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I. BACKGROUND AND CONTEXT FOR THE EVALUATION
In just six years, Early Head Start has grown from 68 initial grantees to almost 650 programs that in 2001 serve more than 55,000 low-income families with infants and toddlers throughout the country. With an increasing share of the Head Start budget, Early Head Start is an ambitious effort in which the Administration on Children, Youth and Families (ACYF) is responding to the "quiet crisis" facing American infants and toddlers, as identified by the Carnegie Corporation of New York in its 1994 Starting Points report.1 This interim Early Head Start evaluation report traces the services that Early Head Start families in 17 programs received during their first 15 months in the program, describes the differences that the programs made in the services families received, and examines their impacts on the children and families through the children's second birthday. (The evaluation's final report, one year hence, will report findings through three years of program participation and the children's third birthday.2) This report builds on the Early Head Start implementation study, which is fully described in two reports: Leading the Way (Administration on Children, Youth and Families 1999a, 1999b, 2000a, and 2000b) and Pathways to Quality (Administration on Children, Youth and Families 2001b).
This chapter begins with a history of the program and a description of the policy, programmatic, and research context for both the program and its evaluation. We summarize the questions the evaluation addresses, the conceptual framework guiding this research, and the general hypotheses that underlie the analyses. We then describe the 17 research programs, their families, and their communities, and follow with a description of the design, sample, and analytic approaches taken in the study.
Subsequent chapters describe:
- The evaluation methodology and analytic approaches
- The services received by Early Head Start mothers, fathers, and
children, and the difference the programs have made in the rates
and intensity of their participation in a wide range of services
during the initial period following program enrollment
- How the programs have influenced children's development, parenting,
and family development when the children are 2 years of age
- Variations in impacts among key subgroups of children and families
- Implications of these findings for policy, practice, and research
This report also recognizes the fathers of Early Head Start children and presents what we have learned about their involvement with the programs and with their families. In addition, findings and perspectives from local program and research partners are integrated throughout.
A. EARLY HEAD START, ITS HISTORY, AND ITS DEVELOPMENT AS A NATIONAL PROGRAM
Early Head Start programs are comprehensive, two-generation programs that focus on enhancing children's development while strengthening families. Designed for low-income pregnant women and families with infants and toddlers up to age 3, the programs provide a wide range of services through multiple strategies. Services include home visiting, case management, child development, parenting education, child care, health care and referrals, and family support. These services are configured into three program approaches (home-based, center-based, and a mixed approach), which are described in Section C.
A number of key events and changes, both external to and within the Head Start/Early Head Start infrastructure, have shaped the development of the programs during their first six years. Figure I.1 depicts the timing of these key events. These and other events are described in the following sections.
1. The Role of Legislation and Advisory Committees
The federal Early Head Start program began with bipartisan support through the 1994 Head Start reauthorization that established the mandate for infant-toddler services within Head Start. A later Congressional mandate (the 1998 Head Start reauthorization) propelled the program toward relatively rapid expansion.
Leading up to these mandates, a comprehensive study of Head Start services by the Advisory Committee on Head Start Quality and Expansion called for developing a "new initiative for expanded Head Start supports to families with children under age three." At the same time, the committee recommended actions to ensure that such services are of the highest quality and that new partnerships be forged to reduce fragmentation of services (U.S. Department of Health and Human Services [DHHS] 1993). In response to the 1994 reauthorizing legislation, the Secretary of DHHS appointed the Advisory Committee on Services for Families with Infants and Toddlers. It envisioned a two-generation program with intensive services beginning before birth and concentrating on enhancing development and supporting the family during the critical first three years of the child's life (U.S. Department of Health and Human Services 1995). The Advisory Committee recommended that programs be designed to produce outcomes in four domains:
1. Child development (including health, resiliency, and social, cognitive, and language development)
2. Family development (including parenting and relationships
with children, the home environment and family functioning, family
health, parent involvement, and economic self-sufficiency)
FIGURE I.1
KEY EVENTS IN THE HISTORY OF EARLY HEAD START
| Jan. 1994 |  |
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Advisory Committee on Head Start Quality and Expansion recommends serving families with children under 3 |
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Carnegie Starting Points report released | ||
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Head Start reauthorized with mandate to serve infants and toddlers | ||
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Advisory Committee on Services for families with Infants and Toddlers sets forth vision and names Early Head Start | ||
| Jan. 1995 | |
First Early Head Start program announcement solicits first grant applications | |
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Federal Fatherhood Initiative formed | ||
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Wave I: 68 new Early Head Start programs funded | ||
|
Oldest child in the research sample born | ||
| Jan. 1996 | |
First Early Head Start programs began serving families, random assignment begins | |
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Welfare reform legislation enacted (PRWORA) | ||
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Wave II: 75 new programs funded | ||
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First round of research implementation study visits conducted | ||
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Revised Head Start Program Performance Standards published for public comment | ||
| Jan. 1997 | |
White House Conference on Early Childhood Development and Learning | |
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Wave III: 32 new EHS programs funded | ||
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Second round of research site visits conducted | ||
| Jan. 1998 | |
Revised Head Start Program Performance Standards take effect | |
|
Monitoring visits to Wave I programs conducted | ||
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Wave IV: 127 new EHS programs funded | ||
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Youngest child in research sample born | ||
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Wave V: 148 new EHS programs funded | ||
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Head Start reauthorized by Coats Human Services Reauthorization Act | ||
|
Random assignment of research families concludes | ||
| Jan. 1999 | |
Wave VI: 97 new programs funded | |
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Third round of research implementation visits conducted | ||
| Jan. 2000 | |
Additional Early Head Start grantees funded, bringing total to 635 |
3. Staff development (including professional development and relationships with parents)
4. Community development (including enhanced child care quality, community collaboration, and integration of services to support families with young children)
The Advisory Committee also stressed continuous program improvement and recommended that national and local research be conducted to inform the development of the new Early Head Start program. The committee specified that local programs conduct annual self-assessments and improve their services based on analysis of local data. Both the 1994 and 1998 Head Start reauthorizing legislation specified that an evaluation begin early to focus on learning about all the services being delivered to families with infants and toddlers and the impacts of services on children and families.
2. The National Early Head Start Program
At the very outset of Early Head Start, ACYF created an infrastructure for supporting programs. This included the revised Head Start Program Performance Standards, an ongoing training and technical assistance (T&TA) system, and program monitoring. Early Head Start program guidelines also emphasized the importance of continuous program improvement, and built in research from the very beginning.
The Head Start Program Performance Standards, which have guided Head Start practice since the 1970s, were revised and published for comment in November 1996. The revised standards went into effect in January 1998, bringing Early Head Start programs under the Head Start standards umbrella. Between fall 1996 and January 1998, the Head Start Bureau worked with Early Head Start programs to clarify a number of the new elements in the standards. Within ACYF, the Head Start Bureau, under the leadership of the late Helen Taylor, emphasized the centrality of children's development and stressed program quality through adherence to the standards. The bureau worked with both Head Start and Early Head Start programs to meet the standards, and some programs that were not able to improve have closed.
