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Summary Report
The Early Head Start Program and Its Early Development
Following the recommendations of the Secretary's Advisory Committee on Services for Families with Infants and Toddlers in 1994, the Administration on Children, Youth and Families (ACYF) designed Early Head Start programs to enhance children's development and health, strengthen family and community partnerships, and support the staff delivering new services to low-income families with pregnant women, infants, or toddlers. In 1995 and 1996, ACYF funded the first 143 programs, revised the Head Start Program Performance Standards to bring Early Head Start under the Head Start umbrella, created an ongoing national system of training and technical assistance (provided by the Early Head Start National Resource Center in coordination with ACYF's regional offices and training centers), and began conducting regular program monitoring to ensure compliance with the performance standards.1
At the same time, ACYF selected 17 programs from across the country to participate in a rigorous, large-scale, random-assignment evaluation.2 The Early Head Start evaluation was designed to carry out the recommendation of the Advisory Committee on Services for Families with Infants and Toddlers for a strong research and evaluation component to support continuous improvement within the Early Head Start program and to meet the requirement in the 1994 reauthorization (continued in the 1998 reauthorization) for a national evaluation of the new infant-toddler program. The 17 research programs include all the major program approaches and are located in all regions of the country and in urban and rural settings. The families they serve are highly diverse (see Table 1). Their purposeful selection resulted in a research sample that reflects the characteristics of all programs funded in 1995 and 1996, including their program approaches and family demographic characteristics.
After a brief description of the nature and operation of the Early Head Start programs, this report summarizes the initial key findings emerging from the evaluation's analysis of program impacts on children and families when the children were 2 years old. The findings are presented in connection with the key policy questions they relate to, beginning with the overall impacts on children and parents and concluding with the delivery of program services and findings on the differential impacts for key subgroups of programs. Details about the study's experimental design, the implementation study, and other methodological features appear in Box 1. Table 2 lists the child and family outcome measures used in the analyses, and Tables 3 and 4 summarize the main impact findings described here.
Early Head Start Programs and Services
Early Head Start grantees are charged with tailoring their program services to meet the needs of low-income pregnant women and families with infants and toddlers in their communities and may select among program options specified in the performance standards. Grantees are required to provide child development services, build family and community partnerships, and support staff to provide high-quality services for children and families. Early Head Start programs may select from a variety of approaches to enhance child development directly and to support child development through parenting and/or family development services. The 17 research programs involved in the evaluation were classified as (1) center-based, providing all services to families through the center-based option (center-based child care, plus other activities) and offering a minimum of two home visits per year to each family; (2) home-based, providing all services to families in the home-based option through weekly home visits and at least two group socializations per month for each family; or (3) mixed approach, providing center-based services to some families, home-based services to other families, or a mixture of center-based and home-based services. When initially funded, the 17 research programs were about equally divided among the three program approaches. However, by fall 1997, seven had adopted a home-based approach, four were center-based, and six were mixed-approach programs.3
The structure of Early Head Start programs has been influenced
during the first five years by a number of changes occurring in their
communities and states. Families' needs have changed as parents have entered
the workforce or undertaken education and training activities in response
to welfare reform or job opportunities created by favorable economic conditions.
The resources for early childhood services have also increased due in
part to strong economies. Meanwhile, state and community health initiatives
have created new access to services for all low-income families, and the
federal Fatherhood Initiative has heightened attention to issues of father
involvement.
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Box 1: Features of the Evaluation To meet multiple purposes, the Early Head Start Research and Evaluation project includes an implementation study, a study of program impacts through the children's second and third birthdays, local research, and special policy studies (on such topics as fathers, child care, health and disabilities, and welfare reform). In addition, longitudinal followup is under way as the children leave Early Head Start and enter Head Start and other prekindergarten programs. The evaluation has the following key features:
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How Do Early Head Start Programs Affect Children's Development?
The Early Head Start programs shared a common goal of improving children's development, including cognitive and language development, social-emotional behavior, and health. The research team selected measures to assess the major domains of children's behavior and development that programs expected to influence at ages 2 and 3, including outcomes that have been shown to be associated with later success in school. These are standard measures with a history of use in research with low-income families and children (see Table 2).
