Diane Paulsell

The Effectiveness of Early Head Start for 3-Year-Old Children and Their Parents: Lessons for Policy and Programs

Early Head Start, a federal program begun in 1995 for low-income pregnant women and families with infants and toddlers, was evaluated through a randomized trial of 3,001 families in 17 programs. Interviews with primary caregivers, child assessments, and observations of parent-child interactions were completed when children were 3 years old. Caregivers were diverse in race-ethnicity, language, and other characteristics. Regression-adjusted impact analyses showed that 3-year-old program children performed better than did control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, Early Head Start parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less. The strongest and most numerous impacts were for programs that offered a mix of home-visiting and center-based services and that fully implemented the performance standards early.

Child Care quality matters: How conclusions may vary with context

Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on childrens development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained. These studies, conducted in three national contexts, with different regulatory climates, ranges of child care quality, and a diversity of family characteristics, suggest a need for more complete estimates of how both quality and quantity of child care may influence a range of young childrens developmental outcomes.

Supporting replication and scale-up of evidence-based home visiting programs: assessing the implementation knowledge base.

In recent years, researchers, policymakers, and practitioners have expressed a growing interest in the use of interventions with scientific evidence of effectiveness. Reproducing positive effects shown in research, however, requires more than simply adopting an evidence-based program. There is growing recognition across disciplines of the importance of implementation research to guide adoption, replication, and scale-up of evidence-based interventions. We evaluate the state of the knowledge base supporting replication and scale-up of evidence-based programs by reviewing information on implementation included in the research literature on 22 home visiting programs that have or are building an evidence base. We used the Interactive Systems Framework for Dissemination and Implementation to assess programs.

A Trusted Source of Information

Background: Systematic reviews sponsored by federal departments or agencies play an increasingly important role in disseminating information about evidence-based programs and have become a trusted source of information for administrators and practitioners seeking evidence-based programs to implement. These users vary in their knowledge of evaluation methods and their ability to interpret systematic review findings. They must consider factors beyond program effectiveness when selecting an intervention, such as the relevance of the intervention to their target population, community context, and service delivery system; readiness for replication and scale-up; and the ability of their service delivery system or agency to implement the intervention. Objective: To support user decisions about adopting evidence-based practices, this article discusses current systematic review practices and alternative approaches to synthesizing and presenting findings and providing information. Method: We reviewed the publicly available information on review methodology and findings for eight federally funded systematic reviews in the labor, education, early childhood, mental health/substance abuse, family support, and criminal justice topic areas. Conclusion: The eight federally sponsored evidence reviews we examined all provide information that can help users to interpret findings on evidence of effectiveness and to make adoption decisions. However, they are uneven in the amount, accessibility, and consistency of information they report. For all eight reviews, there is room for improvement in supporting users’ adoption decisions through more detailed, accessible, and consistent information in these areas.

Understanding and Incorporating Home-Based Child Care Into Early Education and Development Systems

Millions of families across the United States rely on home-based child care—noncustodial care in home-based settings—while they work or attend school. Indeed, home-based child care is the most prevalent form of noncustodial child care in the United States, especially for infants and toddlers and children living in poverty. The National Survey of Early Care and Education (NSECE) estimated that about 7.1 million children from birth to age 5 receive care in home-based child care settings from more than 3.7 million caregivers (NSECE Project Team, 2016). In contrast, an estimated 3.8 million children receive care in centers. About half of home-based child care providers are located in moderateor high-poverty density areas, and less than one third are paid for providing care. Research indicates that families choose home-based care for a number of reasons (Porter, Paulsell, Nichols, Begnoche, & Del Grosso, 2010). Trust is a major factor, especially for families with infants and toddlers. Some families, especially those who are recent immigrants, choose relatives or friends as caregivers because they share the same culture, home language, values, and childrearing practices. Parents who work nontraditional hours—evenings, nights, weekends, or irregular schedules—may use home-based child care because it is flexible enough to meet their needs. They may also prefer a home setting for their young children during early morning, evening, or overnight hours. Some lowincome families choose home-based child care because they cannot afford center-based options or do not have access to child care centers in their neighborhoods. Home-based child care providers have less access to resources and supports than child care centers. Most states offer lower subsidy rates for home-based child care providers than child care centers. Some state quality improvement efforts exclude some or all home-based child care providers. Nearly half of unpaid caregivers have other jobs in addition to caregiving responsibilities, which limits the time during which they can participate in quality improvement initiatives (NSECE Project Team, 2016). Home-based child care providers often work alone and do not have regular opportunities to share ideas with others about how to engage children in learning activities or in the community. Moreover, research suggests that home-based child care providers face a range of other challenges, work-related stress, physical exhaustion, and isolation (Porter et al., 2010). Research on home-based child care is limited. Studies show that many home-based caregivers are positively engaged with children and provide safe, healthy environments but also that home-based child care settings appear to provide lower levels of cognitive stimulation (Paulsell et al., 2010). Available research suggests that most home-based child care is of poor to moderate quality; however, few quality measures have effectively captured the potential strengths of diverse home-based care settings. Perhaps most critical is that the field lacks rigorous evidence of the effectiveness of strategies for supporting quality in home-based child care settings. Whereas evidence-based quality interventions exist for use in center-based settings, little rigorous research has examined the efficacy of strategies for improving the quality of home-based child care. A national scan of the field conducted in 2010 identified eight such strategies, ranging from home-visiting approaches to the provision of materials