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II. PROGRAM DEVELOPMENT AND EVOLVING PROGRAM APPROACHES
As the Carnegie Corporation’s Starting Points report suggested, providing services to support the development of infants and toddlers in low-income families is a challenge. The framework established for Early Head Start (as we reviewed in Chapter I) encompassed several options for providing such services, and all options required extensive planning at the local level. Program staff took on the challenges with enthusiasm, implemented a variety of approaches during their early years, and raised the level of awareness about the importance of providing services for pregnant women and infants and toddlers and their families. Over time, they fine-tuned their approaches in response to their experiences and changing contexts for families, particularly as influenced by changes accompanying welfare reform. Through the lens of the 17 research programs, we see this new national initiative as it is today and how it developed during its short history. In this chapter, we profile the salient features of the programs’ approaches to service delivery as of late 1999 and describe what they were like two years earlier. In addition, we describe the evolution in program approaches, explaining how and why they developed as they did.
Early Head Start programs strive to achieve their goals by designing program options based on family and community needs. Programs are required to reassess community needs and resources regularly (formally, every three years); following each assessment, they reassess the “goodness of fit” between community needs and program approaches. By design, 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. ACYF made this wide range of service delivery options eligible for funding to attract programs that could best serve families with infants and toddlers in their communities. Because a single program may offer families multiple options, for purposes of the research, we have characterized programs according to the options they offer:
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Center-based programs, which provide all services to families through the center-based option (center-based child care plus other activities) and offer a minimum of two home visits per year to each family
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Home-based programs, which provide all services to families through the home-based option (weekly home visits and at least two group socializations per month for each family)
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Mixed-approach programs, which provide some services to some families through the center-based option and some through the home-based option, or provide services to families through the combination or locally designed option (services can be mixed in the sense either that programs target different types of services to different families or that individual families can receive a mix of services at the same time or at different times)
When initially funded, the research programs were about equally divided among these three approaches, with five center-based, five home-based, and seven mixed-approach programs (Figure II.1). By fall 1997, as we reported in Leading the Way, the programs’ efforts to find appropriate ways of meeting their families’ needs had shifted the balance significantly.1 Four programs were then center-based, seven were home-based, and six were mixed-approach. The changes, from the point of initial funding to 1997, were a result of such factors as subsequent funding decisions, changes in families’ needs, and recommendations of technical assistance providers.
Program evolution did not stop there. By fall 1999, programs offering only a home-based approach had become the minority (down from seven to two). All four of the center-based programs continued in that mode, but by 1999, 11 programs were offering a variety of “mixed” approaches to Early Head Start services. Regardless of whether they changed their main approach to service delivery, nearly all programs added services and grew in complexity (Figure II.2)
![[FIGURE II.1: BASIC PROGRAM APPROACHES]](images/pways_fig2_1.gif)
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| SOURCE: Information gathered during visits
to the Early Head Start research programs in fall 1997 and fall 1999.
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:
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The story of these changes is at the heart of this chapter. We begin the chapter by describing the contexts in which the research programs developed and how these contexts changed over time. We then profile each of the 17 research programs as of fall 1999, summarizing their key features and the changes they made in their approaches to service delivery between fall 1997 and fall 1999. We end the chapter with a discussion of the themes of change gleaned from our analysis of the research programs’ development over time.
A. THE CONTEXT FOR PROGRAM DEVELOPMENT
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 had experience operating Head Start programs for preschoolers, and five of these had also served infants and toddlers. Another grantee had operated a Parent Child Center (PCC) as well as a Head Start program and seven had operated Comprehensive Child Development Programs (CCDPs). Many of the grantee agencies had experience providing services to infants and toddlers, but five of them were new to Head Start. Three of the program grantees had not operated Head Start programs, CCDPs, or PCCs, but had operated other community-based programs. These grantees included a Montessori program that had served infants, toddlers, and preschool children, as well as a school district and a well-known national agency that had not.
![[FIGURE II.2 COMPLEXITY OF PROGRAM "APPROACHES" ]](images/pways_fig2_2.gif)
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The research programs are distributed fairly evenly across all major regions of the country and across rural and urban areas. Six programs are located in western states (California, Washington, Colorado, and Utah). Four are in midwestern states (Iowa, Kansas, Michigan, and Missouri). Four are in northeastern or Middle Atlantic states (New York, Pennsylvania, Vermont, and Virginia). Three are in southern states (Arkansas, South Carolina, and Tennessee).
