume the brunt of household and child care responsibilities. And with all the working mothers’ efforts, at the end of each week, their young children have spent the majority of their waking hours with their physical needs being met and their personalities being shaped by other people. The second reality is that the main threads of family-friendly policies are tied to and reinforce female labor-force participation—and would more aptly be labeled ‘‘market friendly.’’ These policies are largely, though not entirely, associated with publicly provided care for children and supports for periods of parental leave. To qualify for parental-leave beneﬁts, it is necessary to have a job before having children. The incentive for early attachment to the labor force is bolstered by publicly subsidized daycare. Child care services both compensate for the absence of parental child care in families with working

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mothers and generate an economic spur for mothers to shift their labor from the home to the market. In Sweden, for example, free daycare services are state subsidized by as much as $11,900 per child.26 They are free at the point of consumption but paid for dearly by direct and indirect taxes—in 1990, Swedish taxes absorbed the highest proportion of the gross domestic product of all the OECD countries. Paying in advance for the ‘‘ free’’ daycare service tends to squeeze mothers into the labor force, because the crushing tax rates make it difﬁcult for the average family to get by on the salary of one wage earner. State-sponsored social welfare activities accounted for about threequarters of the net job creation in Sweden between 1970 and 1990, with almost all of these public-service positions being ﬁlled by women.27 Thus much of the voluntary labor animated by a sense of family commitment and invested in care for children, disabled kin, and elderly relatives was redirected to providing social care to strangers for pay. In sum, the disbeliever argues that the quality of family life suffers when mothers with young children go to work; hence, policies that create incentives to shift informal labor invested in child care and domestic production to the realm of paid employment are not ‘‘family friendly.’’ From this perspective, there is a meaningful connection between the decline in marriage and fertility that has accompanied increasing investments in family beneﬁts in recent decades. Seen in the context of women’s diverse interests in work and family life, each of the interpretations outlined above frames a slice of reality. That is, the consequences of family-friendly policies vary in strength and direction for women who may be drawn toward different lifestyle preferences. The skeptic is correct in the sense that these policies probably have little effect on women at the two ends of the work=family continuum—those who prefer the traditional or postmodern lifestyles. Just as the availability of subsidized child care services is unlikely to redirect women who are career centered and not interested in having children, it is doubtful that most women disposed toward rearing three or more children would be seriously inﬂuenced by the prospect of having their children cared for on a daily basis by other people. Although there is a degree of elasticity within each lifestyle category, the largest potential for movement is among the lifestyles in the center. On one hand, the believer probably has a point in that child care and other family beneﬁts facilitate the lifestyle objectives of the modern group: the left-of-center along the work=lifestyle continuum—which is most work oriented and inclined to limit family size. In the absence of family beneﬁts, the increased difﬁculty of rearing children while actively pursuing a career might have a dampening effect on fertility and marriage rates among these women—some of whom might move into the postmodern lifestyle. On the other hand, the disbelievers’ view that most family-friendly policies undermine the institution they are purported to support probably resonates with many women in the neotraditional group for whom work is secondary to child care. In the absence of family beneﬁts that create incentives to work and lend impetus to the normative devaluation of

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childrearing and the domestic arts, fertility rates might rise, as some of the women disposed toward a neotraditional lifestyle would gravitate into the traditional category.

Policy Implications: Balancing Public Incentives The analysis of diverse preferences underscores the reality that family policies can be friendlier to some types of lifestyle choices than to others. Recognition of this diversity also invites us to explore alternatives to the conventional perspective on family policies designed to harmonize work and family life. The conventional approach is implicitly oriented toward helping mothers to work while raising children. It is informed by the traditional experience of men, which basically involves a seamless transition from school to the paid labor force, along with a drive to rise as high as possible in the given line of work. This male model of an early start and a continuous work history imposes a temporal frame on policies to harmonize work and family life, which stresses the idea of ‘‘balancing’’ the concurrent performance of labor-force participation and child-rearing activities. Child care services and even periods of parental leave facilitate an ongoing and relatively stable work history—a lifestyle preferred by many, although clearly not all, women. But the male model creates a narrow perspective on lifestyle choices. Viewing the issue from a life-course perspective reframes and extends the choices by including the possibility that a ‘‘balance’’ between motherhood and employment might be achieved by sequential as well as concurrent patterns of paid and domestic work. From a life-course perspective, the conventional continuum of family=work lifestyle choices is reframed to encompass not only women who want to combine work and family life at the same time but also those who might envision investing all their resources in child care and domestic activities for 5 to 10 years and then spending the next 25 to 30 years in paid employment. There are good reasons why some women, particularly among those in the traditional and neotraditional categories, might prefer the tradeoffs of the sequential approach to balancing motherhood and employment. The contributions of full-time homemakers to their families and to society vary according to different stages of the family life cycle. The early years of childhood are critical for social and cognitive development; some mothers want to invest more heavily in shaping this development than in advancing their employment prospects. Home care during the early childhood years is labor intensive, which heightens the economic value of the homemaker’s contribution during that period. Finally, as the span of life has lengthened, even after 10 years at home, most women would have more than 25 years to invest in paid employment—enough time to extinguish the alleged joys of work for many people.28 Of course, choosing to invest 5 to 10 years in child care and household management would cut off a few career options that require early training, many years of preparation, or the athletic prowess of youth, and a later start lessens the

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likelihood of rising to the very top of the ladder in many career lines. Those are the tradeoffs for the choice to enjoy two callings in life. Various measures could be initiated to support the choice of a sequential approach to balancing family and work. For example, we have seen that the federal government already provides about $16 billion in subsidies for a variety of cash and in-kind beneﬁts to working parents who place their children in daycare. The provision of similar supports through tax credits and home-care allowances to full-time homemakers with children under 5 years of age would afford parents greater freedom to choose between caring for children at home and consuming state-subsidized daycare beneﬁts. To guard against home-care beneﬁts that would end up disproportionately subsidizing wealthy families, these schemes could be progressively indexed. The home-care allowance would create a time limit that is potentially longer (if there is more than one child in the family) than the period of welfare coverage under the Temporary Assistance for Needy Families program, but not as open-ended as in the socialassistance beneﬁts previously available in the Aid to Families with Dependent Children program. Some might object that this allowance would create an incentive for low-income mothers to stay at home during the early years of child rearing. However, on balance, it is not necessarily the case that this outcome would be detrimental to most of their children or to society. In 1998, Norway initiated a policy to pay cash beneﬁts to all families with children up to 3 years old as long as the child was not enrolled in a statesubsidized daycare center. Finland employs a similar policy, which was fully implemented in 1989. Between 1989 and 1995, labor-force participation of Finnish women with children under 3 years old declined from 68% to 55%.29 Direct child-rearing beneﬁts are not the only way that public beneﬁts can be redesigned to balance incentives for lifestyle choices involving both out-ofhome employment and home care during the early childhood years. Several countries provide varying amounts of pension credits toward retirement to parents who stay home to care for young children. Family-friendly policies might even award ‘‘social’’ credits for each year at home with young children, which could be exchanged for beneﬁts that would assist parents in making the transition from homemaker to paid employment; such beneﬁts could include tuition for academic and technical training and preferential points on federal civil service examinations.30 The social credit scheme would be somewhat akin to certain veterans’ beneﬁts, which were granted in recognition of people who sacriﬁced career opportunities while serving the nation. In shaping the moral and physical stock of future citizens, the homemaker’s contribution to national well-being is obviously quite different from that of veterans. By recognizing this contribution, the family social credit scheme would elevate the sagging status of domestic activities and child-rearing functions as well as reinforce the thinning fabric of informal social support networks. The case for rethinking what we mean by ‘‘family-friendly’’ policies is put forth not to advance the sequential pattern of motherhood and employment but to give equal consideration to the diverse values and lifestyle preferences

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that inﬂuence how women respond to the conﬂicting demands of work and family life. As things now stand, public policies are far from neutral in offering incentives that support either caring for young children at home or joining the paid labor force and outsourcing a large part of the daily job of motherhood.

Notes 1 This chapter is a revised and expanded version of my article ‘‘What Do Women Really Want,’’ published in The Public Interest (Winter 2005). 2. The monthly ADC grants—$18 for the ﬁrst child and $12 for each additional child— were based roughly on the amount received by families of soldiers who lost their lives in World War I. In Leiby, J. (1978). History of social welfare and social work in the United States. New York: Columbia University Press. 3. Belkin, L. (2003) The opt-out revolution. The New York Times Magazine, October 26. 4. Bradbury, K., & Katz, J. (2005). Women’s rise: A work in progress. The Federal Reserve Bank of Boston Regional Review, 14(3), 58–67. 5. Hotchkiss, J. (August, 2005). What’s up with the decline in female labor force participation? Federal Reserve Bank of Atlanta Working Paper 2005–18. 6. U.S. Census Bureau. (2000). Statistical abstract of the United States: 2000 (pp. 195– 196). Washington, DC: U.S. Government Printing Ofﬁce. 7. U.S. Census Bureau. (2006). Statistical abstract of the United States: 2006 (p. 378). Washington, DC: U.S. Government Printing Ofﬁce. 8. U.S. Census Bureau. ( January, 2006). Women-owned ﬁrms: 2002. Washington, DC: U.S. Government Printing Ofﬁce. 9. Coleman, D. (1996). New patterns and trends in European fertility: International and sub-national comparisons. In D. Coleman (Ed.), Europe’s population in 1990. Oxford: Oxford University Press. 10. Eurostat. (2002). Eurostat Yearbook 2002: The statistical guide to Europe. Luxembourg: Ofﬁce for Ofﬁcial Publications of the European Community. 11. Here we ﬁnd a similar pattern of change in family size. Although the rate (12.3%) of women without children at age 40 is smaller than that in the United States, the cohort of Norwegian women aged 40 in 1998 had a 25% higher rate of childlessness and a 35% higher rate of having one child than did women at the age of 40 in 1975. During that period, the number of Norwegian women with two children increased by 33%, and the number with three or more children at the age of 40 declined by 33%. In 1998, Norwegian women aged 40 with the most education had the highest rate (19%) of childlessness (Lappegard, T. [2000]. New fertility trends in Norway. Demographic Research, 2[3]; electronic version available at www.demographic-research.org=Volumes=V012=3). Hakim14 reports a somewhat higher rate of 14% to 15% of Norwegian women being childless at age 40 (p. 51). 12. Capizzano, J., & Adams, G. (March, 2000). The hours that children under ﬁve spend in child care: Variations across states. New Federalism National Survey of American Families. Series B, No. B-8. Washington, DC: The Urban Institute. 13. Up until 1972, it was illegal in Massachusetts to provide contraceptives to single people to prevent pregnancy. See Eisenstadt v. Baird (405 U.S. 438). The distri-

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14. 15.

16.

17.

18. 19.

20.

21.

22. 23.

24. 25. 26. 27.

28.

Children in Families bution of contraceptives to minors was legalized in 1977 in the case of Carey v. Population Services International (431 U.S. 678). Hakim, C. (2000). Work life-style choices in the 21st century. Oxford: Oxford University Press. Weber’s ‘‘ideal-types’’ were not ideal in the sense of achieving perfection or representing exemplary values; they were constructs that captured the central tendencies of a phenomenon but were by no means exhaustive. Expanding the frame to include marital status, sexual orientation, and income might generate additional categories. There were, as Weber put it, ‘‘ideal-types of brothels as well as religions.’’ See Miller, S. M. (Ed.) (1963). Max Weber: Selections from his work (p. 31). New York: Thomas Crowell. Although there were high rates of childlessness during earlier periods of the twentieth century, the rates in 2002 are historic in the sense that they have never been this high in such prosperous and relatively peaceful times. Citing the ﬁndings of the United Nations–supported World Fertility Survey in the 1970s, which revealed that primary infertility affects only 2% to 3% of women aged 25 to 50, Hakim14 notes that infertility does not account for the sharp rise in childlessness after mid-1970s (p. 54). Hewlett, S. A. (2002). Creating a life: Professional women and the quest for children. New York: Talk Miramax Books. Goldin, C. ( July, 1995). Career and families: College women look to the past. Working paper No. 5188. Cambridge, MA: National Bureau of Economic Research. A more detailed argument is developed in Gilbert, N. (2008). A mother’s work: How feminism, the market and policy shape family life. New Haven, CT: Yale University Press. Gornick, J., Meyers, M., & Ross, K. (1997). Supporting the employment of mothers: Policy variations across fourteen welfare states. Journal of European Social Policy, 7(1), 45–70. Besharov, D., & Samuri, N. (2000). Child care after welfare reform. Washington, DC: American Enterprise Institute. For fertility rates r ¼ 0.568 (p < 0.10) and for marriages r ¼ 0.767 (p < 0.01). Because we cannot assume that the data in these analyses (average rates of the same group of countries at different time periods) involve independent observations, Pearson’s r cannot be used to test hypotheses or predict future relationships. It is reported here only as a way to summarize the observed relationship between two variables. Billari, F. C., & Kohler, H. P. (2004). Patterns of low and lowest-low fertility in Europe. Population Studies, 58(2), 161–176. Schorr, A. (1965). Income maintenance and the birth rate. Social Security Bulletin, 28(12), 2–10. Swedish Institute. (1992). Child care in Sweden. Stockholm: Swedish Institute. Esping-Andersen, G. (1991). The welfare state in the reorganization of working life. In P. Sanders and D. Encel (Eds.), Social policy in Australia: Options for the 1990s (Vol. 1). New South Wales: Social Policy Research Center, University of New South Wales. For an analysis of early retirement trends and reasons given for leaving work, see Gilbert, N. (2005). Family life: Sold on work. Society, 42(3), 12–17.

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29. The home-care allowances were cut back substantially in 1995, followed by a 3% decline in the Finnish birthrate the next year. See Sipila, J., and Korpinin, J. (1998). Cash versus child care services in Finland. Social Policy and Administration, 32(3), 263–277. 30. For a more detailed discussion of an earlier social credit proposal, see Gilbert, N. (1983). Capitalism and the welfare state. New Haven, CT: Yale University Press.

6 Child Support: How Much Is Just Right? Ira Ellman & Tara Ellman

Most of the attention given to the subject of child support in the popular press focuses on its enforcement. But improved enforcement makes the content of support orders more important. This chapter looks at the rules for setting the dollar amount of the support order: what are they, and do they make sense?1 At one time, child support orders were determined case by case. Trial judges exercised discretion under statutes that left them largely free to set the award for the dollar amount they thought appropriate. Not surprisingly, the result was wide variation in the amount of child support ordered among cases whose essential facts seemed quite similar.2 It was often said that the law required support amounts based on the standard of living maintained in the intact family, but that principle was illusory. The greater expense of maintaining two post-divorce households typically requires that at least one of them experience a living-standard decline, which means the real question is the proper allocation of this shortfall. Trial judges necessarily answered that question implicitly as they set support levels in individual cases, but they rarely had to explain their choice. That is why the governing rules could seem to vary between cases. Some commentators argued that orders were often too low to meet a child’s minimum needs, much less maintain the prior standard of living.3 Even if this were not true, the burden of making out a case for support was itself an important barrier to establishing an order, and thus to enforcement of the support obligation.

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Reforming this discretionary system thus became part of the federal effort in the 1980s to improve the collection of child support. Congress conditioned federal funding for each state’s welfare program on the state’s creation of child support guidelines. Under rules still in effect, the Family Support Act of 1988 required that these guidelines establish, in every case, a dollar ﬁgure that is presumed by law to be the correct amount of child support. States must bind their courts to set the support order for this presumed amount, unless the judge writes an opinion to explain why that amount was inappropriate in the particular case in question.4 Although federal law requires child support guidelines, it leaves states free to fashion them as they wish. One’s ﬁrst thought might be to base the guidelines on the cost of children, but that cannot work. A rule that guidelines should cover the children’s ‘‘cost’’ would tell us nothing, because one cannot measure what children cost without ﬁrst deciding what living standard to provide for them. That choice of living standard is a value judgment the guideline writer must make. It is a difﬁcult judgment because the child and the custodial parent share the same living standard when they share a home— the custodial parent cannot be expected to eat noodles while feeding the child steak—and unless the two parents have inﬁnite resources, the higher the living standard enjoyed by the custodial household, the lower the living standard enjoyed by the support obligor. So child support awards inevitably transfer resources from the support obligor to both the child and the custodial parent. Formally, however, the law ignores this reality. It pretends that dollars are true to their label: that child support dollars go only to children, and alimony dollars go only to the parent. A sensible analysis of child support policy requires abandoning that pretense. Much of this chapter, therefore, discusses the relative situations of the custodial and noncustodial households, rather than the relative situations of the individuals within them, on the assumption that the members of a family household share a common living standard and ﬁnancial fate. Indeed, increasing proportions of separated parents enter new households in which they live with a new spouse or partner as well as additional children who are not the children of their former partner. The fact that these persons were not members of the pre-separation family does not shield them from the living-standard impact, positive or negative, of a child support award that may be calculated without consideration of their presence. Just as signiﬁcantly, the additional adults often have income that contributes to the well-being of other members of their new household. For example, the income of a custodial mother’s new husband will almost always improve his stepchild’s living standard, and the income of the support obligor’s new spouse may improve to the obligor’s living standard, and thus the obligor’s capacity to pay support. Existing law usually ignores these realities as well. For now we too will ignore the complications of new household members, but we will return to them in the ﬁnal section of this chapter.

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Current Practice Overview

What principles do current state guidelines reﬂect? One cannot tell from the aspirational statements contained in state statutes or regulations. Most are so vague as to be practically contentless. California, for example, speciﬁes that the parents should support their child ‘‘in a manner suitable to the child’s circumstances.’’5 Perhaps because any principle requires potentially politically contentious tradeoffs between the parties, policymakers usually avoid clear statements of principle, or offer inconsistent statements that they do not reconcile.6 A disinclination to confront the inevitable tradeoffs was facilitated by two studies funded by the Department of Health and Human Services in the late 1980s. Meant to assist states in complying with the forthcoming guideline requirements, the studies focused on estimating how much parents in intact families spend on their children, as a substitute for estimating how much children ‘‘cost.’’ The ﬁrst (the Williams7 study), conceding that ‘‘there is no absolute standard for the ‘cost’ of rearing a child,’’ concluded that ‘‘economic studies are able to infer the ‘cost’ . . . at a given income level only by observing the actual expenditures allocated to a child in existing households.’’ The second (the Betson8 study) simply conﬂated the concepts of cost and expenditure. While offering a method for estimating expenditures on children in intact families, using parental income and family size, the study’s title and text both refer repeatedly to the costs of children, as if costs and expenditures were the same. Of course they are not. But as the quote from Williams suggests, the shift from cost to expenditure (Williams endorsed Betson’s method) is offered as a way to avoid the value judgments (about the appropriate living standard) necessary if one is seeking to estimate costs. It seems to get the guideline writer off the policy hook, because the amounts set in the guidelines are determined by the consultant’s estimate of the average spending behavior of parents in intact families, not by the policy judgments of the guideline writers. Essential to this illusion is the assumption that the task of estimating parental expenditures on children is purely a technical exercise requiring no policy choices. Perhaps at least in part because of the appeal of a ‘‘value-neutral’’ methodology, the Williams-Betson method is employed by the great majority of states, and we will refer to it as the conventional methodology.9 Yet once one pierces the method, it becomes clear that value judgments are not avoided by it; they are simply hidden from view. One cannot tally what parents spend on their children without ﬁrst deciding what counts as a child expenditure. More than arithmetic is involved. If a couple spends the same amount on rent after having a child as they did before, does that mean that none of their postbirth rent is an expenditure on their child? What if they move to a different rental unit, perhaps in a different location, and pay the same price? How much of the family’s utility bill is an expenditure on children? Different answers to such

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questions will yield different expenditure estimates, with a corresponding effect on any support guideline based on them. There are in fact competing methods for estimating expenditures on children that yield different results because they assume, implicitly or explicitly, different answers to questions like these. So the conventional method requires preliminary judgments about what counts as a child expenditure—and thus what expenditures are included in the tally that forms the basis of the support guidelines. If expenditures on gas, electricity, telephones, or a car are not counted as child expenditures, then their cost will not be reﬂected in the support payment speciﬁed in the resulting guideline.10 The ‘‘income shares’’ guidelines that most states employ use the conventional method for estimating total child expenditures, and then allocate responsibility for those expenditures between the two parents in proportion to their incomes. The noncustodial parent pays his share to the custodial parent as the support order. But, of course, items that are not counted as child expenditures are not part of the estimate and are thus not allocated. In that case, the custodial parent needs other income to pay for these items. What if the custodial parent does not have much other income? Does that mean we should count utilities as child expenditures? Or should we say the utility bill is the custodial parent’s responsibility because it is not much affected by the child’s presence in the household? Or should we make an adjustment depending on the parent’s relative income? How we resolve this is a question of child support policy, not cost accounting. Equivalent questions can be repeated with most other expenditure categories, and the answers will determine the shape of the support guideline grid. But the child support policy choices implicit in these expenditure classiﬁcations are typically inaccessible to the state ofﬁcials charged with formulating support guidelines, who usually have neither the skills nor the inclination to pierce the cloud of technical jargon in order to reveal them. The result is that policy decisions are not avoided by the shift in focus from cost to expenditure; they are simply made opaque, often hidden from the view of the policymakers themselves. Nevertheless, they are there. Policy Consequences

What is in fact the policy result of the conventional method? Consider Table 6.1, which sets out examples of three cases, all involving a custodial parent (CP) who lives with the couple’s one child and earns $1,000 monthly. The cases differ only in the income earned by the noncustodial parent (NCP), who lives alone and earns either $500 (Case 1), $2,500 (Case 2), or $6,000 (Case 3) monthly. The table shows the support payments called for in each case under the child support schedule currently in effect in Arizona. Arizona is an income-shares state with guidelines based on the conventional methodology, and it revised its guidelines in 2004. The required payment is shown both in dollars and as a percentage of the noncustodial parent’s income. Finally, the

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Table 6.1. Low-Income Custodial Parent in Three Situations

Case Number 1 2 3

NCP Income (Before Support Payment)

Support Payment (Under Arizona Guideline)

Payment as Percent NCP Income

CP Income After Payment, as Percent Poverty

NCP Income After Payment, as Percent Poverty

$ 500 $ 2500 $ 6000

$110 $471 $781

22% 19% 13%

107% 142% 173%

50% 260% 668%

CP: custodial parent; NCP: noncustodial parent. For the purposes of this table, CP earns $1,000 monthly and lives with one child. All income ﬁgures are gross incomes (before tax calculations); poverty threshold calculations based on 2002 data.

last two columns of the table show the incomes of the custodial and noncustodial households after the support transfer payment as a percentage of the federal government’s poverty threshold for a household of that composition.11 For ease of exposition, I will refer to the custodial parent in these examples as the mother and the noncustodial parent as the father, which conforms to the actual facts in the great majority of such cases. Case 1 is the all too common problem in which both parents are poor, with the father earning even less than the mother. Their combined monthly income of $1,500 cannot possibly support two households above the poverty line, and in fact it does not. The ﬁfth column shows that after the child support payment of $110, the child’s household income barely exceeds the ofﬁcial federal estimate of the amount this household requires to avoid poverty, their aftertransfer income of $1,110 being equal to 107% of that poverty threshold. The child’s household is thus in relatively desperate straits. The father is even worse off, however, as the $390 left after the support payment leaves him with an income that is half the poverty threshold for a single individual. In fact, Arizona would probably excuse this father from making more than a nominal support payment. Like most states, the Arizona guidelines provide for a ‘‘selfsupport reserve.’’ The details of these provisions vary among the states, but their general purpose is to shield obligors from support orders that would impoverish them. In Arizona, the trial court is authorized to reduce the support payment to zero if the obligor has less than $775 in monthly gross income.12 This father qualiﬁes for that reduction, which is left to the court’s discretion. Of course, if the court orders no support, then the child’s household will also fall below the poverty threshold of $1,037. The Arizona guidelines rightly observe that in such cases it is ‘‘evident that both parents have insufﬁcient income to be self-supporting.’’ It is also evident that the guidelines’ allocation of this shortfall is not based exclusively on the child’s well-being. There is

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another principle also operating here, which we can call the earner’s priority principle (EPP). It is the simple idea that everyone, including parents, ordinarily has ﬁrst call on his or her own income. That priority is not absolute—if it were, no support could ever be ordered—but it appears to have special force in the case of the poor obligor. That is at least the apparent message of the selfsupport reserve. We will return to this observation later when we consider the EPP in more detail. For now, the self-support reserve provides an early example of the tradeoffs in child well-being and fairness that must take place in setting child support amounts. In Case 1, the child support system is arguably unimportant. If neither party has much money, the child’s well-being depends on ﬁnding a third source of funds, whether a new spouse, private charity, or a public income support system. Moving money around among desperately poor families cannot contribute much to social welfare. For our purposes, therefore, Cases 2 and 3 are more interesting. While the mother’s income is no different in these cases, the father has much more money and can therefore pay amounts that would make an impact on child well-being. Yet the current child support schedule may do less for the custodial household in Cases 2 and 3 than one might expect. In Case 2, the larger support payment lifts the living standard of the custodial household from 107% of the poverty threshold to 142%. Yet the father’s situation improves much more, from half the poverty level to more than 2.5 times. The father is hardly rich, but he has some degree of ﬁnancial security, especially compared with the child, who is still in a ﬁnancially precarious state. It seems the child in Case 2 could beneﬁt substantially from a larger support payment, and the father is capable of providing that. Case 3 makes the same point more dramatically. This father is earning 12 times the amount earned by the father in Case 1—a solidly middle-class income that leaves a single individual comfortably circumstanced. But the relatively modest increase in his child support payment still leaves the child’s household at less than twice the poverty threshold. The father, by contrast, is at nearly seven times the poverty threshold after making the support payment, and thus enjoys a leap in his ﬁnancial well-being compared with Case 1. It seems unlikely that the EPP can justify this large disparity between the child’s living standard and the father’s, and it is equally unlikely that this disparity would seem appropriate to most people asked to balance the interests of the child and each of the parents. No such balancing exercise was ever undertaken by the various committees responsible for these guidelines, however, because that question was never presented to them. The operating assumption of the current system in Arizona, as in most states, is that a guideline grid based on the consultant’s estimates of child expenditures yields generally appropriate support payments without the need to ask such questions. Table 6.1 shows that this operating assumption is probably not correct. In fact, the surprising results shown in Table 6.1 are inevitable under the conventional methodology employed for estimating child expenditures to generate support guidelines, not only in Arizona but in most states. The next section explains why.

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How the Conventional Methodology Produces These Results

As noted earlier, the conventional method assumes that support guidelines should be based on the expenditures on children in intact families. It measures such expenditures by attempting to look at childless-couple households, at various expenditure levels, and asking how much more an intact, two-parent household with children must spend for the parents to enjoy the same living standard as the childless couple.13 (Expenditure levels are then converted to equivalent income levels to actually create the guideline grid.) Put another way, the method seeks to estimate the additional expenditures—marginal expenditures, in economic terms—required to maintain the same living standard when children are added to the household.14 The assumption that marginal expenditures are the correct measure of expenditures on children is the main reason for the results we have just observed. The impact of that conceptual assumption is then enlarged by problems in the data on which this method must rely. The data problems are straightforward. The only source of comprehensive data that ties expenditures to household income is the Consumer Expenditure Survey (CES), which consists largely of interviews with consumers in which they are asked to recall their expenditures on each item in a list that the survey designers hope is a comprehensive inventory of all the categories of expenditures that consumers make. As documented elsewhere,15 these expenditure data systematically undercount actual consumer expenditures in higherincome families—the higher the household income, the higher the proportion of the household’s expenditures that is erroneously omitted from the expenditure tabulation. The conventional method effectively translates this CES undercount into an undercount of expenditures on children, so that as household income goes up, the percentage of household income that the method treats as spent on children declines precipitiously.16 That is one important reason that most states’ guidelines call for support payments that fall, as a percentage of parental income, as the income rises. In the three cases in Table 6.1, for example, the support order ranges from 22% of obligor income, for the lowest-income family, to 13%, for the highest-income family. Support payments therefore do not rise proportionately with income—far from it. But this data problem is only a subplot; the conventional method’s focus on marginal expenditures is the main story.17 Imagine a couple who move from a one-bedroom apartment to a two-bedroom apartment when they have a child. Their rent increases from $1,000 a month to $1,200. A marginal-expenditure analysis would ﬁnd that the housing expenditure on the child is the rental difference, or $200. A support guideline for rent, based on a marginalexpenditure methodology, will therefore allocate only that $200 between the parents. The actual method does not examine individual expenditures in this way but attempts to gauge the aggregate marginal expenditures through

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the household comparison explained in the ﬁrst paragraph of this section. The principle, however, is the same, and the method’s impact is most easily understood if one imagines how it would work in the context of particular expenditure categories such as rent. In the incomes-shares model used by most states, the $200 marginal housing expenditure in this example would be allocated between the parents in proportion to their incomes. So if Mom, the custodial parent, earns $1,000, and Dad, the noncustodial parent, earns $3,000, Dad earns 75% of the parental income, and his share of this marginal housing expenditure is 75% of $200, or $150. He pays this to Mom as his share of the child’s $200 housing expenditure. Yet Mom now has only $1,150. She cannot possibly rent an apartment anything like the one that the couple rented when they were together, because she does not have the base income that allowed the couple to rent their prechild one-bedroom apartment in the ﬁrst place. The quality of housing enjoyed by the child—and the parents—when they were together assumed that base, and the child necessarily beneﬁted from it, but only the marginal expenditure of $200 is allocated between the parents when support payments are based on this method, not the $1,000 base to which the marginal expenditure was added. As previously noted, the conventional method does not really look at expenditures by category in this way. It instead compares expenditures in different size households of equal living standards to generate estimates of the aggregate marginal expenditures on the child in all expenditure categories simultaneously, at various income levels and for various numbers of children. But the impact is the same as in this more easily understood example focused on housing. The example shows how the consequence of this method is that the economic welfare of the child after separation is left dependent primarily on the pre-support-payment income of the custodial parent. If it is high, and the base is present, the child’s well-being will not be endangered. If it is low, the child will suffer a serious economic decline. The impact of the noncustodial parent’s income on the outcome is, by comparison, much smaller. The main reason is that the child support system is allocating only marginal parental expenditures on children. Table 6.1 has given us a window into this reality. To appreciate it over a wider range of situations, look at Figure 6.1. It compares 10 custodial households consisting of one parent and one child. The combined income of the child’s parents is the same in all 10 households—$3,550 per month. That is 300% of the poverty threshold for the intact household of two parents and one child. While these 10 sets of parents all have the same total income, they differ in the proportion of income earned by the custodial parent, from zero at the left end of the horizontal axis to 100% at the right end. The two diagonal lines plot the custodial household income for each of these 10 households, not in dollars but as a percentage of the poverty threshold for a one-parent, onechild household. The solid diagonal line plots this percentage for the custodial household income after receipt of the support payment called for in the

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Figure 6.1. Range of custodial household outcomes; example of one-child family with $3,550 combined monthly income (measured as percent of poverty levels).

Arizona support guidelines, while the dashed diagonal line plots it for the income before the support payment’s receipt. Let us then compare the case in which the custodial mother earns 70% of the total parental income of $3,550—about $2,500 a month—with the more typical case in which she earns 30% of the total parental income, or about $1,050 a month. A custodial household earning $1,050 monthly is barely above the poverty threshold. Receipt of the child support payment raises it to 150% of poverty threshold, certainly a help. Now consider the other case, in which Mom earns $2,500, or 70% of the same total parental income. This household is at about 230% of the poverty threshold before receiving any child support payment, and over 250% after. One can see that the children in our two sample cases come out very differently after divorce despite the fact that their parents earn the same total income. This seeming discrepancy is an unavoidable consequence of the marginal-expenditure method. A support guideline that allocates only the marginal expenditures on children leaves most household expenditures out of the calculation and thus out of the support payment. And so, as Figure 6.1 shows, the child’s living standard will depend primarily on the share of the total parental income earned by the custodial parent. In the extreme cases, where the custodial mother earns either none or all of the parental income, the difference is enormous. The child living with a stayat-home mother—not an entirely fanciful example with very young children— sees the child’s household living standard decline from 300% of the poverty threshold when the family was intact to a catastrophic 70% after the sepa-

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ration. At the other extreme, where the custodial parent earns all the $3,550 of the parental income, at the right end of the chart, our two lines converge, because at that point her household income after the support payment is the same as her income before the payment—the full $3,550 of parental income. At this point the custodial household is better off, economically, than the intact, pre-separation household. This is what one should expect, because the custodial household is smaller but has the same income as the intact household. In sum, support guidelines produced using the conventional method will result in (a) children’s situations depending primarily on the income of the custodial parent with whom they live; (b) children with low-income custodial parents living poorly, no matter the income of their other parent; and (c) different living standards for children whose respective sets of parents earn the same total income, when one child lives with a parent who accounts for a small proportion of the total parental income and the other lives with the higherearning parent. These outcomes result primarily from two assumptions that underlie the conventional method used in most states: (1) that child support amounts should be based on expenditures in intact families, as tracked in the CES; and (2) that only the family’s marginal expenditures on children count as child expenditures, thus excluding many household expenditures that in fact confer beneﬁts on children. Because these premises were adopted without considering whether they made sense in light of a central purpose of child support, protection of child well-being, guidelines based on them give no weight to this purpose. That is why the guidelines do not require payments that would substantially improve child well-being even when the support obligor has sufﬁcient income to make them. Indeed, it seems fair to say that in most states the current support guidelines do not reﬂect any systematic policy judgment about the appropriate and inevitable tradeoffs between custodial and noncustodial households.18 They instead reﬂect the particular methodological choices their consultant made to generate the expenditure estimates.19 The choice is ostensibly made on ‘‘neutral’’ technical grounds, which means the consultant never directly faces the child support policy questions, nor directs the policymaker’s attention to them. Policymakers must consider a fundamental shift in the method employed for constructing support guidelines. The current method looks backward, basing support orders on marginal expenditures in the intact family that no longer exists—and which never existed in an increasing proportion of child support cases. It would be better to look forward, assessing the impact of the support guidelines on both the parents and their children, in the situation in which they ﬁnd themselves at the time the support order is made. But that requires a systematic evaluation of the tradeoffs implicit in any set of guidelines, to facilitate a policy decision. But how would one know when the ‘‘right’’ tradeoff between the two post-separation households had been achieved? We now consider that question.

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Toward a New Approach to Constructing Support Guidelines Child support laws reﬂect the widespread belief that state support for children is only appropriate if parental support is impossible—what one might call the primacy of the parents’ support obligation.20 While this parental obligation explains why the law requires support at all, it does not help much in determining its amount. A principled and systematic approach to setting support levels requires closer examination of the support order’s purpose. In fact, support orders serve three distinct purposes: (1) to protect the well-being of the child who is the order’s intended beneﬁciary (the well-being component); (2) to enforce the social consensus that both parents have a support obligation, even if the child lives primarily with one parent (the dual-obligation component), and (3) to limit the size of the gap that will otherwise sometimes arise between the child’s living standard and the higher living standard of the support obligor (the gross disparity component). I elaborate below on each of these components, exploring their rationales and their contributions to determining the appropriate size of the support award. The gross-disparity component is treated last because it is more contested than the ﬁrst two. But claims arising from all three components are also limited by a general idea we earlier labeled the EPP. We elaborate further on the EPP after ﬂeshing out the three basic support components. The appropriate support amount depends on how we measure each of these three components, how we weight them in relation to one another, and how we balance them against the counterconsideration of the EPP. The goal of this discussion is not philosophical but sociological. The analysis is meant to identify the factors that inﬂuence people’s judgment about when a child support award is fair. This effort is necessarily tentative because the available social science data are limited. Indeed, a principal conclusion of this chapter is that policymakers need better data on how people think about this fairness question, because the setting of child support awards involves the kinds of tradeoffs among people’s interests that are ultimately political in nature. The discussion that follows makes two simplifying assumptions. First, we assume that the custodial household contains only the custodial parent and the children who are the intended beneﬁciaries of the support order and that the noncustodial parent lives alone in a household of one. This simplifying assumption is probably wrong in many if not most actual cases, yet it is the implicit assumption of existing law (which treats additional household members as largely irrelevant to the support calculation), and we initially take existing law on its own terms. We will later consider how the principles we develop in this simpliﬁed context apply to claims that the support amount should be altered to reﬂect the presence of additional persons in either household. Our second simplifying assumption is that the child lives primarily with one parent, and that the child’s well-being is therefore affected primarily by the environment in that custodial household and is not importantly affected

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by the environment in the other parent’s household. This assumption is also wrong in some cases. While the principles developed here could be extended to joint-custody cases, we defer that exercise to another day. The Child Well-being Component

As income is added to a household, does child well-being improve? We cannot offer an empirical answer to that question without ﬁrst deﬁning what we mean by child well-being. Physical health is certainly one component of child wellbeing, but there are others as well. We might measure the child’s academic success, by considering school performance or the child’s scores on various standardized tests. We might measure a child’s psychological well-being with standardized tests or through interviews with the child’s parents, counselors, teachers, or medical personnel. We might ask the child if he or she is happy. We might take these measures when the child is a toddler, a primary school student, or an adolescent. If we look at the child as an adolescent, we might want to add questions to our inquiry: Does the child smoke? Abuse alcohol or other drugs? Engage in antisocial or criminal activity or self-destructive behavior such as casual sex? Finally, we can decide that we care only, or primarily, about the long-term impact of money on children, so that our primary measure of the well-being of children should be their well-being as adults. We could look at outcomes as adults with many of the measures we consider for them as children, but we can also consider other measures: How much education did they ﬁnally achieve? What is their income and socioeconomic status? Have they established, as adults, a stable and satisfying family life? Not surprisingly, the answer we get depends on the question we ask: the impact of money on child well-being varies with the measure of well-being.21 The existing literature suggests that family income has a positive effect on children’s cognitive outcomes and educational attainment, and thus their eventual socioeconomic status as adults. There are many studies that ﬁnd results consistent with this suggestion, whether they measure children’s scores on various tests of cognitive functioning, children’s school performance, the years of education they complete by adulthood, or their income as adults. While the effect is found across many studies, there is variation in the effect size. The overall impression is that the effect size is smaller than many people would assume, but not trivial or an artifact of the inquiry’s design or of chance ﬂuctuation. The effect of income on children’s psychosocial well-being, in contrast to their cognitive functioning or ultimate socioeconomic status, is less clear. There is evidence that lower income increases parental stress, which is associated with parental conﬂict in two-parent families, which is in turn associated with less favorable psychosocial outcomes for children. The relevance of such data to single-parent families is, however, unclear. Finally, consider that any effort to relate income to some aggregate measure of well-being requires weighting the relative importance of these various well-being measures, an exercise involving value judgments with which people may not agree. The point is that the

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relationship between income and child well-being is necessarily a value judgment as well as an empirical question. Most methodologically sophisticated studies examine primarily lowincome families that fall close to the poverty line, and one cannot necessarily extend their ﬁndings about income’s effect to middle- or upper-class families. In general, however, there is stronger evidence for the positive impact of money on children’s well-being when the additional funds are added to low-income families than when they are added to families with higher incomes. There is also some evidence that child support dollars have a greater positive impact on children’s outcomes than dollars from other sources, although the methodological challenges are particularly great with studies of this kind. Figure 6.2 offers a schematic representation of relationships that might exist between an unidentiﬁed measure of child well-being and household income. (For this purpose, we assume that household income and household expenditures rise and fall together, and therefore use the terms interchangeably.) The dotted line represents the case in which child well-being is poor at very low income levels and remains unchanged until household income

Figure 6.2. Household income and child well-being (illustrative). The dotted line represents a linear relationship in which every increase in income (beyond a threshold level) leads to an equivalent increase in child well-being. Evidence suggests, however, that in actuality increases in income affect child well-being in a manner more consistent with the solid line. Point A represents the income level at which additional income begins to produce diminished returns on well-being, and point B represents the income level at which increases in well-being relative to additional income become negligible.

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reaches a threshold level. Above the threshold, additional income has a simple linear relationship with child well-being: every additional dollar of income yields an equivalent increase in child well-being. The solid line represents a different case in which the relationship above the threshold is not linear. Initial dollars above the threshold buy larger increases in child well-being than do later dollars. The higher the household income, the smaller the impact of any additional income on child well-being. Data limitations, as well as the conceptual complications involved in aggregating well-being measures into some overall index, make it impossible to offer a deﬁnitive description of the well-being=income function that relates speciﬁed dollar amounts to aggregate well-being. We nonetheless can say that the available evidence suggests that (a) there are aspects of child well-being that are affected by income and (b) data with respect to these measures are more consistent with a function that has the shape of the solid line in Figure 6.2 than the shape of the dotted line. The data are less helpful in locating Points A and B on the solid line—the income level at which returns to additional dollars begin to decline (Point A), and the income level at which returns to additional dollars become small enough to ignore, for policy purposes (Point B). One study of both cognitive functioning and behavior problems in 3-year-olds located Point A at the poverty threshold and Point B at ﬁve times the poverty threshold.22 For a family of four in 2002, the year in which these data were collected, the poverty threshold was $18,400, and ﬁve times that amount is $92,000. By way of comparison, the median income in the United States for a family of four in 2002 was $67,732, ranging from $87,000 in New Jersey to $46,000 in New Mexico.23 Clearly, given the quantity and quality of available data, as well as the conceptual problem of choosing measures of child well-being and of aggregating them into a single weighted measure, these numbers are at best suggestions. Nonetheless, child support guidelines are written and revised somewhere every year, reﬂecting explicit or implicit judgments about the importance of money to children. Given that reality, it is probably useful to offer policymakers information of this kind to supplement the intuitions which would otherwise form the sole basis of their judgments. What might reasonable policymakers conclude from these data? Perhaps that the goal of advancing child well-being can justify requiring support at least to the point at which the custodial household reaches the median family income, and probably somewhat higher, because nontrivial gains in well-being will result from the additional income within this range. The data also suggest that payments are especially important to child well-being at lower levels of custodial-household income. These conclusions may seem obvious. Yet it seems from the prior section that they are inconsistent with support guidelines currently in place, because those guidelines often set support payments to lowincome custodial households at lower levels than the other parent can pay. Are these features of most existing guidelines reasonable? The principles developed in this section of this chapter should help one decide.

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Consider Figure 6.2 again. Let us call Point B in Figure 6.2 the ‘‘well-being maximum’’—shorthand for the idea that when the custodial-household income reaches this level, the possible additional gains in child well-being are too small to justify imposing additional child support obligations. Child support guidelines unavoidably, even if only implicitly, must assume some value for the well-being maximum. A support guideline under which support payments continue to rise with income, no matter how high the income level, would seem to assume a much greater value for the well-being maximum than a guideline in which in which the required payments level off with rising income. Guideline committees, like policymakers generally, must usually act on imperfect information. For the purpose of this discussion, let us assume our best guess is that the well-being maximum is reached at about the 75th percentile in family household income. That means that whenever the custodial household income is below the 75th percentile, child well-being can offer some justiﬁcation for requiring support. The power of the justiﬁcation, however, will gradually decline as the 75th percentile is approached, so that countervailing policy factors (like the EPP, as we discuss later) become correspondingly more important. On the other hand, we will see that the gross disparity and dualobligation components may justify awards even when the well-being component does not. Data and intuition combine to suggest that the well-being component has compelling importance at lower levels of custodial-household income. Because child well-being falls off particularly steeply below Point A, the well-being component has its greatest force in this income range. Let us assume that Point A is located at 150% of the poverty threshold, an income characterized by the American Law Institute (ALI) as providing the ‘‘minimum decent standard of living.’’24 Given that all child support awards impose tradeoffs between the obligor and obligee households, it is especially important to distinguish cases in which additional support dollars are very important to child well-being from cases in which they are less important. Points A and B in our curve locate these boundaries. It is of course a tricky business to make interpersonal comparisons of well-being, and surveying the considerable literature on that question is beyond this chapter’s scope.25 So long as families have ﬁnite resources, however, such tradeoffs cannot be avoided in setting support levels. Principle 1 summarizes this discussion of the child well-being component: Principle 1. Protecting child well-being, an essential purpose of child support, has particular force when the income of the custodial household would otherwise deny the child a minimum decent living standard (located at Point A in Figure 6.2). The impact of additional dollars on child well-being then declines gradually as custodial household income increases, until income reaches a point at which additional dollars have too small an impact on measurable child wellbeing to be of public-policy importance. This upper income bound, Point B in Figure 6.2, can be called the well-being maximum. Policymakers cannot avoid judgments about the location of Points A and B, despite their inevitably im-

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perfect knowledge. It is suggested here that a reasonable dollar ﬁgure at which to place Point A is 150% of the poverty threshold for a family of the size and composition of the custodial household. Reasonable arguments can be offered to place Point B anywhere within a broad range between the median income and the 75th income percentile (for two-parent families with the same number of children as the custodial household).

