Association of a full-day vs part-day preschool intervention with school readiness, attendance, and parent involvement

Early Correlates of School Readiness Before and During the COVID-19 Pandemic Linking Health and School Data

Importance

Many known correlates of kindergarten readiness are captured in developmental and social screenings in primary care; little is known about how primary care data predicts school readiness.

Objective

To identify early Kindergarten Readiness Assessment (KRA) correlates by linking electronic health record (EHR) data with school district KRA data and to examine potential outcomes of the COVID-19 pandemic using KRA scores between 2018 and 2021.

Design, Setting, and Participants

This was a retrospective cohort study linking a large primary care practice (PCP) with school assessment data. Linkage used patient name, date of birth, and address. The setting was an urban school district and PCP affiliated with an academic medical center. Students had a KRA score from fall of 2018, 2019, or 2021 (no 2020 KRA due to the COVID-19 pandemic) and at least 1 prior well-child visit at the PCP.

Exposures

Exposures included year KRA administered, reported child race and ethnicity, child sex, interpreter for medical visits, child ever failed Ages & Stages Questionnaire (ASQ) 18 to 54 months, ever rarely read to, Medicaid status, food insecurity, housing insecurity, problems with benefits, and caregiver depressive symptoms.

Main Outcomes and Measures

KRA score (continuous), with a possible range of 0 to 300 (passing score = 270).

Results

A total of 3204 PCP patients (mean [SD] age, 67 [4] months; 1612 male [50.3%]; 2642 Black [82.5%]; 94 Hispanic [2.9%]; 244 White [7.6%]) were matched to their KRA score. Mean (SD) KRA scores were significantly lower in 2021 (mean [SD], 260.0 [13.0]; 214 of 998 [21.4%]) compared with 2019 (mean [SD], 262.7 [13.5]; 317 of 1114 [28.5%]) and 2018 (mean [SD], 263.5 [13.6]; 351 of 1092 [32.1%]), a pattern mirrored in the larger school district. In the linear regression final model (n = 2883), the following binary variables significantly lowered the child's KRA score (points lowered [95% CI]) below a mean passing score of 270.8: child ever failed ASQ after 18 months (-6.7; 95% CI, -7.7 to -5.6), Medicaid insured (-5.7; 95% CI, -9.0 to -2.3), Hispanic ethnicity (-3.8; 95% CI, -6.9 to -0.6), requires interpreter (-3.6; 95% CI, -7.1 to -0.1), 2021 year (-3.5; 95% CI, -4.7 to -2.3), male sex (-2.7; 95% CI, -3.7 to -1.8), ever rarely read to (-1.5; 95% CI, -2.6 to -0.4), and food insecurity (-1.2; 95% CI, -2.4 to -0.1). Race, caregiver depression, housing insecurity, and problems receiving benefits were not associated with KRA scores in final model.

Conclusions and Relevance

Findings of this cohort study suggest a deleterious association of the COVID-19 pandemic with early learning and development. There may be potential for PCPs and school districts to collaborate to identify and mitigate risks much earlier.

School Performance in Third Grade After a Full-Day vs Part-Day Preschool Program

This study assesses whether learning gains associated with full-day preschool were sustained through third grade by analyzing achievement scores and need for remediation.

School readiness and social determinants of health: A collaboration with community teachers and parents

PURPOSE

To explore perceptions of community dwelling caregivers of preschool-aged children regarding the influence of social determinants of health (SDOH) on children's school readiness. Parents' perspectives regarding solutions to enhance school readiness in preschool-aged children are also explored.

METHODS

This study employed a qualitative, descriptive design and a community based participatory research (CBPR) approach. An academic institution collaborated with parents, teachers, and administrators at a community-based preschool learning center. Ten young-adult to middle-aged mothers and caregivers attended two separate focus groups and completed open-ended questionnaires. Inductive and deductive thematic analysis of text were employed.

FINDINGS

Three themes emerged 1) Families described the vast lack of appropriate community resources and inability to access those resources that are available to prepare their children for school 2). Family members need help processing information about social resources 3) Community, individual and systemic level solutions to enhance school readiness.

