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I. CHILD CARE AND EARLY HEAD START: BACKGROUND AND PURPOSE OF THE STUDY
Child care is one of many services Early Head Start programs provide to families. Furthermore, the Early Head Start national evaluation found that the vast majority of Early Head Start families used child care at some point during the child’s first three years of life, and many of these families called on their Early Head Start programs to help provide or find affordable, good-quality child care. Because of the centrality of child care to many Early Head Start programs, the pervasive importance of child care for low-income families with infants and toddlers, and the challenges programs faced in developing child care options that could meet Head Start Program Performance Standards, the Administration for Children and Families commissioned this special Early Head Start policy report using data from the national evaluation.
In this report, we examine patterns of child care use among Early Head Start families at points corresponding to children’s first, second, and third birthdays and then describe how Early Head Start influenced those patterns of child care use. We also examine the quality of child care used by Early Head Start children at these three birth dates. Third, since Early Head Start programs are charged with ensuring that children receive good-quality child care, we take advantage of the randomized design of the Early Head Start evaluation to examine the impact that Early Head Start had on the quality of child care experienced at all three ages, using data from the four center-based sites included in the evaluation and a subset of the mixed-approach sites, where we obtained a substantial and representative sample of observations of child care used by both program and control group children. Finally, we conducted analyses within the Early Head Start sample to examine relationships between child care use and quality and selected child outcomes at ages 2 and 3.
Thus, our research questions include, first, descriptive questions about the child care services used by Early Head Start families:
- What types of child care were used by families in Early Head
Start and for what hours?
- What was the quality of child care used by Early Head Start
families?
- How satisfied were Early Head Start families with their child care arrangements?
The research also includes questions about the impacts of Early Head Start on child care use:
- How did Early Head Start affect families’ child care use,
including the type and hours of child care?
- How did Early Head Start affect the quality of child care used?
Finally, we ask a question about relationships between child care and children’s development to provide evidence relating to an important issue, albeit using an analytic approach that is not as strong as those that address the more-central research questions:
- How, and to what extent, were the child care intensity and quality experienced by Early Head Start children associated with developmental outcomes at 2 and 3 years of age?
In this chapter we begin by providing the context—how the vision of the initial blueprint for Early Head Start brought together the twin themes of quality and partnership. We then describe the Early Head Start programs and how they worked to develop child care options in their communities. Finally, we discuss the design of the Early Head Start evaluation and the study of child care embedded in that evaluation.
A. THE CHILD CARE CONTEXT FOR EARLY HEAD START
Many communities struggle to help working parents find stable, supportive child care for their infants and toddlers (Paulsell, Nogales, and Cohen 2003). Providing good-quality infant-toddler care poses stiffer challenges than care for preschool-age children, primarily because younger children need more attention from adults to meet health, safety, and developmental needs, and the corresponding need for lower child-adult ratios increases the costs of infant-toddler care.
As early as 1994, when the Early Head Start program was authorized, the lack of good-quality infant-toddler care for low-income families was a public concern, and indeed, was one of the issues that planners sought to address through the design of the program. In that year, the Carnegie Corporation released its Starting Points report citing major risk factors confronting a significant number of children under 3 years of age. One of the risks cited was substandard child care.1
In light of these concerns about the quality of infant-toddler child care, the Secretary’s Advisory Committee on Services for Families with Infants and Toddlers, in its blueprint for the Early Head Start program, underscored the importance of several key themes that were integral to its vision for the new program and for the role that child care services would play (U.S. Department of Health and Human Services 1994). These themes included:
- The expectation that Early Head Start would offer high-quality
services—whether provided directly by program staff or through
partnerships with other community services providers
- The importance to children’s healthy development of establishing
secure, continuous relationships between young children and their
caregivers
- The necessity of establishing strong partnerships with parents
and community partners
- A mandate to undertake community-building efforts that would increase the level of community support for families with infants and toddlers.
The expectation that Early Head Start programs would form partnerships with community-based organizations and engage in community-building efforts has led naturally to partnerships between Early Head Start and the child care community, given the critical importance of child care services to low-income families with infants and toddlers. The rapid proliferation of welfare reform programs across the states in the early 1990s only intensified the need for infant-toddler child care because work requirements were, for the first time, being applied to mothers with children under 3 years.2 The Committee reinforced the importance of partnerships with child care by declaring that, “child care can be provided directly or in collaboration with other community providers as long as the Early Head Start program assumes responsibility for ensuring that all settings meet the Early Head Start performance standards” (U.S. Department of Health and Human Services 1994, p. 16; emphasis added).
