Early Childhood Development Programs: Comprehensive, Center-Based Programs for Children of Low-Income Families

Task Force Finding*

Child development is a powerful determinant of health in adult life: One indication of this is the strong relationship between measures of educational attainment and adult disease. The early years of life are a period of considerable opportunity for growth and vulnerability to harm. Children affected by poverty are especially vulnerable: A socioeconomic gradient effect in early life has been found in cognitive and behavioral development, and this modifiable socioeconomic factor affects readiness for school.

Early childhood development programs are designed to promote social competence and school readiness in children aged 3 to 5 years. Publicly funded programs such as Head Start target preschool children disadvantaged by poverty. The holistic view of the child incorporated by such programs addresses cognitive, social, emotional, and physical development, as well as the ability of the child’s family to provide a home environment appropriate for healthy development. The health component of early childhood programs includes health screenings. The parental component provides job training and employment opportunities and encourages participation in social programs, ultimately supporting the child in all areas.

A child’s readiness when starting school is related to motivation and intellectual performance in subsequent years; initial readiness is critical to establishing a trajectory for success in educational attainment. Improved social cognition and higher educational attainment are important intermediary determinants of health risk behaviors.

Comprehensive, center-based, early childhood development programs for low income children are recommended on the basis of strong evidence of improved cognitive development and academic achievement. The Task Force looked for evidence of improvement in four general areas: cognitive development and academic achievement, children’s behavioral and social outcomes, children’s health screening, and family outcomes. Evidence of improved cognitive development and academic achievement was strong, and on the basis of their effectiveness in decreasing retention in grade and decreasing placements in special education classes, the Task Force recommends publicly-funded, center-based, comprehensive early childhood development programs for low income children aged 3 to 5 years.

Evidence was insufficient, however, to determine the effects of early childhood development programs on children’s social outcomes, children’s health screening outcomes, or family outcomes, primarily because too few studies of sufficient design and execution examined these outcomes (see the accompanying article). Although the body of published research is large, relatively few studies assess program impact in areas beyond cognitive gains (i.e., longer-term measures of health, well-being, and life success).

*From the following publication:

Task Force on Community Preventive Services. Recommendations to promote healthy social environments. [PDF - 72KB] Am J Prev Med 2003;24(3S):21-4.

Review completed: June 2000