Help for Children, Families Must Start Before Birth : Poverty: The most successful programs also encourage self-reliance and social responsibility, and they follow through. But these are few.

The declining fortunes of America’s children are starkly visible to all of us. But for every social problem that causes children to suffer, someone has developed a preventive or healing technique somewhere. The most promising efforts start before birth, with prenatal care, and follow through as a child learns to crawl, toddle and run. They can’t replace parental love but can support parents struggling to raise their young.

Two programs stand out as models: The Comprehensive Child Development Program, a federal demonstration project in 24 sites nationally, and the Center for Family Life, a community program in Brooklyn, N.Y. They reflect different approaches--public and private--for distinct communities.

The Comprehensive Child Development Program builds on the well-known successes--and the less well-known failures--of Head Start. Head Start is an effective preschool education program, but it reaches only about one-quarter of the children who need it. “Head Start is too late for many children”--notably those whose problems begin before birth, says Dr. Toni Linder, a child-development researcher at the University of Denver.

The five-year, $125-million comprehensive program begins before birth and continues through preschool, helping both children and their parents develop basic skills. Recognizing that the common failing of federal programs is their central planning and bureaucratic inflexibility, each site designs its own means of delivering services.

In a Seattle-area site, the comprehensive Families First program is focused on preventing teen-age mothers from being permanently trapped in poverty and dependent on welfare. Every year, half a million babies are born to teen-age mothers ill-prepared to raise them. In this statistical group, the fastest-growing segment is white. Meet Cheryl, who is typical:

Pregnant at 16, Cheryl moved from the Seattle area to Olympia, Wash., where she lived with a couple who take in unwed mothers-to-be. She enrolled in a special high school teen-pregnancy program, learning how to take care of herself and a newborn. When she returned to her parents’ home with a healthy baby, Kayla, they came to love their grandchild.

The baby’s teen-age father had vanished, and Cheryl faced a bleak future of welfare dependency as a single mother. Families First challenged Cheryl to create a plan, then it helped her achieve each goal: She got her own apartment, found good child care and completed two years of college. Cheryl, who is now on the board of directors of Families First, is working toward a degree as a probation officer.

“Families First helped me become independent--that’s the best thing,” Cheryl says. “If there were more programs like these, there would be fewer dependent people.”

Families First’s annual budget of $1.3 million amounts to about $15,000 per family. (By contrast, that is less than the average cost of two weeks in intensive care for a baby who is born premature because of prenatal neglect.) Reducing government dependency is a prime objective. Most of the parents in the program are now employed or in job training, in college or working on high-school equivalency.

Across the country, the nonprofit Center for Family Life has become the hub of the Sunset Park neighborhood of Brooklyn.

In 1978, the center’s founders, two Roman Catholic nuns, drew an invisible circle around the community of 100,000 and began after-school programs to help working families. The center now provides full-time child care, before- and after-school programs, counseling, food, health, foster care and employment services.

All of the center’s programs are available, free of charge, to anyone who lives in the neighborhood. Funding for its $2-million budget comes largely from private donations. The whole community gets involved: Parents volunteer in child care; older children help nurture younger kids in youth groups. Gang activity has dropped dramatically.

Radiating from the Center for Family Life is hope--not the easy hope that a magic formula will solve all problems, but the hard hope that with tenacity, inventiveness, discipline and a great deal of love, children’s lives can be bettered.

The federal Comprehensive Child Development Program and the Center for Family Life share basic tenets: They help children and families; they encourage self-reliance and social responsibility; they begin early and follow through.

As hopeful as these programs are, their number is few in comparison to the millions of American children growing up trapped in toxic cocoons of poverty.

The steps we take to help people grow and to support families will determine whether this nation has a secure future or prematurely declines. America’s development is predicated on child development.