Child care subsidy programs funded jointly by federal and state governments and the funding initiatives of community and private organizations have also sought to address the need for infant-toddler care. In some cases, these programs have contributed to partnerships with Early Head Start through which good-quality infant-toddler care has developed (Mitchell, Stoney, and Dichter 1997; and Paulsell et al. 2003). At the time Early Head Start was being implemented, federal welfare reform legislation combined several child care funding streams into a single Child Care and Development Fund. CCDF provides funds to states and territories and tribes to assist low-income families in paying for child care, and reserves some funds for investment in quality improvement activities, technical assistance, and research. Federal funding for state child care subsidy programs increased and resources expanded further as states transferred substantial TANF resources to CCDF (Collins, Layzer, Kreader, Werner, and Glantz 2000; and Schumacher, Greenberg, and Duffy 2001). In addition, CCDF includes a $100 million earmark for infant-toddler child care supply and quality enhancement activities ($22 million in fiscal year [FY] 2001), which some states have used to support infant-toddler provider training and for grants linked to improvements in the quality or supply of infant/toddler child care (Administration for Children and Families 2002a).
B. EARLY HEAD START PROGRAM STANDARDS AND CHILD CARE OPTIONS
Early Head Start grantees are required to provide child development services, build family and community partnerships, and support the staff needed to provide high-quality services for children and families. Grantees select among program options specified in the performance standards to fulfill these goals. The program options include:
- Home-based—provide Early
Head Start program services to children primarily in the child’s
home, through weekly home visits and at least two group socializations
per month for each family
- Center-based—provide services
to children primarily through center-based child care plus other
activities, and offer a minimum of two home visits per year for
each family
- Combination option—provide services to children in both a child care center and in the child’s home; includes a prescribed combined number of home visits and center-based experiences
In addition, grantees can propose alternative program variations to meet community needs, subject to approval by the Administration on Children, Youth and Families (ACYF) in the Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services (DHHS). Grantees may, with regional office approval, change their program options in response to emerging needs of families. For example, a home-based program may become a combination option in response to a growing need for child care and the opportunity to partner with a community child care provider who can offer care meeting the Head Start performance standards. Early Head Start evaluation reports adopted the convention of referring to programs as “mixed approach” when they offered both center- and home-based services, regardless of their official program “option.”
- Mixed approach—provide services to some children primarily in the home, through weekly home visits and periodic group socializations; and to some children primarily through center-based care or family child care with periodic visits to the home and/or child care setting. Children may receive home-based services at one point and center-based services at another as they progress through the program.
Standards for the quality of Early Head Start child care services were formalized in January 1998, when the revised (and current) Head Start Program Performance Standards took effect. The standards established a clear set of expectations for the quality of both center-based child development services and child care provided in community child care settings.3 Among other things, the standards require (1) a child-staff ratio of 4 to 1 and a maximum group size of eight infants and toddlers in center-based child care settings, and (2) child care staff to have a Child Development Associate (CDA) credential within one year of being hired as an infant-toddler teacher (U.S. Department of Health and Human Services 1996).
In keeping with the Committee’s recommendation, the Head Start Bureau expects programs to help all families find and access child care arrangements if and when they need child care. Moreover, programs must make significant efforts to ensure that these arrangements, whether provided in a child care center operated by Early Head Start or through a community child care provider, adhere to the Head Start Program Performance Standards. Grantees are charged with developing systems to support and monitor this effort. The evaluation’s implementation reports (Leading the Way and Pathways to Quality) have documented the challenges programs faced in meeting the child development aspects of the performance standards (ACYF 1999, 2000; and ACF 2002c). Over time, most of the programs reached compliance with these standards (ACF 2002c).
The growing importance of child care services for low-income parents with infants and toddlers has thus enhanced the salience of child care issues for Early Head Start grantees. At the same time, community child care providers have found an important source of support in Early Head Start. Across many communities, Early Head Start and child care are intertwined in a variety of ways, many of which respond to the vision of the Advisory Committee on Services for Families with Infants and Toddlers (U.S. DHHS 1994):4
- Some Community Child Care Providers
Became Early Head Start Grantees. Community-based child
care providers who operate good-quality programs are typically
skilled at obtaining available funding to support their mission.
Some Early Head Start grantees originated as community-based child
care providers that offered good-quality infant-toddler child
care before 1995, and they secured competitive Early Head Start
grants to support extending their mission, for example, by adding
more infant-toddler slots or by expanding comprehensive services
for families (ACF 2002c).
