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Overview of Program Services
The research programs provided a rich array of services to achieve their desired outcomes. Highlights of the services that programs provided in each key domain include:
Child Development and Health
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Across the nine programs that provided center-based child development services to some or all families, these services were almost always full-time and were based on a variety of curriculum resources. They were usually provided to infants and toddlers with relatively small child-staff ratios (4 to 1 or smaller), often in small group sizes (8 or fewer children), and showed good to excellent observed quality (see page 15 for more details). These ratios and group sizes are generally associated with more positive child outcomes. (See pages 15-16 for discussion of the quality of center-based child care.)
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Of the 13 programs that provided home-based services, 10 planned the required weekly home visits with families, and 3 were able to complete weekly visits with most families. Two programs reported completing three visits per month, on average, and six programs reported completing an average of two visits per month. Most home visitors had caseloads of 10 to 15 families. According to staff members' reports, the amount of time home visitors spent on child development during a typical home visit varied widely across programs--eight programs reported that at least half of the time during a typical home visit was spent on child development, while five reported that less than half the time or a varying amount of time was spent on child development. The extent to which the child was directly involved in the home visit activities also varied widely, from the entire visit to very little of it.
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At the time of the site visits, 6 of the 13 programs that did not provide center-based services to all children were assessing, monitoring, and/or promoting the quality of community child care to ensure that Early Head Start children received high-quality child care in a community setting. The remaining seven programs were not assessing, monitoring, or promoting the quality of community child care settings in fall 1997. At that time, the expectation that programs are responsible for ensuring high quality in the community child care arrangements used by Early Head Start families (by forming partnerships with community child care providers and overseeing the care) was not clear to all programs (see pages 15-16 for a discussion of the quality of community child care). In most of the communities, the quantity and quality of child care available for infants and toddlers was inadequate, according to program staff and other community members.
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Most programs were experiencing some difficulty in planning and getting families to attend the group socializations required for families served through the home-based option. However, at the time of the site visits, all except one of the programs offering home-based services invited families at least once a month to regular group activities, such as classes, play groups, family outings, and special events.
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All the programs regularly and frequently assessed the developmental progress of enrolled children, checked on children's immunization status and receipt of health care, followed up with parents when necessary, and made referrals to health care providers. Many programs also provided additional health care and/or health education services, such as health screenings and care on site or during home visits (10 programs directly and 7 programs in collaboration with health care providers) and health education during home visits and group socializations (6 programs).
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At the time of the site visits, the majority of programs reported that at least 10 percent of the enrolled children had a suspected or diagnosed disability.(4) Of these, 6 programs reported a figure of at least 15 percent. Six programs reported that fewer than 10 percent of enrolled children had suspected or diagnosed disabilities, but many of these programs were still recruiting or conducting assessments.
Family Partnerships
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All the programs had a process in place and forms to use for assessing family needs and developing individual family partnership agreements. At the time of the site visits, eight programs reported that some families had not yet completed the process, because they had enrolled recently, had resisted setting formal goals, or had become inactive.
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All the programs provided case management to link families with needed services in the community.
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The programs encouraged parents to become involved, both by participating in program governance and social activities and by volunteering. All the programs had or were forming policy councils at the time of the site visits, and 14 programs provided volunteer opportunities.
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All the programs invited and encouraged fathers to participate in regular program activities and become involved as parents, and 10 offered special services for fathers and father figures.
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All the programs helped families apply for Medicaid, made referrals to health care providers, and provided prenatal education and care either directly or through referrals. In addition to making referrals for mental health care needs, 10 programs offered some counseling services, either directly or through collaboration with other agencies. Fourteen programs also provided nutrition education and/or services. Twelve programs provided prenatal education during home visits, while two offered prenatal classes. Two programs employed nurses or health specialists to visit pregnant women at home.
Staff Development
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The research programs generally hired highly educated staff members. Among all staff members, 20 percent had a graduate degree, 14 percent had taken some graduate courses, and 24 percent had a 4-year college degree. In addition, 12 percent had a 2-year college degree. Overall, 14 percent of staff members had a Child Development Associate credential.
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All the programs provided extensive training, supervision, and support for frontline staff members (home visitors and teachers). Most programs provided preservice orientation and training, which was sometimes extensive. All programs provided regular in-service training, either in group sessions or through individual observation and feedback, and all but one conducted regular performance reviews with staff members. Program managers also provided individual support and supervision to frontline staff.
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The wages of frontline staff members averaged $9.77 per hour at the time of the site visits ($8.41 per hour in center-based programs, $12.00 per hour in home-based programs, and $9.07 per hour in mixed-approach programs). Average wages ranged from $6.37 to $14.18 per hour across programs. Most staff members reported receiving key fringe benefits such as paid health insurance, dental insurance, pension or retirement benefits, paid vacation time, and paid sick leave.
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On average, 20 percent of staff members had left and been replaced by the time of the site visits. Four programs experienced especially high staff turnover (one-third of their staff or more). Three of these programs had also undergone changes in leadership. Five programs experienced low rates of staff turnover (under 10 percent).
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The workplace climate in the research programs at the time of the site visits was very positive. In an anonymous survey, at least three-fourths of staff members agreed that their director communicated a clear vision for the program, recognized good work, kept staff informed, and had realistic expectations. Similarly, at least three-fourths of staff members reported that decision-making was collaborative, their relationships with other staff members were cooperative or very cooperative, staff development was encouraged, and the materials they needed were available. Many staff members had concerns in two areas, however. Sixty-two percent of staff members were not satisfied with their salaries, and 41 percent reported that paperwork interfered with their jobs. At the time of the site visits, levels of job satisfaction among Early Head Start staff members were high, and levels of job-related stress were modest. Overall, 80 percent of staff members were satisfied with their position in their Early Head Start program, and only 5 percent reported that they frequently felt like quitting their jobs or felt stuck in their current position. One-fourth of staff members reported that their job was always or usually stressful, but the percentage ranged from 0 to 63 percent across the 17 research programs. In general, staff members in center-based programs were less likely than those in home-based or mixed-approach programs to report that their job was always or usually stressful.
Community Partnerships
- The programs had formed numerous partnerships with
community agencies, and all were participating in interagency coordination
groups in their communities. Twelve programs were collaborating with
major partners to provide important services to Early Head Start families.
- Programs were most likely to forge close working relationships with the local Part C program. At the time of the site visits, 11 of the 17 research programs were collaborating with the local Part C agency to develop joint individual family service plans and to coordinate services for families with children with disabilities. The remaining programs reported that they followed the Part C individual family service plans for families with children with disabilities and in some cases, they also participated on the Part C Local Interagency Coordinating Council.
4 Most programs reported suspected and diagnosed disabilities together during the fall 1997 site visits. Many of the children with suspected disabilities were in the process of identification through the local Part C program. (back)
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