![[Early Head Start Research Programs]](images/pways_fig2_3.gif) |
About half (eight) of the Early Head Start research programs are in urban areas, and the other half are in small towns or rural areas. 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 serve. Many of the programs operate in areas where the unemployment rate was 5 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. By 1998, the unemployment rate in the United States had fallen to 4.5 percent (from 5.6 percent in 1995), and rates in most of the areas where the programs operate also fell below 5 percent. Four programs, however, served families in areas where the unemployment rate was between 5.5 and 10.2 percent.
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. Thirteen of the programs indicated that their community lacked sufficient affordable housing, and ten 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. SALIENT FEATURES OF EARLY HEAD START RESEARCH PROGRAMS IN 1999 AND THEIR KEY DEVELOPMENTS OVER TIME
Over time, some research programs made fundamental changes in their approaches to serving families, and others made significant changes without altering their basic approach. In this section, we describe the key features of each program in 1999 and summarize the major developmental milestones each achieved since receiving Early Head Start funding. We describe (1) center-based programs that remained center-based, (2) home-based programs that remained home-based, (3) mixed programs that stayed mixed, and (4) home-based programs that became mixed.
1. Center-Based Programs—that Remained Center-Based
We begin with the four center-based programs, which were among the five initially funded to implement center-based child development services and continued with this approach through 1999. Even while continuing to provide center-based services, however, these programs were not static. These programs (all of which provided full-day, week-day, full-year services, with at least two home visits per year) were a diverse group. Child Development, Inc. in Arkansas expanded services into additional counties; Educational Alliance in New York City began as a half-day program and expanded to a full-day program; Colorado’s Family Star program made a number of changes to promote quality and continuity of care and to expand services; and Northwest Tennessee Early Head Start, among other changes, began closer collaboration with welfare-to-work case managers.
Child Development, Inc. Early Head Start (Russellville, Arkansas). Child Development, Inc., a community-based organization that operates both center-based and home-based child development programs, including Head Start, operates an Early Head Start program for 108 families in centers in six rural Arkansas counties. The program serves mostly white, working-poor families, most of which are headed by a single parent. The program provides full-year, full-time child development services in its centers and offers parent training and case management in group sessions, during home visits, and in one-on-one sessions at the centers. When they enroll in the program, parents must agree to spend two hours a week on developmentally appropriate activities with their child. The program helps parents who need it obtain child care before or after Early Head Start in the grantee’s centers and obtain state child care vouchers to pay for it. Families who cannot obtain vouchers receive priority for extended-hours slots in Early Head Start classrooms. Child development services are based on the premise that children should lead by expressing their needs and interests and that staff should be there to support them.
Between 1997 and 1999, the program received new grants to expand the number of children it can serve in Early Head Start from 45 to 108 families, and the program opened new Early Head Start centers in three additional counties. To accomplish this expansion, the program hired new staff and changed the supervisory structure. The program also strengthened staff development by providing financial support to staff who are working toward their associate’s degrees and by implementing a new salary scale that will increase the pay of teachers with degrees. In addition to expanding services to more families, the program also increased the range of physical and mental health services it offers to children and families, and it began offering services for extended hours to a few children in three of the centers. Four of the six Early Head Start centers had received NAEYC accreditation by fall 1999, and the two remaining centers were expected to receive accreditation in spring 2000.
Family Star Early Head Start (Denver, Colorado). Family Star, which operates a Montessori school for infants and toddlers, operates an Early Head Start program for 75 families at two centers in northeast and northwest Denver. Many families served by the program are Latino and speak Spanish. The program provides full-year, full-time child development services in Family Star’s Montessori school while parents are working or in school and offers monthly parent education meetings and semiannual home visits. Program services are child-centered, and staff members speak both Spanish and English with the children.
The program made several changes between 1997 and 1999. It reduced the maximum group sizes in all classrooms to meet the revised Head Start Program Performance Standards. To promote continuity of care, the program created a classroom in which the directress stays with the children as their classroom is transformed from a Nido (classroom for infants up to 14 months old) to an Infant Community (classroom for children older than 14 months). To facilitate transitions out of Early Head Start, the program received a waiver from the school district to allow all children in the research sample to attend the city’s Montessori magnet school through the eighth grade. The staff continues to work on transition plans for other children. The program now requires eligible families to apply for state child care subsidies to offset a portion of the costs of operating the school. In addition, it expanded participation in the Child and Adult Care Food Program to provide breakfast and a snack for children during the school day. The program hired a mental health coordinator to work with staff and provide services to families and children.