In 1995, ACYF created the Early Head Start National Resource Center (NRC) to provide ongoing support, training, and technical assistance to all waves of Early Head Start programs. Operated under contract by the Zero to Three national organization, the NRC provided a range of services:
- Week-long training in infant care ("intensives") and annual institutes for all Head Start programs serving families with infants and toddlers
- Provision of a cadre of infant-toddler experts for (1) working with ACYF regional offices and Indian and Migrant program branches, and (2) conducting one-on-one consultations
- Coordination with ACYF's regional training centers, the Head Start Quality Improvement Centers (HSQICs) and Disabilities Services Quality Improvement Centers (DSQICs)
The 1998 Head Start reauthorization included funding for a leadership position for Early Head Start programs within the Head Start Bureau, supporting the mandated expansion of Early Head Start and the monitoring that is carried out to ensure program quality. Through comprehensive on-site visits, monitoring teams review programs for standards compliance every three years.
3. The Program's Policy Context
During the initial period of Early Head Start's implementation, significant national, state, and local changes were occurring, potentially affecting the approaches taken by Early Head Start programs, the way families responded, and how programs and communities interacted. The increasing focus on the importance of early development (including brain development) attracted the attention and support of policymakers, program sponsors, and community members for Early Head Start services. Just at the time that Early Head Start began serving families, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) enacted major reforms to the nation's system for providing income support to low-income families. This caused some programs to adjust their service delivery plans to meet changing family needs. Because some states no longer exempted mothers of infants from work requirements, some parents became more receptive to employment-related services (including child care) and may have been less available to participate in program activities.
In some states, changes associated with PRWORA have made it easier for families to obtain child care subsidies and have spurred states to improve and expand child care. Several states where Early Head Start research programs are located have increased funding for child care, aided centers seeking accreditation, or facilitated quality improvements for infant-toddler care. The expansion of prekindergarten programs may have created opportunities for children's transition to other programs when they leave Early Head Start, while new prekindergarten programs often compete for the same well-trained staff that Early Head Start programs need.
The federal Fatherhood Initiative has heightened attention to the role of fathers in a wide range of federal programs and has increased Early Head Start programs' efforts to draw men into their program activities and into the lives of Early Head Start children. In addition, programs have responded to PRWORA's increased emphasis on establishing paternity and enforcing child support.
A strong economy with low unemployment rates throughout the period of the early development of Early Head Start programs probably helped them meet the many needs of their low-income families. While some of the families were eligible for health care assistance through the Children's Health Insurance Program (CHIP), most were served by Medicaid. With CHIP, some states with Early Head Start programs have moved far in providing health services for all children.
4. The Research Context for the Early Head Start Program and Its Evaluation
Over the past decade, findings from a number of program evaluations have emerged that have a direct bearing on the Early Head Start evaluation. Some findings-particularly those from the Comprehensive Child Development Program (CCDP) and the Packard Foundation's review of home-visiting programs-identified many of the challenges inherent in trying to make a difference for infants and toddlers in low-income families. The CCDP experience highlighted the importance of focusing program services on child development, while the home-visiting literature reveals the importance of understanding-and measuring-the implementation and intensity of services. These lessons influenced both the guidance that ACYF has provided to Early Head Start programs over the past six years and the design of this evaluation.
a. Brief Review of Other Studies
A number of evaluations of two-generation programs serving low-income families with infants and toddlers have been conducted over the last quarter century. Program effects have often appeared weak, but the findings are difficult to interpret because of the great diversity in both program approaches and research methodologies across studies. Programs have varied in (1) the duration and intensity of services, (2) the timing of services, (3) their status as home- or center-based (or both), (4) the duration and intensity of the parenting component, (5) the extent of reliance on case management, and (6) the nature of self-sufficiency (adult education and job training) components. The research has also been variable, with differences in designs, domains assessed, timing of assessments, degree of information on program implementation, and extent of information on services received by control group families.
The Child and Family Resource Program was a comprehensive, two-generation demonstration program for families with infants and toddlers. The program produced significant effects on a number of parent outcomes after three years (employment or job training, coping skills, sense of control) and on parent-child teaching skills, but did not significantly affect children's cognitive or social development (Nauta and Travers 1982).
Randomized studies of three Parent Child Development Centers (PCDCs) focused on mother-child interactions and infant/toddler cognitive development. Dokecki, Hargrave, and Sandler (1983) found impacts on positive maternal behaviors at two sites and significantly higher Stanford Binet scores for PCDC children at two sites.
Between 1972 and 1977, the Carolina Abecedarian Project enrolled 120 "high-risk" families in four cohorts. From these, 111 children were randomly assigned to the program, which included full-time child care beginning in the first three months of life, or to a control group. Families and children continued receiving services until age 5. The program, which also provided social supports for families, was highly successful in improving children's cognitive development relative to the control group, with significant differences at 18, 24, and 36 months of age, and with an effect size of more than 1 standard deviation at 36 months (Campbell and Ramey 1994; and Ramey and Campbell 1991). The largest effects were found for children with the most extreme environmental risks. No effects were found on the families' home environments. The intervention impacts appeared to be smaller when control group children enrolled in community child care (Guralnick 2000). Follow-up studies showed that program effects persisted at every assessment point through 16 to 20 years of age.
Olds's Nurse Home Visitation Program is a model, designed some 20 years ago, in which nurses visit mothers, beginning during pregnancy and continuing until the children are 2 years old, "to improve pregnancy outcomes, promote children's health and development, and strengthen families' economic self-sufficiency" (Olds et al. 1999). Results of two randomized trials show reduced rates of childhood injuries and ingestions (events perhaps associated with child abuse and neglect). For the mothers in one site, they found long-term reductions in child abuse and neglect, reductions in subsequent pregnancies, increased economic self-sufficiency, and avoidance of substance abuse and criminal behavior. At age 15, the children had fewer arrests, convictions, and other negative outcomes. However, "the program produced few effects on children's development or on birth outcomes," and the other benefits were found for the neediest families rather than the broader population (Olds et al. 1999).
Project CARE tested the effectiveness of home-based parent education and social services with and without full-time, center-based child care. At 2 years of age, differences in language and cognitive development significantly favored the group that had received child care combined with family education, and these differences continued to 4 years of age (although somewhat lessened) (Wasik, Ramey, Bryant, and Sparling 1990). Project CARE compared two treatments (child care plus family support, family support only) with a no-services control group. The group with child care plus family support performed significantly better than both the other groups (Wasik et al. 1990).
