Preventing The Summer Slide

Summertime provides children a welcome break from the classroom. Summer vacations means fun – playtime with friends, family gatherings, adventure and lazy days.

But when children spend two or more months away from the regular exercise of learning they are at risk of the “summer slide.” Kids not exposed to ongoing summer learning, such as reading and solving math problems, can lose anywhere from one to three months of what they learned in the previous grade. When that happens, children start the next year playing catch up. If they suffer the slide continually in the early years, it creates a potentially life-long problem. We already know that children who are not reading proficiently by third grade tend to stay behind in future grades, and that they are four times less likely to graduate from high school.

The summer slide is especially devastating to children from low-income families.  Summers without academic practice contribute to the big achievement gap that exists between disadvantaged kids (who qualify for free or reduced lunch) and their more advantaged peers.

The good news is, there are many fun and enriching educational experiences parents, families and communities can do to halt the summer slide. We organized a few of our favorite recommendations here for parents of toddlers to second graders.

Read, read, read

Reading is the single most impactful activity for young children in the summer. A summer reading program helps maintain and advance reading and language comprehension from one grade to the next grade.

Recognizing this fact, Governor Bill Lee recently committed $5 million to the Read to be Ready summer camps for rising 1st through 3rd graders as a feature of Tennessee’s efforts to help young kids a strong start.

Schools and local libraries offer reading programs and resources so that children can read grade-level books throughout the summer.  Make it a family effort – with siblings, parents and relatives devoting regular time to reading and reading aloud to young children.

Numerous free options abound. Dolly Parton’s Imagination Library sends a free, grade-appropriate book every month to children from birth to age 5.  Several websites offer free, online PDFs of children’s books and bookstores such as Barnes & Noble provide children with free books as part of sponsored summer reading programs.

Embrace family time

Visit one of Tennessee’s many public libraries or museums as a family. Challenge your child to think about what they learned from the experience by describing interesting details of what they learned or what they still want to know.  Ask them questions that stretch their thinking, such as “Why do you think that?” or “What would happen if…?”

Cook together and have the children reference the recipes and make shopping lists using their creativity and emerging writing skills, even if they are only able to draw pictures and “scribble”.  Each one of these early steps prepares them for writing in school.

While at the grocery, challenge your children to find items on the shelves by looking for the first letter in the title or a picture of the item.  Ask children to guess how many pasta shells are in a box or ask them questions about what they notice – like the cold and warms parts of stores. Shopping can be one of the most enriching learning activities for young children!

Whatever you do, make it fun and interactive.  Your child will enjoy new adventures, especially if they are with the people they love most in this world – their parents and families.

Encourage play

Although it might be hard during the long summer days, families can halt the summer slide by limiting screen time. Replace it with activities such as an art project, a nature scavenger hunt or free play outside with peers. 

Encourage your kids to play consistently and often with other children.  Oral language between children of similar and different ages contributes significantly to their reading comprehension and vocabulary, as well as their social-emotional skills – all of which will prepare them for the grade that lies ahead in the fall.

Children’s Mental Health #1 Concern of Teachers

“Without question, it’s the No. 1 piece of feedback I heard from every single group,” [Tennessee Department of Education Commissioner] Penny Schwinn told Chalkbeat this week. “There is a growing concern about how we can support our children, not only academically but also behaviorally.”

What Commissioner Schwinn heard most on her statewide listening tour, which will heavily influence the department’s new strategic plan, was teachers’ concerns about students’ mental health. While distressing to hear that mental health was the most frequent feedback, at TQEE we are grateful teachers are pulling this critical issue out of the shadows – and that the department is listening.

An approach to education that prioritizes excellent teaching, high-quality curriculum and rigorous standards is essential for Tennessee students to be prepared for life after their formal education has ended, but children will struggle to achieve academically if saddled with anxiety, depression, trauma or other mental health challenges. As the Commissioner and her team finalize the strategic plan, we encourage three essential priorities to address mental health issues in our elementary schools:

  1. Prioritize social and emotional learning;
  2. Invest in trauma informed schools; and
  3. Strengthen home-school connections.

Social and Emotional Learning (“SEL”)

SEL helps students make friends, care for others, resolve conflicts, handle emotions appropriately, and stay focused on a task -– the very skills they will need to be successful on the job later in life. Without these critical SEL skills children become isolated, angry and depressed, preventing them from learning and thriving.  