Educational Alliance Early Head Start (New York, New York). The Educational Alliance, a community-based organization that began as a settlement house and now provides many services, including Head Start and child care, in New York City, operates an Early Head Start program for 75 families in three centers. One center is located at the Educational Alliance headquarters, and two are in schools for pregnant and parenting teenagers. The families served by the program are ethnically diverse, predominantly single-parent families, about one-third of whom receive welfare cash assistance. The program emphasizes the development of supportive relationships and mental health, and in addition to center-based child development services, provides families with psychotherapy services. Families have access to employment-related and other support services provided by the Educational Alliance.
The program experienced several major changes between 1997 and 1999. Because of philosophical differences, it dissolved its partnership with a residential program for pregnant and parenting substance-abusing women and developed a new partnership with a second school for pregnant and parenting teenagers. The program received an expansion grant to extend its child care hours at the Educational Alliance site to full-time (37.5 hours per week), so that it can better meet families’ child care needs. The original program director left and was replaced in fall 1999.
Northwest Tennessee Early Head Start (Jackson, Tennessee). Northwest Tennessee Head Start, a program of the Northwest Tennessee Economic Development Council, operates an Early Head Start program for 75 families in child development centers located in five rural Tennessee counties and in the town of Jackson. The program serves mostly African American, single-parent families who are receiving welfare cash assistance. Many parents are teenagers who live at home with their own mothers. The Early Head Start centers provide full-day, full-year child care and parent-training activities. Program staff also provide family development services and referrals designed to help families achieve self-sufficiency, and they focus on arranging health and developmental screening and treatment services for Early Head Start children. The program focuses on providing developmentally appropriate, responsive care in a nurturing environment.
Since it began serving families in fall 1997, the program has increased its focus on health and development by providing frequent opportunities for comprehensive health and developmental screening and by advocating intensively for improved Medicaid services for infants and toddlers. Program staff also began collaborating more closely with welfare-to-work program case managers. Because there was no early childhood degree program nearby, the program worked with several local colleges to create an appropriate program so teachers can begin working toward their associate’s degree. Early Head Start classrooms in four centers received NAEYC accreditation in 1998. The program’s original director left and was replaced in fall 1998.
2. Home-Based Programs that Remained Home-Based
Two research programs that were initially funded as home-based programs continued to provide home-based services to all families through fall 1999. While continuing their efforts to complete weekly home visits and offer at least two group socializations per month, they extended their efforts to support families’ use of high-quality child care. In Pittsburgh, Pennsylvania, Family Foundations Early Head Start remained home-based while beginning an initiative to improve the quality of child care used by its families. In Logan, Utah, Bear River Early Head Start, in its effort to improve quality and meet the performance standards, made significant refinements in its approach to enhancing parent-child relationships and began providing respite care in a small on-site center, but retained its basic home-based approach.
Family Foundations Early Head Start (Pittsburgh, Pennsylvania). The University of Pittsburgh’s Office of Child Development operates an Early Head Start program for 140 families in four centers in three diverse communities in the Pittsburgh area. Across the four centers, the program serves mainly African American and white families headed by single parents, two-thirds of whom were receiving welfare cash assistance when they enrolled in the program. The centers provide services to families in home visits: family advocates visit families weekly to address child development issues, and family development specialists visit families biweekly to work with them on their goals and link them with community services. Staff members organize group activities for parents and families at each center. The program also works with child care providers to develop individual quality enhancement plans and visits providers (mostly family child care providers) to work with them on implementing the plans. Child development services focus on working with parents to improve their interactions with their children and in fall 1999 were beginning to focus on working with child care providers to enhance the quality of care they provide to Early Head Start children.
Between 1997 and 1999, the Family Foundations Early Head Start program, a former Comprehensive Child Development Program, decided to continue providing home-based services but enhanced its focus on the child and began a new initiative to improve the quality of child care arrangements used by Early Head Start families. The program restructured the staff and created a new staff training curriculum to ensure that staff are knowledgeable about child development and focus on it in all home visits (including family development visits). The program also began working with centers and family child care providers to improve quality.
To illustrate this process in greater detail, Carol McAllister, a local research partner with the Pittsburgh Early Head Start program, describes the program’s evolution to having a greater focus on child development while remaining home-based (see box on the following page). Through self-examination, the program modified its emphasis without altering its basic home-based approach.
Bear River Early Head Start (Logan, Utah). The Bear River Head Start agency operates an Early Head Start program for 75 families in three rural counties in northern Utah and southern Idaho. The program serves primarily white, two-parent, working-poor families. The program provides child and family development services primarily in weekly home visits and weekly Baby Buddy groups for parents and children. The program also offers respite and drop-in child care in its on-site center, and program staff are trying to improve the quality of child care by visiting family child care and relative care settings of program children twice a year. Staff members work to foster positive parent-child interactions and increase parents’ understanding of their children’s development. They also work with parents to help them achieve their personal and family goals and link them with services in the community.
