Preschool education programs

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Disparity Rating  
Disparity rating: Potential to decrease disparities

Strategies with this rating have the potential to decrease or eliminate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.

Health Factors  
Date last updated
Community in Action

Expanding a Model Preschool Program in UT

When a model preschool program in Utah’s Salt Lake County showed early results—improving kindergarten readiness and grade school performance—United Way of Salt Lake (UWSL)...

Preschool education programs, also called early childhood education (ECE) or early childhood education and care (ECEC) programs, are center-based interventions that foster children’s cognitive and social-emotional development. Programs usually focus on children who are at least three years old but not yet old enough to enter formal schooling1, 2. Preschool programs typically are offered for a half-day or a full school day3. Black, Hispanic, and Native children and children from families with low incomes are less likely to be enrolled in preschool or have access to high quality preschool than white children and children from families with higher incomes and are less likely to be prepared for kindergarten as a result4.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased academic achievement

  • Improved cognitive skills

  • Improved social emotional skills

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased high school completion

  • Reduced delinquent behavior

  • Improved healthy behaviors

  • Improved mental health

  • Reduced obesity

What does the research say about effectiveness?

There is strong evidence that preschool participation increases academic achievement and improves children’s cognitive and social skills1, 2, 5, 6, 7, 8. Effects are strongest immediately following preschool but can persist1, 2, 9, especially if combined with continued support in later school years9, 10, 11. Additional research is needed to determine which components of comprehensive preschool programs (e.g., teacher training, curriculum, class size, child assessment, additional services offered, etc.) are most important for improving child outcomes1, 12.

Preschool improves cognitive abilities (e.g., general knowledge, language, and math skills) and educational success among participating children1, 2, 7, 8. Available evidence shows greater improvements in academic and executive function skills among students who spend more time in high quality early childhood education (ECE) programs than those spending less time13, 14. Among children attending high quality elementary schools, the academic benefits of preschool can persist through fifth grade; however, academic effects fade more quickly among children attending low quality elementary schools10. ECE participation is associated with decreases in special education placements and grade retention and increases in high school completion among participants5. Gains in cognitive skills and academic achievement are larger for students from families with low incomes than for students from families with high incomes15, 16. Participation in economically integrated preschool programs may improve academic achievement more for children from families with low incomes than programs that only serve children from disadvantaged backgrounds17, 18. Available evidence suggests participation in Head Start, a publicly funded preschool program for children from low income backgrounds, is associated with large benefits over the long-term, including increased high school completion, college enrollment and completion, economic self-sufficiency, and labor force participation19.

Preschool participation also improves social-emotional abilities; such gains can persist after cognitive effects fade7. In some circumstances, preschool participation can modestly reduce social deviance in adolescence2, 7 and can increase determination and positive attitudes around goal-setting among middle school students20. Preschool program participation is also associated with reduced obesity, improved mental health and social competence for children21, and improved adolescent health outcomes, especially in cardiovascular health22. Programs support healthy behaviors as children age but have no impact on chronic disease outcomes23, 24.

Teachers with higher qualifications are associated with improved learning environments and higher quality ECE25. In-service professional development programs can improve outcomes for child development and increase quality of ECE26. Overall, preschool enhancement programs, such as curricular enhancements, parent education, skills-based opportunities, and professional development, whether implemented alone or in combination, can improve behavioral, cognitive, health and socio-emotional outcomes for participating children27. Among early childhood education curriculum options, implementation varies and teacher training and ongoing support are needed to achieve intended child development benefits28.

Comprehensive preschool programs that include direct teaching and child-initiated activities, also called free play, increase literacy and language development; programs that focus solely on child-initiated activities do not29. Child-directed play is important, however, as it contributes to healthy cognitive, social, and physical development30. Explicit academic instruction, low staff-to-student ratios7, instructional support for students, and rich student/teacher interactions are components of effective preschool programs6.

Part- and full-day programs and 1- and 2-year programs have demonstrated positive effects16. Overall, higher quality programs have modestly stronger and more sustained effects than lower quality programs16, 31. High quality preschool programs in racial or ethnic minority communities or communities with low incomes can reduce educational achievement gaps1, 15 in some circumstances2.

The estimated economic return for full-scale, high quality preschool ranges from $2-$4 for every $1 invested16. Models suggest that providing high quality, free preschool programs for children from families with low socio-economic status generates positive net gains to society32. A benefit-cost analysis of the Perry Preschool Project shows multi-generational benefits for participants and their children, as well as large, positive net gains for society from high quality ECE programs33.

