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RELATIONSHIPS BETWEEN SERVICES AND CHILD OUTCOMES IN AN URBAN EARLY HEAD START PROGRAM
Jane Atwater, Judith Carta, Jean Ann Summers, and Martha
Staker
Kansas Early Head Start Partnership
A primary mission of the Kansas Early Head Start Partnership has been to identify program features and services that are most effective in promoting the best outcomes for children and families. This mission is fundamental for improving our local program and for contributing to the national knowledge base on effective intervention practice. As a first step in that effort, the present interim analyses seek to determine whether differences in services across individual families are related to child progress within Early Head Start.
Method
The analysis sample included 77 families in an urban community who were randomly assigned to the Early Head Start program group. All families in the program group were offered home-based intervention services. For families with child care needs, the Early Head Start program also provided placement in developmentally appropriate, community-based child care programs. The sample is ethnically diverse: 59 percent African American, 20 percent European American, and 20 percent Hispanic.
Children's Development
To track developmental progress, analyses focused on growth over time in children's cognitive and language development, using hierarchical linear modeling (HLM) (Raudenbush et al. 2000). Child assessments were scheduled every 4 to 6 months from 8 to 24 months of age, with actual age of administration ranging from 7 to 29 months. Developmental measures included (1) cognitive development, assessed with the Bayley Mental Development Scale; and (2) verbal communication during typical activities at home, assessed with the CIRCLE Observation System (Atwater et al. 1993).
Early Head Start Program Services
Program service variables were examined as possible predictors of children's developmental progress. In other words, we asked whether children who experienced different types and levels of service would have different developmental trajectories. Program service measures included (1) child's age at enrollment; (2) program model--home visiting only or home visiting plus child care services; (3) duration of program services--number of months through child's second birthday; (4) intensity of home-based services--number of home visits per month through child's second birthday; and (5) parent engagement in the program-a composite score based on staff ratings of the level and consistency of parent participation over time, active engagement during home visits, and follow-through on individual program goals between visits.
Family Risk Factors
In previous studies, family risk factors have been associated with a higher risk of developmental delay (see, for example, Sameroff and Fiese 1990). Thus, to control for the possible confound of family risk status in the present analyses, a Cumulative Risk Index (CRI) was calculated for each family, made up of factors assessed at enrollment: low parent education, parent not employed or in school, single-parent status, adolescent mother, large family, minority status, and limited English proficiency.
Summary of Key Results
Predictors of Children's Development
First, we used HLM analyses to determine whether family risk status was a significant predictor of the two dependent measures: cognitive development and verbal communication. Given the focus on developmental outcome, the intercept in HLM analyses was centered at 24 months. The CRI was related significantly both to 24-month outcomes and to developmental progress over time in Bayley scores (df = 71, p < .005; df = 71, p < .05, respectively), but was not a significant predictor of verbal communication.
Second, the five program service measures were examined individually as possible predictors of Bayley performance and verbal communication. To control for the number of analyses conducted, results were evaluated at a .01 significance level, using Bonferroni's correction for each dependent measure. Higher levels of parent engagement in program services were predictive of higher Bayley scores at 24 months of age (df = 70, p < .001). The relationship between engagement and developmental progress was positive but did not meet the corrected significance standard (df = 70, p < .05). Notably, when we considered parent engagement, family risk status dropped out as a predictor of development. Thus, children's 24-month outcomes in cognitive development were significantly higher when programs successfully engaged parents as active participants in home-based services. To illustrate, for families in the lowest quartile for engagement, children's Mental Development Index (MDI) scores at 24 months averaged 78.46 (raw score = 121.55), indicating developmental delay. In contrast, for the most highly engaged families, the mean MDI was 92.74 (raw score = 129.53), well within the typical range.
Similarly, in more highly engaged families, children talked more during home observations (df = 67, p < .01) and had more rapid increases in verbal communication over time (df = 67, p < .01). Duration of services also was positively related to progress in communication (df = 66, p < .01). In contrast, service intensity was negatively related to growth (df = 66, p < .01) and to 24-month outcomes (df = 66, p < .01). The latter finding may reflect the program's efforts to provide more intensive services for children with greater needs.
Factors Related to Parent Engagement
Given the significance of parent engagement as a predictor of children's development, we examined the relationship between parent engagement and risk status and to other program service variables. Compared to less engaged parents, more highly engaged parents had received more months of service before their child's second birthday (r [73] = .341, p < .005). Furthermore, active parent engagement during home-based services was significantly higher in families who also received child care services (mean = 11.5), compared to families who had only home visits (mean = 9.3) (t [71] = -2.411, p < .05). In particular, the families with child care services received higher ratings in two specific components of engagement: consistency of participation across time (t [71] = -2.802, p < .01) and active engagement during home visits (t [71] = -2.679, p < .01).
Conclusion
Taken together, the results highlight the critical importance of active parent engagement to the success of Early Head Start services for young children at risk and suggest that a constellation of services, including quality child care, may support parents' efforts to engage actively in services for their young children.
References
Atwater, J., D. Montagna, M. Creighton, R. Williams, and S. Hou. CIRCLE-II: Code for Interactive Recording of Caregiving and Learning Environments - Infancy Through Early Childhood. Kansas City, Kansas: Early Childhood Research Institute on Substance Abuse, Juniper Gardens Children's Project, 1993.
Raudenbush, S., A. Bryk, Y.F. Cheong, and R. Congdon. HLM5: Hierarchical Linear and Nonlinear Modeling. Lincolnwood, Illinois: Scientific Software International, 2000.
Sameroff, A.J., and B.H. Fiese "Transactional Regulation
and Early Intervention." In Handbook of Early Childhood Intervention,
edited by S.J. Meisels and J.P. Shonkoff. Cambridge: Cambridge University
Press, 1990, pp. 119-149.
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