Measuring Up

Early ChildhoodMar 15 2022

The Measuring Up project works to identify promotive and protective factors (circumstances) that help children develop optimally and equitably. The project focuses on identifying these factors for the prenatal period (before birth) through age 2. We also identify risk factors that can prevent very young children’s optimal development. In addition, we identify policies and programs that support optimal development for kids. Child Trends is partnering on this work with several other organizations: the National Center on Birth Defects and Developmental Disabilities (NCBDDD) at the Centers for Disease Control and Prevention (CDC), the Georgia Department of Public Health (GA-DPH), the U.S. Health Resources and Services Administration (HRSA), and the Marcus Autism Center (MAC). This group of partners is referred to as “the Collaborative.”

Measuring up logo

The ultimate goal of the Measuring Up project is to help policymakers, researchers, and other individuals and organizations with an interest in early childhood development assess strengths and areas for improvement for key policies, programs, and practices that affect the well-being of children in the prenatal, infant, and toddler stages of development.

Key Findings from the Measuring Up Project

  • Existing measures of infant and toddler well-being focus heavily on the child’s physical health, and little attention is given to their cognitive (i.e., brain) and social-emotional-behavioral health.
  • Many existing indicators come from one of three data collection systems supported by the U.S. Department of Health and Human Services (HHS): the National Immunization Survey (NIS), the National Survey of Children’s Health (NSCH), and the National Vital Statistics System (NVSS).
  • Most indicators focus on contextual, or environmental, influences on a child’s development (for example, health care settings and family and caregiver environments) rather than on the actual outcomes (i.e., results) experienced by that child.
  • Indicators that examine outcomes for individual children frequently focus on the absence of positive development (in other words, problems or delays in development) rather than the presence of positive development.
  • Data sources generally do not collect enough data to allow useful breakdowns of findings by race and ethnicity at state or local levels. This means that data do not consistently report how outcomes may be different for children of different races and ethnicities. This drawback prevents decision makers from understanding whether specific programs and policies benefit all groups of children.
  • State-level implementation of key federal policies (e.g., the Earned Income Tax Credit, or EITC; and Temporary Assistance for Needy Families, or TANF) varies widely and data connecting implementation features to intended outcomes are scarce.

Conceptual Model


Project Status

To date, we have completed steps #1 and #2 and are in the process of completing steps #3 and #4. Specifically, the project has accomplished the following: identified risk factors and protective or promotive factors that are associated with important child development outcomes; developed partnerships with other organizations (e.g., the Prenatal to Three Policy Impact Center and the Zero to Three State of Babies Yearbook team); consulted with experts on child development; and identified state-level data on policies and child outcomes to use in a rigorous multivariate analysis (i.e., a statistical way of measuring what does and doesn’t work).

Analyses are currently underway to examine whether certain policy characteristics might have some influence on child maltreatment rates—in other words, which types of policies most help families avoid child maltreatment. This work includes a difference-in-difference multivariate analysis examining the various ways states are implementing the focal policies and how these policies are associated with substantiated child maltreatment reports, net of other state characteristics.

These analyses will serve as a blueprint for future work focused on additional key outcomes associated with child well-being. Results and recommendations will be shared (step #4) with state and national policymakers, and other individuals and organizations with an interest in better understanding how to improve early outcomes for children. We also hope to replicate the analytic model—meaning, re-create our approach to studying child maltreatment—to help us learn more about other important child well-being outcomes.

What’s new

In 2023, we are beginning a new project: Measuring Up2: Examining Policy Factors Related to Prevalence of Infant-Toddler Development Delay. This work will examine risk and protective factors associated with developmental delay, as well as specific policies, programs, and practices that exist to prevent or address developmental delay. Specifically, the Collaborative will explore state variability in referrals, screenings, and service uptake among children experiencing developmental delay, hoping to discover how to promote maximum positive development among children who do not meet developmental milestones. More specifically, we aim to identify systemic or programmatic achievements that may mitigate racial and ethnic inequities related to identifying and serving all children experiencing developmental delay. Our ultimate goal is to identify states that have successfully made connections with or between policies, programs, or practices—with evidence of effects on the prevalence of positive developmental outcomes for very young children—and amplify their strategies for others to replicate.


Measuring Up Project Executive Summary and Call to Action

This brief describes the need for more comprehensive data that describe children’s overall health—including their cognitive and social-emotional-behavioral development—to better support infants and toddlers, as well as their families, service providers, and policymakers working to foster their development. We provide recommendations for improving federal data collection efforts.

Suggested citation: Darling, K. & Ryberg, R. (2022). Better Data Needed for Monitoring and Promoting Infant and Toddler Well-Being. Child Trends. Available at:

Measuring state-level infant and toddler well-being in the United States: Gaps in data lead to gaps in understanding

In this peer-reviewed, open-access paper, we review currently available indicators of well-being from the prenatal period to age 3. Most of the child-level indicators identified were in the physical health domain; relatively fewer were found in the early cognition and language or social-emotional-behavioral domains. While some states are making progress toward developing integrated early childhood data systems, more work is needed to provide robust data on infant and toddler development. These results highlight the need to develop a broader range of indicators of infant and toddler well-being and improve measurement sources to better inform policies and programs that advance population health.

Suggested citation: Ryberg, R., Wiggins, L., Daily, S., Moore, K. A., Piña, G., & Klin, A. (2022). Measuring state-level infant and toddler well-being in the United : Gaps in data lead to gaps in understanding. Child Indicators Research. Available at:

Identifying the Effectiveness of Policies That May Prevent Child Maltreatment Among Infants and Toddlers 

This brief summarizes the policy scan conducted to identify policies theorized to help reduce child maltreatment rates for children from birth through age 2. We also noted gaps in the existing research and data sources that, if addressed, could lead to improved policy implementation and research. Recommendations include (1) strengthening existing or enacting new policies based on evidence of what drives reductions in child maltreatment; (2) establishing or improving accountability requirements around child maltreatment-related data collection, review, and publication; and (3) conducting additional rigorous research to identify associations between policy characteristics, implementation, and child well-being outcomes.

Abdi, F. M., Piña, G., Darling, K.E., & Moore, K. A. (2023). Identifying the effectiveness of policies that may prevent child maltreatment among infants and toddlers. Child Trends.

Measuring Up Collaborative Members and Funders

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