How could this strategy advance health equity? This strategy is rated potential to decrease disparities: supported by strong evidence.

There is strong evidence that high quality preschool education programs reduce disparities in educational attainment, especially between students from low income backgrounds and students from high income backgrounds1, 13, 15, 16, 43. Gains in cognitive skills and academic achievement are larger for students from families with low incomes than for students from families with high incomes15, 16, and can persist through 3rd grade for reading and math achievement43. Over the long term, among children from low income backgrounds, more time spent in high quality early childhood education (ECE) programs is associated with greater increases in college completion rates and income levels, and can help close education and income gaps with their peers from higher income backgrounds13. Available evidence suggests participation in preschool programs such as Head Start and the Perry Preschool Project is associated with large long-term benefits for children from low income backgrounds, including increased high school completion, college enrollment and completion, economic self-sufficiency, labor force participation19, increased earnings, and improved health outcomes44.

High quality preschool programs that focus on reducing disparities in education access and quality in racial or ethnic minority communities can reduce racial achievement gaps1, 2. Black, Hispanic, Asian, and Native children as well as children from families with low incomes are less likely to be enrolled in preschool or have access to high quality preschool than white children and children from families with higher incomes4, 45, 46. Available evidence suggests that lower preschool enrollment rates among Hispanic families is largely due to language barriers, limited access to ECE programs, and economic inequities47, 48. Experts suggest locating high quality preschool programs in Hispanic communities and using family-centered and culturally responsive outreach and retention strategies to better serve Hispanic families47. ECE classrooms can implement supports for dual language learners whether or not teachers speak the second language49. An Illinois-based study shows that implementing bilingual preschool classrooms on a large scale can increase ECE enrollment among students with English language learner (ELL) status50.

Research has shown higher rates of exclusionary disciplinary action (i.e. suspensions and expulsions) taken against Black and Hispanic children than against white children, starting in preschool51, 52. Black male children are especially likely to be disciplined at school52. Disparities in exclusionary disciplinary action are not supported by any observed differences in disruptive behavior measurements, which suggests that preschool programs need to raise awareness and provide teacher training and professional development to prevent discriminatory punishment practices due to implicit and explicit racial bias51, 52. One study suggests that both teacher and child race or ethnic identification relates to teacher response to children’s behavior and disciplinary recommendations52.

What is the relevant historical background?

In the U.S., there has never been an integrated national policy for early childhood education and care (ECEC) programs. Programs focused on child care and programs focused on early education developed separately. In the 1830s, nurseries provided children with basic care and supervision. Enrollment in such programs increased the most during times of war, and generally decreased after wars ended (from the Civil War through WWII). Early childhood programs became more available in the 1960s and 1970s, as maternal workforce participation increased and the number of households headed by single mothers grew3. In 1965, Head Start was established at the federal level as a community action program overseen by the Economic Opportunity Office to provide non-segregated preschool education programs to children from families with low incomes. Despite many obstacles and resistance from school boards and community organizations, many Civil Rights leaders and advocates persisted to establish and develop successful Head Start programs. Head Start programs also created employment opportunities and hired educators, administrators, and employees of color, even in the South53. When Head Start funding expanded in the 1980s and 1990s, preschool enrollment rates increased, though there still were not enough spaces to provide preschool for all eligible children. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 required single mothers to work to receive public assistance and created an even greater need for ECEC programs for infants and children3. Historically roles for women in American society have been constrained, at least in part to discourage mothers from middle class backgrounds from participating in the work force, by offering unequal pay and limited job opportunities. However, policies have simultaneously forced single mothers from low income backgrounds to work outside of the home, regardless of their preferences, the age of their infants or children, or the quality of ECEC available to them3.

Overall, access to high quality ECEC programs varies substantially3, 36. Preschool enrollment growth rates vary by geography and race or ethnicity. Even though publicly funded preschool is designed for children from families with low incomes, enrollment gaps remain based on family income and parent education levels36. States still have responsibility for preschool program offerings and some states are trying to increase preschool access. For example, Georgia and Oklahoma were the first two states to adopt universal pre-K programs, and state-funded pre-K has been expanded in many states from 1998 to the present36. However, in many areas, the need for high quality preschool opportunities persists3, 36.

