The average age of diagnosis is now around 4 years, but the goal is to get it well under 2, she said. And children who are at higher risk — for example, those whose siblings have A.S.D. — should receive especially close screening and attention.

Since the waits can be long at specialty clinics, the authors of the report hope to see more general pediatricians and primary care providers working with families, even while they are waiting for a full evaluation, referring young children to early intervention or to special preschool programs, so that treatment can begin.

Most people think of Rosa Parks as the first person to refuse to give up their seat on a bus in Montgomery, Alabama. There were actually several women who came before her; one of whom was Claudette Colvin.

It was March 2, 1955, when the fifteen-year-old schoolgirl refused to move to the back of the bus, nine months before Rosa Parks’ stand that launched the Montgomery bus boycott. Claudette had been studying Black leaders like Harriet Tubman in her segregated school, those conversations had led to discussions around the current day Jim Crow laws they were all experiencing. When the bus driver ordered Claudette to get up, she refused, “It felt like Sojourner Truth was on one side pushing me down, and Harriet Tubman was on the other side of me pushing me down. I couldn’t get up.”

Claudette Colvin’s stand didn’t stop there. Arrested and thrown in jail, she was one of four women who challenged the segregation law in court. If Browder v. Gayle became the court case that successfully overturned bus segregation laws in both Montgomery and Alabama, why has Claudette’s story been largely forgotten? At the time, the NAACP and other Black organizations felt Rosa Parks made a better icon for the movement than a teenager. As an adult with the right look, Rosa Parks was also the secretary of the NAACP, and was both well-known and respected – people would associate her with the middle class and that would attract support for the cause. But the struggle to end segregation was often fought by young people, more than half of which were women.

Martin Luther King Jr. improvised the most iconic part of his “I Have a Dream Speech.”

On Wednesday, August 28, 1963, 250,000 Americans united at the Lincoln Memorial for the final speech of the March on Washington. As Martin Luther King Jr. stood at the podium, he eventually pushed his notes aside.

The night before the march, Dr. King began working on his speech with a small group of advisers in the lobby of the Willard Hotel. The original speech was more political and less historic, according to Clarence B. Jones, and it did not include any reference to dreams. After delivering the now famous line, “we are not satisfied, and we will not be satisfied until justice rolls down like waters and righteousness like a mighty stream,” Dr. King transformed his speech into a sermon.

Onstage near Dr. King, singer Mahalia Jackson reportedly kept saying, “Tell ‘em about the dream, Martin,” and while no one will know if he heard her, it could likely have been the inspiration he needed. Dr. King then continued, “Even though we face the difficulties of today and tomorrow, I still have a dream. It is a dream deeply rooted in the American dream….” And then the famous Baptist preacher preached on, adding repetition and outlining the specifics of his dream. And while this improvised speech given on that hot August day in 1963 was not considered a universal success immediately, it is now recognized as one of the greatest speeches in American history. For more information on the 1963 March on Washington, visit pbs.org/marchonwashington.

Inoculation was introduced to America by a slave.

Few details are known about the birth of Onesimus, but it is assumed he was born in Africa in the late seventeenth century before eventually landing in Boston. One of a thousand people of African descent living in the Massachusetts colony, Onesimus was a gift to the Puritan church minister Cotton Mather from his congregation in 1706.

Onesimus told Mather about the centuries old tradition of inoculation practiced in Africa. By extracting the material from an infected person and scratching it into the skin of an uninfected person, you could deliberately introduce smallpox to the healthy individual making them immune. Considered extremely dangerous at the time, Cotton Mather convinced Dr. Zabdiel Boylston to experiment with the procedure when a smallpox epidemic hit Boston in 1721 and over 240 people were inoculated. Opposed politically, religiously and medically in the United States and abroad, public reaction to the experiment put Mather and Boylston’s lives in danger despite records indicating that only 2% of patients requesting inoculation died compared to the 15% of people not inoculated who contracted smallpox.

Onesimus’ traditional African practice was used to inoculate American soldiers during the Revolutionary War and introduced the concept of inoculation to the United States.

The earliest recorded protest against slavery was by the Quakers in 1688.

Quakers, also known as “The Society of Friends,” have a long history of abolition. But it was four Pennsylvania Friends from Germantown who wrote the initial protest in the 17^th century. They saw the slave trade as a grave injustice against their fellow man and used the Golden Rule to argue against such inhumane treatment; regardless of skin color, “we should do unto others as we would have done onto ourselves.” In their protest they stated, “Pray, what thing in the world can be done worse towards us, then if men should robb or steal us away, & sell us for slaves to strange Countries, separating housband from their wife and children….”

