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Chapter I: Introduction and Background

Early Head Start is a comprehensive, two-generation federal initiative begun in 1995 and aimed at enhancing the development of infants and toddlers while strengthening families. Designed for low-income pregnant women and families who have infants and toddlers 3 years of age or younger, Early Head Start programs, like preschool Head Start programs, must comply with the Head Start Program Performance Standards—a rigorous set of criteria that are based on best practices identified by a wide range of practitioners and researchers (Administration for Children and Families 1996).

As is the case with Head Start, research with a focus on continuous program improvement has been incorporated into Early Head Start since the inception of the program. At the time the program began, Congress mandated a rigorous evaluation designed to include an implementation study and an impact study to inform program improvement and to assess the program’s effects on child and family outcomes—the Early Head Start Research and Evaluation Project (EHSREP).1 Following that effort, the Administration for Children and Families (ACF) is embarking on a descriptive study of Early Head Start, which has grown from 68 programs in 1995 to nearly 750 nationwide. This report contains information from the first step of this descriptive research effort—the Survey of Early Head Start Programs, which provides information on program management, populations served, and services provided. It also answers the following questions:

1. What are the characteristics of Early Head Start programs?

2. Who is served by Early Head Start programs?

3. What services do Early Head Start programs provide?

4. How are Early Head Start programs managed and staffed?

5. Do key program subgroups differ in their characteristics? If so, how?

The next section provides a brief description of Early Head Start services, reviews previous research findings, and describes the Performance Measures for Head Start Programs Serving Infants and Toddlers, which provide the basis for the Survey of Early Head Start Programs.

BACKGROUND ON EARLY HEAD START

Early Head Start programs provide a wide range of services, as mandated in the comprehensive Head Start Program Performance Standards.2 These include child development services, child care, parenting education, case management, health care and referrals, and family support. In addition to providing many services directly, programs also form partnerships with other community service providers as vehicles for providing some services. To ensure that high-quality services are delivered, the performance standards identify explicitly what programs must do to meet standards of quality (for example, they specify child:adult ratios in child care centers and educational requirements for staff providing child care). The standards also define four service delivery options that programs can choose for providing services to families based on their unique needs: (1) a home-based option—families receive weekly home visits and at least two group socializations3 per month, (2) a center-based option—families receive center-based child care plus other activities, (3) a combination option—families receive both home visits and center experiences, and (4) a locally designed option. A program can choose to deliver one option to all families, or different combinations of these options to different families based on the program’s determination of the best mix of services for meeting families’ needs.4

Program Impacts and Implementation

Early Head Start’s focus on continuous program improvement reflects the importance that Head Start has traditionally placed on this aspect of program development. In 1996, after the Administration on Children, Youth and Families (ACYF) funded the first Early Head Start programs, Mathematica Policy Research, Inc. (MPR), together with Columbia University’s Center for Children and Families at Teachers College and the Early Head Start Research Consortium, conducted a rigorous, large-scale program evaluation. The intent of this random assignment study of 17 Early Head Start programs was to inform program improvement and assess the effects on child and family outcomes. The EHSREP yielded much valuable information on program implementation (ACYF 1999, 2000a, 2000b, 2002) and program impacts (ACYF 2001, 2002) and also stimulated many other scholarly papers, conference presentations, books, and local site-level studies.

The implementation study provided much-needed information on how these first programs began serving families and how services evolved (ACYF 1999, 2000a, 2000b, 2002) and was useful for policy development and technical assistance efforts. That study examined program implementation and demonstrated that 5 of the programs were early implementers (judged to be fully implemented after two years of serving families), while 12 were not. Of these 12, more than half (7 programs) were fully implemented two years later, the remaining 5 did not achieve full implementation within the study period, the first 3 years of serving families. At the outset, the number of programs with home-based, center-based, and mixed (different combinations of home- and center-based) approaches was balanced. After two years, only 2 of the programs were still completely home-based; while 11 had begun providing a mixture of home- and center-based services.