The Dual-Obligation Component

A second function of child support laws is to enforce a societal consensus that both parents have a moral obligation to support their children, and, more speciﬁcally, that the noncustodial parent retains this obligation even if (a) the child primarily lives with the custodial parent and (b) the custodial parent has sufﬁcient resources to ensure the child’s well-being. The dual-obligation component explains why states require support payments to custodial households whose income already exceeds plausible estimates of the value of the well-being maximum (Point B on our curve). In such cases the motivation is not preserving the child’s well-being, which will be ensured whether or not any support is paid. The explanation is instead society’s determination to make sure the noncustodial parent contributes his fair share to the child’s support. Who is entitled to receive the contribution? The custodial parent, who would otherwise shoulder all the cost of providing for the child. Public policy provides the basis of both support components we have thus far considered: ensuring the child’s wellbeing (the well-being component) and enforcing the support duty (the dualobligation component). But the private interest protected by each is different. The private interest protected by the well-being component is the child’s interest in maximizing his or her cognitive, psychological, and social development. The private interest protected by dual-obligation component is the custodial parent’s in not having to shoulder an unfairly disproportionate ﬁnancial burden in order to provide for the child’s well-being. If the custodial household is above the well-being maximum before any support payment, then the entire support payment consists entirely of the dualobligation component (unless it also includes a gross disparity component, considered in the next section). If custodial-household income does not reach the well-being maximum even after the support payment is included, then the entire support payment consists of the well-being component. Where the custodial-household income alone approaches, but does not reach, the wellbeing maximum, the support award may consist of both a well-being component (equal to the additional custodial parent expenditures needed to bring the custodial household up to the well-being maximum) and a dual-obligation component (covering the noncustodial parent’s fair share of the custodial parent’s initial base expenditures to which the supplement must be added). The dual-obligation component of a child support award is important because it maintains the principle that both parents must contribute to the child’s

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support. It may also be essential to maintaining the noncustodial parent’s social status as parent. Certainly, excusing the noncustodial parent from any support obligation might cast doubt on his legitimacy as a parent. But neither this concern with parental legitimacy nor the principle of requiring parents to provide support helps to identify the appropriate amount of the dualobligation component. Even nominal awards may be sufﬁcient to satisfy both concerns. Overall, then, the dual-obligation component’s underlying rationales are less compelling justiﬁcations for any particular amount of support than is the child well-being rationale. That means it may yield to counterconsiderations more easily than would the well-being component, at least insofar as the amount of support required to vindicate it. This point is explored more fully below when we consider the principal counterconsideration, the EPP. But some immediate discussion of how we may calculate its amount is necessary to give the dual-obligation component more substance. Our prior discussion implies that the dual-obligation component equals the noncustodial parent’s fair share of the expenditures the custodial parent would make to bring the custodial household to the well-being maximum. (The wealthy custodial parent may spend funds on the child in excess of the wellbeing maximum, but the other parent has no obligation to share in those expenditures.) In considering the noncustodial parent’s fair share, there is a crucial difference between the dual-obligation component and the well-being component itself. The well-being component arises only in cases in which the custodial household, by itself, does not have sufﬁcient resources to reach the well-being maximum. The support payments are intended to bring the custodial household closer to that level. But because members of a household generally share a living standard, child support payments will necessarily confer beneﬁts on the custodial parent (just as other sources of custodial parent income, including, e.g., alimony, will necessarily confer beneﬁts on the child). In the case of the well-being component, this means the policymaker must determine the appropriate tradeoff in choosing between a higher award, which invites obligor objections to the beneﬁts it will provide the custodial parent, and a lower award, which can compromise child well-being. No similar tradeoff arises, however, in determining the dual-obligation component. By deﬁnition, the dual-obligation component arises only in cases in which the income of the child’s household puts it at or above the well-being maximum, which means there is no well-being concern to trade off against the obligor objections to conferring beneﬁts on the custodial parent. That means that the dual-obligation component should be sufﬁcient to make the custodial parent wholly secure, considering the additional expenditures her household makes on account of the child’s presence, but no more. Put another way, the dual-obligation component should cover the noncustodial parent’s share of the additional (marginal) expenditures the custodial parent must make on account of the child’s presence in the household (but ignoring expenditures that exceed the well-being maximum, which high-income custodial households will likely meet). Of course, in basing estimates of the dual-obligation component on

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marginal expenditures on the child, we mimic the conception that lies behind the conventional method currently used to generate the entirety of support guidelines, which also uses marginal expenditures, and which was criticized on that account in the ﬁrst part of this chapter. But marginal child expenditures are indeed exactly the appropriate measure when the question is reimbursement of the custodial parent, as opposed to child well-being.26 What we have not considered here is how to determine the noncustodial parent’s fair share of these marginal expenditures. The conventional incomeshares system of support would assume that the parental shares should be proportional to the parental incomes. We accept that assumption now but revisit it later when we consider the EPP. Principle 2 summarizes this discussion of the dual-obligation component. Principle 2. Where the custodial household has sufﬁcient income to enjoy a living standard at or above the well-being maximum, a support award is justiﬁed to ensure that the other parent contributes his or her fair share to the expenditures required to bring the custodial household to (but not beyond) that level. The appropriate award is the obligor’s fair share of the marginal expenditures made necessary by the child’s presence in the custodial household, comparing the expenditures required for the custodial household to live at the wellbeing maximum, with the expenditures required to provide the same living standard to a household without the child. Where the custodial household has sufﬁcient income to approach but not quite reach the well-being maximum, the support award may have both a well-being component and a dual-obligation component.

The Gross Disparity Component

The ﬁrst two principles seek to ensure, respectively, that (1) the custodial household has the income necessary to ensure measurable child well-being and (2) the obligor contributes his proportionate share of these well-being expenses, even if the custodial household has sufﬁcient income to meet them on its own. We now consider a third group of cases involving noncustodial parents whose income well exceeds what is required to provide for measurable well-being. For the purpose of this discussion, let us continue to assume that Point B in Figure 6.2—the well-being maximum—is reached at family incomes at the 75th percentile. Some states cap awards so they do not increase beyond speciﬁed income levels, while others allow judicial discretion above speciﬁed income levels. But many state guidelines call for awards that continue to rise with obligor income well beyond the point at which the custodial household reaches the 75th percentile of income.27 The question is, why? Evidence of popular views is largely unavailable. The few studies we have certainly ﬁnd respondents favoring support awards that increase with obligor income, but they do not typically ask about incomes above the 75th percentile.28 The ALI recommends that once the custodial household has been assured a minimum decent living

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standard, additional support amounts are appropriate to provide the child ‘‘a standard of living not grossly inferior to that of either parent.’’29 This clause, which by its terms becomes applicable only when the support obligor’s income exceeds both the custodial parent’s and the level needed to ensure the child a minimum decent living standard, would also explain support awards that raise custodial household income above the well-being maximum. The ALI position could be described as a compromise between fully honoring the child’s claim to living as well as the ﬁnancially comfortable noncustodial parent and fully honoring the support obligor’s objections to providing support beyond that needed to ensure measurable child well-being. But is such a claim for the child valid, and is such a compromise appropriate? The law does not require parents in intact families to provide a child with more than basic needs. That rule, however, is not based on a considered judgment that basic needs are all the child is entitled to. It is rather a particular instance of the law’s more general reluctance to intervene in intact families. The law therefore defers to a very wide range of parental choices concerning expenditures on their children: almost any parental choice that does not threaten the child’s health or safety is accepted. Similarly, the law never concerns itself with the parental choice about where the child should live, other than in rare and extreme cases in which the parents needlessly expose the child to a dangerous environment. In separated families, however, when the parents do not agree, the law cannot defer to parental choice, because the parents present competing choices. The law must therefore pick between the conﬂicting (and potentially self-interested) parental choices, even when both lie within the ordinary range of reasonableness. This can happen in the context of custody (should the child live with the competent and loving mother in California or the competent and loving father in New York?) or, here, in the context of support (should parental expenditures on the child be limited to those that have a demonstrated impact on measurable well-being, or should the child be more fully protected from avoidable reductions in living standard?). Embedded in this public-policy choice is a reasonable debate over whether additional household income beyond the well-being maximum can be justiﬁed as serving any interest of the child’s. Award proponents might argue that standard well-being measures simply fail to capture real well-being gains contributed by additional dollars in the higher-income range. Certainly, even afﬂuent adults welcome additional income. The relationship between income and one’s subjective sense of well-being (SWB) is not linear, and research clearly suggests that additional income has more impact on SWB at lower income levels than at higher levels. But studies also ﬁnd a positive correlation between income and happiness at higher income levels even after correcting for other factors, such as age, gender, and health, that also inﬂuence such selfreports.30 One likely reason for the income–SWB connection is that additional income promises greater choice and control in one’s life, and people like choice

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and control. Additional income may offer the same amenity to children, even if the increased choice is not entirely theirs to exercise but must be shared, or even controlled, by their parents (or the custodial parent). For example, people may see value in a wider choice about where the child lives or what school the child attends, even if the wider choice has no impact on measurable child wellbeing. That is one reason people may favor transfers to custodial households with income beyond the measurable well-being maximum. A second possible reason that people may favor such transfers is associated with the mounting evidence that, as economists have increasingly recognized, relative income is what people care about most of all.31,32 That is because income is important not only for the intrinsic value of the particular amenities that additional dollars may purchase but also for the improved social status that accompanies an advance in one’s position in the overall income distribution.32 People’s sense of how well off they are is strongly affected by their position relative to those immediately around them. Protecting this sense of relative well-being may not seem a very compelling social concern, as a general matter. It perhaps feels different, however, when the question is the child’s living standard relative to the noncustodial parent’s, especially when the child and the noncustodial parent previously lived in the same household and shared the higher living standard the noncustodial parent still enjoys. In that case, the noncustodial parent’s living standard is a more natural benchmark against which to judge the child’s. A living-standard decline is experienced as a decline in well-being, even if the new and reduced living standard is above the societal median. Those who have advanced to the median enjoy a greater sense of well-being than those who have fallen to it. Finally, the expected process of accommodation to new circumstances may not work as well for the child who experiences a living-standard decline as a result of divorce if the child is regularly reexposed to the gap between his current living standard and that of the noncustodial parent he or she visits. Indeed, if the noncustodial parent has new children living with him who share that parent’s superior living standard, the salience of the gap may be increased further. Some will be less persuaded than others by the foregoing arguments for a gross disparity component in support. All the components of a child support award are limited by the EPP, discussed more fully in the next section, but the gross disparity component is especially sensitive to this counterconsideration. The gross disparity component is easy to minimize or reject if one sees it as a claim to provide an already adequately circumstanced child with nonessential amenities, because the natural conclusion is that the support obligor is entitled to give himself priority in the use of his own earnings to provide such amenities. That conclusion is strengthened by the reality that it is not possible to ensure the child a living standard close to the support obligor’s without providing it as well to the custodial parent, who is an inevitable but unintended (and some would say undeserving) beneﬁciary of the support payment. The skeptic’s conclusion might then be that while this unavoidable diversion,

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so to speak, of some support dollars to confer beneﬁt on the custodial parent must be tolerated if the child’s measurable well-being lies in the balance, it should not be tolerated to provide the child with nonessentials. People clearly vary in their resolution of these questions, and in the end the guideline writer must make a value judgment about it. That judgment could be aided considerably by systematic information about the public’s intuitions. They could reveal, for example, that the child’s claim to share the absent parent’s living standard is viewed sympathetically but is ultimately rejected because of strong objection to the custodial parent’s sharing the beneﬁts of higher payments. One might then ﬁnd wider support for the gross disparity component if all or some portion of it were required to be deposited into a segregated account that may only be applied to expenditures conferring beneﬁt on the child alone, including perhaps expenditures we would not ordinarily require of the obligor, such as the cost of college or of private school.33 Principle 3 summarizes our discussion of the gross disparity component. Principle 3. Child support awards may include a component intended to protect children from declines in their living standard that leave them at a level below, and grossly disparate to, the living standard of the support obligor, even if the child’s household already enjoys an income above the well-being maximum. In determining the extent and nature of such awards, guideline writers should be assisted by scientiﬁcally valid surveys of public views about the appropriate way to balance the conﬂicting claims that arise in connection with this component.

The Earner’s Priority Principle

The earner’s priority principle is a pompous name for the entirely obvious idea that all individuals get to keep what they have in the absence of some very good reason to take it from them. While the EPP always applies, its power in the child support context varies with both the earner’s circumstances and the child’s, and is thus a factor to be accounted for. The EPP explains, among other things, why income-shares states sometimes depart from their usual rule of income-proportionality in allocating the support burden between the parents. Obligors Cannot Be Impoverished

The self-support reserve, included in most state guidelines, shields impoverished obligors from onerous support obligations. It is more than a child support analog to progressive taxation. Progressivity could explain the selfsupport reserve when the custodial household has adequate resources, because it then shifts most or all the support burden from the impoverished noncustodial parent to the ﬁnancially comfortable custodial parent. But most states also allow application of a self-support reserve when both the custodial household and the support obligor are ﬁnancially stressed. That practice cannot be

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explained by a progressivity principle. Concerns about the practicality of collecting support obligations from the impoverished may contribute to practice, but they are probably not the entire explanation. It may also reﬂect the view that while the law’s failure to alleviate custodial household poverty is bad, exacerbating the obligor’s poverty by taking funds from him is even worse. The poor should support their children if they can, but that duty does not justify taking money from them that they desperately need to buy basic necessities. The EPP is strongest when the earner has the least. Obligors Are Entitled to Retain Some Priority in the Use of Their Own Income

The EPP can matter even when the obligor is not impoverished. No state requires an obligor who is ﬁnancially more comfortable than the custodial household to pay child support in amounts that would leave him worse off than the custodial parent, even if doing so would improve child well-being and would not impoverish the obligor. This is perhaps the minimal statement of the principle. A more aggressive version allows the earner to retain some of any living-standard advantage he may enjoy over the custodial household. The ALI supports this more ambitious version, once the custodial household is assured of a minimum decent living standard, when it requires only that the child’s living standard not be ‘‘grossly inferior’’ to the obligor’s. And, in fact, rules requiring awards that establish equal living standards in the custodial and noncustodial households, although long urged by some, have never knowingly been adopted, and the reason is surely, at least in part, objection to equalizing the living standard of the two parents under the child support rubric. Equity theory teaches that people believe that outcomes should be related to inputs, and they feel distress when they are not, even if they are the beneﬁciary of the inequity.34 The beneﬁt to the custodial parent seems in this circumstance such an inequity. Some custodial parents will have claims in their own right to share the other parent’s post-separation income, but alimony is the rubric under which such claims are supposed to be considered. If the custodial parent has no valid claim under that legal regimen, realizing its equivalent from child support payments seems to many an unjustiﬁed windfall for the custodial parent and an unjustiﬁed injury to the child support obligor. Every child support award requires compromise between justiﬁed claims (a) on behalf of the child, certainly for the funds necessary to well-being but also to share the obligor’s living standard; and (b) on behalf of the obligor, to resist coerced contribution to the custodial parent’s living standard. The less compelling is the child’s claim, the more powerful is the obligor’s objection. The child’s claim is most compelling when there is evidence that the child’s wellbeing would be endangered by lower levels of support. But as we move from awards protecting child well-being to awards ensuring the child a living standard comparable to the support obligor’s, the EPP becomes relatively more weighty.

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The Questionable Dual-Obligation Exception

There is one group of cases in which most support guidelines seem to require results inconsistent with protecting obligors from support obligations that bring them below the custodial-household living standard. These are the cases in which the obligor’s living standard is near or below the custodial household’s before any support payment. The particularly striking cases involve obligors living far below the custodial household standard. So, for example, all support guidelines would require more than symbolic payments by a noncustodial parent earning $25,000 to a custodial parent earning $65,000, thus reducing the obligor’s living standard further below the custodial household’s. This result seems to conﬂict with the EPP and is especially difﬁcult to defend when the custodial household is near or above the well-being maximum before any payment is made. Awards in these cases consist entirely of a dualobligation component, a less compelling rationale for overriding the EPP. A nominal award seems more appropriate in such cases, as sufﬁcient to serve the symbolic purpose of conﬁrming the legitimacy of the noncustodial parent’s status as parent, and to uphold the principle that both parents must contribute to the child’s support. In fact, actual practice appears to conform to this recommendation, even if the formal guidelines do not. Both family law practitioners and judges observe that when the proposed obligor earns signiﬁcantly less than the custodial parent, the parties usually agree to reduce or even waive the award called for by the guidelines. Guidelines should probably be revised to conform to this practice, which is also consistent with the analysis here. Principles 4 and 5 state conclusions that follow from this discussion of the EPP. Principle 4. Child support awards should ask for no more than nominal amounts from impoverished obligors and should avoid reducing obligor income below poverty levels. Operationalizing this principle requires establishing the poverty level to employ. Guidelines should specify a gradual transition from nominal awards to more meaningful awards as obligor income rises above the speciﬁed poverty level. Principle 5. Where possible without sacriﬁcing important interests of the child, support awards should leave the higher-earning obligor with some advantage in living standard over the custodial household. However, ensuring the impoverished custodial household a ‘‘minimum decent living standard’’ is a sufﬁciently important interest to override this usual preference, and in such cases the award may equalize the household living standards rather than leave the obligor with a living-standard advantage. Operationalizing this principle requires establishing a benchmark for the minimum decent living standard. No interest of the child is normally sufﬁcient to justify an award reducing the obligor’s living standard below that of the custodial household. Where the obligor’s living standard is substantially below the custodial household before any child support transfer, the amount of the required support payment should be appropriately reduced from the level that would otherwise apply.

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Putting It Together: Constructing Guidelines Based on These Principles The combined impact of all ﬁve principles is summarized in Figure 6.3, which consists of a 16-cell matrix constructed by considering four levels of custodial parent income, going from low to high as one proceeds vertically downward through the rows, and four levels of noncustodial parent income, going from low to high as one proceeds to the right through the columns. One can imagine the support award consisting of a base amount and an adjustment to that base. The base amount is derived primarily from the custodial household income. At lower levels of custodial-parent income, represented in Figure 6.3 by cells 1 through 8, this base amount consists principally of the award necessary to raise the custodial household to the well-being maximum. At higher levels of custodial-parent income, represented by cells 9 through 16, the base amount consists primarily of the dual-contribution component, measured as the noncustodial parent’s fair share of the marginal expenditures required to bring the custodial household to the well-being maximum. The precise point at which the base amount shifts from having some well-being component to consisting entirely of a dual-obligation component depends on the income level at which one locates the well-being maximum. These base amounts are then adjusted, upward or downward, to respond to either the EPP or the inclusion of a gross disparity component. The EPP operates to reduce awards primarily at lower levels of noncustodial-parent income, represented here by the ﬁrst two columns, while the gross disparity component adds to the award at the higher noncustodial-parent incomes represented in the two columns on the right-hand side. The construction of actual support guidelines could proceed by ﬁrst choosing representative dollar amounts for these four income levels (low, low-median, high-median, and high), and then determining the base support level, based on these dollar ﬁgures, for each cell in the matrix. These base support levels would require the policymakers’ judgment, informed to the extent possible by available social science evidence, of the well-being maximum, and of the marginal expenditures on children in households at the well-being maximum. Base support levels would then be adjusted, upward or downward, to reﬂect the weight given by the policymaker to the EPP and the gross disparity component. Once a basic approach is decided on, using such a 16-cell matrix, one can expand to a fuller set of guidelines through interpolation. Such a matrix may also be a convenient tool for thinking about the necessary policy judgments. Two sets of cells are particularly useful for this purpose. The Equal-Earner Diagonal: Cells 1, 6, 11, and 16

These cells all involve parents who are equal earners. If the noncustodial parent pays support equal to his half-share of the marginal expenditures on the

Figure 6.3. Combined impact of all principles across incomes. As rows go from dark to light, the base award shifts from consisting primarily of the well-being component to consisting primarily of the dual-obligation component. Intermediate shades consist mostly of one, but may contain some of the other.

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child, the two post-separation households will have approximately the same living standard. That living standard is necessarily below the intact family standard, but the children and both parents share equally in the decline. This result is consistent with Principles 1, 2, and 5 because these noncustodial parents, earning no more than the custodial parents, are not entitled to a livingstandard advantage, but neither can we reduce their living standard below that of the noncustodial parent. In Cell 1, however, Principle 4 also applies and overrides this analysis, yielding a nominal award only. Cell Pairs: 2 and 5, 3 and 9, 4 and 13, 7 and 10, 8 and 14, and 12 and15

Total parental income, and thus the living standard of the intact family, is the same in both members of each of these cell pairs. What differs is the relative income contributions of the custodial and noncustodial parents. From the child’s perspective, that does not matter, and Principles 1 and 3 therefore lead to the conclusion that the support award should yield the same post-payment income for the custodial household in both cells of each pair. No child support system in the country produces this result, however, and the explanation is Principle 5. By focusing on these cell pairs, the policymakers can resolve the relative weights they wish to give Principles 1, 3, and 5. Some variation in the relative weights might be anticipated in a rationally designed system, because in some pairs the claims of the child in the lower-earning custodial household are stronger than in other pairs. The children in cells 5, 9, and 13 have stronger Principle 1 claims, for example, than the children in cell 15, whose claims are grounded more in Principle 3. Having resolved these weights across all these cell pairs would, however, permit reasonable interpolations to ﬁll in the remaining cells in the grid.

Complicating Realities: Additional Household Members Remarriage of the Custodial Parent and Other Additions to the Custodial Household

Although the law usually excludes consideration of the custodial spouse’s remarriage and of the income of the new stepparent, it appears that many people believe the custodial spouse’s remarriage to an income earner does justify reducing the other spouse’s support payments.35 Our principles lead to the conclusion that reductions are sometimes warranted. Consider a custodial parent earning $2,500 a month and a noncustodial parent earning $5,000— cell 10 in Figure 6.3. The application of Principle 1 should yield a reasonably substantial award in this case; Principles 2 and 3 have little application. But now assume the custodial parent remarries a man earning $7,500 a month.

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Principle 1 ceases to seem applicable, as the child’s living standard is now likely to exceed the living standard in the original intact marriage without any support payment. Our reluctance to eliminate the support award entirely arises from Principle 2. What the remarriage has done is shift the basis of the support award from concern for the child’s well-being to concern for maintaining the principle that a parent, including an absent parent, should contribute to his child’s support. Along with that shift is an appropriate recalculation of the award’s amount, which can be reduced because Principle 2, the dual-obligation component, yields more easily to the EPP than Principle 1, the child’s well-being component. In this case, then, the obligor need pay no more than his proportionate share of the marginal expenditures on the child that would have been made by these two parents were they living together in an intact family with the child. We reach a different conclusion if the new member of the custodial household generates marginal expenditures greater than his or her income. No adjustment to the support award is justiﬁed in this case. The award certainly cannot be increased, because the obligor is not responsible for the custodial household shortfall created by additional members to whom the obligor has no legal or moral support obligation. But neither should his payments be reduced, even though they may confer beneﬁts on these legal strangers as well as his child: their addition to the household cannot justify penalizing the child. Remarriage of the Obligor

A sense of symmetry might lead one to assume that the same rules should govern the remarriage of the support obligor as govern the remarriage of the custodial parent. But in the more common situation, in which the child lives primarily with one parent, symmetrical treatment is inappropriate. The support obligor’s remarriage has no direct impact on the ﬁnancial well-being of the child who is the intended beneﬁciary of the support order, and the obligor’s new spouse has no obligation to the child. In most cases this is sufﬁcient to conclude that the remarriage has no effect on the support order. The possible exception arises when the obligor was excused from more than nominal support because of his very low income, but now marries someone with an ample income. Especially where the custodial-household income is well below the well-being maximum, an upward revision of the support award may be appropriate. The obligor is no longer impoverished and will not become impoverished if the support obligation is increased, and this new fact weakens the force of the EPP that justiﬁed the initial choice of a nominal award.

Conclusion The conventional method used to generate child support guidelines conceals important policy choices from those charged with making them. A systematic

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analysis of the policy purposes for collecting child support reveals that most existing guidelines are inconsistent with them. Careful analysis of the policy issues suggests a superior alternative to the conventional methodology in current use, and also helps to resolve the difﬁcult problems created by the increasing incidence of blended families containing both child support obligors and child support recipients.

Notes 1. A more detailed discussion can be found in the authors’ article ‘‘The Theory of Child Support,’’ published in the Harvard Journal of Legislation (2008, 45[1]), from which this chapter is adapted. 2. See Yee, L. M. (1979). What really happens in child support award cases: An empirical study of establishment and enforcement of child support orders in the Denver District Court. Denver Law Journal, 57, 21, 38– 42; White, K. R., & Stone, R. T., Jr. (1976). A study of alimony and child support rulings with some recommendations. Family Law Quarterly, 10, 75, 83. 3. Weitzman, L. J., & Dixon, R. B. (1979). Child custody awards: Legal standards and empirical patterns for child custody, support and visitation after divorce. University of California at Davis Law Review, 12, 473, 494–501; Hunter, N. D. (1983). Child support law and policy: The systematic imposition of costs on women. Harvard Women’s Law Journal, 6, 1. 4. Pub. L. 100– 485, 42 U.S.C. § 667(b) (2001). 5. Calif. Fam. Code § 3900. 6. See, e.g., descriptions of the purpose of New York’s child support law as contained in three different ofﬁcial documents described in Ellman, I. M. (2004). Fudging failure: The economic analysis used to construct child support guidelines. University of Chicago Legal Forum, 167, 179–180. As explained therin, the three descriptions are mutually inconsistent, and only one of them could possibly be interpreted in a manner consistent with New York’s actual guidelines. 7. See Williams, R. (1987). Development of guidelines for child support orders: Advisory panel recommendations and ﬁnal report (p. II-ii). Washington, DC: U.S. Department of Health and Human Services, Ofﬁce of Child Support Enforcement. This report was formally issued by an advisory panel assembled by the National Center for State Courts but was funded by the federal Ofﬁce of Child Support Enforcement. 8. This second report, by David Betson, was prepared under a contract with the University of Wisconsin’s Institute for Research on Poverty for a ﬁnal report to the U.S. Department of Health and Human Services, Alternative Estimates of the Cost of Children from the 1980–86 Consumer Expenditure Survey, Institute for Research on Poverty Special Report # 51, 1990. Even though the title, as well as the text, refers to the cost of children, the report describes itself as a response to a provision in § 128 of the Family Support Act of 1988 (PL 100– 485) that required the U.S. Department of Health and Human Services to ‘‘detail the patterns of expenditures on children in two-parent families and single-parent families’’ (emphasis added). And, indeed, the methodology employed is offered as a way to estimate those expenditures.

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9. Williams founded a consulting company (Policy Studies, Inc., or PSI) as the guideline era began, and that company now prepares the guideline grid in the majority of states. Early on, PSI signed up Betson to provide the expenditure calculations that it uses. Even states that do not use PSI often use its methods. 10. This example is not fanciful. The marginal expenditure methodology employed in the Williams-Betson approach is in fact likely to lead to an estimate of expenditures on children that includes nothing, or next to nothing, for utilities, without regard to whether the custodial parent has other funds with which to pay utility bills. That is because the addition of a child to an intact household previously consisting of two adults may not increase utility bills by very much, if at all, and it is only such increases, not the base costs, that count as marginal expenditures on children. This is similar, for example, with costs for automobiles and for the largest proportion of housing costs (because, e.g., only the additional cost of the twobedroom apartment over the one-bedroom apartment would count as a marginal expenditure, with all the cost of the base apartment excluded). 11. The poverty threshold is set by determining the cost of the breadbasket necessary to provide a family of the speciﬁed size with a basic but nutritionally adequate diet. That amount is then multiplied by a standard constant, originally set at 3, to get the total household income required to maintain a family of that size above the poverty level. See Fisher, G. M. (1992). The development and history of the poverty thresholds. Social Security Bulletin, 55(4), 3–14. This very simple calculation has its critics; see Citro, C. F., & Michael, R. T. (Eds.). (1995). Measuring poverty: A new approach. Washington, DC: National Academy Press. There is no doubt that it is an inapt device for comparing the living standards of households in the upper half of the income distribution. It is nonetheless a standard measure that is easy to understand and provides a useful, if imperfect, way of comparing the living standards of households, especially those in the lower end of the income distribution. 12. Paragraph 15 of the 2004 Arizona Child Support Guidelines, at page 14, directs the court to subtract the self-support reserve of $775 from the obligor’s monthly income. Whenever the remainder, called the ‘‘resulting amount’’ in the guidelines, is less than the support order called for in the guidelines, the court is authorized to reduce the order to this ‘‘resulting amount.’’ In Case 1, the resulting amount is a negative number, which means the court would be authorized to reduce the order to zero. The guidelines allow the court discretion in these cases, observing that under such facts it is ‘‘evident that both parents have insufﬁcient income to be selfsupporting.’’ The Arizona guidelines may be accessed at http:==www.supreme .state.az.us=dr=childsup=CSG2004.pdf. 13. Determining when households of different composition have the same living standard is fraught with difﬁculties, but we do not examine them here. For a full treatment of this problem, see Ellman, I. M. (2004). Fudging failure: The economic analysis used to construct child support guidelines. University of Chicago Legal Forum, 167, 199–215. 14. There are many methodological choices that must be made in generating estimates of marginal expenditures, and different choices lead to very different estimates. But not only are there competing methods for estimating marginal expenditures; it is far from obvious that marginal expenditures are the appropriate benchmark anyway, and there are alternatives to marginal-expenditure estimates. The best-

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15. 16.

17. 18.

19.

20.

21.

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known alternative is the annual report by Lino, M. (2002). Expenditures on children by families: 2001 Annual Report. Washington, DC: U.S. Department of Agriculture, Center for Nutrition Policy and Promotion, Miscellaneous Publication No. 1528–2001. (For a published version of the prior year’s equivalent study, see Lino, M. [2001]. Expenditures on children by families: U.S. Department of Agriculture estimates and alternative estimators. Journal of Legal Economics, 11, 31.) Lino argues that the Department of Agriculture’s approach is a better basis for support guidelines than alternative approaches using a marginal-expenditure methodology (p. 35). While the debate among marginal expenditure methodologies is usually cast in technical terms, it is in fact a policy debate, as is also the choice between marginal expenditures and other methods such as Lino’s. For a more complete description of the technical issues involved, and their policy implications, see Note 13. See the article cited in Note 13. Of course, at very high incomes, savings rates will increase, and expenditures as a percent of income will thus indeed decline. The general trend is therefore not implausible. The CES ﬁgures, however, greatly exaggerate this reality because of the expenditure undercount at higher income levels. The CES ﬁgures could only be valid if one assumed savings rates among middle-class families that are far higher than anyone believes plausible. See the article cited in Note 13. The discussion that follows is a simpliﬁed schematic representation of the methodological points. For a more detailed and complete description, see Note 13. This is despite the fact that the inevitability of such tradeoffs was noted by Betson himself in an article he co-authored early in the guideline era: Betson, D., Evenhouse, E., Reilly, S., & Smolensky, E. (1992). Trade-offs implicit in child-support guidelines. Journal of Policy Analysis & Management, 11(2), 1–20. Perhaps surprisingly, given the widespread use of the Williams-Betson methodology, plugging any given set of family facts into the guidelines of the various states yields a remarkably wide range of outcomes. The variety of results yielded by various guidelines is easily seen in the reviews prepared periodically by Maureen Pirog and her co-authors. For a recent example, see Pirog, M., Grieshop, T., & Elliot, B. (Spring, 2003). Presumptive state child support guidelines: A decade of experience. Policy Currents, 12(1), 15. These differences appear to result from nonsystematic variations in the details of the methodology (as in the choice of equivalence scale used to determine the incomes at which families of different composition enjoy the same living standard) and varying patches to the methodology that states employ, reﬂecting perhaps some intuition that the conventional methods’ unadorned results do not seem right. The basis for identifying persons as parents of a particular child, obligated to support that child, is perhaps not as obvious, on close examination, as it might at ﬁrst seem. The problem is highlighted when one considers that support obligations can result from involuntary parenthood (most clearly in the case of a support order for a child conceived as a result of rape, entered against the rape victim), while consent may alone be inadequate to justify a support order where conception took place without sex (as in the consensual use of sperm for artiﬁcial insemination). But these cases, while fascinating, are matters for a different work. The observations made here summarize the ﬁndings in George, P., & Ellman, I. M. (unpublished, 2005). A review of the literature on the relationship between income

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and child well-being. The studies examined in this literature review included Ackerman, B., Brown, E., & Izard, C. (2004). The relations between contextual risk, earned income, and the school adjustment of children from economically disadvantaged families. Developmental Psychology, 40(2), 204–216; Amato, P., & Gilbreth, J. (1999). Nonresidential fathers and children’s well-being: A metaanalysis. Journal of Marriage and the Family, 61, 557–573; Blau, D. M. (1999). The effect of income on child development. The Review of Economics and Statistics, 81(2), 261–276; Dearing, E., McCartney, K., & Taylor, B. (2001). Change in family income-to-needs matters more for children with less. Child Development, 72, 1779–1793; Dooley, M., & Stewar, J. (2004). Family income and child outcomes in Canada. Canadian Journal of Economics, 37(4), 898–917; Duncan, G. J., & Brooks-Gunn, J. (1997). Consequences of Growing Up Poor. New York: Russel Sage; Duncan, G. J., Brooks-Gunn, J., & Klebanov, P. K. (1994). Economic deprivation and early-childhood development. Childhood Development, 65, 296–318; Linver, M., Brooks-Gunn, J., & Kohen, D. (2002). Family processes as pathways from income to young children’s development. Developmental Psychology, 38(5), 719–734; Luthar, S. (1999). Poverty and children’s adjustment. Beverly Hills, CA: SAGE; McLanahan, S. S., Seltzer, J. A., Hanson, T. L., & Thomson, E. (1994). Child support enforcement and child well-being: greater security or greater conﬂict? In I. Garﬁnkel, S. McLanahan, & P. K. Robins (Eds.), Child support and child well-being Washington, DC: Urban Institute; McLoyd, V. (1998). Socioeconomic disadvantage and child development. American Psychologist, 53, 185–204; Mistry, R., Biesanz, J., Taylor, L., Burchinal, M., & Cox, M. (2004). Family income and its relation to preschool children’s adjustment for families in the NICHD study of early child care. Developmental Psychology, 40(5), 727–745; Morris, P., & Gennetian, L. (2003). Identifying the effects of income on children’s development using experimental data. Journal of Marriage and the Family, 65(3), 716–730; Sobolewski, J. M., & Amato, P. R. (2005). Economic hardship in the family of origin and children’s psychological well-being in adulthood. Journal of Marriage and Family, 67, 141–156; Yeung, W., Linver, M., & Brooks-Gunn, J. (2002). How money matters for young children’s development: Parental investment and family processes. Child Development, 73(6), 1861–1879; and Yoshikawa, H. (1999) Welfare dynamics, support services, mothers’ earnings, and child cognitive development: Implications for contemporary welfare reform. Child Development, 70(3), 779–801. 22. Mistry et al. (Mistry, R. S., Biesanz, J., Taylor, L., Burchinal, M., & Cox, M. [2004]. Family income and its relation to preschool children’s adjustment for families in the NICHD study of early child care. Developmental Psychology, 40[5], 727–745) found a relationship between cognitive functioning and household income in children who were 36 months old. They also found a relationship between household income and behavior problems, as reported by the mother, which appeared to result from the impact of income on maternal health and on the mother– child relationship. To compare the impact of income across households of different size and composition, Mistry et al. used a ‘‘needs’’ ratio for each of the 1,300 families in their sample by dividing the family’s actual household income by the appropriate poverty threshold for the family—essentially equivalent to reporting their income as percentage of the poverty threshold. Mistry et al. found that the impact of income on these well-being measures began to decline when household

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23.

24.

25.

26.

27.

28.

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income rose above poverty level, and largely disappeared for families above 500% of the poverty threshold—about $92,000 for a family of four in 2002, the year in which Mistry et al.’s data were collected. Median household income that year for a family of four was $67,732. These numbers, provided by the U.S. Census Bureau (available at http://www .census.gov/hhes/income/4person.html), are used by the U.S. Department of Health and Human Services for the Low Income Home Energy Assistance Program and are published annually in the Federal Register. The ALI identiﬁes two main claims of the child that the support system should take account of: (1) a minimum decent standard of living when the combined income of the parents is sufﬁcient to achieve such result without impoverishing either parent and (2) a standard of living not grossly inferior to that of either parent. American Law Institute, Principles of the Law of Family Dissolution, § 3.04(1). For a collection of writings on this problem that includes leading commentators of various persuasions, see Elster, J., & Roember, J. (Eds.). (1991). Interpersonal comparisons of well-being. Cambridge: Cambridge University Press. The conventional method, of course, looks at marginal expenditures in the mythical intact family that does not exist at the time of the support order. The argument here suggests looking at the marginal expenditures the custodial parent will incur on the child’s behalf in the one-parent household that exists at the time of the order. For example, Arizona provides a statutory cap when ‘‘the combined adjusted gross income of the parties is greater than $20,000 per month, [in which case] the amount set forth for combined adjusted gross income of $20,000 shall be the presumptive basic child support obligation.’’ Ariz. Rev. Stat. § 25–320(8) (2005). The court may consider the parties’ arguments that a higher award is warranted, on a case-by-case basis. The Massachusetts statutory cap is set where the parties’ combined gross income is $135,000, or where the noncustodial parent’s income exceeds $100,000. In those cases, the minimum presumptive level of support for the $135,000 or $100,000 income group is to be awarded, although ‘‘[a]dditional amounts of child support may be awarded at the judge’s discretion.’’ Mass. C.S.G. II(c) (2005). In New York, where the combined parties’ income exceeds $80,000, the court is given discretion to order. A 1985 telephone survey of randomly chosen residents presented them with a variety of vignettes with varying incomes: the noncustodial fathers in their examples earned from $500 a month to $5,000, and the mothers from nothing to $1,500. The respondents favored support amounts that increased with the obligor-father’s income through this entire range (Schaeffer, N. [1990]. Principles of justice in judgments about child support. Social Forces, 69, 157–179). It appears that the same survey data are also presented in Corbett, T., Garﬁnkel, I., & Schaeffer, N. C. (1992). Public opinion about a child support assurance system. In I. Garﬁnkel, S. S. McLanahan, & P. K. Robins (Eds.). (1992). Child support assurance: Design issues, expected impacts, and political barriers as seen from Wisconsin (pp. 339–364). Washington, DC: Urban Institute Press. They indicate that some respondents were asked to identify the appropriate support amount in dollars, while others were asked to identify it as a percentage of the father’s income. The average response (for a one-child family, across all income amounts) of those who

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29. 30. 31. 32. 33.

34. 35.

Children in Families answered in dollars, when converted to percentages, was 21.4%, while the average for those who answered directly in percentages was 24.7%. There was a drop-off in the percentage of the father’s income that respondents thought he should be required to pay in support, as paternal income reached the highest amounts respondents were asked about, but the dollar amount of the award continued to go up with paternal income. These surveys also found considerable dispersion in the answers given by respondents, making the group means less meaningful. American Law Institute, Principles of the Law of Family Dissolution, § 3.04(1). See the studies described in Frey, B., & Stutzer, A. (2002). Happiness and economics (pp. 81–85). Princeton, NJ: Princeton University Press. See the studies described in Frey, B., & Stutzer, A. (2002). Happiness and economics (pp. 86–90). Princeton, NJ: Princeton University Press. Frank, R. (1999). Luxury fever: Why money fails to satisfy in an era of excess. New York: The Free Press. There is evidence that one consequence of divorce is a reduction in ﬁnancial contributions of noncustodial parents to their children during their later adult years. See Furstenberg, F. F., Jr., Hoffman, S. D., & Shrestha, L. (1995). The effect of divorce on intergenerational transfers: New evidence. Demography, 32, 319– 333. This kind of program might be seen as an appropriate corrective to that tendency. Walster, E., Walster, G. W., & Berscheid, E. (1978). Equity: Theory and research. Boston: Allyn and Bacon. Schaeffer, N. (1990). Principles of justice in judgments about child support. Social Forces, 69, 157, 167.

PART II OUTSIDE FORCES: SHAPING HEALTH AND EDUCATION

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7 Framing Public Interventions with Respect to Children as Parent-Empowering Stephen D. Sugarman

Parents need government assistance in order to promote their children’s best interests. Most parents try to protect their child from dangers, to nourish their child’s development, and to instill values and a sense of purpose in their child so that, as he or she matures, each child will be able to make sensible choices for his or her own life path. Yet not all parents always satisfactorily perform these jobs. A variety of personal conditions may undermine parental efforts, some of which may be blamed on the parents and others not. These conditions include ignorance, selﬁshness, personal crises, family poverty, bad judgment, inattention to the parenting role, and so on. Outside forces may also interfere and overwhelm parental efforts. These include the child’s peers, undesirable cultural and commercial inﬂuences, and so on. Further, parents may have a vision of what their child should be or become that does not best suit the sort of child they have, and as a result they may unduly narrow their child’s future opportunities. To me, these parental shortfalls most importantly demonstrate that parents often cannot do the child-raising work by themselves. The key message is that parents need help, not only from extended family members and the community at large but also from government. For example, public regulation can increase parental power and authority over their children by preventing others from tempting children into self-destructive behaviors.1 The state can also provide information (or require others to provide information) that parents need to enable them to make good decisions for their children. Moreover, government can provide resources that some parents lack. In all of these 151

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power-enhancing ways, government can help parents better fulﬁll their responsibilities to their children. Too often, however, the state’s role is framed in terms of reducing—rather than enhancing—parental power. In the name of ‘‘child protection,’’ government is called upon to step in where parents have failed by substituting collective or professional decisions as to what is best for children. Yet policymakers may be too quick to curtail parental power when further empowering parents would, overall, be best for children. Furthermore, sometimes public policies are framed as ‘‘child protection’’ measures that, on closer analysis, can be better understood as parent-empowering. Add to that this key point: it may often be politically easier to win the adoption of a policy when it is understood as helping people be good parents than when it is understood as overriding parental authority. Isn’t helping people be good parents something on which conservatives (the ‘‘family values’’ crowd) and liberals (who talk of ‘‘personal empowerment’’) agree? By contrast, the constituency may be narrower for ‘‘child protection’’ measures, especially those that are seen to push a large share of parents around because ‘‘legislators or experts know better.’’ All of this implies that not only the substance but also the framing of any speciﬁc policy initiative may be of great importance. Put differently, having a policy be understood as helping large numbers of parents might facilitate its adoption when it would fail if framed differently. In the next two sections, I offer some brief examples to illustrate various points I have just made. Later on, I will examine two particularly controversial topics—obesity in children and school vouchers—in order to more thoroughly explore the importance of framing in discussing policies that impact families.