The evaluation found that by 2 years of age, Early Head Start children were functioning significantly better than their non-Early Head Start peers across a wide range of cognitive, language, and social-emotional development measures (assessed by researcher observation, parent report, and direct child assessments):4
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Early Head Start children scored higher on a standardized assessment of infant and toddler cognitive development, the Bayley Scales of Infant Development Mental Development Index (MDI; 90.1 for the Early Head Start group versus 88.1 for the control group). More importantly, a smaller percentage of Early Head Start children (33.6 percent versus 40.2 percent in the control group) scored in the at-risk range of developmental functioning (below 85 on the Bayley).
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Early Head Start children were reported by their parents to have larger vocabularies and to use more grammatically complex sentences at age 2, although the children did not differ on whether or not they combined two or more words.
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Early Head Start children displayed lower levels of aggressive behavior, according to ratings completed by their parents.
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Early Head Start did not have an impact on children's ability to regulate their emotions or to engage in task-oriented behavior during the cognitive assessment. Similarly, no differences were seen in Early Head Start children's engagement, negativity, or attention span while playing with their mothers in a videotaped free-play interaction.
How Do Early Head Start Programs Affect Parenting and the Home Environment?
A major goal of Early Head Start is to encourage close, supportive relationships between parents and their infants and toddlers-both because these are important for families and because they lead to emotional and cognitive supports that enhance children's development. The evaluation found that Early Head Start parents gained more knowledge of infant-toddler development and were more likely to provide experiences and environments known to support the early cognitive and social development of children than did control group parents. Findings also suggest that Early Head Start had reduced the stress of parenting. These findings were consistent across measures obtained from both parent reports and researcher observations.
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The home environments of Early Head Start 2-year-olds were more supportive and stimulating of cognitive development, language, and literacy than control children's homes, based on a standard scale that measured, for example, the presence of stimulating toys and books in the home, and parents reading and talking to their children. Early Head Start parents were more likely to read to children daily and at bedtime. Early Head Start parents also engaged in important activities with their children more frequently than control group parents, for example, singing songs and nursery rhymes, dancing, and playing outside. Together, these differences show that Early Head Start families are creating a richer literacy environment for their children.
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Early Head Start mothers displayed more-supportive parenting behaviors (in videotaped free-play interactions). They showed greater enjoyment, greater sensitivity and less detachment, created more structure, and extended play to stimulate cognitive and language development. However, there were no differences in levels of maternal intrusiveness or negative regard of the child.
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Early Head Start mothers were more emotionally responsive, displaying greater warmth, praise, and affection toward their children, according to direct observations made during the interview process.
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Early Head Start increased mothers' knowledge of infant-toddler development and developmental milestones.
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Early Head Start parents created more structure in their children's day by setting a regular bedtime.
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Early Head Start mothers were less likely to report having spanked their child in the past week than control group mothers. In addition, when presented with hypothetical parent-child conflict situations, they were more likely to suggest using a positive discipline strategy, such as distracting the child or explaining to the child. In conflict situations, Early Head Start mothers were more likely to suggest only mild responses.
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Early Head Start parents reported lower levels of family conflict and parenting stress.
How Do Early Head Start Programs Affect Family Health and Self-Sufficiency?
In addition to directly addressing child development and parenting outcomes, Early Head Start programs support their families' efforts to become healthier and more economically self-sufficient. Such support contributes to parents attaining the resources needed to provide a healthy environment for their children, and over the long term could support parents' ability to sustain the developmental advances made by their children.
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Early Head Start parents were more likely than control group parents to participate in an education or job-training program. They also spent more time in an education program during their first 15 months in the program.
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During the first 15 months, Early Head Start had no impact on the percentage of parents employed, hours per week employed in all jobs, receipt of welfare benefits, family income, or levels of family resources (as rated by the parents). However, during this period employment levels increased among both Early Head Start and control families. Similarly, after the first 9 months, welfare receipt declined among both Early Head Start and control families.