Trauma-Informed Schools

When children enter school having experienced trauma in their young lives, teachers, school staff and leaders must be equipped and supported with tools and strategies to respond with care and mitigate stress. Trauma-Informed Schools provide increased access to behavioral and mental health services, an increased feeling of physical, social, and emotional safety among students, and positive and culturally responsive discipline policies and practices that increase school connectedness. In 2017, Governor Haslam initiated the Building Strong Brains Innovation Grants – a pilot program to assist school teachers, staff and leaders in creating a trauma-informed culture. Tennessee should continue and expand these grants with a goal that every school has a trauma-informed culture.

Strengthen Home-School Connections

Parent and family engagement is not only about asking parents to volunteer or attend school events. When children present with trauma or troubling behaviors, the best problem-solving approach is to engage the adults closest to that child – their parents/caregivers and teachers – to collaborate on ways to get to the root of the issue and support each other through multi-step solutions. Absenteeism, bullying, and discipline issues are most effectively addressed via a holistic approach that brings adults at home and adults at school together to strengthen the development and growth of the child, propelling the child into a safe and productive space for learning.

Evidence of High-Quality Pre-k Value Grows

The evidence of the value of high-quality pre-k has always far exceeded reports that pre-k is not effective. That trend continues with the release of a study by Nobel Prize-winning economist, James Heckman, detailing the benefits of high-quality pre-k that extend into adulthood. And because high-quality is essential to sustained pre-k benefits, Tennessee’s Voluntary Pre-k program is continuing to improve and school districts, both urban and rural, are adding pre-k classrooms. Below, you can take a look at the Heckman study and the state preschool report from the National Institute for Early Education Research (NIEER).

Columbia Daily Herald: State Funds Add 2 Pre-k Classrooms in Maury

www.heckmanequation.org: Perry Preschool FAQs

www.nieer.org: State Preschool Yearbooks 2018

TQEE Statement on Voluntary Pre-k Funding Awards

“High quality pre-k works – students who are enrolled in quality programs have a measurable advantage over their peers who do not attend pre-k.  The 2016 reforms approved by the Tennessee General Assembly, including the introduction of competitive grants for VPK funding, elevated quality standards across the state for truer consistency of quality.  Tennessee should continue to demand that pre-k programs receiving state investment meet the highest quality standards. The next step is to expand pre-k access for all disadvantaged Tennessee 4-year-olds and commit to a program of higher quality in grades K-3 so that pre-k gains are sustained through 3rd grade.

The fact that almost two-thirds of Tennessee school students are not proficient in English or math in third grade underscores an urgent need for change and a focus on improving early education from birth to third grade. We must be fully committed to improving the quality of children’s early learning as a fundamental strategy to improving Tennessee’ entire public education system.

That’s a policy direction and investment that Tennesseans stand behind, according to a statewide survey conducted for TQEE in fall 2018. Eighty-six percent believe that early grades form the building blocks for all learning, and 94 percent support expansion of pre-k to all 4-year-old Tennesseans.”

TN Voluntary Pre-k Makes Quality Strides

With recent news that the State of Tennessee Department of Education (TNDOE) has granted funding for Voluntary Pre-K (VPK) classrooms in 138 school districts, it’s important to underscore that investment in high quality Pre-K is vital if Tennessee is going to improve our public schools.

The immediate priority is to improve the percentage of third grade students reading on grade-level from 34 percent in 2016 to 75 percent by 2025 – a fundamental goal of the TNDOE’s strategic plan, Tennessee Succeeds.

Pre-K plays a central role in improving third grade achievement for all students, and especially underserved groups of children, including children from economically disadvantaged backgrounds and those with special needs. Students who fall behind in the early years rarely catch up in later grades when remediation efforts are costlier and less likely to succeed, which is why a strong foundation of early education is an imperative.

In Pre-K – as in all grades – quality in teaching and curriculum is essential. And quality has been a big focus of Tennesseans for Quality Early Education (TQEE) and other statewide advocates for a stronger system of early education.