Equity Considerations
  • Which neighborhoods in your community have access to high quality preschool education programs? Are there publicly funded preschool options available for families with low incomes?
  • How could you support quality improvements for early childhood education and care programs in your community? Are there partnerships or collaborations that could support teachers, students, and parents involved in the program?
  • What can you do to increase enrollment in preschool education programs among students identifying as a racial or ethnic minority? Among students with English language learner status? Among students from low income backgrounds?
  • How can local preschool education programs support equitable outcomes for students of all backgrounds? What training can you offer to teachers and providers to reduce implicit and explicit bias and promote fair punishment practices?
Implementation Examples

During the 2021 legislative session, state legislatures in 43 states enacted 208 bills related to early childhood; many bills aimed to increase access to center-based programs and many others focused on improving preschool education programs and school readiness34. The National Conference of State Legislatures maintains a database to track legislation on early childhood education (ECE) in all 50 states and U.S. territories35.

As of 2018, approximately 61% of 4-year-olds and 34% of 3-year-olds were enrolled in center-based preschool programs36. As of 2020, 44 states and Washington, D.C. have publicly funded pre-kindergarten (pre-K) programs that serve over 1.37 million 4-year-olds, about one-third of all 4-year-olds in the country. Idaho, Indiana, Montana, New Hampshire, South Dakota, and Wyoming do not have publicly funded pre-K programs. Eight states served nearly 50% or more of 4-year-olds in their states, and five states enrolled more than 70% of their 4-year-olds. Alabama, Hawaii, Michigan, Mississippi, Missouri, and Rhode Island are the only states with programs that meet all 10 of the National Institute for Early Education Research’s (NIEER’s) quality benchmarks for state preschool. The COVID-19 pandemic has significantly reduced previous progress achieved in preschool education enrollment and funding37. The Administration for Children and Families’ (ACF) Office of Childcare offers tips for choosing a preschool program and a database searchable by state for finding local preschool programs and resources38, 39

The U.S. Department of Education (U.S. ED) administers several programs and grants to support early learning initiatives and to develop state capacity for preschool education programs40. The Preschool for All proposal aims to establish a cost sharing partnership between U.S. ED and all 50 states, to improve access to high quality preschool programs in all states41. As of 2022, federal investment in Head Start and Early Head Start has also increased, with some funds earmarked for quality improvement initiatives42.

Implementation Resources

Resources with a focus on equity.

Head Start - Head Start. Early childhood learning & knowledge center (ECLKC). An office of the Administration for Children and Families, U.S. Department of Health and Human Services (U.S. DHHS).

HighScope - HighScope. Inspiring educators to inspire children.

CN-ROA 2015 - California Newsreel (CN). The raising of America: Early childhood and the future of our nation. 2015.

US DHHS OCC-CC state search - U.S. Department of Health & Human Services (U.S. DHHS), Administration for Children & Families, Office of Child Care (OCC), See your state’s resources: Find local resources on child care (CC), health and social services, financial assistance, support for children with special needs, and more.


* Journal subscription may be required for access.

1 CG-Health Equity - The Guide to Community Preventive Services (The Community Guide). Health equity.

2 Burger 2010 - Burger K. How does early childhood care and education affect cognitive development? An international review of the effects of early interventions for children from different social backgrounds. Early Childhood Research Quarterly. 2010;25(2):140-165.

3 Kamerman 2007 - Kamerman SB, Gatenio-Gabel S. Early childhood education and care in the United States: An overview of the current policy picture. International Journal of Child Care and Education Policy. 2007;1(1):23-34.

4 US ED-Preschool 2015 - U.S. Department of Education (U.S. ED). A matter of equity: Preschool in America. 2015.

5 McCoy 2017 - McCoy DC, Yoshikawa H, Ziol-Guest KM, et al. Impacts of early childhood education on medium- and long-term educational outcomes. Educational Researcher. 2017;46(8):474-487.

6 Garcia-Carrion 2016 - García-Carrión R, Villardón-Gallego L. Dialogue and interaction in early childhood education: A systematic review. REMIE - Multidisciplinary Journal of Educational Research. 2016;6(1):51-76.

7 Camilli 2010 - 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(3):579-620.

8 Manning 2010 - Manning M, Homel R, Smith C. A meta-analysis of the effects of early developmental prevention programs in at-risk populations on non-health outcomes in adolescence. Children and Youth Services Review. 2010;32(4):506-519.

9 Ansari 2018 - Ansari A. The persistence of preschool effects from early childhood through adolescence. Journal of Educational Psychology. 2018;110(7):952-973.

10 Ansari 2018a - Ansari A, Pianta R. The role of elementary school quality in the persistence of preschool effects. Children and Youth Services Review. 2018;86:120-127.

11 Brookings-Sawhill 2015 - Sawhill IV, Karpilow Q. How much could we improve children’s life chances by intervening early and often? Washington, D.C.: Center on Children and Families, Brookings Institution; 2015.