Their protest against slavery and human trafficking was presented at a “Monthly Meeting at Dublin” in Philadelphia. The Dublin Monthly Meeting reviewed the protest but sent it to the Quarterly Meeting, feeling it to be too serious an issue for their own meeting to decide. The four Friends continued their efforts and presented at the Philadelphia Yearly Meeting, but it wasn’t until 88 years later that the Society of Friends officially denounced slavery.

Over the centuries, this rare document has been considered lost twice. Most recently it was rediscovered in 2005 and is now at Haverford College Special Collections.

Of the 12.5 million Africans shipped to the New World during the Transatlantic Slave Trade, fewer than 388,000 arrived in the United States.

In the late 15^th century, the advancement of seafaring technologies created a new Atlantic that would change the world forever. As ships began connecting West Africa with Europe and the Americas, new fortunes were sought and native populations were decimated. With the native labor force dwindling and demand for plantation and mining labor growing, the transatlantic slave trade began.

The Transatlantic Slave Trade was underway from 1500-1866, shipping more than 12 million African slaves across the world. Of those slaves, only 10.7 million survived the dreaded Middle Passage. Over 400 years, the majority of slaves (4.9 million) found their way to Brazil where they suffered incredibly high mortality rates due to terrible working conditions. Brazil was also the last country to ban slavery in 1888.

By the time the United States became involved in the slave trade, it had been underway for two hundred years. The majority of its 388,000 slaves arrived between 1700 and 1866, representing a much smaller percentage than most Americans realize.

The diverse history of Historically Black Colleges and Universities.

While Jewish and African American communities have a tumultuous shared history when it comes to the pursuit of civil rights, there is a chapter that is often overlooked. In the 1930s when Jewish academics from Germany and Austria were dismissed from their teaching positions, many came to the United States looking for jobs. Due to the Depression, xenophobia and rising anti-Semitism, many found it difficult to find work, but more than 50 found positions at HBCUs in the segregated South.

Originally established to educate freed slaves to read and write, the first of the Historically Black Colleges and Universities was Cheyney University in Pennsylvania, established in 1837. By the time Jewish professors arrived, the number of HBCUs had grown to 78. At a time when both Jews and African Americans were persecuted, Jewish professors in the Black colleges found the environment comfortable and accepting, often creating special programs to provide opportunities to engage Blacks and whites in meaningful conversation, often for the first time.

In the years that followed, the interests of Jewish and African American communities increasingly diverged, but this once-shared experience of discrimination and interracial cooperation remains a key part of the Civil Rights Movement.

One in four cowboys was Black, despite the stories told in popular books and movies.

In fact, it’s believed that the real “Lone Ranger” was inspired by an African American man named Bass Reeves. Reeves had been born a slave but escaped West during the Civil War where he lived in what was then known as Indian Territory. He eventually became a Deputy U.S. Marshal, was a master of disguise, an expert marksman, had a Native American companion, and rode a silver horse. His story was not unique however.

In the 19^th century, the Wild West drew enslaved Blacks with the hope of freedom and wages. When the Civil War ended, freedmen came West with the hope of a better life where the demand for skilled labor was high. These African Americans made up at least a quarter of the legendary cowboys who lived dangerous lives facing weather, rattlesnakes, and outlaws while they slept under the stars driving cattle herds to market.

While there was little formal segregation in frontier towns and a great deal of personal freedom, Black cowboys were often expected to do more of the work and the roughest jobs compared to their white counterparts. Loyalty did develop between the cowboys on a drive, but the Black cowboys were typically responsible for breaking the horses and being the first ones to cross flooded streams during cattle drives. In fact, it is believed that the term “cowboy” originated as a derogatory term used to describe Black “cowhands.”

Esther Jones was the real Betty Boop

The iconic cartoon character Betty Boop was inspired by a Black jazz singer in Harlem. Introduced by cartoonist Max Fleischer in 1930, the caricature of the jazz age flapper was the first and most famous sex symbol in animation. Betty Boop is best known for her revealing dress, curvaceous figure, and signature vocals “Boop Oop A Doop!” While there has been controversy over the years, the inspiration has been traced back to Esther Jones who was known as “Baby Esther” and performed regularly in the Cotton Club during the 1920s.

