A majority of states used funding from the Child Care and Development Fund (CCDF) in fiscal year 2017 to entirely or mostly support 7 of 10 major state child care activities. Chapters 1 and 2 examine the extent to which states use CCDF funds to support their child care system, the kinds of CCDF-related activities states engage in that affect children who are not receiving CCDF subsidies, and how states plan to use the increase in CCDF funding from the Consolidated Appropriations Act, 2018. Each year, millions of children age 5 and under receive publicly funded early care and education (ECE) services. Chapter 3 examines the number and characteristics of state ECE programs and the extent to which they share characteristics or overlap with federal or other state programs; and how states fund their ECE programs, including any related benefits and challenges reported by states. Chapter 4 discusses examines the federal investment in early learning and child care programs; fragmentation, overlap, and duplication among early learning and child care programs and agencies' efforts to address these conditions; and the extent to which agencies assess performance for programs with an explicit early learning or child care purpose. The cost of safe, good-quality child care prevents many low and middle-income parents from working, or forces them to work fewer hours, or accept lower wages. The federal government provides direct support to improve child care quality and subsidize child care costs for low- and middle-income families through the Child Care and Development Block Grant (CCDBG). Chapter 5 discusses recent legislation on child care quality and access. Trauma is a widespread, harmful, and costly public health problem, and its effects are especially detrimental to children. Any frightening, dangerous, or violent event that threatens a child or their loved ones can potentially be traumatic. Chapter 6 reviews selected states' efforts to support children affected by trauma. Some international human rights standards allow broad state interventions in families based on the state's conception of the best interest of the child. These states believe it is better to remove a child from its biological parents rather than let the child stay at home. The United States has grappled with where the threshold should be for removal of children from their parents. One major consideration in this balancing of interests should be the potentially lifelong suffering and even abuse faced by children who were removed from their own families, and who remain without permanent families in the foster care system as reported in chapter 7.