Promoting Health Equity, Education Programs and Policies: Full-Day Kindergarten

Task Force Finding & Rationale Statement

Definition

Full-day kindergarten is a formal program offered for children aged 4 to 6 years in a school or school-like setting during the school year prior to entering first grade. Activities are organized, developed, and supervised by at least one adult. Full-day kindergarten programs run 5 days a week and last 5 to 6 hours per day.

Task Force Finding

The Community Preventive Services Task Force recommends full-day kindergarten programs to improve the health prospects of low-income and minority children, based on strong evidence that full-day programs substantially improve reading and mathematics achievement—determinants of long-term academic and health-related outcomes (e.g., reduced teen pregnancy and risk behaviors)—when compared with half-day kindergarten or full-day kindergarten on alternating days. The achievement gains apparent at the beginning of first grade do not, themselves, guarantee academic achievement in later years. Ongoing school environments that support learning and development are essential.

Rationale

Basis of Finding
Children in low-income families often experience delays in language and other development by the age of three. Compensating for these delays before children begin regular schooling can be critical to providing them with equal opportunities for lifelong employment, income, and healthy behavior.

The Task Force finding is based on a published meta-analysis¹ that meets Community Guide systematic review standards in terms of intervention definition, search procedures, outcome assessment, study design and execution evaluation, and synthesis of effect estimates. An updated search for studies published since 2009, when the search conducted for the meta-analysis ended, did not identify additional studies that met review inclusion criteria. To assess longer-term effects of full-day kindergarten, the Community Guide review also included evidence from other sources.

The meta-analysis focused on full-day kindergarten (FDK) programs and their association with improved kindergarten academic achievement as compared separately to half-day kindergarten (HDK) and full-day kindergarten on alternating days (FDKAD; the temporal equivalent of half-day kindergarten). Effectiveness was measured by standardized achievement tests or assigned grades by the end of kindergarten or the beginning of first grade. Thirty reports contained 43 samples that compared FDK with HDK; these studies indicated that FDK improved academic achievement by an average of 0.35 standard deviations (Cohen’s d; 95% CI= 0.23, 0.46). Using the Binomial Effect Size Display, this result implies that if a group of children were evenly divided between FDK and HDK, 59% of those in FDK would have test scores above the population median, compared to 41% of those in HDK. Seven studies compared FDK with FDKAD and found that FDK improved achievement by an average of 0.43 standard deviations (Cohen’s d; 95% CI= 0.07, 0.79).

Education, intended to increase acquired knowledge, improve the ability to reason and solve problems, and improve social-emotional skills that allow healthy social interaction, is a major determinant of health. Educational attainment leads to health through three interrelated pathways^2,3: (1) development of psychological strengths promoting healthy interaction, problem-solving ability, and a consequent sense of control; (2) ability to pursue and maintain productive work and income; and (3) knowledge of health and the ability to negotiate the health care system. In addition there is extensive evidence from early childhood experiments, such as the Perry Preschool Study,⁴ the Carolina Abecedarian Project,⁵ and the Chicago Child-Parent Centers,⁶ as well as systematic reviews,⁷ that academic achievement in early childhood programs has long-term educational, economic, and health consequences. For these reasons, the Task Force considers measures such as standardized tests of academic achievement reasonable recommendation outcomes.

Other results from the meta-analysis were each based on a single study. Outcomes included self-confidence, ability to work or play with others, independence, and school attendance by the end of kindergarten or the beginning of first grade. The outcome most relevant for this review is ability to work and play with others, which can be regarded as a social-emotional health outcome. The study that reported on this outcome showed a significant effect favoring FDK (d=1.06, 95% CI= 0.63, 1.49).⁸

Cooper and colleagues1 analyzed data derived from the Early Childhood Longitudinal Studies (ECLS) separately. ECLS began in 1998 and included approximately 21,000 kindergarteners. Results from the ECLS studies supported their meta-analysis, revealing a greater positive gain in reading and math at the end of kindergarten or beginning of first grade for children in FDK programs than for those in HDK programs. Data also indicated the possible loss of effect by the end of third grade.

Cooper and colleagues also analyzed studies included in the meta-analysis¹ to assess effects of FDK by the end of third and fourth grade. Findings were inconsistent. Some studies showed an increased benefit over time, and others showed a decreased benefit. Studies of the long-term effects of early childhood education are challenging because of potential confounding and other issues. Children in low-income families are more likely to participate in FDK than are children in families with higher income; they are also more likely subsequently to attend poorer quality schools (an independent cause of low achievement and other poor outcomes). In addition, children whose academic performance has improved because of FDK programs may receive less attention in elementary school if their teachers give more attention to classmates with achievement problems. If children with achievement problems improve from increased attention, the early benefits attained by children who attended FDK programs appear to be diminished in comparison. Systematic reviews of long-term effects of early childhood education, conceptually comparable to kindergarten, indicate that better-designed studies show greater long-term academic and health effects than do studies not controlling for conditions following the early childhood program.⁹

Other Benefits and Harms
In addition to improved educational and social-emotional outcomes, full-day kindergarten may be responsible for other benefits as well as potential harms. Some researchers postulate that full-day kindergarten allows more individualized instruction, easier identification of and referral for problems, and improved nutrition.¹⁰ In contrast, other researchers propose that full-day kindergarten may put pressure on children to achieve before they are developmentally ready; increase fatigue and irritability for both students and teachers; and reduce planning time for teachers.¹¹

Implementation Issues
Barriers to establishing full-day kindergarten may include concerns about a lack of play time; lack of qualified teachers; and rapid turnover among teachers.

References

1. Cooper H, Batts Allen A, Patall EA, Dent AL. Effects of full-day kindergarten on academic achievement and social development. Review of Educational Research 2010;80:34.
2. Robert Wood Johnson Foundation Commission to Build a Healthier America. Education matters for health. 2009. https://folio.iupui.edu/bitstream/handle/10244/681/commission2009eduhealth.pdf
3. Ross CE, Wu CL. Education, age, and the cumulative advantage in health. J Health Soc Behav. 1996 Mar;37(1):104-20.
4. Schweinhart LJ, et al. Lifetime effects: The High/Scope Perry Preschool Study through age 40. Monographs of the High/Scope Educational Research Foundation: 14. Ypsilanti, MI: High/Scope Press, 2005.
5. Ramey CT, et al. Persistent effects of early childhood education on high-risk children and their mothers Appl. Dev. Sci. 2000;4:2.
6. Reynolds J. Success in early intervention: The Chicago Child-Parent Centers. Lincoln, NE: Univ. of Nebraska Press, 2000.
7. Camilli G, Vargas S, Ryan S, Barnett WS. Meta-analysis of the effects of early education interventions on cognitive and social development. Teachers College Record 2010;112:579.
8. Anderson E. Increasing school effectiveness: the full-day kindergarten. Paper presented at the Annual Meeting of the American Educational Research Association, New Orleans, LA. April, 1984.
9. Barnett WS. Effectiveness of early educational intervention. Science. 2011;333(6045):975-8.
10. Walston JT, West J. Full-day and Half-day Kindergarten in the United States: findings from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–99 (NCES 2004–078). U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office, 2004.
11. Gullo DF. The changing family context: implications for the development of all day kindergarten. Young Children 1990;45:35–39.