ACF OPRE: Early Head Start Research and Evaluation Project (EHSRE)

X. PATHWAYS TO IMPLEMENTATION AND QUALITY

Early Head Start programs are expected to grow and improve over time. In fact, the Head Start Bureau has taken significant steps to ensure that staff monitor programs’ compliance with the Head Start Program Performance standards, and the bureau provides guidance to programs from the monitoring results. More important, however, programs are required to engage in continuous improvement activities, and the Head Start Bureau has established a training and technical-assistance system to support programs in their efforts to improve. New programs are especially apt to grow and improve during their early years of operation, as they learn more about families’ needs and the services and strategies that best address them.

Beyond the normal growth and development that programs are likely to experience over time, changes in the context in which they operate have required them to adjust and adapt. The research programs, as well as all programs funded in the early waves of Early Head Start funding, have had to adjust to several major changes. For example, the new welfare policies that took effect in late 1997 drastically changed the needs and prospects of some families. Resources for child care often increased, and the implementation of child care subsidies changed in some places. Other significant policy changes occurred in particular states and communities.

Thus, we expected to observe changes as the research programs adapted their approaches and made both adjustments in the implementation of particular services and improvements in the implementation of key services. In fact, we saw substantial changes. The implementation and quality ratings presented in the previous chapters reveal the substantial growth that the Early Head Start research programs experienced between fall 1997 and fall 1999.

Stepping back from all the individual ratings and the particular areas of implementation and quality, it is possible to discern trends in the directions that programs moved and identify common strategies that programs used to respond to changing family needs and to meet the performance standards. Other common program experiences, key events, and circumstances also influenced the directions that programs took and the strategies they adopted. In this chapter, we summarize the major changes in approach and progress in implementation that programs made during their early years, identify the common themes that characterize their early development, note other common experiences that influenced the programs, and identify other key events and circumstances that influenced program pathways. The following sections also examine the strategies that the programs adopted to accomplish needed changes, highlight noteworthy accomplishments, and identify challenges that still lie ahead.

A. CHANGES IN APPROACH AND IMPLEMENTATION LEVELS OVER TIME

The research programs began with very different amounts of experience both in serving families with infants and toddlers and in operating Head Start programs (Administration on Children, Youth and Families 1999a). They also began with different plans for serving families with infants and toddlers, based on the varying needs of these families in their communities.

Although we tried to identify a few common developmental pathways followed by the Early Head Start research programs, the complexity of program services and the variations in communities in which they operate made it impossible to do so. Although the research programs share common pathways along particular dimensions, when we look across dimensions and examine different combinations of changes, each of the 17 programs emerges as unique. It is possible, however, to identify common types of changes the programs made or experienced along particular dimensions. We describe these next.

1. Evolution in Program Approaches

Over time, program approaches to delivering services increased in complexity. The research programs were initially divided about equally among center-based, home-based, and mixed- approach strategies. By fall 1997, however, the home-based approach predominated. Nevertheless, by fall 1999, only two home-based programs continued to rely exclusively on the home-based approach; the others began delivering center-based services to some families either directly or through formal partnerships with child care providers. The four exclusively center-based programs remained center-based throughout the evaluation period.

2. Progress in Overall Program Implementation Over Time

According to our implementation ratings, all the research programs made progress toward full implementation of key elements of the performance standards during the evaluation period. The patterns of change and growth, however, were quite diverse.

Six programs—the early implementers—reached full implementation in fall 1997 and maintained that level in fall 1999. These programs benefited from experience, started with a strong focus on child development, and were not hampered by early staff turnover or leadership changes. They continued to refine and improve the quality of their services. Many also expanded by adding children or services. The early implementers also built in greater accountability over time by improving internal monitoring or staff supervision, or by improving their service-tracking systems. Figure X.1 shows the growth of one of these programs.

Six programs were not fully implemented in fall 1997 but by fall 1999 had made significant improvements and reached full implementation. These programs—the later implementers—often received key feedback from Head Start Bureau monitors and promptly improved services to meet the Head Start Program Performance Standards. They often had to shift the primary focus of their services from the family to the child. The home-based programs in this group increased their attention over time to ensuring that child care for children who needed it was of good quality. Early leadership changes were more common among the later implementers.