The Infant Health and Development Program (IHDP) combined home visiting, center-based education, and family services to low-birthweight premature infants and their families during the first three years of life. At age 3, the program group scored significantly higher on the Stanford Binet and lower in behavior problems. The heavier low-birthweight infants benefited more at ages 2 and 3 than did the lower low-birthweight children (Brooks-Gunn, Klebanov, Liaw, and Spiker 1993). Effects were sustained through age 8 for the heavier low-birthweight children (McCarton et al. 1997).
The Comprehensive Child Development Program (CCDP) was implemented in 24 sites beginning in 1989 and 1990. Programs featured intensive social services and parent education, although direct child development services and program-sponsored child care were far less intensive than in the IHDP and Abecedarian programs. When children were 2 years old, the national evaluation (conducted in 21 of the sites) found that CCDPs significantly improved (1) mothers' parenting skills and attitudes (for example, greater sensitivity to cues given by children in parent-child interactions and more appropriate responding to signals of distress), (2) parents' economic self-sufficiency, and (3) children's cognitive development (Bayley Scales of Infant Development) and social behavior (cooperation and following rules). (Language development at age 2 was not measured.) These effects largely disappeared by age 5. At one site, however, significant and moderately large positive impacts were found at age 5 on children's cognitive development, parenting skills, and several self-sufficiency outcomes (St. Pierre, Layzer, Goodson, and Bernstein 1997). Impacts at intervening ages have not been reported.
In a secondary analysis of CCDP's 2- to 5-year impact data, Brooks-Gunn, Burchinal, and Lopez (2000) found that when sites were divided into two equal-size subgroups with more- and less-intensive parenting education (based on the average number of home visits families at each site received), the subgroup of programs with more-intense parenting education showed three important significant impacts relative to the control groups at those sites: (1) higher Bayley scores at age 2, (2) higher Kaufman Assessment Battery for Children (K-ABC) Achievement Scale scores at ages 3 to 5, and (3) higher Peabody Picture Vocabulary Test-R scores at ages 3 to 5. No impacts were found in the subgroup of sites where programs had less-intense parenting education.
Comparisons of the effects of home visiting and center-based programs are difficult to make. In a careful review, however, Benasich, Brooks-Gunn, and Clewell (1992) examined 27 studies and discovered that 90 percent of the center-based programs (compared with 64 percent of the home-based programs) produced immediate impacts on cognitive outcomes.
b. Building a Knowledge Base for Early Head Start
When they recommended Head Start services for infants and toddlers, the Head Start Quality and Expansion Panel and the Advisory Committee on Services for Families with Infants and Toddlers drew upon evidence of effectiveness in the existing research literature (including some of the findings cited here). The Advisory Committee on Services to Families with Infants and Toddlers consolidated knowledge from the research literature and from practice into nine principles to guide Early Head Start programs: (1) high quality; (2) prevention and promotion; (3) positive relationships and continuity; (4) parent involvement; (5) inclusion; (6) culture; (7) comprehensiveness, flexibility, responsiveness, and intensity; (8) transition; and (9) collaboration. These principles, along with the revised Head Start Program Performance Standards, set the stage for quality as they guided programs to implement specific practices (for example, low child-teacher ratios in relation to high quality).
Head Start advisory committees have called for research that learns about the conditions under which programs are successful (and for whom programs can be more effective) and promotes continuous program improvement. The Early Head Start Research and Evaluation project, therefore, represents not only an evaluation of the initial stages of Early Head Start but an important step in expanding the Early Head Start knowledge base in very systematic ways. It attempts to do so by building in a number of features in response to the shortcomings of previous studies and the challenges of the new standards, guidelines, and principles. These features include:
- A comprehensive implementation study to provide data on the services specified in the revised Head Start Program Performance Standards that Early Head Start programs delivered
- Collection of extensive data on the services individual families receive at specified intervals following random assignment, while also carefully and thoroughly documenting services received by control group families along the same dimensions and at the same intervals as for the program families (see Chapter III)
- Documenting the overall impacts of Early Head Start on children and families (see Chapters IV, V, and VI) and conducting analyses that take participation rates into account in testing for program impacts
- Conducting subgroup analyses to examine the extent to which different program approaches have different kinds of effects on Early Head Start's children and families (as described in Chapters III, IV, V, and VI)
- Conducting subgroup analyses to learn how the effectiveness of Early Head Start may differ according to the characteristics of the families being served (see Chapter VII)
- Conducting subgroup analyses to examine the relationship between levels of program implementation and the impacts achieved (Chapters III through VI)
- Incorporating local research, as well as other local documentation (including from program staff), to supplement the cross-site national data collection and analysis (highlighted throughout this report)
This research and evaluation work paves the way for a final Early Head Start evaluation report, in spring 2002, on child and family outcomes when children are 36 months old. In addition, a longitudinal follow-up study is currently underway, as the first Early Head Start "graduates" began preschool in fall 2000.
B. RESEARCH QUESTIONS ADDRESSED IN THE EARLY HEAD START IMPACT STUDY
1. Central Questions of the Study
The national evaluation has two overarching goals: (1) understanding the extent to which the Early Head Start intervention can be effective for infants and toddlers and their low-income families, and (2) understanding what kinds of programs and services can be effective for children and families with different characteristics living in varying circumstances and served by programs with varying approaches. The study was designed to address several key questions:
- How do Early Head Start programs affect child, parent, and family
outcomes?
- How do different program approaches and community contexts affect
these outcomes?
- How do program implementation and services affect outcomes?
- How do the characteristics of children and families affect outcomes?
These broad questions are translated into more specific research questions as we approach the analysis of impacts on services, children, parenting, and families (and are presented within the appropriate chapters).
2. Conceptual Framework
Like its older sibling Head Start, Early Head Start has the ultimate goal of promoting children's social competence, in the fullness of Zigler's original definition-children's "everyday effectiveness in dealing with their present environment and later responsibilities in school and life" (Zigler 1972). Infants and toddlers, however, have unique qualities that are different from those of preschool-age children, including their period of rapid development and important developmental milestones (such as developing trust and language development). Good nutrition and health are particularly important during the first three years of life, as are both emotional and cognitive stimulation. Infants and toddlers develop in the context of relationships, and interventions during this period typically focus on those relationships, especially the one between parent and child.
The five objectives of the Head Start performance measures also apply conceptually to infants and toddlers, even though they were designed for preschool-age children. The objectives describe both processes and outcomes of the program. One can visualize the conceptual framework as a pyramid, with program management and operations at the base, providing the foundation for delivering services, supporting child and family development, and creating the ultimate outcomes that support social competence (Administration on Children, Youth and Families 1998). The evaluation design (described in greater detail in Section D and in Chapter II) follows this overarching framework:
- The evaluation of Early Head Start began by documenting and analyzing
program implementation to ascertain whether the research programs
were well managed and had the potential for making a difference
in the lives of children and families.