From 1997 to 1999, the program refined its focus on improving parent-child relationships, infant-parent play interactions, and parental knowledge of child development by adding several child development staff positions, improving home visitor training based on reviews of videotapes of home visits, focusing group activities on parent-child interactions, and providing child development services in its on-site respite center. To encourage active participation in the program, staff members have begun scheduling more home visits on weekends and in the evenings, as well as offering special incentives to families who complete Individual Family Partnership Agreements and volunteer in program activities. The program has also begun emphasizing involvement of fathers and father figures.
3. Mixed-Approach Programs that Remained Mixed
Six of the seven programs that planned a mixed approach to service delivery at the time of funding were still operating as mixed-approach programs in 1997 and continued to take such an approach in 1999, while continuing to evolve. They served some families in center-based settings and some through the home-based option; in addition, they provided some families with both center- and home-based services, either at the same time or at different times as families’ needs changed. The Clayton/Mile High Family Futures program in Denver significantly expanded service options; Project EAGLE, in Kansas City, Kansas, obtained state funding to boost its ability to provide child care assistance; Sumter (South Carolina) School District 17 Early Head Start expanded its child care options while strengthening the child development focus of its home visits; Early Education Services Early Head Start, in Brattleboro, Vermont, increased the home-visit time spent on parent-child activities and took formal steps to ensure the child care providers met the revised Head Start Program Performance Standards; the United Cerebral Palsy program in Alexandria, Virginia, improved collaborations with the child care licensing office; and the Children’s Home Society of Kent, Washington, added child care classrooms.
Clayton/Mile High Family Futures, Inc., Early Head Start (Denver, Colorado). Clayton/ Mile High Family Futures, Inc., a partnership between a foundation and a child care resource and referral agency that operates a Head Start program, is operating an Early Head Start program for 123 families in Denver. The program serves low-income families from diverse racial and ethnic backgrounds. It provides child and family development services in four ways, depending on family needs and preferences: (1) in weekly home visits, when children are not in licensed child care; (2) in weekly visits, two in the home and two at the child care center, when children are enrolled in licensed child care centers in the community; (3) through full-year, full-time Early Head Start center-based child development services and monthly visits, alternating between the home and the center; and (4) through child care in a contracted center and two visits monthly, one in the home and one at the center. Child development services focus on improving parent-child relationships and helping parents meet their children’s needs.
From 1997 to 1999, the program changed dramatically. Soon after it received Early Head Start funding, many staff members who had been with the program when it was a Comprehensive Child Development Program, including the director, left and were replaced. To meet the revised Head Start Program Performance Standards, the new staff increased the intensity of services offered, expanded the service options to meet families’ needs better, and strengthened the child focus in program services. The program began requiring eligible families with children enrolled in the Early Head Start center to apply for state child care subsidies to offset the cost of care, which freed resources and enabled the program to improve other services. The program also began tracking services more carefully and added a “continuous improvement” researcher to its staff to help the administrative team monitor progress toward goals and targeted outcomes. The Early Head Start center received NAEYC accreditation in 1999.
The flow chart on the next page was created by Chris Sciarrino and Rebecca Soden, of the Clayton Mile High Early Head Start program, to trace the program’s evolution back to its “roots” in CCDP. It shows how this mixed-approach program remained “mixed” while increasing in intensity and developing its vision, questions, and expected outcomes.
Project EAGLE Early Head Start (Kansas City, Kansas). The University of Kansas Medical Center’s Child Development Unit operates an Early Head Start Program, called Project EAGLE, for 160 families in Kansas City, Kansas. The program serves ethnically diverse families, half of which were receiving welfare cash assistance when they enrolled. Program staff members provide child and family development services in two ways: (1) through weekly home visits or (2) through full-day, full-year child care in a center or family child care home that meets the revised Head Start Program Performance Standards, plus biweekly home visits (for families in which the primary caregiver is working or attending school or for families whose child is at risk or whose situation places program staff at risk). The program has established collaborative agreements with several child care centers and family child care providers in the area to provide care for Project EAGLE children, and program staff provide ongoing training and technical assistance to center staff members and the family child care providers to ensure that Project EAGLE children receive high-quality child care. The child development services are designed to increase parents’ responsiveness to their children, engage them in their children’s development, and empower them to obtain the formal and social supports they need to create a better environment for their child.
