Flourishing From the Start: What Is It and How Can It Be Measured?

Every parent wants their child to flourish, and every community wants its children to thrive. It is not sufficient for children to avoid negative outcomes. Rather, from their earliest years, we should foster positive outcomes for children. Substantial evidence indicates that early investments to foster positive child development can reap large and lasting gains. But in order to implement and sustain policies and programs that help children flourish, we need to accurately define, measure, and then monitor, “flourishing.”

By comparing the available child development research literature with the data currently being collected by health researchers and other practitioners, we have identified important gaps in our definition of flourishing.2 In particular, the field lacks a set of brief, robust, and culturally sensitive measures of “thriving” constructs critical for young children.3 This is also true for measures of the promotive and protective factors that contribute to thriving. Even when measures do exist, there are serious concerns regarding their validity and utility.

We instead recommend these high-priority measures of flourishing be developed:

• Self-regulation: A child’s ability to recognize and control impulses, manage stress and emotions, and exert self-control
• Attachment: A child’s positive relationship to, feelings of safety with, and trust in a parent or caregiver; co-regulation
• Engagement/approaches to learning: Cognitive, emotional, and behavioral engagement; interest, curiosity
• Communication: The child’s ability to verbally and non-verbally express needs, preferences, and emotions, and to listen and respond to the communications of others a Throughout this brief, we use the terms flourishing, thriving, and well-being interchangeably to mean that children are doing well across developmental domains—health, social, emotional, cognitive development, and relationships. Flourishing From the Start: What Is It and How Can It Be Measured? Research Brief 22 In addition, we identify the following high-priority measures of risk and protective factors:
• Positive parenting skills: Authoritative parenting
• Conflict-resolution skills within families: Non-violent strategies to recognize and resolve differences
• Social support for parents: Parents’ abilities to form relationships with other adults

 Community cohesion: Helps parents meet basic needs and form social bonds Together, these measures can be used to set goals, monitor trends, conduct useful research, and evaluate programs and policies related to flourishing. If they are used at the local, state, and national levels, we can monitor trends over time for individual children, for communities, and for the nation. Common metrics also help to grow the knowledge base, and to thereby promote positive health across communities, interventions, and initiatives.

This brief distills key findings and recommendations from two more extensive papers by Child Trends and the Child and Adolescent Health Measurement Initiative (CAHMI) at the Johns Hopkins Bloomberg School of Public Health.4,5 It makes the case for establishing an applied conceptual framework and measurement methods that are feasible for assessing flourishing in a variety of settings and for different purposes, including in social services and child welfare, community-based programs and initiatives, and in health care systems and schools.

Specifically, in this brief we:
• offer a conceptual model for defining and achieving flourishing, or child well-being;
• share the findings of a scan of measures currently available and applied across key constructs reflected in this model, and across a number of maternal and child health initiatives in the United States;
• recommend a small set of critical constructs that, if measured for children up through age 8, would tip the scale toward a more balanced view of children, one that highlights flourishing, as well as promotive and protective factors; and
• recommend next steps and considerations for developing and using measures of flourishing across varied systems of care that address children’s needs, such as health care and child welfare.