- Some Early Head Start Grantees Created
New Infant/Toddler Classrooms. Some Early Head Start grantees
began as Head Start programs and extended their mission by adding
services for infants and toddlers, sometimes by opening infant/toddler
classrooms in the Head Start center (ACF 2002c). Some grantees
started out as family support agencies (for example, former Comprehensive
Child Development Programs, or CCDPs). Many of these agencies
recognized the need for good-quality infant-toddler care when
parents enrolled in their programs seeking child care and when
the Head Start Bureau highlighted the child development aspects
of the performance standards. Some responded to the need by establishing
infant-toddler classrooms. These classrooms could be on site at
the Early Head Start program or developed through partnership
with an established child care center in the community that could
find space for another classroom.
- Some Early Head Start Grantees Contracted
with Community Child Care Providers for Child Care Services.
Some grantees contracted for a specified number of slots in community-based
child care centers or family child care homes. The Early Head
Start grantee would work with these providers to ensure that performance
standards were met (including ratio and training requirements).
The Early Head Start funding sometimes enabled a center to keep
open an infant-toddler room that included both Early Head Start
and other children (Paulsell, Nogales, and Cohen 2003).
- Some Early Head Start Grantees Extended
Quality Enhancement Assistance to Community Child Care Providers.
Grantees also worked on quality improvement with the child care
providers whom parents chose on their own. Grantees offered training
and technical assistance to help with planning activities, arranging
the room, communicating with parents, and running a business.
Some providers received equipment (such as cribs, shelving, and
outdoor play equipment), and opportunities to network with other
providers. One program developed individual quality enhancement
plans with providers and offered incentives, materials, and training
to encourage and enable providers to make progress toward their
goals (ACF 2002c).
- Some Early Head Start Grantees Reached Out to Family, Friends, and Neighbors Caring for Early Head Start Children. Early Head Start grantees implemented creative strategies for developing relationships to support quality enhancement among family, friend, and neighbor providers parents had selected. Several programs began making monthly home visits to children in these child care settings to foster a partnership between the provider and Early Head Start, to share child development information with the provider, and to work with the provider on quality improvement (ACF 2002c).
As the examples indicate, Early Head Start grantees and community child care providers work together in many ways to expand the supply of good-quality infant/toddler care. The variety of responses to families’ child care needs exemplify the ways in which Early Head Start grantees tailor their services to reflect the needs of low-income, pregnant women and families with infants and toddlers in their communities.
C. THE EARLY HEAD START NATIONAL RESEARCH AND EVALUATION PROJECT
This policy report is based on analyses conducted as part of the Early Head Start National Research and Evaluation Project, a rigorous, large-scale, random-assignment evaluation of 17 Early Head Start programs (see the study’s final report—ACF 2002b). The research programs, selected purposively from the first two waves of programs funded in 1995 and 1996, are located in all regions of the country and in both urban and rural settings. The research sample of families reflects the diverse family characteristics and the major program approaches of all programs funded in 1995 and 1996.
To be eligible for Early Head Start, families must include a pregnant woman or a child under 3 years old, and for the most part, families must have income at or below the federal poverty guidelines ($15,600 for a family of four in FY1996 when the research sample began enrolling; $16,050 in FY1997). In addition, grantees are required to make at least 10 percent of their spaces available to children with disabilities who are eligible for Part C services under the Individuals with Disabilities Education Act in their state. Grantees may develop additional eligibility criteria to help target services to best meet the needs in their communities. Important for this study, families eligible for the Early Head Start research sample had to include a pregnant caregiver or a child younger than 12 months of age.
Once programs determined through their application process that families met the Early Head Start and the research eligibility guidelines, Mathematica Policy Research (MPR) randomly assigned the families either to the program or to the control group (with equal probabilities). Program staff then contacted the program group families, while representatives of the local research partners notified the control group families of their status. Families were enrolled in the research sample from July 1996 through September 1998. A total of 3,001 families were randomly assigned, with 1,513 in the program group and 1,488 in the control group. The samples in most sites included between 150 and 200 families, divided fairly evenly between the two research groups.
Control group families were able to receive any services in the community except Early Head Start until their applicant child reached the age of 3 (and was no longer eligible for Early Head Start). Many control group families received parenting education and child care services without the assistance of Early Head Start. Comparing outcomes for groups that differ only in the offer of Early Head Start services ensured that our analytic comparisons of program and control group outcomes represented the effects of Early Head Start services relative to the receipt of all other community services that would be available to families in the absence of Early Head Start. Analyses of the research sample indicated that random assignment was implemented well. The random assignment process yielded equivalent groups (in terms of average baseline characteristics). For the most part, control-group families did not receive any Early Head Start services. Details about the random assignment process and its integrity are documented in the evaluation’s final report (ACF 2002b).