| Evolution Of Clayton/Mile
High Early Head Start Chris Sciarrino and Rebecca Soden Clayton/Mile
High Early Head Start |
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| CCDP
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EHS BEGINS
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“Blossoming” | EHS CHANGES
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Shift in goals to:
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| Vision | “Through the eyes of the family”
Family Services—Child Development and Integral Piece ![[right arrow]](images/pways_arrow.gif){kind=icon} |
“Through the eyes of the child”
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| Belief | Self-sufficiency Child
Outcomes |
Intensity of Children’s Services
Child Outcomes |
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| Intensity | Expectation: Home Visits 4 Times/Month
Program Design did not meet this standard
Program Designmeetsthestandard
Rationale = Cost/Unit of Service Rationale
= Dosage
Child Outcomes |
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Outcomes Matrix refined Program activities
aligned with standards Reports generated in response to outcomes |
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From 1997 to 1999, the program received state funds to serve more families and to add staff. The program also obtained state funding to pay for child care, so it no longer has to rely primarily on state child care subsidies for individual families and has more flexibility to provide child care assistance during changes in employment (when families may lose their eligibility for state subsidies). The program also developed and implemented a best-practices tool designed to help home visitors see themselves as agents of change, improve service quality, and make services more consistent across caseloads. The program has formed new partnerships with child care providers and is investing more resources into staff training to promote higher-quality child care. The diagram on the next page illustrates the service model for Project EAGLE. It depicts the mixed program’s model of services in fall 1999, with the multiple service options that have evolved to meet the diverse needs of families.
Sumter School District 17 Early Head Start (Sumter, South Carolina). School District 17 in Sumter, South Carolina, operates an Early Head Start program for 75 families. It provides full-year, full-time center- or home-based child development services to pregnant and parenting primary and secondary school-age students and young high school graduates who are employed. Most of the parents in the program are African American teenagers. Parent educators conduct weekly home visits with families whose children are not enrolled in the centers and less-frequent home visits with other families to work with them on parenting and child development, help them identify their needs and goals, and link them to services in the community. Child development services focus on (1) teaching parents to take responsibility for themselves and their children, (2) teaching them how to obtain the resources they need to be better parents, and (3) providing high-quality child care that is child-centered, child-directed, and adult-supported.
From 1997 to 1999, the Sumter Early Head Start program reorganized its staff to ensure a stronger focus on child development in home-based services. The program also began contracting with a community child care center to provide Early Head Start care to up to eight children, and through that relationship is working to improve the quality of child care in the community. The program’s relationship with the Part C agency has improved as staff members have worked with Part C service providers in center classrooms and learned about caring for children with disabilities. The program has increased its visibility and acceptance in the community.
Early Education Services Early Head Start (Brattleboro, Vermont). The Brattleboro, Vermont, school district’s Early Education Services office operates an Early Head Start program for 107 families in rural Windham County. The program serves primarily white families, half of which include both parents. The program provides child and family development services, primarily in home visits. It also provides full-year, full-time center-based child development services for a small number of families and brokers child care for 20 children in family child care homes and center-based settings in the community. After the first year, the program often reduces the number of home visits to two per month and adds two visits per month to the center where the child is receiving care. The program also organizes play groups and monthly parent-child group activities. Teams of staff members work with families to build on their strengths and achieve their personal and family goals, and they link families with needed services in the community. Child development services are designed to promote strong parent-child relationships and positive interactions.
| Project EAGLE Early
Head Start/Head Start Program Options
Martha Staker Project EAGLE Early Head Start
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From 1997 to 1999, the program, a former Comprehensive Child Development Program, increased its child focus by spending more time during home visits on parent-child activities and sponsoring a community college course in child development, in which staff and participants receive priority in enrollment. The program also took on direct responsibility for developing written agreements with licensed child care providers to care for Early Head Start children. In these agreements, the providers agree to adhere to the relevant portions of the revised Head Start Program Performance Standards, and the program agrees to supplement subsidy rates when needed and provides materials and equipment as necessary. During the past three years, Early Education Services also became a Head Start grantee and worked toward providing continuous, seamless services to children from birth through age 5. The director took a leave of absence, returned for a year, and then left permanently.