- We collected extensive data on program services to determine the
extent to which programs (1) provided children and families with
the appropriate services, and (2) linked children and families to
needed community services and resources.
- We then measured children's growth and development, along with
their families' functioning and strengths and, by contrasting them
with the same measures in control group children and families, assessed
the impacts the research programs are having at this early stage
in their development.
3. Overarching Hypotheses
As described in Section C, Early Head Start programs strive to influence
children's development, parenting, and family functioning through
three main approaches (center-based, home-based, and mixed). Within
these approaches, we see that programs may follow multiple pathways
for achieving their outcomes. Although service delivery strategies
are implemented in diverse ways, they reflect two primary pathways
to achieving the ultimate enhanced development of infants and toddlers
(these can also be thought of as alternative theories of change by
which programs achieve their effects):
1. The direct child pathway, for which we hypothesize that impacts on children's development will be either more probable or stronger than impacts on parenting, parent-child interactions, and family functioning. Programs emphasizing this pathway work with children and families primarily through child development centers. Caregivers interact directly with children to establish relationships, and conduct activities designed to enhance children's health and their cognitive, social-emotional, and physical development. These programs also support families through social services, parent education, and parent involvement, but most services are child-focused.
2. The indirect child pathway through parenting and parent-child relationships, for which we hypothesize that impacts on parenting, parent-child relationships, and family functioning will be more common or stronger than the impacts on children's development, at least during the first two years of life. We hypothesize that child development impacts will manifest themselves somewhat later than through the direct child pathway. Programs emphasizing this pathway work with children and families primarily through home visiting (combined with social supports and group socialization activities). Home visitors interact with parents with the aim of strengthening the parent-child relationship, enhancing parenting skills, and supporting their efforts to provide an educationally stimulating and emotionally responsive home environment. These activities are then expected to lead to changes in the children's health, cognitive, social-emotional, and physical development.
Programs may follow multiple pathways for achieving their desired outcomes. In practice, their emphasis on each pathway varies. Hypothesized impacts depend on the balance adopted by the particular program, that is, whether it takes (1) predominantly a direct child pathway, with some parent and parent-child focus in the services offered; (2) predominantly an indirect pathway through parenting, with some direct child services added; or (3) a more equal balance between these two pathways. Program impacts may also vary depending on the emphasis placed on the indirect pathways through family support. Programs whose theory of change follows either a direct or an indirect path to child development also strive to strengthen family self-sufficiency and resources so that parents are better able to provide emotional and educational stimulation for their children and to interact with them in positive ways.
In general, programs that emphasize creating a balance of both direct and indirect pathways would be expected to have stronger impacts on parenting and family outcomes than programs that emphasize the direct child pathway. They would also be expected to have stronger child development outcomes than programs that emphasize the indirect pathway through parenting. Because little research has been conducted with programs that emphasize both pathways, the Early Head Start evaluation examines more than one hypothesis. Programs emphasizing both pathways may have more flexibility to respond to the varying needs of families, by providing predominantly home visiting, predominantly center care, or a mixture of the two that is tailored to the needs of the individual family. This flexibility may create a synergy that leads to effects greater than the sum of the effects of the two approaches alone. On the other hand, it is possible that in the short term, some dilution in both child and parent/family impacts could occur if emphasizing both pathways stretches the program's resources or creates complex operational challenges.
In the context of this basic conceptual framework, each of the chapters describing program impacts on children, parenting, and families (Chapters IV through VI) begins with a detailed discussion of hypothesized effects in each outcome area.
C. THE EARLY HEAD START PROGRAMS, FAMILIES, AND COMMUNITIES
1. The 17 Early Head Start Research Programs
Unlike some programs, Early Head Start does not embrace a particular program "model," but asks each grantee to select service delivery options that will best meet the needs of the families and communities it serves. The period of dynamic change (since the initiation of Early Head Start) has provided ample opportunity for program adaptations over time. Each program has strived to implement the revised performance standards, find the approach (or mix of approaches) that will continue to meet changing family needs, and strengthen strategies that will promote children's development. Early Head Start programs try to meet families' and communities' needs through one or more program options: (1) home-based, (2) center-based, (3) combination (in which families receive both home visits and center experiences), and (4) locally designed.
Because a program may offer multiple options, we characterized programs for research purposes according to the options they offer families:
- Center-based programs, which provide all services to families
through the center-based option (center-based child care plus other
activities) and offer a minimum of two home visits a year to each
family
- Home-based programs, which provide all services to families through
the home-based option (weekly home visits and at least two group
socializations a month for each family)
- Mixed-approach programs, which provide services to some families through the center-based option and to some through the home-based option, or provide services to families through the combination or locally designed option (services can be mixed in the sense of programs targeting different types of services to different families or in the sense that individual families can receive a mix of services either at the same time or at different times; thus, in different ways, programs adjust the mix of home- and center-based services to meet the needs of families)
The 17 programs selected to participate in the national Early Head Start Research and Evaluation Project include 16 Wave I programs (the 68 programs funded in 1995) and 1 Wave II program, funded in 1996. They are located in all regions of the country and in both urban and rural settings, and they include all major Early Head Start program approaches. The families served are highly diverse, as described later.
When funded, the research programs were about equally divided among the three program approaches (Figure I.2). By fall 1997, the home-based approach predominated, having increased from five to seven programs (four were center-based and six were mixed-approach in fall 1997). Program approaches continued to evolve, and by fall 1999, most home-based programs had become mixed-approach.
This evolution in program approaches occurred as programs responded to changing family needs, particularly the increasing need for child care. Some programs changed their approaches in fundamental ways; others significantly altered services within their basic approach. Details of this evolution are described in the Pathways to Quality report, but we summarize key changes here. Comparing programs in 1997 and 1999 (the two periods in which we obtained detailed implementation data from site visits), we see that:
- The four programs that began with a center-based approach remained
center-based throughout but enhanced their programs in a variety
of ways, such as achieving NAEYC accreditation; strengthening staff
development; adding more classrooms; reducing group sizes; making
changes that promoted greater continuity of care; collaborating
more closely with welfare-to-work case managers; and expanding health,
nutrition, and mental health services.
- Two of the seven home-based programs remained home-based while
adding enhanced support for families' efforts to use good-quality
child care.
- Five of the seven home-based programs expanded services options
to such an extent that by fall 1999 they had become "mixed"
in their approach to serving families. The changes included (1)
helping families find good child care and paying for quality child
care that some home-based families used, (2) adding a child care
center to serve a small portion of the enrolled families for whom
the home visiting approach was not appropriate, (3) working with
community partners to improve community child care, and (4) visiting
children in their child care settings as well as in their homes.