In 2016, the Tennessee General Assembly approved the Pre-K Quality Act, which for the first time since Tennessee premiered Pre-K in 2005, defined program quality, standards and student performance measures.  An added boost emerged from the Gates Foundation through a partnership with the Ounce of Prevention Fund and Alliance for Early Success, titled the Partnership for Pre-K Improvement (PPI).  Tennessee was one four states chosen in 2016 to participate in the PPI national cohort of states leading the charge to make pre-k high quality and impactful.

The confluence of these efforts has resulted in numerous positive changes to the state’s Pre-K program, including those outlined below.

  • Pre-k quality has been defined. For the first time since the VPK program was founded, Pre-K quality has been defined in a clear, coherent and evidenced-based definition. All Pre-K improvement efforts are aligned to the new definition to ensure consistency in quality.
  • Pre-K, K, and 1st through 3rd grade standards have been revised. TN’s K-12 Academic Standards and Early Learning Developmental Standards have been revised and aligned in English Language Arts and Math. Standards were implemented in 2017-18.
  • Pre-K funding is dependent on demonstrated progress towards high quality. Prior to 2016, districts received VPK funds based on formulas largely unchanged since VPK’s founding a decade prior. In 2016-17, TNDOE instituted a competitive grant process aligned to quality benchmarks. The grant application set a high bar for programs to meet to ensure their programs are funded.

The VPK competitive grant application and process have been continuously improved each year, based on district feedback and data, and in 2018-19 the department experienced the most successful grant administration to date.

  • Pre-K and kindergarten teachers now have a way to monitor student learning. In 2017-18, TNDOE instituted a new pre-k and kindergarten student growth portfolio model that helps teachers track and monitor student learning aligned to priority literacy and math standards.
  • New curriculum has been adopted. The TNDOE reduced the number of state-approved Pre-K curricula from 37 options to only 3 evidenced-based, high-quality curricula. The department invested in training and materials for VPK districts to implement the new high-quality curricula in 2018-19. The department is piloting a coaching initiative in 2019-20 to further supports districts in quality curriculum implementation.
  • Data is being collected on the efficacy of VPK classrooms. For the first time since the VPK program was scaled in 2008-9, and was evaluated by Vanderbilt in 2009-10, statewide data has been collected using the CLASS tool to provide a baseline measure to assess quality improvement efforts, including instructional quality and teacher-student interactions.

Ensuring access and quality for students in pre-k programs statewide is challenging. To build on the success of the initiatives outlined above, it is important for Tennessee to prioritize early learning and further focus Pre-K improvement efforts, particularly in the following areas:

  • Data collection. To continuously assess progress of the state’s Pre-K improvement efforts, the department will need to collect data from CLASS, ECERS or other tools. Key to continued success is selection of the right metrics aligned to the department’s definition of quality, adequate resources dedicated to data collection and analysis, and successful implementation of assessment.
  • Funding that reflects the cost of quality. The amount of VPK funding a district receives per classroom has not changed in a decade, despite increases in teacher salaries and other programming costs, leaving districts to make up for any resulting shortfall of funds if they choose to maintain and/or expand their capacity. Additional investment in the VPK program should factor in the actual cost of quality per classroom, based on the state’s definition of quality and the actual costs to maintain a quality program.
  • Professional development and monitoring. Currently, there is one administrator at the department to lead, manage, monitor, and assess Tennessee’s VPK program statewide. Successful Pre-K programs in benchmark states that have seen long-term positive impact ensure adequate resources are provided to support and monitor district pre-k programs. To build district capacity to effectively support teachers, focus should be placed on targeted professional learning and monitoring for districts.
  • A systems approach to access. Demand is high in many regions for quality Pre-K programs, and Tennessee families overwhelmingly want more access for all children, but expansion is a challenge due to state budget constraints, quality issues that must be problem-solved, and the potential negative impact of Pre-K expansion on child care in Tennessee. To ensure access and quality, Tennessee must develop a systems-approach to Pre-K, potentially including blended funding, coordinated enrollment through multiple providers, and better alignment between the policies, governance structure and practices of the department of education and department of human services, which leads and manages child care in the state.

Legislative Support Signals Commitment to Improve Tennessee early education

Early education advocates across Tennessee are cheering results of the 2019 Tennessee legislative session that include a slate of approved policy proposals aimed at boosting learning prior to third grade as a strategy to improve Tennessee’s public education system.