United Cerebral Palsy Early Head Start (Alexandria, Virginia). United Cerebral Palsy of Washington, DC, and Northern Virginia operates an Early Head Start program with a special emphasis on children with disabilities for 75 families in Fairfax County, Virginia. The program serves an extremely diverse group of working-poor families, including military families. Many are immigrants who do not speak English or do not speak it well. The Early Head Start program provides child development services to some families full-time in a child care center, some families full-time in family child care, and some families in weekly home visits. Families with children enrolled in the child care center or in family child care receive family development services in monthly home visits. Families are also invited to group socialization activities three times a month. The program provides inclusive services to children with disabilities and works to foster inclusive services for all children in the community.
From 1997 to 1999, the program developed collaborations with new community partners and improved its collaborations with the county child care licensing office and Part C and Part B service providers. The program also enhanced child development services by maintaining portfolios for each child in the center, increasing the frequency of group socializations and providing transportation to them, and adding an additional child development assessment tool. The original program director left and was replaced in late summer 1999.
The Children’s Home Society of Washington—Families First Early Head (Kent, Washington). The Children’s Home Society of Washington operates the Families First Early Head Start program for 120 families in South King County. The Early Head Start program builds on the agency’s experience as a child welfare agency and as a former Comprehensive Child Development Program. The program serves diverse families, half of which were receiving welfare cash assistance when they enrolled. It provides child and family development services in three ways: (1) through weekly home visits and biweekly group socializations; (2) in Early Head Start classrooms in full-year, full-time child care centers operated by the Children’s Home Society, with monthly home visits and bimonthly group socializations; and (3) through a combination of services, either (a) in two home visits and two child care visits per month, or (b) in child-parent/parenting classes for 12 hours per week plus monthly home visits. All families also receive monthly home visits from a public health nurse. Child development services focus on building supportive relationships, especially between parents and children.
From 1997 to 1999, the Families First Early Head Start program expanded case management services and increased its emphasis on mental health. It also added child care classrooms and added new group socialization activities. The program has experienced considerable staff turnover, including two directors, although the original director still works for the Children’s Home Society and provides some oversight. To increase staff retention and improve services, the program increased salaries, added more case management staff, and formed a support group for frontline staff.
4. Home-Based Programs that Became Mixed-Approach Programs
Five of the programs that were funded as home-based programs continued in this approach in 1997, but expanded the service options they offered to families so that by 1999 they were mixed-approach programs: (1) the Venice Family Clinic Children First Early Head Start, in Venice, California, increased home visitors’ focus on parent-child relationships and child development and began paying for and supporting the quality of child care used by some families; (2) Mid-Iowa Community Action, in Marshalltown, Iowa, took on greater responsibility for helping families find child care and began conducting visits with child care providers; (3) Community Action Agency Early Head Start, in Jackson, Michigan, added a child care center to serve some of its families; (4) KCMC Early Head Start, in Kansas City, Missouri, began working with community partners to improve community child care and visiting children in their child care settings; and (5) the Washington State Migrant Council’s Early Head Start program, in Yakima Valley, Washington, began offering center-based services at one of its sites.
Venice Family Clinic Children First Early Head Start (Venice, California). The Venice Family Clinic, a private, community health clinic that has provided health care to low-income families for many years, operates the Children First Early Head Start program for 100 families in the Venice area. The program, which serves primarily Hispanic families, provides child and family development services to most families in weekly home visits and biweekly group socialization activities. The program refers families who need child care to a state-funded resource and referral agency that screens providers, makes referrals, and monitors quality. In addition, the program now funds child care for 15 children whose families cannot afford it. Providers who care for these children must sign a contract that requires them to meet many Head Start Program Performance Standards. Families receiving program-funded child care receive child and family development services in a combination of home and child care visits and in biweekly group socialization activities. The child development services focus on strengthening parents’ and caregivers’ relationships with children through instruction and modeling.
From 1997 to 1999, the program strengthened its focus on child development by hiring new staff with child development and early intervention expertise and by strengthening the training and supervision of home visitors. These changes have helped home visitors focus consistently on parent-child relationships and child development. The program also increased its focus on child care quality by funding some child care and requiring funded providers to make improvements, get ongoing training, and meet standards. All these changes have resulted in part from suggestions by Head Start Bureau monitors and from a self-assessment in which small workgroups of staff and parents addressed various program issues. In fall 1999, the program director, who had been with the program since its days as a Comprehensive Child Development Program, left and was replaced.
Mid-Iowa Community Action, Inc. Early Head Start (Marshalltown, Iowa). Mid-Iowa Community Action, Inc., a community-based organization that has provided services (including a Head Start program) to low-income families for 24 years, operates an Early Head Start program for 75 families in five rural counties in central Iowa. The families are primarily white, and many are two-parent households. The program provides child development services in weekly home visits (or home and child care visits) and family development services in separate biweekly home visits. The program also holds monthly parent meetings in each county. The child development services focus on strengthening parents’ skills and abilities as their children’s first teachers.
