As I look back on the various clinical and administrative positions I have held in the field of mental health and addiction in my nearly 30 year career, I have always considered my work with children and adolescents to be among the most rewarding. This is one reason why I read a report released in May by Burlington, Vermont-based Let's Grow Kids, entitled "Stalled at the Start: Vermont's Child Care Challenge," with both interest and concern.

The report provides some compelling statics. These include the fact that more than 70 percent of children in Vermont under the age of 6 have all parents in the labor force and thus are likely to need some form of child care. In addition, nearly 50 percent of Vermont infants and toddlers who are likely to need child care have no access to "regulated" early care and learning programs. And last, when you focus entirely on access to "high-quality" programs, 79 percent of Vermont infant and toddlers who are likely to need child care lack access to high-quality, regulated programs.

These statistics point to some fairly obvious conclusions: namely that parents of young children in Vermont who need or want to be in the work force are having a very difficult time balancing career and family, and that lots of children are not receiving adequate care during a very critical time in their overall development. This last point is of critical concern to me as a health care professional.

That's because we know young children who lack consistent, nurturing relationships with adults are at greater risk of suffering from the kind of harmful stress that can cause developmental delays and lead to a variety of health problems (including mental illness and addiction) later in life.


While we can—and do—debate the meaning of the word "quality" when used in the context of child care, I think we can all agree that in this case quality implies the following characteristics: safety, appropriate physical activity, attention to nutrition, supervision and/or support from trained professionals, protection from abuse and neglect, and opportunities for children to learn social and emotional skills.

The reasons why quality is important in child care are numerous. For example, we know from research that about 90 percent of brain development is completed by age 5 and during this period children form between 700 and 1000 new brain connections every second! The take home message here is that healthy brains develop in nurturing environments that allow for cognitive and emotional growth, thus setting the stage for success in the future.

Providing Vermont's youngest citizens with quality child care is the right thing to do on many levels. For example, research shows that every dollar we invest into early childhood programs brings a 7–10 percent return through reduced costs in public education, health care, and the correctional system. We also know that U.S. businesses suffer to the tune of $3 billion annually due to workplace absenteeism attributed to child care issues.

Like others in our state, I await with anticipation a report by the Blue Ribbon Commission on Financing High Quality, Affordable Child Care. Due out in November, it will outline specific strategies and recommendations to support high-quality, affordable child care in Vermont. My hope is that Vermonters will embrace the report and use it as a foundation for real action. I say this as a parent of grown children who benefitted tremendously from their experiences in quality child care programs, and also as CEO of the Brattleboro Retreat who knows firsthand the value to individuals, families, and communities, of preventing psychiatric and addiction problems before they occur.

Louis Josephson is president & CEO of the Brattleboro Retreat. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.