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II. OVERVIEW OF THE EARLY HEAD START RESEARCH PROGRAMS

The Early Head Start research programs built on diverse experiences, served families from different backgrounds, and in fall 1997 were taking a variety of approaches to serving children and families. Early Head Start programs strive to achieve their goals by designing program options based on family and community needs. Programs may offer one or more options to families, including: (1) a home-based option, (2) a center-based option, (3) a combination option in which families receive a prescribed number of home visits and center-based experiences, and (4) locally designed options, which in some communities include family child care. Because a single program may offer multiple options to families, for purposes of the research, we have characterized programs according to the options they offer to families as follows:

• Center-based programs, which provide all services to families through the center-based option (center-based child care plus other activities)
• Home-based programs, which provide all services to families through the home-based option (home visits plus other activities)
• Mixed-approach programs--which provide services to some families through the center-based option and some families through the home-based option, or provide services to families through the combination option or locally designed option

This chapter presents the history and approaches of the Early Head Start research programs, describes the communities in which they operate, provides a portrait of the families enrolled in the programs, and examines the extent to which these programs reflect the characteristics of all the Early Head Start programs funded in the first two waves. It also explores the goals, expected outcomes, and theories of change the research programs had adopted as of fall 1997. The next chapter will describe program activities and services in detail.

A. BACKGROUND OF THE RESEARCH PROGRAMS

The Early Head Start research program grantees were at various stages of implementing services for infants and toddlers and incorporating Head Start program features at the time they were funded. Nine of the Early Head Start research program grantees had operated Head Start programs, and of these, five had served infants and toddlers in the past. One of the new Early Head Start research program grantees had operated a Parent Child Center (PCC), as well as a Head Start program. Seven of the new Early Head Start research programs had operated Comprehensive Child Development Programs (CCDPs). All of these programs had provided services to infants and toddlers before, but five of them were new to Head Start. Three of the new Early Head Start program grantees had not operated Head Start programs, CCDPs, or PCCs but had operated other community-based programs. These grantees include a Montessori program that had previously served infants, toddlers and preschool children, as well as a school district and a well-known national agency that had not previously served infants or toddlers (Table II.1).

When they were initially funded, similar numbers of programs were center-based (five programs), home-based (five programs), and mixed-approach (seven programs). By fall 1997, eight programs were home-based, four were center-based, and five were mixed-approach programs (Figure II.1). These changes in approach resulted from subsequent funding decisions, changes in families’ needs, and recommendations of technical assistance providers. Several programs are continuing to make changes in their basic approaches.

The research programs are distributed fairly evenly across all major regions of the country and across rural and urban areas. Six programs, three of which are center-based or mixed-approach programs, are located in western states (California, Washington, Colorado, and Utah). Four, all home-based programs, are in midwestern states (Iowa, Kansas, Michigan, and Missouri). Four programs, three of which are center-based or mixed-approach programs, are in northeastern or mid-Atlantic states (New York, Pennsylvania, Vermont, and Virginia). Three programs, all center-based, are in southern states (Arkansas, South Carolina, and Tennessee).

OVERVIEW OF EARLY HEAD START RESEARCH PROGRAMS

TABLE II.1

Program	Grantee	Local Research Partner	Location	Previous Experience	Approach
		DHHS Region 1
Early Education Services (Brattleboro, VT)	School district	Harvard University	Small town/rural	CCDP	Mixed
		DHHS Region 2
The Educational Alliance (New York, NY)	Community- based social services agency	New York University	Urban	Head Start	Center- based
		DHHS Region 3
Family Foundations (Pittsburgh, PA)	University	University of Pittsburgh	Urban/small town	CCDP	Home-based
United Cerebral Palsy (Alexandria, VA)	National agency providing services to individuals with disabilities	Catholic University of America	Urban	New program	Mixed
		DHHS Region 4
Sumter School District 17 (Sumter, SC)	School district	Medical University of South Carolina	Small town/rural	Title I preschool program	Mixed
Northwest Tennessee Head Start (McKenzie, TN)	Community action agency	None	Small town/rural	Head Start	Center-based
		DHHS Region 5
Region II Community Action Agency (Jackson, MI)	Community action agency	Michigan State University	Urban	Head Start, infant mental health program	Home-based
		DHHS Region 6
Child Development, Inc.(Russellville, AR)	Community-based child development organization	University of Arkansas, Little Rock	Small town/rural	Head Start, Parent ChildCenter	Center-based
		DHHS Region 7
Mid-Iowa Community Action (Marshalltown, IA)	Community action agency	Iowa State University	Rural	CCDP, Head Start	Home-based
Project EAGLE (Kansas City, KS)	University medical center	University of Kansas	Urban	CCDP	Home-based
KCMC Child Development Corporation (Kansas City, MO)	Community-based child development organization	University of Missouri, Columbia	Urban	Head Start	Home-based
		DHHS Region 8
Family Star (Denver, CO)	Community-based Montessori program	University of Colorado Health Sciences Center	Urban	Infant-preschool Montessori program	Center-based
Clayton Mile High Family Futures Project (Denver, CO)	Partnership between a foundation and a child care resource and referral agency	University of Colorado Health Sciences Center	Urban	CCDP, Head Start	Mixed
Bear River Head Start (Logan, UT)	Head Start agency	Utah State University	Small town/rural	Head Start	Home-based
		DHHS Region 9
The Children First (Venice, CA)	Private community health clinic	University of California, Los Angeles	Urban	CCDP	Home-based
		DHHS Region 10
Families First (Kent, WA)	Community-based child welfare agency	University of Washington School of Nursing	Suburban/small town	CCDP	Mixed
Washington State Migrant Council Early Head Start (Sunnyside, WA)	Community-based organization serving migrant families	University of Washington College of Education	Rural	Migrant Head Start	Home-based

SOURCE: Preliminary Head Start Family Information System application and enrollment data. NOTE: For purposes of this report, “mixed approach” includes programs that serve some families through a center-based option and some through a home-based option, as well as those serving families through a combination option that provides a prescribed number of home visits and center-based experiences. CCDP = Comprehensive Child Development Program.

 

FIGURE II.1

PROGRAM APPROACHES IN THE EARLY HEAD START RESEARCH PROGRAMS [D]

SOURCE: Information gathered during visits to the Early Head Start research programs in the fall of 1997. NOTE: Early Head Start programs may offer one or more options to families, including (1) a home-based option, (2) a center-based option, (3) a combination option in which families receive a prescribed number of home visits and center-based experiences, and (4) locally designed options. For purposes of the research, we have characterized programs according to the options they offer to families as follows: Center-based programs, which serve all families through the center-based option Home-based programs, which serve all families through the home-based option Mixed-approach programs, which serve some families through the center-based option and some families through the home-based option, or serve families through the combination option

Early Head Start Research Programs

[D]

 

About half the Early Head Start research programs (eight) are in urban areas, and the other half are in small towns or rural areas (see Table II.1). Two programs have sites in both rural/small town and urban/suburban areas. Both the rural and the urban groups include a mix of home-based, center-based, and mixed-approach programs.