From 1997 to 1999, the program, which is a former Comprehensive Child Development Program, made a number of changes to meet families’ increasing needs for child care in the wake of welfare reform. Home visitors became responsible for helping parents find child care, and child development home visitors now conduct two visits per month in the child care setting and two per month at home for families using child care. The program also began offering training and materials to community child care providers to help improve child care quality. Staff members are planning to add center-based child care services for eight children. Responsibility for program management became more decentralized, and county directors now oversee all county office activities, including collaboration and fundraising.
Community Action Agency Early Head Start (Jackson, Michigan). Community Action Agency, a community-based organization with more than 30 years of experience (some as a Head Start grantee) serving low-income families, operates an Early Head Start program for 95 families in Jackson and Hillsdale counties. The Early Head Start program builds on the agency’s infant mental health program. The families in the program are mostly white, single-parent families. The program provides child and family development services primarily in weekly home visits by registered social workers and monthly play groups for parents and children. Home visitors work extensively with parents on their problems in order to enable them to be better parents. The program also provides full-year, full-day child care for 8 infants and toddlers in a center in the city of Jackson, and planned to increase the size of the center to 16 children in 2000.
The program changed significantly between 1997 and 1999. Following a monitoring visit by the Head Start Bureau, the program intensified its focus on child development by increasing the amount of home visit time devoted to the child and by bringing learning materials to visits more often. To improve the quality of child care, the program provides some center-based care directly and convenes monthly meetings of child care providers to discuss developmentally appropriate practices. Along with Head Start, the Early Head Start program is a key part of the agency’s 0 to 5 focus and its efforts to promote family self-sufficiency.
KCMC Early Head Start (Kansas City, Missouri). KCMC Child Development Corporation, a community-based organization that provides child care and Head Start services to low-income families, operates an Early Head Start program for 75 families in the poorest neighborhoods of Kansas City. The Early Head Start program serves primarily African American, single, teenage parents, two-fifths of whom were receiving welfare cash assistance when they enrolled. The program provides child and family development services in three ways: (1) through weekly home visits; (2) through monthly home visits and monthly child care visits, for children enrolled in licensed child care centers; and (3) through one to two home visits and one to two child care visits for families whose children are in a family child care setting in which the provider has agreed to work with the program on quality improvement. The program also offers several group socialization opportunities for parents and children each month. Child development services focus on establishing and supporting parent-child relationships and working with parents to support their children’s development.
From 1997 to 1999, KCMC Early Head Start made several changes to strengthen its focus on child development. The program entered a partnership with a child care center to provide center-based services for some children. Following a Head Start Bureau monitoring visit, and after a new program director assumed leadership in early 1997, program staff took responsibility for child development home visits (previously, a program partner was responsible) and received significant training in child development to enable them to do so. Home visitors also began to develop individual child development plans with families. The program hired a child development coordinator to serve as a resource, consultant, and trainer in the areas of prenatal health and education, child health and development, disabilities/special needs, and transitions. In summer 1999, KCMC received a state grant to work with community partners on improving the quality of child care in the community.
Washington State Migrant Council Early Head Start (Yakima Valley, Washington). The Washington State Migrant Council, the largest Hispanic-operated and Hispanic-serving organization in the Northwest, operates a Migrant Head Start program as well as Early Head Start for 75 intrastate and former migrant families2 in six small towns in Yakima County. The program serves many first-generation Mexican Americans who migrated to Washington to work on farms. Many speak only Spanish. The program provides child and family development services primarily in weekly home visits and group activities for parents and children. Child development services focus on establishing supportive relationships and enhancing the social and verbal contexts for early childhood development. The program celebrates families’ Mexican American heritage and culture and emphasizes sensitivity to families’ concerns with acculturation.
From 1997 to 1999, the program increased the frequency of home visits to meet the revised Head Start Program Performance Standards that took effect in January 1998, and opened a child care center to provide center-based services in one of its sites, extending services to Native American families as well as to the Hispanic population. It also increased its emphasis on mental health by hiring a specialist both to work directly with families and to improve staff’s understanding of mental health issues. The program has increased outreach to fathers and worked to make program activities more appealing to them. The program experienced two changes in directors during the three years of program enrollment.