Baby Esther’s trademark vocal style of using “boops” and other childlike scat sounds attracted the attention of actress Helen Kane during a performance in the late 1920s. After seeing Baby Esther, Helen Kane adopted her style and began using “boops” in her songs as well. Finding fame early on, Helen Kane often included this “baby style” into her music. When Betty Boop was introduced, Kane promptly sued Fleischer and Paramount Publix Corporation stating they were using her image and style. However video evidence came to light of Baby Esther performing in a nightclub and the courts ruled against Helen Kane stating she did not have exclusive rights to the “booping” style or image, and that the style, in fact, pre-dated her.

Baby Esther’s “baby style” did little to bring her mainstream fame and she died in relative obscurity but a piece of her lives on in the iconic character Betty Boop.

The first licensed African American Female pilot was named Bessie Coleman.

Born in Atlanta, Texas in 1892, Bessie Coleman grew up in a world of harsh poverty, discrimination and segregation. She moved to Chicago at 23 to seek her fortune, but found little opportunity there as well. Wild tales of flying exploits from returning WWI soldiers first inspired her to explore aviation, but she faced a double stigma in that dream being both African American and a woman.

She set her sights on France in order to reach her dreams and began studying French. In 1920, Coleman crossed the ocean with all of her savings and the financial support of Robert Abbott, one of the first African American millionaires. Over the next seven months, she learned to fly and in June of 1921, the Fédération Aéronautique Internationale awarded her an international pilot’s license. Wildly celebrated upon her return to the United States, reporters turned out in droves to greet her.

Coleman performed at numerous airshows over the next five years, performing heart thrilling stunts, encouraging other African Americans to pursue flying, and refusing to perform where Blacks were not admitted. When she tragically died in a plane accident in 1926, famous writer and equal rights advocate Ida B. Wells presided over her funeral. An editorial in the “Dallas Express” stated, “There is reason to believe that the general public did not completely sense the size of her contribution to the achievements of the race as such.”

Interracial marriage in the United Sates was banned in 1664 and not overturned until 1967.

During the seventeenth and early eighteenth century, the growing number of interracial marriages (also known as miscegenation) between Blacks and whites led to the passage of this new law. The first anti-miscegenation law enacted was in the colony of Maryland in 1664 and additional colonies quickly followed suit. These marriages were prohibited and penalties included the enslavement, exile or imprisonment of the white perpetrators. These laws grew and evolved over the years and attempts were even made to modify the Constitution to ban interracial marriage in all states.

It would take three hundred years for this law to be overturned. In 1967, Richard Loving, a white man, and Mildred Jeter, a Black woman, were married in the District of Columbia. When they returned home to Virginia, they were arrested and convicted of violating the state’s anti-miscegenation law. They each faced a year in jail and their case went to the Supreme Court. The Supreme Court found in favor of the Lovings in the famous trial Loving v. Virginia. They ruled that prohibiting interracial marriage on state and local levels was unconstitutional; this meant that marriages between the races were legal in the country for the first time since 1664.

In 2000, Alabama became the last state to officially legalize interracial marriage by removing the unenforceable ban that was still contained in their state constitution. Read more famous cases about interracial relationships that changed history.

Children or teens who are “revved up” and prone to rages or—alternatively—who are depressed and apathetic have become disturbingly commonplace. Chronically irritable children are often in a state of abnormally high arousal, and may seem “wired and tired.” That is, they’re agitated but exhausted. Because chronically high arousal levels impact memory and the ability to relate, these kids are also likely to struggle academically and socially.

At some point, a child with these symptoms may be given a mental-health diagnosis such as major depression, bipolar disorder, or ADHD, and offered corresponding treatments, including therapy and medication. But often these treatments don’t work very well, and the downward spiral continues.

What’s happening?

Both parents and clinicians may be “barking up the wrong tree.” That is, they’re trying to treat what looks like a textbook case of mental disorder, but failing to rule out and address the most common environmental cause of such symptoms—everyday use of electronics. Time and again, I’ve realized that regardless of whether there exists any “true” underlying diagnoses, successfully treating a child with mood dysregulation today requires methodically eliminating all electronics use for several weeks—an “electronics fast”—to allow the nervous system to “reset.”

If done correctly, this intervention can produce deeper sleep, a brighter and more even mood, better focus and organization, and an increase in physical activity. The ability to tolerate stress improves, so meltdowns diminish in both frequency and severity. The child begins to enjoy the things they used to, is more drawn to nature, and imaginary or creative play returns. In teens and young adults, an increase in self-directed behavior is observed—the exact opposite of apathy and hopelessness.

It’s a beautiful thing.

At the same time, the electronic fast reduces or eliminates the need for medication while rendering other treatments more effective. Improved sleep, more exercise, and more face-to-face contact with others compound the benefits—an upward spiral! After the fast, once the brain is reset, the parent can carefully determine how much if any electronics use the child can tolerate without symptoms returning.