FIGURE I.1

KEY EVENTS IN THE IMPLEMENTATION OF EARLY HEAD START
	Families Served
1987	45	Agency began home visiting program for families with children 0-5




1989	120	Agency received CCDP and Even Start grants, created an infant/toddler center, increased community collaborations, and began helping families gain access to comprehensive services




1991




1993




1995	130	Agency received Parent-Child Center designation, received an Early Head Start grant, increased focus on 0-3 year-olds, operated an on-site child care center for children 0-3, and integrated state funding




1997	220	Agency received an Early Head Start expansion grant and an interim Head Start grant




1999	270	Agency received permanent Head Start grant, received funding for building renovations, and received state funding for full-day/full-year center-based programs

		Agency expands to 3 infant/toddler centers, creates indoor playground, increases play groups in county, and opens 2 classrooms for children 3-5

The remaining five programs—the incomplete implementers—were moderately implemented in both fall 1997 and fall 1999. These were more likely to be new programs serving families with infants and toddlers for the first time. They often received important feedback from Head Start Bureau monitors but sometimes had trouble responding to it. They frequently had to increase their focus on child development. The incomplete implementers were more likely to experience high rates of staff turnover during their first year of operation and to experience leadership changes. They were also more likely to have to change course midstream as a result of difficulties with community partnerships. Like other programs, the incomplete implementers increased their accountability over time by improving internal monitoring of program services or staff supervision, and improving their tracking of service receipt.

B. THEMES CHARACTERIZING EARLY PROGRAM DEVELOPMENT

We asked program staff to look back over their early years and identify the key events that had made a difference in their program’s growth and development. From these reports and our own observations of changes that were common across programs, we identified a number of themes that characterized the early development of the Early Head Start research programs.

1. Increased Attention to the Revised Head Start Program Performance Standards

Programs received ongoing guidance from the Head Start Bureau and technical-assistance providers to help them interpret the performance standards. In addition, the research programs received Head Start Bureau monitoring visits between our 1997 and 1999 visits. These visits clarified the standards in the context of each program, identified areas that programs needed to change in order to comply with the standards, and motivated staff to address these areas. Staff in about half the research programs mentioned visits by their federal project officer or other technical-assistance consultants as key events in their program’s development.

2. Increased Service Intensity

Many programs increased the frequency of home visits, the hours of child care they provided in their centers, and/or the frequency of group socializations as the requirements of the Head Start Program Performance Standards became clearer and as family needs changed. One home-based program planned initially to conduct home visits biweekly, but changed to weekly to meet the revised Head Start Program Performance Standards, which took effect in January 1998. One of the center-based programs initially offered part-time day care in its main child development center, but increased its hours to help the growing number of families that needed full-time child care in order to work toward self-sufficiency. Many programs increased the frequency of group socialization activities to accommodate the varied schedules of families and increase participation levels in group activities.

3. Increased Focus on Child Development

Some programs began with a family support focus and had to go through a process of studying the performance standards, reevaluating their theories of change, and reexamining their services. Increasing the child development focus of services often involved increasing the time that was devoted to child development activities during home visits and parent activities, changing curricula or emphases in home visits, engaging staff in intensive training on relevant topics, and providing supervision to help staff focus more consistently on child development and parent-child relationships during home visits. The increase in focus on child development occurred, at least in part, in response to strong messages from Head Start Bureau monitors that although Early Head Start rests on four cornerstones, Early Head Start is a child development program and the focus of services needs to be the child.

4. Refocused Efforts to Improve Child Care Quality and Availability

As it became clearer to programs that the Head Start Bureau required them to take responsibility for the quality of child care arrangements that program children are in, many programs began focusing on improving the availability and quality of that child care. Several programs refocused their efforts to improve child care quality and availability from community-level collaborations with child care providers and agencies. Either by helping Early Head Start families find good child care arrangements or by working with providers to improve the quality of their existing arrangements, they improved Early Head Start children’s access to high-quality child care. Sometimes these efforts resulted in improvements in the quality of care for other children as well. Section C describes some of the strategies that programs used to improve child care availability and quality for enrolled children.

5. Enhanced Participation in Program Services/Activities

Some programs made strong efforts to increase family involvement in services—for example, participation in home visits and group socializations, and involvement of males in program activities—and succeeded to some extent in doing so. Because the new welfare requirements often led families to give priority to work-related activities, some programs experienced low levels of participation in program services and searched for strategies for improving it. In addition, programs recognized the importance of involving fathers as well as mothers in program activities and devoted resources to reaching out to them.