Highlights include a new pilot to create a network of early grades literacy and math coaches to help teachers in the state’s lowest performing schools, an increase in funding for evidence-based home visiting (EBHV) programs, and ongoing funding and more robust training and improvements for Pre-K and kindergarten teachers who use the portfolio model to measure academic growth. And the Tennessee General Assembly formed a bipartisan House and Senate caucus to provide exclusive focus on early education policy.

Altogether, approval of these policies delivers a successful outcome to an agenda of the state’s leading early education advocates, said Mike Carpenter, executive director of Tennesseans for Quality Early Education (TQEE).

“This was a very successful legislative session for our youngest students and an indication that Tennessee is committed to building a stronger early education system,” Carpenter said. “All Tennesseans want better education outcomes. The policies supported by the General Assembly and Lee administration move Tennessee in the right direction of building a more robust system of quality education for children from birth to third grade and to accelerate progress that helps Tennessee kids get a smart start in life.  This legislative session was a necessary step to address the unacceptable condition of our student’s proficiency scores and begin to build a foundation that produces better outcomes.”

While in the past decade Tennessee made strides as one of the most improved states in education outcomes, it still ranks in the bottom half of all states. Most Tennessee students in grades 3-12 are not proficient in math or English; by the third grade, most Tennessee students are behind and remain there.

TQEE was formed to address poor proficiency and advocate for strong early education programs that can help students get a strong start that ensures they are proficient before they enter third grade. TQEE achieved success on its 2019 policy agenda, which included the coaching pilot program, maintaining the state’s commitment to voluntary Pre-K and EBHV programs.

Governor Bill Lee’s administration increased financial support to create a coaching pilot to support early grades teachers in low performing schools and the General Assembly provided additional funding to support EBHV programs that help connect parents with community resources to assist parenting, health, development and learning of their young children.

Creation of the coaching pilot is a strategic approach to provide early grades teachers with greater support as the state works toward a goal to increase the percentage of third graders who are reading, writing and doing math on grade level from about 37 percent today to 75 percent by 2025. Embedding instructional coaches in schools to support teachers is proven to be a successful tool to improve teaching and student outcomes.

EBHV is a nationally proven programming that is successfully applied in many Tennessee communities to assist young parents, improve their parenting skills, reduce abuse and neglect, improve health of babies and ready children for learning. Studies demonstrate that EBHV has an impressive $5.70 return for every $1 of public investment through reduction of costs for remedial education, public financial support, criminal justice and other societal impacts. “TQEE thanks Governor Lee, Education Commissioner Penny Schwinn, Senate Education Chairman Dolores Gresham, House Education Chairman White, Senator Steve Dickerson and Representative Bill Dunn, and the legislature for supporting strong early education,” Carpenter said.

The Art of Appreciating Special Teachers

High quality teachers impact lives. We see it everywhere from the most advanced academic studies all the way down to the look on a child’s face when that child begins to learn.

May 6-10 is Teacher Appreciation Week and something we always need to remember is that teachers should feel valued for all of the ways they are a positive force in a kid’s life.

How do you do appreciate your child’s teacher? We all know teachers need supplies and funds for special projects, but sometimes an expensive gift isn’t necessary to show you care. The best gifts of appreciation often come from children themselves.  

One great way to involve your child in teacher appreciation is to help your child write a thank you note to the teacher, something that can be done at home. For kids who already have writing skills, it can be great practice in showing motor and language ability. And for preschoolers, dictating a note with parents helps literacy by representing sounds and symbols in a written form. Children love to illustrate too!

Writing a note and teaching appreciation helps a child learn to focus on the needs, perceptions, and ideas of others. Parents and caregivers can establish gratitude as a fundamental behavior in their children’s lives that will provide a fully enriching, lasting impact.

According to the Harvard University Healthbeat, “Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and built strong relationships. For young children, gratitude is expressed in consistently saying ‘thank you’ to others, making thank you cards, and identifying things that make them feel thankful, such as a favorite toy or a visit from grandma.

Another way parents and their children could show appreciation is through a creative project that can express thee same sentiment as a thank you note while also stimulating a child’s imagination. Talk with them about the things they like about their teacher and then channel it into a something a child can make: a picture, an art project, a craft, a necklace or beads, a sculpture with clay or play-doh, or a jar of their favorite things. The more heartfelt it is, the greater your teacher will appreciate it.