Simple Framing Examples I believe that several existing policies that at ﬁrst blush may seem very different from one another are all best framed as aimed at helping people be better parents. Consider, for example, policies that (a) require that all television sets come with a ‘‘V chip’’—that clever little technological device that is supposed to allow parents to prevent their children from viewing programs that the parents consider unsuitable2; (b) require that products sold in supermarkets and drug stores that could be unexpectedly dangerous to children contain warnings that they should be kept out of the hands of children3; and (c) provide food stamps to low-income families, enabling large numbers of parents to put food on the household table when they might not otherwise be able to do so.4 These policies respond to different needs parents have in order to better serve their children: (a) the V-chip gives parents more power over outside inﬂuences in order to help them better control their children’s behavior, (b) product warnings

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give parents more information in order to help them better protect their children from dangers at home, and (c) food stamps give parents more resources in order to help them better provide for their children’s needs (and leaves it to parents to decide which food to buy and serve to their children). Not every policy is sensibly framed as parent-enhancing, of course. Some policies clearly do take power away from families in order to help children, to protect others from harm children might cause, or to liberate children from their parents. For example, precluding children from marrying under the age of, say, 16, even if they have parental permission, is a child-protection measure. So, too, are laws requiring children to wear helmets while cycling and requiring parents to transport their young children in the family car only if the child is in the back and strapped into a special seat. Forbidding teenagers from driving cars before they are 16 years old and licensed by the Department of Motor Vehicles, regardless of what parents think about any particular child driving at a younger age, is perhaps best thought of as a protection of others on the road (and nearby sidewalks), although the young teen driver is also being protected against personal dangers arising from his or her own immaturity. And enabling mature teens under the age of 18 to obtain abortions if they so wish, without having to either notify their parents or gain their approval, is an example of a policy aimed at helping to emancipate the young girl from her family. In all of these latter examples, parental authority is diminished, and surely the reduction in parental power illustrated by these examples is sometimes well-justiﬁed. Yet, because restricting parental rights is sometimes resented, and because interventions of that sort may be difﬁcult to enact in the face of complaints about the ‘‘nanny state,’’ I repeat one of my central points: children’s advocates might fare better if, when appropriate, they structured and argued for policies that could be viewed as parent-empowering.

More Complex Examples That May Be Framed as Empowering Parents In this section, I discuss policies that others might not frame as powerenhancing for parents but which I believe can be sensibly understood, and might wisely be framed, in this way. Vaccinations Against Disease

Take, for example, the policy of ‘‘requiring’’ children to be vaccinated. Some may instinctively think of this centrally as a child-protection strategy—forcing health-promoting measures on the child, regardless of the parent’s desires. I understand this point of view, and surely many who support mandatory vaccines see it this way.

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But, with a bit more thought, one realizes that vaccinations are centrally required for diseases that are communicable, and so the mandatory nature of this policy may just as easily be understood as protecting others (especially other children) from the harm that an unvaccinated child might cause them. Note that this policy is typically enforced by denying children access to school if they are not properly vaccinated—partially because of fears that they might become contagious and thus a menace to other children.5,6 Yet, if one looks still deeper, one might conclude that, in its details, our current vaccination policy may actually be best framed as parent-assisting. Notice ﬁrst that by designating vaccines as ‘‘required,’’ the state conveys information to parents as to the great importance of seeking this beneﬁt for their child. Second, along with the ‘‘required’’ feature of the policy typically comes the free provision of vaccines, at least for those parents with ﬁnancial need— thereby enabling a subset of parents to obtain resources they want for their children anyway but might otherwise not be able to provide. And, ﬁnally, it turns out that those rare parents who actually have compelling reasons for not having their children vaccinated are allowed to exclude their children from what otherwise appears to be the mandatory feature of the rule—such as those parents whose religious beliefs preclude them from consenting to these vaccinations. In sum, by paying attention to these speciﬁc features, the plan overall may be best described as parent-empowering. Fluoride to Prevent Tooth Decay

Our evolving approach to tooth decay in children also suggests some ambiguity in the state role or roles being promoted, and hence the opportunity for framing. Initially, ﬂuoride was added only to toothpaste, and I view this change as one that helps parents be better parents. Armed with information about the beneﬁts of ﬂuoride, all parents had to do was get their children to brush their teeth with the right material in order to provide them with greatly enhanced protection against cavities. What are we to make of the government putting ﬂuoride in the drinking water? At ﬁrst, one might say that this policy is best understood as a childprotection measure, forcing tooth-decay protection on pretty much everyone’s children, regardless of how parents act. I assume that this policy of ﬂuoridation of the water only provides substantial beneﬁts for children of parents who neglect to (or choose not to) have their children brush properly with the appropriate toothpaste, again emphasizing the state’s child-protection role. Yet, today, when our society is awash with ‘‘pure’’ bottled water that does not contain ﬂuoride, the story is perhaps again different. Nowadays, parents can, in effect, choose how to provide dental protection for their children— with tap water, toothpaste, or both. As a result, ﬂuoride in the regular drinking water can now be understood as a convenient way for most parents to get for free a resource they want for their children—in short, as a parent-empowering

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policy. After all, parents can resist by deliberately choosing to have their children consume water and use tooth cleaners that are ﬂuoride free, an escape hatch that a true child-protection policy would not likely allow. Consistent with this theme, notice that some rural communities that do not have ﬂuoride in their drinking water instead offer parents the option of having school personnel regularly provide their children with ﬂuoride mouthwash without charge to the family. This offer of information and resources also seems parentempowering to me. Preventing Sales of Cigarettes to Minors

Consider next policies that may be best understood as providing the assistance that parents, as a group, want in order to help them protect their children from undesirable outside inﬂuences. I have especially in mind here parents’ desires to protect their children from temptations and risks they encounter away from the home, although to the extent that outside inﬂuences increasingly penetrate the home, those, too, are relevant. Think about the rule that precludes retailers from selling cigarettes to minors. I believe that this policy is an example of a state intervention that is best justiﬁed and defended as serving to enhance parental power. I say this because, as I see it, the real point of forbidding sales of tobacco to children is to keep cigarettes out of the hands of children whose parents do not want them to smoke. After all, this policy does not prevent parents from providing cigarettes to their own children, nor does it stop them from permitting their own children to smoke at home. Rather, it tries to assist parents who do not want their children to smoke by negating the enticements of tobacco sellers that confront children when they are out of the home and necessarily beyond parental supervision. Obviously, many junior and senior high school students go shopping and=or to and from school on their own. Parents understandably want help in preventing their children from making purchases of things they do not want their children to have. By enlisting retailers to the parental cause—that is, by threatening retailers with penalties if they violate the law—parents’ control over their children’s behavior is enhanced. If, by contrast, the law of child neglect actually threatened to remove children from their homes and place them in foster care if their parents permitted them to smoke at home, that measure would be properly understood as a true child-protection measure. But, at least for now, that is not the law. To be sure, some parents might be slightly inconvenienced by the rule forbidding sales of tobacco products to minors (e.g., the parents cannot send their children to the store to buy their cigarettes) and some parents may not care about having retailers barred from selling such products to their children (either because they are content to let their children smoke or because they are

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conﬁdent that their children would not buy them anyway). This shows that rules reﬂecting the wishes of most parents could have some minor costs. But the point remains that if enough parents seek this help from the state, then, on balance, this sort of parent-empowering measure may be well justiﬁed. R-Rated Movies

The practice of assigning certain movies an R-rating may be understood as similar to the ban on the sale of cigarettes to minors. That is, the R-rating is meant to help parents by denying their children access to such movies unless they are brought to the movies by their parents (or other adults who are parental designates). To be sure, just like the sale of cigarettes to minors, this policy is by no means always effectively enforced. But, as I see it, the sentiment behind both policies is the same—assisting parents who do not want their children to be tempted in settings where parents cannot reasonably be expected to personally supervise their children’s moment-to-moment behavior. Once more, this policy may create some inconvenience to those parents who are content (or even eager) to have their children see an R-rated movie but who do not want to bother joining their children at the cinema (and are too impatient to wait to have the child see the movie at home when it comes out on DVD). But, again, on balance, this small cost has been seen as worth paying for the beneﬁts that so many other parents gain. Notice that if R-rated movies were treated like PG-13-rated movies and merely provided a warning as to content, and cinema operators were permitted to admit unaccompanied children, then R-rated movies would only serve to provide information to parents (and perhaps an extra temptation to children). To be sure, providing information can also help people be better parents. But it is the forbidden-sale feature of R-rated movies (as with cigarettes) that I want to emphasize as properly seen as giving greater power to parents. Curfews

Curfew laws that ban children under a certain age from being out in public (out on the streets) after certain hours may also be viewed as enhancing parental power. Do not lose sight of a key feature of curfew laws, which is that they help parents control their own children. First, parents can warn or threaten their children of the risk of being apprehended by police if they are out in violation of curfews, and, second, if need be, parents can actually call on police or other public ofﬁcials to bring their wayward children home. Indeed, when children talk about having a ‘‘curfew,’’ they usually have in mind one that their own parents have set. To be sure, curfew laws can serve to protect children whose parents are neglectful, as well as to protect others from dangers that ‘‘teens on the loose’’ can create. But what I mean to emphasize here is that enforcing a curfew may

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be practically quite difﬁcult for some parents without the help of the government. And, in the end, analogous to points I made about R-rated movies and cigarettes, curfew laws normally do not apply to children when they are out in the street in the company of their parents. Note, too, that our laws concerning ‘‘runaway’’ children and the like, at base, provide parents with help from government in retrieving their children. In this respect, such children are curfew violators.

Framing Controversial Issues With this overview in mind, I next explore two very contentious matters, seeking to show that advocates of particular policies might more effectively gain their adoption if they can convincingly frame their proposals as parentempowering. Childhood Obesity

Consider ﬁrst the problem of childhood obesity. In the past, say, 30 years, the rate of childhood obesity in the United States has roughly doubled.7 Scientists and physicians are becoming increasingly aware of the serious long-term health problems that readily follow from obesity, including, most prominently, diabetes and high blood pressure.8 During the presidential terms of Johnson and Nixon, our nation was especially concerned about hunger, particularly childhood hunger; today, the focus is largely on the opposite problem. Admittedly, we have not eliminated hunger in America, and sadly some children who are obese also suffer from hunger. This can certainly happen in ﬁnancially impoverished families that often run out of money (and food stamps) before the end of each month. I am talking about children who go hungry for part of the time, yet are substantially overweight, probably from eating much too much at times when food is (or has been) available.9 Alas, falling into this pattern seems quite understandable—if you think you may go without later on, you might well get into the habit of gorging when you can; indeed, this behavior may be a programmed holdover from the time we were hunter-gatherers. Yet, even though lower-income children are disproportionately obese, it is well understood that childhood obesity is a problem that runs through all economic classes. It is perhaps axiomatic to say that obesity is the result of taking in a lot more calories than are consumed through normal bodily functions and exercise. This leads to something of a ‘‘blame the other guy’’ mentality in which, for example, food and beverage makers point to the fact that kids today seem to spend so many hours in front of TVs, computers, and video games instead of riding their bikes or otherwise engaging in physical activity.10 For their part, too, public-health leaders often seem divided as to whether the problem is greater on the healthy-eating side or on the healthy-activity side.

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More important to me, however, is the seeming effort by the food and beverage industry to frame childhood obesity as a problem of parental failing.11 The perspective being promoted is that everyone knows that obesity is not good for children, so society should consider parents responsible for ‘‘allowing’’ children to become overweight. Clearly, this framing is pushed by food and beverage makers who are resisting being sued by parents on behalf of their obese children. Yet emphasizing that parents are responsible for childhood obesity also raises the possibility of a counterstrategy: framing proposed state interventions as intended to enhance parents’ ability actually to take responsibility for the obesity problem. So far, most people in the public-health community seem to respond narrowly within this ‘‘blame the parents’’ frame. For example, they respond that some parents actually do not realize how dangerous obesity is for their children (especially, perhaps, if the parents themselves are obese—although in some families that fact could cut the other way). Moreover, they argue that in order to take responsibility for preventing obesity in their children, parents need to know more about how to do that. Both of these arguments point toward providing parents with more information. This might call for at least two state interventions that could be framed as parent-empowering12: (1) parental-education campaigns designed to help parents recognize the signs of childhood obesity and the risks associated with it and (2) required disclosure policies that provide parents with knowledge about the calories and other features of the speciﬁc food they are considering feeding to their children. For example, many advocates are pushing to have fast-food outlets disclose the calories, fat content, and other dimensions of the foods they sell. Advocates have in mind here the sorts of labels that now are placed on nonprepared and packaged foods sold in grocery stores. Their main underlying assumption seems to be that too many parents simply do not appreciate that fast food, for example, is typically far less healthy than are fresh fruits and vegetables, lean meats, and so on. Food and beverage makers are not eager for mandatory-disclosure regulation of this sort. They are apt to argue that if parents demand this information, the market will produce it. And, indeed, we have recently seen some fast-food sellers come forward with increasingly accessible disclosures, even when those disclosures are not yet formally required by law. Whether this is a genuine market response or an effort to forestall tougher regulation is not clear. But it does seem clear to me that the food and beverage makers are eager to cabin regulation—if it occurs—to these sorts of informational measures. For example, they certainly do not want it made illegal to sell things like candy, potato chips, and sweetened carbonated beverages to minors—that is, to put ‘‘ junk’’ foods in the same category as cigarettes and R-rated movies. If a proposal as radical as this were to emerge, the food and beverage industry would likely try to frame it not as parental-power enhancing but as misguided child-protection advocacy by ‘‘public health fanatics’’—just as some regulatory controls over

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tobacco products have been attacked by the industry as the agenda of ‘‘antismoking Nazis.’’ Next, consider childhood-obesity interventions far stronger than merely requiring information disclosures that can also be framed as what parents (or most parents, or, better yet, nearly all parents) want. Think ﬁrst of the now increasingly common call to ban the sale of sodas in schools.13 This initiative, it seems to me, can be readily framed as a policy aimed at helping parents be better parents. After all, surely the case can be made that most parents are not eager for their children to consume unlimited quantities of sweetened beverages. But the reality is that if schools have Coke, Pepsi, and the like in vending machines or in school cafeterias, then kids may well be tempted to drink much more of them than parents wish. Of course, parents can attempt to instruct their children as to what to drink at lunch and during the day, but in reality parents cannot effectively control how their children act at school. Hence, preventing sodas from being sold at school could help parents achieve what they wish. An even stronger policy initiative would bar students from drinking sodas at school regardless of their source. As this would block students from bringing sodas from home and drinking them at lunch, this no longer seems easily framed as a policy of empowering parents. After all, shouldn’t parents themselves control what their children take in their lunchboxes? By this way of thinking, a ban seems more a child-protection strategy pushed by those who do not want children to drink sodas at school regardless of parental views. Yet this latter line of analysis overlooks important realities. Suppose a ban on in-school sales mainly caused students (in deﬁance of their parents) to simply bring into school sodas they bought from stores en route to school. In that case, a ‘‘no inschool sales’’ rule could be rendered almost meaningless. Moreover, it would likely be unworkable to ask school ofﬁcials to determine the source of the soda (i.e., home-provided or not). Given those realities, a ban on drinking sodas in school could indeed be framed as helping parents be better parents. Recently, the leading sweetened beverage companies agreed to pull drinks like Coke and Pepsi from schools, and this might be seen as a response to demands made by parents.14,15 Yet it appears that ‘‘sports drinks’’ will continue to be sold in schools, even though they are, in general, just as unhealthy as traditional sodas. Moreover, as already noted, bans on soda sales by themselves may not sufﬁce to help parents prevent their children from drinking sodas during school hours if alternative sources are readily available. Think next about foods and beverages that are promoted in connection with children’s TV programs. Most of these promotions would clearly be understood by adults as ‘‘ads.’’ Yet studies suggest that many young viewers (certainly those under 8 years of age) do not appreciate the difference between an ad and a program. Other promotions may come as paid product placements in the shows themselves, a marketing strategy that younger children are very unlikely to understand on their own.

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Suppose, then, that parents as a group come forward and complain that these promotions are enticing their children to demand products to eat and drink that parents believe are bad for children. And suppose that parents argue that these commercial promotions are presented in a misleading way that undermines children’s abilities to separate hucksters from reliable information providers. And suppose parents then push to have these promotions banned, or limited in quantity, or regulated in various other respects. My central point here is that this sort of regulation of children’s TV advertising could be framed as a means for helping people be better parents. To be sure, TV advertisers would seek to reject this framing. They would likely argue that objecting parents already have within their power a clear solution to ads that are offensive to them: turn off the TV when objectionable ads or shows come on, or, if need be, make their entire home TV-free. Moreover, they could point out that, with a sophisticated V-chip, parents who are motivated to control their children’s access to programs with these ads could do so without being in the same room as the TV. Hence, if advocates complain about children’s TV advertising, in a context in which parents are failing to curtail their own children’s access to the ads, the proposed policies likely will be framed by food and beverage companies as ‘‘child-protection’’ measures to aid hapless parents, rather than ‘‘parentenhancing’’ measures desired by most parents. Of course, as I already noted, in many settings ‘‘child protection’’ itself can be a politically attractive cause. Yet, if responsible parents are perceived as not really in need of help, the government risks being framed as an ofﬁcious nanny. In support of their framing, food and beverage companies are likely to offer testimony from parents who say that they are simply uninﬂuenced by their children’s pleas to serve them certain food and drink products based on what the children see on TV, that they watch TV with their kids and laugh with them at the ads (perhaps using the occasion as a teaching lesson), or that they reward their kids occasionally with things their kids want after seeing them on TV but are well able to control their children’s overall diet.16 Put differently, when parents already have considerable power, proposed state interventions may be effectively framed as paternalistic measures that are aimed at a small number of ‘‘other’’ parents and that are unneeded and unwanted by the majority. In short, it may be difﬁcult to convincingly frame regulations of TV ads aimed at children as what ‘‘most parents’’ want. Nonetheless, even here creative framing from the other side may enable advocates to portray controls on children’s TV advertising as parent-enhancing after all. The strongest argument, in my view, starts with the idea that virtually all parents object to their children’s being taken advantage of. To frame this argument successfully, advocates must convince policy makers that (a) advertisers are promoting products that children themselves cannot possibly judge as good (or bad) for their health and (b) the sophisticated marketing strategies of the advertisers succeed in turning young children into

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‘‘whiners’’ today (begging parents for certain products) and from there into brand-loyal teenage and adult consumers. In support of these points, advocates should rhetorically ask, ‘‘Why else would so many millions of dollars be spent on ads aimed at children who currently have little or no money at their personal disposal?’’ My point is that if children’s TV advertising were successfully framed as misleading and unfair in terms of its impact on the child, then a convincing case might well be made for enabling parents to shield their kids from such ads (without having to force their children to give up TV altogether). Perhaps advocates could cast children’s TV ads as parallel to the problem presented when some children bully other children on the school playground. When playmates behave like this outside school hours, parents can perhaps be expected to intervene on their own—by keeping their children away from the bullies. But when this happens during recess or the school lunch hour, parents understandably believe that they have a right to call on public ofﬁcials to step in on the parents’ behalf to protect the children. It is hardly sufﬁcient for school ofﬁcials to say that parents can take their children to a different school (although this is a last resort to which some parents may ultimately have to turn). Parents who do not want TV advertising to take advantage of their children may be able to frame their demand for help from governmental authorities in a similar way. And, as I have argued throughout, this framing may be the key to winning the controls over TV ads that advocates are seeking.

School Choice (Vouchers) Finally, I turn to the school voucher debate, once more seeking to demonstrate that at least certain proposals for expanding school choice may be best framed as enhancing parents’ ability to be effective actors on behalf of their children.17 These days, the reality is that reasonably well-to-do parents are generally able to select schools for their children that they believe well serve their children’s needs. They do so primarily by deciding where the family will live and then enrolling the children in the local public school. Secondarily, about 10% of American families send their children to private schools, which the parents presumably believe are better for their children than public schools, as the family is choosing to pay for something that otherwise would be largely without ﬁnancial cost. Both of these choices are clear examples of the exercising of parental power on behalf of children. Yet most working-class and ﬁnancially impoverished parents do not have the ability to make such choices. Instead, they are given what someone else has, in effect, decided is best for their children. If, instead of using public money only to pay for locally assigned public schools, government were to provide all families (or, perhaps better, just low-income families) with scholarships they

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could use to obtain an education for their children at a much wider range of schools, this could be framed as parent-empowering. All too often, in my view, proponents seek to frame school vouchers as a mechanism that, through the operation of market forces, would yield bettereducated children for the beneﬁt of employers or the nation as a whole (frequently resting the case for school vouchers on the relatively low level of academic achievement of U.S. children compared with those of many other nations). Alternatively, many pro-voucher voices seem more concerned with framing this reform as teacher-union-busting than as promoting children’s education. So, too, opponents of school vouchers typically frame the issue as one that undesirably increases the power of religion in American society or that paves the way for hucksters to make money off the taxpayers, rather than addressing vouchers’ potential impact on families who today do not have the power to choose. For school voucher advocates to make greater headway, especially with liberals, I believe that both the campaign and the proposal details must credibly present the proposal as parent-empowering—and especially empowering the ‘‘have-nots.’’ After all, liberals typically see themselves as champions of lowincome children and their families. Recall that it was Clinton Democrats who readily embraced ‘‘the end of welfare as we know it.’’18 The ideology underneath that call was rooted in the notion of getting more parents to take greater responsibility for their lives by working in the paid labor force and, in turn, setting good examples for their children. For today’s low-income family, however, the school often comes across to the child as an all-powerful institution that parents are largely helpless to change or inﬂuence. With a scholarship in their hands, parents would have a much greater opportunity to take responsibility and serve as real deciders with respect to their child’s education. If school choice proposals are framed in this way, liberals may also come to better appreciate that in making choices to live in certain suburbs or to enroll their children in private schools, many parents today are deliberately acting to keep their children away from other people’s children—especially the children of the poor. Were those latter children’s families also empowered, then that sort of exclusionary practice might be reduced. Of course, merely offering a scholarship may be insufﬁcient to effectively empower lower-income parents. They might also need informational help, such as assistance from neutral guidance counselors as to what schools are likely to be better for their children. And they might also need help from the government in weeding out corrupt and phony schools, perhaps by making ﬁnancial audits, required disclosure of student achievement results, and the like integral parts of the school voucher program. Moreover, some types of school voucher proposals should be exposed as mostly helping parents with means, rather than genuinely empowering low-income families. But the core case for school vouchers for the poor, like food stamps and many other policies

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discussed here, should be framed (and debated) in terms of whether this policy initiative would help people be better parents than they are today. In fact, some headway in this direction has been achieved in the past decade or so. While publicly funded private-school voucher plans remain few and are available only in a small number of communities around the nation (most importantly in Milwaukee, Cleveland, and Washington, D.C.), there has been a signiﬁcant expansion in public school choice for families who previously had little choice. I refer here to the charter school movement, the growth in statewide interdistrict transfer programs, the embrace by many urban school districts of smaller ‘‘choice’’ schools inside the district, and the increase in the number of communities in which all (or nearly all) of the district’s public schools are thrown open to families who do not live in the vicinity of the local public school they prefer.19,20 All of these developments, in my view, are best understood—and best framed—as strategies to empower parents. Moreover, giving greater school choice to working-class and low-income families may help diffuse controversies that now plague public schools, particularly those controversies involving parental ability to control some aspect of a child’s education. Many of those evangelical families who oppose the teaching of evolution in the schools might happily send their children to religious schools that teach ‘‘creationism’’ or ‘‘intelligent design,’’ if they only could afford those schools. Similarly, the battle over whether bilingual education classes or total-immersion programs are better for non-English-speaking children could be resolved by empowering the parents of those children to decide what they think is the best educational approach given their particular family situation. And, ﬁnally, contentious arguments about whether sex education should be taught in schools or whether particular books should be available to children in school libraries could be considerably muted if objecting families had genuine alternatives available to them.

Conclusion The bottom line is this: Many people jump to the conclusion that proposed state interventions with respect to child rearing must be motivated by those who seek to beneﬁt children in ways they think best, to protect others from children, or to liberate children from their parents. This point of view seems to stem from the mistaken assumption that the best way to enable parents to take responsibility for their children is to not interfere with the family and simply leave parents alone. By contrast, I have shown that there are several ways in which government can act to help parents better promote the best interests of their own children. Providing resources and information to parents are good examples that I think many would acknowledge. But perhaps the most important point I have tried to make here is that government regulation of the world that is importantly

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outside of parental control, if properly framed, can also be understood as enhancing parents’ power to be better ﬁduciaries. To be sure, not all policies one can think of that could theoretically be framed as parent-empowering are going to be successfully framed as reﬂecting what ‘‘most=nearly all parents want.’’ Imagine, for example, a movement to ban high school football on the ground that parents have concluded that it both is too dangerous and promotes violence among the participants—things that most parents surely do not want for their children. Of course, many parents actually believe that playing football is, on balance, a good experience for their children. Hence, it would be a hard sell to convince most people that this proposal is appropriately framed as enhancing parental power—especially if the school speciﬁcally requires parental consent before a student can be on the football team. Rather, this is much more likely to be seen as a paternalistic child protection effort, and as such, I suggest, it is less likely to gain public acceptance. Independent teen access to contraceptives is yet another complicated issue. Is this a child emancipation policy, a child protection policy, a policy aimed at preventing harm to other children, or all three? But notice, too, how a contrary policy—one that blocked the direct sale or distribution of contraceptives to teens by schools, health centers, and pharmacies—could be framed as parentempowering on the ground that it is something that most parents favor. The claim would be that, just like cigarettes, these are products to which parents want to control their children’s access. This example shows that government policies put forward as having been designed to help parents do a better job in raising their children need not be exclusively advanced by ‘‘liberals.’’ Of course, liberals are likely to respond to attempts to frame such a policy as inconsistent with what most parents want, or, alternatively, as one of those circumstances in which reduced, not enhanced, parental power is socially more desirable. Nonetheless, the message I present here is perhaps best addressed to liberals. As I see it, they all too often approach and present policies concerning children on the basis of what they think is best for children, and they ﬁnd it bafﬂing and frustrating that everyone does not see it that way. But they might fare better politically (and better serve the well-being of children) if they examined policies in terms of their potential to enhance parents’ ability to be good parents. This approach, of course, requires one to then be tolerant of choices that ‘‘other’’ parents make for their children when they are choices that ‘‘we’’ might not make for ours. Obviously, some choices should not be tolerated—like those creating an unreasonable risk of substantial physical harm to the child. But in most cases, however, we must keep in mind what it means to empower parents—helping people make decisions about the raising of their children. That includes deciding what movies their children should be blocked from seeing, whether their children should be stopped from smoking cigarettes, what school their children should attend, how much junk food and drink their

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children should consume, and more. For these important matters, it may well be best for society to rely on social norms rather than legal regulation to help shape the choices made by empowered parents.

Notes 1. Feldman, S., Wolf, A., & Warmouth, D. (1977). Parental concern about childdirected commercials. Journal of Communication, 27(1), 125–137. 2. Rideout, V. (2007). Parents, children and media: A Kaiser Foundation survey. Menlo Park, CA: Kaiser Foundation. 3. Deturck, M., & Goldhaber, G. (1989). Effectiveness of product warning labels: Effects of consumers’ information processing objectives. Journal of Consumer Affairs, 23(1), 111–126. 4. Wolkwitz, K. (2007). Trends in Food Stamp Program participation rates 1999–2005. Prepared by Mathematica Policy Research Inc. for the Food and Nutrition Services. Retrieved September 14, 2007, from http://www.fns.usda.gov/oane/menu/ Published/FSP/FILES/Participation/Trends1999-2005.pdf. 5. Feudtner, C., & Marcuse, E. (2001). Ethics and immunization policy: Promoting dialogue to sustain consensus. Pediatrics, 107(5), 1158–1164. 6. Salmon, D., Omer, S., Moulton, L., Stokley, S., DeHart, M., Lett, S., et al. (2005). Exemptions to school immunization requirements: The role of school-level requirements, policies, and procedures. American Journal of Public Health, 95(3), 436– 440. 7. Deckelbaum, R., & Williams, C. (2001). Childhood obesity: The health issue; Section I—Obesity, the major health issue of the 21st century. Obesity Research, 9, S239–S243. 8. Must, A., & Strauss, R. (1999). Risks and consequences of childhood and adolescent obesity. International Journal of Obesity, 23(2), s2–s11. 9. Crawford, P., Townsend, M., Metz, D., Smith, D., Espinosa-Hall, G., Donohue, S., et al. (2004). How can Californians be overweight and hungry? California Agriculture, 58(1), 12–17. 10. Robinson, T. (2001). Television viewing and childhood obesity. Pediatric Clinics of North America, 48(4), 1017–1026. 11. Golin, J. ( July, 2005). Marketing and parental responsibility. Retrieved August 28, 2007, from http://www.commercialfreechildhood.org/articles/marketingandpar entalresponsibility.htm. 12. Seiders, K., & Petty, R. (2004). Obesity and the role of food marketing: A policy analysis of issues and remedies. Journal of Public Policy and Marketing, 23(2), 153– 169. 13. Fried, E., & Nestle, M. (2002). The growing political movement against soft drinks in schools. The Journal of the American Medical Association, 288(17), 2181. 14. DiMassa, C. (2003). Sale of junk food at school banned. Los Angeles Times, October 29. 15. Hayasaki, E. (2002). Schools to end soda sales; L.A. uniﬁed: The soft drinks won’t be allowed on campuses starting in 2004. Los Angeles Times, August 28. 16. Macklin, M., & Carlson, L. (1999). Advertising to children: Concepts and controversies. Thousand Oaks, CA: Sage Publications.

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17. Coons, J., & Sugarman, S. (1978). Education by choice: The case for family control. Berkeley: University of California Press. 18. Weaver, R. (2000). Ending welfare as we know it. Washington, DC: Brookings Institution Press. 19. Miron, G., & Nelson, C. (2002). What’s public about charter schools? Lessons learned about choice and accountability. Thousand Oaks, CA: Corwin Press. 20. Goenner, J. (1996). Charter schools: The revitalization of public education. Phi Delta Kappan, 78(1), 32–36.

8 Childhood ADHD: Biological Reality or Social Construction, with Policy Implications Stephen P. Hinshaw

Unless one has made a considerable effort to actively avoid all media outlets in recent years, it would be impossible to escape the controversies surrounding the existence, nature, and treatment of Attention-Deﬁcit=Hyperactivity Disorder (ADHD). Many questions abound in both scientiﬁc and more popular dialogue: Is ADHD a real condition, or does its diagnostic prevalence reﬂect increasing social tendencies toward conformity, a lack of tolerance of children’s diverse developmental pathways, or the expanding medicalization of emotional and behavioral problems? Is the increased focus on ADHD related to societal concern with school achievement at the expense of other forms of competence? Is medication treatment overzealous and potentially dangerous, or is there a sound conceptual and empirical basis for pharmacological intervention? What other forms of intervention have received empirical support— and is there adequate insurance coverage for accurate diagnosis and responsive treatments for families who request such? Is ADHD a white, middle-class phenomenon, or does it exist across diverse socioeconomic and racial strata? Given my background and training as a clinical psychologist and developmental psychopathologist, my focus herein is primarily on causal factors, developmental progressions, and treatment strategies for children and families. Yet because of the high prevalence of ADHD, as well as the major developmental and social issues that emanate from diagnosis and treatment of this disorder, addressing pertinent considerations for social policy is essential. My aims in this chapter are the following—to describe what ADHD is (and is not); to discuss the genetic, biological, familial, and social forces that shape its 167

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symptomatology; to show that despite its quantitative (rather than categorical) nature it can yield signiﬁcant impairment in core developmental domains; to consider the controversies and truths about medication treatments (as well as family- and school-based psychosocial treatments) for this condition; to highlight the key ways in which families (and schools) are central to clinical and developmental outcomes; to place the current controversies about its very existence in the context of the pervasive stigmatization of all mental disorder; and to focus on several core implications for public policy. My hope is that readers will come away with a better sense of the underlying issues regarding ADHD, as well as a sound perspective on the kinds of psychological, social, political, and policy-related controversies in which any discussion of behavioral disturbance and mental disorder in children is embedded.

Attention Deﬁcits and Impulsivity: Normal Behaviors or Signs of Disorder? An essential issue is that the deﬁning features of ADHD are behaviors that characterize nearly all very young children. Indeed, because of the long time frame for both neural development and the cultural socialization necessary for full maturation of the frontal lobes, poor attentional capacities, emotional lability, dysregulation of impulse control, and overactivity are ubiquitous among toddlers and early preschoolers.1 Because these are the very behaviors that deﬁne ADHD, however, controversy abounds in that the core symptoms include everyday actions rather than the noticeably aberrant characteristics of conditions such as autism. It is essential to realize, however, that when a child or adolescent shows noteworthy problems in inattention, impulsivity, and hyperactivity that are developmentally extreme—that is, quite deviant for his or her age—and that occur in both home and school settings, the consequences can be far-reaching.2 Indeed, as discussed later in the chapter, impairments attending to such behavior patterns are extremely predictive of long-term developmental maladaptation. Thus, a key policy issue related to ADHD is its accurate assessment. If, as is far too often the case, the diagnosis is made after a cursory pediatric ofﬁce visit, a range of behavior patterns—normal variations in behavior patterns, responses to life stress or family disharmony, or reactions to faulty classroom environments (including poor ‘‘ﬁt’’ between school setting and child)—may well be misdiagnosed as ADHD. Because the constituent symptoms exist at high rates in the general population, with overall diagnostic prevalence ranging from 5% to 8% of the school-aged population,3 claims of ADHD occur with high frequency, fueling concerns that it could in fact be overdiagnosed. In addition, unless medical and neurological evaluation is performed, a diagnosis of ADHD can mistakenly be given to a seizure disorder or other neurological condition. Other psychological and psychiatric problems may also be misdiagnosed as ADHD. For example, one of the cardinal symptoms of

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depression is poor concentration, and the sequelae of some forms of child abuse can mimic the constituent symptomatology of ADHD.3,4 In sum, without careful evaluation, overdiagnosis is a real possibility. It is important to realize that false-positive diagnoses are not the only problem. That is, when clinicians rely too heavily on their own impressions during a brief ofﬁce visit, underdiagnosis (false-negative appraisals) may well occur, because many individuals with ADHD often ‘‘pull it together’’ for a brief time period in novel settings and because clinicians may be biased in their belief that ADHD occurs only in white, middle-class youth. In fact, the behavior patterns reﬂective of ADHD show up most frequently in large-group, structured interactions (e.g., classrooms) or during everyday tasks requiring concentration and self-direction (e.g., while performing homework). In contrast, attention may be overfocused in the presence of individually tailored, colorful stimuli such as video games or self-selected tasks of high intrinsic interest—or when confronting a professional in a one-on-one interaction. Furthermore, the prevalence of inattentive, impulsive, and hyperactive symptoms is similar across racial and socioeconomic groups. Implications for assessment and evaluation are apparent. First, clinicians must obtain a thorough history of the child’s developmental milestones, family transitions and stressors, and patterns of behavioral and emotional adjustment.5,6 Such a history provides necessary contextualization of the child’s troublesome actions; it is also essential to guarantee that the behavior patterns are long-standing rather than transitory responses to stress or even trauma.3 If a cross-sectional snapshot of current behavior constitutes the only data, overzealous diagnosis is a clear possibility. Second, the assessor must obtain data from those individuals who know the child in his or her everyday settings—parents and teachers—and must obtain quantitative ratings on wellnormed checklists. Only by so doing can it be asserted that the behavior patterns in question are statistically rare given the child’s age or developmental level. Third, whereas cognitive assessments, medical and neurological tests, and (more recently) brain-imaging methods are important for research on the underpinnings of ADHD,7,8 they cannot presently be used to diagnose ADHD. Much greater scientiﬁc validation is required before these methods can be useful for diagnosis of individual cases. Fourth, given the strong likelihood that ADHD occurs in conjunction with additional psychological conditions—such as learning disorders, conduct problems, and anxiety and=or mood disorders— evaluation must assess for the presence of such comorbidities, which are highly likely to require alternative treatment strategies. Finally, assessors must realize that ADHD appears across diverse national, racial, and cultural groups and that it exists on a continuum. Indeed, in many respects, ADHD symptoms are like blood pressure, which also follows a continuous, normal distribution—but for which designation of thresholds for ‘‘hypertension’’ is essential for clinical and policy decisions. In all, thorough assessment is not a luxury but rather a necessity if one wishes to avoid either overdiagnosis or underdiagnosis of ADHD. Professional

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guidelines for appropriate diagnosis have existed for a number of years3,5; yet, unless they are enforced, unless professionals are trained in valid diagnostic evaluations, and unless insurance coverage allows for the thorough assessments needed, the situation is not likely to change.

Causal Factors Is there strong genetic liability for ADHD? The answer is a clear ‘‘yes.’’ Twin and adoption studies can help to uncover whether individual differences in a trait or condition are related to genes, shared environments, or nonshared (unique) environments. A host of recent evidence from such investigations reveals that over 70% of the individual differences in ADHD symptoms across the population are due to genetic (rather than environmental) factors, meaning that the heritability of ADHD is stronger than that of schizophrenia or depression.7–9 Importantly, such heritability estimates apply to both categorical and dimensional deﬁnitions of ADHD,10 meaning that genetic risk factors pertain to the entire continuum of ADHD-related symptomatology. In other words, like most other mental disorders and a host of medical conditions, ADHD is clearly dimensional (rather than involving a distinct category), even at the level of the underlying genetic liability. I must point out, however, that ADHD (and its precursor terms) did not really emerge as a condition worthy of clinical attention until compulsory education became law in various nations. In other words, the underlying genetic predisposition toward poor focus and underregulation of impulses is ‘‘activated’’ by shifting demands on children in industrialized societies. Thus, ADHD is at once extremely biological and extremely cultural in its origins. Although heritability estimates alone cannot specify the nature of the genetic risk, evidence is converging on ﬁndings that genes related to the functioning of dopamine in the brain are highly likely to be implicated.7,8 Other biological factors are salient. Low birth weight is a risk factor for ADHD-related symptomatology, even controlling for gestational age and maternal substance use; maternal ingestion of alcohol or nicotine can also predispose to the constituent behavior patterns.8,11 Intriguingly, the most striking behavioral consequence of severe institutional deprivation (for example, of the type found in Eastern European orphanages) is inattentive=overactive behavior rather than aggression or depressed=anxious behavior patterns.12 On the other hand, there is little evidence that, in less extreme environments, early insecurity of attachment or poor parenting practices contribute to ADHD9 (but see Carlson et al.13 for contradictory evidence regarding the role of overstimulating and insensitive parenting in some low-income families). Importantly, however, even though consensus is emerging that ADHD results from temperamental variations in activity level, effortful control, and impulse regulation, it is still the case that how parents and other socialization agents respond to such early appearing, biologically mediated behavior patterns

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is crucial for outcome.1,14,15 In other words, despite the undoubted psychobiological origins of ADHD, bidirectional processes between parent and child (as well as teacher and child) serve to shape ultimate developmental adaptation or maladaptation in transactional fashion. Overly simplistic and unidirectional models featuring either biological=genetic or environmental= psychosocial causation must give way to integrative, transactional models from developmental psychopathology. Finally, I reiterate that ADHD exists across ethnic and racial groups, in multiple nations and cultures, and among diverse socioeconomic strata.11 It is not exclusively a middle-class, suburban phenomenon. Yet the strongest press for medication treatments often emanates from middle-class, suburban communities, leading to the false conclusion that ADHD is an ‘‘excuse’’ for low achievement or behavioral dyscontrol promoted by afﬂuent families. When clinicians and professionals realize that ADHD is an ‘‘equal opportunity’’ disorder—and that, in fact, risk factors for ADHD tend to congregate in the lower rungs of socioeconomic status—there is greater potential for diagnoses not to be clouded by bias.

Impairments and Life Course Does ADHD portend signiﬁcant developmental problems, or is it an example of societal concern (or overconcern) with what are essentially normal-range deviations? Overwhelming evidence favors the former answer—namely, that children with well-diagnosed ADHD are at risk for developing one or more negative developmental trajectories, in precisely those domains of functioning that are crucial for life success.2 It is now clear that ADHD is associated, ﬁrst and foremost, with problems in schoolwork and academic achievement. Even with statistical control of associated learning disorders or other comorbidities, ADHD is speciﬁcally linked to lowered grades, school dropout, and poor scores on objective measures of achievement.16 Effects are large in this domain: children with ADHD are often considerably behind their peers, despite normal or above-normal intellectual functioning. Other indicators of school maladjustment (grade retention, need for special education services, and the like) are also associated with childhood ADHD, particularly when inattention and impulsivity are accompanied by disruptive behavior patterns.17 Given the crucial role of academic skill in predicting life success, the status of ADHD as a risk factor for markedly deﬁcient performance in this domain is a major cause for concern. Potentially even more devastating are the ramiﬁcations of ADHD for social functioning. For one thing, families of youth with this condition are marked by high levels of parenting stress, risk for escalation of negative and ineffective discipline practices, sibling problems, and higher-than-normative rates of marital dissolution.11,18 Thus, even though there is little evidence for the role of poor parenting in the genesis of ADHD, when parents encounter the

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oppositional and poorly self-regulated behavior patterns of such children with conﬂictual, negative affect-laden parenting strategies, the child’s (and the family’s) problems are likely to become magniﬁed. In addition, across all child and adolescent psychological and psychiatric disorders, ADHD is the condition most likely to be associated with peer rejection.19–21 That is, the impulsive and poorly modulated behavior patterns linked with ADHD promote conﬂicts with agemates, who are prone to dislike and reject youth with ADHD after extremely short exposures to their disruptive behaviors.22 Given that rejection from the peer group is an extremely potent predictor of subsequent academic maladjustment, delinquency, and mental health problems,23 there is little surprise that children with ADHD are at continuing risk for maladjustment. ADHD is also associated with risk for accidental injury. This risk appears ﬁrst during the preschool years,24 when a dysregulated behavioral style predicts burns, falls, and emergency department visits. Such risk extends at least until late adolescence, when motor vehicle accidents occur at far higher rates in samples of individuals with ADHD than in the general population.17 In short, the serious risk for injury and accident-related impairment in the ADHD population constitutes a strong counterargument against those who contend that ADHD is simply a societal overlabeling of normal-range behavior patterns, bothersome to adults but not otherwise contributing to impairment or disability. On the contrary, ADHD is linked with serious physical consequences. I pause to point out that, like all other neurodevelopmental disorders with origins in early childhood, ADHD shows a clear male predominance, even in community samples, with a male-to-female ratio of approximately 3:1. Yet girls have been extremely neglected in existing research, at rates of 1 in 10 or lower. Importantly, cross-sectional investigations have revealed that girls with ADHD have similarly high risk as do boys for social, academic, and other functional impairments.25,26 Furthermore, a recent prospective longitudinal study reveals that when ADHD exists in girls, impairments are highly likely to persist into adolescence, even if some of the core symptoms (especially those related to hyperactivity per se) recede.27 Strikingly, this investigation noted that girls with ADHD may show even higher rates of multiﬁnality than do boys with this condition, meaning that they are at risk for a wider range of impairing outcomes (e.g., depression, eating pathology, substance abuse) than are males, who tend to show continuing problems largely in the ‘‘externalizing’’ realm of delinquency and substance abuse.28 The overall conclusion is that ADHD is far from a transitory problem in either sex. Unlike the clinical lore from several decades ago, which held that ADHD essentially disappeared with the onset of puberty, it is now ﬁrmly established that it persists throughout development, with adult manifestations increasingly recognized. Implications for public policy and public health are clear: unless the condition is detected with accuracy, and unless evidencebased treatment strategies can be mounted, there are likely to be substantial

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costs—economic, family related, and personal—as a function of persisting impairments. Priority also needs to be placed on prevention, over and above tertiary treatments for those already diagnosed.

