Sure Start had positive health benefits for children in poorer neighbourhoods

A new evaluation conducted by the Institute for Fiscal Studies considers the overall impacts on children’s health of the Sure Start programme as a whole between its inception in 1999 and its peak in the late 2000s. Sure Start is an early intervention programme targeted at parents and children under the age of four living in the most disadvantaged areas. Sure Start projects deliver a wide variety of services, which are designed to support children’s learning skills, health and well-being, and social and emotional development. They include preschool education; medical, dental, and mental health care; nutrition services; and efforts to help parents encourage their child’s development.

The study, funded by the Nuffield Foundation, followed children who had access to Sure Start right through to the end of primary school, and found that Sure Start had major health benefits for children living in disadvantaged areas. The main findings of the study include:

  • Sure Start reduced hospitalisations among children by the time they finished primary school, and these effects built over time. By age 11, greater Sure Start coverage (one more centre per thousand children ages 0–4) prevented around 5,500 hospitalisations per year (18% of the pre-Sure Start baseline).
  • Sure Start benefited children living in disadvantaged areas most. While the probability of any hospitalisation fell by 11% at age 10 and 19% at age 11 for children in the poorest 30% of areas; those in more affluent areas saw smaller benefits, and those in the richest 30% of areas saw practically no impact at all.
  • At every age in primary school, Sure Start reduced hospital admissions for injuries. At younger ages, injury-related hospitalisations fell by around 17% of their pre-Sure Start (1998) baseline; at ages 10 and 11 they fell by 30%. 

The authors suggest that a reason greater benefits were seen in the poorest neighbourhoods could be because disadvantaged children were more able to benefit from Sure Start as the types of services the programme offered in poorer areas were more helpful, or because children in disadvantaged areas were more likely to attend a centre.

In 2012 the Department for Education published a report on the impact of Sure Start Local Programmes (SSLPs) on seven-year-olds and their families, which found no impact on children’s outcomes.

Source: The health effects of Sure Start (June 2019), The Institute for Fiscal Studies

Examining research on the Big Lift preschool initiative

Celia Gomez and colleagues from the RAND Corporation have released a new research brief that examines Big Lift, a preschool to third-grade initiative designed to boost literacy skills and ensure that children are reading proficiently by third grade (Year 4). The initiative has been implemented in seven US school districts in San Mateo County, California, that have below-average third-grade reading levels. According to the brief, Big Lift seeks to improve third-grade reading through a set of four co-ordinated and integrated “pillars”: High-Quality Preschool, Summer Learning, School Attendance and Family Engagement.

The researchers have examined outcomes for two cohorts of pupils: Cohort 1 includes pupils in four districts who receive Big Lift services, and Cohort 2 an additional three districts. Data sources include early childhood cognitive assessments, kindergarten (Year 1) and first-grade (Year 2) entry forms completed by parents, and the San Mateo County Office of Education’s countywide data system.

The current research brief is part of a multiphase evaluation of Big Lift, and reports on findings after two years of implementation. Key findings are as follows:

  • Big Lift preschool children in the 2017–2018 kindergarten class were better prepared for kindergarten than demographically similar peers who did not attend preschool — but they were less prepared than similar peers who attended non–Big Lift preschool programmes.
  • Children who attended two years of Big Lift preschool were more kindergarten-ready than similar peers who attended only one year.
  • In the 2016–2017 kindergarten class, Big Lift preschool children had reading levels at the end of kindergarten and the start of first grade that were on par with similar peers who attended other preschool programmes and higher than similar peers who attended no preschool at all.

Source: The Big Lift preschool, two years in: What have we learned so far? (2018), RAND Corporation Research Briefs RB-10047-SVCF

The impact of full-day preschool on children’s school readiness skills

An EdPolicy Works working paper reports on a randomised controlled trial of the effects of full- versus half-day preschool on children’s school readiness.

Four-year-old children in a US school district near Denver were randomly assigned to either half-day (n=112) or full-day (n=114) preschool classrooms. To examine the impact on children’s outcomes, Allison Atteberry and colleagues assessed children’s receptive vocabulary skills using a standardised test in which children point to one of four pictures that best corresponds to a spoken word. The researchers also administered a developmental screening tool to assess children’s developmental abilities in relation to school readiness. Both assessments were conducted within the first month of the first term, and again in the last month of the last term.