- The six mixed-approach programs continued taking a mixed approach, but by 1999 they had expanded some service options, including obtaining state funding to enhance the program's ability to provide child care assistance, increasing home visit time spent on parent-child activities, taking formal steps to ensure that child care providers used by Early Head Start families met the revised Head Start Program Performance Standards, adding child care classrooms, and improving collaborations with the local child care licensing office.
THE EVOLUTION OF PROGRAM APPROACHES OVER TIME
 |
| [D] |
Research programs varied along a number of dimensions that provide important context for their evaluation. One dimension is the variety of experiences programs brought to their new mission as Early Head Start grantees. Most of the grantee agencies had experience offering infant-toddler services: nine of the grantees had operated Head Start programs; one had previously operated a Parent Child Center (PCC) as well as Head Start; seven had been Comprehensive Child Development Programs (CCDPs) (five of these were new to Head Start but had served infants and toddlers); and three of the grantees without Head Start, PCC, or CCDP experience had operated other community-based programs. Several programs operated in multiple sites within their service area. The experience of the Mid-Iowa Community Action Early Head Start Program is highlighted in Box I.1, which illustrates how some programs design their services to meet the needs of the local community.
2. The Families That Early Head Start Research Programs Served
Table I.1 displays key characteristics of the 1,513 Early Head Start families at the time they entered the program. At the time of enrollment, primary caregivers were diverse 3:
- Early Head Start applicants (99 percent of whom were mothers)
were on average 23 years old. The mean age across the programs ranged
from 18 to 26. About 62 percent were first-time parents.
- One-fourth of the primary caregivers lived with a spouse. Slightly
more than one-third lived with other adults, and a similar proportion
lived alone with their children.
- Slightly more than one-third of families enrolled in Early Head
Start were headed by teenage parents. The percentage ranged from
19 to 90 across the 17 programs. Two programs had a special emphasis
on serving
- Overall, one-third of families were African American, one-fourth
were Hispanic, and slightly more than one-third were white (with
a small percentage in other groups). Eleven programs were relatively
homogeneous, with at least two-thirds of the families representing
a single racial/ethnic group (four programs enrolled predominantly
African American families, three were predominantly Hispanic, and
five were predominantly white); in six, the racial/ethnic composition
was diverse.
- Overall, one-fifth of the Early Head Start primary caregivers did not speak English as their primary language, although in two programs more than half reported not speaking English well.
BOX I.1 THE CHALLENGES OF EARLY HEAD START SERVING RURAL AREAS: CENTRAL IOWA Kathie Readout Mid-Iowa Community Action (MICA) began by choosing a home-based model as the best way to reach the largest number of Early Head Start-eligible families throughout five counties in central Iowa. The home-based model was appropriate to the widely dispersed population that MICA served. MICA's five-county service area averages 60 people per square mile, compared with 2,500 in Des Moines, Iowa's largest city, or with 20,000 in Chicago. Half the population lives in towns with a population less than 10,000 or in unincorporated areas. The largest city in each of the two "urbanized" counties has 27,000 and 50,000 inhabitants, respectively. Only two cities in the three rural counties have more than 3,000 inhabitants. Families live in small towns because they grew up in them and so they can be near extended family. Some families seek out the lower housing costs in small towns. Because growth in the economy over the past decade has concentrated in larger towns and cities, families living in small towns must seek jobs and services outside the communities in which they live. Welfare reform has cut the TANF rolls in half. Yet despite historically low unemployment rates (three to four percent in MICA's service area), the jobs low-income adults are able to obtain do not support their families. Low wages have made Iowa the state with the second-highest percentage (82 percent) of families in which either both adults in two-parent families work or the single parent in one-parent families works. Jobs for which the greatest number of openings exist in central Iowa (retail, services, manufacturing) pay modest wages ($8 to $10 per hour), and are the least likely to be full-time and to include fringe benefits such as health insurance. Only 14 of 77 (18 percent) Early Head Start children are covered by private, third-party health insurance. The most common reason for children leaving Early Head Start is a family move out of the service area, usually driven by the parents seeking jobs elsewhere. The 1998 Bureau of Economic Analysis (U.S. Census) figures place Iowa second to the bottom in average income per job when compared with the six contiguous states: $25,861 per year or an hourly wage equivalent of $12.43. In contrast, average wages per job in Missouri, Minnesota, and Illinois were 12, 21, and 42 percent higher, respectively. The second most prevalent reason parents give for taking their children out of Early Head Start is lack of time to meet with Early Head Start staff for home visits. Working adults in rural families nearly always have to commute. It is necessary to own a personal vehicle, as public transportation is too limited and inflexible to be useful for getting to work or for keeping most appointments. Working low-income adults have great difficulty finding affordable, quality child care. Because parents often commute, children spend long hours in child care. One Early Head Start parent recently lobbied for her child to be selected into an already full MICA toddler room, because she was going to school and had found no acceptable care alternative. Few small towns can support center-based child care. MICA has recognized three distinct responses it must offer to meet EHS family needs for quality child care: (1) center-based services in the largest cities with the population density to support centers;(2) home-based services to a small but important group of families; and (3) family care provider support, technical assistance, and professional development to raise the quality of care available where centers are not an option. Geography affects how rural low-income families live their lives; it also shapes program options. A single Early Head Start model can not meet the work schedules and child development/child care needs of families in towns of dramatically different sizes that are distant from one another. |
|
All Research Programs Combined (Percentage) |
Range Across Research Programs (Percentage) |
|---|---|---|
| Primary Caregiver (Applicant) Is Female | 99 | 97 to 100 |
| Primary Caregiver Is a Teenager (Under 20) | 39 | 19 to 90 |
| Primary Caregiver Is Married and Lives with Spouse | 25 | 2 to 66 |
| Primary Caregiver’s Race/Ethnicity | ||
| African American | 34 | 0 to 91 |
| Hispanic | 24 | 0 to 90 |
| White | 37 | 2 to 91 |
| Other | 5 | 0 to 14 |
| Primary Caregiver’s Main Language Is Not English | 20 | 0 to 81 |
| Primary Caregiver Does Not Speak English Well | 11 | 0 to 55 |
| Primary Caregiver Lacks a High School Diploma | 48 | 24 to 88 |
| Primary Caregiver's Main Activity | ||
| Employed | 23 | 11 to 44 |
| In school or training | 22 | 4 to 64 |
| Other | 55 | 24 to 78 |
| Primary Caregiver Receives Welfare Cash Assistance (AFDC/TANF) | 36 | 12 to 66 |
| Number of Applicants/Programs | 1,513 | 17 |
| SOURCE: Head Start Family Information System application and enrollment data. | ||
- Nearly half the Early Head Start primary caregivers did not have
their high school diploma at the time they enrolled (however, in
four programs, two-thirds were high school graduates, and in three
programs two-thirds were not).
- At enrollment, 45 percent of primary caregivers were employed
or in school or training.
