Ellen Eliason Kisker

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.

Do School-Based Health Centers improve adolescents' access to health care, health status, and risk-taking behavior ?

PURPOSEnThe purpose of this investigation was to assess the School-Based Adolescent Health Care Program, which provided comprehensive health-related services in 24 school-based health centers.nnnMETHODSnThe outcomes evaluation compared a cohort of students attending 19 participating schools and a national sample of urban youths, using logit models to control for observed differences between the two groups of youths. Outcome measures included self-reports concerning health center utilization, use of other health care providers, knowledge of key health facts, substance use, sexual activity, contraceptive use, pregnancies and births, and health status.nnnRESULTSnThe health centers increased students access to health care and improved their health knowledge. However, the estimated impacts on health status and risky behaviors were inconsistent, and most were small and not statistically significant.nnnCONCLUSIONSnSchool-based health centers can increase students health knowledge and access to health-related services, but more intensive or different services are needed if they are to significantly reduce risk-taking behaviors.

Low-Income Children's School Readiness: Parent Contributions Over the First Five Years

Early development is likely influenced by quality of early parenting and improvements or declines in quality over time. Little is known about how changes in different dimensions of parenting influence child outcomes, nor the relative sizes of associations when considering several aspects simultaneously. These questions are addressed in the Early Head Start Research and Evaluation Project (N = 1273). Assessments occurred when children were 1, 2, 3, and 5 years old. Parent supportiveness (videotaped play interactions), home learning environment (observed), and depressive symptoms and parenting stress (self-report) were assessed. Childrens school readiness at age 5 was assessed via receptive vocabulary, letter–word knowledge, observed emotion regulation, approaches toward learning, and behavior problems. In this low-income sample, early parenting as well as change over time predicted school readiness. Associations mostly followed predictions from the family stress model and cognitive stimulation models; learning environment and maternal supportiveness were most strongly associated with child vocabulary and letter–word knowledge, although supportiveness was also linked with observed emotion regulation, and learning environment early on was also linked with emotion regulation, and early learning environment was also linked with emotion regulation, and early learning environment was also linked with behavior problems and approaches toward learning. Depressive symptoms and parenting stress were more strongly associated with behavior problems, although early parenting stress was also associated with approaches toward learning and emotion regulation.

Perils of single life and benefits of marriage

Numerous studies have indicated that married persons experience a more favorable mortality profile than unmarried persons. Hypotheses about possible explanations for mortality differentials by marital status fall into 3 categories: 1) hypotheses regarding errors in the data 2) hypotheses related to the selection of persons into and out of marital states and 3) hypotheses regarding environmental and behavioral factors associated with various marital states. The present analysis sought to assess the extent to which mortality differences by marital status are similar across populations and to determine the importance of selection factors in producing the excess mortality among single populations. The data analyzed were derived from 26 Western European countries known to have high-quality mortality and population statistics. The married consistently experience the lowest death rates in the countries examined although the ranks of the other 3 marital states vary. In general the absolute magnitude of the effects associated with each marital status are greater for men than women. The data from the 26 developed countries indicate excess deaths among the unmarried of 2-3000 for females and 8-10000 for males in 1980. The age patterns of correlation coefficients relating proportions single and excess mortality of the single show strong constant correlations for women starting with -.59 at 20-24 years and dropping to -.49 at ages 65-74 years; among men the same correlations are negligible before age 35 years small for ages 35-44 years and then rise to -.50 and remain constant thereafter. The very high correlation coefficients between the proportions single and the relative mortality rate of the single to married for men and women in most age groups between 30-50 years in France Japan and UK suggests that much of the excess mortality of the never-married is due to a selectivity effect in which health conditions deter some persons from entering marriage.

Arranging Child Care

More than half of the children in families supported by welfare are under age six, and another third are in grade school. The mothers of these children cannot leave welfare for employment unless they can find and pay for child care. Yet, as this article points out, the child care needs of these families are not easily met: Many require care for infants and toddlers, care at odd hours, and care in poor neighborhoods-all of which are scarce. Evidence reviewed by the authors indicates that problems with child care affordability, availability, and quality impede mothers from participating in the labor force and in job training programs. Recent public finding for child care subsidies has helped families leaving welfare to afford the child care they need, although the demand for financial assistance outstrips available funding. This article urges that policymakers work to facilitate access to subsidies, increase the supply of care that can meet the needs of poor working families, and guard against exposure to poor-quality care that can jeopardize both childrens well-being and parents employment.

Early Head Start: Identifying and Serving Children with Disabilities

Early Head Start (EHS) is a comprehensive, two-generation program that provides services to low-income families with children under the age of 3 years. As part of their mandate, staff members of EHS programs collaborate with other service providers in their local communities, including Part C and childcare providers. The incidence of disabilities among low-income children was tracked as part of the EHS Research and Evaluation Project. The incidence of indicators of disabilities (or potential disabilities) was extremely high (87%) among these very young children living in poverty; however, only 99 participating families (4.7% of the sample) received Part C services. Receipt of Part C services was related negatively to specific family characteristics (e.g., mother less well educated, being of color, not speaking English). Participation in EHS had a positive impact on receipt of Part C services.

Child Care for Low-Income Children with Disabilities: Access, Quality, and Parental Satisfaction.

Using data from the Early Head Start Research and Evaluation Project, this study analyzed the similarities and differences of variables associated with child care services for low-income families with young children with disabilities and low-income families with typically developing children. Four major variables were analyzed: access to child care; maternal participation in self-sufficiency activities, such as work or education; quality of care; and parental satisfaction with care. Rates of child care utilization and maternal self sufficiency activities were similar for both groups. At age 3, however, children with disabilities received care of lower quality than their typically developing peers, and their parents were less satisfied with the child care arrangements. Policy and research implications, stressing the importance of improving child care quality for low-income children with disabilities across all types of settings, are presented.

Nonexperimental Designs and Program Evaluation

Sometimes implementing evaluation designs that involve random assignment or strong nonrandomized comparison group designs is not feasible. When this is the case, several other types of comparisons may offer credible, though not conclusive, evidence on program effects. This article describes three approaches—comparisons of the outcomes of the treatment group with a national sample, comparisons of the outcomes of program participants and nonparticipants, and dose-response analyses—and illustrates their use in the evaluation of the School-Based Adolescent Health Care Program. The findings suggest that if outcomes are measured before and after the intervention, comparisons of the treatment group outcomes to outcomes for a national sample may provide valid estimates of program effects. The other two types of comparisons produced implausible and unstable estimates of program effects. Because of the selection bias inherent in these two methods, researchers cannot count on being able to produce plausible estimates of program effects with such comparisons.

Health disparities in low-income families with infants and toddlers: needs and challenges related to disability.

This study examines disparities in health status, health care utilization, insurance coverage and satisfaction in US low-income parents of infants and toddlers with disabilities compared to low-income parents of children without disabilities. The Early Head Start Research and Evaluation Project is a longitudinal study involving 2087 families in 17 communities across the United States. Families completed interviews at enrollment and at 7, 16, and 28 months after enrollment. Descriptive analyses were conducted to characterize children’s status in terms of health, health care use, and insurance coverage. Children with disabilities were more likely to experience poor health and to use more health care services. Parents of children with disabilities were more likely to report that medical care was inadequate. Hispanic children were less likely to experience excellent health. Hispanic parents were less likely to have health insurance or to report that their medical care was adequate. Low-income parents of young children with disabilities perceived their children as less healthy, more vulnerable and needing more health services. This study demonstrates the importance of providing accessible, culturally-competent services to this vulnerable population.