Pharmacological and Psychosocial Treatments Although a host of treatment strategies have been touted for ADHD, including additive- or sugar-free diets, neurofeedback (which continues to show promise, although appropriately controlled studies are still lacking), and other, far less credible treatments, only two evidence-based intervention procedures exist: (1) medication treatments (comprising the stimulant category but also including, recently, at least one antidepressant agent) and (2) behavioral interventions, including specialized classroom or summer-program settings, parent training, teacher consultation, and social-skills groups for children.11,28,29 Both types of strategies are efﬁcacious for ameliorating core symptoms and improving at least some aspects of academic and social functioning for youth with ADHD. The overall conclusion, from carefully conducted trials, is that medications produce effects that are larger and more robust.28,30,31 Yet behavioral treatments do yield beneﬁt, and pharmacological and psychosocial=behavioral treatments share an important limitation—their effects dissipate rapidly when active intervention is terminated. In other words, no treatment strategy for ADHD can be considered curative at present; symptom relief and production of viable academic and social skills remain the key targets of interest. Crucially, combining medication and behavioral treatments can lead to the greatest chance for normalization of functioning, as evidenced by most investigations that have compared unimodal with multimodal treatment strategies.32–34 Thus, medication and behavioral strategies may, in many cases, combine to yield improvements beyond either treatment modality alone. Nowhere has controversy regarding ADHD raged more strongly than over stimulant medication interventions. Stimulant treatment for children with behavioral disorders began far earlier than most other psychopharmacological interventions—in the 1930s, with Bradley’s35 original observations of youth in residential treatment settings. More recently, and for over four decades, the stimulants methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) have been prescribed, with a large number of controlled studies attesting to their efﬁcacy in terms of alleviating the core symptoms of the condition and promoting improvements in academic efﬁcacy and social behavior more generally.36 Newer, longer-acting formulations allow once-daily dosing, an important clinical enhancement of stimulant medications. Overall, the database on the beneﬁts of stimulants for ADHD dwarfs the scientiﬁc literature on additional agents for all other forms of psychopathology; there is consensus that 80% or more of youth with this disorder show positive beneﬁt (in contrast to a placebo response rate hovering around 10%).

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Raising concern, however, are several issues: the increase in stimulant prescriptions in the last 10 to 15 years, fueled in part by the enhanced use of direct-to-consumer advertisements for a host of psychotropic medications; the potential for side effects, which may have been understated; the concerted efforts of antipsychiatry and antimedication interest groups to taint the entire enterprise; and concerns that medications are being used for mind and behavior control with a growing number of youth whose ADHD diagnoses are not clinically or scientiﬁcally valid. First, there is no doubt that medication treatment of ADHD has witnessed a major increase since the early 1990s.11,37 Part of the reason is related to a parallel increase in diagnostic prevalence of the condition itself, which followed congressional reauthorization of the federal special education act in 1990–1991. Speciﬁcally, although the Education for All Handicapped Children Act, ﬁrst passed in 1975, did not specify conditions such as ADHD (then called hyperactivity) as a trigger for special education services, the act’s reauthorization—as the Individuals with Disabilities Education Act (IDEA) — speciﬁcally earmarked ADHD as one of a number of other health-related conditions that may create the need for specialized services. Intriguingly, the diagnostic prevalence of ADHD—that is, the number of cases brought to clinical attention—increased precipitously within the next year.38 Clearly, then, changes in social and educational policy can have major implications for the diagnosis of children. Medication treatments for ADHD gained momentum throughout the 1990s. Was this ADHD-related increase a legitimate recognition of the need for pharmacological intervention for a diagnostic category that was previously neglected? Or, rather, did it signal a capitulation to the increased ‘‘creation of need’’ by pharmaceutical ﬁrms, now able to advertise directly to consumers for the heavily promoted diagnostic category of ADHD?39 Arguments abound on both sides. There is undoubtedly some legitimacy to concerns that, particularly in selected suburban settings, ADHD diagnoses and medication prescriptions have been fueled by an overconcern with conformity and achievement. Yet what is not often recognized or realized is that in many other communities, children of color—or girls—are simply not believed to be capable of experiencing ADHD, with underdiagnosis and=or underutilization of medication treatments (as well as other interventions) likely to be the rule. Once again, unless diagnostic standards are taught, monitored, and upheld, both overzealous assessment practices and underrecognition of the potential for ADHD are likely to exist. It is certainly the case that stimulant prescription rates vary rather dramatically by geographic region as well as by a number of demographic predictor variables.40 A fundamental question still remains, however: if medication treatments are beneﬁcial for ADHD—and if they, like other performance-enhancing medications, do not require an ADHD diagnosis to provide beneﬁt for sustained attentional effort and reductions of impulsivity—what is the harm of greater use of such pharmacological interventions? Aside from a more gen-

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eralized concern with the potential for reductions in intrinsic personal motivation related to overreliance on ‘‘pills,’’ there is, in fact, the potential for major problems, in that stimulants can deﬁnitely be drugs of abuse if they are misused. For individuals without ADHD, stimulants create euphoria, followed by craving and increased use related to tolerance; serious consequences can result. Furthermore, side effects of appetite suppression, insomnia, and (usually) small increases in pulse and blood pressure exist for anyone using stimulants, and these can become problematic if inadequate follow-through and poor monitoring are the rule. It is therefore crucial that stimulant prescriptions (a) follow and are based on a careful diagnostic work-up and (b) be monitored with care and precision. In 2006, the U.S. Food and Drug Administration (FDA), following imposition of ‘‘black box’’ warnings about the potential dangers of antidepressant use in children and adolescents, considered whether similar warnings should appear with respect to stimulant treatment for ADHD. After votes and deliberations went back and forth, the tentative decision was not to include such stringent measures. Still, the high prevalence of stimulant prescriptions means that even very small risk for adverse effects could appear in a measurable subset of the population. Along these lines, it is quite instructive to examine the actual practices in place regarding the monitoring of medication treatments for ADHD. In community care across the United States, the modal number of stimulant prescriptions written for this condition is one—meaning that follow-up care is so poor that the family never comes back for a second appointment.41 In another investigation, it was found that children with ADHD whose families opted for medication intervention saw community pediatricians about once every 6 months, for under 10 minutes per visit, exemplifying a standard of care that is inadequate for the task of appropriate treatment monitoring.31 If diagnostic appraisals are made casually, if medications are prescribed cavalierly, and if evaluation of treatment response is essentially nonexistent, then a real crisis in policy related to adequate clinical care indeed exists. The situation has become extremely political. The antipsychiatry movement, fueled and funded in large measure by the Church of Scientology and staffed by individuals who have been victims of past psychiatric abuses,42 has mounted concerted campaigns to eliminate all psychotropic medications, under the premise that mental illness is mythical. Several states have passed legislation over the past several years essentially banning school personnel from discussing ADHD diagnoses and medication treatments with families.43 Although it is clear that nonmedical personnel should not promote or consult directly about pharmacological interventions, the school setting is crucial for ascertaining the child’s level of attention and impulse control, and families need sympathetic ears and appropriate referrals to help their children in need. Stopping discussion about levels of problematic attention, impulse-control difﬁculties, and hyperactive behavior will not help the situation and in fact may well hinder it.

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Amid all this discussion of medications, what of psychosocial treatments? There is extremely little evidence that one-on-one therapy (including play therapy) provides meaningful beneﬁt for the core symptoms or the key impairments related to ADHD. Data reveal that active teaching of social skills and the use of active behavior management—involving consultation with parents and teachers in how to provide more regular and more consistent rewards and punishments—are needed to make inroads with this disorder. What is perhaps most important based on careful treatment research is that, despite the clear psychobiological underpinnings of ADHD, highlighted in earlier sections, alterations in family discipline practices (and, very probably, in school classroom environments) make a crucial difference in clinically signiﬁcant beneﬁts. Speciﬁcally, in a large, landmark clinical trial known as the Multimodal Treatment Study of Children with ADHD (MTA Study), my colleagues and I followed up the main study ﬁndings with a crucial mediator analysis, which yielded provocative ﬁndings. In this large clinical trial, 579 children with carefully diagnosed ADHD were assigned randomly, across six sites in the United States and Canada, to 14 months of (a) a careful medication management condition, (b) an intensive behavioral treatment condition (involving family, school, and social skills components), (c) the combination of the two, or (d) routine community care. Primary ﬁndings were that, in terms of reducing ADHD symptomatology, the medication and the combined treatment conditions were superior to the behavioral or community conditions.30,31 Yet for other outcome domains, particularly parenting practices, the multimodal treatment combining medication and behavioral therapy yielded the best outcomes44; across functional impairments (academics, social skills), only the combined treatment condition consistently outperformed the community-care condition. Furthermore, for the critical outcome measure of improvements in disruptive behavior at school, parental reductions of negative and ineffective discipline at home served as an important mediator of change. This key ﬁnding bears explanation. In brief, the only subgroup of children in the entire MTA trial who showed not just improved but fully normalized levels of disruptive behavior in the classroom were those (a) who had received combined treatment (i.e., medication plus behavior therapy) and (b) whose parents had shown meaningful improvements in their negative=ineffective discipline during the trial.33 That is, changes in parenting practices were associated with major improvements—into the normal range—in school-based disruptive behavior for families who received both medication and training in behavior management. Thus, even for a condition as heritable and biologically predisposed as ADHD, changes in parenting style and practice during childhood were the key ingredient in predicting levels of school behavior that improved to the levels of classroom peers. Clinical policies recognizing this crucial fact—that psychosocial processes are of major importance for psychobiological conditions such as ADHD—are clearly in order.

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Mental Disorder, Stigma, and Politics Mental illness continues to be hugely stigmatized by the general public, the media, and even mental health professionals themselves. The roots of such stigma lie deep within human reactions to deviance and difference; they reﬂect social processes of differentiation from outgroups, deep fears of the threat entailed by deviant behavior, preservation of self-esteem, proclivities to ‘‘blame victims’’ in the service of system justiﬁcation, and even naturally selected tendencies to shun those who appear to be either contagious or poor social partners.45 When children display deviance, there is double jeopardy, given (a) the low status afforded to children throughout history and (b) the tendency, spanning nearly the entire twentieth century, for the mental health professions to blame parents for all mental conditions in their offspring. Implications for ADHD are striking, given (a) the public outcry that it is not a real condition, (b) that it is often concealable (i.e., children with ADHD do not show extreme deviance in all situations), and (c) the ﬁerce ﬁghts for scarce resources among parents and advocates. What are the ramiﬁcations for the discussion in this chapter? First, the ‘‘courtesy stigma’’ related to being the parent of a child with a behavioral or mental disorder46 means that caregivers may well be reluctant to acknowledge or understand that their child’s behavioral extremes and inconsistencies reﬂect a condition such as ADHD. Thus, over and above the lack of education about behavioral and emotional disturbance in children, reluctance to accept a diagnosis may be a direct reﬂection of the stigma that parents are likely to receive. Second, however, over the past several decades there has been a proliferation of self-help and advocacy movements related to mental disorders in general and ADHD in particular. These consumer-led groups can be quite liberating and empowering, given the underlying messages that mental illness is a reality, that it does not reﬂect weak will or poor parenting, and that individuals with such conditions deserve respect and access to treatment. On the other hand, to the extent that such movements emphasize an exclusively biological=genetic view of the causation of mental illness—an understandable counterreaction to the decades of blaming of family members for having foisted psychological disturbance on their children through faulty child-rearing practices—parents who become involved may well take on such an exclusively biological perspective that they fail to realize a crucial fact, and one emphasized throughout this chapter. Speciﬁcally, even though current knowledge of the biological=genetic underpinnings of many domains of psychopathology absolves parents of the blame for having caused conditions like ADHD (except, perhaps, for the genes that they may have transmitted), the parallel message is that such conditions are permanent and that they respond solely to biologically based intervention strategies.45 The important lesson should be a dual one: Families can and should be absolved of the blame for having caused their child’s ADHD—but not of the responsibility for dealing

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with it. In other words, an essential policy message needs to be made clear: parents can reduce self-blame, but this ‘‘absolution’’ does not reduce their need to realize that alterations in family practices may have a major impact on longterm outcome.

Summary of Policy Implications This book deals with policy issues related to children and their families. Although my focus has necessarily been on some of the most salient clinical, etiological, and treatment-related issues surrounding ADHD, I have attempted to integrate this material with key implications for social policy. I summarize with an overview of the most important policy issues that have been covered. First, if evaluation of ADHD is done in cursory fashion, both overdiagnosis and underdiagnosis can result. Thus, several core policy-related issues related to assessment and diagnosis are paramount: trainees and professionals must be taught the proper means of making accurate diagnostic determinations; health insurance must cover the time and effort needed to yield valid diagnoses; and education across the population must occur, so that families and the general populace can realize how the symptoms of ADHD can be mimicked by both normal development and a host of psychosocial and cultural processes, as well as that ADHD is a valid, and real, diagnosis. It is not sufﬁcient to insist that health-insurance beneﬁts incorporate thorough evaluation practices, given that far too many Americans (not to mention the majority of world citizens) lack even rudimentary access to health care. Wide-ranging policy initiatives related to health and mental health care are therefore paramount. Second, parallel procedures need to be put in place with respect to ensuring that appropriate monitoring of treatment procedures for ADHD can take place. Both medication and behavioral interventions require careful, active evaluation if they are to be delivered in a successful fashion. Clearly, it is not enough to write a prescription for medication or to simply hand a family a book on setting up a reward program. Both types of intervention require recording of ongoing information about behavior changes as well as consultation from professionals who are skilled in knowing when to persist and when to alter the course of treatment. Without such monitoring and feedback, even the best-intentioned interventions do not have a chance of success. Third, the FDA, which was excoriated two decades ago for not moving sufﬁciently fast on approving treatments for HIV but which is now criticized for too-quick approvals of medications and for failing to require reporting of negative as well as supportive data on clinical trials, needs to make transparent its standards for medication approvals. Note, relatedly, that there is no parallel ‘‘FPPTA’’ (‘‘Federal Psychosocial and Psychotherapeutic Treatment Administration’’) for monitoring and approving psychological treatments. What a different world it would be were there an impartial board to monitor

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and approve evidence-based psychosocial treatments for children, adolescents, and their families, supplementing the FDA role for pharmacological intervention. Fourth, policies that limit consumers’ and families’ rights to know about children’s behavior patterns in schools should be thought through carefully. Certainly, no one wants children to be misdiagnosed and overmedicated; but just as assuredly, youth with clear mental disorders deserve the best treatments for which evidence exists. There is an appropriate middle ground between the poles of contending either that medication is an outrageous affront to children’s liberty or that stimulant treatments should be routinely and casually prescribed. Denying needed intervention helps no one and may, in fact, reﬂect the continued stigmatization of mental conditions in children and adolescents. Furthermore, even well-delivered medication treatments need supplementation with consideration of the types of school-based accommodations, changes in parenting strategies, teacher consultation, and assistance with social functioning so often required for comprehensive treatment of ADHD. In sum, ADHD is a topic surrounding which there is considerable heat but all too little light. It is a real condition, but one that is underappreciated in terms of its potential negative impact on families, individuals, and society. If we realize its associated impacts and impairments, if we insist on careful diagnostic procedures so that it is not overdiagnosed (or underdiagnosed), if we avoid the stigmatization that typically accrues to parents and caregivers, and if we synthesize views of mental conditions in terms of biological=genetic and environmental=psychosocial risk factors that interact, we could have a ﬁghting chance of mounting the kinds of research, treatment, and advocacy efforts that would beneﬁt countless families and children. The beneﬁt for all of society would be great.

Acknowledgments Work on this chapter has beneﬁted from the support of National Institute of Mental Health Grant R01 MH45064 and Contract N01 MH12009.

Notes 1. Campbell, S. B. (2002). Behavior problems in preschool children (2nd ed.). New York: Guilford Press. 2. Hinshaw, S. P. (2002). Is ADHD an impairing condition in childhood and adolescence? In P. S. Jensen and J. R. Cooper (Eds.), Attention-deﬁcit hyperactivity disorder: State of the science, best practices (pp. 5-1–5-21). Kingston, NJ: Civic Research Institute. 3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: American Psychiatric Association.

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4. Briscoe-Smith, A. M., & Hinshaw, S. P. (2006). Linkages between child abuse and attention-deﬁcit=hyperactivity disorder in girls: Behavioral and social correlates. Child Abuse & Neglect, 30, 1239–1255. 5. American Academy of Child and Adolescent Psychiatry, Workgroup on Quality Issues (1997). Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deﬁcit=hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 85S-121S. 6. American Academy of Pediatrics. (2000). Clinical practice guidelines: Diagnosis and evaluation of the child with attention-deﬁcit=hyperactivity disorder. Pediatrics, 105, 1158–1170. 7. Swanson, J. M., & Castellanos, F. X. (2002). Biological bases of ADHD: Neuroanatomy, genetics, and pathophysiology. In P. S. Jensen and J. R. Cooper (Eds.), Attention deﬁcit hyperactivity disorder: State of the art, best practices (pp. 7-1, 7-20). Kingston, NJ: Civic Research Institute. 8. Nigg, J. T. (2006). What causes ADHD? Understanding what goes wrong and why. New York: Guilford Press. 9. Hinshaw, S. P. (1999). Psychosocial intervention for childhood ADHD: Etiologic and developmental themes, comorbidity, and integration with pharmacotherapy. In D. Cicchetti and S. L. Toth (Eds.), Rochester Symposium on Developmental Psychopathology (Vol. 9): Developmental approaches to prevention and intervention (pp. 221–270). Rochester, NY: University of Rochester Press. 10. Levy, F., Hay, D. A., McStephen, M., Wood, C., & Waldman, I. (1997). Attention-deﬁcit hyperactivity disorder: A category or continuum? Journal of the American Academy of Child and Adolescent Psychiatry, 36, 737–744. 11. Barkley, R. A. (2006). Attention deﬁcit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York: Guilford Press. 12. Kreppner, J. M., O’Connor, T. G., Rutter, M., Beckett, C., Castle, J., Croft, C., et al. (2001). Can inattention=overactivity be an institutional deprivation syndrome? Journal of Abnormal Child Psychology, 29, 513–528. 13. Carlson, E. A., Jacobvitz, D., & Sroufe, L. A. (1995). A developmental investigation of inattentiveness and hyperactivity. Child Development, 66, 37–54. 14. Hinshaw, S. P., Zupan, B. A., Simmel, C., Nigg, J. T., & Melnick, S. M. (1997). Peer status in boys with and without attention-deﬁcit hyperactivity disorder: Predictions from overt and covert antisocial behavior, social isolation, and authoritative parenting beliefs. Child Development, 64, 880–896. 15. Tully, L. A., Arsenault, L., Caspi, A., Mofﬁtt, T. E., & Morgan, J. (2004). Does maternal warmth moderate the effects of birth weight on twins’ attentiondeﬁcit=hyperactivity disorder symptoms and low IQ? Journal of Consulting and Clinical Psychology, 72, 218–226. 16. Hinshaw, S. P. (1992). Externalizing behavior problems and academic underachievement in childhood and adolescence: Causal relationships and underlying mechanisms. Psychological Bulletin, 111, 127–155. 17. Barkley, R. A. (2003). Attention-deﬁcit=hyperactivity disorder. In E. J. Mash and R. A. Barkley (Eds.), Child psychopathology (2nd ed., pp. 75–143). New York: Guilford. 18. Johnston, C., & Mash, E. J. (2001). Families of children with attention-deﬁcit= hyperactivity disorder: Review and recommendations for future research. Clinical Child and Family Psychology Review, 4, 183–207.

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19. Asarnow, J. R. (1988). Peer status and social competence in child psychiatric inpatients: A comparison of children with depressive, externalizing, and concurrent depressive and externalizing disorders. Journal of Abnormal Child Psychology, 16, 151–162. 20. Hinshaw, S. P., & Melnick, S. (1995). Peer relationships in children with attention-deﬁcit hyperactivity disorder with and without comorbid aggression. Development and Psychopathology, 7, 627–647. 21. Hoza, B., Mrug, S., Gerdes, A. C., Hinshaw, S. P., Bukowski, J. M., Gold, J., et al. (2005). What aspects of peer relationships are impaired in children with ADHD? Journal of Consulting and Clinical Psychology, 73, 411– 423. 22. Erhardt, D., & Hinshaw, S. P. (1994). Initial sociometric impressions of ADHD and comparison boys: Predictions from social behaviors and from nonbehavioral variables. Journal of Consulting and Clinical Psychology, 62, 833–842. 23. Parker, J. G., & Asher, S. R. (1987). Peer relations and later personal adjustment: Are low-accepted children at risk? Psychological Bulletin, 102, 357–389. 24. Lahey, B. B., Pelham, W. E., Stein, M. A., Loney, J., Trapani, C., Nugent, K., et al. (1998). Validity of DSM-IV attention-deﬁcit=hyperactivity disorder for younger children. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 695–702. 25. Biederman, J., Faraone, S. V., Mick, E., Williamson, S., Wilens, T., Spencer, T. J., et al. (1999). Clinical correlates of ADHD in females: Findings from a large group of girls ascertained from pediatric and psychiatric referral sources. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 966–975. 26. Hinshaw, S. P. (2002). Preadolescent girls with attention-deﬁcit=hyperactivity disorder: I. Background characteristics, comorbidity, cognitive and social functioning, and parenting practices. Journal of Consulting and Clinical Psychology, 70, 1086–1098. 27. Hinshaw, S. P., Owens, E. B., Sami, N., & Fargeon, S. (2006). Prospective followup of girls with attention-deﬁcit=hyperactivity disorder into adolescence: Evidence for continuing cross-domain impairment. Journal of Consulting and Clinical Psychology, 74, 489– 499. 28. Hinshaw, S. P., Klein, R., & Abikoff, H. (2007). Childhood attention-deﬁcit hyperactivity disorder: Nonpharmacologic treatments and their combination with medication. In P. E. Nathan and J. Gorman (Eds.), A guide to treatments that work (3rd ed., pp. 3–27). New York: Oxford University Press. 29. Pelham, W. E., Wheeler, T., & Chronis, A. (1998). Empirically supported psychosocial treatments for attention deﬁcit hyperactivity disorder. Journal of Clinical Child Psychology, 27, 190–205. 30. MTA Cooperative Group. (1999). Fourteen-month randomized clinical trial of treatment strategies for attention-deﬁcit hyperactivity disorder. Archives of General Psychiatry, 56, 1073–1086. 31. MTA Cooperative Group. (1999). Moderators and mediators of treatment response for children with ADHD: The MTA Study. Archives of General Psychiatry, 56, 1088–1096. 32. Conners, C. K., Epstein, J. N., March, J. S., Angold, A., Wells, K. C., Klaric, J., et al. (2001). Multimodal treatment of ADHD in the MTA: An alternative outcome analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 159–167.

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33. Hinshaw, S. P., Owens, E. B., Wells, K. C., Kraemer, H. C., Abikoff, H. B., Arnold, L. E., et al. (2000). Family processes and treatment outcome in the MTA: Negative=ineffective parenting practices in relation to multimodal treatment. Journal of Abnormal Child Psychology, 28, 555–568. 34. Swanson, J. M., Kraemer, H. C., Hinshaw, S. P., Arnold, L. E., Conners, C. K., Abikoff, H. B., et al. (2001). Clinical relevance of the primary ﬁndings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 168–179. 35. Bradley, C. (1937). The behavior of children receiving Benzedrine. American Journal of Psychiatry, 94, 577–585. 36. Greenhill, L. L., & Osman, B. B. (Eds.). (2000). Ritalin: Theory and practice. Larchmont, NY: Mary Ann Liebert. 37. Zito, J. M., Safer, D. J., DosReis, S., Gardner, J. F., Magder, L., Soeken, K., et al. (2003). Psychotropic practice patterns for youth: A 10-year perspective. Archives of Pediatrics and Adolescent Medicine, 157, 17–25. 38. Swanson, J. M., Lerner, M., & Williams, L. (1995). More frequent diagnosis of attention deﬁcit-hyperactivity disorder. New England Journal of Medicine, 333, 944. 39. deGrandpre, R., & Hinshaw, S. P. (2000). Attention-deﬁcit hyperactivity disorder: Psychiatric problem or American cop-out? Cerebrum: The Dana Foundation Journal on Brain Sciences, 2, 12–38. 40. Cox, E., Mothera, B., Henderson, R., & Mager, D. (2003) Geographic variation in the prevalence of stimulant medication use among children 5 to 14 years old: Results from a commercially insured sample. Journal of Pediatrics, 111, 237–243. 41. Rappley, M. D., Gardiner, J. C., Jetton, J. R., & Houang, R. T. (1995). The use of methylphenidate in Michigan. Archives of Pediatrics and Adolescent Medicine, 149, 675–679. 42. Rissmiller, D. J., & Rissmiller, J. H. (2006). Evolution of the antipsychiatry movement into mental health consumerism. Psychiatric Services, 57, 863–866. 43. Fine, L. (2001). New laws leave Ritalin decisions to parents and doctors. Education Week, 20(43), 31. 44. Wells, K. C., Chi, T. C., Hinshaw, S. P., Epstein, J., Pﬁffner, L., Nebel-Schwalm, M., et al. (2006). Treatment related changes in objectively measured parenting behaviors in the Multimodal Treatment Study of Children with ADHD. Journal of Consulting and Clinical Psychology, 74, 649–657. 45. Hinshaw, S. P. (2007). The mark of shame: Stigma of mental illness and an agenda for change. New York: Oxford University Press. 46. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.

9 Do Immigrant Children Have a Fair Chance? Sylvia Guendelman & Kate Cosby

Immigration is one of the single most deﬁning characteristics of U.S. history. The continuous ﬂow of immigrants into the United States has required frequent adjustment of law and policy to accommodate the needs of both the citizenry and those who desire citizenship or residency. At a time when immigration accounts for 40% of annual population growth and where immigrants make up 12% of the population and 14% of the workforce, health policy for immigrants is under scrutiny.1 Policies must weigh the social and economic costs of investing in the health of and health care for immigrants against the potential economic payoff that healthy immigrants may provide the United States now and in years to come. Immigrants, who tend to be younger than the native born, are playing an increasingly important role in our economy, competing in the global market and supporting our aging native population. Furthermore, the children of immigrants, most of whom will be lifetime residents, will become part of the nations’ workforce, supporting the economy and sustaining the viability of Social Security and Medicare. They will also serve in the military, act as civil servants, and hold public ofﬁce. These contributions notwithstanding, immigrant labor is often at a disadvantage because a large percentage of immigrant workers are employed in low-paying jobs that provide few or no beneﬁts to them or their families. More than 50% of immigrants work in production=transportation, service, or construction=maintenance jobs, while less than 27% are employed in management or professional jobs.1 A constant ﬂow of low-skilled workers further 183

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serves to depress wages. Low earnings, usually by only one parent, make immigrant families a sizeable component of the working poor. Poverty is a well-known contributor to ill health and disability.2 Furthermore, conditions of poverty, like a lack of health insurance or inability to pay for health services, can deter individuals from seeking care in a timely manner, thereby contributing to ill health. Among the nation’s children, immigrant children in working poor families tend to be the most disadvantaged with regard to insurance coverage and health-care access.3,4 The economic and health conditions of immigrant families raise important policy questions. Should U.S. immigration policy focus exclusively on the number, qualiﬁcations, and legal documentation of those entering our country, or, alternatively, must the health and welfare of newcomers also be attended to? If we believe that our immigration policies should cover more than just border security and labor demands, what health and welfare services should be provided to immigrants? At the core of our health-policy controversies is whether immigrant children and their families should qualify for the same health beneﬁts as children in native families or whether investing in immigrants serves as a magnet for unwanted, unauthorized immigration. Indeed, it is at the crossroads where poverty and immigration intersect where we ﬁnd vigorous health-policy discussions regarding our nation’s commitment to universal access to health care. This chapter examines current U.S. health policies that affect healthinsurance coverage and access to and utilization of health-care services for immigrant and U.S.-born children of the working poor. Most health policies explored in this chapter are decided at the federal level. However, states often maintain responsibility for interpreting and implementing federal decisions and share in ﬁnancial responsibilities. Due to its size and large immigrant population, California often acts as a bellwether state for immigration and health issues. Furthermore, California has more children, and more working poor children, than any other state.5 Therefore, in this chapter we ﬁrst identify the immigrant working poor and examine how national health policies and ancillary social and immigration policies shape immigrant children’s access to and use of health services. Next, we explore how California responds to federal policy in the development and implementation of state health programs for children in working poor families, and for immigrant children in particular. Finally, we use original research on working poor families to compare immigrant and nonimmigrant children’s access to and utilization of the healthcare system and apply the ﬁndings to discuss policy options for improving health-care access for immigrant children.

Many Immigrants Are Working Poor Working poor can be generally deﬁned as those families whose annual income is less than 200% of the federal poverty level (FPL) and who derive most of

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their income from earnings rather than from public assistance.6 Nearly half (49%) of immigrant families live at or below 200% of the FPL, compared with 34% of the native born.2 Despite their higher poverty level, immigrant families are less likely to rely on public assistance than are the native born. For instance, only 17% of children in working poor, recent immigrant families receive food stamps compared with 35% of children of native-born working poor families.7 Furthermore, only 7% of children of recent immigrants receive Temporary Assistance for Needy Families (TANF), compared with 13% of their native-born counterparts.7 Barriers to using these resources, including fear of jeopardizing their own legal status or that of other family members if these public resources are used and a lack of awareness of the availability of assistance, often deter immigrants from applying for welfare. Unlike families on welfare, which are predominantly single-parent families, the working poor tend to be two-parent families. In 2007, 200% of the FPL, which is equivalent to $41,300 for a family of four, translates to an income that falls short of providing an adequate standard of living.8 Therefore, many working poor families living in near poverty (100% to 200% of FPL) experience many of the same hardships as those living below the poverty level, including hunger, severe overcrowding, or telephone or utility shutoffs.9 In California, where the cost of living is higher than in most of the rest of the nation, it is projected that a family of four with two working parents would need to have a yearly income of $63,921 in order to pay for basic necessities such as food, health care, transportation, housing, taxes, and child care.10 An income this high requires each parent to earn an average of $15.38 per hour, a ﬁgure that is far higher than California’s $6.75 minimum wage. Therefore, it is not surprising that in 2002, a larger percentage of California’s working families were living below 200% of the FPL compared with the rest of the United States, with a staggering 1.4 million California families living at less than 200% of the FPL.10 Because out-of-pocket disbursements for health care represent a proportionately higher expenditure for poor families than for nonpoor families, health insurance with affordable or no premiums and co-payments is a particularly strong ﬁnancial support for meeting the health needs of children in poor families.11 In recent years, substantial numbers of children of the working poor have lost employer-based insurance due mainly to hefty hikes in insurance premiums. Employers who are unwilling or unable to pay high premiums either pass on costs to employees or abandon providing beneﬁts altogether. In fact, in many low-wage industries such as retail and fast food, employers have effectively shifted responsibility for health-care beneﬁts to U.S. taxpayers by offering no beneﬁts and keeping wages so low that employees are eligible for public health insurance.12 Some large employers such as Wal-Mart even encourage families to use public beneﬁts by posting information on how to access beneﬁts in employee break rooms.13 As a result, the number of child enrollees, including immigrant children, in public insurance programs has been growing.

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Public Insurance for Poor Children: Medicaid and SCHIP Medicaid, which was created in 1965 through Title XIX of the Social Security Act, and the State Children’s Health Insurance Program (SCHIP), which was established by Congress in 1997 as part of the Balanced Budget Act, are two public programs that provide children in poor and working poor families with public or subsidized health coverage. Medicaid is a means-tested program that originally covered children and adults who received welfare. In the late 1980s, a new law unbundled Medicaid from welfare and gradually extended Medicaid eligibility to children in working poor families. In 2004, Medicaid insured nearly 29 million children who met certain income, age, and family requirements. The two groups of Medicaid-eligible children are those under age 6 with a family income of less than 133% of the FPL and those from age 6 to under age 18 with a family income of up to 100% of the FPL. Most disabled children who qualify for federal Supplemental Security Income are also covered.14 Under Medicaid, children must be provided with a comprehensive beneﬁt package that includes preventive care (including vision, hearing, and dental checkups) and other medical services deemed medically necessary. Current law provides that Medicaid ofﬁcials cannot charge premiums or copayments for children and cannot charge for emergency services. Congress enacted SCHIP in an effort to expand insurance coverage to children in families with incomes between 100% and 200% of the FPL. This program offers an additional ﬁnancial incentive for states to narrow the insurance gap for children by extending Medicaid coverage or establishing a separate child health program. Federal matching for SCHIP is 30% higher than for Medicaid; however, it is a capped grant for a deﬁned period extending from 1998 through 2007, and the future of this program is currently being discussed by Congress.15 By 2002, 4 years into its implementation, 4 million children were covered by SCHIP.16 By the end of 2006, 6 million were covered. Like Medicaid, SCHIP has federal oversight, but state programs vary signiﬁcantly from one another with regard to program design, eligibility, beneﬁts, and payment levels. Most states (38 states and the District of Columbia) now cover children whose households earn up to 200% of the FPL or higher.16,17 Coverage in separate SCHIP programs can be less comprehensive than Medicaid, and many states charge families for premiums and require co-payments. The introduction of SCHIP provided several improvements for public insurance coverage in addition to extending eligibility to many working poor families. SCHIP engaged in extensive outreach efforts through state-, county-, and community-based organizations; reduced the stigma of public assistance; and streamlined the application process.16 Furthermore, many states used SCHIP to expand Medicaid coverage for children, and nearly all states took steps to improve Medicaid participation rates.18 By 2003, Medicaid and SCHIP covered 50.7% of all children living in households making under 200% of the FPL in the United States.19,20

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Use of Social Programs by Immigrants Despite publicly ﬁnanced health-insurance-expansion efforts targeted to poor children, the differential in the use of social programs by poor children living in immigrant families may be growing as a result of countervailing forces. Federal policies enacted in 1996, such as the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) and the Illegal Immigrant Reform and Immigration Responsibility Act (IIRIRA), were aimed a curbing immigrants’ access to health care, social, and educational beneﬁts. PRWORA gave states the option of terminating nonemergency Medicaid coverage for legal immigrants who arrived after August 22, 1996. After a 5-year stay, those immigrants arriving after 1996 could apply for Medicaid but would be held to a different set of eligibility requirements. For example, the means test to determine ﬁnancial need would now assess the income and economic status of both the immigrant and his or her sponsoring family. This is a marked change from the prior social contract, which treated legal immigrants and U.S. citizens alike in determining income and eligibility. Further, restrictions under PRWORA continued to prohibit undocumented children of immigrants from receiving Medicaid or assistance through other public health-insurance programs. IIRIRA placed additional restrictions on access to public beneﬁts for immigrants. Sponsors of family visa applicants were required to submit a legally enforceable afﬁdavit of support stating that their assets of at least 125% of the FPL would be used to cover the costs of uncompensated care or to assess an immigrant’s eligibility for public programs, should the immigrant(s) be unable to cover the costs themselves. Additionally, IIRIRA required states that requested reimbursement for emergency Medicaid services from the federal government to verify the patients’ immigration status. PRWORA and IIRIRA, in their original forms, were so restrictive that the only immigrants eligible for nonemergency Medicaid and SCHIP were those who had been legally admitted as permanent residents prior to August 22, 1996, and had been in ‘‘qualiﬁed immigrant status’’ for at least 5 years or were granted refugee asylum status. Since the laws were enacted, many states have chosen to restore beneﬁts for immigrants.21 Additionally, Congress lifted several of the original restrictions, restoring food stamp beneﬁts to certain legal immigrants and emergency Medicaid for all children and pregnant women. However, the complexity of changing eligibility requirements has compounded access barriers for immigrants who already had trouble navigating the health system. Confusing rules and procedures and ﬂuctuations in family income add to the bureaucratic hassles that families confront.22 Further, changes in eligibility rules and procedures can increase the likelihood that agencies will incorrectly deny beneﬁts to eligible immigrants. Mixed-citizenship status is common among immigrant families, in which some members may be naturalized citizens while others may be legal or undocumented residents. Therefore, many immigrant families do not attempt to

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use beneﬁts for fear that veriﬁcation and reporting procedures may label a family as a ‘‘public charge’’ and inﬂuence the family’s ability to obtain legal permanent-residence status or citizenship. These fears have deterred or slowed down enrollment in Medicaid and SCHIP for children in immigrant families.23 A new law, the Deﬁcit Reduction Act, adopted by Congress in February of 2006, imposes even stricter requirements for proof of citizenship. It requires Medicaid to verify citizenship with a passport or birth certiﬁcate. Until now, most states required applicants to swear under the oath of law that they were citizens or asked that they show a Social Security card or driver’s license. States now have no ﬂexibility to waive these requirements. Estimates indicate that this regulation might place up to 2.9 million children of citizen parents at risk because they lack passports or birth certiﬁcates.24 Moreover, laws that incorporate health-care providers into the immigration-enforcement mechanisms can further reduce trust between patients and providers while placing providers in ethical dilemmas by potentially denying necessary treatment and=or enforcing laws that conﬂict with their professional values.22 Issues regarding how to treat immigrants once they are admitted are hotly contested among policymakers. Those who oppose welfare eligibility for noncitizens argue that compared with other countries, America offers immigrants vast individual freedom while providing opportunities to participate in a prosperous economy.25 In exchange, noncitizens must obey the law and avoid receiving certain federally funded public beneﬁts until they become citizens. From this standpoint, the 1996 welfare reforms are not seen as altogether restrictive because they have allowed immigrants to participate in a host of programs that provide education and training and make them eligible for the earned income tax credit, a wage supplement paid to low-income workers. In contrast, policymakers who favor welfare eligibility argue that immigrant children should have the same access to public programs that reduce hardship and improve opportunities as citizen children, and they urge the equal treatment of citizens and legal immigrants that prevailed in public assistance programs before 1996. They contend that because immigrant families pay taxes and contribute to the economy, no discriminatory rules should be put in place, and every effort should be made to accelerate their assimilation to society.25

State Responses to Federal Policy The federal policies described here are not implemented uniformly by states. While all states have extended health-insurance coverage for the working poor, states vary in their responses to immigrant-speciﬁc coverage. About half of the states have responded to changes in immigrant eligibility for Medicaid and SCHIP by expanding their own state programs.26 Of the states with the highest populations of immigrants, Illinois and California both created ‘‘a state-funded only’’ Medicaid program for newly arrived, legal immigrants,

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while Texas, Florida, and New Jersey still deny Medicaid to new arrivals. New York, the state with the second highest population of immigrants, adopted the restrictions of PRWORA initially, but in 2001 a New York court held that the refusal to provide beneﬁts to legal immigrants was unconstitutional.21 Every state but Wyoming has continued to provide Medicaid to legal immigrants who arrived before 1996. Nevertheless, undocumented immigrants (including children) continue to be denied Medicaid by federal law in all but emergency situations.21 Several states, including the District of Columbia, Massachusetts, Illinois, New York, Washington, and Rhode Island, offer at least some coverage for undocumented children.21 California is noted for being a generous state when it comes to public beneﬁts. Medi-Cal (California’s Medicaid program) eligibility levels extend to 200% of FPL for infants, 133% of FPL for children aged 1 through 5, and 100% of FPL for older children.27 Healthy Families (California’s version of SCHIP) is available to children younger than age 19 in families with incomes up to 250% of the FPL. Combined, these programs provide coverage annually to more than 3.8 million citizen and legal resident children.28 Nongovernmental organizations and county programs in California have also worked to meet the needs of undocumented immigrant children in creative ways. In 2000, The California Endowment developed a demonstration project to subsidize the coverage of more than 7,500 uninsured, undocumented children by utilizing public health-insurance provider networks and private nonproﬁt provider networks.29 Several local counties, with funding from antitobacco initiatives and various other private sources, also extended insurance to undocumented children.30 For example, Sacramento County offers a program to employers of low-wage workers that insures uninsured children at a rate of $22 per month, along with small co-payments. These programs also ﬁll in the insurance gap for children living in families with an income between 250% and 400% of the FPL.30 However, such efforts represent the tip of the iceberg for insuring California’s estimated 180,000 uninsured undocumented children.

The Original Research Our study, Access to Care for Children of the Working Poor, has been monitoring the effects of health and social policies on rates of insurance coverage, access to care, and use of health services among working poor children, including immigrant children of the working poor. Baseline national and California survey data from 1997 and 1994, respectively, allowed us to examine access to care among children prior to the full implementation of welfare and immigration policies enacted in 1996 and expansions in public health insurance initiated in 1997.3,31 Children’s access was also examined in California following the enactment of these policies using the 2001 California Health Interview Survey (CHIS), the largest state health survey.32,33

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Monitoring was done through key indicators of health-insurance coverage, nonﬁnancial access to care, and use of medical services. Keeping in mind that the American Academy of Pediatrics recommends annual visits for children 2 years of age and older (except for children ages 7 to 9) and more frequent visits for children younger than 24 months, we assessed the following indicators34:

Indicators of health-insurance coverage included whether the child was insured or uninsured; whether insurance was paid by an employer, out of pocket, or by a public source such as Medicaid or SCHIP; and whether the child experienced any breaks in coverage. Indicators of nonﬁnancial access to care focused on whether the child had delayed or missed medical care indicating an unmet medical need; had a usual source of care (i.e., a particular person or place to which a child usually goes for treatment when sick, for advice or for routine health or preventive medical care); and whether the usual care source was located in a physician’s ofﬁce or health-maintenance organization versus a community clinic or community hospital. Well-child care received through a usual-care source is associated with improved preventative care beneﬁts, including immunizations, developmental screening, and anticipatory guidance. Usual care received in the private sector is associated with shorter waiting times for appointments and increased continuity of care.19,20 Indicators of use of health care included whether the child had visited a physician in the past year and the number of physician visits, hospitalizations, and emergency department visits a child had made in the past year, stratiﬁed by health status.

The Nation’s Working Poor Children in 1997 In 1997, 22% of children in working poor families were uninsured, a rate more than four times higher than that of nonpoor children. Even parental full-time, year-round work did not improve children’s coverage rates (22%). Employersponsored insurance and self-pay covered only 53% of the children whose parents were ﬁrmly attached to the workforce. Barriers to public insurance access were also sharp. Despite parental low earnings, only 31% of children of the working poor were covered by Medicaid, a rate 2.5 times lower than that of other poor children, and almost 1 in 10 children experienced disruptions in insurance coverage. Continuity of coverage may be a problem for working families who transition away from welfare, who experience job loss or a change in income, or who face high insurance costs relative to low income and competing needs.35 Evidence shows that lack of insurance coverage and disruptions in coverage may delay entry into care.36 Relative to other children, more children in working poor families had experienced delayed or missed care in the previous year because of ﬁnancial constraints. In fact, children in working poor families who were in excellent health were far less likely than were nonpoor children to have visited a physician in the last year (82% versus 90%), suggesting missed

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opportunities for preventive care. Similarly, among children in less than excellent health, children of the working poor were less likely than were nonpoor children to have visited a physician in the past year (84% versus 91%) and more likely to have visited the emergency department for treatment of an acute or chronic condition (12% versus 7%). Nevertheless, hospitalization rates did not vary among children of the working poor compared with nonpoor children, indicating perhaps that our health-care system erects fewer barriers for conditions requiring inpatient care. Compared with nonpoor children, working poor children’s access to a regular source of care was also disadvantaged. Among those with a regular source of care, working poor children were more likely to be seen in a public setting than in a physician’s ofﬁce or a health-maintenance organization. Usual care obtained in public settings has been associated with longer waiting times for appointments and with less ability to provide optimum continuity of care for chronic conditions.37 Working Poor Immigrants Versus Nonimmigrants

The disparities that placed children of the working poor at a disadvantage, especially compared with nonpoor children, were exacerbated among immigrant children of the working poor. Even within the working poor, immigrant children were far more vulnerable to experience barriers to access and utilization of health care than their nonimmigrant counterparts. As shown in Figure 9.1, among the immigrant children a gaping 52% were uninsured in 1997, 2.5 times the rate of U.S.-born children of the working poor. Such inequities translate into less access to a regular source of care (66% versus 92%)

Figure 9.1. Lack of insurance coverage: rates among children of working poor in the United States, 1997. Source: 1997 National Health Interview Survey.

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and lower rates of physician visits among immigrant versus nonimmigrant children. Among immigrant children who were in less than excellent health, 39% had not seen a physician in the past year, compared with only 17% of their U.S.-born counterparts, and 4% had never seen a physician. Moreover, consistent with other studies on minority health, Latino foreign-born children— who constitute 58% of the immigrant children of the working poor—faced more barriers if uninsured than did their white counterparts, perhaps because of cultural, language, and legal barriers.38,39

California’s Working Poor Children: 1994 Versus 2001 Similar, but somewhat more pronounced, disparities were observed in California in the mid-1990s (Fig. 9.2). Several factors may account for the inequalities observed in California. While working poor children in California are more likely to have two parents in the household than are working poor children nationally, they are less likely to beneﬁt from a two-income family.5 In addition, fewer heads of working poor households have completed a high school education, and families are both poorer and larger than national averages.40 These differences are partially explained by the larger share of the United States’ foreign population living in California, which includes a sizeable undocumented population. A comparison of rates in insurance coverage and access to and utilization of health care in 1994 and 2001 allows us to examine the impact of changing health policies on children of the working poor. Between 1994 and 2001, the percentage of children in working poor families who were uninsured decreased from 32% to 20% (Fig. 9.2). By 2001, there were slight increases in the number of children covered by Medi-Cal (30.7% to 33.8%). Healthy Families

Figure 9.2. Lack of insurance coverage: rates among children of working poor in California, 1994 and 2001. Source: 1994 National Health Interview Survey; 2001 California Health Interview Survey.

