Thursday, February 11, 2016

Universal preschool: Is it enough?

There's been a lot of talk about universal preschool to get kids off to a good start, but what about resources to help parents who need it?

Universal preschool: Is it enough?


In the past few months, universal preschool fever has swept the county. On a daily basis, it seems like the President, multiple governors and newspapers are touting the positive impact that would be seen in school achievement, reduction in special education costs, high school graduation rates, college attendance, careers and raised lifetime earnings.

All we need to do is simply provide every four-year-old access to a high quality preschool experience in a safe stimulating environment with good nutrition and great teachers. 

The work of Nobel economics laureate James Heckman is often cited, with a frequent reference to a 7 to 1 return on this type of educational investment. We are told that past studies found a seven dollar return in reduced costs and increased earnings for every dollar spent on preschool.

The programs often mentioned are the 1962-67 Perry Preschool Project from Michigan, and for those who can pronounce it, the early 70s Abecedarian project in North Carolina. The data from both of these very well designed and run early intervention programs are quite impressive in terms of positive outcome. They show that children who were in the experimental intervention to be healthier, higher achievers and over the course of their lives had more stable employment and family life.

However, these two programs were much more than a high quality preschool.  Both of these programs and all successful early intervention programs are two generational interventions aimed at improving the lives of not only the children, but also the parents.

In the Perry preschool project, each class of six pre-school age children had a well trained teacher with a bachelor’s degree in early childhood, who also received training and supervision in a special curriculum.  Each teacher had a two and a half hour daily class with the children and then in the afternoons conducted 90 minute home visits.  Each family got a home visit every week with the teacher or other trained staff. All of the mothers were: stay at home, married and supported by the husband’s income; or single mothers receiving government assistance with no limits.   

The Abecedarian project focused on very young, poor high school dropout mothers.  This full day seven hour program, on average, started with the child at four months of age with a full day program, and supplied diapers, groceries, clothes to the family and  during those days.  The program went from infancy to age five.  Thus, not only were there five years of intervention, the mothers were offered classes to complete their GED and job training, as well as parenting classes.  For some of these families, there were family coaches available for the first eight years of life.  Again, the data for outcome were very impressive, the children and mothers thrived with better jobs for the mothers and much better outcome for the children. The return on investment for both of these comprehensive family focused programs is excellent.  

Currently, Delaware and other states are in the middle of an investment in early care and education programs, Delaware Stars.  In a private-public partnership, licensed child care providers can go through a program to improve their skills and their facilities, and evaluation receive a higher star rating and higher rates of reimbursement.  It is resulting in a significant improvement in early care and education in this state.  Children are being provided with a safe stimulating environment and good nutrition.  Staff at these sites are learning how to interact in a more responsive way with the children. The Stars program has been a great success to date and continues to grow and thrive thanks to the dedicated effort of providers, state, and university staff working together. Pennsylvania has a similar program.

These are good programs, but they’re missing the component that helps parents. While we have a few excellent specialized small home visiting programs for high needs families, it is not nearly as extensive as Delaware Stars. These programs do not have the home visits, parent coaches, or other resources that were critical to the success of the Perry Preschool or Abecedarian projects.  Those were true, two generational approaches designed to lift up both parent and child.

The research is clear: parents raise children, and parent responsiveness to their children is the most critical variable predicting child success. The often cited work of Betty Hart and Todd Risley shows that parent language and how much they talk with their children is one of the best predictors of outcome. It demonstrates how critical the home environment is for child development. Often young parents are the ones in need of help and guidance in a way that is accessible, acceptable, and effective. 

We have focused on what the children and preschool providers need for the children to be successful in school.  Now it’s the time to also empower parents. Universal preschool is a start, but by itself, it will not be enough.  It takes a family to raise a child, not a village. The role of the village is to help and support that family as they raise their children.  

We need to be more creative in reaching out and supporting families, and helping parents. In our increasing connected world, some researchers are showing that new technologies such as texting to parents, helpful videos and reminders can all help the process. It’s time to combine home visits with these technologies along with high quality preschools if we are to help children reach their full potential.

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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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