Some of the Early Head Start research programs provided services in more than one site. Most home-based programs were based in one central place, but two served several communities and had multiple offices. Most of the center-based and mixed-approach programs operated a number of centers. Three of the nine programs operated two centers, three operated three centers, and one operated six centers. The programs that operated three or more centers tended to be in rural areas and to serve families in more than one county.

The vitality of the economies varies in the areas the Early Head Start research programs served. Many of the programs operate in areas where the unemployment rate was five percent or higher in 1995, but seven programs are located where unemployment was lower. In four of the areas with relatively high unemployment rates, program staff members described job or job training opportunities as inadequate.

Although a few of the programs described their communities as “service-rich,” all of them identified some areas in which services for low-income families were inadequate. All except one program reported that the supply of affordable high-quality child care in their community was inadequate to meet the demand, at least for infants, toddlers, and children with special needs. Many of the programs (13) indicated that their community lacked sufficient affordable housing, and most (10) also reported that public transportation was lacking or inadequate. Smaller numbers of programs noted that health care, mental health care, or dental services were inadequate. According to staff members in several of the programs, even where services are available, some families encounter barriers, such as lack of information about the services and how to get them, eligibility criteria that exclude the working poor, language barriers, unwillingness or inability to seek services because of the time and commitment required, mistrust or fear of the “system,” fear of stigma, and lack of confidence and experience in seeking services. Lack of transportation also deters some families from seeking other available services.

B. CHARACTERISTICS OF FAMILIES ENROLLED IN THE RESEARCH PROGRAMS

Many of the research programs were still enrolling families at the time of the fall 1997 site visits, but by the end of 1998, all enrollment for the research was finished. The following sections provide a brief description of the enrolled families based on preliminary data from the Head Start Family Information System application and, for most of the families, enrollment forms.1

1. The Parents

Most of the primary caregivers who applied with their children to the Early Head Start research programs were female, but six percent were male (Table II.2). In every research program, at least 88 percent of primary caregivers were women.

Many primary caregivers, 40 percent overall, described their families as two-parent families. (Approximately one-fourth of the primary caregivers were married.) The extent to which the research programs served two-parent families varied widely. In five programs, more than half the families enrolled were two-parent families.

Many of the children’s primary caregivers were teenage parents (about one-third across all the research programs). However, the extent to which the programs served teenage parents varied substantially, from 12 to 84 percent. In two programs, more than half of all families were headed by a teenage parent.

The racial/ethnic composition of enrolled families varied across the research programs. On average, about one-third of the families were African American, one-fourth were Hispanic, slightly more than one-third were white, and a small proportion belonged to other groups. In 11 programs, enrolled families belonged predominantly to one group. In four programs, at least two-thirds of families were African American; in two programs, at least two-thirds were Hispanic; and in five programs, at least two-thirds were white. In six programs, the racial/ethnic composition of enrolled families was diverse and not dominated by one group.

 

KEY CHARACTERISTICS OF FAMILIES ENTERING THE EARLY HEAD START RESEARCH PROGRAMS

TABLE II.2

	All Research Programs Combined (Percent)	Range Across Research Programs (Percent)
Primary Caregiver (Applicant) Is Female	94	88 to 99
Primary Caregiver Is a Teenager (under 20)	35	12 to 84
Primary Caregiver Is Married	28	2 to 70
Family is a Two-Parent Family	40	9 to 74
Primary Caregiver's Race/Ethnicity
African American	33	0 to 89
Hispanic	24	0 to 89
White	37	2 to 91
Other	6	0 to 16
Primary Caregiver's Main Language Is Not English	21	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
Unemployed	29	13 to 43
Other	26	2 to 55
Number of Applicants/Programs	1,514	17

SOURCE: Preliminary Head Start Family Information System application and enrollment data.

 

Communication with families presented a challenge for some of the research programs. For a sizable minority of primary caregivers, English was not the main language. On average, 21 percent of primary caregivers did not speak English as their main language; 11 percent did not speak English well. In four programs, more than one-third of primary caregivers did not speak English as their main language. In two programs, more than half the primary caregivers did not speak English well.

The children’s primary caregivers entered the research programs with varying levels of education. Overall, nearly half did not have a high school diploma. In three programs, more than two-thirds of the primary caregivers lacked one, while in four other programs, two-thirds of the caregivers had one.

Many of the primary caregivers in the Early Head Start research programs were employed or in school or training when they enrolled. On average, 23 percent were employed, and 22 percent were in school or training (usually school). In six of the research programs (four of which were center-based), more than half the caregivers were employed or in school or training, while in four other programs (all home-based or mixed-approach), fewer than one-third of the caregivers were employed or in school or training.

2. The Children

Most families enrolled before their child reached the age of 6 months.2 Approximately one-fourth of the primary caregivers enrolled while they were still pregnant (Table II.3). Many additional families (42 percent, overall) enrolled after their child was born but before the child was 6 months old. The age distribution of children varied widely across the research programs. In three programs, more than three-fourths of the families enrolled before their child was 6 months old, whilein another program, fewer than one-third of the families did.

KEY CHARACTERISTICS OF CHILDREN ENTERING THE EARLY HEAD START RESEARCH PROGRAMS

Table II.3

	All Research Programs Combined (Percent)	Range Across Research Programs (Percent)
Child’s Age
Unborn	25	7 to 67
to 6 months old	42	12 to 57
to 12 months old	33	1 to 75
Child Was Born at Low Birthweight (Under 2,500 grams)	10	4 to 23
Concerns About Child’s Development Were Noted on Application	13	3 to 26
Number of Applicants/Programs	1,514	17

SOURCE: Preliminary Head Start Family Information System application and enrollment data.

 

Among the children who were born before their family enrolled, 10 percent had a low birthweight (under 2,500 grams). This, too, varied across the research programs, from 4 to 23 percent. Similarly, when they applied to Early Head Start, 13 percent of the primary caregivers reported that they or someone else had a concern about their child’s development. Across the research programs, the extent of concerns ranged from 3 to 26 percent.

Together, these indicators suggest that 20 percent of the children who were enrolled in the Early Head Start research programs after birth might have had or were at risk for a developmental disability.3 Four percent of the children who were enrolled after birth had been born at a low birthweight, and concerns about their development were reported in the application form. Nine percent of the children had not been born at a low birthweight, but their primary caregivers reported that someone had a concern about their development. Seven percent had been born at a low birthweight, but their primary caregiver did not report that someone had a concern about their development.