6. Expansion of Services

Many of the programs expanded their services during the evaluation period. To meet the demand for Early Head Start services in their communities, some programs expanded the number of children they served through new grants, either Head Start Bureau expansion grants or state grants. In response to changing family needs, and applying lessons from their initial experiences serving families, other programs expanded their options for providing child development services to children and families, helping them meet their child care needs, and ensuring that those who needed child care received high-quality care. In particular, for some families, several programs added a center-based option, either through partnerships with community child care providers or by opening their own center. Other home-based programs added an option in which they conducted visits to children both at home and in their child care setting. This expansion of program options, which increased program complexity, improved the fit between program services and family needs.

7. Evolution of Community Partnerships

As programs gained experience working with community partners and increased their focus on child development services, they sometimes found that their initial partnerships had become unproductive or that they were unable to overcome difficulties that had arisen with their partners. Some ended partnerships that had become unnecessary or were unsuccessful. Over time, most of the programs developed new community partnerships and joined interagency collaborative groups, often with child care providers or Part C agencies.

Changes in partnerships sometimes caused setbacks or required programs to redesign services, and sometimes they enabled programs to solve problems more quickly. Regardless, staff often saw these changes as key events in their programs’ development. For example, one program initially worked with the local resource and referral agency on strategies to improve child care quality, but staff members encountered problems in their relationship with the agency, ended this partnership, and went back to the drawing board to develop new strategies for promoting quality in Early Head Start children’s child care settings. In another program, after staff encountered difficulties in working with their partners in continuous program improvement and ended that relationship, they eventually hired a continuous program improvement researcher to work with them.

8. Leadership Changes

Nine programs experienced director turnover during the evaluation period, although in three cases the director moved to a higher position within the agency. Leadership changes sometimes set back or stalled program progress. However, sometimes they also created opportunities for positive change. For example, the newly hired program director in one program was unable to build necessary relationships within the grantee agency and overcome staff morale problems, and left the program after about one year. Other staff also left around the same time. The new director, an employee with a long history with the grantee agency, hired new people who were better suited to their jobs and in time created a staff with high morale and strong commitment to the program. In other programs, the departure of the program director caused some activities to be put on hold while the program sought a new director.

9. Staff Changes

Nearly all the research programs mentioned staff changes as key events in their program’s development, including the addition of new staff members, staff turnover in key positions, new training for staff, and reallocations of staff responsibilities.

Many programs experienced moderate or high levels of staff turnover, which often disrupted services. When programs were unable to fill staff openings quickly, families receiving home-based services experienced periods of less-intensive or no services. Children and families also lost the trusting relationships they had built with the staff members who left, and new staff had to establish new relationships with them. Staff turnover sometimes required programs to “start over” with training staff and helping them obtain their CDA credential.

10. Shift Toward Providing Training and Technical Assistance

Some programs reported that in addition to receiving training and technical assistance, they began providing it to other, newer Early Head Start programs. Because they were in the initial waves of program funding and further along the pathway to full implementation, the research programs were often called on to share what they had learned and provide help to newer programs in their region.

C. STRATEGIES FOR CHANGE

The common themes described above, as well as other changes that individual programs made, generally came about through the conscious and concerted efforts of program staff. These efforts employed some common strategies, which are described below. The strategies refer to the types of actions that programs took, often as a result of the key events just described.

1. Using New Curricula and Assessment Tools

One strategy for increasing the emphasis on child development or strengthening the focus of program services on the child was to add or change curricula. A number of programs added the Creative Curriculum for Infants and Toddlers. One mixed-approach program began using a common curriculum in its centers and in home visits to promote consistency and continuity when families move between center-based and home-based services.

Some programs added to or changed the child assessment tools they were using. Several programs added the Ages and Stages Questionnaires, because they are parent-friendly and offer an opportunity for parents to participate in and learn from the assessment process.

One program designed and implemented an outcomes/best practices tool for working with families. It was designed to improve service quality and make services more consistent across families.

2. Creating Early Head Start Child Care Centers

Several programs expanded their child development services by creating a child care center for some program children and to provide a model for high-quality child care in the community. In one case, the center was designed to provide respite child care services for a limited time to families who needed it. In another case, the center had spaces for eight children, and plans were in place for adding additional spaces.