- Most families were receiving public assistance of some kind (77
percent were covered by Medicaid, 88 percent were receiving WIC
benefits, almost half were receiving food stamps, just over one-third
were receiving AFDC or TANF, and 7 percent were receiving SSI benefits).
- Approximately one-fourth of primary caregivers enrolled while
they were pregnant. The percentage that were pregnant ranged from
8 to 67 percent across the programs.
- HSFIS items relating to families' needs and resources indicated that the greatest self-reported needs of parents were for adequate child care (34 percent of families overall, ranging from 11 to 68 percent across the programs); transportation (21 percent, ranging from 12 to 35); and medical care (14 percent overall, ranging from 3 to 36 percent).
Several local research teams worked with their program partners to collect baseline information about their families that would provide a richer understanding of families' characteristics than is available through the HSFIS data. Working with the Vermont program, the Harvard University researchers obtained information about their families' values and emotional health, and note the implications for families' ability to benefit from the program (Box I.2).
To be eligible for the research, the primary caregiver in the research program families had to be pregnant or have a child younger than 12 months of age. The Early Head Start children who were born at the time of enrollment also had diverse characteristics:
- They varied in age, with about half under 5 months. Including
families in which the focus child was not yet born, the mean age
at enrollment was 3.5 months. The mean age at enrollment ranged
from 2.0 to 8.6 months across programs.
- About 10 percent of the born children had been born at low birthweight
(under 2,500 grams), although the figure was 24 percent in one program.
- We estimate that 20 percent of children who were born at the time of enrollment might have had-or were at risk for-a developmental disability.4
BOX I.2 PARENTING VALUES AND EMOTIONAL HEALTH, ENGAGEMENT
IN RESEARCH Barbara Alexander Pan, Catherine Snow, and Leah
Bratton Conducting research with and providing services to families experiencing the stress of poverty can be a formidable challenge. Many low-income families frequently relocate and do not have consistent phone service. One of the outcomes many Early Head Start programs target is the quality of parent-child interaction and communication, but intervention can be effective only if families are locatable and engaged with the program. Research carried out by the Harvard Graduate School of Education research team, in collaboration with Early Education Services in Vermont, suggests that parenting values and emotional health may influence parents' participation in the research study, their use of Early Head Start services, and their access to intervention with regard to parent-child communication and interaction. At entry into the study, 133 parents living in Windham County, Vermont, completed the Child Abuse Potential Inventory (CAP) a 120-item questionnaire about parents' values and beliefs, emotional health, and relationships with others. Between 20 and 26 percent of parents scored above clinical thresholds for unhappiness, distress, problems with family or others, and/or child abuse potential, often despite apparent efforts to project socially desirable responses. Some months later, when their children were 14 months old, the study asked each parent to be videotaped at home interacting with her child with a set of toys. Seventy-six percent of parents who completed the CAP questionnaire at baseline were located and agreed to participate in this aspect of the study. However, of those parents whose earlier responses on the CAP questionnaire indicated potential for child abuse/neglect, only 57 percent participated. Least likely to participate in the videotaped parent-child interaction were those parents whose responses evidenced both potential for child abuse/neglect and effort to provide socially desirable responses. This variability in research participation was mirrored in program involvement. Of 17 parents in the program group who were at risk for dysfunctional parenting, 11 dropped out of the program within a few months. Only four (24 percent) engaged in the program in a meaningful way for more than a few months. Previous research has shown that quantity and quality of adult communication predict children's rate of vocabulary growth, which in turn is highly predictive of children's later academic achievement. Because mothers differ widely in their degree of communicative engagement, it is important to provide intervention around parent-child communication to those experiencing the most difficulty. Unfortunately, the findings reported here suggest that those mothers may be among the parents most challenging to engage in programs such as Early Head Start, and furthermore, that they are often missing from the research picture because they have reservations about participating fully in the research and because researchers cannot locate them. Parents experiencing stress with respect to the parent-child relationship may find it particularly difficult to engage in a program that focuses on parenting and child development. Often, help in overcoming social and environmental barriers must precede direct work on parenting and parent-child communication. For those high-risk mothers programs successfully engage, intervention can focus on ways of alleviating parenting distress and on cultivating parents' enjoyment of communicating positively with their children. |
3. The Communities Served by Early Head Start Research Programs
The 17 research programs are distributed across the major regions of the country-six in the West, four in the Midwest, four in the Northeast or Mid-Atlantic, and three in the South. About half are in urban areas and half in small towns or rural areas, with home-based, center-based, and mixed-approach programs in each. Most programs are located in areas of low unemployment (the median 1998 unemployment rate was 3.8 percent). During this period, the national unemployment rate was about 4.5 percent. Four of the research programs are in cities or areas where unemployment exceeded 5.5 percent in 1998; the rates across those sites ranged from 5.5 to 10.4 percent. In these communities with higher unemployment rates, staff described job and job-training opportunities as inadequate.
Welfare reform influenced the community context in several ways. One key factor affecting Early Head Start families was whether or not the state (or, in some cases, the county) exempted mothers of infants under 12 months of age from the work requirements. Seven of the research programs operated in areas where there was no exemption. In these areas, mothers were expected to enter the workforce when their babies reached ages ranging from 6 weeks to 9 months.
A few programs described their communities as "service rich," yet all identified some services for low-income families that were inadequate or lacking. As Chapter III documents, families in the control group, who did not have the benefits of Early Head Start, generally received substantially fewer services. During implementation visits, staff reported the major service inadequacies in communities to be lack of affordable and high-quality child care, insufficient affordable housing, and poor public transportation.
4. How Early Head Start Research Programs Compare with All Funded Programs from Which They Were Selected
The 17 selected research programs reflect the populations served by all Wave I and II programs from which they were selected (Table I.2). 5 For example:
- The average number of families enrolled in the research programs
(85) is very similar to the number in Wave I (81) and Wave II (84)
programs.
- The racial/ethnic distribution is similar, but the research programs
have a slightly larger percentage of African American families and
a slightly smaller percentage of white families.
- The percentage of single- and two-parent families in the research
programs is similar to the average percentage in the Wave I and
II programs.
- About the same percentage of primary caregivers are in school or training.