3. Basic Needs and Receipt of Public Assistance

Some of the families had basic needs that were not being met when they enrolled in the research programs. Overall, 5 percent reported that they did not have adequate food, and 12 to 14 percent did not have adequate housing, medical care, or personal support (Table II.4). Approximately 13 percent also indicated that they did not have adequate parenting information.

A substantial unmet need for child care was expressed by the primary caregivers who enrolled in the research programs. Overall, 35 percent of the primary caregivers did not have adequate child care arrangements when they enrolled. Unmet child care needs varied across the research programs, however. In four programs, at least half the families had unmet child care needs, while in three other programs, fewer than 15 percent had them.

FAMILY RESOURCES AND RECEIPT OF ASSISTANCE BY FAMILIES ENTERING THE EARLY HEAD START RESEARCH PROGRAMS

TABLE II.4

	All Research Programs Combined (Percent)	Range Across Research Programs (Percent)
Adequacy of Resources
Inadequate food	5	0 to 20
Inadequate housing	12	4 to 24
Inadequate medical care	14	3 to 36
Inadequate child care	35	11 to 67
Inadequate transportation	21	12 to 35
Inadequate parenting information	13	0 to 39
Inadequate personal support	13	3 to 39
Assistance Received Currently
Medicaid	77	47 to 89
AFDC/TANF	34	11 to 64
Food stamps	48	22 to 75
WIC	87	69 to 96
SSI	7	0 to 16
Number of Applicants/Programs	1,514	17

SOURCE: Preliminary Head Start Family Information System application and enrollment data.

 

Many primary caregivers also reported that they did not have adequate transportation. Overall, 21 percent of the primary caregivers did not have adequate transportation when they enrolled in the research programs. Unmet transportation needs varied across research programs, ranging from 12 to 35 percent.

Most of the families who enrolled in the research programs were receiving some kind of public assistance. Overall, 77 percent were receiving Medicaid coverage, and 87 percent were receiving WIC benefits. Almost half the families were receiving food stamps, and slightly more than one-third were receiving AFDC or TANF cash assistance (some mothers were pregnant with their first child when they enrolled and were not yet eligible for cash assistance). A small proportion (seven percent) were receiving SSI benefits. As in other areas, the extent to which families were receiving assistance varied across the research programs. In all the programs, however, many families were relying on these sources of assistance.

C. SIMILARITY OF THE RESEARCH PROGRAMS TO ALL EARLY HEAD START PROGRAMS

ACYF selected 15 of the 17 research programs from among the 41 Wave I Early Head Start programs that applied with a university partner to conduct local research and participate in the national cross-site evaluation. The university partners agreed to conduct data collection for the national evaluation under subcontract to MPR and to form a consortium with the other local researchers and MPR to ensure that all parts of the study form a cohesive whole. As noted in Chapter I, the 15 programs were selected to include a balanced distribution of sites by program approach, program history, geographic location (regions and urban/rural locations), and racial/ethnic composition of families in the target population.

Because the final selection of 15 research programs included a disproportionately low number of center-based programs, ACYF added two center-based programs to the national research. In selecting them, ACYF also sought to bring further balance by adding a center-based program that would serve predominantly African American families and one that had not operated as part of CCDP. One of the added research programs was funded in Wave II of Early Head Start programs.

The final selection of 17 research programs constitutes a balanced group that includes variation in the key characteristics considered in the site-selection process. All approaches, backgrounds, regions, urban/rural areas, and racial/ethnic makeups are represented among the research programs (see Table II.1). This variation will facilitate the cross-site evaluation’s investigation of what program approaches work for whom and under what circumstances.

Not only were the programs that ACYF selected for the cross-site research balanced, they broadly resembled all Wave I and Wave II Early Head Start programs. Comparisons of available Program Information Report (PIR) data for Wave I and II programs with Head Start Family Information System data for the research programs indicate that the two groups of programs are very similar. They have approximately the same ACYF-funded enrollment, on average, and the characteristics of enrolled children and families are very much alike (Table II.5). Because the research sites closely resemble the Wave I and II programs in both program and family characteristics, lessons learned from these programs are likely to be applicable to other Early Head Start programs.

COMPARISON OF RESEARCH PROGRAMS AND WAVE I AND II PROGRAMS

TABLE II.5

	Wave I Programs (Percent)	Wave II Programs (Percent)	Research Programs (Percent)
Total ACYF-Funded Enrollment
10 to 29 children	6	0	0a
30 to 59 children	14	9	6
60 to 98 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	23
White	39	46	37
Other	6	5	6
English Is the Main Language	85	79	80
Family Type
Two-parent families	39	46	40
Single-parent families	51	46	52
Other relatives b	7	5	3
Foster families	1	1	0
Other	1	1	5
Employment Status(c)
In school or training	20	22	22
Not employed	48	48	56
Number of Programs	66	11	17

SOURCE: Preliminary 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 preliminary Head Start Family Information System application and enrollment data from 1,462 families. Percentages may not add up to 100, as a result of rounding. a. The data for the research programs refer to families instead of children. b. The 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. c. The 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.

 

D. PROGRAM THEORIES OF CHANGE

As we have seen, Early Head Start programs have adopted a variety of program approaches and taken a variety of shapes. The evaluation must be able to describe and understand this program diversity, not only for descriptive purposes, but also to enable researchers to ascribe impact findings to the important experiences of the children and families enrolled. In recent years, an approach to understanding programs’ intended outcomes and strategies for achieving them has emerged in the program evaluation literature. Sometimes referred to as a “logic model” (for example, Harrell 1996) or a “theory-of-change” approach (Berlin, O’Neal, and Brooks-Gunn 1998; Chen and Rossi 1992; Connell and Kubisch 1998; Hebert and Anderson 1998; Kagan 1998; Mulligan et al. 1998; and Weiss 1972 and 1995), this approach allows program evaluators, in collaboration with program staff, to go through a systematic process of (1) identifying specific outcomes the program expects to achieve; (2) articulating the program strategies and activities that are designed to achieve the outcomes, as well as the context in which the strategies and activities occur; (3) selecting measures appropriate for assessing the outcomes; and (4) planning analyses that will focus on the outcomes of importance to the program. In this section, we focus on the outcomes to illustrate both commonalities and differences in the expected achievements identified by the Early Head Start research programs in their early stages.

Unfortunately, the history of program evaluation is replete with examples of evaluators assuming, without verifying, that all programs sharing the same label (whether “Even Start,” “Comprehensive Child Development Program,” “Early Head Start,” or even “child care” or “home-based programs”) have the same objectives and intentions and are engaged in the same activities. Although programs that are part of the same national initiative share broad goals, they often adopt a range of different specific goals and take diverse approaches to achieving them. Policymakers too often are presented with evaluation findings that appear not to have captured these variations in programs’ specific goals and approaches, so they have little value for guiding policy changes. In Early Head Start, programs share the broad goal of promoting the healthy development of young children and their families, and they must adhere to basic program guidelines and the revised Head Start Program Performance Standards. Within these broad guidelines, however, Early Head Start programs have the flexibility to customize their goals and approaches to fit the circumstances, needs, and resources of their local communities. By using a theory-of-change approach in the Early Head Start evaluation, we are identifying the variations across Early Head Start research programs in their specific goals, approaches, and expected outcomes and planning targeted impact analyses that close the circle between the programs’ intentions and their outcomes.