CONCLUSIONS

Academic-Community partnerships provide an opportunity to (1) identify solutions to remove systemic barriers that impede children's readiness for school, and (2) design interventions to support families through that process. Interventions to enhance school readiness should be family-focused and can be informed by understanding the influence of SDOH during the planning stages. SDOH create barriers and prevent parents from prioritizing their children's school, health-care, and developmental needs.

PRACTICE IMPLICATIONS

Interventions to enhance school readiness should be family-based and can be informed by understanding the influence of SDOH during the planning stages. Social advocacy is also needed to enhance the ability of parents to enhance their children's school readiness.

A new look at teacher interactional quality: Profiles of individual teacher-child relationship and classroom teaching quality among Head Start students

Preschool teachers' relationships with children are a critical component of classroom quality. We draw from a sample of N=2,114 children attending Head Start to examine child-centered profiles of experiences across two dimensions of classroom interaction quality that are often considered separately, individual teacher-child closeness and conflict and classroom-level instructional and emotional support. Findings reveal considerable heterogeneity in Head Start children's experiences, as the profiles differed on individual conflict, and classroom emotional and instructional support. The largest profile was characterized by a positive emotional climate and low instructional support. Higher teacher distress was associated with the highest quality and the highest conflict profiles. The results also revealed early evidence for gender and race and ethnicity-based disadvantages in Head Start classroom experiences.

Is more child-initiated always better? Exploring relations between child-initiated instruction and preschoolers' school readiness

Although research suggests that the use of child-initiated vs. teacher-directed instructional practices in early childhood education has implications for learning and development, the precise nature of these effects remains unclear. Using data from the Midwest Child-Parent Center (CPC) Expansion Project, the present study examined the possibility that a blend of child- and teacher-directed practices best promotes school readiness among preschoolers experiencing high levels of sociodemographic risk and explored whether the optimal blend varies based on child characteristics. Sixty-two CPC preschool teachers reported their instructional practices throughout the year, using a newly developed questionnaire - the Classroom Activity Report (CAR). The average reported proportion of child-initiated instruction was examined in relation to students' end-of-year performance on a routine school readiness assessment (N = 1,289). Although there was no main effect of child-initiated instruction on school readiness, there was a significant interaction between instruction and student age. Four-year-olds' school readiness generally improved as the proportion of child-initiated time increased, while three-year-olds showed a U-shaped pattern. The present findings add to the evidence that child-initiated instruction might support preschoolers' school readiness, although they also suggest this relation may not always be linear. They also point to the importance of examining instructional strategies in relation to student characteristics, in order to tailor strategies to the student population. The CAR has potential as a brief, practical measurement tool that can support program monitoring and professional development.

Distinct patterns of organized activity participation and their associations with school readiness among Chinese preschoolers

Organized extracurricular activities (EAs) constitute an important part of many young children's lives. However, the role of EAs in children's development during early childhood is poorly understood. The current study examined the associations between EA participation and a range of school readiness outcomes in a sample of 345 urban Chinese preschoolers. Using three waves of data collected on EA participation and applying growth mixture modeling, we discovered two distinct trajectory classes with respect to the breadth of EA participation as well as two classes for EA attendance intensity. With a series of covariates controlled for, children's greater initial levels of or rates of increase in EA breadth were related to better early math skills. Greater probabilities of belonging to the higher-intensity class were also associated with better early math skills in children. However, EA participation did not predict other aspects of children's school readiness, including Chinese reading, receptive vocabulary, expressive language, social skills, and problem behaviors. This study extends existing EA literature, which has primarily focused on school-aged populations in Western contexts, by demonstrating substantial individual variations in Chinese preschoolers' trajectories of EA participation. Our findings suggest that EAs seem to have little unique contribution to children's school readiness except for early math skills.

A Two-Generation Education Intervention and Children's Attendance in Head Start

Two-generation human capital programs seek to promote the education of parents and children simultaneously. This study examines relations between family participation in CareerAdvance, which recruits parents of Head Start children into a workforce training program, and children's Head Start attendance. The sample included 293 children (on average 4 years old) and their parents. After one semester, CareerAdvance children demonstrated higher rates of attendance and lower rates of absence and chronic absence (missing 10% or more of school days) than matched comparison children. These associations were similar across a range of high- and low-risk subgroups at baseline. These findings are discussed in terms of the implications of a family systems approach for improving children's Head Start attendance.