Lots of in-school ideas can have an impact as well. It could be something as simple as working with the principal to organize an applause parade in hallways as teachers head to their classrooms. Decorations can be effective, whether it’s a bulletin board or a classroom door. Or even just giving them some free time with a coupon for covering their responsibilities in the drop-off/pickup line. The national Parent Teacher Organization website has a number of themed ideas, too.

Teachers spend their days in some of the most important work possible — developing our kids. It’s important for them to understand how much parents and kids appreciate all of their hard work.

Home Visiting’s Powerful Human Stories

Take a step back from the compelling financial return on investment of evidence-based home visiting (EBHV) policy to study the true impact of this vital program through the lives of Tennessee children.

While home visiting boasts a remarkable $5.70 positive return for every $1 investment, it’s most powerful performance measure is best viewed via the experiences of thousands of Tennessee children around the state whose lives – and futures – are improved.

Home visiting is a voluntary program that works by deploying professionals to visit families in their homes to coach parents on how to support their child’s healthy development as well as offer connections to additional community resources and services to meet their child’s health, developmental and learning needs.

This evidence-based solution has repeatedly proven to strengthen bonding between mothers and infants, improve parenting skills, reduce abuse and neglect, improve health of parents and babies, and ready children for their school years.

The experiences told by Hunter and his mother Tyne in Nashville, and Itzel, Carlos and Alia in Nashville, and, through a terrific report in The Commercial Appeal by Jennifer Pignolet, the story of Shante and Ja’Mykal in Shelby County, illustrate the amazing impact of home visiting. Their stories demonstrate the real bottom line – home visiting works. By voluntarily accessing local community home visiting resources, parents are placing their children on a path to life-long success.

The preservation and expansion of these vital programs is essential for Tennessee’s most vulnerable children and families, but there are still far too many families with no access to help. At the current level of funding, Tennessee can provide home visiting services to only 1.7% of the children who would qualify for services. And of the 95 counties in Tennessee, 45 counties have no home visiting services at all.

These are the stories that go beyond ROI:

Sometimes a picture says a lot.

Hunter is building a tower out of colored blocks with his mom and his friend Tevri at home. It’s a photo that was years in the making, in part because of his involvement in one of Prevent Child Abuse Tennessee’s most successful development programs.  The “I did it” badge he’s wearing reflects the confidence and accomplishment Hunter has experienced through his family’s participation in the program.

After she became pregnant, Hunter’s mother Tyne was referred by a friend to Healthy Families Tennessee, a home visiting program that provides weekly support for parents from pregnancy through when their child enters kindergarten. That’s how she met Tevri, a PCAT visitor.

“[Tevri] would just come once a week and she would go over where I should be at in my stage of pregnancy and just help me get ready for the baby,” Tyne says. “And then after Hunter was born, she would still come by on a weekly basis and teach me about his milestones.”

As Hunter got older, Tevri would mark his progress on everything from word acquisition to motor skills, often working with Hunter outside, drawing shapes with sidewalk chalk and mastering colors. The program provides what Tyne calls a “full spectrum,” helping her son master everything from letters and numbers, to recognizing emotions, to how to deal with them effectively.

Read the rest of the story here.

Itzel is protective of her mother today, forgiving her with words even though she didn’t have the easiest childhood.

“My mom didn’t know any better and she definitely didn’t have anyone to turn to,” she says.

Itzel’s mother called her names and made her daughter feel unwanted and unloved. It’s tough to grow up strong when you are neglected and told that you are a burden.

As a young adult, Itzel found support four years ago at a community baby shower on the Tennessee State University campus. Newly pregnant and “completely scared,” she learned about Healthy Families, an evidence-based home visitation (EBHV) program from Prevent Child Abuse Tennessee (PCAT) designed to support parents from pregnancy through kindergarten.

Determined to be a better mother than her own, Itzel was attracted to an opportunity through Healthy Families to obtain strong parenting skills and to make certain her daughter has a bright future.

Read the rest of this story.

Starting at home: visitation programs seek to aid vulnerable children in Shelby County

By Jennifer Pignolet, The Commercial Appeal, October 11, 2018

After three years, Cassandra Ruffin knows the first rule of visiting the Dennard family.”You cannot come into this home with only one book,” Ruffin said. 

So although she’s there specifically to check in on 3-year-old Ja’Mykal, she arrives at the Oakhaven town home with a bag of children’s books for the boy and his two older siblings. 