The benefits of working with programs’ theories of change come only after substantial effort. Kagan (1998), for example, noted the extensive nature of this effort in connection with family support programs. As part of the Early Head Start evaluation, the national evaluation team began the theory-of-change process in 1996 at meetings of the Early Head Start Research Consortium, with discussions that engaged both local researchers and program directors from the research sites. In many sites, discussions between local research and program staffs continued, resulting in increasingly sophisticated iterations of programs’ theories of change; many of these programs produced documents detailing the process and the resulting theories of change. During MPR’s site visits in fall 1997, site visitors discussed theories of change with program staff and usually included one or more representatives from the local research team. Site visitors followed a common group interview guide and asked the following types of questions with respect to outcomes:

1. Considering all your goals and all the outcomes your program is trying to influence, which two or three are you focusing most intensively on? Which are your highest priorities? Why?
2. Are these the outcomes you think you are most likely to influence? Why or why not? If not, what outcomes do you think you will be able to influence the most? I know you think you will influence many outcomes, but if you were going to place bets on two or three outcomes that you think you will influence most, which would you choose?

Then, for each of the key outcome areas--child development, family development, staff development, and community-building--we asked a series of questions designed to bring out specific details in each of the outcome areas.

The evaluation team also tried to understand strategies for attaining outcomes and the extent to which program staff saw factors outside the program as affecting the program’s ability to achieve the outcomes they described. Program staff described factors as diverse as the (as yet uncertain) influence of welfare reform, the availability and quality of child care or other services in the community, the strong presence of a local church, or the closing of a housing project.

Through this approach, we obtained the information firsthand without having to rely on written communication alone (although in a number of cases program staff and/or local researchers provided the site visitor with written materials from their previous discussions about their theories of change). By engaging program staff members in similar discussions across all sites and allowing them to elaborate on particular elements of their theories of change, the evaluation team was able to compare information obtained through a relatively uniform process. Thus, we obtained a fuller sense of the nuances of programs’ theories of change than we would have had our analysis been limited to written documents.

On the other hand, we acknowledge that this approach contained variability. Usually, the program staff who participated represented diverse roles (program directors, supervisors, specialists, and frontline staff such as home visitors or center caregivers), but there were also site differences in the mix of staff. Furthermore, the amount of time spent varied according to the availability of staff and the time spent on other site-visit interviews. When the time was shorter than planned, some of the areas were not covered as thoroughly as we had hoped. The sessions began with an open-ended discussion of the program’s most important goals followed by a focus on each key area, beginning with child and family development. Therefore, the areas most likely to be slighted by this process were staff development and community building. Although the information about outcomes in those areas is not as rich as in the child and family development areas, the process resulted in the most complete information in the areas that are most central to Early Head Start program goals.

After the site visits, at a meeting of program directors and researchers held in spring 1998, we asked program directors to (1) indicate all outcomes across all the program areas that were “important” goals for their program and (2) identify the three important outcomes that were the “highest priority” for their program, regardless of the area the outcomes were in. In addition, we asked program directors attending the meeting to “tell a success story.” We asked them to think of a family that exemplified the success their program had had so far (as of spring 1998) and to describe in some detail the experiences of the children and family and the outcomes the children and family achieved. The sections that follow report on the results of both our theory-of-change discussions in fall 1997 and program directors’ ranking of outcomes in spring 1998. We also use information from the success stories to illustrate or expand on the theory-of-change information obtained from the interviews.

The results of the theory-of-change discussion described here are the first installment in a dynamic, ongoing process. Since spring 1998, local researchers and program staff in many sites have continued their theory-of-change discussions. During the summer/fall 1999 site visits, the national evaluation team engaged program staff in additional discussions, and the second implementation study report will present an analysis of the then-current Early Head Start programs’ intended outcomes within the context of their theories of change, and how they evolved over time.

1. Articulation of Programs’ Expected Outcomes

Several general features of programs’ expected outcomes (as articulated through our process) are worth noting before presenting the specific findings. One is that all programs were able to articulate a number of critical aspects of their expected outcomes. Typically, several staff within a program had considered, often in discussions with their local research partners, their expected outcomes and how they hoped to achieve them. This occurred at different levels of detail and breadth: some had worked closely with their local researchers, others not so closely, a few not at all. Staff identified outcomes they considered important in all four areas, as well as in parent-child relationships, which we added as a fifth area since it overlaps the child and family areas and includes outcomes that program staff and researchers alike were reluctant to place into either the child or the family category.

We found that program staff members tended to think about outcomes in broad, rather than focused and specific, terms. Thus, they might tell us about “improving children’s social competence” rather than “enhancing peer interactions” or “reducing aggressiveness.” Staff often had difficulty getting beyond process to think about outcomes. Thus, they might report that “families will participate in more group socializations” or “families will succeed in attaining a medical home.” Site visitors took these as implicit theory-of-change statements and probed to learn what particular outcome or outcomes program staff believed that participation would bring about. Staff members sometimes had difficulty identifying the most important outcomes, because they are well aware of the great variation in where families start out, what their different needs are, how long they have been engaged in program activities, and so forth.

2. Outcomes Expected Across Program Areas

There was considerable diversity in both the type and the number of outcomes that individual programs described. Table II.6 summarizes the major types of outcomes that each research program cited during sites visits, organized by area, with their priority outcomes italicized (programs were not limited in the number of outcomes they could identify). Because our focus here is on understanding the range, diversity, and similarities across Early Head Start research programs, we do not identify the individual programs.