The major focus of the evaluation were the impacts of Early Head Start on family well-being, the parent-child relationship, and children’s development, which have been reported in the evaluation’s interim (results through age 2; ACYF 2001) and final (through age 3; ACF 2002b) reports, and summarized in the child development literature (Love et al. 2003; and Raikes et al. in press).
To measure these impacts, the evaluation included parent surveys at specified intervals after random assignment (7, 16, and 28 months) and parent interviews coupled with child assessments and observations of parent-child interactions at intervals linked to the child’s age. These parallel data collection efforts included the following information:
- Parent Services Interviews—at
7, 16, and 28 months after random assignment, measured the parent’s
employment and education activities, maternal and child health,
and use of a broad set of services that Early Head Start programs
might provide, but which families might also obtain on their own
in the community. The Parent Services Interviews were designed
to capture monthly information on employment and service use so
that durations and changes in these activities could be examined.
An exit interview conducted at the time of the 36-month birthday-related
assessment provides a snapshot of the parent’s economic
activity and key services used at the time children were transitioning
out of Early Head Start.5
- Birthday-Related Assessments—conducted when children were 14, 24, and 36 months old, were designed to gauge children’s development across cognitive, language, and social-emotional domains when they were infants, toddlers, and beginning preschoolers. Parenting knowledge, the home environment, and qualities of the parent-child relationship were also measured at the birthday-related assessments because these aspects of parenting and the child’s environment relate closely to children’s development.
For many types of analysis, the two streams of data can be used independently to provide, for example, a record of service use following random assignment, or measures of child development and parenting at the three age points. But some analyses require combining these data sets. The study of child care embedded in the broader Early Head Start evaluation includes elements of service use (the types and characteristics of child care arrangements used over time) and elements of the child’s environment (the quality of child care).
D. THE EMBEDDED CHILD CARE STUDY
The dual nature of child care, as both a service to parents that supports employment and education activities and an environment in which children grow and develop, led us to measure aspects of child care through both data collection streams. The Parent Services Interviews measured child care use over time so that the data could easily be related to patterns of employment and education activities. The birthday-related assessments included interviews with providers and observational assessments of the child care environments so that the information could easily be related to assessments of the home environment, parenting, parent-child interactions, and children’s development obtained at the same time.
- Parent Services Interviews. Parents
were asked about the types of child care used, hours, cost to
the family, and satisfaction with care since random assignment.
From this information, variables measuring the type, duration,
and stability of child care could be calculated for a specific
point in time or over a period of time.
- Birthday-Related Assessments. Parents were asked about the types of care used at the time of each birthday-related assessment, thus providing a snapshot of the child care arrangements used at the time of the child assessments. For children with a regular, out-of-home child care arrangement, we conducted in-depth, observational assessments of the quality of child care used by children. From this information, global ratings of the quality of the primary child care arrangement were obtained, as well as ratings of provider behavior, snapshots of the child’s experiences in child care, staff-child ratios, group size, provider education and training, and other provider characteristics.
Using these data, we conducted analyses designed to answer the questions raised at the beginning of this chapter. Our findings are reported in two chapters. Chapter II focuses on child care use and parents’ satisfaction with their child care arrangements. We examine the patterns of child care use (types of arrangements) and intensity of use (amount of time in care) among Early Head Start children and then compare Early Head Start and control-group children’s child care participation to assess the impact that the program had. In Chapter III, we focus on quality, reporting both the nature and range of quality of care experience by Early Head Start children and the impacts the program had on the quality of children’s child care placements. We also explore the relationships among intensity and quality, on the one hand, and children’s developmental outcomes, on the other. Each chapter includes descriptions of the instruments used to collect the usage and quality data and the analytic methods employed.
1 Other risk factors cited by the report were increased chances of living with a single and younger parent; family poverty; increases in foster care; high mortality rates and low rates of immunization; and physical abuse, neglect, and unintentional injury (Carnegie Corporation of New York 1994). (back)
2 State welfare reform programs were adopted under waivers of federal rules for the Aid to Families with Dependent Children (AFDC) program during the early 1990s. (back)
3 In August 2000, the DHHS issued draft performance standards for services provided through family child care homes (U.S. Department of Health and Human Services 2000). Under these standards, teachers in family child care homes must possess the same qualifications as center-based teachers. Ratio and group-size requirements limit groups to six children per teacher when two or fewer children are under age 3. If more than two children are under age 3, the maximum group size is four children, with no more than two children under age 2. (back)
4 The various strategies programs used to improve the quality of child care for infants and toddlers, and their collaboration with other community-based organizations toward this goal, are described in more detail in Pathways to Quality (ACF 2002c). (back)
5 Families did not have an exit interview if their 28-month Parent Services Interview occurred when the child was age 30 months or older. (back)
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