Does early childhood education enhance parental school involvement in second grade?: Evidence from Midwest Child-Parent Center Program

This paper examines the impact on parent involvement in second grade in the Midwest Child-Parent Centers (MCPC), a high-quality preschool-to-third-grade school reform model. A new focus of research on early childhood programs is understanding how early childhood learning gains can be sustained. Two-generation programs that provide diverse family services may be one approach. The MCPC expansion was implemented for a cohort of over 2000 Chicago and Saint Paul students beginning in preschool. Based on a comparison of the program and usual-service comparison groups matched at the school level via propensity scores, ratings were obtained for a subset of the sample by teachers and parents on parent involvement in school in second grade. After accounting for potential attrition bias via multiple imputation and propensity score weighting, results indicated that MCPC participation was associated with significantly higher parent involvement in school at the end of second grade both in the aggregate sample (Effect Size = 0.19 SD) and in Chicago (ES = 0.24). Differences in Saint Paul, however, were small (ES = 0.15) and not statistically significant. Robustness testing using different model specifications revealed similar results. Implications for assessing and sustaining early childhood learning gains are discussed with a focus on recognizing that parental involvement is an integral component of high-quality programs.

Reducing Aggression Using a Multimodal Cognitive Behavioral Treatment Approach: A Case Study of a Preschooler With Oppositional Defiant Disorder

Individual cognitive behavioral therapies (CBT) have been shown to be effective in decreasing disruptive behaviors in children and adolescents; however, less is known regarding their efficacy with preschoolers given the developmental limitations accompanying this age range. The current case study extends the use of individual CBT to a preschool aged girl with oppositional defiant disorder (ODD), and is the first to investigate its efficacy in combination with behaviorally-based parent training and classroom teacher consultation. A total of 18 CBT sessions with the child and her parents, in addition to school observations and on-site and phone consultations with teachers, were conducted over a 4-month period. Post-treatment and 2-month follow-up assessments demonstrated significant decreases in physical aggression and property destruction, as well as for parent and teacher reported internalizing and externalizing symptoms. Collectively, results of the case study provide preliminary evidence that a multimodal approach can be applied effectively to treat behavioral problems in preschool-age children.

Reducing poverty and inequality through preschool-to-third-grade prevention services

The contributions of psychology to the development and evaluation of preschool-to-third-grade prevention programs are analyzed with an emphasis on poverty alleviation through implementation of effective services for a greater number of children. The need to alleviate poverty and increase economic success is high. Early childhood programs have been found to be an effective strategy for promoting educational success and economic well-being, but the availability of high quality programs that are aligned and integrated with schools across the learning continuum is limited. Psychology has made major contributions to knowledge and practice in (a) defining and evaluating educational enrichment and (b) understanding mechanisms of behavioral change. As an empirical illustration of these contributions for enhancing economic well-being, we report new midlife income data in the Child-Parent Centers, a preschool-to-third-grade program that integrates the two major contributions to improve life course outcomes. Based on a well-matched alternative-intervention design with high sample retention (86%; N = 1,329), findings indicate that participation was associated with a 25% increase in average annual income at age 34 years ($22,708 vs. $18,130; p < .01). Graduates were also more likely to be in the top income quartile (≥$27,500; 30.7% vs. 20.2%; p < .01). Most of the main effects were explained by cognitive, school, and family factors, though further corroboration is needed. Implications for strengthening the impacts of early childhood programs as an avenue for increasing well-being and reducing inequality emphasize redressing ecological barriers, improving continuity and alignment with other strategies, and implementing effectiveness elements widely. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Socio-Emotional Learning among Low-Income Prekindergarteners: The Roles of Individual Factors and Early Intervention