12 Mathematica-Caronongan 2016 - Caronongan P, Kirby G, Boller K, Modlin E, Lyskawa J. Assessing the implementation and cost of high quality early care and education: A review of the literature - OPRE Report 2016-31. Washington, D.C.: U.S. Department of Health and Human Services (U.S. DHHS), Administration for Children and Families, Office of Planning, Research and Evaluation; 2016.

13 Bustamante 2022 - Bustamante AS, Dearing E, Zachrisson HD, Vandell DL. Adult outcomes of sustained high‐quality early child care and education: Do they vary by family income? Child Development. 2022;93(2):502-523.

14 Shah 2017 - Shah HK, Domitrovich CE, Morgan NR, et al. One or two years of participation: Is dosage of an enhanced publicly funded preschool program associated with the academic and executive function skills of low-income children in early elementary school? Early Childhood Research Quarterly. 2017;40:123-137.

15 Duncan 2013 - Duncan GJ, Sojourner AJ. Can intensive early childhood intervention programs eliminate income-based cognitive and achievement gaps? Journal of Human Resources. 2013;48(4):945-968.

16 RAND-Karoly 2016 - Karoly LA, Auger A. Informing investments in preschool quality and access in Cincinnati: Evidence of impacts and economic returns from national, state, and local preschool programs. Santa Monica: RAND Corporation; 2016.

17 Miller 2017a - Miller P, Votruba-Drzal E, McQuiggan M, et al. Pre-K classroom-economic composition and children’s early academic development. Journal of Educational Psychology. 2017;109(2):149-165.

18 NBER-Cascio 2017 - Cascio E. Does universal preschool hit the target? Program access and preschool impacts. The National Bureau of Economic Research (NBER). 2017.

19 Bailey 2021 - Bailey MJ, Sun S, Timpe B. Prep school for poor kids: The long-run impacts of Head Start on human capital and economic self-sufficiency. American Economic Review. 2021;111(12):3963-4001.

20 Phillips 2018 - Phillips DA, Anderson S, Gormley WT Jr. The dog that didn’t bark: Preschool education and middle-school attitudes in Tulsa. Applied Developmental Science. 2018;22(3):200-216.

21 D’Onise 2010a - D'Onise K, Lynch JW, Sawyer MG, McDermott RA. Can preschool improve child health outcomes? A systematic review. Social Science & Medicine. 2010;70(9):1423-1440.

22 Sabol 2017 - Sabol TJ, Hoyt LT. The long arm of childhood: Preschool associations with adolescent health. Developmental Psychology. 2017;53(4):752-763.

23 D’Onise 2010 - D'Onise K, McDermott RA, Lynch JW. Does attendance at preschool affect adult health? A systematic review. Public Health. 2010;124(9):500-511.

24 Englund 2015 - Englund MM, White B, Reynolds AJ, Schweinhart LJ, Campbell FA. Health outcomes of the Abecedarian, Child–Parent Center, and HighScope Perry Preschool programs. In Reynolds AJ, Rolnick AJ, Temple JA, eds. Health and Education in Early Childhood. Cambridge: Cambridge University Press; 2015:257-292.

25 Campbell-Manning 2017 - Manning M, Garvis S, Fleming C, Wong GTW. The relationship between teacher qualification and the quality of the early childhood education and care environment. Campbell Systematic Reviews. 2017;13(1):1-82.

26 Egert 2018 - Egert F, Fukkink RG, Eckhardt AG. Impact of in-service professional development programs for early childhood teachers on quality ratings and child outcomes: A meta-analysis. Review of Educational Research. 2018;88(3):401-433.

27 Joo 2020 - Joo YS, Magnuson K, Duncan GJ, et al. What works in early childhood education programs?: A meta–analysis of preschool enhancement programs. Early Education and Development. 2020;31(1):1-26.

28 Jenkins 2019 - Jenkins JM, Whitaker AA, Nguyen T, Yu W. Distinctions without a difference? Preschool curricula and children’s development. Journal of Research on Educational Effectiveness. 2019;12(3):514-549.

29 BEE-Chambers 2016 - Chambers B, Cheung ACK, Slavin RE. Literacy and language outcomes of comprehensive and developmental-constructivist approaches to early childhood education: A systematic review. Best Evidence Encyclopedia (BEE). Educational Research Review. 2016;18:88-111.

30 Belknap 2014 - Belknap E, Hazler R. Empty playgrounds and anxious children. Journal of Creativity in Mental Health. 2014;9(2):210-231.