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Few overall effects on family health emerged, consistent with the few overall differences between program and control groups in the receipt of health services (see next section). Early Head Start and control group children did not differ in their health status as reported by parents.5 Similarly, Early Head Start parents did not differ from control group parents in their self-reported health status when their children were 2 years old. Early Head Start did not substantially improve reported safety practices within families' homes.
Did Early Head Start Programs Deliver the Intended Services to the Families They Served?
Early Head Start provided child development/parenting services to nearly all families who enrolled and, more important, provided them with more-intensive child development/parenting services than control group families received from other sources in their communities. The implementation study found that the child development services provided by the Early Head Start programs were usually of relatively high quality.6
Program impacts on the receipt of key Early Head Start services were large and statistically significant (see Table 4 for more details on the magnitude of the impacts). Highlights of the findings related to service use include:
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The research programs succeeded in implementing and delivering home visits, center-based care, case management, and/or group parenting activities-to a very high proportion of families. Thus, even though three-quarters of control group families received some key services from other community sources during the first 16 months after enrollment, program families were significantly more likely than control families to receive any key services.7
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Early Head Start families were much more likely than control families to receive the core child development or parenting-focused services. (Most home visits were at least an hour in length and focused entirely or in part on child development.) In addition, Early Head Start families were more than twice as likely as control families to participate in parent education, parent-child, or parent support group activities.
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The Early Head Start programs increased the receipt of intensive child development/parenting services even more dramatically. During the first follow-up period, the majority of Early Head Start families received home visits at least monthly, and nearly half received them at least weekly (an intensity of child development services generally regarded as necessary to produce child or parenting effects). In contrast, very few control families received monthly and weekly home visits. In home-based programs, the majority of Early Head Start families received weekly home visits, while very few control families did so. During the first 16 months after enrollment, children who enrolled in center-based Early Head Start programs were in center-based care for almost twice as many hours, on average, as control children.
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The quality of Early Head Start services was generally good. The implementation study rated program factors related to service quality and found that the quality of factors believed to influence home visiting effectiveness was high in most of the Early Head Start programs that provided home-based services (see Pathways to Quality 2001).8 Factors such as home visitor hiring, training, and supervision; planning and frequency of home visits; staff reports of child development emphasis during home visits; and integration with other services were rated as "good" or "high" quality in 9 of the 13 programs that provided home-based services in 1997. The number of programs with factors rated as "good" or "high" quality increased to 11 in 1999. The implementation study also found that Early Head Start centers provided good-quality care during their first two years of serving families. On average, the centers maintained teacher-child ratios and group sizes that met the Head Start Program Performance Standards, and the average score on the Infant-Toddler Environment Rating Scale was 5.4 (in the good-to-excellent range of the 1-to-7 scale).
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The Early Head Start programs also increased families' receipt of case management and their use of services in the community such as education and employment-related services and transportation assistance.
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Medicaid and State Children's Health Insurance Programs have made health care services widely accessible to low-income families, and nearly all program and control group families reported receiving basic health services.
How Did Variations in Levels of Implementation and Program Designs Affect the Impacts of Early Head Start?
The Early Head Start programs participating in the evaluation varied in their approach to serving families and in their pattern of progress in implementing key elements of the revised Head Start Program Performance Standards. Accordingly, the evaluation explored how impacts vary by program approach and implementation level. Variations in impacts across groups of programs using particular approaches may provide useful insights into differences in impacts that could be expected when communities choose these approaches to meet the needs of their families. Similarly, variations in impacts across programs that achieved different levels of implementation may provide insights into the importance of fully implementing key program services. However, in assessing variations in impacts by program approach and implementation level, it is important to keep in mind that other program or community characteristics of the programs that selected particular approaches or were able to reach full implementation may also be contributing to differences in impacts by program approach or level of implementation.9
The overall impacts of Early Head Start varied by the timing of programs' achievement of "full implementation."10 Based on systematic ratings completed as part of the implementation study, we classified programs as early implementers (if they achieved an overall rating of "fully implemented" by fall 1997--six programs), later implementers (achieved rating of "fully implemented" by fall 1999--six programs), or incomplete implementers (never rated as "fully implemented" overall, but demonstrated a number of strengths and were continuing to progress--five programs). As already described, as of fall 1997, programs had adopted three basic service delivery approaches--four were center-based, seven were home-based, and six adopted a mixed approach.