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played a crucial role in increasing insurance coverage for children in working poor families during this time period. By 2001, almost 11% of children of the working poor were covered by Healthy Families. California’s public insurance expansions also had a positive effect on securing a regular source of care and allowing children to see a physician. Working Poor Immigrants Versus Nonimmigrants

While the number of working poor immigrant children who had insurance coverage increased 13% between 1994 and 2001, 44% still lacked coverage in 2001, compared with 17% of their U.S.-born counterparts. In 1994, immigrants were twice as likely to lack coverage as nonimmigrants (57% versus 27%); by 2001, this proportional disparity had widened so that poor immigrants were 2.5 times as likely to lack coverage as nonimmigrants, suggesting that the barriers erected to deter immigrants from applying for public insurance were showing their effect. Gains in coverage were overwhelmingly for naturalized citizens and legal residents, while undocumented children, who are poorer, were for the most part excluded. Among children of the working poor who had public insurance in 2001, immigrant children were more likely than nonimmigrant children to have Medi-Cal coverage (64% versus 41%); however, they were much less likely to have Healthy Families coverage (9% versus 14%), probably because immigrant children were poorer. Employer-sponsored insurance was also much lower among immigrants (26% versus 44%), primarily due to low-wage employment that does not offer beneﬁts.3,31 Despite wide gaps in insurance coverage, there were some positive trends suggesting improvement in working poor immigrant children’s nonﬁnancial access to and utilization of care. For instance, immigrant working poor children were more likely to have a usual source of care in 2001 (74%) than they were in 1994 (58%), and 68% of immigrant children had at least one physician visit in 2001, compared with 64% in 1994. It is interesting to note, however, that while the proportion of immigrant children who were receiving regular care in a private physician’s ofﬁce or a health-maintenance organization dropped markedly during the period in question, as was the case for native children, our ﬁndings demonstrate that among uninsured immigrant children, the use of community clinics helped to counteract barriers to care associated with lack of English language proﬁciency, undocumented status, and poverty. In fact, less access to community clinics among uninsured documented children compared with uninsured undocumented children seems to explain why, among uninsured children, those with documentation reported more missed physician visits, lack of a usual source of care, and more perceived discrimination when receiving care. The ﬁndings from the Access to Care for the Working Poor project should be interpreted cautiously, given that the studies relied on cross-sectional surveys using self-reported assessment of key measures. It is also hard to disentangle the comparative effects of welfare, immigration, and health-care reforms

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on the eligibility and participation of children in public insurance and in the use of health services. Further, we could not consistently include measures of legal status because they were not available in the baseline surveys that we used. However, other studies that have examined the effects of citizenship corroborate our ﬁndings that the risk of no insurance coverage is greatest for immigrant children and that U.S. citizen children with immigrant parents bear a lower risk, but one that is still higher compared with native-born children with U.S.-born parents.41 In one recent study conducted in Boston, children with a documented immigrant parent had double the adjusted odds of being uninsured, and those with an undocumented immigrant parent had more than six times the odds of being uninsured, compared with children with citizen parents.40 Evidence from national studies suggests that the rest of the country mimics California’s expansion in insurance take-up.42 Between 1997 and 2003, uninsured rates for poor children dropped from 23% to 14%, a reduction of more than one-third in 6 years. Medicaid and SCHIP have eased enrollment through simpliﬁed application forms and vigorous outreach efforts, attracting large numbers of children. However, rates of lack of insurance among immigrant children remain high, hovering at 50%.43,44 One recent study by the Children’s Defense Fund found that the percentage of noncitizen immigrant children without health insurance increased from 39.2% in 2000 to 42.1% in 2002.45 This rise could not be accounted for by an inﬂux of recent immigrants.

From Evidence to Action: Implications for Policy This chapter has shown that economic and legal barriers act as strong deterrents to acquiring health insurance among immigrant children in working poor families. Despite their attachment to the workforce, a large proportion of poor immigrant families lack employer-sponsored health insurance, and strong barriers have prevented both legal immigrants and undocumented immigrant parents from accessing public insurance for their children. Because many working poor immigrant families cannot afford out-of-pocket expenditures for premiums or co-payments for medical visits, emergency department visits, and prescription drugs, a substantial number of children fail to be connected to a regular source of care, and their parents delay or forego seeking needed care. Postponement can result in more serious health problems, which are more costly to treat. Barriers to access are far weaker for inpatient care than for primary care. For this reason, many local hospitals serving the poor are burdened with large expenditures for uncompensated care. The issues highlighted in this chapter raise several policy implications that are paramount for improving access to health care for immigrant children. Some policy issues will need to be addressed by the health-care system, while others will require changes in our immigration policies. With respect to the health-care system, the following health-policy options are most pressing:

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Health insurance must cover all children, regardless of immigration status. Given the developmental needs of children and the health payoffs that arise from timely and preventive care, all children should have the right to access health care. It should not be a privilege. Some policy choices of late suggest that universal insurance, at least for children, is gaining momentum. A few states such as Illinois and Washington recently passed legislation allowing undocumented immigrant children to obtain health insurance. In California, Governor Schwarzenegger proposed a bold plan to expand health coverage for all uninsured Californians and provide subsidized coverage for all children regardless of immigration status. Schwarzenegger cogently argues that the undocumented, insured or not, are already entitled by federal law to costly care at overcrowded emergency departments and that everyone, including taxpayers, policy holders, patients, and medical providers, help to pay for such care. It is cheaper to treat routine ailments in low-cost clinics as the plan proposes. The greatest hurdle with such plans is determining who will pay. In this plan, ﬁnancing would come from various sources. A state insurance pool would be available for the working poor, who would pay no more than 6% of their gross income for coverage. All employees with more than 10 workers would be required to offer insurance or pay the equivalent of 4% of their payroll into state funds. These employer contributions, along with hospital and physician taxes (i.e., a fee on provider revenues), tobacco taxes, and matching Medi-Cal funds, would help subsidize health insurance for the working poor. Initiatives for universal coverage of children must be supported and implemented in other states. Short of universal coverage, we need to strengthen the safety net of community and public clinics that provide care for the uninsured. Community clinics seem to provide much needed comprehensive care to uninsured immigrant children while decreasing barriers to accessing and utilizing care. In another health-coverage expansion program, 22 California counties have implemented programs that seek to expand insurance coverage to all children living in households earning less than 300% of the FPL regardless of immigration status. Together, these Children’s Health Initiative programs have insured 87,000 children since 2000.46 We must continue to safeguard these safety net programs. Ensure that Medicaid and SCHIP are protected. Estimates indicate that there are approximately 6 million uninsured children nationwide still eligible for these programs. Yet, despite new presidential initiatives to enroll more lowincome children in these programs, rising health-care costs are forcing many state policymakers to revise the amount of health-care coverage available through Medicaid and SCHIP. A major problem for SCHIP is that the funding formula lacks an inﬂation factor to adjust for rising health-care costs. In addition, in the early years of SCHIP, states that insured many children and spent their allotments were able to draw on unspent allocations of states that covered fewer kids—but this funding pool has shrunk considerably. Furthermore, current expansions in the Medicare program threaten the allocation of public funds for federal programs that insure the poor. Efforts need to be made to create the necessary political will so that lawmakers will continue to protect and expand these programs.

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We must make insurance affordable for families. Unless children are eligible for no-cost Medicaid=Medi-Cal, working parents have to buy coverage to enroll their children and maintain enrollment in SCHIP=Healthy Families or in private health plans. In the private market, rising health-care costs are passed on to consumers, many of whom cannot afford to pay higher premiums or copayments. Some solutions look toward small business owners, who employ the majority of unskilled laborers, to join large insurance pools or to pay or play in the insurance market. Efforts to create purchasing pools that make it less expensive for employers and employees to obtain coverage through employer-sponsored insurance need to be expanded, as do efforts to subsidize premiums and copayments for children whose parents do not qualify for private health insurance. Under Schwarzenegger’s plan, undocumented children—most of whom are poor—would be eligible for nonemergency Medi-Cal and Healthy Families for the ﬁrst time. Similar eligibility criteria for public insurance programs should be considered by other states. Many lawmakers and policymakers are driven by concerns that health beneﬁts for immigrants act as immigration magnets, further pushing health-care costs. The fears persist despite evidence that the foreign-born are relatively infrequent users of medical care, and especially of publicly funded care.47 Fears drive the creation of stronger restrictions to access health care for both documented and undocumented immigrants. Recent federal legislation such as the Deﬁcit Reduction Act, which imposes strict proof-ofcitizenship requirements for Medicaid and SCHIP applicants, reﬂects these prevailing concerns. Ultimately, making it easier for all children to access and use health care not only humanizes the health-care system, reduces health disparities, and cuts back on costly treatments but also offers relief to working poor families who already have to weigh the costs of providing health care against other essential needs or face the prospect of bankruptcy. Changes in health policy have to be accompanied by changes toward more open immigration policies at the federal level to address the health-careaccess needs of new arrivals. Although heightened border security has reduced the number of undocumented immigrants entering per year by roughly one-half in the last 5 years, these tougher restrictions have not stopped the inﬂux of poor immigrants.47 Despite restrictions, economic incentives rather than health-care needs act as magnets, enticing people to cross the border. In fact, people who successfully enter are staying longer in the United States.47 Many intermarry with U.S. citizens and=or give birth to U.S.-born children. Mixed-citizenship families encounter many barriers to care, including fears of deportation of undocumented members if they accept public insurance coverage for their U.S.born children. By regularizing the legal status of long-term undocumented families, access to care can beneﬁt children and parents. Recently, the U.S. Senate proposed avenues by which undocumented people could possibly earn citizenship in the United States. The steps that were delineated include coming forward to register with the government while paying a ﬁne, paying back taxes, and taking English-language classes. Short of legalizing the status of undocumented families through an amnesty program, if an agreement with the government of Mexico and other Central American countries for a temporary guest worker program in the United States becomes enacted, this

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program should include strategies for strengthening access to health care for the workers and their families. The enforcement of health and labor laws under free trade agreements such as NAFTA and CAFTA could also help reduce the numbers of uninsured. Strengthening transnational policy solutions can bring added advantages. Since 2000, the governments of the United States and Mexico have spearheaded two initiatives, the California-Mexico Health Initiative (CMHI) and the Mexico-Texas Health Initiative, that positively address the health needs of migrants on both sides of the border. These initiatives work binationally with federal, state, and local agencies to promote community health. In California, large efforts are being mobilized toward the creation of transnational healthinsurance products and public–private health plans for Mexican immigrants and their families. Such efforts have the advantage of mobilizing a large number of stakeholders at the government and grassroots levels.

Future research will have to assess whether certain states are attracting immigrants as a result of their more inclusive health-care access policies. Evidence to date suggests that California no longer serves as the primary destination choice for new immigrants despite its more generous health and immigration policies compared with those of other states. In sum, health-care policies for immigrant children have not kept up with the rapid inﬂux of immigrant families. Further, these policies are fragmented and inconsistent, reﬂecting the range of American attitudes toward immigration more than the needs and contributions of immigrant families themselves. While in our society there seems to be widespread societal consensus about the importance of protecting poor children, investing in poor immigrant children, particularly if they lack legal authorization, is far more controversial. Investing in the health of immigrant children will require political will and continued funding to remove economic and legal barriers to accessing health care, along with the conviction that this investment will yield immediate beneﬁts for children and long-term beneﬁts for society. Given that immigrant children will join the future labor force that will support our aging population, it behooves us to protect and promote their health. Ultimately, making it easier for immigrant children to access insurance and health care will protect and promote their health and well-being while allowing children to participate in social spheres that will accelerate their integration into U.S. society.

Notes 1. Bureau of Labor Statistics. Labor force characteristics of foreign born workers summary. Retrieved March 6, 2006, from www.bls.gov=news.release=forbrn.nr0.htm. 2. Hernandez, D. J. (2004). Demographic change and the life circumstances of immigrant families. The Future of Children, 14(2), 17– 47. 3. Guendelman, S., Schaufﬂer, H. H., & Pearl, M. (2001).Unfriendly shores: How immigrant children fare in the U.S. health system. Health Affairs, 20(1), 257–266.

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4. Guendelman, S., Angulo, V., Wier, M., & Oman, D. (2005). Overcoming the odds: Access to care for immigrant children in working poor families in California. Maternal and Child Health Journal, 9(4), 351–362. 5. Palmer, J., Song, Y., & Lu, H.-H. (2002). The changing face of child poverty in California. New York: National Center for Children in Poverty. 6. Department of Health and Human Services. (n.d.). The Health and Human Services poverty guidelines. Retrieved March 6, 2006, from http:==aspe.hhs.gov=poverty= 06poverty.shtml. 7. U.S. Census Bureau. (n.d.). Annual social and economic supplement to the current population survey. Retrieved March 6, 2006, from http:==www.bls.census.gov=cps= asec=adsmain.htm2006. 8. Department of Health and Human Services. The 2007 Health and Human Services Poverty Guidelines. Retrieved August 31, 2007, from http:==aspe.hhs.gov=poverty= 07poverty.shtml. 9. Sherman, A. (2004). Hardships are widespread among families in poverty. Washington, DC: Center on Budget and Policy Priorities. 10. The California Budget Project. (2005). Making ends meet: How much does it cost to raise a family in California? Sacramento, CA: California Budget Project. 11. Newacheck, P. W., Hughes, D. C., Hung, Y. Y., Wong, S., & Stoddard, J. J. (2000). The unmet health needs of America’s children. Pediatrics, 105(4, Pt 2), 989–997. 12. Levy, C. J. (2006). The new corporate outsourcing. The New York Times, sec. The Nation (Week in Review), January 29. 13. Greenwald, R. (Director=Producer). (2005). Wal-Mart: The high cost of low price [Motion picture]. United States: Brave New Films. 14. Schneider, A., Elias, R., Garﬁeld, R., Rousseau, D., & Wachino, V. (2002). The Medicaid resource book. Menlo Park, CA: The Kaiser Commission on Medicaid and the Uninsured. 15. Perry, M., Kannel, S., Valdez, R. B., & Chang, C. (2000). Medicaid and children: Overcoming barriers to enrollment. Findings from a National Survey. Menlo Park, CA: The Kaiser Commission on Medicaid and the Uninsured. 16. Kenney, G. M., & Chang, D. I. (2004). The state Children’s Health Insurance Program: Successes, shortcomings, and challenges. Health Affairs, 23(5), 51–62. 17. Ross, D. C., & Cox, L. (2004). Beneath the surface: Barriers threaten to slow progress on expanding health coverage of children and families (a 50-state update on eligibility, enrollment, renewal and cost-sharing practices in Medicaid and SCHIP). Menlo Park, CA: Kaiser Commission on Medicaid and the Uninsured. 18. Selden, T. M., Hudson, J. L., & Banthin, J. S. (2004). Tracking changes in eligibility and coverage among children, 1996–2002. Health Affairs, 23(5), 39–50. 19. Chung, P. J., & Schuster, M. A. (2004). Access and quality in child health services: Voltage drops. Health Affairs, 23(5), 77–87. 20. Hoffman, C., Carbaugh, A., Yang Moore, H., & Cook, A. (2005). Health insurance coverage in America, 2004 data update. Washington, DC: The Kaiser Commission on Medicaid and the Uninsured. 21. Kaushal, N., & Kaestner, R. (2005, June). Welfare reform and health insurance of immigrants. Health Services Research, 40(3), 697–721. 22. Rehm, R. S. (2003). Legal, ﬁnancial, and ethical ambiguities for Mexican American families: Caring for children with chronic conditions. Qualitative Health Research, 13(5), 689–702.

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23. Fix, M., & Passel, J. (1999). Trends in non-citizens’ and citizens’ use of public beneﬁts following welfare reform: 1994–1997. Washington, DC: Urban Institute. 24. Ku, L., Cohen Ross, D., & Broaddus, M. (2006). Survey indicates deﬁcit reduction act jeopardizes Medicaid coverage for 3 to 5 million U.S. citizens. Washington, DC: Center on Budget and Policy Priorities. 25. Haskins, R., Greenberg, M., & Fremstad, S. (2004). Federal policy for immigrant children: Room for common ground? Washington, DC: The Brookings Institute Press. 26. Lessard, G., & Ku, L. (2003). Gaps in coverage for children in immigrant families. The Future of Children, 13(1), 9–10. 27. Edmunds, M., & Joel Coye, M. (Eds.). (1998). America’s children: Health insurance and access to care (p. 198). Washington, DC: National Academies Press. 28. The Kaiser Commission on Medicaid and the Uninsured. State Medicaid fact sheet: California and the United States. Retrieved March 5, 2006, from http:==www.kff .org=mfs=medicaid.jsp?r1¼CA&r2¼US. 29. Frates, J., Diringer, J., & Hogan, L. (2003). Models and momentum for insuring low-income, undocumented immigrant children in California. Health Affairs, 22(1), 259–263. 30. 100% Campaign: Outreach: County programs. Retrieved February 28, 2006, from http:==www.100percentcampaign.org=resources=publications=otr-child-healthprograms.htm. 31. Examples of funding are given in Guendelman, S., Wyn, R., & Tsai, Y. (2002). Children of working poor families in California: The effects of insurance status on access and utilization of primary health care. Journal of Health & Social Policy, 14(4), 1–20; Guendelman, S., Wyn, R., & Tsai, Y. (2000). Children of working low-income families in California: Does parental work beneﬁt children’s insurance status, access, and utilization of primary health care? Health Services Research, 35(2), 417– 441; Guendelman, S., Wyn, R., & Tsai, Y. (1999). Access to health care for California childrenoftheworkingpoor.Berkeley,CA:CaliforniaPolicyResearchCenter;Guendelman, S., & Pearl, M. (2004). Children’s ability to access and use health care. Health Affairs, 23(2), 235–244; Guendelman, S., & Pearl, M. (2001). Access to care for children of the working poor. Archives of Pediatric and Adolescent Medicine, 155(6), 651–658; Guendelman, S., Schaufﬂer, H., & Samuels, S. (2002). Differential access and utilization of health services by immigrant and native-born children in working poor families in California. Journal of Health Care for the Poor and Underserved, 13(1), 12– 23; and Guendelman, S., Schaufﬂer, H., & Pearl, M. (2001) Unfriendly shores: How immigrant children fare in the U.S. health system.Health Affairs, 20(1), 257–266. 32. Guendelman, S., Angulo, V., & Oman, D. (2005). Access to health care for children and adolescents in working poor families: Recent ﬁndings from California. Medical Care, 43(1), 68–78. 33. See Note 4. 34. Committee on Practice and Ambulatory Medicine. (2000). American Academy of Pediatrics: Recommendations for preventive pediatric health care. Pediatrics, 105(3), 645–646. 35. Gresenz, C. R., & Klerman, J. A. (2002). Beyond Medi-Cal: Health insurance coverage among former welfare recipients. Oakland, CA: Medi-Cal Policy Institute. 36. Kasper, J. D., Giovannini, T. A., & Hoffman, C. (2000). Gaining and losing health insurance: Strengthening the evidence for effects on access to care and health outcomes. Medical Care Research and Review, 57(3), 298–318; discussion 319–325.

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37. Lewin, M. E., & Altman, S. H. (Eds.). (2000). America’s health care safety net: Intact but endangered (p. 281). Washington, DC: National Academies Press. 38. Valdez, R. B., Giachello, A., Rodriguez-Trias, H., Gomez, P., & de la Rocha, C. (1993). Improving access to health care in Latino communities. Public Health Reports, 108(5), 534–539. 39. Flores, G., Abreu, M., & Tomany-Korman, S. C. (2006). Why are Latinos the most uninsured racial=ethnic group of U.S. children? A community-based study of risk factors for and consequences of being an uninsured Latino child. Pediatrics, 118(3), e730–e740. 40. The California Budget Project. (2005). Working hard, falling short: Investing in California’s working families. Sacramento, CA: The California Budget Project. 41. Brown, E. R., Wyn, R., Yu, H., Valenzuela, A., & Dong, L. (1999). Access to health insurance and health care for children in immigrant families. In D. J. Hernandez (Ed.), Children of immigrants: Health, adjustment, and public assistance (pp. 126– 186). Washington, DC: National Academies Press. 42. Ku, L. (2003). CDC data show Medicaid and SCHIP played a critical counter-cyclical role in strengthening health insurance coverage during the economic downturn. Washington, DC: Center on Budget and Policy Priorities. Retrieved August 27, 2007, from http:==www.cbpp.org=9–23– 03health.pdf. 43. Holahan, J., Dubay, L., & Kenney, G. M. (2003). Which children are still uninsured and why. The Future of Children, 13(1), 56–79. 44. Holahan, J., & Ghosh, A. (2005). Understanding the recent growth in Medicaid spending, 2000–2003. Health Affairs, Supplementary Web Exclusives, W5-52– W5-62. 45. Parker, E., & Teitelbaum, M. (2003). Percentage of immigrant children without health insurance is on the rise: House and Senate conferees on the Medicare Prescription Drug Bill could reverse this trend by helping hundreds of thousands of children obtain health coverage. Washington, DC: Children’s Defense Fund. 46. Institute for Health Policy Solutions, California. Coverage solutions. Retrieved September 5, 2007, from http:==ihps-ca.org=localcovsol=index.html. 47. Berk, M. L., Schur, C. L., Chavez, L. R., & Frankel, M. (2000). Health care use among undocumented Latino immigrants. Health Affairs, 19(4), 51–64. 45. Passel, J. S. (2005). Unauthorized migrants: Numbers and characteristics. Los Angeles, CA: Pew Hispanic Center.

10 Nonacademic Needs of Students: How Can Schools Intervene? Susan Stone

Scholars from a range of disciplinary backgrounds assert that the ‘‘nonacademic’’ needs of students represent a salient concern of educational practice and policy.1,2 Over the past few decades, a diverse set of models to address these needs has emerged (e.g., curricula focused on socio-emotional learning, school-based health and mental health centers, family resource centers, Comer schools, community schools, school-based prevention of risk behaviors, systems-of-care models). These developments share several core assumptions: (1) that there is consensus about what nonacademic needs are, as well as their related outcomes; (2) that addressing pupils’ nonacademic needs can inﬂuence academic progress at either the student or school level; (3) that the school, albeit in varying forms and levels, represents the logical point of intervention; and (4) that the addition of a particular program or program element (e.g., a new curriculum, a health center) is often a critical ingredient in meeting pupils’ needs. At this point, this programmatic proliferation and its associated assumptions bear critical reﬂection, especially as the notion of expanding the school’s role in addressing nonacademic needs of pupils has garnered increasing attention from policymakers.3 While educator concerns about these needs have been voiced since the turn of the century, most agree that there has been little sustained progress, using a wide variety of strategies, over time.4 Programs addressing these needs have been particularly difﬁcult to sustain in schools.4,5 The process of labeling pupils with variously deﬁned nonacademic needs, moreover, often results in their segregation from natural educational settings.6 201

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These segregated settings may offer suboptimal learning opportunities and set conditions for iatrogenic peer-mediated effects.7 Finally, the education system often functions as a conduit for various interests, many of which are loosely coupled with the actual capacity of the system as a whole, underscoring the importance of careful deliberation when implicating schools as programmatic levers.8 This chapter blends conceptual, empirical, and historical perspectives to critically assess nonacademic needs as an educational problem and the potential and limitations of using schools as an intervention lever. The ﬁrst section describes the scope of nonacademic needs as well as evidence informing the overlap of these needs and indicators of academic performance. The second section provides an overview of the current range of programmatic options. In order to map the boundaries of schools as a possible point of intervention, the ﬁnal section presents a model for conceptualizing school effects and synthesizes recent evidence (from both empirical and historical perspectives) about the effectiveness of schools as points of intervention.

Nonacademic Factors and Their Academic Correlates There are at least seven non–mutually exclusive subgroupings of children and youth deﬁned to have signiﬁcant ‘‘nonacademic’’ needs, including those (1) with a key set of demographic and family risk factors, (2) with unmet basic needs (e.g., hunger or homelessness), (3) involved in child-serving systems (e.g., child welfare, juvenile justice), (4) with health and mental health problems, (5) who engage in various risk behaviors, (6) who demonstrate low levels of social competence and skills, and (7) with poor learning-related habits, skills, and attitudes. This is clearly not an exhaustive listing of all possible nonacademic needs. Rather, I provide a review of these particular needs because current conceptualizations highlight these factors as ‘‘barriers to learning.’’9 Before embarking on this review, I must point out that the knowledge base is limited by two unanswered questions. One question is where to locate the ‘‘barrier to learning’’—as characteristics of children or families and=or in capacities of teachers and schools to address such needs. Second, the range of outcomes encompassing the concept of learning has not been speciﬁed. This represents a crucial gap, as various nonacademic needs may be linked to different sets of academic outcomes, and the relative strengths of these relationships likely vary considerably (see Chapter 11). The studies reviewed below typically examine linkages between nonacademic needs and ‘‘hard’’ academic outcomes such as achievement and grades versus other indicators of school progress. Finally, we know very little about the direct and indirect mechanisms linking nonacademic needs to learning outcomes or the interrelationships among various nonacademic needs and academic outcomes.

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Sociodemographic and Family Risk Factors

Educational research distills a robust set of academically related risk factors, which represent characteristics that children and families ‘‘bring’’ to schools, including minority racial=ethnic background, low levels of ﬁnancial and social resources (including poverty status, income, parents’ education), larger family size and single-parent structure, and low levels of family involvement in and expectations for education.10 These factors relate to a wide variety of academic outcomes including achievement, grades, grade retention, and school dropout. The effects of poverty, in particular, are notable.11 Poverty affects signiﬁcant numbers of children. Recent Current Population Survey estimates indicate that approximately 18% of children under 18 live in poverty and that this rate is magniﬁed for both Latino (21.9%) and African American (24.7%) children.12 It represents a pervasive explanatory risk factor—over and above other risk factors—especially if poverty is prolonged.13 For example, observed achievement gaps of African American and Latino versus white kindergartners at school entry can be almost totally explained by poverty-related factors.14 Efforts to disentangle the association between poverty- and achievementrelated outcomes implicate low birth weight, lead poisoning, residential mobility, and key home environmental differences (e.g., levels of cognitive stimulation) as particularly salient.15 Poverty, minority status, and residential mobility exert inﬂuences on students’ cognitive and academic outcomes both directly and through school compositional effects. That is, regardless of their individual characteristics, students in schools with higher proportions of peers who are impoverished, residentially mobile, or minority, on average, have lower achievement than their counterparts in schools without these attributes.16 Moreover, the most sociodemographically vulnerable students attend the nation’s most under-resourced and underperforming schools.16,17 Finally, a robust line of scholarship links particular attributes of families, one of which is clearly associated family socioeconomic status, to child outcomes. Adverse health, mental health, and cognitive outcomes among children share a robust risk factor—‘‘risky’’ family social environment, characterized by high levels of parental discord, psychosocial stress, and cold and unresponsive parenting.18 Unmet Basic Needs

Given the strong relationship between poverty and school outcomes, we would expect indicators of material hardship such as hunger or food insecurity and homelessness to also relate to academic outcomes. Hunger and food sufﬁciency appear to exert differential inﬂuences on academic outcomes as a function of child age.19 Among elementary-school-aged students, food insufﬁciency negatively relates to mathematics achievement and increases the risk of grade

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repetition. Among high school students, food insufﬁciency is related to school suspension. In addition, there is some evidence that food insufﬁciency may relate to child health and internalizing (depression and anxiety) symptoms.20 There is sparse research on the relationship between the experience of homelessness and academic achievement, but what exists suggests the experience of homelessness does not directly inﬂuence student achievement, though it perhaps does so indirectly through higher levels of school mobility.21 System-Involved Youth

The substantial academic difﬁculties of children and youth involved in one or more child-serving systems (e.g., child welfare, juvenile justice, child mental health, and special education) are well documented. As a group, children involved in the child-welfare system exhibit low levels of achievement and are at risk for both grade retention and dropout.22 Youth involved in the juvenile justice system show a wide range of severe learning problems, including deficits in basic reading skills.23 Youth with psychiatric disorders as well as those participating in special education drop out of school at twice the rate of youth in the general population.24 Child-system involvement in general is associated with elevated rates of mental health conditions and mental health service utilization.25 The academic difﬁculties of these youth are likely accounted for by both child- and system-related factors. For example, poor and minority youth are disproportionately served by these systems.26 Speciﬁc systemslevel factors include the continuity and quality of schooling while system involved, especially at system entry and exit points and in cases of service fragmentation.22,23,27 Health and Mental Health Conditions

Literature generated from a public-health perspective points to a wide range of health and mental health conditions affecting children and youth. Two concerns typically emerge: that particular health or mental health conditions may directly or indirectly inﬂuence children’s academic achievement or that, given their sheer numbers, affected children may inﬂuence or be inﬂuenced by particular school practices. Both childhood asthma (affecting 5% to 10% of school-aged children) and obesity (affecting 16%), which disproportionately manifest in poor and minority children, are representative of such health concerns.28 Estimates indicate that one in ﬁve children aged 9 to 17 have a diagnosable mental health condition. Approximately 11% and 5% of children experience moderate or severe levels of impairment, respectively.3,29 Of affected children and youth, only about 20% receive needed services, and service-utilization patterns are highly related to both race=ethnicity and socioeconomic status.3 Because schools typically operate as a key portal into mental health services, they are identiﬁed as an intervention lever.3,30,31

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Evidence informing the direct overlap between health and mental health problems and academic difﬁculty is mixed. While some studies ﬁnd associations between chronic health conditions, adolescent-reported health status, internalizing symptomatology, disruptive behavior disorders, and various academic performance indicators, others do not ﬁnd consistent relationships among these variables.28,32–34 This inconsistent patterning of effects almost certainly reﬂects methodological inconsistencies across studies (e.g., crosssectional versus longitudinal comparisons, how conditions are measured, clinical versus nonclinical samples, different levels of control for background characteristics, different academic outcome measures, age differences). These mixed effects also point to important sources of heterogeneity among affected students. One source of heterogeneity relates to the particular condition and its severity. Among health outcomes, for example, the severity of medical conditions (not the condition itself ) relates to children’s academic outcomes.35 Among mental health outcomes, associations between attention deﬁcit hyperactivity disorder and academic underachievement are robust and speciﬁc.36 However, studies focused on internalizing symptoms generate more mixed results.37 Anxiety is more robustly associated with school achievement than is depression.32,38 Another source of heterogeneity is age. For example, it appears that academic difﬁculty among children with chronic medical conditions decreases with age; for externalizing conditions (attention-deﬁcit= hyperactivity disorder, oppositional deﬁant disorder, and conduct disorder), academic problems may increase with age.35,36 A ﬁnal source of heterogeneity is the presence of multiple risk factors (including sociodemographic factors and=or other comorbid conditions). Studies of both health and mental health difﬁculties among early adolescents indicate that those who are most vulnerable academically are those who possess multiple risk factors.37 Additionally, comorbidity among mental health conditions is common (depending on the condition, upward of 80%) for any psychiatric condition, and comorbidity is related to severity of impairment.31 Evidence also suggests that the strength of relationships between condition and academic performance is moderated by prior school performance, family background, and characteristics of the social environment.35,39 These moderating effects are complex, and not always in expected directions. For example, the analysis by Guttman and colleagues33 of data from the Rochester Longitudinal Study indicated that mental health was negatively related to grade point average (about one-half grade point difference between those with good versus poor mental health) for low-risk but not high-risk children. Risk Behaviors

Finally, national surveys of adolescents document relatively high rates (typically around 25%) of risky sexual behaviors; tobacco, alcohol, and illicit drug use; and engagement in aggressive and delinquent acts.40 While the direction

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of the relationship is not always clear and differs by type of behavior, these behaviors show correlations with school-related behavior problems (e.g., absenteeism, suspension, and expulsion) as well as school achievement and dropout.41 Further, engagement in any risk behavior sets in motion pathways to increasingly diverse sets of risk activities, leading some to speculate that it is the constellation of risk behaviors (versus any one) that poses signiﬁcant risk.42 Social Competencies and Skills

An accumulating body of mostly cross-sectional research explores direct and indirect relationships between various social and emotional competencies and academic attitudes, behavior, and performance.43 While prosocial skills and attitudes clearly are an asset for children and youth and poor social functioning is an associated impairment of many child health and mental health conditions, evidence for the direct relationship between this set of competencies and academic achievement is weak in methodologically rigorous studies.44,45 In their randomized, controlled trial, Dolan and colleagues45 found no relationship between socioemotional skills and reading achievement. Drawing on a nationally representative longitudinal study of kindergartners, Duncan and colleagues46 did ﬁnd positive associations, adjusting for family background factors, between these competencies and achievement. However, the magnitudes of these effects are quite small (on average, ranging from one-twentieth to one-tenth of a standard deviation). These effects appear more pronounced (but, overall, still quite modest) for poor African American and Latino students. Learning-Related Habits, Skills, and Attitudes

Other research, however, does point to the salience of a key set of academic attitudes and behaviors (sometimes termed ‘‘academic enablers’’) that may explain the relationship between prior and subsequent levels of academic achievement.47 These include motivation and effort, study skills and habits, and engagement in learning. High levels of motivation are strongly associated with study skills and habits as well as engagement. In turn, study skills and engagement inﬂuence achievement. Indicators of these academic enablers appear to fully or substantially explain, respectively, relationships between adolescent health status and internalizing symptoms and achievement.34 It is also notable that adolescents reporting low levels of motivation and engagement and those reporting greater depression or anger=aggression and low levels of engagement had poorer academic outcomes than those reporting high rates of depression or anger=aggression alone.37 In summary, this brief review highlights the wide range of issues affecting children and youth that have been considered nonacademic needs. Two points, in particular, are worth highlighting at this point. The ﬁrst is that school investment in particular nonacademic needs will probably not consistently

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yield academic achievement and=or performance beneﬁts. There is considerable heterogeneity within and across these needs; the patterning of effects appears complex, and it may often be indirect or interact with other child and family characteristics. Second, schools likely serve varying densities of students within and across these needs, and their distribution would likely be salient for service planning, yet schools and districts neither systematically collect this information nor share student data with other child-serving systems.48

Characterizing Strategies for School Service Provision What do we know about how schools currently address nonacademic needs? First, programs themselves vary widely. Payne and colleagues,49 for example, highlight several salient dimensions, including (1) stafﬁng (what particular school staff are present and=or the extent to which nonschool staff are used), (2) strategy (primary or tertiary prevention or intervention), (3) targeting (universal versus subgroup), (4) location (to what extent are services provided at the school site), (5) funding (hard versus soft funding sources), (6) modality (strategies used to provide a particular service), and (7) penetration (extent to which services are aligned with the overall school mission and goals). Two recent national surveys provide a descriptive portrait of the distribution of services across schools. The ﬁrst proﬁles mental health services (broadly deﬁned) delivered in a nationally representative sample of schools. Results indicate that a vast majority of schools (greater than 70%) offer some form of mental health services to all students and provide drug, alcohol, and tobacco prevention. Students are typically referred for services for social, interpersonal, or family problems and services are provided by school staff—particularly school counselors and nurses.50 The second, also utilizing a national sample of schools, describes prevention activities employed by schools. Over 75% of schools provide either information to students and families, utilize prevention curriculums and=or counseling interventions, or implement structural modiﬁcations (i.e., organization of grades, grouping strategies). Schools routinely use more than 10 activities at once.51 Overall, the quality of programming is low; on average, activities last only about a month and are loosely related to ‘‘best’’ and ‘‘evidence-based’’ practices.52 Low program quality may be linked to the practices of school support personnel (e.g., school psychology or social work staff).4,53

Conceptualizing School Effects on Nonacademic Needs The previous sections discussed alternative conceptualizations of nonacademic needs, variation in the extent to which these needs relate to academic outcomes, potential variation in service provision options, and a general picture as to how schools address a broadly deﬁned set of nonacademic needs. Given

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that these efforts are located in (or, at minimum, imply close coordination with) schools, there is surprisingly little attention or reference to education literature specifying the nature and range of school effects (student composition, resources, and structural or organizational elements), school change processes, and a lesson-rich history literature on psychosocial service provision in schools. Rutter and Maughan54 reviewed research assessing the inﬂuence of school effects on both pupil academic achievement and psychosocial adjustment. Several empirical generalizations emerge from their review and serve as a general model of school effects for this discussion. First, they estimate that a substantial amount of the variability in child ability=achievement and behavioral adjustment is explained by child and family sociodemographic characteristics such as socioeconomic status. School factors, not surprisingly, are more strongly related to cognitive and academic achievement and performance outcomes than to psychosocial outcomes. Within psychosocial outcomes, school effects are more strongly related to externalizing than internalizing behaviors. Second, school effects generally do not alter the overall distribution of child performance or behavior. That is, they generally function as a rising tide (e.g., raising overall performance versus eliminating preexisting gaps). Finally, school effects are complex. They are likely to be most pronounced at the margins (i.e., the most meaningful contrasts are between the best and worst performing schools), and their overall patterning includes inﬂuences of the school environment, classrooms, teachers, and peer groups on students and vice versa. School effects, moreover, likely have varying relationships to shortand long-term academic achievement, performance (e.g., grades), and academic progress (e.g., course-taking patterns), and the salience of such effects may differ as a function of grade level (see Chapter 11). School effects include the inﬂuence of inputs (student body and teacher characteristics, resources), organizational structures (e.g., class size) and quality-related processes.55 Over and above inputs, two factors have consistently been linked to student achievement. The ﬁrst is the structural feature of small classroom size, especially for younger children.56 Second, ﬁve speciﬁc school organizational processes appear to impact to student achievement—strong principal leadership, parent and community ties, professional capacity, ‘‘ambitious’’ instruction, and ‘‘student-centered’’ learning climates characterized by orderliness and both high expectations for achievement (academic press) and high levels of support (i.e., teacher–student relationships characterized by caring and concern).57 Student Compositional Effects and Nonacademic Needs

Most research that examines how the composition of the student body might inﬂuence outcomes focuses on aggregate effects of student background characteristics. Regardless of their individual characteristics, students in schools with higher proportions of peers who are impoverished, residentially mobile,

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minority, low achieving, or dropouts, on average, show lower achievement than their counterparts in schools without these attributes.16 While it is reasonable to conclude that schools vary in terms of the numbers of students with nonacademic needs as well as the nature of these needs, evidence, again, is sparse and mixed. Data from the Chicago Public School system indicate that rates of children with substantiated maltreatment reports and foster care involvement vary across schools.58 Across-school variation has also been observed in incidences of school-based victimization (from verbal threats to physical altercations) and in densities of students with conduct disorders.59 In contrast, adolescent-reported internalizing symptoms and health condition do not vary signiﬁcantly across schools.34 In addition, it is also reasonable to conclude that the most vulnerable schools serve the most psychosocially vulnerable children.17 School-Quality Processes and Nonacademic Needs

A robust body of literature links indicators of student-centeredness at levels of the teacher-student dyad, the classroom, and the school to student achievement, academic enablers, and school engagement.57,60 Children with poor teacher-rated relationships in kindergarten earn lower early elementary grades and have more disciplinary problems in upper elementary school.61 Positive teacher-student relationships also appear beneﬁcial for adolescents.62 There is a growing body of evidence linking indicators of student-centeredness— especially at the level of the teacher–student dyad—to various nonacademic needs. Low achieving, minority, and low-income kindergartners placed in ﬁrst-grade classrooms characterized by high levels of instructional and relational support achieved similarly to their low-risk counterparts.63 Kindergartners with disruptive or anxious behaviors exhibit impaired relationships with teachers in ﬁrst grade.64 Children with externalizing behavioral problems (inattentive, disruptive, and=or aggressive behavior) both receive less instruction from and report poorer relationships with teachers.65 At the school level, supportive school climates protect against youth risk behaviors.66 Programmatic Effects

So far, I have approached nonacademic needs from the perspective of schools in general. An additional perspective examines evaluations of school programs designed directly to impact particular nonacademic needs. There are two major lines of research here: one analyzes school-based prevention of various risk behaviors including substance abuse, school dropout, delinquency and aggressive behaviors, and teen pregnancy; the other focuses on classroom approaches with students with substantial achievement and=or behavioral problems.67–69 This literature is informative not only about programmatic effects in general but also about factors—at the programmatic and school levels—that inﬂuence their magnitude.