RESEARCH FINDINGS

Previous research has indicated that low-income children are at increased risk for socio-emotional problems, which may contribute to socioeconomic disparities in wellbeing and academic achievement. The present study examines socio-emotional learning (SEL) across the prekindergarten year in a low-income, racially and ethnically diverse sample of Chicago Public School students (N=2,630). The sample included participants of the Child-Parent Center early educational intervention program (N=1,724) and a propensity-score matched comparison group (N=906). At the beginning of the prekindergarten year, teachers rated boys and lower income participants as having relatively lower SEL skills, and CPC participants and older children as having slightly higher SEL skills. Over time, CPC participants exhibited significantly greater rates of SEL growth, ending the prekindergarten year with teacher-rated SEL scores that were an average 10.30% higher than control participants. There were no significant differences in SEL growth over time by sex or family income.

PRACTICE AND POLICY IMPLICATIONS

Multicomponent, school-based early intervention programs (e.g., CPC) have the potential to promote SEL among at-risk populations.

Analysis of whole-school policy changes in Austrian schools

Health Policies with school-wide effects have been shown to improve the health of students and school staff, but in practice, schools struggle with this approach. Ten Austrian schools which had recently adopted new time structure policies were investigated: On the basis of 19 interviews with school staff, we used thematic analysis to identify facilitating and hindering factors for the implementation processes. Furthermore, agency analysis was applied, in which the interviewees’ use of language was interpreted to estimate their perception of their own agency in the context of policy change. We found that in schools where policy changes were perceived as successfully implemented, staff was convinced of the benefits. In these schools, time structures were understood to directly influence learning and teaching processes and staff members showed a strong feeling of agency. On the other hand, schools were confronted with hindering factors similar to those known from the implementation of other health policies. The results are discussed in the light of current implementation practices, and conclusions for practitioners are drawn.

The effect of child-parent relationship therapy on social skills of Preschool Children: a semi-experimental study

BACKGROUND AND OBJECTIVE

Playing games for children is an instinct needed for ensuring happiness, it is a language for communication and self-expression, and a way to learn new things. Therefore, the present study aimed at evaluating the effectiveness of child-parent relationship therapy (CPRT) on the social skills of preschool children.

METHODS

An experimental study with a pretest-posttest design was conducted on 60 preschool children in Kordkuy City, Golestan Province, Iran in 2017 by using a simple random sampling method in both the experimental and control groups. Routine preschool education was performed in the control group and in the experimentalgroup it was done based on play therapy protocol in 10 sessions for 45-60 min. The social skills questionnaire authored by Gresham and Elliott was used as a data gathering tool. The data were analyzed by SPSS 16.

FINDINGS

An analysis of variance (ANOVA) test showed a significant difference between the scores of the experimental and control groups, which suggests that the CPRT model, a short-term plan of parental play therapy, can improve social skills in preschool children (p = 0/001).

CONCLUSION

Regarding the effectiveness of the CPRT, it is recommended that this method be used is an interactive-educational way in preschool centers of Iran.

Dimensionality and Predictive validity of the Classroom Learning Activities Checklist in Prekindergarten

The Classroom Learning Activities Checklist (CLAC) is a brief classroom observation measure that assesses task-oriented and self-regulated learning in early childhood environments. We assessed the tool's dimensionality and validity in predicting prekindergarten (PreK) learning gains. The study sample is from the Midwest Child-Parent Center (MCPC) program, an evidence-based PreK-3rd grade school reform model providing comprehensive educational and family support services. Data from 1358 enrolled students in 72 observed classrooms indicated that a 2-factor model-instructional responsiveness and student engagement-explained 50% of the variance in item scores. Evidence for construct validity was strong. Linear and probit regression analyses indicated that CLAC scores independently predicted learning gains in literacy (ES = .34 SD) and math (ES = .30 SD) on the Teaching Strategies Gold Assessment System, a standardized performance assessment. Findings support the validity of the CLAC in assessing the classroom learning environment. Implications for program monitoring, evaluation, and professional development are discussed.

The Power of P-3 School Reform

Arthur Reynolds describes the significance, development, and effects of preschool to 3rd grade approaches. This school reform strategy integrates services and supports transitions, thereby increasing achievement, sustaining gains, and realistically reducing achievement gaps. Evidence from the Child-Parent Center (CPC) program is reviewed to illustrate key principles, strategies, and elements. Data from the Chicago Longitudinal Study and the more recent Midwest CPC expansion show that the program is effective in enhancing the transition to school and promoting longer-term well-being.