The three children sit on the edge of a tan couch and the carpeted living room floor, tearing into a picture book about a bumpy pumpkin and a Disney-themed alphabet paperback. Their mother, 33-year-old medical assistant Shante Dennard, helps Ja’Mykal turn the pages and reads aloud to him. 

It’s that interaction that Ruffin wants to see between Dennard and her children. 

Ruffin is a parent educator with Porter-Leath, an early childhood organization in Shelby

County. She’s known the Dennard family since before Ja’Mykal was born. 

The family is part of a bi-weekly home visitation program called Parents As Teachers that provides social services and support to about 300 clients with young children, all done out of the client’s home. Many families, but not all in the program, live below the poverty line.

Read the rest of the story.

Early Home Visiting Programs: Compassionate and Cost-Effective Policy

Backed by compelling data and amazing personal success stories, Tennessee Senator Steve Dickerson and Speaker Pro Tempore Bill Dunn are advancing an important solution to help parents develop the skills they need to give their young children a great start in life: increasing the state’s investment in voluntary, evidenced-based home visiting.

Home visiting professionals visit families in their homes to coach parents on how to support their child’s healthy development, as well as offer connections to additional community resources and services to meet their child’s health, developmental and learning needs.

This evidence-based solution has repeatedly proven to strengthen bonding between mothers and infants, improve parenting skills, reduce abuse and neglect, improve health of parents and babies, and ready children for their school years.

“In short, voluntary home visiting programs change lives,” Kristen Rector, CEO of Prevent Child Abuse Tennessee (PCAT), recently stated. “We know that parents are their child’s first teacher and home visiting empowers parents to be the best they can be.”

PCAT, through its Nurturing Parenting and Healthy Families Tennessee, is the largest provider of voluntary evidence-based home visiting in the state.

“Of the children and families who benefit from the program, 98 percent show improvement in key areas, ranging from health to school readiness,” Rector said. “And with the proper nurturing in these early, formative years, children are better set up for success later in life. It’s even been linked to improvements in children’s behavior, cognitive development, performance in school and graduation rates.”

There is also considerable evidence that home visiting generates strong ROI: investments in home visiting programs reduce negative societal impacts immediately and in the long run. That transformation saves taxpayers substantial money by providing a return on investment of up to $5.70 for every $1 invested through reducing costs associated with child abuse, poor health and academic failure, and a corresponding increase in economic self-sufficiency.

The positive impact of home visiting is clear but Tennessee’s challenge is the need, which far outweighs what is currently available. Tennessee is home to 118,580 children younger than 5 who live in poverty, which often creates conditions leading to toxic stress and childhood trauma. At the current level of funding, Tennessee is only able to provide home visiting services to less than 2 percent of those children. And of the 95 counties in Tennessee, 45 have no home visiting services at all.

Dickerson, Dunn, Representative Gary Hicks and Representative Ryan Williams are among the legislative champions of investments in evidence-based home visiting programs (EBHV).  Tennesseans for Quality Early Education applauds legislative leadership on this vital effort and urges the Tennessee General Assembly to support their request for an additional investment of $1.5 million in home visiting this budget year.

The reasons are clear: Home visiting works. It is vital to the health and well-being of children, families, and communities. And it is enormously popular in Tennessee with a 70 percent approval rating among voters, according to a TQEE survey conducted in 2018.

The benefits of home visiting far outlast and outweigh the investments, as evidenced improvements in maternal, newborn and child health, reductions in child abuse and neglect; improved parent-child bonding; and improvements in children’s school readiness. 

These are exactly the powerful outcomes Tennesseans want – and deserve – from public investments.

More about Home Visiting

You have probably noticed we talk a lot about home visiting. That’s because it works! Unfortunately, even though the evidence continues to show the benefits of evidence-based home visiting, less than 2% of eligible Tennessee children have access. Put another way, of Tennessee’s 95 counties 45 do not have any type of home visiting program.

Here are few more resources supporting home visiting. Take a look and become a voice in support.

Why Evidenced-Based Home Visiting and ACEs Training for Early Childhood Workers Matters

The Research Case for Home Visiting

5 Things to Know About Early Childhood Home Visiting

Evidence-Based Home Visiting in Tennessee

Proven Results

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