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Meta-analyses indicate that school-based prevention of adolescent risk behaviors have small to low moderate overall effects on relevant behaviors, a ﬁnding that is not at all inconsistent with what would be predicted from the school-effects literature. However, effects become moderate to large under particular programmatic and school conditions. Programs, on average, have larger effects when they are delivered by high-quality staff and incorporate cognitive-behavioral components. At the school level, effect sizes are positively related to school quality processes (i.e., strong principal leadership). Recent evidence, moreover, indicates that schools with low achievement levels and high rates of absenteeism, residential mobility, and student poverty moderate the effects of high-quality ‘‘evidence-based’’ programs delivered either universally or selectively.68 Finally, effect sizes also vary by the type of risk behavior. Teen-pregnancy prevention programs, for example, show larger effects when they are delivered in community versus school settings.67 Similar themes emerge in a synthesis of meta-analyses of classroom-based interventions for children to improve both academic and behavioral skills.70 In general, particular instructional strategies (peer tutoring, direct instruction, emphasis on reading comprehension) and classroom-based contingencymanagement strategies (generally teacher delivered or teacher delivered with some additional professional support) show very large effect sizes on both student achievement and behavior. The beneﬁts of these strategies are fairly nonspeciﬁc. That is, they appear to work equally well for low-achieving students, students with particular mental health conditions, and children classiﬁed as severely emotionally disturbed. However, teachers are not consistently trained or supported in these types of practices.71 Class-based contingency management is enhanced in schools that are characterized by order and student centeredness.71,72 In summary, the research ﬁndings on school programs that seek to ameliorate nonacademic needs reveal three important patterns. First, teacher instructional and relational attributes are associated with both ‘‘academic enablers’’ and student achievement. Second, school quality indicators are associated with programmatic effects. Third, a fairly nonspeciﬁc set of strategies—either delivered at the classroom or incorporated at the programmatic level—are associated with positive beneﬁts in particular behavioral domains. School-Change Processes and Nonacademic Needs

Whether and how schools identify, respond to, and address nonacademic needs must also be considered from the perspective of school-change processes in general. While there is consensus about the general dimensions that are correlated with effective schooling, we also know that school personnel vary in their capacity to enact these processes.73 We know that there are staggering levels of variation in instructional and relational supports at the classroom level during the early elementary years.60,73 This variation is not associated with either class size or teacher experience. Indeed, a complicated

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set of conditions shape school-quality indicators, including strong relational ties between students and school constituents including principals, teachers, parents, and community members as well as supportive community contexts.74 There is provocative evidence that certain high-risk groups of children may also represent important conditional factors for schools. Schools serving critical densities of child-welfare-system-involved youth, for example, must be of particularly high quality in order to sustain and improve overall student achievement over time.57 The school-change literature typically focuses on instructional innovation and achievement outcomes. School response to nonacademic needs may be shaped by additional factors. From the inception of the common school at the turn of the century, educators have raised concern about the extent to which nonacademic needs impact student engagement and performance in school work. David Tyack4 argues that these services have never been conceptualized as intrinsically necessary to schools (by either educators or the public) and, therefore, are rarely sustained over time. Efforts to insert this kind of programming in schools are often accompanied by both professional conﬂicts (including within-school disciplines and between within-school disciplines and others) and school-parent-community conﬂict.75 Programs for nonacademic needs may be particularly vulnerable because they often have goals and=or call for structural changes that are at odds with widely held cultural beliefs about the ‘‘proper’’ scope and function of schools, a factor that has historically been linked to failed attempts at school reform.76 This uneven history anticipates two sets of issues related to the capacities of schools to meet students’ nonacademic needs. The ﬁrst relates to the overall goals and structural capacity of the education system. There are no uniform understandings of the goals and purpose of the education system.8 The structure and capacity of the system represent another factor. The modern school (age-graded and organized around a common curriculum) was designed in response to a particular set of historical and economic conditions—namely to achieve universal enrollment, sort the college bound, and ‘‘hold’’ others until they entered the labor market.77 Different resources are required to move beyond access parity (indeed, American schools offer nearly universal access) to parities in opportunity to learn and, ultimately, outcomes. In general, the additional investments are quite substantial and have marginal and diminishing returns.55 Goals and resource constraints shape public expectations about the proper organization and functions of schools that do not emphasize meeting nonacademic needs. Some argue that schools—as they are currently organized—do not have the capacity to deliver ‘‘state of the art’’ or ‘‘evidencebased’’ practices for mental health needs in general.71 A second set of issues relates to programmatic coherence. ‘‘Christmas Tree’’ schools use multiple levels of supplementary programs that are poorly targeted, oftentimes duplicating services, and that are not integrated with the school as a whole. Most important, these add-ons are loosely coupled with academic and instructional goals.6,78 A growing body of research suggests that strategies to

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meet nonacademic needs must be coupled with a strong focus on academic goals and quality instruction, positive relationships with and high expectations for students, and a spirit of persistence with difﬁcult or struggling students.79

Summary and Implications This chapter began by discussing the range of nonacademic needs that are often invoked by terms such as ‘‘barriers to learning.’’9 The range of these needs is highly variable in terms of both their correlates (e.g., by etiology, age, severity, and co-occurrence with other academic risk factors) and their relationships to academic outcomes, particularly academic achievement. While some factors—poverty and its correlates, child system involvement, learningrelated attitudes and behaviors—show strong relationships to achievement outcomes, others do not show consistent relationships. Socioemotional competencies appear to have weak relationships with achievement. Effects of health and mental health conditions are quite mixed but may exert inﬂuence through learning-related behaviors. On the one hand, this pattern of effects could be interpreted as reﬂecting a limited knowledge base. Indeed, much beneﬁt would accrue from scholarship that (1) conceptualizes and integrates this broad set of needs, (2) speciﬁes the extent of interrelationships and overlap among them, and (3) begins to map a reasonable set of short- and long-term academic outcomes (including both hard measures of academic achievement and other forms of academic progress). Attempts to justify education-system involvement by invoking a ‘‘barriers to learning’’ argument narrowly focused on academic achievement can easily be challenged or, at least, moderated. This is not to say school efforts to address nonacademic needs that are indirectly or unrelated to pupil achievement are without merit. It does, however, suggest that schools may face important tradeoffs in efforts to maximize both overall pupil well-being and academic achievement, especially given a policy climate where schools and districts are evaluated on pupil academic achievement.80 At the same time, the multiplicity and complexity of these needs also suggest the primacy of school and district assessment. The distribution of these needs likely differs quite substantially between schools and districts—from schools that have students with high rates across all needs to those with small rates within a single need domain. In this respect, data linkages between school and child-serving systems appear to be a quite promising ﬁrst step.57 Even if such data were available, the research reviewed here suggests the limits of schools in terms of both their potential range of effects on nonacademic needs and their current capacity to deliver related programs and services to students. Clearly, the core values behind these various programmatic efforts are hard to question. As a whole, they emphasize the importance of holistic perspectives on children’s academic experiences and trajectories, the primacy of the school as a key developmental setting for children, and the importance of providing children and youth and, in some cases, their families with the best

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quality supports to meet their various needs. The program developers would also agree that the contexts of schools matter.1,9 Thus, I must admit I am ambivalent about current programmatic efforts. Students come to schools with varying levels of psychosocial risk, and schools have little capacity (or, perhaps, willingness) to respond to them; in areas where schools do have the capacity, they will likely be hard pressed to reduce population risk in academic, psychological, or behavioral outcomes. In this vein, some argue that poverty-reduction efforts represent the only solution for ameliorating academic and nonacademic needs alike.11 Given the current options for more incremental approaches to nonacademic needs, I worry about the current focus of program developers on ‘‘scaling up’’ their efforts—that is, how to transport or translate them into ‘‘real world’’ schools.2 Instead, I would much rather see investments in schools to enhance their ‘‘readiness’’ to receive such programming. It is heartening that studentcentered teachers, classrooms, and schools appear to proffer both universal and protective (i.e., to at-risk students) beneﬁts. Larger school-reform efforts designed to improve achievement among all students hold promise for enhancing the adjustment of psychosocially vulnerable students. Well-functioning schools and classrooms are, at minimum, necessary, and may often be sufﬁcient to meet many student nonacademic needs. These conditions also represent the most fertile ground for additional programming efforts. We also know that schools must cultivate student-centeredness, through strong leadership, high-quality instruction, and professional capacity as well as through maintaining relationships between school staff and between school staff and family and community constituents. Perhaps most critically, studentcenteredness ultimately involves teachers, who need strong skills as well as professional and school supports to engage and persist in their work with very vulnerable students. This, beyond programmatic supports, is the hard work to be done.

Notes 1. On various approaches to student non-academic needs: Greenberg, M. T., Weissberg, R. P., Utne O’Brien, M., Zins, J. E., Fredericks, L., Resnik, H., et al. (2003). Enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning. American Psychologist, 58(6=7), 466– 474; National Research Council and the Institute of Medicine. (2004). Engaging schools: Fostering high school students’ motivation to learn (Committee on Increasing High School Students’ Engagement and Motivation to Learn, Board on Children, Youth and Families, Division of Behavioral and Social Sciences and Education). Washington, DC: National Academies Press; Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology Review, 3(4), 223–241; and Tolan, P. H., & Dodge, K. A. (2005). Children’s mental health as a primary care and concern. American Psychologist, 60(6), 601–614.

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2. Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., & MorrisseyKane, E (2003). What works in prevention: Principles of effective prevention programs. American Psychologist:Special Issue: Prevention that works for children and youth, 58(6–7), 449– 456. 3. Federal statements related to mental health: Ofﬁce of the Surgeon General. (1999). Mental Health: A report of the Surgeon General. Washington, DC: U.S. Department of Health and Human Services; President’s New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Washington, DC: U.S. Government Printing Ofﬁce. DHHS Publication No. SMA-03–3832. 4. On providing psychosocial services in schools: Tyack, D. (1992). Health and social services in public schools: Historical perspectives. The Future of Children, 2, 19–31; and Pianta, R. C. (2003). Commentary: Implementation, sustainability, and scaling up in school contexts: Can school psychology make the shift? School Psychology Review, 32(3), 331–335. 5. Tyack, D., & Cuban, L. (1995). Tinkering towards utopia: A century of public school reform. Cambridge, MA: Harvard University Press. 6. Deschenes, S., Cuban, L., & Tyack, D. (2001). Mismatch: Historical perspectives on schools and students who don’t ﬁt them. Teachers College Record, 103(4), 525–547. 7. Dodge, K. A., Dishion, T. J., & Lansford, J. E. (2006). Deviant peer inﬂuences in intervention and public policy for youth. Social Policy Report, 20(1), 1–20; Foley, R. & Pan, L. (2006). Alternative education programs: Program and student characteristics. High School Journal, 89(3), 10–21. 8. Ravitch, D. (2000). Left back: A century of failed education reform. New York: Touchstone. 9. Adelman, H., & Taylor, L. (2006). The school leaders guide to student learning supports: New directions for addressing barriers to learning. Thousand Oaks, CA: Corwin Press. 10. Wang, M. C., & Gordon, G.W. (1994). Educational resilience in inner-city America. Hillsdale, NJ: Lawrence Erlbaum Associates. 11. Berliner, D. C. (2006). Our impoverished view of educational research. Teachers College Record, 108(6), 949–995. 12. Fronczek, P. (2005). Income, earnings, and poverty from the 2004 American Community Survey. Washington, DC: U.S. Census Bureau. 13. On inﬂuences of poverty on child outcomes: Duncan, G. J., Brooks-Gunn, J., & Klebanov, P. K. (1994). Economic deprivation and early childhood development. Child Development, 65(2), 296–318; Evans, G. W. (2004). The environment of childhood poverty. American Psychologist, 59(2), 77–92. 14. Fryer, R. G., & Levitt, S. D. (2004). Understanding the black-white test score gap in the ﬁrst two years of school. Review of Economics and Statistics, 86(2), 447– 464. 15. On the mechanisms linking poverty and academic outcomes: Barton, P. E. (2003). Parsing the achievement gap: Baselines for tracking progress. Policy Information Report. Princeton, NJ: ETS Policy Information Center; Guo, G., & Harris, K. M. (2000). The mechanisms mediating the effects of poverty on children’s intellectual development. Demography, 37(4), 431– 447. 16. On sociodemographic compositional effects: Bryk, A. S., & Thum, Y. M. (1989). The effects of high school organization on dropping out: An exploratory investigation. American Educational Research Journal, 26(3), 353–383; Lee, V. E., &

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Burkam, D. T. (2002). Inequality at the starting gate: Social background differences in achievement as children begin school. Washington, DC: Economic Policy Institute; Rumberger, R. W. (1995). Dropping out of middle school: A multilevel analysis of students and schools. American Educational Research Journal, 32(3), 583–625; Rumberger, R. W., & Larson, K. A. (1998). Student mobility and the increased risk of high school dropout. American Journal of Education, 107(1), 1–35; Rumberger, R. W., & Willms, J. D. (1992). The impact of racial and ethnic segregation on the achievement gap in California high schools. Educational Evaluation and Policy Analysis, 14(4), 377–396. Darling-Hammond, L. (1998). Unequal opportunity: Race and education. Brookings Review, 16(2), 28–32. Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social environments and the mental and physical health of offspring. Psychological Bulletin, 128(2), 330–366. Alaimo, K., Olson, C., & Frongillo, E. (2001). Food insufﬁciency and American school-aged children’s cognitive, academic, and psychosocial development. Pediatrics, 108, 44–51. Weinreb. L., Wehler, C., Perloff, J., Scott, R., Hosmer, D., Sagor, L., et al. (2002). Hunger: Its impact on children’s health and mental health. Pediatrics, 110, 1–9. Buckmer, J., Bassuk, E., & Weinreb, L. (2001). Predictors of academic achievement among homeless and low income youth. Journal of School Psychology, 39, 45–69. Stone, S. (2007). Child maltreatment, out-of-home placement and academic vulnerability: A decade review of evidence and future directions. Children & Youth Services Review, 29(2), 139–161. On educational issues among system-involved youth: Burrell, S., & Warboys, L. (2000). Special education and the juvenile justice system. Juvenile Justice Bulletin, Ofﬁce of Juvenile Justice and Delinquency Prevention. Washington, DC: Ofﬁce of Justice Programs; Foley, R., & Pan, L. (2006). Alternative education programs: Program and student characteristics. High School Journal, 89(3), 10–21. On long-term outcomes among affected youth: Blackorby, J., & Wagner, M. (1996). Longitudinal post-school outcomes of youth with disabilities: Findings from the National Longitudinal Transition Study. Exceptional Children, 62(5), 399– 413; Vander Stoep, A., Weiss, N. S., Kuo, E. S., Cheney, D., & Cohen, P. (2003). What proportion of failure to complete secondary school in the U.S. population is attributable to adolescent psychiatric condition? Journal of Behavioral Health Services and Research, 30(1), 119–124. Hazen, A. L., Hough, R. L., Landsverk, J. A., & Wood, P. A. (2004). Use of mental health services by youth in public sectors of care. Mental Health Services Research, 6(4), 213–226. Hill, R. B. (2006). Disproportionality of minorities in child welfare: Synthesis of research ﬁndings. Race Matters Consortium. Chicago: WESTAT. Conger, D., & Rebeck, A. (2001). How children’s foster care experiences affect their education. New York: Vera Institute of Justice; Holden, E. W., Friedman, R. M., & Santiago, R. L. (2001). Overview of the national evaluation of the comprehensive community mental health services for children and their families program. Journal of Emotional and Behavioral Disorders, 9(1), 4–12. Currie J. (2005). Health disparities and gaps in school readiness. The Future of Children, 15, 117–138.

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29. Shaffer, D., Fisher, P., Dulcan, M. K., & Davies, M. (1996). The NIMH diagnostic interview schedule for children version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of the American Academy of Child & Adolescent Psychiatry, 35(7), 865–877. 30. On children’s mental health: Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M., et al. (1995). Children’s mental health service use across service sectors. Health Affairs, 14, 147–159; Leaf, P. J., Alegria, M., Cohen, P., & Goodman, S. H. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35(7), 889–897. 31. Costello, E. J., Angold, A., Burns, B. J., Erkanli, A., Stangl, D. K., & Tweed, D. L. (1996). The Great Smoky Mountains study of youth: Functional impairment and serious emotional disturbance. Archives of General Psychiatry, 53(12), 1137–1143. 32. On overlap between health, mental health, psycho-social competences and academic outcomes: Fergusson, D. M., & Woodward, L. J. (2002). Mental health, educational, and social role outcomes of adolescents with depression. Archives of General Psychiatry, 59(3), 225–231; Field, T., Diego, M., & Sanders, C. (2001). Adolescent depression and risk factors. Adolescence, 36(143), 491– 498; Hinshaw, S. P. (1992). Academic underachievement, attention deﬁcits, and aggression: Comorbidity and implications for intervention. Journal of Consulting and Clinical Psychology, 60(6), 893–903; Luthar, S. S. (1995). Social competence in the school setting: Prospective cross-domain associations among inner-city teens. Child development, 66(2), 416– 429; Reinherz, R. M., Giaconia, E. S., Lefkowitz, E. S., Blige, P., & Frost, A. (1993). Prevalence of psychiatric disorders in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 32(2), 369–377; Roeser, R. W., Eccles, J. S., & Sameroff, A. J. (1998). Academic and emotional functioning in early adolescence: Longitudinal relations, patterns, and prediction by experience in middle school. Development and psychopathology, 10(2), 321–352; Thies, K. M. (1999). Identifying the educational implications of chronic illness in school children. Journal of School Health, 69(10), 392–397; and Wentzel, K. R., & Asher, S. R. (1995). The academic lives of neglected, rejected, popular, and controversial children. Child development, 66(3), 754–763. 33. Gutman, L. M., Sameroff, A. J., & Cole, R. (2003). Academic growth curve trajectories from 1st grade to 12th grade: Effects of multiple social risk factors and preschool child factors. Developmental psychology, 39(4), 777–790. 34. Needham, B. L., Crosnoe, R., & Muller, C. (2004). Academic failure in secondary school: The inter-related role of health problems and educational context. Social Problems, 51(4), 569–586. 35. Fritz, G. K., & McQuaid, E. L. (2000). Chronic medical conditions: Impact on development. In A. J. Sameroff, M. Lewis, & S. M. Miller (Eds.), Handbook of developmental psychopathology (2nd ed., pp. 277–289). Dordrecht, the Netherlands: Kluwer Academic Publishers. 36. Hinshaw, S. P. (2002). Is ADHD an impairing condition in childhood and adolescence? In P. S. Jensen and J. R. Cooper (Eds.), Attention-deﬁcit hyperactivity disorder: State of the science, best practices (pp. 5-1–5-21). Kingston, NJ: Civic Research Institute.

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37. Roeser, R., Eccles, J., & Freedman-Doan, C. (1999). Academic functioning and mental health in adolescence: Patterns, progressions, and routes from childhood. Journal of Adolescent Research, 14, 135–174. 38. Woodward, L. J., & Fergusson, D. M. (2001). Life course outcomes of young people with anxiety disorders in adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 40(9), 1086–1093. 39. Chen, X., Rubin, K. H., & Li, B. (1995). Depressed mood in Chinese children: Relations with school performance and family environment. Journal of Consulting and Clinical Psychology, 63(6), 938–947. 40. Centers for Disease Control and Prevention (2006). Youth risk behavior surveillance—United States, 2005. Surveillance Summaries, June 9, 2006. MMWR. CDC Surveillance Summaries: Morbidity and Mortality Weekly Report, 55(SS-5). 41. Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64– 105. 42. Jessor, R., Turbin, M. S., & Costa, F. M. (1998). Risk and protection in successful outcomes among disadvantaged adolescents. Applied Developmental Science, 2(4), 194–208. 43. Zins, J. E., Weissberg, R. P., Wang, M. C., & Walberg, H. J. (Eds.). (2004). Building academic success on social and emotional learning: What does the research say? New York: Teachers College Press. 44. Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56, 227–238. 45. Dolan, L., Kellam, S., Brown, C., Werthamer-Larsson, L., Rebok, G., Mayer, L., et al. (1993). The short-term impacts of two classroom-based preventive interventions on aggressive and shy behaviors and poor achievement. Journal of Applied Developmental Psychology, 14, 317–345. 46. Duncan, G. J., Claessens, A., & Engel, M. (2004). The contributions of hard skills and socio-emotional behavior to school readiness. Unpublished manuscript. 47. On academic enablers: DiPerna, J. C., Volpe, R. J., & Elliott, S. N. (2002). A model of academic enablers and elementary reading=language arts achievement. School Psychology Review, 31(3), 298–312; DiPerna, J. C., Volpe, R. J., & Elliott, S. N. (2005). A model of academic enablers and mathematics achievement in the elementary grades. Journal of School Psychology, 43(5), 379–392; Eccles, J., & Roeser, R. (1999). School and community inﬂuences on human development. In M. Bornstein and M. Lamb (Eds.), Developmental psychology: An advanced textbook (pp. 503–554). Mahwah, NJ: Lawrence Erlbaum Associates. 48. Jehl, J., & Kirst, M. W. (1993). Getting ready to provide school-linked services: What schools must do. Education and Urban Society, 25(2), 153–165. 49. Payne, A. A., Gottfredson, D. C., & Gottfredson, G. D. (2006). School predictors of the intensity of implementation of school-based prevention programs: Results from a national study. Prevention Science, 7(2), 225–237. 50. Foster, S., Rollefson, M., Doksum T., Noonan, D., and Robinson, G. (2005). School mental health services in the United States, 2002-2003. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. DHHS Publication No. (SMA) 05-4068.

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51. Gottfredson, G. D., & Gottfredson, D. C. (2001). What schools do to prevent problem behavior and promote safe environments. Journal of Educational & Psychological Consultation, 12(4), 313–344. 52. Gottfredson, D. C., & Gottfredson, G. D. (2002). Quality of school-based prevention programs: Results from a national survey. Journal of Research in Crime and Delinquency, 39(1), 3–35. 53. Frey, A., & Dupper, D. ( January, 2005). A broader conceptual approach to clinical practice for the 21st century. Children & Schools, 27(1), 33– 44. 54. Rutter, M., & Maughan, B. (2002). School effectiveness ﬁndings, 1979–2002. Journal of School Psychology, 40(6), 451– 475; see also Duncan, G. J., & Magnusson, K. (2005). Can family socioeconomic resources account for racial and ethnic test score gaps? Future of Children, 15(1), 35–54. 55. Farrell, J. (1999). Changing conceptions of equality of education: Forty years of comparative experience. In A. Arnove & C. Torres (Eds.), Comparative education: Dialectic of the global and the local (pp. 149–177). Boston: Rowman and Littleﬁeld. 56. Biddle, B. J., & Berliner, D. (2002). Small class size and its effects. Educational Leadership, 59(5), 12–23. 57. Sebring, P. B., Allensworth, E., Bryk, A. S., Easton, J. Q. & Luppescu, S. (2006). The essential supports for school improvement. Chicago: Consortium on Chicago School Research. 58. Smithgall, C., Gladden, R. M., Howard, E., Goerge, R., & Courtney, M. (2004). Educational experiences of children in out-of-home care. Chicago: Chapin Hall Center for Children. 59. Benbenishty, R., & Astor, R. A. (2005). School violence in context. New York: Oxford University Press; Maughan, B. (1994). School inﬂuences. In M. Rutter and D. F. Hay (Eds.), Development through life: A handbook for clinicians (pp. 134–158). Oxford: Blackwell; Mortimore, P. (1995). The positive effects of schooling. In M. Rutter (Ed.), Psychosocial disturbance in young people: Challenges for prevention (pp. 333–363). New York: Cambridge University Press. 60. On multiple manifestations of student centeredness: Davis, H. A. (2003). Conceptualizing the role and inﬂuence of student-teacher relationships on children’s social and cognitive development. Educational Psychologist, 38(4), 207–234; Lee, V. E., & Smith, J. B. (1999). Social support and achievement for young adolescents in Chicago: The role of school academic press. American Educational Research Journal, 36(4), 907–945. 61. Hamre, B. K., & Pianta, R. C. (2001). Early teacher-child relationships and the trajectory of children’s school outcomes through eighth grade. Child Development, 72(2), 625–638. 62. Wentzel, K. R. (2002). Are effective teachers like good parents? Teaching styles and student adjustment in early adolescence. Child Development, 73(1), 287–301. 63. Hamre, B. K., & Pianta, R. C. (2005). Can instructional and emotional support in the ﬁrst-grade classroom make a difference for children at risk of school failure? Child Development, 76(5), 949–967. 64. On teacher–student relationships: Birch, S. H., & Ladd, G. W. (1997). The teacher-child relationship and children’s early school adjustment. Journal of School Psychology, 35(1), 61–79; Birch, S. H., & Ladd, G. W. (1998). Children’s interpersonal behaviors and the teacher-child relationship. Developmental Psychology, 34(5), 934–946; Ladd, G. W., Birch, S. H., & Buhs, E. S. (1999). Children’s social

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66.

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68.

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and scholastic lives in kindergarten: Related spheres of inﬂuence? Child Development, 70(6), 1373–1400. Spira, E. G., & Fischel, J. E. (2005). The impact of preschool inattention, hyperactivity, and impulsivity on social and academic development: A review. Journal of Child Psychology and Psychiatry, 46(7), 755–773. On schools as communities: Astor, R. A., Benbenishty, R., Pitner, R. O., & Meyer, H. A. (2004). Bullying and peer victimization in schools. In P. Allen-Meares and M. W. Fraser, Intervention with children and adolescents. An interdisciplinary perspective (pp. 417– 448). New York: Pearson; Battistich, V., & Hom, A. (1997). The relationship between students’ sense of their school as a community and their involvement in problem behaviors. American Journal of Public Health, 87(12), 1997–2001. Franklin, C., Grant, D., Corcoran, J., Miller, P. O., & Bultman, L. (1997). Effectiveness of prevention programs for adolescent pregnancy: A meta-analysis. Journal of Marriage and the Family, 59(3), 551–567. Key metanalyses of school based interventions: Forness, S. R. (2001). Special education and related services: What have we learned from meta-analysis? Exceptionality, 9(4), 185–197; Tobler, N. S., & Stratton, H. (1997). Effectiveness of school-based drug prevention programs: A meta-analysis of the research. The Journal of Primary Prevention, 18(1), 71–128; Wilson, D. B., Gottfredson, D. C., & Najaka, S. S. (2001). School-based prevention of problem behaviors: A metaanalysis. Journal of Quantitative Criminology, 17(3), 247–272. Gottfredson, G. D., Jones, E. M., & Gore, T. W. (2002). Implementation and evaluation of a cognitive-behavioral intervention to prevent problem behavior in a disorganized school. Prevention Science, 3(1), 43–56; Hughes, J. N., Cavell, T. A., Meehan, B. T., Zhang, D., & Collie, C. (2005). Adverse school context moderates the outcomes of selective interventions for aggressive children. Journal of Consulting and Clinical Psychology, 73(4), 731–736. Forness, S. R. (2003). Barriers to evidence-based treatment: Developmental psychopathology and the interdisciplinary disconnect in school mental health practice. Journal of School Psychology, 41(1), 61–67. Hunter, L. (2003). School psychology: A public health framework III: Managing disruptive behavior in schools: The value of a public health and evidence-based perspective. Journal of School Psychology, 41(1), 39–59. Fullan, M. (2001). Leading in a culture of change. San Francisco: Jossey-Bass. National Institute of Child Health and Human Development Early Child Care Research Network (2005). A day in third grade: A large-scale study of classroom quality and teacher and student behavior. Elementary School Journal, 105(3), 305–323. Bryk, A. S., & Schneider, B. (2003). Trust in schools. A core resource for school reform. Educational Leadership, 60(6), 40– 44; Kochanek, J. R. (2005). Building trust for better schools: Research-based practices. Thousand Oaks, CA: Corwin Press. Smrekar, C. E. (1994). The missing link in school-linked social service programs. Educational Evaluation and Policy Analysis, 16(4), 422– 433. Tyack, D., & Tobin, W. (1994). The ‘‘grammar’’ of schooling: Why has it been so hard to change? American Educational Research Journal, 31(3), 453– 479. Graham, P. A. (2005). Schooling America. New York: Oxford University Press. Sebring, P. B., Bryk, A. S., Roderick, M., Camburn, E., Luppescu, S. Thum, Y. M., et al. (1996). Charting reform in Chicago: The students speak. Chicago: Consortium on Chicago School Research.

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79. On key school processes: Ferguson, R. (2005). Teacher perceptions and expectations and the black-white test score gap. In O. Fashola (Ed.), Educating African American males: Voices from the ﬁeld (pp. 179–228). Thousand Oaks, CA: Corwin Press; Flessa, J. J. (2005). Principal behaviors and school outcomes: A look inside urban schools. In L. W. Hughes (Ed.), Current issues in school leadership (pp. 265– 288). Mahwah, NJ: Lawrence Erlbaum Associates; Yowell, C. M., & Smylie, M. A. (1999). Self-regulation in democratic communities. The Elementary School Journal, 99, 469– 490. 80. Heubert, J. P., & Hauser, R. M. (1999). High stakes: Testing for tracking, promotion, and graduation. Washington, DC: National Academies Press.

11 Families and Schools Raising Children: The Inequitable Effects of Family Background on Schooling Outcomes W. Norton Grubb

Children are raised by their parents. They may be cured by the medical system; they may be schooled by a system of public and private schools and colleges; they may be cared for outside of their homes at earlier ages, in early childhood programs of many sorts; they (and their parents) may be inﬂuenced by the media, by the dominant culture, and by legions of child-rearing professionals and advisors; and they may be strongly affected by their communities and their peers, for good and for ill. But what has been the dominant narrative1 in this country since the early nineteenth century at least is that parents are primarily responsible for child rearing and indeed determine the futures of their children. Only in extremis, in cases of child abuse and neglect, family collapse, dire poverty, or juvenile crime, is the privacy of the family breached by the state stepping in to care for children. And this narrative, initially developed as part of reformulating of the family as a domestic sphere, a ‘‘haven in a heartless world,’’2 has dominated policy as well, consistently limiting the ability of government to intervene in families.3,4 But this narrative, like many others that inﬂuence policy, is in many ways exaggerated and ahistorical. In foreign policy, the narrative of the Cold War, and now of global terrorism, has always exaggerated and distorted the threats to our country. In education, the narratives of human capital and the Education Gospel—the view that making schools and universities more occupationally focused will address both social problems and individual desires for success—have always been exaggerated and often demonstrably wrong.5 The image of the private family is also inaccurate: it developed during the 221

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nineteenth century, just when the development of public children’s institutions was particularly active—the elaboration of public schools, a juvenile justice system, an early child welfare system, the emergence of poorhouses and scientiﬁc philanthropy to address poverty, the beginning of child care and early childhood education. The image of the ‘‘private’’ family has become increasingly anachronistic, as families send their children out of the house at earlier ages, the reach of culture and media into the family has become pervasive and unstoppable, and child rearing in its broadest sense now extends into ‘‘children’s’’ 20s as middle-class youth pursue formal schooling for longer periods of time. In particular, the transformation and expansion of schooling have made the older image of the self-sufﬁcient family impossible to maintain. Since around 1900, formal schooling has emerged as the dominant route into adult occupations, displacing the family-based mechanisms—apprenticeships, or the direct inheritance of farms or trades—that preceded it.6 Families no longer sponsor their children’s future success directly; rather they do so indirectly, by inﬂuencing the schools their children attend, by preparing children for schooling and sustaining their performance through schooling, by supporting their attendance in postsecondary education (particularly in an era of College for All)6—or, conversely, by failing in these responsibilities. Because raising children to healthy adulthood requires preparing them for their economic roles as well as others, collaboration between families and schools in raising children has become unavoidable. Figure 11.1 presents some simple diagrams, drawn from the path models used by sociologists, illustrating the shift from familybased attainment to school-based adult attainment. As educational institutions become vocationalized, the collaboration between parents and schools may be equitable and reinforcing in the image of families and schools as roughly equal partners; conversely, it may be antagonistic, as it sometimes is when schooling becomes overtly compensatory, designed to do for children what parents cannot, with the suspicion of parental deﬁciency. But there is little doubt that such collaboration is a central feature of raising children to become competent adults. The shift to occupational attainment through schooling raises the problem of equity. Inequality was a feature of prevocational schooling, of course; the founders of the early nineteenth-century schools complained about the unwillingness of poor parents to educate their children, and the common schools were created in part to ensure that all children, from all backgrounds, might have access to the schooling necessary for moral and civic development. But vocationalizing schools and colleges gave inequality a new twist: while the common schools had a prayer of being equal—in the terms of Figure 11.1, the possibility of a meritocratic system with parents having no inﬂuence on school attainments was just barely imaginable—it is hard to imagine a vocationalized schooling system in which powerful effects of family background do not exist. In the ﬁrst place, a vocationalized education system creates educational

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FB 0 ED

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Figure 11.1. The shift from family- to school-based attainment. (A): Family-based attainment. (B): School-based attainment. (C): Meritocratic attainment. FB: family background; ED: education; SES: socioeconomic status.

institutions that mirror the inequalities of the labor market: graduate schools providing access to the high professions, colleges providing preparation for the semi-professions, community colleges training for the middle-skilled labor market, high school graduates and especially dropouts destined for unskilled work. Then, when the high-status tracks of schools and universities prepare students for high-status occupations—particularly professional and managerial positions—they inevitably favor (or ‘‘privilege’’) those cognitive abilities, values, and behaviors associated with such occupations. Inevitably, these are learned earliest by the children of professionals and managers, and are reinforced most powerfully by these parents. If, on the contrary, educational practices developed abilities and norms that favored working-class children, this could occur only in programs or tracks preparing for working-class jobs; inevitably these would be second-class alternatives like the ‘‘dumping ground’’ of traditional vocational education, or the occupational programs in community colleges criticized for ‘‘cooling out’’ nontraditional students. So vocationalism replicates old patterns of inequality in new forms: some parents are better able, because of their own education and occupational standing, to enhance the success of their children through schooling. This leads in turn to the questions of precisely what kinds of differences among families lead to differences in children’s school performance and outcomes. These questions have generated enormous debates and substantial literatures, both quantitative and qualitative. Here, I examine some new quantitative results, from a particularly rich data set that enables me to disentangle

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many different aspects of family background, to test which elements of family background are critical to schooling outcomes and which are not. But quantitative work can specify only which of many potential inﬂuences are important, not precisely how they work. In the second section, therefore, I review some of the enormous qualitative literature to clarify the mechanisms by which particular dimensions of family background inﬂuence schooling. This exercise helps clarify the many ways that certain dimensions of family background—parental education, for example—inﬂuence schooling. These results then raise the obvious policy question: what can public policies do to reduce or eliminate the inﬂuence of family background on schooling outcomes, as these effects are both inequitable and, from the perspective of the Education Gospel, inefﬁcient? There are many conventional answers to this question, particularly within education policy, though they are easier to articulate than to implement. But they also ignore the range of nonschool policies that are necessary both to equalize educational opportunities and to reduce some of the disjunctions between parents and schools. And so it becomes necessary to do more than just articulate a series of desirable educational policies, worthy as that is. It is also necessary to develop alternative policy narratives, and particularly to replace the narrative of ‘‘private’’ families being wholly responsible for child rearing, in an era when standing assumptions have become completely anachronistic. In the end, a coherent social policy should recognize that children are jointly raised by different social institutions, and only policies that enhance all of these institutions can resolve equity problems.

The Effects of Family Background: Evidence from NELS88 Recognition of the effects of family background on education dates at least from the early nineteenth century, when charity schools began providing formal schooling for low-income children whose parents could not afford tuition. The modern era of efforts to measure the effects of such actions starts with the Coleman Report,7 which found family background to be much more powerful than school resources in explaining school performance and which has led to a long debate about the relative efﬁcacy of school resources versus family background.8 Many of the data sources underlying this research have had limited measures of family background, however, such as a measure of parent’s socioeconomic status conﬂating the education and earnings of their occupation or eligibility for school lunch (a crude measure of income),9 and virtually all of them have measured schooling outcomes by test scores only. The National Educational Longitudinal Survey of the Class of 1988 (NELS88), which followed eighth graders in 1988 through high school and afterwards, includes questionnaires to students and parents as well as teachers and ad-

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ministrators. It allows the construction of about 15 different measures of family background (each with several variants) and 29 different outcome measures, including test scores, attitudes and values (such as educational aspirations), and progress through high school (credits accumulated, graduation, and progression to college). This is an ideal data set to disentangle the different effects of family background and to examine a greater variety of outcomes than simply test scores.10 The results of this exercise, summarized in Table 11.1, clarify the powerful effects of family background.11 The numbers in these tables are beta coefﬁcients, which describe the standard deviation change in the dependent variable given a 1-standard-deviation change in an independent variable. These coefﬁcients can be compared across independent variables (i.e., different measures of family background) and across equations (i.e., different schooling outcomes) to judge which inﬂuences are the most powerful, with coefﬁcients under 0.04 indicating relatively weak effects, coefﬁcients between 0.04 and 0.10 indicating middling effects, and coefﬁcients over 0.10 indicating substantial effects. The most consistent and powerful effects are those of maternal education. More education is always better than less, but the effects are also nonlinear because having a mother with a college education or higher is particularly beneﬁcial, and middling levels of schooling (e.g., some college) make much less difference. Similarly, the effects of low levels of schooling are universally negative, but they are often insigniﬁcant and quite small. The second most powerful effect involves parents’ aspirations for their children, as reported by students themselves. High aspirations for children affect students’ own aspirations and plans to continue education, complete an academic program, and obtain a diploma much more than they inﬂuence test scores; low aspirations, on the other hand, affect the entire range of outcomes, with effects that are often quite large. The combination of low aspirations and low education levels or, conversely, high aspirations and high education levels is particularly powerful. Overall, parental occupation levels are much less inﬂuential than is parental education. Having a mother employed in unskilled work is consistently detrimental, although the effects are relatively small except for a strong negative effect on attending community colleges. Unlike the effects of high levels of education, having a parent in a professional or managerial occupation does not affect outcomes. Evidently, the lessons of parental occupations, presumably about the connections between schooling and subsequent success, are available to a broad variety of students except for those whose parents have such low-skilled occupations that schooling matters not at all. Somewhat surprisingly, while income has consistently positive effects, they are statistically signiﬁcant only for two test scores and for educational aspirations.12 The other measure related to income—saving for college—affects, as one might expect, the intention to continue education after high school, the completion of the standard academic program necessary for most colleges, and

Table 11.1. Effects of Family Background on School Outcomes Dependent Variables Class Rank

High Educational Aspirations

Math Test

Reading Test

Science Test

History Test

.025** .021*

.008 .019*

.031*** .026** .099***

.008 .021* .111***

.006 .026* .102***

.023*

.008 .005

Mother’s Education Level

High school or less Some college Bachelor’s degree or higher

.105***

.020 .010 .054***

.097***

226

Mother’s Occupation Level

Unskilled Professional= managerial Family Income per Dependent{ Parents Have Saved for College Female-Headed Household Household’s Native Language Not English

.021**

.029***

.024

.021

.007

.001

.010

.004

.032**

.023**

.014

.015

.023*

.001

.031***

.008

.005

.011

.003

.021*

.000

.002

.008

.003

.015

.043***

.022

.011

.010

.005 .045***

.005 .000

Changed Schools During High School Change in Parental Marital Status

.024**

.002

.011

.002

.021

.004 .012

.005

.016

.017*

.014

.017

.009 .088***

.017* .075***

.011 .063***

.020* .060***

.033*** .066***

.002

.020**

.010

.015

.111*** .068*** .039*** .020*

.099*** .041*** .047*** .009

.164*** .074*** .042*** .011

.082*** .038*** .045*** .001

12,021 .53

12,020 .43

11,943 .45

11,887 .41

Parental Aspirations

High Low Religious=Attend Church or Synagogue 227

Black Latino Native American Asian American N R2

.046***

.533*** .019**

.019*

.076*** .058*** .020 .008

.024 .002 .001 .006

11,184 .41

13,623 .44

Table 11.1. (continued )

High Occupational Aspirations

Continuing Education

Total Credits Earned

Standard Academic College Program Completed

High School Diploma Received (TranscriptReported)

Entered 4-Year College Within 2 Years of Graduation (Self-Reported)

Entered 2-Year College Within 2 Years of Graduation (Self-Reported)

Mother’s Education

High School or Less Some College Bachelor’s Degree or Higher 228

.008 .037** .042***

.018 .068*** .104***

.023*

.032

.019

.011

.019

.022

.0911

.006

.014

.028

.020

.022 .016 .059***

.024* .021 .088***

.031 .004 .012

.020 .032** .145***

.012 .026 .032

Mother’s Occupation

Unskilled Professional= Managerial Family Income per Dependent{ Parents Have Saved for College Female-Headed Household Household’s Native Language Not English

.015

.001

.023**

.009

.033**

.010*

.023

.066***

.006

.007

.024

.069***

.002

.002

.004

.041***

.019

.004

.019

.018

.019

.000

.008

.053***

.040***

.049***

.021**

.016

.028

.021

.021

229

Changed Schools During High School Change in Parental Marital Status Parental Aspirations High Low Religious=Attend Church or Synagogue Black Latino Native American Asian American

.023

.007

.082***

.027**

.058***

.041***

.044**

.000

.009

.021*

.015

.004

.034***

.004

.050*** .161***

.034*** .118***

.008 .029

.030** .053***

.028* .023

.030*** .111***

.023 .000

.024**

.006

.002

.020*

.010

.016*

.015

.020 .014 .005 .013

.024* .062*** .006 .035***

.033* .018 .029* .025*

.012 .035*** .001 .028**

.059*** .019 .034** .015

.027** .011 .017* .001

.033** .015 .006 .001

Class rank in percentile. Coefﬁcients are beta coefﬁcients. *Signiﬁcant at 10% or better; **Signiﬁcant at 5% or better; ***Signiﬁcant at 1% or better; {Adjusted for crosssection price differences. Other independent variables include 35 measures of school resources, 15 measures of student behavior, and 4 measures of student values, in addition to gender and physical handicap. All independent and dependent variables are measured as of twelfth grade, except for High School Diploma Received, measured by transcript, and Entered 4- or 2-Year College, measured in the third follow-up.

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the likelihood of attending a 4-year college, so its effects are speciﬁc to dimensions of college attendance. Income does, to be sure, have a number of indirect effects: apart from saving for college, higher incomes increase participation in extracurricular activities and nonschool activities that enhance school outcomes, and they decrease the likelihood of students working, an activity sometimes detrimental to schooling. Overall, however, the effects of income are relatively modest. Once education and other dimensions of family life are considered, living in a female-headed household has relatively few effects—contrary to the prevailing view that children in female-headed families are educationally ‘‘at risk.’’ To be sure, living in a female-headed family reduces credits accumulated and the likelihood of receiving a diploma; I interpret this as reﬂecting the lack of pressure, support, and encouragement that students are likely to have when their mothers have many responsibilities and no spouse to share them. Similarly, the potential negative effects of having a mother tongue other than English are not particularly substantial; it lowers reading test scores, not surprisingly, but effects on other tests are insigniﬁcant, and the effects on class rank and on credits accumulated are positive, perhaps reﬂecting the additional effort that immigrant groups are often said to make in school. Family instability—which reﬂects separation, divorce, and remarriage—is consistently detrimental to schooling, but the effects are not especially powerful, and are often insigniﬁcant. However, changing schools is clearly detrimental (as others have found).13 This type of instability does not particularly affect test scores, but it does reduce virtually all measures of progress— accumulating credits, completing an academic program, completing a high school diploma, and going on to a 4-year college. The ﬁnding that it increases rates of community-college attendance is testament to the second-chance nature of these institutions: students who have not completed enough credits or the kinds of academic courses required for all 4-year colleges—or, in these results, whose parents have failed to save for college—can still go to community college and, under the right conditions, continue up the ladder of educational opportunity. Finally, another measure of family values sometimes asserted to affect schooling positively—religious afﬁliation—is usually not signiﬁcant, and the effects are generally modest when it is; the only substantial effect is on class rank, presumably through its encouragement of hard work. Religious observance reduces the incidence of low aspirations for African American and Latino students signiﬁcantly more than for white students, although it also reduces math and reading scores among African Americans—so overall there is no strong support for the role of religion in education in African American and Latino communities. A large number of other measures of family background were tried but discarded as ineffective, including other measures of income, the number of dependents, and whether parents had had discussions about educational and career issues. Overall, then, the most powerful effects of family background

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come principally through parental education and aspirations for their children and secondarily through the effects of mothers in low-skilled occupations, but not particularly through income. Many of these effects are quantitatively more powerful than the effects of speciﬁc school resources (with the exception of being in general, vocational, or remedial tracks, the effects of which are quite large and consistent)—which might lead one to conclude that family background is more powerful than school resources, except that the variety of school resources affecting outcomes is quite substantial. And some aspects of family background inﬂuence student attitudes and measures of progress more than test scores—particularly changing schools and living in a female-headed family—clarifying the value of including a broader range of outcome measures in considering family effects on schooling. Conventionally, family effects on schooling outcomes might include the effects of racial and ethnic variables. These variables prove to have substantial effects on most outcomes, even after all other inﬂuences on schooling outcomes have been considered. The effects in Table 11.1 reﬂect, of course, the racial and ethnic gaps in test scores that have been of such concern,14 but these results with their broader array of outcome measures clarify that gaps exist for many other outcomes as well. The gaps are all in the anticipated directions, with African American, Latino, and Native American students consistently doing less well than white and Asian American students. Most effects are, in an absolute sense, larger for African Americans than for Latino and Native American students, although Latino students lag behind African American students in occupational aspirations, completing academic programs, and enrolling in 4-year colleges. There are no racial=ethnic differences in educational aspirations, but African American and Native American students are less likely to obtain high school diplomas, even after controlling for the effects of family background and student behavior. However, African American students are more likely than others to attend 4-year colleges despite their lower rate for obtaining high school diplomas, and they shun community colleges—a pattern in the African American community of particular dedication to college attendance and the perception of community colleges as ‘‘not real colleges.’’ In these results, the effects of racial=ethnic variables on test scores are much greater than are any of the effects on aspirations or progression through schooling. What this means is that of the various racial=ethnic ‘‘gaps,’’ differences in test scores are substantially larger than differences in attitudes or educational progress. In many ways, progress through schooling makes a greater difference to occupational futures than do test scores, so one might argue that the overemphasis on test scores in our test-besotted age has exaggerated racial=ethnic differences. However, for access to the best colleges, and surely to graduate schools, where preparation for the best managerial and professional jobs takes place, higher levels of learning and various speciﬁc test scores (on, e.g., the SAT or the GRE) are crucial, so reforms both within and outside of schools should emphasize improvement in all outcomes.