3. Developing New Approaches to Improving Quality in Community Child Care Settings

During the evaluation period, the research programs began many efforts to improve the quality of child care for Early Head Start children in the community. Program staff devoted substantial time to these efforts, and worked hard to overcome the challenges presented by the limited supply of good-quality infant and toddler child care in their communities and the limited capacity of many community child care providers to make the changes necessary to meet the Head Start Program Performance Standards. Because of these challenges, some programs focused on training strategies for improving child care quality. Several programs and their community partners began offering free training and materials to child care providers. One program also offered a monetary payment for attending monthly training sessions.

Several programs began assessing quality and working with center-based and family child care providers to improve it. One program, as it worked with providers that cared for Early Head Start children, created individual quality enhancement plans and offered incentives, materials, and training to encourage and enable them to develop their plan. Staff members in that program were also beginning to visit informal neighbor and relative caregivers monthly. Another program began paying for child care for some children and worked with the funded providers individually to improve quality. Most of these were family child care providers.

In addition to or in place of some home visits, several programs began visiting children in their community child care settings. During these visits, staff members shared child development information with the providers and, when possible, offered feedback on the care of the program child. Through these visits, program staff built relationships with Early Head Start children’s care providers and encouraged them to work in partnership with Early Head Start on behalf of the child.

4. Creating Systems for Tracking Services More Effectively

Several research programs made changes in their management information system and/or their data collection procedures to facilitate access to information about families’ receipt of services, especially health services. One program hired a consultant who helped them implement the Head Start Family Information System (HSFIS) and streamline their data collection procedures. Several other programs began using the HSFIS to track services or made improvements to their existing tracking systems. The transition to using the HSFIS was sometimes difficult for program staff, especially when staff were not accustomed to using a computerized management information system or were used to a different system.

5. Ending Partnerships

As already noted, changing partnerships was an important theme of change for Early Head Start programs. Sometimes partnerships ended or changed as a result of circumstances outside the program’s control. Sometimes the programs accomplished important changes by ending partnerships or forming new ones. As programs gained a better understanding of the importance of focusing on child development services, they sometimes found that the initial partnerships they had formed no longer met their needs and should be ended. For example, one program initially relied on a collaborative agreement with another agency to provide child development home visits, but the agency did not provide the number of visits Early Head Start required, nor did it provide the needed support for Early Head Start staff in this area. The program ended its partnership with the agency, and staff members took direct responsibility for child development services.

6. Forming New Partnerships and Strengthening Existing Ones

The breadth of partnerships the programs had with other community programs and agencies increased over time. Programs found new partners to help them meet families’ needs. Programs also continued participating in interagency collaborative groups, and in some cases increased their leadership role in these groups (for example, one program became more visible and accepted in the community over time, and the director gained leadership roles in new community and statewide early childhood initiatives).

Many of the programs and their Part C partners began participating together in SpecialQuest1 and working together on joint goals for improving services to families and children with disabilities. In fall 1999, program staff reported that participation in SpecialQuest had improved their relationships with Part C staff and that frontline staff in both programs worked more effectively together on behalf of children with disabilities.

In their work on improving the quality of child care for enrolled children, many of the research programs began developing partnerships with child care providers during the evaluation period. These partnerships were both formal (involving contracts in which child care providers agreed to meet the performance standards) and informal.

7. Reorganizing or Creating New Staff Positions

To strengthen their focus on child development, some programs created new positions and either promoted existing staff or hired child development specialists or coordinators to support frontline staff in this area. To boost efforts to ensure that children received immunizations and needed health care and that staff had access to infant mental health expertise, some programs created positions for nurses or infant mental health specialists.

8. Hiring New Staff into Existing Positions

Staff turnover presented opportunities for filling positions with new staff who better met the needs of the program. Several programs experienced turnover and saw it as an opportunity to fill positions with staff better suited for the job. For example, in one program, many families who enrolled in the program were headed by teenage parents (even though teenage parents were not explicitly the target of program recruiting efforts). Many existing frontline staff did not like working with teenage parents, who present a unique set of challenges. As these staff left, the program hired new staff members who were interested in and qualified to work with these younger parents.

9. Providing Intensive Staff Training

A key strategy for programs that increased their emphasis on child development and strengthening child development services was providing intensive training in that area to staff. In one program, for example, the program’s continuous program improvement partner (university researchers) provided an eight-week course on child development and working with families and children at risk, for which staff received college credit. The program’s partner also helped program managers arrange a Child Development Associate (CDA) class for staff and providers who cared for Early Head Start children.