C. THEMES OF CHANGE
A number of themes characterize the changes we observed in programs approaches to service delivery. In this section, we describe themes related to the reasons changes in program approaches were made. These include changes in families’ needs, the need to improve the fit between program services and family needs, increasing clarity of expectations, and program responses to monitoring and technical assistance. We also describe several themes related to the kind of changes programs made. To navigate changes in their approaches to service delivery, programs often needed to make changes in their approach to improving child care quality for program children, expectations for program staff, and relationships with child care providers.
Changing Family Needs. Between fall 1997 and fall 1999, many families experienced a greater need for child care as their children got older. Parents also responded to TANF work requirements and time limits by participating in education or job training programs and by seeking and obtaining employment. Increasing needs for child care led programs to develop ways of ensuring good quality in the child care arrangements families used. At the same time, in home-based programs parents became less available to meet with home visitors and were less receptive to home visits during evenings and weekends when they were tired or needed to do other things, although home visitors became more flexible in scheduling home visits. In response to these changes in family needs, some programs began offering child care directly, and some programs added the option of visiting children both at home and in their child care setting.
Increasing Fit of Program Services to Family Needs. Even in sites where families’ needs did not change, early experiences demonstrated that some programs’ approaches to serving children and families did not always match well with families’ needs. Programs learned from these early experiences and made changes to their approaches to better meet families’ needs. Increasing Clarity of Expectations and Goals. During the early years of Early Head Start, the Head Start Bureau clarified many expectations about how this new program should be instituted. The Head Start Bureau approved the new performance standards, provided written guidance, training, and monitoring. In addition, the Head Start Bureau clarified its expectation that programs take responsibility for helping all families who need child care find good-quality child care arrangements that comply with the performance standards. As this requirement became clearer, some of the research programs adjusted their approaches to focus more on child care quality. As Head Start Bureau expectations were clarified, programs also engaged in adjusting and refining their goals and approaches.
Responding to Monitoring and Technical Assistance. Programs often made changes in their approaches in response to feedback and encouragement from Head Start Bureau monitors and training and technical assistance consultants. Sometimes the monitors or consultants suggested specific changes, and sometimes they recommended self-assessment or planning processes that led programs to make changes. Many home-based programs received a clear message from federal project officers that the program needed to become more child-focused. In several cases programs that were once family-support oriented changed to incorporate an explicit child development focus.
Increasing Focus on Improving Child Care Quality for Individual Children. Some programs had previously worked with community collaborative groups and through partnerships with child care resource and referral or other agencies to improve the quality of child care in their communities. The changes programs made in their approaches reflected a shift in focus from working on overall child care quality in the community to improving the quality of specific arrangements in which Early Head Start children received care. Changing Expectations for Program Staff. Changing approaches required substantial effort on the part of staff. Often the change entailed designing new services (such as child development and quality enhancement services to be provided in child care provider visits, or center-based child development services to be offered in a new center). New services created new expectations for program staff families with the former services. Some staff changed from being home visitors to working in centers. Others experienced changes when positions were reconfigured, when supervisory responsibilities changes, or as definitions of their jobs otherwise changed.
Building Relationships and Developing New Partnerships with Community Child Care Providers. Many programs built new relationships with child care providers and some established formal partnerships. These new relationships and partnerships were sometimes the reason for change and sometimes the result of it. Most of the Early Head Start programs grew in outreach to the child care community during the period of change we assessed. Programs developed relationships for training, formalized partnerships for meeting the performance standards, visited Early Head Start children in their child care settings, shared information about children’s developmental assessments, and worked generally in partnership with the providers on behalf of the child.
Obtaining Additional Resources. When programs added a center-based option, they usually had to obtain additional resources for creating new child development centers and hiring new staff. When programs added child care visits to home visits or began developing partnerships with child care providers, they needed resources to pay for hiring new staff, training staff to perform new functions, and providing resources and support to child care providers. The research programs received additional funds from a variety of sources, including expansion grants and quality improvement grants from ACYF, state Early Head Start grants, state child care subsidy funds, and other grants.
D. SUMMARY
The discussion in this chapter illustrates that Early Head Start programs experienced many changes during their first three years of serving families. A number of programs changed their main approach to service delivery, while others retained their basic approach but refined it. These changes were not confined to programs in a particular area of the country, or to a particular type of program auspice, but, rather, seemed to be a phenomenon common to all or nearly all programs. In subsequent chapters, we will describe in more detail the implementation issues program faced as they developed.
1For details about the programs’ features and approaches in 1997, see the preceding report, Leading the Way, Vols. I to III, and executive summary (ACYF 1999a, 1999b, 2000a, and 2000b).(back)
2These families are those who stay within the state or who have “settled out” and no longer migrate across state lines.(back)
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