Their results showed that full-day preschool had positive effects on children’s vocabulary skills (+0.27 standard deviations) by the end of the school year. Positive impacts were also indicated on cognition, literacy, maths and physical skills – with effect sizes from +0.19 to +0.39.

Source: The effects of full-day pre-kindergarten: experimental evidence of impacts on children’s school readiness (July 20189), EdPolicyWorks Working Paper Series No. 64.

Lessons from the scale-up of an early maths programme

Pre-K Mathematics is a supplementary mathematics curriculum for pre-k (Reception) children. It focuses on the pre-k classroom and home learning environments of young children, especially those from families experiencing economic hardship. Activities aim to support mathematical development by providing learning opportunities to increase children’s informal mathematical knowledge.

In an article published in Evaluation Review, Jaime Thomas and colleagues report on a cluster-randomised control trial of the scale-up of Pre-K Mathematics in 140 schools in California (70 intervention schools, 70 control). The post-test measured outcomes on the Early Childhood Longitudinal Study, Birth Cohort Mathematics Assessment (ECLS-B) and the Test of Early Mathematics Ability (TEMA-3) at the end of the pre-k year. Results showed that Pre-K Mathematics had positive and significant effects, with an effect size of +0.30 on the ECLS-B and +0.23 on the TEMA-3.

The authors consider how these results differ from previous, smaller studies of the efficacy and effectiveness of Pre-K Mathematics. They find that effect sizes were usually larger in the earlier studies. As studies became larger, more heterogeneous, and less controlled, they tended to yield smaller results.

Source: The Sequential Scale-Up of an Evidence-Based Intervention: A Case Study (August 2018), Evaluation Review

Effect of preschool home visiting on school readiness

A study published in JAMA Pediatrics examines the sustained effects of a preschool home visiting programme on child outcomes in third grade (Year 4). Karen Bierman and colleagues conducted a randomised controlled trial of the Research-Based and Developmentally Informed Parent home visiting program (REDI-P) on 200 families with preschool children recruited from 24 Head Start centres in Pennsylvania.

Families were assigned to either receive the REDI-P intervention or be sent maths learning games in the post (control group). The intervention focused on improving academic performance and social-emotional adjustment, and reducing children’s problems at home. Families received ten visits from home visitors during preschool and six follow-up visits in kindergarten. Parents received coaching to enhance parent–child relationships and home learning materials to support children’s development and school readiness.

Overall, REDI-P produced sustained benefits four years after the intervention, with children in the REDI-P intervention group needing and using fewer school services than children in the control group. Results showed improvements in academic performance in third grade, measured by direct assessments of child sight-word reading fluency (effect size = +0.28) and teacher-rated academic performance in third grade (effect size= +0.29). The intervention also promoted sustained improvements in children’s social-emotional adjustment, reflected in direct assessments of social understanding (effect size = +0.31). REDI-P also produced reductions in the home problems that parents reported (effect size= −0.28).

Source: Effect of Preschool Home Visiting on School Readiness and Need for Services in Elementary School: A Randomized Clinical TrialJAMA Pediatr. 2018;172(8):e181029.

Reform needed for early years initiative

As part of their Straight Talk on Evidence initiative, the Laura and John Arnold Foundation (LJAF) has released a report that discusses new findings from a randomised controlled trial (RCT) of Tennessee’s voluntary pre-kindergarten programme for low-income children.

The Voluntary Pre-K (VPK) initiative provides Tennessee’s four-year-old children—with an emphasis on four year olds who are at-risk—an opportunity to develop school readiness skills (pre-academic and social skills). The study randomly assigned 3,131 eligible children who applied for admission at one of 79 oversubscribed VPK programmes across the state to either a programme group that was offered admission or a control group that was not (but could access other available child and family services in the community). Pupil achievement and other outcomes were measured in third grade (Year 4) using state educational records.

According to the LJAF report, the study found positive short-term effects on achievement (at the end of the pre-k year), but these effects dissipated as children entered elementary (primary) school and turned modestly negative by third grade (Year 4). At the third-grade follow-up, the control group scored significantly higher in maths and science achievement than the pre-k group.

The report offers possible reasons for the adverse effects, and suggests that the programme be reformed by incorporating evidence-based funding criteria aimed at improving its effectiveness over time.

Source: Large randomized trial finds state pre-k program has adverse effects on academic achievement. Reform is needed to increase effectiveness. Straight Talk on Evidence, The Laura and John Arnold Foundation