31 Keys 2013 - Keys TD, Farkas G, Burchinal MR, et al. Preschool center quality and school readiness: Quality effects and variation by demographic and child characteristics. Child Development. 2013;84(4):1171-90.

32 NBER-Heckman 2013 - Heckman JJ, Raut LK. Intergenerational long term effects of preschool - Structural estimates from a discrete dynamic programming model. National Bureau of Economic Research (NBER). 2013: Working Paper 19077.

33 NBER-Garcia 2021 - García JL, Bennhoff F, Leaf DE, Heckman J. The dynastic benefits of early childhood education. National Bureau of Economic Research (NBER). 2021: Working Paper 29004.

34 NCSL-ECE report 2022 - National Conference of State Legislatures (NCSL). 2021 Enacted legislation on early care and education (ECE) report. 2022.

35 NCSL-ECE tracking - National Conference of State Legislatures (NCSL). Early care and education (ECE) bill tracking.

36 NBER-Cascio 2021 - Cascio EU. Early childhood education in the United States: What, when, where, who, how, and why. National Bureau of Economic Research (NBER). 2021: Working Paper 28722.

37 NIEER-Friedman-Krauss 2021 - Friedman-Krauss AH, Barnett WS, Garver KA, et al. The state of preschool 2020: State preschool yearbook. New Brunswick, NJ: National Institute for Early Education Research (NIEER); 2021.

38 US DHHS OCC-Preschool - U.S. Department of Health & Human Services (U.S. DHHS), Administration for Children & Families, Office of Child Care (OCC), Preschool programs.

39 US DHHS OCC-CC state search - U.S. Department of Health & Human Services (U.S. DHHS), Administration for Children & Families, Office of Child Care (OCC), See your state’s resources: Find local resources on child care (CC), health and social services, financial assistance, support for children with special needs, and more.

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41 US ED-Preschool for all - U.S. Department of Education (U.S. ED), Administration for Children & Families, Office of Early Childhood Development. Preschool for all

42 Head Start-2022 funding - Head Start, Early Childhood Learning & Knowledge Center. FY 2022 Head Start funding increase. ACF-PI-HS-22-02. 2022.

43 Manfra 2017 - Manfra L, Squires C, Dinehart LHB, et al. Preschool writing and premathematics predict Grade 3 achievement for low-income, ethnically diverse children. Journal of Educational Research. 2017;110(5):528-537.

44 NBER-Garcia 2021a - Garcia JL, Heckman JJ, Ronda V. The lasting effects of early childhood education on promoting the skills and social mobility of disadvantaged African Americans. National Bureau of Economic Research (NBER). 2021: Working Paper 29057.

45 Colaner 2020 - Colaner AC. Availability of preschool in Chicago’s Hispanic-concentrated communities: A study of supply and directors’ support for universal programming. Early Childhood Research Quarterly. 2020;52:15-24.

46 Latham 2020 - Latham S, Corcoran SP, Sattin-Bajaj C, Jennings JL. Racial disparities in pre-k quality: Evidence from New York City’s universal pre-k program. Annenberg Institute for School Reform at Brown University. 2020: Working Paper 20-248.

47 Mendez-Smith 2021 - Mendez-Smith J, Crosby D, Stephens C. Equitable access to high-quality early care and education: Opportunities to better serve young Hispanic children and their families. Annals of the American Academy of Political and Social Science. 2021;696(1):80-105.

48 Ansari 2017 - Ansari A. The selection of preschool for immigrant and native-born Latino families in the United States. Early Childhood Research Quarterly. 2017;41:149-160.

49 Partika 2021 - Partika A, Johnson AD, Phillips DA, et al. Dual language supports for dual language learners? Exploring preschool classroom instructional supports for DLLs’ early learning outcomes. Early Childhood Research Quarterly. 2021;56:124-138.

50 Chan 2020 - Chan EW. Preschool for all? Enrollment and maternal labour supply implications of a bilingual preschool policy. Applied Economics. 2020;52(9):970-986.

51 Sabol 2022 - Sabol TJ, Kessler CL, Rogers LO, et al. A window into racial and socioeconomic status disparities in preschool disciplinary action using developmental methodology. Annals of the New York Academy of Sciences. 2022;1508(1):123-136.

52 Wymer 2022 - Wymer SC, Corbin CM, Williford AP. The relation between teacher and child race, teacher perceptions of disruptive behavior, and exclusionary discipline in preschool. Journal of School Psychology. 2022;90:33-42.

53 NHSA-Head Start history - National Head Start Association (NHSA). Black history month: A reflection on Head Start history.