Preschool programs with family support services

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  
Decision Makers
Date last updated

Preschool programs with family support services are center-based programs that support the cognitive and social development of children from low income backgrounds prior to kindergarten. These intensive programs usually include a combination of high quality preschool, parental education, and additional services such as home visiting, health, and family services. Examples of such programs include: Chicago Child-Parent Centers, HighScope Perry Preschool, and the Carolina Abecedarian Project.

What could this strategy improve?

Expected Benefits

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

  • Increased academic achievement

  • Improved social emotional skills

Potential Benefits

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

  • Increased employment

  • Reduced delinquent behavior

  • Reduced arrests

  • Reduced obesity

  • Improved mental health

  • Increased healthy behaviors

  • Improved cognitive skills

  • Increased school readiness

  • Increased parental involvement

What does the research say about effectiveness?

There is strong evidence that preschool programs with family support services increase academic achievement1, 2, 3, 4, 5, 6 and social emotional development among children from low income backgrounds3, 7, 8. Effects are strongest immediately following preschool, but can persist6, 9, especially if combined with continued support in later school years3, 10. Additional research is needed to determine which program components (e.g., social services, health care services, parental involvement, meals served, etc.) have the greatest effect on children’s outcomes6, 11.

Participants in preschool programs with family support services have greater gains in cognitive skills and academic achievement than non-participants5, 6, 7, 8, 12. These programs can improve school readiness1, 12, 13, and reading and math skills, while reducing grade retention and special education usage among participants7, 12. They may also increase high school completion rates, college degree attainment, economic self-sufficiency, and labor force participation4, 14. The longer students participate in the program, the larger the effect size is for academic achievement and social emotional development3.

Preschool programs with family support services may reduce arrests during adolescence and adulthood2, 5, 15, 16, 17, 18, 19 and teenage delinquent behavior and drug use5. It may also reduce serious criminal convictions (e.g., felonies) in adulthood15, especially for participants that receive a higher level of child-initiated instruction16. Positive intergenerational spillover effects have been identified in the children of HighScope Perry Preschool students, a preschool program with family support services, compared to those of nonparticipants; effects include fewer school suspensions, higher levels of education, a greater likelihood of employment, and lower likelihood of committing criminal offenses2.

Participation in preschool programs with family support services may improve health outcomes20, 21, reduce rates of obesity22, 23, and improve children’s mental health and social competence20, 23. Programs may support healthy behaviors as children age, including increased use of preventive health care and reduced alcohol and drug use24, and may be predictive of lower risk for cardiovascular disease in mid-life25. It is unclear if they have an impact on other chronic disease outcomes26, 27.

Preschool programs with family support services may increase parental engagement28, 29, which may be connected to reduced adolescent problem behaviors and substance use30. These programs may improve parenting skills31, 32, 33, parent supportiveness33, 34, and emotional responsiveness33, and increase use of positive discipline35. Additionally, parents may be more likely to create home environments that support learning29, 31, 33.

Chicago Child-Parent Centers (CPC), the HighScope Perry (HSP) program, and Smart Start North Carolina are three examples of preschool programs with family support services that have been shown to improve academic achievement1, 2, 3, 4, 36. A Minnesota-based study suggests that the CPC model is scalable; the expansion to new school districts was shown to improve academic achievement and increase school readiness1, 13. Programs with more child-initiated instruction may be associated with better long-term outcomes in adulthood16.

Cost benefit analyses of these programs indicate substantial societal returns for the funds invested19, 37. For example, an analysis of HSP found the benefit-cost ratio was 9 to 1, when accounting for the cumulative benefits of increased labor income, reduced crime and costs to the criminal justice system, improved health and healthy behaviors, and the positive spillover effects on participants’ families38. An analysis of CPC found, not including the benefits of increased lifetime earning the subsequent tax revenue, a net $1.73 in societal benefits per dollar spent39.

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

There is strong evidence that preschool programs with family support services, such as Chicago Child-Parent Centers (CPC) and HighScope Perry Preschool (HSP), reduce disparities in academic achievement between students from low and high income backgrounds3, 4, 6, 12, 46, 47, 48, 49, especially for Black students from families with low incomes50. A benefit-cost analysis of the HSP preschool project shows multi-generational benefits for participants and their children, as well as large, positive net gains for society38. Generally, studies of preschool education programs have shown that gains in cognitive skills and academic achievement are larger for students from families with low incomes than for students from families with high incomes51, 52.

Gains in academic achievement are larger for students the longer they participate in the program, all the way up to third grade3, 18, 50. Additionally, the emphasis on parent involvement and intervention in early childhood is associated with a reduction in violent crime in adulthood, which is a public health issue that disproportionately impacts Black males in urban centers15, 17.

Over the long term, participation in preschool programs with family support services up to third grade is associated with greater increases in college completion rates and income levels, which can help reduce education and income gaps between those from lower and higher income backgrounds50. Additionally, disparities in school readiness between children from families with lower and higher incomes may be twice as large as school readiness disparities by race50. Preschool programs with family support services are associated with producing significant improvements in math and reading skills for all children, but especially boys, and the greatest gains among boys emerge for those from less advantaged families53.

