Extended Childhood Intervention Prepares Children for School and Beyond

Children raised in poverty can do well in school and later in life, but they face many more obstacles than children reared in wealthier homes.¹ The more obstacles the individual child faces, the greater the likelihood he or she will not achieve success in elementary school. Today 4 million, or more than 1 in 5, US children younger than 6 years live in poverty² ; the associated risks also affect the large number of near-poor children whose family incomes place them above the artificial poverty index.³ The scope of the problem has changed little since 1964 when an all-out War on Poverty was declared by President Lyndon Johnson. As the nation's leaders pondered the causes and cures for poverty, Johnson's antipoverty chief, Sargent Shriver, offered his observation that the children of the poor were ill-prepared when they entered school. Starting with this disadvantage, they fell further behind through progressive grades, and they never attained the education needed to break the cycle of poverty. Thus was born Head Start, a nationwide program designed to foster school readiness through comprehensive, 2-generation services targeting the various obstacles poor children face.

The Head Start model has come to be recognized as the prototype of effective early childhood intervention. The program currently enrolls more than 860 000 children ages 3 to 5 years in nearly 16 000 centers.⁴ Most children attend a half-day program for 1 academic year, although some have access to longer days, a second year, or both. Virtually all of the children live in families whose income is below the federal poverty level. About 13% have disabilities. While there is considerable local control over program content, all Head Start centers are required to provide the same basic services and conform to precise quality standards. For example, children must receive physical, dental, and mental health care, sound nutrition, and preschool education. As partners in their children's schooling, parents have access to adult education and family support services, and they are invited to participate at both classroom and administrative levels. The program also links to the communities where it is hosted. While it has served younger children in migrant programs and a longstanding demonstration, the Early Head Start program for families and children ages 0 to 3 years is a new effort that is gradually expanding across the nation.

The planners of Head Start had little research available to guide them, but a substantial literature now supports the concept of early childhood intervention. Today, reasons poor children are behind in school readiness skills are more clearly understood, and more is known about what needs to be done to help them. Yet there remains skepticism about whether preschool in general and in paticular Head Start actually have achieved the desired outcomes. Some reviews of the literature show that they do,^{5 - 6} but many analysts remain unconvinced.⁷ These opposing conclusions can be explained by the different expectations people have of early intervention. For instance, if school readiness is seen as the goal, the evidence is convincing that quality preschool programs work.⁸ But if life success indices such as high school graduation and self-sufficiency are construed as the goal, the evidence is weak.⁹ The reason is obvious but rarely acknowledged by policy makers and other desiring a quick and easy solution to academic failure: A year or 2 of attending preschool is not an inoculation against all past and future developmental risks imposed by living in poverty. Just as 1 year of good nutrition is not expected to make a child healthy for life, it is foolish to assume that any brief intervention will lead to academic success and a good-paying job.

The fact remains that society wants poor children to do better, and theories of human development provide 2 clear guides to action. First, development is a continuous process, and children need appropriate environmental nutrients at each and every stage. This means that support services must be present for a significant part of the growing years to have a meaningful impact on the child. Second, because poverty imposes many types of risk to good developmental outcomes, intervention must target the ecology in which children are raised, not just that piece of the environment that exposes them to preschool educational tasks.

Empirical tests of the notion that extended, comprehensive services can enhance life outcomes are sparse because of the cost, time commitment, and methodological difficulties common to longitudinal research. A few such studies do exist (although not of Head Start), and the results are generally positive. The best known are the Abecedarian Project,¹⁰ which served children for 5 years beginning in infancy (and some into grade school), and the High/Scope Perry Preschool.¹¹ Although the latter effort enrolled most children for only 2 years, follow-up studies have been conducted through age 27 years. A third program is the Chicago Child-Parent Centers (CPCs), reported on by Reynolds and colleagues¹² in this issue of THE JOURNAL.

All 3 projects generally reported that compared with children with no or less-intensive intervention, participants had higher academic achievement, reduced need for special education, and less grade retention and dropout rates. Juvenile and adult crime rates also were lower. In both the Abecedarian and CPC, longer treatment was associated with better outcomes. Cost-benefit analyses of the Perry project and unpublished cost-effectiveness data from the CPC show considerable returns to society for the funds invested in the programs.¹³ These positive results were not significant in all subgroups in all of the studies, but the combined pattern of findings shows a clear trend in the desired direction. However, it is important to note that although the participants had better outcomes than those without the intervention, in absolute terms they did not fare as well as one might like. Compared with population norms, crime rates were high and the high school completion rate was low. In school, however, adaptation and academic achievement were closer to the average. A fair conclusion is that efforts to enhance school readiness and support the transition to school have a definite impact on academic performance. Although this should be related to life success indices, the influence may be moderated when the broader environment retains high risk.

Unlike the other 2 projects, the CPC is contemporary, focuses more on the child's total environment, and for some cohorts, continues for 6 years. Another difference is that the CPC is not a small, tightly controlled model but, similar to Head Start, it is a large program carried out by public employees in Chicago's impoverished neighborhoods and schools. The results indicate that health and quality educational services, delivered in a venue that involves parents and strengthens families, can improve developmental outcomes among poor children.

These promising findings convey lessons to several groups. First, they contradict the naysayers who believe that public schools cannot be fixed or that poor children cannot be helped because of nature or nurture. Second, these findings confirm that policy makers are taking the right steps to bolster Head Start's effectiveness, particularly in the areas of quality, evaluation, and program length. Quality in the CPC appeared to be relatively high with respect to staff training and curricula. Head Start centers have demonstrated uneven quality but improvement efforts have been funded and appear to be showing positive results.¹⁴ The CPC also has a long history of evaluation to inform service content and delivery and to justify program expenditures. Research studies assessing Head Start have not been a priority, although this too is beginning to change. Students participating in CPCs attended 2 years of preschool, and some had dovetailed services into elementary school. Head Start is authorized to enroll children for 2 years but usually it does not so more children have access to at least 1 year. Similarly, the program has long piloted attempts to enroll children before and after the preschool years. The results of the CPC study lay to rest the hope that 9 months of enrollment in the Head Start program is a magic cure for the ill effects of poverty and also validate plans to lengthen services.

State lawmakers should also take heed of the CPC study. The generally positive results of school readiness programs have prompted most states to initiate prekindergarten classes. Most of these programs are reserved for at-risk children, but the movement is advancing toward universal preschool. Although earlier schooling for every child is a welcome idea, the state's efforts are generally based on tradition rather than empirical findings. That is, public prekindergartens are strong on educational tasks and short on comprehensive services, parent involvement, and transition activities.¹⁵ The CPC findings show that more intervention is necessary to change the academic trajectory of children who are at risk of failing in school and that less may not be the wisest use of tax dollars.