The impact study found that Early Head Start programs had a broad range of positive effects on child and parent outcomes, both when children were 24 months old and when they were 36 months of age (ACYF 2002a). Child outcomes positively affected by program participation included children’s health and cognitive, language, and social-emotional development. Among parents, Early Head Start positively affected parenting behaviors, such as supportiveness for children’s emotional and literacy development, as well as indicators of self-sufficiency. Impact analyses showed that most groups of families benefited from the program. The evaluation team defined 29 subgroups based on family characteristics at enrollment and program characteristics (for example, race/ethnicity, maternal age, maternal depression, and so on) and found positive impacts for 28 of the 29 subgroups, although the pattern and magnitude of the impacts varied by group. Program impacts varied by characteristics of programs, notably their success in implementing the performance standards and their approaches to service delivery.5 The embedded implementation study provided a framework for rating the level and timing of program implementation (early, later, and incomplete implementers based upon information gathered on in-depth site visits). Analysis of program-control differences within subgroups showed that programs fully implementing key elements of the Head Start Program Performance Standards in the evaluation period demonstrated the broadest pattern of impacts. All program approaches achieved favorable impacts, but programs that provided both home- and center-based services, referred to as “mixed approach” programs, produced a stronger pattern of impacts. A followup of these children in the spring prior to kindergarten entry found that Early Head Start continued to have positive impacts, mainly in the areas of children’s social-emotional development and parenting (ACF 2006). Box I.1 provides further detail about program impacts from EHSREP.

BOX I.1 EARLY HEAD START IMPACTS The Early Head Start Research and Evaluation Project was a comprehensive and rigorous study of Early Head Start, beginning at its inception in 1995. Mathematica Policy Research, Inc., along with partners at Columbia University and the Early Head Start Consortium, conducted the impact study, including random assignment of 3,001 families in 17 programs to either Early Head Start or a control group (ACYF 2001, 2002). Families were followed over time, with data collected when children were 14, 24, and 36 months of age, and finally at approximately age 5 (when children were in their prekindergarten year). In addition to direct child assessments, parent information, and videotaped semistructured parent-child interactions, were collected. By the time children were 3 years old, the Early Head Start program group had experienced modest positive impacts across a broad range of child and parent outcomes. Overall, program children performed better on measures of cognition, language, health, and social-emotional functioning compared with control group children. Further, parents in the program group showed more support than control parents for their child’s development (emotional, cognitive, and language). The programs had some impacts on self-sufficiency as well: program parents were more likely to be in school or job training. Within 29 subgroups based on family characteristics, such as race/ ethnicity and number of risk factors, African American families, those enrolling during pregnancy, and families with a moderate number of demographic risks benefited most from the program, and all subgroups showed some positive impacts, with the exception of children from families with the most risk factors. Programs that fully implemented the Head Start Program Performance Standards and programs that offered both home- and center-based services (termed mixed approach) had the largest impacts. At approximately age 5 (two years after the program ended and children were in their prekindergarten year), the evaluation team once again gathered information from study children and families (ACF 2006). The team found significant favorable impacts of the program on children’s social-emotional development, specifically behavior problems and approaches toward learning. There were no impacts on behavior in play with a parent. For language outcomes, we found significantly better receptive vocabulary among Spanish-speaking children, although not native English speakers. There were no impacts on children’s academic skills. The Early Head Start program group was also significantly more likely to be in a formal child care program in their prekindergarten year. Among parents, Early Head Start continued to have positive impacts on support for children’s learning (including daily reading, home environment, and teaching activities). There was no impact on other parenting behaviors, although there was a decreased risk of maternal depression (a new impact at prekindergarten). Impacts within subgroups continued to show sustained impacts from 36 months, and positive impacts for the highest demographic risk group emerged. Program implementation no longer showed differences in impacts, but program approach did. However, at prekindergarten, home-based rather than mixed approach programs had the strongest impacts.