OVERVIEW OF KEY OUTCOMES IDENTIFIED IN PROGRAMS’ THEORIES OF CHANGE WITHIN EACH DOMAIN(a)

TABLE II.6

Programs b	Parent-Child Relationships	Child Development	Family Development	Staff Development c	Community Building c
Center-Based Programs
A	Parental knowledge of child development Attachment, knowledge of childdevelopment, and understandingthe parent-child relationship	Cognitive development Cognitive, language, social-emotional, physical, approaches toward learning, and schoolreadiness	Physical health, mental health and healthy family functioning, self-sufficiency, literacy and education, and home environment	Improved staff competencies Staff competencies and community involvement	Quality of community childcare, quality of other community services, coordination of services and collaboration, and involvement of parents in the community
B	Parent-child relationships Attachment and knowledge ofchild development	Cognitive, social-emotional, physical, and school readiness	Mental health Physical health, mental health andhealthy family functioning, self-sufficiency, and home environment	Staff self-esteem Staff competencies	Quality of community child care and involvement of parents in the community
C	Parent-child relationships Attachment and knowledge ofchild development	Cognitive, social-emotional, physical, approaches toward learning, and readiness for HeadStart	Self-efficacy mental health and healthy family functioning, self-sufficiency, and literacy and education	Improved staff competencies Staff competencies and career development	Involvement of parents in the community
D	Parent-child relationships Knowledge of child development	Cognitive, social-emotional, approaches toward learning, and school readiness	Economic self-sufficiency/employment Self-sufficiency and home environment	Improved staff competencies Staff competencies and teamwork and morale	Involvement of parents in the community
Home-Based Programs
E	Parental knowledge of child development Attachment, knowledge of child development, and understanding the parent-child relationship	Cognitive development Social-emotional and approaches toward learning	Family goal setting Mental health and healthy family functioning, self-sufficiency, and home environment	Staff development not discussed during site visit	Community cornerstone not discussed during site visit
F	Understanding the parent-child relationship	Language development Cognitive, social-emotional, and physical	Literacy/education Mental health and healthy family functioning, self-sufficiency, literacy and education, and home environment	Staff competencies and teamwork and morale	Improved quality of community child care Involvement of parents in the community
G	Parent-child relationships Parenting stress Attachment, knowledge of child development, and understanding the parent-child relationship	Cognitive, language, social-emotional, and approaches toward learning	Mental health and healthy family functioning, self-sufficiency, and father involvement	Improved staff competencies Staff competencies, teamwork and morale,career development, and community involvement	Quality of community child care, and coordination of services and collaboration
H	Parent-child relationships Parental knowledge of child development Attachment, knowledge of child development, and parenting	Language, social-emotional, physical, approaches towardlearning, and school readiness	Self-sufficiency, home environment, and father involvement	Improved staff competencies Staff competencies, teamwork and morale, and career development	Quality of community child care, quality of other community services, coordination of services and collaboration, and involvementof parents in the community
I	Attachment, knowledge of child development, understanding the parent-child relationship, and parenting	Cognitive development Language development Social development Social-emotional and physical	Physical health, mental health and healthy family functioning, self-sufficiency, and home environment	Staff development not discussed during site visit	Quality of community child care, quality of other community services, coordination of services and collaboration, and involvement of parents in the community
J	Parent-child relationships Knowledge of childdevelopment, understanding theparent-child relationship, and parenting	Cognitive, social-emotional, physical, and approaches toward learning	Literacy/education Physical health, mental health andhealthy family functioning, self-sufficiency, literacy and education, and home environment	Staff competencies and career development	Quality of community child care Quality of community childcare, quality of other community services, coordination of services and collaboration, and involvementof parents in the community
K	Parenting confidence and competence Parent-child relationships Knowledge of child evelopment and parenting	Social-emotional development Cognitive, language, social-emotional, physical, and approaches toward learning	Self-sufficiency and home environment	Staff competencies	Quality of community child care and involvement of parents inthe community
L	Parent-child relationships Parental knowledge of child development Attachment, knowledge of child development, understanding the parent-child relationship, and parenting	Physical development/health Cognitive, social-emotional, physical, and school readiness	Physical health, mental health and healthy family functioning, self-sufficiency, literacy and education, and father involvement	Staff competencies, teamwork and morale, and career development	Quality of community child care, quality of other community services, and involvement of parents in the community
Mixed-Approach Programs
M	Parent-child relationships Attachment, knowledge of child development, and understanding the parent-child relationship	Social-emotional and approaches toward learning	Economic self-sufficiency/employment Mental health and healthy family functioning	Staff development not discussed during site visit	Quality of community child care Involvement of parents in the community
N	Knowledge of child development and parenting	Language development Language, social-emotional, physical, approaches toward learning, and knowledge of their community and its diversity	Economic self-sufficiency/employment Mental health and healthy family functioning, self-sufficiency, home environment, and father involvement	Teamwork and morale and career development	Coordination of services Quality of community child care
O	Parenting stress Knowledge of child development and parenting	Physical development and health Cognitive, language, social-emotional, physical, and approaches toward learning	Physical health, mental health and healthy family functioning, self-sufficiency, and home environment	Staff competencies and career development	Collaboration Quality of other community services, coordination of services and collaboration, and involvement of parents in the community
P	Attachment, knowledge of child development, and parenting	Language development Social development Cognitive, language, social-emotional, and physical	Physical health, mental health and healthy family functioning, self-sufficiency, and home environment	Staff competencies, teamwork and morale, and career development	Quality of community child care Quality of community child care, coordination of services and collaboration, and involvement of parents in the community
Q	Parent-child relationships Parental knowledge of child development Attachment, knowledge of child development, and parenting	Social-emotional and physical	Mental health and healthy family functioning and self-sufficiency	Teamwork and morale	Quality of community child care Quality of other community services, coordination of services and collaboration, and involvement of parents in the community

 

Even though the national Head Start Bureau has been clear that child outcomes are the most important program goals, we begin our discussion with parent-child relationships because of their special importance during infancy and because a number of program staff felt that secure attachment in the parent-child relationship establishes the foundation for enhanced development of children. We then discuss programs’ expected outcomes in child development, family development, staff development, and community development.

Both in programs’ descriptions of their expected outcomes and in our analysis of these descriptions, we find that boundaries around the key program areas can be drawn in more than one way. For example, one reason we treat parent-child relationships separately is that we find considerable overlap with both the child and the family development areas. In the presentation that follows, there remain some topics that could be categorized differently. For example, we discuss the home environment within the family development area, because it is a broad category that encompasses aspects of the context in which children live, even though some elements of the home environment might well be placed under parent-child relationships. The categorization presented here is based on program staff members’ responses to the questions about key expected outcomes in each key program area and thus largely reflects their own perception of outcomes.

Parent-Child Relationships. Table II.7 displays the outcomes that program staff identified as important in parent-child relationships. Early Head Start research programs viewed enhancing parent-child relationships and parenting as central to their mission. Within this area, however, considerable diversity characterizes the specific outcomes that programs were trying to accomplish.

TABLE II.7

KEY PARENT-CHILD RELATIONSHIP OUTCOMES IDENTIFIED BY PROGRAMS

	* Secure attachment
	* Understanding the nature of the parent-child relationship
	* Seeing the importance of the relationship for the child’s future development
	* Knowledge of child development
	* Developing respect for the child
	* Reducing the stress of parenting
	* Developing good parenting skills

 

One of the most important outcomes within parent-child relationships is a secure parent-child attachment. Program staff expressed this in various ways, such as infants becoming more securely attached to their mothers, “bonding,” and developing a strong relationship with the parent. Some behavioral indexes of secure attachment included mothers learning to “read” their children’s cues and establishing “reciprocity of attachment.” “Understanding the nature of the parent-child relationship” is another identified outcome that is closely associated with the attachment concept, and some programs had a particular interest in helping parents see the importance of the relationship for the child’s future development. Many program staff were more general and talked about their goal of developing parent-child relationships that were “more positive.”