Restricting electronics may not solve everything, but it’s often the missing link in treatment when kids are stuck.  

But why is the electronic fast intervention so effective? Because it reverses much of the physiological dysfunction produced by daily screen time.

Children’s brains are much more sensitive to electronics use than most of us realize. In fact, contrary to popular belief, it doesn’t take much electronic stimulation to throw a sensitive and still-developing brain off track. Also, many parents mistakenly believe that interactive screen-time—Internet or social media use, texting, emailing, and gaming—isn’t harmful, especially compared to passive screen time like watching TV. In fact, interactive screen time is more likely to cause sleep, mood, and cognitive issues, because it’s more likely to cause hyperarousal and compulsive use.

Here’s a look at six physiological mechanisms that explain electronics’ tendency to produce mood disturbance:

1. Screen time disrupts sleep and desynchronizes the body clock.

Because light from screen devices mimics daytime, it suppresses melatonin, a sleep signal released by darkness. Just minutes of screen stimulation can delay melatonin release by several hours and desynchronize the body clock. Once the body clock is disrupted, all sorts of other unhealthy reactions occur, such as hormone imbalance and brain inflammation. Plus, high arousal doesn’t permit deep sleep, and deep sleep is how we heal.

2. Screen time desensitizes the brain’s reward system. 

Many children are “hooked” on electronics, and in fact gaming releases so much dopamine—the “feel-good” chemical—that on a brain scan it looks the same as cocaine use. But when reward pathways are overused, they become less sensitive, and more and more stimulation is needed to experience pleasure. Meanwhile, dopamine is also critical for focus and motivation, so needless to say, even small changes in dopamine sensitivity can wreak havoc on how well a child feels and functions.

3. Screen time produces “light-at-night.”

Light-at-night from electronics has been linked to depression and even suicide risk in numerous studies. In fact, animal studies show that exposure to screen-based light before or during sleep causes depression, even when the animal isn’t looking at the screen. Sometimes parents are reluctant to restrict electronics use in a child’s bedroom because they worry the child will enter a state of despair—but in fact removing light-at-night is protective.

4. Screen time induces stress reactions.

Both acute stress (fight-or-flight) and chronic stress produce changes in brain chemistry and hormones that can increase irritability. Indeed, cortisol, the chronic stress hormone, seems to be both a cause and an effect of depression—creating a vicious cycle. Additionally, both hyperarousal and addiction pathways suppress the brain’s frontal lobe, the area where mood regulation actually takes place.

5. Screen time overloads the sensory system, fractures attention, and depletes mental reserves. 

Experts say that what’s often behind explosive and aggressive behavior is poor focus. When attention suffers, so does the ability to process one’s internal and external environment, so little demands become big ones. By depleting mental energy with high visual and cognitive input, screen time contributes to low reserves. One way to temporarily “boost” depleted reserves is to become angry, so meltdowns actually become a coping mechanism.

6. Screen-time reduces physical activity levels and exposure to “green time.”

Research shows that time outdoors, especially interacting with nature, can restore attention, lower stress, and reduce aggression. Thus, time spent with electronics reduces exposure to natural mood enhancers.

In today’s world, it may seem crazy to restrict electronics so drastically. But when kids are struggling, we’re not doing them any favors by leaving electronics in place and hoping they can wind down by using electronics in “moderation.” It just doesn’t work. In contrast, by allowing the nervous system to return to a more natural state with a strict fast, we can take the first step in helping a child become calmer, stronger, and happier.

Victoria L. Dunckley M.D.

The doorbell rings at our apartment eight times each week, and my son knows it’s time to play with one of his friends. Patricia helps him learn to walk up the stairs. Lauren helps him use both hands to roll Play-Doh. Alaina helps him profess his love for macaroni and cheese.

We have an All-Star team of cheerful and experienced therapists dedicated to helping him navigate the world. It has already changed his life, and it didn’t cost us a penny.

This is Early Intervention, a national program created in 1986 to help children under age 3 who have developmental delays and disabilities. In New York State, where we live, the program serves nearly 70,000 children each year who have conditions like autism, Down syndrome and vision impairment. Some children, like my son, have a mild disability, and others have more serious challenges.

I had a mostly uneventful pregnancy and delivery, and our son appeared healthy. Then at 4 months old, I noticed that he favored his right hand and often held his left in a fist. A night of frenzied Googling found that children his age shouldn’t prefer one hand over the other.