Performance Measures for Head Start Programs Serving Infants and Toddlers

After the initial results from the EHSREP became available, ACF was in a position to develop performance measures that outlined specific programmatic activities and expected outcomes for children and families (ACF 2003). Much work had already been done for preschool Head Start programs in articulating a comprehensive framework for providing quality services, desired outcomes for children, and the mechanisms by which programs meet these goals. The effort for programs serving infants and toddlers built upon this existing framework (ACF 2003). Specifically, the Performance Measures Framework for Head Start Programs Serving Infants and Toddlers (hereafter “performance measures framework”) is based on (1) the Head Start Program Performance Standards, which include the regulations and rules all programs must follow; (2) the Head Start Performance Measurement Framework, which identifies mechanisms by which programs will affect preschool children’s outcomes; (3) the Statement of the Advisory Committee for Head Start Programs Serving Infants and Toddlers (ACF 1994), which provided guidance in developing the new program; and (4) findings from the EHSREP.

MPR guided the process of developing performance measures for Early Head Start (ACF 2003). The process was lengthy and included regular meetings of an internal working group of federal staff, followed by consultation with the Early Head Start Technical Work Group (consisting of experts in the field, including Early Head Start staff and parents) and focus groups with program staff, parents, regional office staff, and technical assistance providers.

What emerged from this process was a conceptual framework for programs serving families with infants and toddlers (Figure 1.1). Structured as a pyramid, the framework rests on a foundation of four cornerstones for Early Head Start services articulated by the Advisory Committee for Head Start Programs Serving Infants and Toddlers: (1) staff, (2) child, (3) family, and (4) community. The framework has four layers, with program management at the base supporting a layer representing effective services that in turn bring about positive family and child outcomes and, ultimately, children’s competence. Within each layer of the pyramid, blocks represent objectives that include specific performance measures representing key program goals (Figure I.1 illustrates the pyramid and objectives; Table I.1 lists specific performance measures within each objective). For example, the four objectives of the management systems layer are (1) to support staff to work effectively with parents and children, (2) to create child development environments, (3) to involve parents, and (4) to develop strong community partnerships. Programs maintain high quality by achieving these objectives and can then offer effective services to children and families. The services layer has three key objectives: (1) providing children with individualized services, (2) developing relationships with parents and children, and (3) linking children and families to community services. These services bring about positive child and family outcomes that support children’s competence (the ultimate goal, at the top of the pyramid). Our focus in this research is on the two bottom layers of the pyramid: management systems and services. Chapter II describes our approach to operationalizing the performance measures—that is, creating precise statements about how performance measures are being implemented by programs, based on their responses to survey questions.6

OVERVIEW OF THE SURVEY OF EARLY HEAD START PROGRAMS

The Survey of Early Head Start programs is the first step in a planned series of descriptive studies about Early Head Start. Rapid expansion of the program over the past decade has increased the importance of this research. Since its inception in 1995, Early Head Start has grown from 68 programs to nearly 750 (figures I.2 and I.3). Beyond the need for an updated picture of the Early Head Start program, the Survey of Early Head Start Programs was designed to build upon the earlier impact and implementation studies to provide information to support program improvement in Early Head Start. As described earlier, child and family outcomes varied by program approach and implementation.

[D]

The Survey of Early Head Start Programs study approach and rationale focused on collecting quantitative data on all programs, supplemented in breadth and depth by qualitative information on a smaller subset of programs. The first and primary data source is the survey, which included a comprehensive set of questions on program management and services (Appendix A contains the survey instrument). The second data source is a series of site visits to 17 programs to gather in-depth information about implementation. The goal of the survey was to take a “snapshot in time” and paint a basic picture of all Early Head Start programs. We conducted the site visits to help illuminate and explain survey findings and identify potential implementation issues and lessons.

We developed the survey items to produce clear and quantifiable performance measures in the two foundation layers of the conceptual framework: management systems and services. Operationalizing and measuring these performance indicators sets the stage for later analyses of programs’ progress toward and achievement of the desired outcomes shown in the pyramid.