Although the findings reported in subsequent chapters are not statistically generalizable to all Early Head Start programs, they are clearly relevant to the rest of the programs because (1) the research sites include the full range of locations and program approaches, and (2) the families served by the research programs resemble the families served by other Wave I and II programs. Thus, the lessons drawn from the experiences of these programs are likely to be applicable to the others.
|
Wave I Programs (Percentage) |
Wave II Programs (Percentage) |
Research Programs (Percentage) |
|---|---|---|---|
| Total ACYF-Funded Enrollment | |||
| 10 to 29 children | 6 |
0 |
0a
|
| 30 to 59 children | 14 |
9 |
6 |
| 60 to 99 children | 62 |
64 |
65 |
| 100 to 199 children | 15 |
27 |
29 |
| 200 to 299 children | 3 |
0 |
0 |
| (Average) | (81) |
(84) |
(85) |
| Race/Ethnicity of Enrolled Children | |||
| African American | 33 |
21 |
34a
|
| Hispanic | 22 |
27 |
24 |
| White | 39 |
46 |
37 |
| Other | 6 |
5 |
5 |
| English Is the Main Language | 85 |
79 |
80 |
| Family Type | |||
| Two-parent families | 39 |
46 |
40 |
| Single-parent families | 51 |
46 |
52 |
| Other relativesb | 7 |
5 |
3 |
| Foster families | 1 |
1 |
0 |
| Other | 1 |
1 |
5 |
| Employment Statusc | |||
| In school or training | 20 |
22 |
22 |
| Not employed | 48 |
48 |
55 |
| Number of Programs | 66 |
11 |
17 |
| SOURCE: Head Start Family Information System application and enrollment data. NOTE: The percentages for the Wave I and II Early Head Start programs are derived from available Program Information Report (PIR) data. The percentages for the Early Head Start research programs are derived from Head Start Family Information System application and enrollment data from 1,513 families. Percentages may not add up to 100, as a result of rounding. aThe data for the research programs refer to families instead of children.(back) bThe HSFIS data elements and definitions manual instructs programs to mark "other relatives" if the child is being raised by relatives other than his/her parents, such as grandparents, aunts, or uncles, but not if the child is being raised by his/her parents and is living with other relatives as well.(back) cThe research program data and PIR data are not consistent in the way that they count primary caregivers' employment status, so it is not possible to compare the percentage of caregivers who are employed.(back) |
|||
1. Description of the Evaluation
The National Early Head Start Research and Evaluation Project is a cross-site national study conducted by Mathematica Policy Research, Inc. (MPR) and Columbia University's Center for Children and Families at Teachers College, in collaboration with the Early Head Start Research Consortium. All together, the study encompasses the following components:
- Implementation Study. Issues related to program
implementation have been addressed in the Early Head Start implementation
study and reported in two sets of reports; see Leading the Way (Administration
on Children, Youth and Families 1999, 2000a, 2000b) and Pathways
to Quality (Administration on Children, Youth and Families 2001b).
- Continuous Program Improvement. Throughout the evaluation,
reports and presentations have provided new information that all
Early Head Start programs can use to enhance their ability to meet
their families' needs.
- Impact Evaluation. Program impacts are the focus
of this report and of the final report, to be completed in spring
2002.
- Local Research Studies. Elements of these are integrated
in this report, in boxes throughout the chapters and in Appendix
A. The local university research and program teams will report other
local findings separately.
- Special Policy Studies. These include studies of issues relating to welfare reform, health and disabilities, child care, and fatherhood. Key findings from the Early Head Start fatherhood research are presented in this report. Special reports on child care and on health and disabilities will be issued separately, as will additional reports focused on particular issues related to father involvement.
The impact analyses (reported here) focus on program impacts on children and families; analyses of outcomes in the staff and community development areas are reported in the Pathways to Quality implementation report. The study is grounded in an experimental design in which about 3,000 families across the 17 program sites were randomly assigned to participate in Early Head Start or to be in the control group. Special features of the study include 6:
- Partnerships with 15 local research teams that permit the cross-site
study to add site-specific findings from local research and to benefit
from interpretations and perspectives of researchers and program
staff at the local level
- The use of data from the implementation study to conduct targeted
analyses based on subgroups of programs that vary by their approach
to delivering services and levels of implementation
- Analysis of families' baseline characteristics to identify subgroups
for whom the program may have differential effectiveness
- A detailed analysis of the services received by both program and
control group families to understand program impacts better
- Analytic strategies using statistical adjustments to enable the findings to reflect impacts for the Early Head Start families who met a criterion for at least minimal program participation, as well as for all Early Head Start-eligible families
2. The Early Head Start Research Consortium
Under its contract with ACYF, MPR worked with the 15 local research teams, the 17 program directors from the research sites, and ACYF to create the Early Head Start Research Consortium. Beginning in April 1996, shortly after the local research grants were awarded, the consortium has met two or three times each year to review evaluation plans (including instruments, data collection procedures, and data analysis plans) and collaborate on various reporting and dissemination activities. As described in Appendix B, in all but one of the sites, local researchers were responsible for all data collection (conducted under subcontract to MPR). The consortium created several workgroups to carry out research activities related to special topics, such as welfare reform, fatherhood, health and disabilities, and child care. The evaluation reports (including this one and those listed on page ii) embody the spirit of collaboration, as committees of consortium members reviewed the plans for and early drafts of this report and local research and program partners contributed brief reports of local studies, which have been incorporated into this report. The consortium members and their member institutions are listed in Appendix F.
3. Overview of the Implementation Study and Its Findings
The national evaluation includes a comprehensive implementation study that measured the extent to which programs had become "fully implemented" in 1997 and 1999. The assessment of implementation was based on selected key elements of the program guidelines and the revised Head Start Program Performance Standards, as described in Leading the Way (Administration on Children, Youth and Families 1999 and 2000) and Pathways to Quality (Administration on Children, Youth and Families 2001b). Data were collected in three rounds of site visits, and a panel of site visitors, national evaluation representatives, and outside experts, using a consensus-based approach, assessed the degree of implementation both overall and separately for the child and family development areas (see Appendix C).
One-third (six) of the programs were judged to be fully implemented overall by the fall 1997 implementation visits and continued to be fully implemented in late 1999 while still expanding the numbers of families served. We refer to these as the early implementers. By fall 1999, two-thirds of the programs were fully implemented. We refer to the six that reached this level after 1997 as the later implementers. The remaining five programs did not achieve ratings of "fully implemented" during the evaluation period. We refer to them as the incomplete implementers, all of which nevertheless made strides in particular program areas and, in fact, showed a number of strengths. In general, these programs were not rated as "fully implemented" in child development and health services but tended to have strong family development services.7
As part of the implementation rating process, we also rated the degree of implementation of child development and health services, which included programs' efforts in (1) conducting developmental assessments, (2) individualizing child development services, (3) involving parents in child development services, (4) promoting group socializations, (5) providing child care that meets the performance standards, (6) supplying health services for children, (7) offering frequent child development services, and (8) providing services for children with disabilities. Eight programs achieved a rating of "fully implemented" in this area in 1997, a number that increased to nine by 1999.