Programs that were early implementers generally had larger impacts on families' service use and child and family outcomes than later implementers or incomplete implementers. Underlying this overall pattern of findings is a particularly strong association, among mixed-approach programs, between early implementation and stronger impacts. Among the other types of programs no similar association between early implementation and strong impacts exists, although the small number of programs in some categories limits the analysis. While other program characteristics or contextual factors could be contributing to these differences, it appears that full implementation of key elements of the performance standards facilitated families' participation in services and enhanced their outcomes in key areas.11
All three program approaches (center-based, home-based, and mixed-approach) produced positive impacts on children, but in different areas. The Early Head Start impact on Bayley MDI scores was significant only for children in center-based programs. In center-based sites, Early Head Start children were 28 percent less likely than children without Early Head Start to score in the at-risk range (below 85) on the Bayley MDI at age 2. On the other hand, only in home-based and mixed-approach programs did Early Head Start significantly enhance language development, with more impacts found in the mixed-approach sites.12 All program approaches produced significant positive social-emotional impacts, although more of these behaviors were affected in mixed-approach programs. With some exceptions, Early Head Start impacts on parenting and the home environment were concentrated in the home-based and mixed-approach programs (the exceptions were the findings that center-based programs increased reading to children at bedtime and increased parents' repertoire of positive discipline practices). Parent participation in education or job-training programs increased for those families in home-based and mixed-approach programs. These patterns of impacts are consistent with the differences in services provided under each approach, but they may not be due entirely to differences in approach. As was the case with differences in impacts by program implementation, other program characteristics or contextual factors could be contributing to these differences in impacts by program approach.
Conclusions
The initial impacts emerging from the evaluation of the new Early Head Start programs are promising. The pattern of modest but significant impacts across a wide range of child and parent outcomes at a point about two-thirds of the way through children's Early Head Start program experience suggests that the programs are reducing the risk that children will experience poor outcomes later on. The evaluation will continue to follow children and families as those in the program complete their final year in Early Head Start. Analyses of program impacts when children are 3 years old will provide a more complete picture of the benefits of participation in Early Head Start. Because children's experiences after Early Head Start are expected to vary and because little is known about the range of low-income children's early childhood program experiences from birth through school entry, the Early Head Start research sample children will also be assessed immediately prior to school entry to determine whether the promising patterns identified at age 2 are maintained throughout the preschool years.
The initial findings emerging from the Early Head Start evaluation show:
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The Early Head Start programs in this study had modest positive impacts on a range of child development outcomes when children were 2 years old. The pattern of findings is promising because it includes impacts in domains-such as cognitive and language development, as well as problem behaviors-identified by previous research as important for literacy and school readiness. If sustained, these impacts could lead to greater school readiness among Early Head Start children.
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The Early Head Start programs had modest positive impacts across a range of parenting outcomes when children were 2 years old. This pattern is promising because it includes impacts in areas such as literacy environments, parental supportiveness for learning, parental knowledge of child development, and discipline strategies that are also associated with enhanced child development and school readiness.
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The significant reductions in parenting stress and family conflict, along with improvements in parents' strategies for coping with conflict and increases in supportive parenting behaviors, suggest that the Early Head Start programs may be helping to break a cycle of stress, conflict, poor coping strategies and punitive discipline sometimes reported in studies of low-income families. These findings are promising because they are based both on parents' reports of conflict and on researchers' observations of parent-child interactions.
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The Early Head Start programs achieved high levels of participation among enrolled families. The programs substantially increased the extent of child development and parenting services that families received. Although services were available in the communities where the research programs were located, and many control families received some services, the Early Head Start programs served nearly all families who enrolled, provided much more intensive services, and provided intensive services focused on child development and parenting to a majority of enrolled families.