His pediatrician sent us to a neurologist, and an MRI of his brain confirmed that he had had a stroke before he was born. Yes, babies can have strokes. I had no idea. They affect as many as one in 2,300 babies.

Our son’s stroke happened on the right side of his brain, so he has weakness on the left side of his body. The doctors ran a series of tests and couldn’t find an explanation. They said we would most likely never know why it happened.

If you met my son, you might not notice his disability — how he has difficulty using his left arm or wears orthotics in his shoes. At 2, he is walking and talking and keeping up with his peers.

Early Intervention is one of the reasons he’s doing so well. The fact that it’s free, frequent, convenient and high quality has made all the difference.

His neurologist referred us to the program, and he began receiving therapy shortly before his first birthday. My husband and I attend his physical therapy sessions to learn exercises we can do with him on our own. We helped him do “baby crunches” while singing “Row, Row, Row Your Boat” to strengthen his core muscles. We massaged his weak arm and encouraged him to use it by giving us high fives. One day, Patricia appeared with a small metal walker for him to hold while he practiced walking. Our son took his first unassisted steps with her.

We learned about neuroplasticity, the brain’s incredible ability to form new neural pathways. We learned about the proven benefits of constraint-induced movement therapy, when you restrict a child’s strong arm and encourage him to use his weaker one. We joined a Facebook group for the families of children who had pediatric strokes that made us feel less alone.

Before starting Early Intervention, we took our son to a local hospital every Friday for therapy. Our health insurance covered only 50 visits per year, and we had to fork over a $40 co-pay for each session. It was once a week, and we knew he needed more.

Now he receives eight sessions every week: occupational therapy, physical therapy and speech therapy — all for free in our home or at his preschool. I can’t imagine how different his life would be if he were still getting therapy only once a week.

His therapists sent us to a doctor on Long Island who makes special foot orthotics to give him extra support. They built a “Paw Patrol”-themed desk fit to his measurements for art projects. They recommended toys we could use for therapy, like a foam peg board or wooden fruit that he can pretend to cut, and introduced us to an older boy in our neighborhood who also had a stroke.

Not every kid is so lucky. It can be difficult to qualify for Early Intervention. The quality of therapists varies. Families in poorer communities like the Bronx have trouble gaining access to services. As children get older, they can get lost in the system. Navigating the bureaucracy takes a lot of time, and parents who work rigid hours or multiple jobs might give up.

The program also varies from state to state. New York is known for having a good program that is free. In New Jersey, families must pay a fee to participate that is based on their income. Each state sets its own rules and depends on a mix of federal, state and local funding.

Many families don’t know about the program or fail to qualify. More than 350,000 children participate nationwide — about 3 percent of children under 3. But as many as 13 percent of babies and toddlers have delays that could make them eligible, according to researchers. States like Arkansas and Mississippi have among the lowest rates for children receiving services.

There are also racial disparities. Black children who are eligible are five times less likely to receive services than white children are, according to a study by researchers at Boston University.

It’s heartbreaking that so many children miss out because the benefits are clear.

“We have a lot of research on brain development, and we know that children learn a lot in those early years,” Christina M. Kasprzak, an expert on Early Intervention at the University of North Carolina, told me. “It’s the time when families can support their child to help them grow in significant ways that will affect them for the rest of their lives.”

It’s also cost effective. Children can gain enough skills to catch up with their peers and might not need services later, Kasprzak said. Others become independent enough to work and give back later by paying taxes themselves.

The program could go even further. Our son attended a four-week summer camp in New Jersey dedicated to intensive constraint-induced movement therapy. The camp has such a great reputation that some families travel from halfway around the world to participate.

Our son loved camp and started using his left arm more, but it was expensive for us and Early Intervention doesn’t cover extra therapy like this. Imagine how many children would benefit if the government paid for these high-quality programs.

Some parents are also reluctant to have their child evaluated for Early Intervention because it means acknowledging there is a problem. I admit I was relieved when our son didn’t qualify the first time he was evaluated because his delays were considered too minor. He was accepted only after we had the MRI results. Instead of feeling comforted, I should have been angry about having to wait, which denied him months of critical therapy.

If you’re worried that your child has delays, I would encourage you to seek out Early Intervention services and to ask for recommendations to find the best therapists in your area and a good service coordinator, the person who oversees your case.

It was difficult to hear that our baby had a disability that would affect him for the rest of his life. But with the help of his therapists, we’re optimistic that our resilient son will have a full life.

Emma G. Fitzsimmons is the City Hall bureau chief at The New York Times.