Louisa Tarullo

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.

Early Identification and Intervention: Head Start's Response to Mental Health Challenges

Serving low-income children from birth to age five and their families, Head Start is a primary venue for identification and intervention in the area of child mental health. However, recent research has demonstrated that the knowledge base regarding prevalence, developmental course, and predictive power of child mental health problems is lacking for young children in general and low-income, diverse populations in particular. Head Starts agency-level data is often discrepant from both national estimates and small, intensive studies of similar populations, perhaps for reasons related to availability of community services and professional staff, as well as concerns about stigmatization. Following on recent expert recommendations, new collaborative Federal initiatives are underway to increase our understanding of the types, trajectories, and treatments of mental health problems affecting the vulnerable children served by Head Start. The paper concludes with a call to action for the field in the area of young childrens mental health.

I. QUALITY THRESHOLDS, FEATURES, AND DOSAGE IN EARLY CARE AND EDUCATION: INTRODUCTION AND LITERATURE REVIEW.

This monograph addresses the hypotheses that preschool children benefit most strongly when early care and education (ECE) is at or above a threshold of quality, has specific quality features, and/or is of longer duration. These issues are pivotal in recent policies designed to improve the quality of ECE, especially for children from low-income families. Evidence of quality thresholds in which ECE quality has stronger impacts in settings with moderate to high levels of quality than in settings with low quality would inform policy initiatives in which monetary incentives or consequences are allocated to ECE settings based on their level of quality. Evidence that specific features of quality, such as quality of teacher-child interactions and of literacy and mathematics instruction, are predictors of gains in child outcomes could help inform quality improvement efforts. Evidence that more time spent in center-based ECE or in instruction in specific content areas predict larger gains among preschoolers could be useful in designing public preschool programs such as Head Start or prekindergarten. Secondary data analyses of eight large studies of preschool children in center-based ECE were conducted. Analyses focused on quality thresholds and quality features examined the extent to which three types of quality measures predicted gains in childrens language, literacy, mathematics, and social skills. The measures comprised (1) global quality measures that provide an overall or global rating of quality, focusing on interactions as well as on physical features of the environment, activities, and routines; (2) interaction-specific measures that focus in depth on the quality of interactions between teachers and children with respect to instructional and emotional support; and (3) domain-specific measures that focus on the quality of instruction and stimulation in specific content areas such as early language and literacy. The goal was to provide replicated analyses with data from several projects in order to address each question. Multilevel analyses that controlled for entry skills were conducted, and results were combined by using meta-analysis, nonlinear and nonparametric analyses, and propensity score analyses. With respect to thresholds, the analyses suggest that increases in the quality of instruction are related to larger gains in language and literacy outcomes, but only in higher quality classrooms. Results point to stronger associations between quality and child outcomes in higher versus lower quality classrooms for measures of the instructional quality of teacher-child interactions and of the quality of specific activities thought to promote early literacy, such as teaching phonemic skills and book reading. In addition, the items focusing on quality of interactions on the global measure also predicted acquisition of language and social skills in higher but not in lower quality classrooms. With respect to quality features, interaction-specific and especially domain-specific measures of quality remained significant predictors of child outcomes, whereas global measures of quality were never significant positive predictors, when both global and more specific measures of quality were included simultaneously in analyses. There is thus consistent evidence that more specific measures of quality are better predictors of child outcomes. With respect to dosage, several approaches were used in operationalizing both the cumulative and current dosage of childrens exposure to ECE. Propensity score analyses that included baseline scores on outcomes to control for selection into larger dosages suggested that children with two as opposed to one year of Head Start had stronger vocabulary and literacy skills both immediately upon exit from Head Start and at the end of kindergarten. Fewer absences and more observed time spent on instruction were associated with stronger gains in literacy and mathematics skills. Finally, findings revealed that more time spent on instruction in classrooms with higher overall quality was particularly important to the development of mathematics skills. No other replicated evidence of quality by quantity interactions emerged.

IV. TESTING FOR DOSAGE-OUTCOME ASSOCIATIONS IN EARLY CARE AND EDUCATION.

In this chapter, we turn to the question of whether there is evidence of an association between children’s development and the quantity or dosage of ECE across several large studies. As follow-up to the results summarized in the literature review, it is important to control adequately for selection effects in studying effects of dosage. There is also a need to examine different measures of dosage to see if consistent patterns of findings emerge across different measurement approaches. Accordingly, in this chapter, we will summarize analyses by using more rigorous approaches to controlling for selection than those used in previous research and will adopt several approaches to operationalizing dosage. Again, we are seeking replicated findings, as indicated in this section by similar significant findings across projects in analyses of dosage.

III. TESTING FOR QUALITY THRESHOLDS AND FEATURES IN EARLY CARE AND EDUCATION

In this chapter, we report on the analyses focusing on both quality thresholds and quality features. First, we address questions about quality thresholds, using two analytic approaches. The analyses ask whether there is evidence suggesting thresholds in the association between a specific quality measure and a specific child outcome. Second, we extend these analyses to ask whether each child outcome is more strongly related to global quality measures or to quality measures that measure teacher-child interactions or quality of instruction in a given content area. The research to date provides the basis for the articulation of two hypotheses related to quality thresholds and features: (1) the quality of ECE is a stronger predictor of residualized gains in child outcomes in classrooms with higher quality than in classrooms with lower quality and (2) more specific measures of quality are stronger predictors of residualized gains in child outcomes than are global measures. We turn now to analyses intended to address these hypotheses by using data from several data sets.

V. QUALITY THRESHOLDS, FEATURES, AND DOSAGE IN EARLY CARE AND EDUCATION: DISCUSSION AND CONCLUSIONS

By providing an in-depth examination of thresholds of quality, specificity of quality measurement, dosage operationalized in several ways, and interactions of dosage and quality, the secondary data analyses reported here sought to extend the understanding of how early childhood care and education quality and child outcomes are related. We report findings from analyses that included the child’s entry skills and family demographic characteristics as covariates and only report findings that were replicated across studies or across measures as a means to reduce, but not eliminate, potential biases. The results of these analyses are described in detail in the previous two chapters and summarized in the table below (Table 14). Results from the threshold analyses suggested that children experience larger gains in language and literacy skills when the quality of instruction is higher, but only when the quality of instruction is in the moderate to high range. This conclusion was supported by the meta-analysis involving measures of instructional quality based on CLASS Instructional Support and the analysis of the quality of literacy instruction based on the TBRS This article is part of the issue “Quality Thresholds, Features, and Dosage in Early Care and Education: Secondary Data Analyses of Child Outcomes,” Burchinal, Zaslow, and Tarullo (Issue Editors). For a full listing of articles in this issue, see: http://onlinelibrary.wiley.com/doi/ 10.1111/mono.v81.2/issuetoc.