December 2, 2013

Improving the health and safety of North Carolina’s children

Kotch’s accessibility contributes to his success, says June Locklear, who until her retirement, headed the regulatory section of the N.C. Division of Child Development.

“He can speak at any level to child-care providers who weren’t college-educated and to those who run facilities of 100 children or more,” Locklear says.

pram_p5Kotch, the Carol Remmer Angle Distinguished Professor of Children’s Environmental Health in the Gillings School’s Department of Maternal and Child Health until his phased retirement in 2013, has placed children first throughout his 40-year career. As founder of the National Training Institute for Child Care Health Consultants, he helped train health practitioners to monitor child-care facilities and mentor child-care providers in the implementation of stringent sanitation and injury-prevention practices. He taught providers to identify maltreatment of a child and recognize early signs of emotional distress and other special needs.

After 16 years of training instructors of child-care health consultants across the U.S., the Institute recently lost federal funding due to sequestration and was forced to close. However, Kotch continues to direct the N.C. Child Care Health and Safety Resource Center (, a similar organization supported by state funds. The center trains North Carolina child-care health consultants and contracts to train providers from other states.

Having made tremendous progress reducing disease and injuries, the resource center now devises ways to incorporate nutrition and physical activity to prevent obesity and address social and emotional health.

“The more we can do for young children,” Kotch says, “the healthier adults we’ll have in North Carolina.”

Kotch launched the Family Friendly Child Care Project, and the Beaufort-Hyde Partnership for Children was one of its pilot sites. Lisa Woolard, the partnership’s executive director, says Kotch always took care of important details. He found medical homes for children and conducted long-term studies that followed children for 20 years to assess the impact of exposure to abuse and neglect upon their health and behavioral outcomes.

The staff members always looked forward to his site visits, she says. Something fascinating would happen when he arrived in his tweed coat and cap.

children.playing_p5“Good golly, he’s a smart man,” Woolard says. “He drives himself to meet his own high standards, and he wants others to be at that high standard, too.”

Locklear remembers Kotch’s using a fluorescent spray, which glowed in the dark upon contact with bacteria, to demonstrate how germs collect on the underside of a table used by children.

He and his staff developed a poster that leads children, step by step, through the hand-washing process, including the words of a song that lasts as long as handwashing should.

“These seem like such little things, but they’re still being used,” Locklear says. Thanks to those auditory and visual reminders, a generation or two of North Carolina’s children are healthier than they might have been.

Tristan Bruner, evaluation coordinator for another Family Friendly Child Care site, the Lenoir-Greene Partnership for Children, points out that the pilot sites were located in out-of-the-way, downtrodden areas of the state.

“The residents here are poor and easy to forget,” Bruner says, “but they were on Dr. Kotch’s mind the most.”

—Nancy E. Oates

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