Another aspect of parent-child relationships involves what parents know and understand about children. Specifically, staff in all but one of the programs said that increased knowledge of child development was an important outcome for their parents. Programs hoped parents would understand “normal” development, gain accurate knowledge of children’s capabilities at different stages of development, and also recognize individual differences across children. Many staff told us they hoped this would appear as more appropriate and realistic expectations for children’s behavior. In one site, knowledge of child development extended to developing understanding and tolerance for children’s feelings. One program cited a special emphasis on developing the parental knowledge and skills needed to care for infants and toddlers with disabilities, while another cited knowledge of children’s nutritional needs. At another site, helping parents develop respect for their children was an important aim of program staff. In one program, staff added an interest in parents being able to use their knowledge of child development to help them choose quality child care.

Aspects of improved parenting were mentioned often in our theory-of-change discussions. The specific features of parenting were quite diverse, including reducing the stress of parenting (that is, making healthier choices), being the “first teacher” of the child, using positive discipline techniques, empathic listening, being involved in more activities conducive to child development, having greater confidence in parenting, displaying less negativity, showing “resilience by use of appropriate techniques for handling stress and conflict,” and, as staff at several sites mentioned, reducing the incidence of abuse and neglect.

In summary, almost all programs emphasized knowledge of child development, and a substantial percentage focused on supporting parent-child attachment. Most programs saw parent-child relationships as key to enhancing children’s development.

Child Development. Programs identified a large number of outcomes in the child development arena, as is consistent with the national program focus. We organized them into five dimensions of children’s development and learning, as shown in Table II.8.

To arrive at these five dimensions, we sorted all the child outcomes that program staff identified in our interviews into standard categories typically used by developmental psychologists. In particular, we consulted the classification system developed by the Goal One Technical Planning Group of the National Education Goals Panel (Kagan, Moore, and Bredekamp 1995), which articulated five dimensions of children’s early development and learning similar to the ones we present in Table II.8. These dimensions closely parallel those identified in the Head Start Program Performance Measures, which include six “performance measures” under the objective of enhancing children’s growth and development.4 It is especially noteworthy that a number of expected Early Head Start outcomes are highly consistent with an area referred to as “approaches toward learning” (Kagan et al. 1995) or “positive attitudes toward learning” (Administration on Children, Youth and Families 1998), which includes constructs that are not easily classified as cognitive or social-emotional, but often have elements of both and are seen as particularly critical elements of school readiness. It is also noteworthy that programs think well beyond the narrow cognitive or “IQ” outcomes that some past intervention programs have focused on.

KEY CHILD DEVELOPMENT OUTCOMES IDENTIFIED BY PROGRAMS

TABLE II.8

	Cognitive Development		Language Development
•	Improved problem-solving skills	•	Increased communication skills
•	More ready to learn	•	Better able to communicate in a bilingual environment
•	Better prepared for reading	•	Emerging literacy skills
•	Fewer developmental delays	•	Larger vocabulary
	Social-Emotional Development		Approaches Toward Learning
•	Increased spontaneity	•	More engaged with environment
•	More positive attitudes and feelings about school	•	Greater self-regulation, self-control
•	Enhanced emotional well-being	•	Improved task orientation, concentration
•	Sustain healthy relationships with peers	•	More confident, wanting to explore
•	Less fear, anxiety, depression	•	Greater curiosity
•	More secure and relaxed	•	Enhanced independence, self-help skills
		•	Better able to deal with school
	Physical Development, Health, and Safety
•	Better nutrition	•	Fewer accidents
•	Healthier	•	Mobility commensurate with abilities
•	Improved motor development	•	Fewer low-birthweight babies

 

Every one of the programs identified child outcomes across multiple dimensions. The two dimensions in which programs mentioned the most outcomes were social-emotional development and physical development, health, and safety. Social-emotional development is the only dimension in this area that all 17 programs mentioned specifically during the site visits. Table II.8 indicates some of the most common aspects of child development that the programs identified. The table shows considerable diversity in the aspects of physical development, health, and safety that program staff valued. Many of the programs identified cognitive and language outcomes as ones they were expecting to achieve with Early Head Start infants and toddlers, as well as outcomes that we classified as “approaches toward learning.” These latter range from “greater self-regulation and self-control” to “more confident, wanting to explore” to “greater curiosity.”

A look at the child development outcomes overall reveals that the Early Head Start research programs are striving to achieve outcomes for infants and toddlers that will benefit the children as they transition into preschool and school programs. About half the programs explicitly named “school readiness” as an ultimate goal of their program activities, although several made it clear to us that they took an indirect or holistic approach to readiness, cognitive growth, and language development, meaning that these outcomes would be a byproduct of a supportive environment rather than the direct result of a focus on child development activities.

Family Development. With parent-child relationships considered as a separate area, the major dimensions of this area are the home environment and parental self-sufficiency. In addition, programs identified family development outcomes in areas that we describe as parental mental health and healthy family functioning; family physical health, health care, and safety; parent literacy and education; and father involvement. Table II.9 shows the specific expected outcomes that program staff identified within each dimension.

“Home environment,” specially identified by three-fourths of the programs, is a broad area in which programs work to achieve a wide range of outcomes relating to enhancing the immediate surroundings in which Early Head Start infants and toddlers grow up. In contrast to the outcomes described under parent-child relationships, home environment outcomes describe features of the context in which children live. While these outcomes may affect parent-child relationships, they are broader and more oriented toward characterizing what might be thought of as a healthy environment for children’s current well-being and future growth. Programs are striving to improve a number of factors that are likely to enhance child development, whether that means reducing frustration, child abuse, and domestic violence, or increasing parental responsibility for children’s learning and age-appropriate play between parent and child.

Parental mental health and healthy family functioning were important to many programs and were mentioned in our interviews by the majority of the programs. We clustered into this area a number of outcomes the programs cited, including global expectations like “creating a more positive outlook on life” and “developing healthier lifestyles” and specific goals like “improved self-esteem” and “greater family stability.” The area of physical health, health care, and safety includes both outcomes for parents and outcomes that parents are expected to help achieve (or to mediate) for families. Outcomes for parents include increased knowledge of sexuality, sexually transmitted diseases, prenatal care, and nutrition. Specifically, parents are expected to meet family members’ physical needs and take a proactive approach to obtaining appropriate health care for their children.