Mainstream school readiness skills of a group of young cochlear implant users

OBJECTIVES

The aims of the study were to compare the mainstream school readiness skills of young cochlear implant (CI) users to that of a group of normal hearing (NH) children and assessed the inter-rater agreement between parents and teachers on school readiness skills of the CI children.

METHODS

A total of 11 parents and 8 teachers of the 6-year old CI children participated and rated the children using the School Readiness Scale to Year One. Data from 207 6-year old NH children from five states in Malaysia were also collected using the same scale which has nine domains. Results from the NH children were categorized into the 25th and 75th percentile scores to be the reference cut-offs for below average (below the 25th percentile), average (25th to 75th percentile) and above average (above 75th percentile).

RESULTS

The school readiness skills of the CI children were lower than the NH group as rated by teachers especially in the civic and language and communication domains. Comparisons between parents' and teachers' ratings for 8 CI children indicated that teachers tended to rate the CI children's school readiness poorer than that of parents especially in the academic domain. Intra-class correlation analysis revealed poor inter-rater agreement.

CONCLUSIONS

The results suggest that our CI children, generally, need an intervention 'bridging' program to improve their school readiness skills. Parents and teachers had different views on the readiness of the CI children at school entry level.

A Multicomponent, Preschool to Third Grade Preventive Intervention and Educational Attainment at 35 Years of Age

IMPORTANCE

Educational attainment is the leading social determinant of health, but few studies of prevention programs have examined whether the programs are associated with educational attainment outcomes after the mid-20s, especially for large-scale programs that provide a longer duration of services.

OBJECTIVE

To examine the association between a preschool to third grade intervention and educational attainment at midlife and differences by program duration, sex, and parental educational level.

DESIGN, SETTING, AND PARTICIPANTS

This matched-group, alternative intervention study assessed 1539 low-income minority children born in 1979 or 1980 who grew up in high-poverty neighborhoods in Chicago, Illinois. The comparison group included 550 children primarily from randomly selected schools participating in the usual early intervention. A total of 989 children who entered preschool in 1983 or 1984 and completed kindergarten in 1986 were included in the Chicago Longitudinal Study and were followed up for 27 to 30 years after the end of a multicomponent intervention. A total of 1398 participants (90.8%) in the original sample had educational attainment records at 35 years of age. The study was performed from January 1, 2002, through May 31, 2015.

INTERVENTIONS

The Child-Parent Center Program provides school-based educational enrichment and comprehensive family services from preschool to third grade (ages 3-9 years).

MAIN OUTCOMES AND MEASURES

Educational outcomes from administrative records and self-report included school dropout, 4-year high school graduation, years of education, postsecondary credential, and earned degrees from associate's to master's or higher.

RESULTS

A total of 1539 participants (mean [SD] age, 35.1 [0.32] years; 1423 [92.9%] black and 108 [7.1%] Hispanic) were included in the study. After weighting on 2 propensity scores, preschool participants had higher rates of postsecondary degree completion, including associate's degree or higher (15.7% vs 10.7%; difference, 5.0%; 95% CI, 1.0%-9.0%), master's degree (4.2% vs 1.5%; difference, 2.7%; 95% CI, 1.3%-4.1%), and years of education (12.81 vs 12.32; difference, 0.49; 95% CI, 0.20-0.77). Duration of participation showed a consistent linear association with outcomes. Compared with fewer years, preschool to second or third grade participation led to higher rates of associate's degree or higher (18.5% vs 12.5%; difference, 6.0%; 95% CI, 1.0%-11.0%), bachelor's degree (14.3% vs 8.2%; difference, 6.1%; 95% CI, 1.3%-10.9%), and master's degree or higher (5.9% vs 2.3%; difference, 3.6%; 95% CI, 1.4%-5.9%). The pattern of benefits was robust and favored male participants for high school graduation, female participants for college attainment, and those from lower-educated households.

