The effectiveness of early head start for 3-year-old children and their parents: lessons for policy and programs.

Early Head Start, a federal program begun in 1995 for low-income pregnant women and families with infants and toddlers, was evaluated through a randomized trial of 3,001 families in 17 programs. Interviews with primary caregivers, child assessments, and observations of parent-child interactions were completed when children were 3 years old. Caregivers were diverse in race-ethnicity, language, and other characteristics. Regression-adjusted impact analyses showed that 3-year-old program children performed better than did control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, Early Head Start parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less. The strongest and most numerous impacts were for programs that offered a mix of home-visiting and center-based services and that fully implemented the performance standards early.

Engaging pregnant and parenting teens: early challenges and lessons learned from the Evaluation of Adolescent Pregnancy Prevention Approaches.

This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations.

Health disparities in low-income families with infants and toddlers: needs and challenges related to disability.

This study examines disparities in health status, health care utilization, insurance coverage and satisfaction in US low-income parents of infants and toddlers with disabilities compared to low-income parents of children without disabilities. The Early Head Start Research and Evaluation Project is a longitudinal study involving 2087 families in 17 communities across the United States. Families completed interviews at enrollment and at 7, 16, and 28 months after enrollment. Descriptive analyses were conducted to characterize children's status in terms of health, health care use, and insurance coverage. Children with disabilities were more likely to experience poor health and to use more health care services. Parents of children with disabilities were more likely to report that medical care was inadequate. Hispanic children were less likely to experience excellent health. Hispanic parents were less likely to have health insurance or to report that their medical care was adequate. Low-income parents of young children with disabilities perceived their children as less healthy, more vulnerable and needing more health services. This study demonstrates the importance of providing accessible, culturally-competent services to this vulnerable population.

Child care quality matters: how conclusions may vary with context.

Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on children's development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained. These studies, conducted in three national contexts, with different regulatory climates, ranges of child care quality, and a diversity of family characteristics, suggest a need for more complete estimates of how both quality and quantity of child care may influence a range of young children's developmental outcomes.