Self-sufficiency outcomes demonstrate the important goals that programs had for the parents themselves. All but one of the Early Head Start research programs described expected outcomes in this area. The common theme of the specific outcomes identified is that programs are engaged in activities designed to enhance the parents’ ability to be self-reliant and to achieve personal and family goals with increasing degrees of independence from the program. Goals in the area of literacy and education overlap a great deal with self-sufficiency goals, but we list them separately because of their significance for a number of programs.

KEY FAMILY DEVELOPMENT OUTCOMES IDENTIFIED BY PROGRAMS

TABLE II.9

	Home Environment for Children		Parental Self-Sufficiency
•	Create a stimulating home environment	•	Knows about resources and becomes able to do things independently
•	Apply Montessori concepts in the home	•	Motivated to improve standard of living
•	Reduce domestic violence	•	Understands requirements of the welfare system
•	Increase age-appropriate play between parent and child	•	Knows how to access services
•	Include infants and toddlers with disabilities in daily activities in the home and community	•	Sets goals for self and moves toward them on own initiative
•	Encourage parents to take responsibility forchildren’s learning and development	•	Knows ways to plan and have choices
•	Reduce frustration and child abuse in the home	•	Is able to make sound decisions for the family
•	Liberate parents to enjoy their children	•	Is self-confident, able to advocate on behalf of self and family
		•	Is empowered
		•	Achieves economic self-sufficiency
		•	Understands the work ethic
		•	Has confidence, knowledge, and skill to identify barriers and resources, and act independently to achieve own goals
	Parental Mental Health and Healthy Family Functioning		Physical Health, Health Care, and Safety
•	Increased parental social skills	•	Better able to meet the basic physical needs of family members
•	Improved parental self-esteem, pride, and confidence	•	Be more proactive about children’s healthcare
•	Create more stable homes; maintain intact families	•	Able to obtain preventive and emergent medical care, including prenatal care
•	Create positive, strong, and healthy relationships within the family	•	Increased parental knowledge of their own bodies
•	Increase family members’ mutual enjoyment	•	Increased knowledge of sexuality and sexually transmitted diseases
•	Increased conflict-resolution skills, ability to deal with feelings, anger management	•	More knowledge of prenatal care
•	Create in parents a more positive outlook on life	•	Increased use of car seat for infant/toddler
•	Create a world view and sense of self	•	Increased skills in preparing nutritious meals
•	Healthier lifestyles
•	Better able to meet emotional needs of family members
•	Maintain family systems that support open and warm communication, respect, and support for family members
	Parent Literacy and Education		Father Involvement
•	Attend school and further their own education	•	Improved father-child relationships
•	Develop both English and Spanish literacy	•	Encourage fathers to be good role models for their children
•	Achieve adult basic education skills	•	Increase father involvement in the family
		•	Change fathers’ attitudes toward their role as fathers

 

Finally, our discussions of the family development area elicited discussion of intended outcomes for the fathers of Early Head Start children. Although we did not obtain extensive details in fall 1997, it is clear that a number of programs were increasingly emphasizing efforts to enhance father-child relationships and expand fathers’ involvement with their families. As part of the fatherhood research within Early Head Start, both local and national studies will be learning more about program activities aimed at increasing father involvement in families and programs.

In summary, Early Head Start research programs had a great deal in common in their expected family development outcomes. In particular, most indicated a strong focus on enhancing aspects of the home environment, increasing parental self-sufficiency, and improving parental mental health and healthy family functioning; some programs emphasized physical health and safety and parental literacy and education.

Staff Development. Staff development was seen as important both for the sake of effective program operations and for the ultimate benefit that more skillful, satisfied, and stable staff may have on the children and families they work with. Twelve of the 14 programs that we discussed this area with identified staff competencies as important outcomes.5 The range of intended outcomes shown in Table II.10 emphasizes programs’ concerns with knowledge and skills that will directly affect staff members’ ability to do their jobs. These outcomes indicate that programs saw staff as integral to achieving outcomes in all other areas, since the knowledge and skills desired for their staff relate to child development, family development, and the community.

KEY STAFF DEVELOPMENT OUTCOMES IDENTIFIED BY PROGRAMS

TABLE II.10

••	Increased knowledge of child development
••	Increased knowledge of parenting
••	Improved observational skills
••	Know more about their community and be more involved in their community
••	Respect for families’ culture
••	Improved communication with families
••	Build trusting relationships with parents
••	Improved teamwork and morale
••	Skill in relationship building--with children, families, community
••	Collaborative skills in working with other service providers
••	Knowledge about inclusion of infants and toddlers with disabilities
••	Career development

 

Community Building. The focus of programs’ theories of change in this area was clearly associated with one of the major Early Head Start goals as stated in the Early Head Start program guidelines--to increase access to high-quality services, including child care, for program families and to encourage systemic improvements in service delivery for all families in the community. Table II.11 lists the major aspects of community change that program staff told us about.

These outcomes indicate that programs were aware of the complexity of their community-building objectives. They show recognition that parents, staff, and community agencies are all important if changes in child care are to come about, and that programs valued thinking in terms of systems change as opposed to relying on piecemeal efforts. Some programs indicated ambitious goals, such as making all systems that affect children in their community (churches, schools, police, and courts) more sensitive to the needs of children and families. Several noted that they were trying to increase the number of formal and informal agreements with other agencies so they would strengthen their collaborations and community partnerships. A theme common to several programs was an emphasis on the role of parents--most of the programs we discussed this area with mentioned increasing parents’ involvement in the community, encouraging them to be advocates for themselves and their children, and helping them become mentors or models for other parents in the community.

3. The Perspective of Prioritized Outcomes

In spring 1998, we asked directors of the research programs to reflect on their theories of change and, first, to identify all the outcomes they considered “important,” and then to select the three most important outcomes--those with the highest priority--regardless of the area they were in. While acknowledging that this was a difficult and somewhat artificial task, we introduced this task as a way of bringing to light what might otherwise remain implicit emphases of the programs.

KEY COMMUNITY OUTCOMES IDENTIFIED BY PROGRAMS

TABLE II.11

•	Deliver program and staff development services to family child care providers
•	Cooperate with county agencies to develop high-quality child care
•	Enhance coordination of services and collaboration
•	Create systems change through provider training
•	Involve Early Head Start parents in the community
•	Parents will understand and value quality in child care
•	Improve quality of other community services

 

We made it clear to the programs, and we want to emphasize here, that programs find many outcomes beyond these to be important, as the details in the preceding section indicate. Nevertheless, programs’ identification of priority outcomes provides additional understanding of their intentions. All programs identified at least one priority outcome in either the child development or parent-child relationships area. Our analysis, however, takes the perspective of all the outcomes and asks, “what are the types and range of outcomes that Early Head Start research programs as a whole see as priority?” The percentages of priority outcomes identified in each area were as follows:

• Parent-child relationships: 37 percent
• Child development: 22 percent
• Family development: 16 percent
• Community building: 14 percent
• Staff development: 12 percent

When parent-child relationships and child development outcomes are grouped together (which is reasonable given that programs’ central purpose in focusing on the parent-child relationship during the infant-toddler period was to enhance children’s development), this combined area encompasses 59 percent of all the priority outcomes.