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Some of the racial=ethnic effects on outcomes are as large as—but not consistently larger than—the most powerful family background measures, parental education and aspirations. Many more of these effects, particularly those on values and progression, are of about the same magnitude as the effects of the other dimensions of family background that have more modest effects. Overall, then, it is impossible to say whether nonracial measures of family background or racial=ethnic variables have stronger effects. To put this simplistically, both race and class matter. However, while the ﬁnding of racial and ethnic differences in academic success is nearly universal and somewhat unsurprising, it is also undesirable because it leaves the causal mechanisms linking demographic variables to schooling outcomes unclear. Ideally, the other differences among racial= ethnic groups should be reﬂected by measured differences in family background, in motivation and engagement of students, and in school resources. If, for example, we ﬁnd that Latino and African American students do less well on tests than do white and Asian American students, that might lead to explanations based on heredity, although evidence from twin studies and other sources has ruled out this persistent interpretation.15 Alternatively, advocates have interpreted such effects as the results of persistent racism, but this is also unsatisfying because it fails to identify what speciﬁc patterns of racism are responsible for schooling outcomes and what can be done about them. When I examine the qualitative literatures in the following section, one of my aims is to see whether these more detailed results can suggest some reasons for these racial=ethnic effects. Finally, these results clarify how class and racial=ethnic differences reproduce themselves over generations. Parents with high levels of education raise children with higher levels of schooling; parents in low-skilled occupations raise children with lower test scores and progress through high school; highincome families are more likely to send their children to 4-year colleges, so their incomes will be relatively higher; African American, Latino, and Native American families replicate their lower standings through their children’s education, although the interpretation of why this is true will be more clear in the next section. Inequality begets inequality, no longer directly through apprenticeship and inheritance but now through the intermediary of formal schooling. So the effects of family background are pervasive and powerful, especially if we include racial=ethnic characteristics—no surprise there. But some effects are more powerful than others. As with the effects of school resources, some of these effects (such as those of parental education and aspirations for children) affect virtually all outcomes; others (such as changing schools and living in a female-headed household) affect progress through high school but not test scores; and family income and college-saving appear to affect only progress into more expensive 4-year colleges. When I turn, in the ﬁnal section, to possible remedies for these effects, these results will suggest a possible hierarchy of reforms, both in educational policies and in nonschool efforts.

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Causal Mechanisms of Family Background: Evidence from Qualitative Research Quantitative analysis from data such as NELS88 can clarify that various dimensions of family background affect (or fail to affect) schooling outcomes, but they cannot be precise about the causal mechanisms underlying these effects. The enormous qualitative literature is more helpful here, because it can typically describe in much greater detail how different dimensions of family background affect children. Unfortunately, this literature is vast and comes from many different disciplines and perspectives, and it is almost impossible to summarize brieﬂy.16 In many cases researchers have found what they were looking for: those concerned with particular racial=ethnic minorities have found differences in the treatment of African American and Latino students; those more attuned to issues of class have found class effects overriding racial effects; those concerned with language issues have found differences in language acquisition; those concentrating on family structure have found female-headed families, families with shifting composition, or unstable families to have detrimental effects on their children. But a different interpretation, other than researchers ﬁnding what they are looking for, is that the effects of family background—and the effects of such powerful variables as parental education and family stability—are so varied and so pervasive that they inﬂuence outcomes in multiple and overlapping ways. One way to start unpacking family effects is to review what the literature says about the variables I stressed in the prior section. Parental education, for example, underlies a considerable literature about ‘‘families as educators’’17— of parents as the ﬁrst and most comprehensive teachers of children, whose inﬂuences not only prepare children for the start of school but continue as they reinforce school lessons with dinnertime conversations, help children with their homework, provide educative activities and trips, and exert constant pressure to succeed. Well-educated parents can also better inform their children about the paths through a complex schooling system, one that is more transparent to those who have been through it—hence the concern for youth who are ‘‘the ﬁrst in their family to go to college.’’ And the idea that parents of different class backgrounds have varying advantages in preparing their children for school, an old idea in wide circulation at least since the beginning of the nineteenth century, has recently been restated in economic language by Bourdieu18 and his notion of ‘‘cultural capital,’’ describing a variety of attitudes and values valuable in formal schooling and more likely to be passed on by middle-class families. Another dimension of education comes through language, where professional parents (compared to working-class and then welfare parents) talk with their children more, use larger vocabularies, use more diverse language, provide more afﬁrmative feedback as opposed to corrections and discouragements, and are more likely to respond to their children.19 Bernstein20 has contrasted the ‘‘restricted codes’’ of working-class families—particularistic and

234

Outside Forces: Shaping Health and Education

tied to local meanings—with the elaborated codes of middle-class families, which are more universalistic, abstract, and consistent with the language of schools. The ways in which Heath21 contrasts the middle-class townspeople or ‘‘mainstreamers’’ with both African American and white working-class populations in Piedmont mill towns also stress language and literacy differences, as well as many other differences related to rhythms of life, views of schooling, and interactions with the wider world. Similarly, Gandara’s22 review stresses literacy as the key to school engagement, with differential literacy arising from language differences among families. Much of the qualitative literature on the effects of family background stresses the role of language, and the effects on English tests (Table 11.1) and on other language-related school competencies are the results. It is less obvious how family background should affect math performance and subjects related to math, and there has been much less research on math-related activities within families.23 However, a study of 2- and 4-year-olds by Saxe, Guberman, and Gearhart24 revealed a large number of math-related activities including number-oriented play, counting and grouping, and some activities related to telling time and spatial relations. Consistently, there are few and insigniﬁcant differences at age 2, but class-related differences emerge by age 4, particularly on more complex tasks. (Class is measured by Duncan’s index of socioeconomic status.) To some extent these results are due to differences in parenting that affect many outcomes—middle-class parents are more responsive to their children, more cooperative, more involved in teaching and playing, less directive and authoritarian, for example—but speciﬁcally in math activities, middle-class mothers structure more complex goals on more difﬁcult problems than do working-class mothers, helping their children achieve more complex results than they could on their own. The role of middle-class parents in helping their children on more complex mathematical activities is likely to be a special problem as their children grow older and encounter ever more complex math in school.25 Still other dimensions of class emphasize the interactions middle-class parents have with their children and presumably apply to all subjects and many behaviors in formal schooling. Lareau’s26 notion of ‘‘concerted cultivation’’ of children by their middle-class parents describes efforts to get children engaged in a variety of activities (e.g., music and dance lessons, sports) and to interact with their schools and teachers—much as schools themselves are devoted to concerted cultivation, hopefully of all children; this is in contrast to the approach of working-class parents, who are more likely to leave children to their own devices, to converse less with children, and to have less interaction with schools. In an earlier work, Lareau27 stressed the differences between middleclass families’ interactions with schools—seeing schools as complementary to their efforts, and therefore seeking out participation and collaboration—and working-class families’ view of the efforts of schools as essentially separate and independent from what parents do; working-class parents are seen as being often intimidated by schools and educational authority, and therefore

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engaging much less in inﬂuencing the schooling process.28 Her work also reinforces the differences in language patterns, including verbal agility and ﬂuidity, use of abstract concepts, and practice in the ‘‘rules of the game,’’ including facility in speaking with adults. These descriptions of interactions are quite similar to those by Clark,29 who describes the varying ability of African American parents to channel their children’s activities. For African American lower-income children in particular, negative inﬂuences such as gangs are more likely to attract children and youth who have not been channeled or directed by parents, an interaction between parental and community inﬂuences. He also notes the ways in which middle-class parents, regardless of race, are more likely to foster ‘‘interpersonal competence,’’ including knowledge of how to interact with adults, something that serves them well in school. In this work, class is usually deﬁned by selecting parents with different kinds of occupations, but the differences are more associated with education than occupation—and for many families the two coincide. In many ways, my ﬁnding that aspirations play such important roles runs contrary to much of the qualitative literature. Many authors have taken great pains not to denigrate parents and to stress that all parents want the best for their children and want their children to do well in school. As Lareau27 expresses it, there are fewer differences in attitudes among parents than in their behavior. But of course there are many ways that parental behaviors convey expectations: in the pressures on youth to contribute to family income in lowincome families; in the sense of not ‘‘letting go’’ of girls in Latino families and of expecting young males to work; in attention or inattention to school attendance, behavior, and performance, particularly likely to be missing in chaotic families30; in the presence or absence of what some have called ‘‘academic press,’’ as important in families as in schools. The students who reported their parents’ low expectations of them in the NELS data may well have reacted more to these kinds of behaviors than to attitudes. Research that focuses speciﬁcally on the effects of occupation seems less common, even though occupation is usually a component of a more diffuse concept of class. However, Kohn and Schooler31,32 conﬁrmed empirically that parents in professional and managerial occupations are more likely to stress independence in their children, while parents in working-class and routinized occupations are more likely to stress conformity, obedience to rules, and ‘‘good behavior’’ in the conventional sense—with these values emanating in obvious ways from the requirements of work. However, independence is more likely to lead to strong school performance—particularly, one might think, in classes emphasizing constructivist pedagogies and student-centered approaches, and in high-track rather than low-track classes. A very different interpretation of occupation is that individuals in unskilled positions simply do not understand the connection between schooling and employment, leaving their children unclear about this connection33,34—a form of knowledge that is crucial once schooling becomes the route to vocations. Alternatively, working-class parents

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Outside Forces: Shaping Health and Education

may not value schooling as a route to upward mobility, preferring to stress instead hard work as the mechanism of the American Dream of self-improvement,35 while professionals are sure to stress education (see also Heath’s descriptions of how parents pass on attitudes toward schooling). Like education, the inﬂuences of occupation may affect schooling in several different ways, and because they all operate to some extent, it is as difﬁcult to disentangle them with qualitative evidence as with quantitative analysis. Many authors have focused on family composition, especially the negative effects of living in a female-headed household—because of lower income, less attention from adults, and a lack of male role models. But Clark,30 who compared two-parent and one-parent African American families, found that ‘‘family intactness is not a necessary or sufﬁcient condition for high-quality learning in the home’’ and pointed instead to family interactions and the role of parents in promoting ‘‘sponsored independence,’’ rather than unsponsored or laissezfaire child rearing. (Lareau’s research on ‘‘concerted cultivation’’ is consistent with this, though she did not look explicitly at single-parent families.) These conclusions are consistent with my ﬁnding that, once other aspects of families such as parental education and income are considered, living in a femaleheaded family does not affect learning as measured by test scores, although it does reduce progress as measured by credits earned and high school graduation, presumably because single mothers are less able than two-parent families to monitor their children and keep them on track to graduation. Similarly, language problems have been the focus of enormous amounts of research and advocacy on behalf of children described as English learners or language-minority students, revisiting the theme of linguistic facility that is related to parental education and class. But language may operate differently in different communities; while both Latino and Asian students are more likely than others to have a non-English native language,36 for other reasons Latino and Asian American students succeed quite differently in schools—so the effect of language is less powerful once other dimensions of family background are considered, especially parental education and aspirations. Family instability is surely detrimental to children, though again there are different ways to conceive of instability. One involves marital instability, as parents separate, divorce, remarry, and recreate family constellations that are either more or less stressful and supportive of children; while the long-run consequences of divorce are often negative,37 the short-run effects might be positive or negative—perhaps explaining why the effects of family change measured in this way are relatively weak. But physical mobility, a different type of instability, operates more by disrupting the curriculum, the accumulation of course credits, and relationships with other students and teachers alike; students changing schools have to make a series of adjustments that cost them time and effort. What causes physical mobility is not well researched, but my informal questions of teachers indicate that housing problems—being evicted, being unable to pay rent, having intolerable arguments with housemates—are to blame, not the kind of middle-class mobility where fathers are sent to new

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jobs. In addition, ethnographic and journalistic accounts describe how lowincome children and youth are farmed out among relatives and ‘‘cousins’’ when one member has a crisis, is evicted, or is otherwise unable to care for a child31,38; it is easy for students in these situations to escape going to school at all because no one is really paying attention to their comings and goings. And so the measurable dimensions of instability are pallid compared to the reality of the worst-off families, where the conﬂuence of poverty, violence, drugs, and mental health problems creates a perfect storm of debilitating conditions. What might it mean to ﬁnd racial and ethnic effects even after considering the inﬂuence of many measures of family background, student behavior, and school resources, all of which may differ by race and ethnicity—particularly when some of the qualitative literature explicitly rejects racial explanations in favor of class effects? From the qualitative literature, two explanations seem plausible. One is that the measures available of family background, even though they are more detailed in NELS88 than in any other data set, are still not detailed enough to measure differences among families. The measure of family change developed here fails to capture the truly hideous instability caused by violence, drugs, and shifting housing on very poor students.38,39 The differences in child-rearing practices among working-class and middleclass parents noted by others—for example, Lareau’s27 notion of ‘‘concerted cultivation’’ among middle-class parents, Clark’s30 similar idea of ‘‘sponsored independence’’ in middle-class African American families, or Kohn’s32 work on the values of independence versus conformity—may be related to maternal education (or, for Kohn, to occupation), but they are not precisely measured by these variables. The lack of role models related to success through schooling in some African American and Latino communities, or on Native American reservations far from mainstream labor markets, is unlikely to be well measured by maternal occupation. Similarly, the pressures of communities as distinct from those of parents—the culture of violence and threat among African American males,39 the culture of early employment being related to machismo in the Latino community, the lure of gangs against the efforts of parents to channel their children into independence30—are not well measured in any of the quantitative literature. The extremely chaotic conditions in some urban schools—described by Kozol40,41 and others raising the alarm about urban schools, as well as legions of equity-related court cases—are not well measured by the indicators of school climate that I have used. These weakly measured effects, all of which are likely to be worse in African American, Latino, and Native American families, are likely to show up in larger coefﬁcients on race and ethnicity.42 A second explanation is the frequency of racial and ethnic mistreatment in public schools. The qualitative literature focusing on African American and Latino students clariﬁes how often they are insulted and overlooked. They are more likely to be demeaned for their language, either nonstandard English or Spanish. They are less likely to ﬁnd adults who can serve as their mentors and sponsors.23 Their teachers, who are predominantly white, are likely to be

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unfamiliar with their circumstances and to come to schools with a range of cultural and racial misconceptions, or simply differences in cultural styles.43 Minority students are more likely to be the victims of the well-documented problem of lower teacher expectations.44,45 They are more likely to be disciplined, suspended, or expelled, even for infractions that other students are not punished for, particularly under ‘‘zero-tolerance’’ policies borrowed from the adult criminal system.46,47 As Ferguson48 expressed, African American boys in particular are ‘‘adultiﬁed,’’ treated from an early age not as rambunctious boys who make mistakes but as adults on potentially criminal paths. The idea that there are cultural differences between schools and some students has a long history,49 but such differences become particularly powerful once schools become the route to economic success. Then the parents who themselves have not experienced this success—those who are working and lower class, minorities, or immigrants—ﬁnd themselves in conﬂict with the ‘‘rules of the game’’ in the classroom, the codes of behavior, language, and relationships, the sense of what is valued.50–51 The dominant metaphor used in the qualitative literature to describe the lasting effects of these various insults is ‘‘scarring,’’ as in James Baldwin’s comment52: I can conceive of no Negro native to this country who has not, by the age of puberty, been irreparably scarred by the conditions of his life . . . the wonder is not that so many are ruined but that so many survive.

The metaphor of scarring implies lasting effects from mistreatment, rather than small events that students can readily overcome. Similarly, those who have examined potential dropouts in high school often describe minority students who have been progressively alienated from schools by a series of events, individually small but cumulatively powerful, related to race and ethnicity. In some widely cited (but empirically controversial) analyses, these in turn lead to ‘‘resistance’’ to schooling,56 or lack of effort in order not to appear to be ‘‘acting white,’’57 or ‘‘alienated embeddedness.’’58 The effects of ‘‘scarring’’ also mean, of course, that schooling is a dynamic process, taking place over a decade or more, and the cumulative effects of this dynamic process—whether the steady encouragement and support of middle-class children or the steady disparagement of low-performing African American, Latino, and working-class children—is poorly reﬂected in conventional crosssectional analysis. I conclude, therefore, that the racial=ethnic coefﬁcients in the NELS88 data are due in part to various forms of mistreatment and discrimination,59 some of them current and some buried in the distant past. Overall, the qualitative literature can help us understand the many mechanisms underlying the effects of family background. These mechanisms are even more varied and complex in ethnographic and journalistic accounts of families, which by their nature can document multiple causal processes. Overall, this conﬁrms the crucial roles of families in preparing their children for formal schooling by sharing child rearing with the schools. And it reinforces

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the observation that while vocationalism has changed the mechanisms by which families pass on economic success to their children, it has not changed the basic patterns of inequality in conventional success through schooling.

The Respective Roles of Families and Schools: Implications for Education Reform and Social Narratives The common observations of how parents inﬂuence their children’s schooling have led to a series of familiar proposals for education reform. Some have tried to change the education system; others have tried to change parents or communities.50 They include, for example, early childhood programs, various kinds of compensatory and intervention efforts to help students who have fallen behind, summer schools and tutoring efforts, and outreach programs to assist minority and ‘‘nontraditional’’ students—those whose families members have not gone to college—in pursuing postsecondary education. But rather than simply listing such efforts, I prefer to identify a number of general approaches or images of how families and schools should share the tasks of child rearing. These approaches then imply various speciﬁc policy initiatives, but the success of these efforts is often related to the more fundamental assumptions underlying a basic approach to families and schools. There are at least four of these that I can readily identify,60 although no doubt a more thorough historical and programmatic analysis would generate even more. 1. Parents are in charge of child rearing—the image created in the nineteenth century version of the independent family. Parents may delegate education roles to churches, apprenticeship mechanisms, or schools, but they retain control and therefore responsibility—and variation in schooling outcomes must reﬂect variation in parental abilities to do so. Choice and voucher mechanisms and home schooling are the most obvious reﬂections of these assumptions, and of course many opponents of vouchers are afraid that they would only magnify the inequalities in schooling. 2. The state intervenes in child rearing only in extremis, when parents have grossly failed. Child welfare laws are the most obvious examples; in education, compulsory attendance laws or public support of poor children in earlynineteenth-century charity schools are good examples. The real power of the doctrine of parens patriae has been to limit state intervention on behalf of children; the parental behaviors that are demonstrably ineffective or counterproductive—authoritarian parenting, laissez-faire attitudes toward the child’s development, an unwillingness to interact with schools—do not rise to the level required for intervention, and so certain parental inﬂuences are regarded as inevitable and unfortunate but not subject to correction. 3. Schooling provides what parents cannot and thereby replaces or displaces families. The early examples include the charity schools for children of poor families of the nineteenth century, then the common schools to provide all

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children with a common political and moral education; current examples include various compensatory efforts, outreach programs, and a few ‘‘child removal’’ programs such as Job Corps. But as schooling becomes increasingly extended and increasingly vocationalized, almost no parents are able to provide the full range of what their children need to learn, and so the displacement of the family by formal schooling becomes routine, not just something for the poor, as the diagrams in Figure 11.1 represent. This approach often takes on very different attitudes toward the remaining roles of parents. In one view, educators are professionals, knowledgeable in ways that parents are not; parents should therefore defer to the authority of teachers both in curricular areas (reading, math, biology, calculus, and other subjects almost no parent can teach sufﬁciently) and issues of behavior. Parents take their cues from schools as part of a long hierarchy: just as universities dictate standards to high schools, high schools dictate to middle schools, and middle schools dictate to elementary schools, so too does the elementary school tell parents (and early childhood programs) what students should know (‘‘school readiness’’) and how they should behave. In an alternative view, parents and educators are partners and coparticipants in child rearing, with educators having certain advantages and responsibilities and parents having others—such as a more intimate knowledge of the child and the right to make choices consistent with family values and parent conceptions of well-being. This approach is most evident in decision-making councils that include parents and in various efforts to enhance parent participation; less concretely, it manifests itself in respectful rather than conﬂictual relations between parents and educators. In this approach, subtle differences in how parents and educators view one another and their responsibilities can generate quite different outcomes. For example, early childhood programs have been promoted since the early nineteenth century to compensate for the ‘‘deﬁciencies’’ of some families. Head Start, developmental child care, exemplary efforts such as the Perry Preschool program, and now the proposed program of universal prekindergarten (UPK) are all examples intended to narrow the ‘‘school readiness gap’’ between children of different family backgrounds. But they also create conﬂict when parents and educators disagree about what is best for the child.61,62 Similarly, another common response to family differences has been parent education, or attempts to teach parents how to foster the success of their children. When the ‘‘teaching’’ has involved information that parents cannot be expected to know—for example, the knowledge among immigrants of how schooling works in this country, or among the general population of how much college costs and what grants are available—then parent education seems both essential and benign. But when substantial changes in values and norms are involved, greater potential for problems and conﬂict arise. The history of parent education is full of paternalistic efforts that have not been particularly successful4,63; even the teaching of (standard) English, one of the most important requirements for success in school, has created serious conﬂict in both African American and

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immigrant communities. Similarly, family literacy programs represent efforts to encourage parents to read with their children, following the lead of ‘‘parents as educators’’; but these efforts (like most educational interventions) vary enormously, with some overly short, concerned only with decontextualized and discrete skills, indifferent to fostering parent–child interaction, and dependent on untrained ‘‘educators,’’ while the best of them follow practices that might indeed improve the literacy of both parents and children.64 Sometimes programs are able to develop subtle forms of parent education using unusual forms of ‘‘teaching’’; for example, the Puente program tries to persuade Latino parents of the value and affordability of college, especially for their daughters— that is, to increase their educational aspirations—in part by forming parent groups and using ‘‘experienced’’ parents to persuade ‘‘inexperienced’’ parents.65 But overall parent participation has been weak in most schools; the effectiveness of early-childhood parent-intervention programs—those that intervene into families to enhance their child-rearing abilities—has not been particularly high on the average, and such programs have perversely proved more effective with middle-class parents.66 Of course, all these interventions intended to minimize the effects of family background suffer problems of inadequate funding and quality. However, there is often a further problem, illustrated by the vast qualitative and quantitative literature clarifying the pervasive effects of family background: it is wholly inadequate, as is done in some parts of the movement for UPK and some parent education programs, to emphasize a narrow set of school-readiness skills to the exclusion of a broader variety of competencies and attitudes, such those instilled by ‘‘concerted cultivation,’’ complex language use, knowledge about school trajectories and school-employment patterns, and the many other inﬂuences of families as educators. Without a deeper understanding of how children are raised by their families, such program will be failures at narrowing the gaps among children. 4. A different approach has been to concentrate not on reformulating educational institutions but instead on improving the conditions of family life so that the effects visible in the qualitative and quantitative literature would not be as pronounced. Such policies have been the responsibility of the welfare state, intervening into the ‘‘private’’ markets and families in order to correct inequalities. For several decades, and particularly in the 1970s, proponents of ‘‘family policy’’ have argued for a series of policies to strengthen families so they might better meet their responsibilities.4 My recent contribution to this argument has been to articulate the need for a Foundational State, one that creates the foundations necessary for the development of human competencies; this in turn requires policies that are complementary to schooling—for example, housing policies to correct the instability caused by the lack of decent housing, health policies to make sure that some students do not miss school because of health problems, urban development policies to correct the wretched conditions of some urban neighborhoods, income-support policies, and several other programs of the welfare state that would directly correct conditions

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undermining the education of some children.6 It does not much matter whether we refer to such policies as part of the welfare state, the Foundational State, or family policy; all of these are part of a historical discussion of whether equity is more likely to be advanced if we concentrate on school reforms, changes in families, or both. Unfortunately, the welfare state in the United States has always been especially weak and particularly deferential to free-market mechanisms.67 With the conceptual and political difﬁculties of intervening in family life, it is no wonder that improving the education of low-performing students has focused on improving the schools themselves. Indeed, a new responsibility seems to have been placed upon the schools, with school reform virtually the only current approach to equity in this country. When George Bush was asked about the widening gap between rich and poor, he responded with platitudes about education: ‘‘the No Child Left Behind Act is really a jobs act, when you think about it.’’68 Alan Greenspan, an architect of anti-inﬂation monetary policies that have often operated to keep unemployment high, similarly promoted a better-skilled workforce as the solution to trade imbalances and outsourcing of jobs to India and China.69 The No Child Left Behind (NCLB) legislation of 2001 promised to eliminate the ‘‘soft bigotry of low expectations,’’ while leaving alone the hard bigotry of employment discrimination. But while virtually everyone supports its goal of creating uniformly higher expectations for all students, the funding and support to build the capacities of all schools to meet the challenges of accountability are almost totally lacking. The calls for equity in schooling—the brave words that ‘‘all children can learn,’’ that ‘‘no child should be left behind’’— are empty rhetoric if they are not matched with capacity building in schools. NCLB has been called the greatest unfunded mandate in the history of federal efforts; the standardized tests used in accountability have driven many schools to routinized and skill-oriented pedagogies, precisely the opposite of what is needed for improved learning.70 At the same time, the Bush administration has been trying to further reduce all other programs of the welfare state that might enhance equity: Temporary Assistance for Needy Families, public housing, Medicaid, and Social Security itself, which supports large numbers of children through survivors’ beneﬁts. And more expansive conceptions of social policy have completely vanished: we no longer hear about creating a family policy; we hear nothing of urban renewal, or converting the poisonous conditions in some inner cities to conditions in which children might grow up healthy. Every narrative related to equity in this country has been systematically undermined in the last 25 years, leaving only equality of educational opportunity—a particularly abstract, difﬁcult, and contested conception of equity. Current social policy involves a kind of twist: turning to schooling to produce greater equity in a subsequent generation, through a program (NCLB) that is more rhetoric than substance, while weakening the policies that might better support equity among parents and enhance their abilities to raise their children. This twisted policy has been pursued with special ferocity by the current administration, although it is also consistent with narratives of public

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schooling and private families that are legacies of the nineteenth century. But this kind of policy cannot possibly work, since the effects of parents on their children and on schooling outcomes is too powerful. If parents are impoverished in any sense—in any of the ways measured in my NELS88 results or in the qualitative literature—then their children suffer predictable problems in schools, starting in the very early grades and cumulating through high school. While schools can be reconstructed so as to do a much better job with lowperforming students—as some of the positive evaluations of whole-school reforms illustrate—it is unclear that schooling by itself has the power to close the various achievement and educational ‘‘gaps’’ associated with class and race.71 More to the point, the resources necessary to reconstruct schools in the right ways are usually missing, because of political resistance, inadequate funding, or lack of understanding of how strong schools function—as NCLB so clearly illustrates. And so this round of school reform has left us more or less as we have been for almost two centuries: those students who are least prepared for formal schooling by their parents are enrolled in the least effective schools, rather than the most effective schools that equity would require. What is necessary is neither an ‘‘either=or’’ policy—one that tries to improve schools while some families sink deeper into need, isolation, and instability—nor the contrary, the call for greater equality among families before the schools can be made more equal.72 Instead, we might remember the words of John Dewey, who consistently reminded us that debates framed in polar opposites—academic versus vocational education, behaviorist versus constructivist pedagogies, educational solutions versus social reforms—often reﬂect false dichotomies. In his introduction to Experience and Education,73 he wrote: ‘‘Mankind likes to think in terms of extreme opposites. It is given to formulating its beliefs in terms of Either-Ors, between which it recognizes no intermediate possibilities’’ (p. 17). In discussing traditional and progressive pedagogies, he lamented that ‘‘the problems are not even recognized, to say nothing of being solved, when it is assumed that it sufﬁces to reject the ideas and practices of the old education and then go to the opposite extreme’’ (p. 22). A better approach to the dilemma of whether to reform schools or to reform social and economic conditions affecting families should be a ‘‘both=and’’ position–reforming schools so that that they have greater capacity to educate low-performing students, and trying in every way possible to improve those conditions of family life that affect the ability of children to beneﬁt from the schools. This would require reforming schools and improving access to health care and nutrition so that children do not miss school because of health problems; it would require a serious housing policy and urban development policy so that the instability and violence of urban communities is eliminated; for adolescents, it would require a grater range of services to cope with health, mental health, drug issues, and family problems. It might require us to return to old ideas of family policy if we think that families today are under particular stresses. It does not much matter whether we frame social policies by a conception of family policy, a strengthening of the welfare state, or the creation of

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a Foundational State creating the economic and social foundations for strong and equitable forms of human development.6 In every instance, social policies would search for complementarity between social policy and educational policy, rather than letting one wither in favor of the other—as we seem now to be doing. We even have a simple narrative to describe this situation: the African saying ‘‘It takes a village to raise all children,’’ popularized by Hillary Clinton74 and embedded in school reforms such as the Comer schools75 and full-service schools.76 What it takes to establish a new narrative partly involves recognizing the ways that older narratives are exaggerated, outdated, or dysfunctional, and the narrative of the private family raising its children independently of other social institutions is surely all of these. In part, the development of new narratives also requires evidence of new and effective practices, and so evidence about exemplars among social programs,77 school reforms that successfully incorporate parents, or forms of parent outreach and education that are not demeaning are all useful in reconstructing a vision or narrative. And a new narrative may also require a new politics, in this case one that is collective rather than selﬁsh, future-oriented instead of oblivious to future consequences, principled rather than opportunistic, clear about current realities rather than mendacious.78 But if we are to raise all our children well, relying on the strengths of schools as well as parents, then we have no choice but to develop new visions and public narratives to guide us.

Acknowledgments A number of individuals provided helpful comments and resources for the second section of this paper in particular: Patricia Bacquendano-Lopez, Patricia Gandara, Susan Holloway, Geoffrey Saxe, Alan Schoenfeld, and participants at a Commission for Children and Young People seminar on an earlier draft. Marcel Paret provided outstanding assistance in programming the NELS88 data reported in this paper.

Notes 1. Policy in many countries is driven by narratives, or widely accepted ‘‘stories’’ about why certain programs are worthwhile. The creation of such narratives typically takes a considerable period of time and many participants. Once widely accepted, policy narratives are resistant to change, and subtle empirical evidence—the results that research can generate—is not usually enough to modify a policy narrative (Roe, E. [1994]. Narrative policy analysis: Theory and practice. Durham, NC: Duke University Press). 2. Lasch, C. (1977). Haven in a heartless world: The family besieged. New York: Basic Books.

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3. Grubb, W. N., & Lazerson, M. (1982, 1988). Broken promises: How Americans fail their children (Chapters 1 & 2—1988; Chapters 8 & 9—1982). New York: Basic Books=Chicago: University of Chicago Press. 4. Laslett, B. (1973). The family as a public and private institution: An historical perspective. Journal of Marriage and the Family, 35, 480– 492. 5. Grubb, W. N., & Lazerson, M. (2004). The education gospel: The economic value of schooling (Chapters 8 & 9). Cambridge: Harvard University Press. 6. Rosenbaum, J. (2001). Beyond college for all: Career paths for the forgotten half. New York: Russell Sage. 7. Coleman, J. S., Campbell, E. Q., Hobson, C. J., McPartland, J., Mead, A. M., Weinﬁeld, F. D., et al. (1966). Equality of educational opportunity. Washington, DC: U.S. Department of Health, Education and Welfare. 8. Hanushek, E. A. (1989). The impact of differential expenditures on school performance. Educational Researcher, 18, 45–62; summarizes the school effects. For my re-interpretation of this debate and the alternative of the ‘‘improved’’ school ﬁnance, which underlies the research in this section, see Grubb, W. N., Huerta, L., & Goe, L. (2006). Straw into gold, resources into results: Spinning out the implications of the ‘‘improved’’ school ﬁnance. Journal of Education Finance, 31(4), 334–359. 9. In Sirin’s meta-analysis, family background has been measured most often by education, then occupation, income, and free-lunch status, and much less often by neighborhood and home resources. The effects sizes for all of these are similar, around 0.30, except that the mean effect size for home resources is 0.51. But other studies have not tried to disentangle which of several potential measures of family background are the most important. See Sirin, S. (2005). Socioeconomic status and academic achievement: A meta-analytic review of the research. Review of Educational Research, 75(3), 417– 453. 10. There proves to be surprisingly little collinearity in these data among the different measures of family background. The highest correlation is 0.38 between college saving and income per dependent; the correlations of high parental education with college saving and with materials in the home are both 0.31; that between low parental education and materials is -0.28, and between low parent education and non-English language it is 0.28. Otherwise the correlations are modest, and the coefﬁcients are robust in different speciﬁcations. 11. See Grubb, W. N. (2008). Multiple resources, multiple outcomes: Testing the ‘‘improved’’ school ﬁnance with NELS88. American Education Research Journal, 45(1) for more details. Subsequent papers will examine dynamic effects, hierarchical linear models, and the other equations of the ‘‘improved’’ school ﬁnance. 12. Income proves to be more consistently signiﬁcant in growth equations, however, perhaps because these models reﬂect the effects of income both across students and over time. 13. Rumberger, R., & Larson, K. (1998). Student mobility and the increased risk of high school dropout. American Journal of Education Research, 107, 1–35. 14. Jencks, C., & Phillips, M. (Eds.). (1998). The black-white test score gap. Washington, DC: Brookings Institution Press. 15. Nisbett, R. (1998). Race, genetics, and IQ. In C. Jencks & M. Phillips (Eds.), The black-white test score gap (pp. 86–102). Washington, DC: Brookings Institution Press.

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16. For summaries from three recent decades see Leichter, H. J. (1974). The family as educator. New York: Teachers College Press; Hess, R., & Holloway, S. (1984). Family and school as educational institutions. Review of Child Development Research, 7, 179–222; Clark, R. (1982). Family life and school achievement: Why poor black children succeed or fail (Chapter 1). Chicago: University of Chicago Press; Scott-Jones, D. (1984). Family inﬂuences on cognitive development and school achievement. Review of Research in Education, 11, 259–304; Gandara, P. (1995). Over the ivy walls—The educational mobility of low-income Chicanos (Chapter 2). Albany: State University of New York Press; Lareau, A. (2000). Home advantage: Social class and parental intervention in elementary education (2nd. ed.; Chapter 1). Lanham, MD: Rowman and Littleﬁeld. See Slaughter, D., & Epps, E. (1987). The home environment and academic achievement of black American children and youth: An overview. Journal of Negro Education, 56(1), 3–20, for a review of family effects on African American children speciﬁcally, with results highly similar to reviews for all children. 17. Leichter, H. J. (1974). The family as educator. New York: Teachers College Press. 18. Bourdieu, P., & Passeron, J. C. (1977). Reproduction in education, society, and culture. Beverly Hills, CA: SAGE. 19. Hart, B., & Risley, T. (1995). Meaningful differences in the everyday experiences of young American children. Baltimore, MD: Paul Brookes, illustrates a dilemma of qualitative research: their measure of socioeconomic status is based on occupation, though in practice they distinguish professional, working-class, and welfare families— and occupation, income, and parental education are so correlated in this small sample that it’s impossible to disentangle them. 20. Bernstein, B. (1995). Class, codes, and control. New York: Schocken. 21. Heath, S. B. (1983). Ways with words: Language, life, and work in communities and classrooms (Chapter 7, Epilogue). New York: Cambridge University Press. 22. Ganadara, P. (1995). Over the ivy walls: The educational mobility of low-income Chicanos. Albany: State University of New York. 23. Personal communication, Alan Schoenfeld; see also the review by Hess, R., and Holloway, S. (1984). Family and school as educational institutions. Review of Child Development Research, 7, 179–222, with many fewer citations for math. They cite some nonconclusive evidence that family effects on math are lower than for other outcomes, but my NELS88 results in Table 11.1 suggest that the effects on math are comparable to other subjects. 24. Saxe, G. B., Guberman, S. R., & Gearhart, M. (1987). Social processes in early number development. Monographs of the Society for Research in Child Development, 52(2). 25. Hess, R., & Holloway, S. (1984). Family and school as educational institutions. Review of Child Development Research, 7, 179–222. 26. Lareau, A. (2003). Unequal childhoods: Class, race, and family life. Berkeley: University of California Press. 27. Lareau, A. (2000). Home advantage: Social class and parental intervention in elementary education (2nd. ed.). Lanham, MD: Rowman and Littleﬁeld. 28. Romo, H., & Falbo, T. (1996). Latino high school graduation: Defying the odds. Austin: University of Texas Press. 29. Clark, R. (1982). Family life and school achievement: Why poor black children succeed or fail. Chicago: University of Chicago Press.

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30. LeBlanc, A. N. (2003). Random family: Love, drugs, trouble, and coming of age in the Bronx. New York: Scribner. 31. Kohn, M. (1977). Class and conformity: A study in values. Chicago: University of Chicago Press. 32. Kohn, M., & Schooler, C. (1983). Work and personality: An inquiry into the impact of social stratiﬁcation. Norwood, NJ: Ablex. 33. Schneider, B., & Stevenson, D. (1999). The ambitious generation: American teenagers, motivated but directionless. New Haven: Yale University Press. 34. Rosenbaum, J., Deil-Amen, R., & Person, A. (2005). College structures in the college-for-all society: Managing dreams and information of the new college students. New York: Russell Sage. 35. In support of this, the correlation between low-skilled work and low aspirations for students in the NELS88 data is 0.15. 36. The correlation coefﬁcients are 0.456 for Latinos and 0.262 for Asian Americans. 37. Wallerstein, J., Lewis, J., & Blakelee, S. (2000). The unexpected legacy of divorce: The 25 year landmark study. New York: Hyperion. 38. DeParle, J. (2004). American dream: Three women, ten kids, and America’s drive to end welfare. New York: Viking. 39. Canada, G. (1995). Fist stick knife gun: A personal history of violence in America. Boston: Beacon Press. 40. Kozol, J. (1968). Death at an early age: The destruction of the hearts and minds of Negro children in the Boston public schools. New York: Bantam Books. 42. Kozol, J. (1992). Savage inequalities: Children in America’s schools. New York: Harper Perennial. 43. The coefﬁcients on variables measured with random error are biased toward zero. If the error is nonrandom—for example, correlated with racial=ethnic measures— this will then increase the coefﬁcients of the racial=ethnic variables. Better measurement would therefore increase the coefﬁcients of family background measures and reduce the racial=ethnic coefﬁcients. 44. Irvine, J. J. (2000). Black students and school failure policies, practices, and prescriptions. New York: Praeger. 45. Weinstein, R. (2001). Reaching higher: The power of expectations in schooling. Cambridge: Harvard University Press. 46. Thompson, G. (2004). Through ebony eyes: What teachers need to know but are afraid to ask about African-American students. San Francisco: Jossey-Bass. 47. Townsend, B. (2000). The disproportionate discipline of African-American learners: Reducing school suspensions and expulsions. Exceptional Children, 66(3), 381–391. 48. Ayers, W., Dohrn, B., & Ayers, R. (2001). Zero tolerance: Resisting the drive for punishment in our schools. New York: The New Press. 49. Ferguson, R. (2003). Teachers’ perceptions and expectations and the black-white test score gap. Urban Education, 38(4), 460–507. 50. Deschenes, S., Cuban, L., & Tyack, D. (2001). Mismatch: Historical perspectives on schools and students who don’t ﬁt them. Teachers College Record, 103(4), 525– 547. 51. Delpit, L. (1995). Other people’s children: Cultural conﬂict in the classroom. New York: The New Press. 52. Hooks, B. (1994). Teaching to transgress. New York: Routledge.

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53. Ladson-Billings, G. (1994). The dreamkeepers: Successful teachers of AfricanAmerican children. San Francisco: Jossey-Bass. 54. Baldwin, J. (1955). Notes of a native son. Boston: Beacon Press. 55. Willis, P. (1977). Learning to labor: How working-class kids get working-class jobs. Farnborough, UK: Saxon House. 56. Fordham, C., & Ogbu, J. (1986). Coping with the ‘‘burden of ‘acting white.’ ’’ Urban Review, 18(3), 176–206. 57. Stanton-Salazar, R. (2001). Manufacturing hope and despair: The school and kin support networks of U.S.-Mexican youth. New York: Teachers College Press. 58. This kind of argument is similar to one in the labor economic literature, where efforts to explain wage and income differentials are often left with racial=ethnic differences that cannot be ascribed to any factor except for racial discrimination. 59. These approaches are based in part on Grubb, W. N., & Lazerson, M. (1988). Broken promises: How Americans fail their children. New York: Basic Books, and Chicago: University of Chicago Press, on reviews of parent intervention and education literature such as Fan, X., & Chen, M. (2001). Parental involvement and students’ academic achievement: A meta-analysis. Educational Psychology Review, 13(1), 1–22; and on work in progress by Tokheim (2007). 60. Joffe, C. (1977). Friendly intruders: Childcare professionals and family life. Berkeley: University of California Press. 61. Lightfoot, S. L. (1983). The good high school: Portraits of character and culture. New York: Basic Books. 62. Schlossman, S. (1976). Before Home Start: Notes toward a history of parent education in America. Harvard Education Review, 46, 436– 462. 63. Askov, E. N. (2003). Filling in the ‘‘black box’’ of family literacy: Implications of research for practice and policy. Goodling Institute for Research in Family Literacy, Pennsylvania State University. Paper presented at the meeting of the 20th Annual Rutgers Invitational Symposium on Education. 64. Grubb, W. N., Lara, C., & Valdez, S. (2002). Counselor, coordinator, monitor, mom: The roles of counselors in the Puente program. Educational Policy, 16(4), 547–571. 65. Bakermans-Kranenburg, M., Van Ijzendoorn, M., and Bradley, R. (2005). Those who have, receive: The Matthew effect in early childhood intervention in the home environment. Review of Educational Research, 75(1), 1–26. 66. Esping-Anderson, G. (1990). The three worlds of welfare capitalism. Princeton: Princeton University Press. 67. See the third presidential debate at www.debates.org=pages=trans2004d.html. 68. See his testimony before the Committee on Education and the Workforce, U.S. House of Representatives, March 11, 2004, at www.federalreserve.gov=boarddocs= testimony=2004=20040311=default.htm. 69. In my NELS88 results, various measures of innovative and constructivist teaching enhance test scores, while conventional behaviorist teaching depresses them—quite consistent with the evidence from various whole-school reform movements.11 70. One reason for concluding this is that even the most powerful whole-school reforms, while they may improve the school performance of low-performing students signiﬁcantly, never eliminate the various ‘‘gaps.’’ 71. Counts, G. (1932). Dare the school build a new social order? Carbondale, IL: Southern Illinois University Press.

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72. Dewey, J. (1938). Experience and education. New York: Macmillan Publishing. 73. Clinton, H. (1996). It takes a village, and other lessons children teach us. New York: Simon and Schuster. 74. Comer, J. (1996). Rallying the whole village: The Comer process for reforming education. New York: Teachers College Press. 75. Dryfoos, J. (1994). Full-service schools: A revolution in health and social services for children, youth, and families. San Francisco: Jossey-Bass. 76. Schorr, L. (1998). Common purpose: Strengthening families and neighborhoods to rebuild America. New York: Doubleday. 77. Just to be clear: I refer in this sentence not only to the systematically monstrous policies of the Bush administration but also to the more general inability of interest-group liberalism to develop any vision of the common good, to plan, or to redistribute; see Truman, D. (1951). The governmental process: Political interests and public opinion. New York: Alfred A. Knopf; and Lowi, T. (1969). The end of liberalism: Ideology, policy, and the crisis of public authority. New York: Norton. We have offered another vision, of the Foundational State, in Grubb, W. N., & Lazerson, M. (2004). The education gospel: The economic value of schooling (Chapters 8 & 9). Cambridge: Harvard University Press.