CONCLUSIONS AND RELEVANCE

This study indicates that an established early and continuing intervention is associated with higher midlife postsecondary attainment. Replication and extension of findings to other locations and populations should further strengthen confidence in the health benefits of large-scale preventive interventions.

Chronic absence, eighth-grade achievement, and high school attainment in the Chicago Longitudinal Study

Although not as commonly reported as average daily attendance, chronic absence data may be of significant importance for understanding student success. Using data from 1148 participants in the Chicago Longitudinal Study, we assessed the associations of chronic absence in the early middle grades, grades fourth through sixth, with eighth-grade achievement and three measures of high school attainment including four-year graduation by diploma, graduation by diploma by age 21, and any high school completion by age 21. The rate of chronic absenteeism, defined here as students missing approximately 14days of school or more in a year, was 15%. Using Ordinary Least Squares, probit regression, and inverse-probability-weighting regression-adjustment methods (IPWRA), results indicated that chronic absence in the early middle grades was negatively associated (d=-0.17) with eighth-grade math achievement and reduced the probability of four-year graduation by diploma by 18 percentage points, graduation by diploma by age 21 by 17 percentage points, and any high school completion by age 21 by 11 percentage points. IPWRA yielded similar estimates. Coefficients varied by subgroup with males and children of mothers who completed high school experiencing more detrimental effects. Associations of chronic absence with outcomes are important to understand because school interventions and practices which begin early can be effective in reducing the prevalence of absenteeism.

Scaling and Sustaining Effective Early Childhood Programs Through School-Family-University Collaboration

We describe the development, implementation, and evaluation of a comprehensive preschool to third grade prevention program for the goals of sustaining services at a large scale. The Midwest Child–Parent Center (CPC) Expansion is a multilevel collaborative school reform model designed to improve school achievement and parental involvement from ages 3 to 9. By increasing the dosage, coordination, and comprehensiveness of services, the program is expected to enhance the transition to school and promote more enduring effects on well‐being in multiple domains. We review and evaluate evidence from two longitudinal studies (Midwest CPC, 2012 to present; Chicago Longitudinal Study, 1983 to present) and four implementation examples of how the guiding principles of shared ownership, committed resources, and progress monitoring for improvement can promote effectiveness. The implementation system of partners and further expansion using “Pay for Success” financing shows the feasibility of scaling the program while continuing to improve effectiveness.

The title for this Special Section is Bringing Developmental Science into the World, edited by Roberta Michnick Golinkoff, Kathy Hirsh‐Pasek, Rachel Grob, and Mark Schlesinger

School Readiness in the Midwest Child-Parent Center Expansion: A Propensity Score Analysis of Year 1 Impacts

In this paper, we evaluate the effectiveness of the first year of a federally-funded, evidence-based preschool through third grade intervention in Chicago. We use inverse probability weighting with regression adjustment to estimate the impacts of the Child-Parent Center (CPC) program on teacher assessments of school readiness for 1,289 low-income preschool and 591 comparison-group participants. Results indicated significant positive impacts of the program for all domains, including literacy, math, socio-emotional development, science and total score. The percentage of CPC children who met national norms in school readiness exceeded the comparison group by 12 to 18.5 percentage points. Full-day participants experienced greater school readiness gains while program impacts were similar by family income and home language. Compared to the original CPC evaluation of children born in 1980 in which few comparison group children attended preschool, we find evidence that the contemporary implementation performs at least as well even though the current comparison group participants had alternative preschool experience.

Processes of Early Childhood Interventions to Adult Well-Being

This article describes the contributions of cognitive-scholastic advantage, family support behavior, and school quality and support as processes through which early childhood interventions promote well-being. Evidence in support of these processes is from longitudinal cohort studies of the Child-Parent Centers and other preventive interventions beginning by age 4. Relatively large effects of participation have been documented for school readiness skills at age 5, parent involvement, K-12 achievement, remedial education, educational attainment, and crime prevention. The three processes account for up to half of the program impacts on well-being. They also help to explain the positive economic returns of many effective programs. The generalizability of these processes is supported by a sizable knowledge base, including a scale up of the Child-Parent Centers.