In the area of programs' implementation of family partnerships, we considered programs' progress in (1) Individualized Family Partnership Agreements; (2) availability of services; (3) frequency of services; and (4) parent involvement in policymaking, operations, and governance. In fall 1997, 9 programs were rated as "fully" implemented in family partnerships; this increased to 12 programs by fall 1999. In addition, father involvement became increasingly important to programs (see Box I.3 and additional information in Chapter III).8
The implementation study also assessed key aspects of the quality of both home- and center-based child development services. We assessed the quality of child care received by program families, including the care provided in both Early Head Start centers and other community child care settings. See Pathways to Quality for a detailed description of our assessment of these data
BOX I.3 IMPLEMENTATION OF FATHER INVOLVEMENT ACTIVITIES Programs increasingly created opportunities for the fathers and father figures of Early Head Start children to become involved in program activities and to be more involved with their children. Programs use a variety of strategies to engage fathers in activities ranging from participation in home visits to special events just for fathers, such as male support groups. In assessing program implementation of father involvement activities, we found through a special survey of programs in 1999 that about one-fourth of programs considered themselves to be at a mature or very mature stage in their efforts to involve fathers and becoming "father friendly." We also learned through the implementation study site visits that about half the programs had a staff member who served as the male involvement coordinator or the person responsible for father involvement. We considered programs to be "fully implemented" in father involvement if they did at least two of the following: encouraged fathers to participate in regular program services, had staff responsible for working with and involving fathers, offered male support groups, provided recreational activities for men, used a special curriculum for males, or provided other services for males. Five programs were considered fully implemented in father involvement in both 1997 and 1999. |
(Administration on Children, Youth and Families 2001b).9 The assessments of the child care arrangements used by program families are based on both field staff observations of child care settings and data collected from program staff during site visits. Observations of child care settings were made in conjunction with the study's 14- and 24-month data collection and included use of the Infant/Toddler Environment Rating Scale (ITERS)10 and the Family Day Care Environment Rating Scale (FDCRS), 11 as well as observed child-teacher ratios and group sizes.
Our preliminary analysis for the implementation study indicates that the quality of care provided by Early Head Start centers during their first two years of serving families was good.12 All nine programs that operated centers from the beginning scored above 4 (the middle of the minimal-to-good range) on the ITERS, with the average being 5.3 (in the good-to-excellent range). Observed child-teacher ratios and group sizes were low and well under the maximum allowed by the revised Head Start Program Performance Standards (below four children per teacher and eight children per group).
Our preliminary analysis suggests that the quality of care received by Early Head Start children in community child care centers varied widely and was minimal to good, on average. The average ITERS score in community child care center classrooms was 3.7 in 1997-1998 and 4.5 in 1998-1999. Observed child-teacher ratios and group sizes exceeded the maximums allowed by the performance standards. The preliminary observational data suggest that quality of care received by program children in family child care homes was consistently minimal. Average FDCRS scores were 3.5 in both time periods. Observed child-teacher ratios and group sizes were low.
In fall 1999, most of the 12 research programs with Early Head Start centers received good or high ratings on several factors that may be responsible for child care quality-curriculum, assignment of primary caregivers, and educational attainment of teachers. Among all research programs, between one-fourth and one-half received good or high ratings in monitoring and in training and support for child care providers.
Since the study was not able to observe home visits directly, we rated quality of child development home visits by considering program factors that are related to service quality. These included supervision, training, and hiring of home visitors; planning and frequency of home visits; and the extent to which staff reported that home visits emphasized child development and were integrated with other services. By fall 1999, 11 of the 13 programs that served some or all families in a home-based option received a good or high rating of quality, up from 9 programs in 1997. At the local level, researchers working with two home-based programs have delved more deeply into the home-visiting process, as described in Box I.4 and Box I.5.
BOX I.4 VOICES OF HOME VISITORS IN ONE EARLY HEAD START PROGRAM Tracy Collins and Catherine Ayoub Early Education Services in Brattleboro, Vermont, is a mature Early Head Start program in which home visitors are responsible for direct provision of services to families. In open-ended, one-on-one interviews, home visitors were asked about their work and professional development. Analysis of the interview data focused on home visitors' talk about their actual work, including how they plan for and carry out home visits, examples of "in the moment" decisions made while in a family's home, and their reflections on the satisfaction derived from relationships that work well and frustration with those that do not. Following are excerpts from the interview record (not their real names) that provide a glimpse into the goals and challenges faced by home visitors and the level of passionate commitment they feel toward families and children. Home visitors see their first task as establishing and maintaining relationships with the family:
Home visitors explain how they see their work with families as centering around, but not limited to, child development:
Home visitors also must deal with many challenges: finding ways to connect with families with histories of difficult or unsuccessful relationships, reassessing or re-establishing connections with families, and being willing to recognize how their own personal histories may interact with those of the families they serve:
These examples illustrate some of the multiple levels on which home visitors approach their work with families. Findings from this study may help inform training and supervision of home visitors, as well as supplement more quantitative methods used in evaluating Early Head Start services provided through the home-visiting model. |
BOX I.5 INSIDE HOME VISITS: A COLLABORATIVE LOOK AT PROCESS AND QUALITY L. A. Roggman, L. K. Boyce, G.A. Cook, and X.
Jump For Bear River Early Head Start, serving northern Utah and southern Idaho, the target and setting of intervention are the mother and child in their home. Like many other home-based Early Head Start programs, Bear River Early Head Start is committed to this strategy for service delivery as a practical way to emphasize parent-child relationships and parent education in a mostly rural area. Home visit quality was assessed in this program (n = 92 families) using measures developed in collaboration with program staff. The families this program served during the evaluation period were predominantly white (82 percent), married (73 percent), and first-time parents (52 percent). Multiple viewpoints of home visits are valuable, because each perspective represents a different view of the quality of home visits. These perspectives together indicated that the quality of home visits in this program was high. They also indicated that how well home visitors and parents worked together was related to how much program staff reported that parents benefited from the program. When researchers independently coded home visitors as more facilitative and parents as more engaged, program staff rated families as having better home visits and making more progress. When home visitors did not effectively facilitate parent-child interaction, and, even more important, when parents were not engaged, families were not seen as improving. Development of this Early Head Start program was enhanced by its collaboration with researchers. The results of this evaluation were used to strengthen the quality of home visits. In response to feedback about variations in the quality of home visits, the program reexamined its home visit strategies and provided more extensive training and supervision for home visitors. Thus, the results of this evaluation were used to strengthen the quality of their home visits. |
1The 1994 and 1998 Head Start reauthorizations directed that the percentage of the annual Head Start budget allocated to the new Early Head Start program was to begin at 3 percent in 1995 and be increased to 9 percent for 2001 and 10 percent for 2002 and 2003. (back)
2TA complete list of the national Early Head Start evaluation reports appears on page ii. (back)
3We describe program and family characteristics at the outset of the study based on data
from the Head Start Family Information System (HSFIS) application and enrollment forms that families completed at the time of application to the program. Programs submitted these forms to MPR for random assignment,