During the evaluation period, the Head Start Bureau notified programs that by September 2003, at least 50 percent of all teachers in center-based programs nationwide must have at least an associate’s degree in early childhood or a related field.2 Many of the research programs began providing more support for staff members to work toward their degree, such as developing individual plans for meeting this requirement, providing tuition support, and offering release time. One program began sponsoring a community college course in child development and gave enrollment priority to program staff and participants. Because some local colleges and universities did not offer degrees in early childhood development, several programs had to work with them to establish such a course of study.

10. Strengthening Staff Supervision

Some programs strengthened their supervision and support for frontline staff by hiring additional supervisory staff, spending more time with staff in supervisory activities such as case conferences and observations of service delivery, and improving the consistency of supervision. In one program, managers began providing monthly feedback on performance to individual home visitors. Another program made staff supervision more systematic and developed forms to facilitate feedback to home visitors after managers observed visits. Yet another implemented a new schedule for meetings and supervision sessions and refocused them on substantive issues (versus systems and process issues).

11. Increasing Staff Salaries

Several programs revised their salary scales in an effort to increase staff retention and attempt to establish pay equity. Two programs developed new scales based on years of experience and level of education, which in one of the programs dramatically increased the pay of Early Head Start teachers with degrees. Another program, which operated multiple sites, developed a new salary scale to make compensation equitable across sites and ensure that all staff received medical benefits. Another increased salaries for teachers and assistants to make them competitive with those of other child care professionals in the area.

12. Seeking Additional Funding

Some programs successfully sought additional grants to support their efforts to improve child care quality or enhance their services in other ways. For example, one program obtained state funds to expand the number of children it could serve and to hire additional staff members who provide intensive training and supervision to home visitors and implement continuous quality improvement activities. Another program recently received a state grant to develop formal partnerships with community child care providers to help them improve the quality of care they provide and work toward meeting the Head Start Program Performance Standards. Another strategy that some programs offering center-based care implemented for obtaining additional funds was to require families to apply for child care subsidies. The subsidies freed up Early Head Start funds for enhancing or expanding other services. Not only did additional funding increase program resources, it diversified programs’ sources of funding and made them less dependent on a single funding source.

D. PROGRAM EXPERIENCES INFLUENCING PATHWAYS

Other aspects of the research programs’ experiences, beyond the conscious strategies they adopted, also influenced their directions and pathways. These include their experiences prior to becoming Early Head Start programs.

1. Conversion from Comprehensive Child Development Programs

Some former Comprehensive Child Development Programs (CCDPs) had to shift the focus of program services from the family to the child. As CCDPs, some of the Early Head Start research programs emphasized family support and focused on supporting parents in their parenting role. In these programs, staff had substantial knowledge of community resources and experience in linking families with community services that address a broad range of parenting issues and barriers to self-sufficiency. As Early Head Start programs, they were expected to increase their focus on child development services and take responsibility for the quality of children’s child care arrangements. In some programs, staff resisted this shift in emphasis, and program managers had to work with them over a period of time to get them to accept the changes.

The former CCDP programs also had to regain confidence after disappointing CCDP evaluation results were released soon after they received Early Head Start funding. These results showed that the CCDP programs had no enduring impacts five years after families enrolled in the programs, although a pattern of positive impacts was found in one of the evaluation sites (St. Pierre, Layzer, Goodson, and Bernstein 1997).

2. Addition of Early Head Start to Head Start Programs

The Early Head Start grantees that operated Head Start programs brought experience with many components of the Head Start program—such as parent involvement activities, policy councils, and community and family partnerships—to the new program. To incorporate Early Head Start, these grantees had to shift their focus to include infants and toddlers. Staff who moved from Head Start to Early Head Start had to adjust to new responsibilities and new work schedules, and they needed to shift their focus to the special needs of infants and toddlers. When training for Early Head Start and Head Start staff was integrated, training activities needed to be reoriented to focus on infants and toddlers as well as preschool children.

Some Head Start programs had to learn to reallocate resources and promote effective communication among staff members to become a seamless 0 to 5 program. Adding Early Head Start to Head Start was not necessarily difficult, but when there were staffing or administrative problems within the Head Start program, and Early Head Start was perceived as competing for resources, tensions sometimes arose between staff members. Lack of communication between Early Head Start and Head Start staffs also presented difficulties in some programs.