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Impacts seem to be greatest among programs that were able to fully implement key elements of the revised Head Start Program Performance Standards early. Thus, full implementation of key elements of the performance standards appears to support families' receipt of services and to strengthen child and family outcomes. This finding underscores the importance of meeting the performance standards.
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Different program approaches, which are chosen to meet the unique needs of children and families in particular communities, produced different patterns of impacts. Center-based programs produced significant improvements in child cognitive outcomes at age 2 and in some parenting behaviors. Home-based programs tended to have more positive impacts on parenting behaviors and produced significant impacts on language development as well as increases in parents' participation in education and job training. Mixed-approach programs-which provided home and/or center-based services depending on family needs-produced a pattern of impacts similar to home-based programs but had more impacts on children's social and language development.
The overall pattern of findings suggests that the programs may be tilting the balance of risk and protective factors within the low-income families that Early Head Start serves, possibly creating or enhancing protective factors for Early Head Start children in the very early years of their development. While families struggle to balance work, education, and parenting, Early Head Start programs appear to be helping families maintain their focus on their children's development.
1The revised Head Start Program Performance Standards were published in the Federal Register for public comment in November 1996 and became effective in January 1998.(back)
2From among 41 Early Head Start programs that applied with local research partners to be research sites, ACYF selected 15 based on the quality of the proposed local research and an effort to achieve a balance of rural and urban locations, racial/ethnic composition, and program approaches. Subsequently, ACYF added two sites to provide the desired balance of approaches.(back)
3Programs have continued to evolve and refine their service strategies to meet changing needs of families. See the Early Head Start implementation report, Pathways to Quality, for a full description of programs' development through fall 1999.(back)
4Throughout this report, we adopt the convention of reporting as significant only program-control differences that are statistically significant. In order to examine patterns of effects, we include differences significant at p<.05 and p<.01, but we also note marginally significant findings (p<.10) when they contribute to a consistent pattern of impacts across multiple outcomes. To provide a common benchmark that allows comparison across various findings, Table 3 reports effect sizes for each impact. Effect sizes are in the 10 to 15 percent range for most impacts. Box 1 describes response rates to the various data collection components. The response rates for the direct child assessments and videotaped interactions were relatively low. Analyses of response patterns show that nonresponders were slightly more likely to be disadvantaged according to some baseline characteristics, but the differences were not large and patterns of nonresponse were similar among Early Head Start and control families.(back)
5When children were 14 months old, program parents reported poorer health status for themselves and their children than control parents. These differences disappeared by the time the children were 2 years old. Additional analyses are under way to explore the patterns of impacts on health-related outcomes in the full sample and in key subgroups over time and will be presented in a policy report focusing on health issues.(back)
6Although the evaluation did not collect information on the quality of all child development services control group families received, center and family child care quality was measured when possible; this will be the subject of a forthcoming special policy report.(back)
7The 15-month parent services follow-up interviews were completed on average 16 months after random assignment.(back)
8No information is available about the quality of factors affecting home visiting effectiveness in the control group.(back)
9To remove the possibility that other factors could be contributing to variations in impacts across these subgroups of programs, it would have been necessary to randomly assign programs to use particular approaches or implement services in particular ways, which was not feasible.(back)
10Programs were rated as "fully implemented" if they substantially met all or most of the key program requirements in the revised Head Start Program Performance Standards (see Box 1 and the Pathways to Quality implementation report).(back)
11The relatively small number of programs participating in the evaluation limits the degree to which patterns of impacts by implementation and program approach (or other program characteristics) can be examined simultaneously. The pattern of stronger impacts among early implementers holds true within the group of programs that took a mixed approach in 1997, the only program approach for which there were sufficient numbers of programs in both the early-implemented and not early-implemented categories for this analysis. In that group, only the early implementers (three out of six programs) had significant impacts on a range of key child and family outcomes.(back)
12The absence of positive impacts on language development in center-based programs may be due to the limitations of the measures for assessing language development of children who are learning two languages. The evaluation assessed language development in one language. In two of the four center-based programs, however, children from Spanish-speaking families are exposed to English at the centers and are learning two languages. Earlier research suggests that children reared in bilingual environments score below average when only one language is assessed.(back)
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