Two aspects of the priority outcomes were shared by all three program approaches:

• All three program approaches identified one-third or more of their priority outcomes in parent-child relationships.
• All three program approaches identified one-fourth or fewer of their priority outcomes in the family development area.

In addition, programs with different approaches reported somewhat different priorities. We offer suggested rationales for them, and will delve more into the theories of change by program approach in the 1999 site visits. Three differences were seen in the spring 1998 priorities:

• Home-based programs emphasized the combination of parent-child relationships and child development outcomes to a greater degree than did center-based and mixed-approach programs. Perhaps because home-based programs have often been seen as focusing on parental self-sufficiency, Early Head Start home-based programs may have been making special efforts to emphasize child development outcomes and the parent-child relationships outcomes that lead to them.
• Center-based programs emphasized family development and staff development outcomes to a greater degree than did programs following the other approaches. While most services were child-oriented, center-based programs may have felt a special need to keep the family as well as the child in the forefront. In addition, staff development may have received special attention in these programs since staff in center-based programs were being paid the least and received the fewest benefits (see Chapter III), and keeping these staff engaged and committed is critical for success in all other areas.
• Mixed-approach programs were most likely to give high priority to community development outcomes. Many of these programs were working with community partners to provide child care for Early Head Start children; thus, they may have placed a greater emphasis on targeting outcomes related to improving the quality of community services, especially child care.

As in all other aspects of programs’ early theories of change, the final round of site visits in 1999 will update and expand on the information presented here.

4. The Perspective of Programs’ Success Stories

As useful as the theory-of-change process is for understanding programs’ expected outcomes, efforts to dissect staff thinking run the risk of decontextualizing the important work that programs do. When asked to talk about individual families and children, program staff quickly described a complex array of circumstances, needs, services, and outcomes. The directors’ success stories help to illustrate both the specific outcomes they value and the complex ways in which multiple program expectations interact. Table II.12 summarizes success stories from three programs. Although each story is unique, and it is difficult to select three that represent the full diversity of programs’ identified successes, clear themes emerge. Regardless of program philosophy, theory of change, or stated intention, low-income families with infants face many obstacles. As these stories illustrate, programs have no choice but to address families’ problems with health, employment, housing, transportation, and abusive relationships. It is easy to read these programs’ success stories as success in moving young mothers toward self-sufficiency. However, it is also clear from these experiences that programs’ broad concerns for the whole family and the mothers’ self-sufficiency exist because of an underlying desire to change the context in which the infant lives and develops. Furthermore, regardless of program approach, we see program efforts to enhance the parent-child relationship for the ultimate purpose of improving the child’s developmental chances.

ILLUSTRATIVE PROGRAM SUCCESS STORIES

TABLE II.12

The “Baylors”
When 10-month-old “Pamela” first entered her center-based Early Head Start program, she was identified as “failure to thrive,” and weighed just 10 pounds. With a large head, tiny body, and translucent skin, she showed little affect, meekly whimpered, and had virtually no language development. She could barely sit up, had no balance, and expressed little interest in exploring her new environment. The community child care center from which she came had allowed her to spend most of the day lying in her crib. Fortunately, Pamela’s mother was determined to make this placement work, and provided hope to the teachers who had little experience with a child showing such profound needs. As the teachers gained Pamela’s trust, she gradually began to explore her world, discovering she could sit without support, then “scoot” toward desired objects, and thus maneuver around her classroom. All center staff carefully observed her progress and celebrated Pamela’s response to the programs’ naturally inclusive environment. Seven months after entering the program, Pamela had become the center’s official greeter, welcoming visitors with her effervescent smile and sparkling eyes. She was fitted for a hearing aide and was beginning to verbalize. Meanwhile, her advocate-mother began exploring a career in human services, possibly with a focus on services for children with disabilities.
The “Jacksons”
“Tina Jackson” was living in an abusive relationship with the father of her two young children when she enrolled in the local Early Head Start home-based program 18 months ago. Herself a victim of abuse and neglect as a child, Tina had difficulties meeting the developmental needs of two young children, one with serious asthma. Through the Early Head Start intervention, Tina was able to obtain her GED, leave the violent relationship with the father, obtain a driver’s license, and begin to purchase the car that would allow her greater independence and ability to meet the medical, educational, and social needs of her children. She enrolled in computer classes at the local community college and became a member of the Head Start Policy Council. The most important changes noted by program staff was in the quality of Tina’s relationship with her children, the increased time she spent with them, and her greater attention to their physical, cognitive, and emotional growth and development.
The “Smiths”
“Alicia Smith,”the 16-year-old mother of a developmentally delayed 1-year-old, “Adam,” had been physically abused by the baby’s father. Alicia was exhausted, nonresponsive, uninterested in her appearance, and--critically-- oblivious of her baby, who was developmentally delayed, irritable, and cried excessively. Her mixed-approach Early Head Start program began weekly home visits by the family educator, who tutored her, modeled good hygiene practices, and provided needed transportation to the center, where Adam was assigned a primary caregiver who provided individualized parent-child activities. The program called upon a number of collaborating agencies (including mental health, family preservation, and vocational rehabilitation) to provide coordinated services. The program’s parent educator began meeting with the father, who started participating in the fathers’ program. Within a year, Alicia became more responsive to Adam’s physical needs and verbal interactions. At the same time, Adam became better able to communicate his needs for bodily care, food, and other things. His language, self-help, and gross motor development improved noticeably, and he now actively explores his environment and initiates contact with familiar adults. Alicia communicates more freely with program staff, takes greater interest in her appearance, and has expressed interest in receiving support services. The father has returned to live with the mother and child and has begun actively seeking employment while continuing to work cooperatively with an intensive home services therapist.

---

1 The data include all forms submitted to and processed by Mathematica Policy Research, Inc. (MPR) for program families by the end of March 1999. The data include information for 1,514 research sample families in the program group.(back)

2 To be eligible for the research, families had to be pregnant or have children under 1 year of age. Thus, all families for which data were available have children younger than age 1.(back)

3 Better information about children’s disabilities will be available from later rounds of data collection conducted when children are older. (back)

4 The six Head Start Performance Measures include (1) emergent literacy, numeracy, and language skills; (2) general cognitive skills; (3) gross and fine motor skills; (4) positive attitudes toward learning; (5) social behavior and emotional well-being; and (6) physical health (Administration on Children, Youth and Families 1998; McKey, Tarullo, & Doan 1999. (back)

5 As noted in Table II.6, site visit schedules sometimes resulted in insufficient discussion of staff development outcomes for us to be able to summarize the program’s expected outcomes in this area.(back)

 

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