3. Community Programs Becoming Early Head Start Programs

Some new grantees brought substantial experience in serving families with infants and toddlers to Early Head Start, but the programs did not have experience with Head Start requirements, such as one to establish a policy council. These programs had to become familiar with the Head Start Program Performance Standards and figure out how to meet them in the context of their agency and community. For example, one program that operated in a university setting had to reconcile university rules for program decision making with the Head Start requirement that the Policy Council make the decisions.

E. CHANGES IN THE POLICY AND PROGRAM CONTEXT

The dynamic nature of the early implementation of the Early Head Start research programs reflects in part their responses to a few key events and circumstances in their community, at the state level, and nationwide. These include revisions to the Head Start Program Performance Standards after programs were funded, welfare reform, changes in Medicaid programs, and changes in local child care markets.

1. Revised Head Start Program Performance Standards

The enactment of the revised Head Start Program Performance Standards required some programs to make changes in order to come into compliance. Sixteen of the research programs were funded in the first wave of Early Head Start programs (all were in the first two waves), before the revised Head Start Program Performance Standards went into effect. Thus, they were at the forefront in seeking clarification of the new performance standards, and their experiences and questions led to increased clarity in Head Start Bureau expectations.

2. Welfare Reform

Welfare reform was enacted in August 1996, shortly after the research programs were funded, and took effect a year later. It was accompanied by consolidation of child care funding streams and increased levels of child care funding. Many low-income parents are now required to work or participate in work-related activities. Time limits on cash assistance and the clear message that welfare recipients must work caused many parents enrolled in Early Head Start to give priority to looking for jobs and working, rather than to participating in program activities, including home visits. Increased participation in work and related activities also increased parents’ needs for child care.

Welfare reform led some research programs to adjust their service delivery approaches and modify specific services to meet the changing needs of families struggling to meet the new welfare requirements. Some programs also built new partnerships with welfare agencies and other community organizations that worked with parents on welfare. In response to families’ increased child care needs, some programs began working with eligible families to obtain child care subsidies or applying for direct grants from state child care subsidy funds.

3. Changes in State Medicaid Programs

Changes in Medicaid programs sometimes required programs to change their approaches to ensuring that children receive needed health care. The changes included shifts to managed care, which required families to select new health care providers and follow new procedures. One program initially formed a partnership with a local health care provider to deliver care for all program families without a medical home, but could not rely on that partnership for health care after the Medicaid program changed and many program families selected other health care providers for their Medicaid managed care. Programs often helped families obtain information and navigate the changes in the Medicaid program.

4. Local Child Care Markets

The availability and quality of child care for infants and toddlers in the community influenced the starting point of many programs in taking responsibility for ensuring that Early Head Start children who need it receive good-quality child care. In many of the research sites, program staff described the availability of child care for infants and toddlers in the community as insufficient and the quality of care as poor. Because good quality child care did not exist in the community, some programs did not have the option of referring families to it or of forming partnerships with providers to ensure that Early Head Start children received it. These programs had to consider ways to improve the quality of existing child care, such as providing training for child care providers, adding child care centers that could be models for good quality child care in the community, and working on quality improvements individually with providers that cared for Early Head Start children.

F. SOURCES OF GUIDANCE RECEIVED BY EARLY HEAD START PROGRAMS

The Early Head Start research programs learned the way to provide high-quality services with help from a number of sources, including:

Lessons from Experience. Lessons from their own and others’ experiences (such as those of Comprehensive Child Development Programs, Parent Child Centers, and other early intervention programs) helped the programs design and implement their Early Head Start programs.
Revised Head Start Program Performance Standards. Even though the new standards did not become official until more than a year after most of the programs began serving families, they guided the programs in their development because they were available soon after programs were funded. Over time, the Head Start Bureau and technical-assistance providers clarified and explained the new performance standards.
Training and Technical Assistance. The programs received varying amounts of help and guidance from the Head Start technical-assistance network, including Quality Improvement Center representatives, Disabilities Services Quality Improvement Center consultants, and infant-toddler consultants from the Early Head Start National Resource Center at ZERO TO THREE, as well as other sources of training and technical assistance to which the programs had access.
Head Start Bureau Monitoring Visits. Feedback and guidance from their federal program officers helped programs find their way and sometimes led them to explore directions they may not have considered otherwise.
Feedback from Continuous Program Improvement Partners. Interactions with and reports from continuous program improvement partners, often including the university-based local research partners, helped many programs reflect on the services they were providing, identify needed improvements, and garner support they needed to make changes. The nature and intensity of the program-research partnerships varied greatly. A few research teams had regular, active involvement with program staff, while others had little or no involvement with program staff beyond data collection. Most researchers were not involved in program activities.
Program Self-Assessment. Many programs conducted regular and intensive self-assessments and used information from them to make changes.
Participation in the National Research and Evaluation Project. Participation in the national evaluation and local research studies provided opportunities for directors of the research programs to meet and discuss implementation issues, and discussions with researchers provided opportunities for directors to reflect on their programs.