Conclusion

In the opening chapter, we were reminded that fears and concerns about raising children in family life are not unique to the twenty-ﬁrst century but rather have been expressed throughout history. Yet public perceptions express the view that, as difﬁcult as things may have been in the recent past, the challenges of being a parent are even greater today. A national survey conducted by the Pew Research Center in March 2007 ﬁnds broad agreement among the public that it is harder to raise children now than it was in the 1970s and 1980s.1 About 70% of the respondents said it was more difﬁcult to be a mother today than it was several decades ago, and 60% said the same for being a father. Not only was the task of raising children judged to be more difﬁcult, but today’s fathers and more mothers were often seen as doing a poorer job of raising children than respondents’ own parents. According to the Pew Research Center survey, the greatest challenges to raising children today include societal forces outside the family, maintaining discipline and morals within the family, being there to care for children, struggling to balance time and work, meeting ﬁnancial costs, and dealing with the educational system. A number of these issues have been addressed in this book, which analyzes them in particular social contexts from the authors’ perspectives. In each case, these analyses inform policy and program recommendations that deal with essential aspects of the modern challenges to raising children. The high levels of divorce, separation, and single-parenthood in modern times have created daunting issues and hardship surrounding social=emotional

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and ﬁnancial care for children in families experiencing these struggles. Chapter 2 critically examines policies that assist grandparents who wish to step in and provide substitute family care for children who can no longer live in their parents’ homes for various reasons such as parental health, maltreatment, substance abuse, and economic disruptions. This analysis cautions against policy measures that may inadvertently provide a strong incentive for low-income women to transfer their children’s care to relatives. To soften these incentive effects, the author recommends several adjustments to current policies that involve offering family stabilization grants to parents when children return home, monitoring subsidized guardianship arrangements, and eliminating the time limits on Temporary Assistance for Needy Families family grants. The provision of ﬁnancial support for children when their parents divorce is a highly contentious and complicated problem. Chapter 6 challenges the conventional policy used to generate child support guidelines. Offering a superior alternative to child support, the authors design a set of guidelines that rest on a principled and systematic method that incorporates the three distinct purposes of support orders: to protect the well-being of the child, to enforce the normative understanding that both parents have a support obligation, and to limit the disparity that might otherwise rise between the child’s living standard and the higher living standard of the noncustodial household. The principles underlying this policy approach not only generate guidelines that weigh the basic considerations for a fair and decent arrangement but also address the thorny issues that arise from the increasing situation of blended families that contain both child support obligors and recipients. Beyond the issue of ﬁnancial support, raising children also requires caring relationships and social=emotional support from their parents—whether married or unmarried. In 2006, the Administration for Children and Families introduced the Promoting Responsible Fatherhood Initiative, aimed at helping fathers improve their relationships with their children and become more effective parents. Reviewing the research on a range of programs that attempt to encourage responsible fatherhood, Chapter 3 recommends a program approach based on a family-systems model, which places the couple’s relationship at the center of the intervention. In addition to its focus on the couple’s relationship and co-parenting, the domains of this model include building on men’s strengths as individuals, promoting the quality of father–child relationships, bringing intergenerational relationships into the picture, and attending to stresses and supports outside the family. At the same time that efforts are underway to enhance fathers’ caring relationships with their children, the increasing labor-force participation of women has created new strains in the realm of child rearing, as young mothers seek to balance the demands of work and family life. While these strains are experienced by almost all working mothers, they vary and have different implications for college women seeking high-powered professional careers that

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require extended periods of training and other women with less demanding educational and occupational aspirations. The lifelong tensions in balancing work and family life encountered by young women on track to professional careers in law, medicine, business, science, and academia are analyzed in Chapter 4 from the student=apprentice years (18 to 30), to the make-or-break years (30 to 40), to the period when women encounter the glass ceiling (40þ). The author examines alternatives, such as moving off the fast track and onto the second tier or ‘‘mommy track’’ of their profession, as adaptations to the demands of child rearing and professional life. Chapter 5 examines a range of family=work lifestyle choices and the extent to which the conventional familyfriendly policies, such as daycare and parental leave, support different approaches to harmonizing work and child rearing. The analysis distinguishes between policies that support the idea of balancing work and family life through the concurrent performance of paid employment and child-rearing activities and those that support a sequential approach to balancing work and family life, which involves an initial investment of 5 to 10 years in child rearing without an outside job followed by 20 to 30 years of labor-force participation. To equalize policy incentives for both approaches, the author recommends that subsidized daycare policies be broadened to include home-care allowances so as not to disadvantage parents who choose the sequential pattern of balancing work and family life. In the second part of this volume, our focus of attention shifts to the various forces outside of the family that may exert undesirable inﬂuences on children. Social policies that affect children are often seen as measures that diminish parental authority. Chapter 7 explains how planners might increase public support for social policies by framing interventions—such as forbidding the sale of cigarettes to minors, curfew laws, and the ﬂuoridation of drinking water—as measures that actually extend parental power and authority to deal with external forces by providing resources, information, and regulations. Applying this perspective to more controversial issues, the author analyzes how parents are empowered by social policies designed to promote school choice through educational vouchers and to combat childhood obesity by, for example, limiting the advertising of unhealthy foods. One of the greatest challenges that parents confront in raising children involves monitoring their health and managing to obtain the proper treatment when needed. When children’s health is at stake, all parents want to ﬁnd the best possible medical care. Yet many parents are unable to evaluate the diagnostic procedures and treatment their children receive, particularly for certain types of problems such as, for example, childhood attention-deﬁcit= hyperactivity disorder (ADHD). Over the past decade, the increasing detection of ADHD has evoked considerable controversy. Analyzing what is known about the cause, effects, diagnosis, and treatment of ADHD, Chapter 8 brings to light the pitfalls of misdiagnosis, the need to recognize the bidirectional processes between parent and child that shape the developmental manifestation of ADHD, and the scientiﬁc and political deliberations surrounding

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medication and psychosocial treatment. Among the policies to advance effective care, the author suggests not only a more rigorous reporting of negative as well as positive data on ADHD medications from the U.S. Food and Drug Administration (FDA) but also the creation of a federal psychosocial and psychotherapeutic treatment administration, which would monitor evidencebased psychosocial interventions for children in the same way that the FDA evaluates pharmacological treatment. While most parents struggle to judge the quality of medical care available to their children, for many of those among the working poor who lack coverage by medical insurance, the greatest problem is simply gaining access to a physician. Immigrants constitute a disproportionate number of working poor families. Although progress has been made since the mid-1990s, Chapter 9 reports that 44% of immigrant children in working poor families were not covered by health insurance in 2001, along with 17% of U.S.-born children of the working poor. The serious vulnerability of children in working poor families highlights the need for continued support of existing programs such as Medicaid and the state Children’s Health Insurance Program, so that they might be extended to the approximately 6 million uninsured children who are currently eligible for coverage. In addition to support for these programs, the authors recommend that states provide universal coverage for all children along the lines of Governor Schwarzenegger’s proposal to expand healthinsurance coverage for all uninsured Californians. Outside of their homes, children spend most of their hours in classrooms. Schools are increasingly implementing policies not only to educate children but also to deliver programs that meet the nonacademic needs of students, including health and mental health conditions, low levels of social competence, prevention education regarding risky behaviors such as illicit drug use, and detrimental habits and attitudes, which are seen as presenting barriers to learning. Chapter 10 critically reviews the empirical evidence on programmatic efforts to meet an array of nonacademic needs in school settings. A number of issues are raised about the structure and capacity of schools to effectively engage in this expanded mission. Evidence reveals, for example, that there are usually limited effects in programs for the prevention of risky behaviors. However, these effects vary according to program design and school conditions. The most successful programs are those delivered by well-trained staff using cognitive-behavioral techniques in schools with high levels of academic achievement and strong administrative leadership. As a general policy orientation, the author suggests that rather than expanding supplementary programs, resources might be better invested in promoting schools with highquality, student-centered instruction and administrative leadership, which are the necessary and often sufﬁcient conditions for meeting the nonacademic needs of many students. But, as Chapter 11 documents, even well-functioning schools will ﬁnd it immensely difﬁcult to overcome the powerful effects of parents on their children and on educational outcomes. While recognizing that schools can be reformed to do a better job with low-performing students,

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the author argues that more than educational policy is required to close the achievement gaps associated with class and race. That is, while educational policies need to include parent outreach and education, these measures must be complemented by a broad range of social polices that strengthen the social and economic conditions of family life for the most disadvantaged. Altogether, the issues surveyed and questions raised in this volume serve to heighten our understanding of the challenges faced in raising children today. While the various policies recommended might ameliorate some of these problems, they will not resolve the troubling public perceptions expressed in the Pew Research Center survey referred to earlier—that it is more difﬁcult to raise children now than it was a quarter of a century ago. It is somewhat paradoxical that although life has improved in so many ways since the 1970s— minority rights have been strengthened; women have gained new freedoms; modern technology has shrunk the world; more students go to college and graduate school; medical advances have extended longevity; and the average family has more material comforts, such as homes, cars, air conditioners, and dishwashers, than ever before—people still feel that it is more difﬁcult to raise children successfully. A number of factors might account for these downbeat perceptions, including changing expectations and conditions of family life. As family size declines, the investment of parenthood becomes more focused and intense. Sharon Hays2 characterizes modern motherhood as devoted to an ideology of intensive mothering, continuously working with children and scheduling a stunning array of activities. Despite the perception that mothers are doing a less satisfactory job today than their parents did in the 1970s, data show that in 2000, employed mothers spent as much time engaged in the primary care of their children as did nonemployed mothers in 1975—and nonemployed mothers today spend more time with their children than did those of the 1970s.3 Even fathers have increased the amount of time they devote to child care over the past several decades.4 Expectations about parenting are high, as are anxieties that today’s children are growing up in a world where they will face global competition for meaningful work and the resources needed to achieve the good life. The historical context given in Chapter 1 opened this volume’s deliberations on the note that it has never been easy to raise children. In closing, we come full circle, returning to the historical insight that caring for and protecting children are aspects of a lifelong work in progress, passed down from generation to generation, each of which confronts new concerns that emerge from rising expectations and the evolving conditions of family life.

Notes 1. Pew Research Center Publications (n.d.). Motherhood today: Tougher challenges, less success. Retrieved August 28, 2007, from http://pewresearch.org/pubs/486/ motherhood.

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2. Hays, S. (1996). The cultural contradictions of motherhood. New Haven, CT: Yale University Press. 3. See, for example, Bianchi, S., Robinson, J., & Milkie, M. (2006). Changing rhythms of american family life. New York: Russell Sage Foundation. 4. Sayer, L., Cohen, P., & Casper, L. (2004). Men, women, and work. New York: Russell Sage Foundation.

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Index

Abandon, 90, 117 Ability, 82 Abortion, 45, 105, 153 Absence, 49, 103, 136, 142, 206 Abstinence, 45, 206, 210 Abstract, 84 Academic, 81–83, 86, 87, 89, 91, 94, 210, 212, 213, 225, 228, 252 Access, 193, 223, 253 Accident, 104 Accountability, 242 Achievement, 5, 9, 48, 103, 104, 204, 206, 207–210, 213, 254 Activist, 86 Adaptation, 49, 56, 252 Adjustment, 48, 56, 139, 142, 208, 236 Administration, 225, 253 Administration for Children and Families (ACF), 44, 65, 71, 251 Adolescence, 63, 82, 83, 205, 209, 210 Adopt(ed=ion), 13, 137, 152 Adoption and Safe Families Act, 29, 31 Adoptive parent, 47 Advancement, 85, 90, 91, 94, 98 Advertise, 252

Afﬂuent, 90 African=African American= black, 27, 47, 49, 50, 57, 63, 203, 227, 229–238, 240, 244, 252 After-school programs, 2 Age, 56, 57, 69, 82, 86, 89, 93, 102, 104, 134, 153, 205 Agency, 45, 51, 55, 64, 68 Aggression, 48, 94, 137, 206, 209 Aid, 18, 31, 35, 37, 98 Aid to Dependent Families (ADC), 98, 112 Aid to Families with Dependent Children (AFDC), 30, 34 Alcohol, 21 Alimony, 117, 137 Allocate, 71, 116 Allowances, 94, 106, 109, 112 Alternative, 71, 90, 92, 101–103, 143, 207, 240 Amenities, 134, 135 American Bar Association, 82 American Dream, 236 American Medical Association, 82 Analysis, 5, 17, 40, 111, 112, 141, 143, 152, 210, 233, 237, 239, 250, 252 Antisocial, 15, 65

257

258

Index

Anxiety, 3, 4, 10, 12, 13, 14, 19, 20, 22, 92, 204 Applicant, 83 Apprentice, 10, 17, 82, 92, 222, 232, 239, 252 Appropriate, 116, 118, 134, 138, 142, 154 Approval, 153 Asian American, 227, 229, 231, 232 Assess(ment), 36, 37, 57, 62, 87, 212 Assistance, 10, 14, 31, 33, 39, 40, 54, 55, 63, 69, 112, 151, 154, 155, 251 Attachment, 57 Attention, 69, 90, 99, 102, 154 Attention-Deﬁcit=Hyperactivity Disorder (ADHD), 3, 4, 5, 167–179, 205, 252, 253 Augment, 140 Authority=authoritarian, 234, 239, 240 Autonomy, 20 Award, 134, 136–140, 142 Babies, 81, 84, 86, 96 Baby boomer, 95 Bargaining, 85 Barriers, 4, 51, 60, 64, 93, 194, 212 Base, 139 Behavior, 51, 66, 94, 99, 118, 152, 209, 210, 212, 213, 229, 231, 235, 238, 239, 252 Beliefs, 56, 67, 91, 110, 154, 243 Beneﬁciary, 137, 142 Beneﬁt=beneﬁcial, 2, 3, 5, 18, 30, 34, 45, 47, 51, 59, 61, 64, 65, 68, 71, 88, 90, 103, 112, 106–108, 135–137, 142, 154, 162, 207, 210, 225 Best interests, 3, 23, 29, 39, 151 Birth control, 45, 52 Birth=biological parent, 29, 30, 47, 49, 70, 86 Birthrate, 108, 109 Blame, 56, 151, 157 Blended family, 143, 251 Blood pressure, 157 Borders, 98 Breadwinner, 88 Budget, 56, 71 Bureaucracy, 39 Bush Administration, 71 Capable=capability, 87, 211 Career, 81–87, 89–94, 99, 101, 102, 104, 112, 251 Caregiver, 31, 33, 38, 39, 57, 102 Caretaker, 89, 94

Caseload=work, 18, 28, 29, 31, 55 Case management, 32 Cash assistance, 30, 98, 112 Cash contributions, 47 Categorical, 33, 103, 104, 111 Certiﬁcation, 37, 38 Charged, 142 Chicago School, 19 Child abuse, 221 Childbearing, 85, 87, 99, 101, 102 Childbirth, 3, 85, 92 Child care, 1, 2, 12, 28, 29, 33, 34, 35, 37, 38, 61, 88, 101, 106, 110 Child Care and Development Fund, 33, 34 Childless, 101–103 Child rearing, 3, 4, 5, 11, 12, 13, 19, 20, 48, 54, 55, 57, 70, 82, 87, 90, 102–104, 111, 112, 221, 222, 224, 238–241, 252 Child support, 3, 4, 5, 47, 52, 53, 55, 60, 65, 68, 116, 117, 136–138, 142, 143, 251 Child welfare, 2, 3, 14, 21, 29, 32, 204, 211, 222, 239 Church, 9, 229, 239 Civilian Concentration Corps, 18 Clinical, 62, 66, 69 Client, 54, 64, 87 Clinton, 244 Coercive, 53, 55 Cognitive, 48 Cognitive-behavioral, 253 Cohabitating, 66, 70 Cohort, 104 Collaborate, 49, 52, 222, 234 Collective, 95 Comfort, 105, 254 Commitment, 50, 82, 94, 101, 104 Communicable, 154 Community, 10, 13, 16, 22, 30, 34, 51, 54, 55, 57, 64, 68, 99, 151, 155, 163, 193, 211, 230, 231, 239, 240 Competence, 17, 56, 234 Competitive, 82, 87, 92 Comprehensive, 50, 69 Conference on Child Health and Protection, 19 Congress, 71, 188 Connections, 67, 69, 136, 225 Consent, 154 Consequences, 17, 48, 59, 82, 94, 110, 244 Conservative, 44, 81, 152 Constituencies, 70, 152 Consultation, 62 Consumer Expenditure Survey, 122, 125

Index Contagious, 154 Contraceptive, 102, 105, 164 Contribution, 141 Control, 3, 9, 10, 21, 22, 54, 61, 62, 64, 66, 95, 134, 152 Controversies, 4, 45, 152, 167 Conventional, 111, 142, 143, 231, 239 Coping, 63, 109 Corporate (corporation), 81, 85, 86, 87, 89–91, 93, 94 Counseling, 45 Couple-focused approach, 70 Court, 37, 237 Court-ordered, 60 Credit, 94 Criminal, 34, 36, 221, 238 Criteria, 93 Critical, 28, 82, 83, 85–87, 94, 201 Crisis, 5, 151 Cross-sectional, 99, 252 Culture (cultural), 9, 15, 16, 23, 28, 30, 34, 54, 57, 81, 83, 90, 94, 95, 101, 151, 221, 238 Curfew, 156, 157, 252 Custody (custodial), 38, 39, 48, 60, 61, 68, 134, 135–139, 141, 142 Danger, 151, 153 Data=database, 35, 50, 57, 64, 82, 88, 92, 99, 100, 106, 107, 207, 212, 235 Daycare, 3, 34, 102, 106, 109, 112, 252 Death, 28, 87 Decision making, 92 Deﬁcit Reduction Act, 44, 46, 188 Deﬁciencies, 240 Deliver(y), 50, 94 Demands, 3, 39, 67, 82, 86, 88, 92, 95, 99, 104, 109, 113 Democracy, 101 Demographic, 27, 49, 56, 57, 101, 202, 208, 232 Dental, 154 Department of Health and Human Services, 52, 118 Dependent, 10, 19, 225, 226, 229 Depression, 19, 48, 65, 204, 206 Design, 55, 62, 65, 70, 71, 87, 141 Desperate, 137 Development, 1, 14, 16, 29, 35, 39, 45, 49, 53, 56, 63, 68–71, 98, 100, 111, 151, 163, 201, 212, 222, 239, 243, 244 Diagnosis, 3, 4, 17, 18, 22, 48

259

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV ), 48 Differentiate, 70, 92 Dimensions, 69 Direct care, 47, 66 Direct service, 53 Disadvantage(d), 16, 35, 38, 254 Discipline, 12, 14, 211 Discrimination, 82, 94, 242 Disease, 154 Disengagement, 56, 64 Disincentive, 36, 37, 68 Disorders, 3, 4, 15, 17, 20, 205 Disparity, 92–94, 135, 136, 139, 140, 191, 251 Disproportionate(ly), 11, 16, 82, 104, 112, 204 Distress, 56, 137 Diverge, 86, 87 Diversity, 47, 49, 58, 69, 70, 104, 112 Divorce, 13, 21, 47, 48–50, 52, 53, 57, 58, 60–63, 65, 66, 68, 70, 82, 87–89, 93, 104, 116, 230, 236, 250 Document, 60, 61, 93, 204 Domestic, 11, 12, 17, 20, 22, 51, 96, 99, 102–105, 109, 111, 221 Domestic violence, 58, 66, 70 Dominant, 81–84, 87, 94, 221, 222 Downgrade, 70 Dramatic, 95 Drinking, 252 Dropout, 82, 83, 95, 204, 209, 223, 238 Drugs, 4, 23, 237, 243 Dual-centric, 95 Dysfunctional, 244 Earning, 93, 104, 124, 138, 141 Earning Priority Principle (EPP), 121, 126, 130, 132, 133, 135–140, 142 Economy (economic), 11, 16, 17, 18, 19, 20, 28, 32, 33, 38, 39, 51, 52, 55, 84, 88, 95, 99, 103, 105, 110, 118, 239, 243, 254 Egalitarian, 68 Elderly, 27, 110 Elementary, 209 Eligible, 31 Elite, 92, 93 Emancipate, 153 Emotional, 250 Empirical, 35, 55, 99, 202, 208, 253 Employment, 1, 18, 36, 55, 57, 65, 85, 87, 94, 102–104, 106, 110, 111, 138, 225, 242, 254

260

Index

Empower(ing), 4, 5, 152–156, 159, 252 Enable, 94, 152–154 Endangered, 137 Engage(ment), 45–60, 62, 63–71, 206, 211, 213, 232–235 Enrollment, 84, 211 Entitled, 134, 141 Environment, 3, 15, 16, 17, 18, 31, 34, 35, 39, 59, 85, 205 Equity (equitable)=equality, 68, 82, 92, 99, 100, 102, 137, 139, 237, 242, 243 Era, 99 Ethical, 64 Ethnic(ity), 57, 58, 68–70, 204, 231–233, 237 Ethnographic, 237, 238 Eugenics, 15 European, 40, 47, 57, 62, 98, 101, 106, 108 Evaluation, 46, 48, 53, 54, 55, 61, 64, 69, 70 Evolve, 163, 254 Exacerbate, 137 Examination, 5 Exception, 138 Exclusion, 93, 105, 142 Excuse, 142 Executive, 88, 91–94 Exemption, 30, 33 Exhaustive, 103 Expectations, 4, 105 Expenditure, 106–108, 118, 119, 134, 136, 139, 142 Expenses, 3, 116 Experimental, 46, 53, 54, 55 Experts, 152 Exploration, 69 Exponential, 70 Expulsion, 206 Extended family, 39, 56, 59, 67, 151 Externalizing, 205, 209 Extracurricular activities, 230 Facilitate, 71, 110, 111, 152 Factors, 48, 69, 82, 84, 94 Facts, 4, 5, 20 Fair Share, 55 Faith-based, 54 Families and Work Institute, 95 Family-centric, 95 Family-friendly, 1, 3, 4, 20, 94, 98, 106, 108–110, 112, 241 Family Support Act, 53, 117

Family systems, 56 Family values, 44, 152, 230 Fate, 102 Fatherhood, 1, 3, 5, 44, 46, 47, 48, 51, 52, 54, 55, 56, 60, 64, 67, 69, 70, 251 Fatherlessness, 49 Fear, 70, 154, 250 Federal, 71, 84, 93, 94, 112, 117, 186 Federal IV-E, 32 Female-headed household, 226, 228, 230, 231, 236 Feminist, 99 Fertility, 2, 88, 101, 106–108, 110, 111 Finance=ﬁnancial, 10, 28, 30, 35, 38, 39, 47, 50, 57, 60, 65, 68, 90, 106, 136, 137, 142, 154, 161, 203, 251 Food and Drug Administration (FDA), 175, 253 Food stamps, 152, 153, 162 Forbid(den), 153, 252 Formation, 71, 82, 83, 154 Foster care, 29, 30, 32, 35, 36, 37, 38, 39 Foster child, 10, 20, 28 Foster parent, 28, 30, 241 Foundation, 83 Frame, 152–154, 158, 162, 252 Framework, 83 Freedom, 91, 112 Full-time, 89, 90, 92, 99, 102–104, 106 Functioning, 5, 253 Fund(ing), 32, 33, 34, 38, 39, 44, 53, 55, 64, 69–71, 121, 137, 186, 207, 243 Gaps, 231, 243, 254 Gate-keeping, 30, 66 Gay, 2 Gender, 82, 83, 94, 134 Gender roles, 21 Generalization, 47 Generation, 5, 16, 56, 59, 60, 63, 95, 96, 100, 232, 254 Generic, 69 Genes, 23 George Bush, 242 Glass ceiling, 92, 93 Global, 88, 221 Goals, 44, 65, 67, 92, 212 Government, 3, 11, 14, 18, 28, 29, 30, 34, 39, 44, 45, 51, 52, 54, 55, 70, 71, 93, 112, 151, 152, 154, 163 GRE (Graduate Record Examination), 231 Gross Disparity Component, 135, 136, 139, 140

Index Gross Domestic Product (GDP), 107, 108, 110 Group, 2, 55, 69, 70, 138, 155 Grow(th), 71, 81, 82, 90, 100, 101 Guardianship, 28, 29, 32, 33, 35, 36, 37, 38 Guidelines, 117–119, 136, 138, 139, 143, 251 Guilt, 88 Harm, 153 Head Start, 55 Health, 1, 2, 3, 4, 13, 19, 27, 28, 29, 70, 90, 134, 157, 158, 160, 164, 183, 204, 205, 209 Health care, 3, 4, 183, 243 Health insurance, 4, 29, 31, 193–197, 253 Heterogeneity, 207 Hierarchy, 93, 240 Higher education, 83, 100 High-income, 70 Hispanic=Mexican American, 27, 47, 57, 62 History, 81, 99, 102, 111, 250, 254 HIV=AIDS, 28 Home visitors, 64 Household, 10, 12, 14, 17, 22, 27, 30–33, 35, 45, 47, 49, 50, 61, 88, 106, 109, 117, 120, 135, 137–139, 141, 142, 152, 226, 236, 251 Human capital, 105 Humanistic, 83 Hunger, 157 Hypothesis, 56, 59, 61 Identify, 69, 71, 84, 239 Ideology, 70, 254 Inferior, 134 Ignorance, 151 Illness, 63, 104 Immature=immaturity, 153 Immigrant=immigration, 2, 3, 4, 5, 10, 15, 16, 20, 31, 184–196, 230, 240, 253 Impoverished, 15, 136–138, 142, 161, 203, 208, 242 Impulse, 9 Inadequate, 34, 241 Inappropriate, 142 Incarceration, 28, 50, 53, 65 Incentive, 3, 32, 35, 36, 37, 110, 113 Incidence, 143 Income, 36, 37, 49, 53, 57, 65, 68–71, 91, 118, 119, 134–137, 139, 140, 141, 142, 225, 226, 228, 230–232, 235, 236 Incremental, 94

261

Independent, 51, 57, 164, 234, 237 Indirect care, 47, 66 Individual rights, 10 Individualistic, 104 Individuals with Disabilities Education Act (IDEA), 174 Industrial, 15, 17, 98, 101, 102, 106 Industry, 86 Inequity=inequality, 137, 223, 239 Infant, 3, 58, 85, 92 Inferior, 137 Infertility, 103, 105 Inﬂuence, 93, 152, 155, 208, 224, 235 In-home care, 103 Initiative, 95, 152, 239 In-kind beneﬁts=contributions, 47, 112 Insecure, 57, 90 Inspection, 37 Institution, 4, 5, 9, 10, 11, 13, 14, 16, 17, 19, 28, 53, 54, 60, 64, 85, 91, 94, 110, 136, 222–224, 230 Interdependence, 16, 17 Interests, 3, 11, 13, 60, 86, 90, 103, 104, 138 Intermediate, 140 Internalize, 204, 206, 208 Interpersonal, 20 Interpolation, 139 Interview, 64, 84, 93, 95 Intervention, 4, 5, 13, 46, 51, 53, 54, 56, 60–71, 153, 155, 158, 204, 207, 239, 241, 251, 252 Intimate, 11 Intrinsic, 135 Investigate, 48, 69 Job skills, 45, 52, 53 Judges, 116, 117 Judgment, 117, 118, 134–136, 139, 151 Justice, 91 Justify, 45, 137, 138, 142, 153 Juvenile court=system, 13, 204, 221, 222 Kidnap, 21 Kinship, 2, 3, 5, 27, 29, 30, 31, 32, 34, 35, 36, 37, 38, 39, 60, 110 Labor=labor force, 1, 35, 53, 65, 86, 99, 100, 102, 105, 106, 109, 110, 112, 113, 183, 223, 251 Language=linguistic, 30, 34, 228, 235, 236, 238 Latino, 192, 203, 227, 229–233, 237, 238, 239, 252

262

Index

Law(s), 52, 68, 81–86, 88, 89, 91–93, 117, 141, 153, 156, 235, 239 Leader(ship), 69, 89, 213, 253 Legal, 82, 137, 142 Legislation, 84, 87 Legislator, 152 Legitimate=legitimacy, 138 Lesbian, 2 Levels, 139 Liability, 84 Liberals, 152, 164 Licensing, 29, 34, 36, 39, 153 Life partner, 85 Lifestyle, 102–104, 110, 111 Limit(ations), 4, 31, 32, 34, 36, 37, 38, 51, 59, 71, 87, 89, 90, 100, 134, 135 Literacy, 234 Literature, 46, 69, 71, 208, 209, 224, 233, 234, 237, 241, 243 Living arrangements, 69 Longitudinal, 50, 61, 65, 82, 205, 206, 224 Long-term, 62, 85, 89, 91 Low-performing, 5, 209, 238, 242, 243, 253 Low-income, 30, 33, 34, 35, 39, 47, 53, 62, 65, 68, 70, 71, 142, 152, 157, 161–163, 209, 224, 235, 236

Mentors, 84, 85 Merit, 94 Meritocracy, 87, 223 Methodology, 118, 143, 205, 206 Mexican American=Hispanic, 27, 47, 57, 62 Middle class, 2, 4, 5, 11, 12, 19, 20, 21, 22, 47, 52, 61, 222, 233, 234, 236, 241 Middle school, 225 Migrants, 15, 17 Minor, 155, 252 Minority, 20, 68, 83, 93, 209, 233, 236, 238 Mobility, 94, 203, 204, 210, 236 Model, 46, 56, 62, 63, 64, 67, 70, 85, 87, 111 Modern, 1, 2, 3, 4, 5, 18, 19, 102, 103, 211, 224, 254 Modify, 69 Monitor, 48, 53 Moral, 142 Motherhood, 81, 84, 86, 88, 89, 98–102, 104, 105, 111–113, 254 Motivation, 44, 45, 51, 53, 54, 55, 56, 63, 65, 67, 69, 206, 232 Movement, 95 Multigenerational, 18 Myths, 4

Maladaptive, 48 Maladjustment, 56 Maltreatment, 28, 32, 37, 209, 251 Mandatory, 153, 154 Marginal(ization), 84, 90, 139, 142 Market, 4, 35, 39, 65, 102, 109, 162, 223, 241, 242 Marital status, 69 Marriage (married), 1, 2, 13, 14, 18, 21, 44– 47, 50, 51, 57–60, 62, 65, 66, 68–70, 82, 85–90, 99, 101, 106, 107, 110, 142, 153 Maternity, 84 Matrix, 139 Mature, 151, 153 Measure, 139, 152, 224, 229, 232 Media, 3, 12, 14, 23, 90, 91, 99, 101, 102 Mediation, 53, 55, 68, 174–178 Medical, 1, 4, 47, 82–85, 87, 89, 92, 93, 183, 221, 253 Medication, 4, 81, 82, 253 Medicaid, 29, 31, 32, 36, 37, 186, 187, 195, 242 Meetings, 69, 94 Mental health, 5, 29, 48, 60, 204–206, 210, 237, 243

Nanny, 153 National Academy of Sciences, 92, 93 National Education Longitudinal Study (NELS), 224, 233, 235 National Fatherhood Initiative (NFI), 54 National Center for Fathering (NCF), 54 National Center for Strategic Nonproﬁt Planning and Community Leadership (NPCL), 54 National Center on Fathers and Families (NCOFF), 54 National origin, 69 National Science Foundation, 82 National Youth Administration, 18 Native American, 227, 229, 231, 232, 237 Naturalized, 17 Nature, 154, 209 Necessity, 105, 137 Needs, 4, 5, 38, 99, 134, 153, 201, 212, 213 Neighborhood, 2, 56, 241 Neglect, 21, 221 Negotiate, 85, 94 Network, 40, 59, 67, 87, 93 Newborn, 54, 60 No Child Left Behind (NCLB), 242, 243 Nominal, 120, 138, 141, 142

Index Noncustodial, 59, 119, 135, 137, 139, 140, 141, 251 Nonproﬁt, 91 Nonresident, 47, 49, 50, 52, 53, 55, 60, 65, 66, 68 Normative, 3, 63, 98, 104, 105, 107 Nuclear unit, 10 Nurture, 1, 2, 19, 20, 44, 61, 94 Nutrition, 103 Obesity, 4, 23, 152, 157, 158, 252 Objection, 136, 137 Obligation, 137, 138, 142 Observation, 64, 239 Occupation, 223, 225, 228, 231, 235 Operationalize, 138 Opportunity, 84, 85, 90, 94, 95, 102, 105, 151, 154, 211, 242, 244 Opt-out revolution, 22, 99, 100, 102 Organization, 86, 90, 91, 208, 211 Organization for Economic Cooperation and Development (OECD), 106, 110 Orphans, 10 Outcome, 45, 48, 49, 53, 56, 65, 69, 137, 201, 202, 205, 206, 208, 213, 225, 226, 232, 233, 240 Out-of-home care, 28, 102 Outreach, 239, 244, 254 Overrepresentation, 90 Ownership, 105 Paradigm, 17 Parental authority, 3, 4, 9, 151–153 Parental choice, 134, 161–164 Parental rights, 10, 153 Parental education, 19, 224, 225 Parenting=parenthood, 1, 4, 44, 45, 46, 48, 50, 54, 56, 59, 61, 62, 65, 86, 92, 93, 151–153, 161, 227, 229, 233, 250 Participants, 70, 71 Part-time, 85, 88–92, 103, 104, 106 Paternalistic, 160 Paternity, 60 Pathology, 16, 18 Patriarchal, 22, 250 Pauper, 15 Payment, 29, 30, 31, 32, 34, 35, 38, 39, 52, 53, 68, 120, 135–137, 138, 141, 142, 186 Peaceful, 99 Peer support, 55 Penalize, 142 Pension, 14, 18

263

Permit=permission, 141, 153 Personality disorder, 48 Personal Responsibility and Work Opportunity Reconciliation Act (PRWOR), 33, 187 Petition, 32, 33, 35, 37 Physical abuse, 49 Placement, 28, 29 Planning, 48, 54, 61 Play, 47 Policy, 1, 4, 5, 10, 14, 15, 20, 21, 23, 28, 32, 34, 35, 38, 39, 45, 46, 51, 53, 54, 56, 60, 71, 94, 98, 99, 106, 108, 110–112, 142, 143, 152–155, 158, 159, 164, 194–197, 224, 232, 239, 241, 243, 252, 254 Policy maker, 70, 118, 139, 141, 152, 188 Politicians, 44, 47 Poor, 2, 3, 4, 10, 14, 22, 27, 35, 101, 103, 104, 184, 190, 222, 239, 240 Popular, 9, 101 Poverty, 15, 17, 18, 20, 103, 120, 137, 138, 212, 213, 222, 237 Power(ful), 13, 93, 99, 100, 102, 103, 106, 151–153, 222, 225, 231, 232, 238 Practical, 137 Practice, 54, 103, 118, 136, 137, 210 Practitioner, 138 Praying, 48 Prediction, 100 Pregnant=pregnancy, 52, 55, 56, 58, 65, 85, 86, 105 Preschool(er), 34, 63, 93, 102 Pressures, 39, 92, 94 Prevention, 52, 53, 55, 56, 63, 83, 93, 207, 210 Primary, 56 Priority, 88 Private, 28, 55, 136, 161–163, 221, 222, 241, 242 Privilege, 102, 223 Probability, 46, 51, 82 Probationary, 87–89, 92 Problem(atic), 5, 15, 16, 19, 22, 28, 48, 49, 143, 194, 237, 243, 252 Procedure=process, 87, 210 Produce, 141 Profession(al), 4, 81–85, 87–90, 94, 95, 99, 102–104, 152, 223, 226, 228 Program(s), 44, 45, 46, 51–56, 60, 61, 63, 64, 69–71, 84, 106, 152, 209, 210, 223, 225, 239, 241, 244 Progress, 81

264

Index

Progressive, 14, 21, 112, 137 Protect(ion), 1, 2, 9, 10, 23, 38, 39, 56, 69, 135, 137, 138, 151–155, 159, 164 Proposal, 56, 70, 239 Provider, 1, 29, 52, 54, 64, 109 Provisions, 3, 60, 154 Psychological, 1, 4, 12, 19, 47, 48, 60, 61, 107, 213 Psychology, 2, 83 Psychosocial, 3, 4, 208, 213, 253 Psychosis, 48 Public, 3, 14, 16, 17, 21, 28, 31, 34, 38, 39, 64, 102, 106–108, 136, 156, 161, 221, 222, 239, 242 Public assistance, 33, 34 Public-health policy, 3 Public interest, 86 Public policy, 39, 134, 152 Punishment, 45, 46 Qualitative, 64, 224, 233, 237, 241, 243 Quality, 45, 48, 50, 56, 57, 58, 59, 62, 65, 70, 71, 94, 207, 210–213, 241 Quantitative, 87, 224, 231, 236, 241 Quantity, 2, 50, 160 Questionnaire, 64, 225 Race=racial, 15, 47, 56, 69, 70, 87, 95, 99, 203, 204, 231–233, 235, 237 Random, 55, 61, 62, 63, 71 Rank, 93 Rate, 2, 21, 29, 33, 34, 37, 39, 88, 89, 98–101, 103, 106–108 Rationale, 138 Recommendations, 46, 51, 63, 68, 87, 138, 250, 251, 254 Recover, 49 Reform, 5, 117, 213, 239, 243 Reject, 94 Relationship, 3, 5, 31, 32, 36, 44, 46– 49, 53, 55–63, 65–68, 70, 71, 89, 209, 212, 252 Relative, 2, 27, 28, 31, 32, 34, 35, 38, 39, 110, 135, 141 Religion (religious), 11, 30, 154, 227, 229, 230 Reluctance, 142 Removal, 28, 82, 240 Represent(ative), 104, 139 Reproduction, 22, 102, 105 Republican, 13 Requirements, 30, 31, 34, 35, 39, 52, 87, 118, 134, 153, 154

Research, 31, 45, 46, 48, 49, 50, 51, 54, 56, 57, 64, 65, 69, 71, 81–83, 86, 87, 93, 134, 189, 203, 209, 211, 212, 224, 233, 235, 250, 252, 254 Resent, 153 Residence, 66, 85, 87, 91 Resilience, 17 Resource(s), 13, 22, 29, 35, 38, 47, 53, 56, 65, 70, 71, 108, 117, 136, 151, 153–155, 208, 211, 224, 231, 232, 252, 254 Responsible=responsibility, 1, 3, 4, 9, 17, 38, 47, 49, 51, 53, 54, 56, 57, 68, 91–93, 99, 101, 103, 142, 152, 222, 242 Responsiveness, 48, 92 Restriction=restrictive, 35, 36, 48, 55, 233 Retirement, 82, 92, 95, 112 Reuniﬁcation, 29, 30 Revolution, 83, 94, 99, 102 Rights, 1, 10, 38 Risk, 2, 3, 4, 5, 37, 45, 46, 56, 58, 62, 63, 64, 69, 155, 203, 210, 212, 213, 252, 253 Role, 1, 4, 28, 46, 51, 52, 53, 54, 55, 59, 61, 62, 63, 66, 68–70, 84, 85, 98, 99, 151, 152, 154, 222, 235, 238, 240 Role model, 84, 236, 237 Rule(s), 116, 117, 142, 154 Runaway, 157 Rural, 16, 17, 19, 155 Sacriﬁce, 82, 95, 109, 138 Safety, 28, 29, 34, 37, 38, 39, 134 Salary, 88, 93, 94 Sample, 70, 88 SAT, 231 Schizophrenia, 48 School-based programs, 5 School choice, 4 School programs, 5 School readiness, 240 School reform, 5, 242 School voucher, 152, 161–163 Screening, 66 Security, 38, 55, 57, 87, 90, 92 Segregated, 136, 201 Self-concept, 56 Self-destructive, 151 Self-esteem, 48 Self-sufﬁciency, 9, 17 Sense of well-being (SWB), 134 Separation, 70, 137, 141, 230, 250 Sessions, 69 Setting, 69, 89 Settlement house, 15

Index Service(s), 11, 32, 35, 36, 38, 39, 47, 54, 64, 68, 70, 92, 106, 107, 111, 194, 207, 208 Sex, 16, 21, 22, 52, 56, 103 Sexual abuse, 49 Sexually transmitted disease, 23 Shareholder, 91 Shift, 96, 104, 140, 142, 222, 223 Short-term, 54 Single mother=parent, 21, 22, 45, 50, 67, 98, 236, 250 Social capital, 52 Social change, 45 Socialization, 19, 109 Social learning, 59 Social movement, 54 Social norms, 1, 4 Social policy, 4, 13, 14, 28, 33, 40, 98, 109 Social Security, 18, 98, 188, 242 Social services, 12 Social welfare, 2, 23, 110 Social welfare policy, 23 Social work, 17, 18 Social worker, 29, 30, 33, 38, 70 Society, 1, 2, 9, 14, 21, 22, 53, 59, 98, 135, 158, 250 Socioeconomic status, 58, 69, 203, 204, 223, 224 Socio-emotional, 206, 212 Solidarity, 16 Solutions, 5, 15, 44 Stabilize, 2, 10, 14, 15, 16, 18, 19, 36, 90, 251 Staff, 69, 92 Stages, 63, 82, 94 Standard(s), 34, 35, 38, 39, 116, 117, 134–138, 141, 142, 225, 228 Standardized, 48 Statistics, 82 Statutes, 94, 116 Stepmother=father, 47, 49, 141 Stereotype, 59, 94 Stranger, 142 Strategy (strategic), 63, 68, 94, 95, 153, 201, 210 Strengths, 4, 46, 60, 61, 63, 65, 70, 95, 107, 135, 243, 254 Stress, 46, 57, 59, 63, 67, 70, 86, 91, 95, 136, 235, 236 Stigmatize, 4, 5 Structure, 34, 87, 95, 153 Studies, 19, 31, 49, 70, 83, 88, 95, 252 Struggle, 1, 3, 5, 89, 95, 105, 212, 251

265

Subsidized, 30, 32, 34, 35, 37, 38, 110, 112, 252 Substance abuse=use, 28, 251 Substitute care, 33, 251 Supervision, 21, 36, 90, 102 Supplement, 70 Supplemental Security Income, 31 Supply, 3 Support, 3, 4, 10, 11, 30, 35, 39, 44, 46, 47, 50, 52, 53, 55, 57–60, 62, 65, 67–69, 81, 86, 87, 90, 95, 112, 116, 117, 134, 136–139, 142, 153, 213 Survey, 50, 52, 69, 88, 89, 136, 207, 250, 254 Survive (survival), 15, 105 Suspension, 206 Symbolic, 138 Sympathetic, 136 Symptoms, 48, 95, 204–206 System(ic), 14, 34, 46, 51, 54, 56, 64, 65, 68–71, 141, 142, 207, 211, 221–233, 250 Task-related, 48 Tax, 110, 112 Technology, 102, 105 Teen(ager), 153, 164 Teenage parents, 2 Teen Fathers Collaborative Project, 52 Temporary Assistance to Needy Families (TANF), 30, 31, 33, 34, 35, 36, 37, 44, 60, 112, 242, 251 Tensions, 109, 252 Termination, 70 Tier, 82–95 Theory, 59 Threat, 94 Time management, 89 Tool, 94, 139 Track(ing), 50, 87, 89, 90, 92, 252 Tradition(al), 2, 10, 17, 23, 47, 48, 91, 102–105, 11 Training, 10, 37, 61, 62, 69, 82–85, 111, 112, 252, 253 Transfer, 35, 38, 39, 117, 135 Transition, 1, 35, 61, 63, 111, 138 Translate, 88 Treatment, 4, 18, 64, 65, 142, 173–178, 253 Trends, 3, 27, 45, 47, 49, 52, 84, 95, 98–101 Underpaid, 90 Underrepresentation, 83

266

Index

Undervalued, 90 Unemployment, 15, 53, 55, 99, 105 Unethical, 64 Universal, 195, 234 University, 69, 81, 88, 92, 93, 99, 221, 223 Unjustiﬁed, 137 Unmarried, 46, 52, 53, 65, 89 Unstable, 2, 14 Urban, 10, 14, 15, 16, 17, 18, 19, 20, 21, 241, 243 Urban Institute, 102 U.S. Census, 2, 27, 82, 88, 89, 92 U.S. Children’s Bureau, 12 Vacation, 105 Vaccinate, 153, 154 Value(s), 53, 54, 56, 94, 112, 118, 151, 233, 236 Variable, 225, 226, 229, 231, 232 Variety, 69, 82, 99, 112, 151, 225 V-Chip, 152 Victim(ized), 21, 209, 238 Violence, 2, 66, 70, 167, 237 Vision, 151, 244 Visitation, 36, 38, 50, 53, 55, 60, 61, 62, 67, 68 Vocational, 13, 222, 240 Voluntary, 60, 68 Volunteer, 91

Voucher, 152, 161–163 Vulnerable, 63, 213, 253 War, 103 Warmth, 48, 62 Warning, 152 Warrant, 141 Welfare, 13, 14, 18, 21, 28, 30, 31, 33, 35, 36, 38, 68, 239 Welfare policy, 32 Welfare reform, 35, 71 Welfare state, 39, 241–243 Welfare-to-work, 35 Well-being, 2, 3, 4, 5, 19, 45, 46, 49, 56, 61, 66, 70, 71, 117, 129, 130, 134–140, 142, 240, 251 Well-functioning, 253 Women’s movement, 91, 92 Work-centric, 95 Workforce, 2, 3, 84, 90, 93, 99, 190 Working class, 4, 17, 19, 61, 223, 234, 238 Workplace, 85, 86, 88, 92–95 Works Progress Administration, 18 Youth, 10, 16, 21, 45, 111, 204, 206, 211, 212, 222, 237 Zero tolerance, 238