Table I.1 Early Head Start Performance Measures Framework, Objectives, and Measures

Management Systems: Processes for Improvement
Programs are well managed operationally and financially.
Programs design and implement services to be responsive to the needs of families in the community.
Programs conduct self-assessments that are used for continuous improvement.
Management Systems: Support Staff
Programs employ qualified staff with the skills necessary to provide high-quality services.
Programs support ongoing staff development, training, and mentoring.
Programs support staff activities through ongoing reflective supervision.
Programs promote staff retention and continuity
Management Systems: Relationships with Community Partners
Programs form partnerships with other community programs and organizations to support an integrated community-wide response to the needs of families with young children.
Programs form partnerships and coordinate services with local Part C agencies.
Programs form partnerships and coordinate services with community child care providers to meet the needs of families and enhance the quality of local child care services through the sharing of resources, training, and knowledge.
Programs form partnerships and coordinate services with local health agencies and health care providers to meet the health-related needs of families.
Management Systems: Involving Parents
Parents are involved actively in program planning and decision making.
Programs encourage and support fathers' involvement in program planning, decision making, and activities.
Program Services: Linking to Community Services
Programs work collaboratively with families to identify their goals, strengths, and needed services and offer them opportunities to develop and implement individualized family partnership agreements that take into account other family plans.
Programs link parents with social service agencies to obtain needed services.
Programs link parents with educational and employment agencies to obtain needed services.
Programs link parents with physical and mental health care prevention and treatment services to obtain needed care.
Programs link parents with needed prenatal care and educational services.
Programs help parents secure high quality child care in order to work, attend school, or gain employment training.
Programs help parents and children make a smooth transition to Head Start or other preschool programs.
Program Services: Responsive and Caring Relationships with Parents and Children
Staff form respectful and supportive relationships with parents through all aspects of service delivery.
Staff form nurturing relationships with children in group-care settings or during home visits.
Programs support and honor the home cultures and languages of families.
Program Services: Provide Children with Individualized Services
Programs provide developmentally enriching educational environments in group care settings and developmentally enriching parenting and child development services during home visits and group socializations.
Programs link children with needed medical, dental, and mental health services.
Programs link pregnant women with comprehensive prenatal health care and education.
Programs provide children in group-care settings with meals and snacks that meet their daily nutritional needs, and parents receiving home-based services are given information about meeting their children's nutritional needs.
Programs provide individualized services for parents and children, including children with disabilities.

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[D]

GUIDE TO THE REPORT

Throughout this report, we present key survey findings and supplement them with qualitative information collected during site visits. Illustrative information from the site visits is highlighted in text boxes. Although by necessity we describe the performance measures framework in a linear fashion, the reality of Early Head Start program operation is dynamic. Elements at the bottom of the pyramid influence those above them, but the same is true in reverse. Changes in needs of families served may result in changes in services that require changes in management. Therefore, we organized the report to provide information in a way that allows the reader to understand the context in which programs operate and the people they serve, how programs provide services, how they are staffed and managed, and how they work with community partners. We also explore differences by program subgroups and sidebar text boxes on special topics in each chapter. The rest of this report is organized as follows:

• Chapter II details the survey and site visit methodologies.

• Chapter III describes programs, their communities, and enrolled families.

• Chapter IV describes program services and ways that programs engage families in them.

• Chapter V outlines programs’ management practices, including staff characteristics and training.

• Chapter VI describes program partnerships with community agencies and the services provided through them.

• Chapter VII describes program subgroups and key differences among them.

• Chapter VIII identifies cross-cutting themes, implications, and next steps for research.

We end each chapter with a summary of key findings. In addition to the information above, the appendixes provide detail on the findings in the main body of the report. Appendix A contains the complete survey instrument; Appendix B describes survey methodology in detail, focusing on how we obtained high response rates. Appendix C provides descriptive information on two instruments piloted during the site visits, including staff reactions to them. Appendix D presents supplemental tables with weighted data.

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