G. CONCLUSIONS: MAJOR ACCOMPLISHMENTS AND REMAINING CHALLENGES

The early implementation of the Early Head Start research programs has been dynamic. The programs’ development and change were fast-paced, and not always in directions that were (or could have been) anticipated. Throughout their first four years, programs made significant progress, achieved noteworthy successes, and encountered important challenges.

1. Noteworthy Accomplishments

The programs achieved many important successes over the first several years of implementation. Looking back, several accomplishments stand out.

Nearly three-quarters of the research programs became fully implemented. Twelve out of 17 research programs, according to our strictest measures, were fully implemented within four years of being funded. Most programs were able to reach full implementation within four years of their initial funding. About a third reached full implementation within the first year of serving families; another third became fully implemented within four years of initial funding. The others made considerable progress in a number of program areas but were not able to become fully implemented within the first four years.
Implementation progress occurred even while program complexity increased and program emphases changed over time. Programs often altered their basic approaches to providing child development services to accommodate the changing needs of families. The changes in approaches usually entailed adding service options. Over time, programs offered a more complex set of options to families. Programs’ theories of change evolved to increasing emphasis on expected outcomes in child development and parent-child relationships.
The infrastructure to support Early Head Start grew alongside the programs. The revised Head Start Program Performance Standards took effect in January 1998, and the first monitoring visits by Head Start Bureau staff took place during spring 1998. During this period, the training and technical-assistance system was growing to accommodate the rapidly expanding number of Early Head Start programs. Even in the midst of these changes, however, the research programs often cited guidance received from Head Start Bureau monitors and training and technical-assistance providers as key to their growth and development.
To a large extent, the programs delivered the required services. Overall, 91 percent of parents met at least a minimal criterion for being considered participants, and programs delivered child development and other services to them in centers, during home visits and case management meetings, and in group parenting activities. Services included child development services (including child care, assessments and screening, activities with children during home visits and group socializations), parenting education, and family development services (including case management, health services [mostly by referral], and transportation assistance [directly and by referral]). Furthermore, by 16 months after enrollment, most families had received the services that related to the needs they expressed at the time they enrolled.
The programs succeeded in providing more intense child development services. Programs providing home visits increased the intensity of home visits, moving from two to three visits a month on average. Programs offering center-based services all increased to full-day, full-year services, if they had not been offering these services initially.
The Early Head Start centers provided good-quality care to infants and toddlers, and many efforts were initiated to enhance quality in community child care programs that Early Head Start children attended. Between the fall 1997 and fall 1999 site visits, the ITERS scores consistently averaged 5.3 (in the good range). Several programs were rated as providing excellent care. All the programs received ITERS scores above 4, well into the minimal-to-good range. In contrast, only 31 percent of centers with infant/toddler classrooms received ITERS scores of 4 or above in the Cost, Quality and Outcomes Study (Cost, Quality and Outcomes Study Team 1995). Programs initiated many efforts to enhance quality in community child care centers attended by Early Head Start children.
Attention to staff training, supervision, and support sustained high ratings of staff satisfaction and commitment. Over time, many programs have continued to refine their training and supervisory approaches, and several have adapted forms and created tools to support staff in providing consistent, high-quality services to families. The research programs have invested a lot in staff and succeeded in creating workplace environments that staff rated highly in the surveys they completed at the time of our site visits. During the fall 1999 site visits, staff noted how much they have learned and expressed confidence that they now have a much clearer idea of what they are trying to accomplish and how to go about it.
Early Head Start programs contributed to their communities. In a number of ways, maturing programs began making a difference for the larger communities in which they are located. For example, staff training increased the number of infant and toddler experts in their communities; when staff move to other organizations, their Early Head Start training and experience benefits the community; efforts to improve child care quality are an investment in the quality of child care for all children in the community; program efforts to help families obtain needed services lead to greater integration of services in the community; and efforts to establish degree programs in early childhood development at local colleges add community resources in early childhood.
Community partnerships grew in number and effectiveness. Early Head Start programs have become better known and more accepted in their communities. Special Quest has played a key role in strengthening partnerships between Early Head Start programs and Part C providers. In addition, more programs have contracts or agreements with child care providers.