Multi-Site Expansion of an Early Childhood Intervention and School Readiness

OBJECTIVES

To evaluate the impacts of the expansion of an evidence-based full- and part-day early childhood development program on multiple indicators of school readiness, attendance, and parental involvement for a large cohort of low-income children.

METHODS

This study involved the end-of-preschool follow-up of a nonrandomized, matched-group cohort of 2630 predominantly low-income, ethnic minority children who enrolled in the Midwest Child-Parent Centers (CPC) or alternative preschools in the fall of 2012 in 31 schools in Chicago, Illinois. The program provides comprehensive education, family support, and health services. In the preschool component assessed in this study, 1724 children aged 3 to 4 years in all 16 Chicago centers enrolled in the program. The comparison group included 906 children of the same age who participated in the usual preschool services in 14 matched schools.

RESULTS

Relative to the comparison group who enrolled in the usual preschool services and adjusted for covariates, CPC participants had higher mean scores on all performance-based assessments of literacy (59.4 vs 52.4; P = .001), socioemotional development (57.0 vs 51.8; P = .001), and physical health (34.5 vs 32.1; P = .001). They also had higher ratings of parental involvement in school (5.3 vs 4.0; P = .04). Group differences also translated into higher rates of meeting national assessment norms. Program estimates were similar for children attending new and established CPCs and according to age, race/ethnicity, and family income status.

CONCLUSIONS

The findings show that expansion of the program to new schools and more diverse populations is feasible and effective in promoting school readiness skills and parental involvement.

Adverse Childhood Experiences and Adult Well-Being in a Low-income, Urban Cohort

OBJECTIVE

This study tests the association between adverse childhood experiences (ACEs) and multidimensional well-being in early adulthood for a low-income, urban cohort, and whether a preschool preventive intervention moderates this association.

METHODS

Follow-up data were analyzed for 1202 low-income, minority participants in the Chicago Longitudinal Study, a prospective investigation of the impact of early experiences on life-course well-being. Born between 1979 and 1980 in high-poverty neighborhoods, individuals retrospectively reported ACEs from birth to adolescence, except in cases of child abuse and neglect.

RESULTS

Nearly two-thirds of the study sample experienced ≥1 ACEs by age 18. After controlling for demographic factors and early intervention status, individuals reporting ACEs were significantly more likely to exhibit poor outcomes than those with no ACEs. Those with ≥4 ACEs had significantly reduced likelihood of high school graduation (odds ratio [OR] = 0.37; P < .001), increased risk for depression (OR = 3.9; P < .001), health compromising behaviors (OR = 4.5; P < .001), juvenile arrest (OR = 3.1; P < .001), and felony charges (OR = 2.8; P < .001). They were also less likely to hold skilled jobs (OR = 0.50; P = .001) and to go further in school even for adversity measured by age 5.

CONCLUSIONS

ACEs consistently predicted a diverse set of adult outcomes in a high-risk, economically disadvantaged sample. Effective and widely available preventive interventions are needed to counteract the long-term consequences of ACEs.

Using Benefit-Cost Analysis to Scale Up Early Childhood Programs through Pay-for-Success Financing

Increasing access to high-quality preschool programs is a high priority at local, state, and federal levels. Recently, two initiatives to expand preschool programming in Illinois and Utah have used funds from private investors to scale up existing programs. Private-sector social impact investors provide funding to nonprofit or public preschool providers to increase the number of children served. If the measured outcomes from preschool participation meet pre-determined goals, then the estimated government cost savings arising from these preschool interventions are used to repay the investors. Social impact investing with a "Pay for Success" contract can help budget-constrained governments expand proven or promising preventive interventions without the need to increase taxes. Cost-benefit analysis plays a crucial role in helping to identify which social, educational or health interventions are suitable for this type of innovative financing. Cost-benefit analysts are needed to design the structure of the success payments that the government will make to the private investors. This paper describes social impact borrowing as a new method for financing public services, outlines the contribution of cost-benefit analysis, and discusses the innovative use of social impact financing to promote scaling up of the evidence-based Child Parent Centers and other early childhood programs.