2. Looking Ahead: Noteworthy Challenges

Looking beyond the Early Head Start research programs’ first four years of operation, several challenges remain:

Continuing to adjust to changing family needs. During their first four years, the research programs adapted their services to family needs that changed as a result of welfare reform. They are likely to continue doing so. In many states, families are just beginning to reach time limits on cash assistance, and programs may face new challenges if they need to help families cope with the loss. If the economy weakens, it may become harder for families to meet the work requirements, and programs may need to do more to help them with their employment and child care needs.
Finding effective strategies for engaging families in parenting education and group socializations. During their first four years, most of the research programs providing home-based services to some or all families were unable to achieve high participation rates in group socializations, even with efforts to vary schedules, create structured and relevant activities for the socializations, and provide incentives for participating. With only about half the parents in center-based programs participating in group parent education activities, programs that were exclusively or partially center-based continued to have difficulty engaging parents more fully in parent education classes and support groups.
Increasing father involvement. In searching for effective approaches to involving parents in group socializations and parenting education, as well as in other program activities, the programs may also discover creative ways to involve fathers.
Ensuring that children’s child care arrangements meet the revised Head Start Program Performance Standards. As the Head Start Bureau clarified its expectation that Early Head Start programs are responsible for ensuring that the child care arrangements of Early Head Start children meet the performance standards, the research programs began responding in diverse ways. In many programs, this effort was starting to gain momentum in fall 1999. Some programs set out to provide center-based child development services and consistently provided child care that met the standards and received good quality ratings in the research. Other programs added center-based services to help meet the child care needs of some program families. One program also organized a network of Early Head Start family child care providers. Programs that had to rely on community child care settings to meet their families’ child care needs developed a range of strategies for ensuring quality. However, most programs that were not center-based Early Head Start programs were not able to ensure quality child care for nearly all children who needed it and will be challenged to continue to increase the number of community child care partnerships to ensure quality child care.

Balancing program needs and the needs of staff. Programs’ staffing needs are likely to continue changing as programs evolve and services change, which will require programs to prepare staff for new responsibilities and sometimes to change their staff structure. In this context, programs also must meet the financial and other needs of a more professional workforce to minimize staff turnover, which can affect programs negatively.

The experience of the research programs shows that reaching full implementation quickly presents a significant challenge for some programs. Reaching full implementation takes time, and not all programs will be successful within the first three or four years of funding. All programs and the infrastructure that supports them need to work together toward the goal of reaching full implementation as quickly as possible.

3. Summary

The first four years of Early Head Start saw fledgling programs accept the challenges of extending the Head Start concept to low-income pregnant women and families with infants and toddlers. By the end of this period, 17 research programs, representing diverse approaches to delivering comprehensive Early Head Start services, were effectively implementing significant portions of the performance standards, while almost two-thirds of them achieved “full implementation.” The pathways that programs followed to achieving implementation and quality of services included evolving program approaches characterized by adaptation to changing needs and circumstances in the many ways described in this report. This dynamic process meant increasing focus, complexity, and intensity, in working both with families and within the programs’ communities. At the conclusion of the evaluation, the programs have accomplished much, but they continue to face significant challenges. The opportunities these challenges create provide the promise of continued growth and improvement for Early Head Start programs.

1SpecialQuest refers to five-day workshops conducted as part of the Hilton/Early Head Start Training Program, which is now part of the Head Start T/TA system. These began in 1998 with funding from the Conrad N. Hilton Foundation. SpecialQuest emphasizes inclusion of infants and toddlers with significant disabilities, nurturing relationships with families, and building/maintaining relationships with early intervention partners. SpecialQuest teams are formed in local communities and comprise Early Head Start staff, parents of infants/toddlers with disabilities, and early intervention staff. The teams attend the workshops and are expected to continue working together when they return to their communities.(back)

2Head Start Act, Section 648A (a) (2), October 1998.(back)

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