While there is evidence participation in high-quality preschool helps close gaps in school readiness for children of color and children from families with low incomes, there is some mixed evidence about the persistence of those effects. The extension of programmatic support for up to six years in the CPC model can sustain early effects on school readiness and academic achievement50. However, available evidence shows there is still a gap between program participants and national averages on indicators of academic achievement, like test scores, demonstrating that sustained early education interventions alone can’t eliminate these disparities50.

What is the relevant historical background?

Disparities in educational opportunities in the United States are shaped by many factors, including a long history of racial segregation in schools and differences in family income levels. In 1954, the U.S. Supreme Court ruled in Brown v. Board of Education that racial segregation in public schools was unconstitutional54, but segregation remains a persistent problem55. Some legal battles over school segregation were not resolved until 201656 and structural barriers, such as continued residential segregation, play a significant role in maintaining school segregation55.

National interest in preschool as an intervention to address educational disparities was high in the 1960s when the Child-Parent Center (CPC) program began in Chicago and HighScope Perry (HSP) preschool program in Michigan. The federal Head Start program began in 196557, but many areas remained unserved50. Educational disparities across racial and economic groups were highlighted as a concern by teachers, administrators, and policymakers during this period with the Civil Rights movement and the “war on poverty”58. Since then, evidence from the HSP preschool model and Head Start has been influential in garnering support for more recent early childhood education models.

Equity Considerations
  • What community partnerships could help preschool programs in your community offer comprehensive family support services? In your community, what aspects of preschool programs are important to families with low incomes? To students and families identifying as a racial or ethnic minority? How can your community support preschool programs so they can provide these educational opportunities and services?
  • How could your community increase access to high quality preschool programs for children from families with low incomes? For students identifying as a racial or ethnic minority?
  • Which populations in your community have lower rates of preschool attendance? What outreach activities might help reduce those disparities?
  • What disparities in educational opportunities and outcomes exist in your community? How do systemic factors such as residential segregation and disproportional school discipline rates contribute to these disparities?
  • What knowledge, skills, and abilities do families and children with low incomes in your community already have? How can your local preschool program be structured to highlight and build on those strengths?
Implementation Examples

Head Start, a federal program for children under 5 from families with low incomes, provides preschool education and school readiness programming, as well as social, health, and other services. In 2021, the Office of Head Start distributed over $10.4 billion in grant funding to 1,700 local public and private agencies that offer Head Start services to their communities40, 41.

Chicago Child-Parent Centers (CPC) provide preschool education and comprehensive family support to children from families with low incomes for up to six years, including free daily meals for children, health screening, home visiting, and connecting families to additional resources. CPC uses Title I funds and operates through the Chicago Public School system42. As of 2022, CPC programs operate in 26 centers in the Chicago area, eight in Minnesota, and one in Wisconsin43. State legislatures can support the adoption of the CPC education model in their communities44.

Educare schools are another example of preschool programs with family support services. Established in over 21 communities across the country, in urban, suburban, and rural areas, Educare schools provide early childhood education and family support services for children under 5 from families with low incomes. Schools also help connect families with additional resources, such as health and mental health services, provided by community organizations45. Potential partners can consider getting involved as philantrophic partners, becoming a program provider, or becoming a local advocate for increased school district and community support45.

Implementation Resources

Resources with a focus on equity.

HighScope - HighScope. Inspiring educators to inspire children.

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).

Educare - Educare. The Educare model: Our approach and our schools.

CPC P-3 Implementation - Child-Parent Center Preschool to 3rd Grade (CPC P-3). Implementation. Human Capital Research Collaborative, Institute of Child Development, University of Minnesota.


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19 Reynolds 2011a - Reynolds AJ, Temple JA, White BAB, Ou SR, Robertson DL. Age 26 cost-benefit analysis of the child-parent center early education program. Child Development. 2011;82(1):379-404.

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27 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.

28 Varshney 2020 - Varshney N, Lee S, Temple JA, Reynolds AJ. Does early childhood education enhance parental school involvement in second grade?: Evidence from Midwest Child-Parent Center program. Children and Youth Services Review. 2020;117:105317.

29 Harden 2012 - Harden BJ, Chazan-Cohen R, Raikes H, Vogel C. Early Head Start home visitation: The role of implementation in bolstering program benefits. Journal of Community Psychology. 2012;40(4):438-455.

30 Hayakawa 2016 - Hayakawa M, Giovanelli A, Englund MM, Reynolds AJ. Not just academics: Paths of longitudinal effects from parent involvement to substance abuse in emerging adulthood. Journal of Adolescent Health. 2016;58(4):433-439.

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32 Vallotton 2012 - Vallotton CD, Harewood T, Ayoub CA, et al. Buffering boys and boosting girls. The protective and promotive effects of Early Head Start for children's expressive language in the context of parenting stress. Early Childhood Research Quarterly. 2012;27(4):695-707.

33 Raikes 2014 - Raikes HH, Roggman LA, Peterson CA, et al. Theories of change and outcomes in home-based early head start programs. Early Childhood Research Quarterly. 2014;29(4):574-585.

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38 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.

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40 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).

41 OHS-Head Start - Office of Head Start (OHS). Head Start: What we do.

42 PPN - Promising Practices Network (PPN). On children, families and communities.

43 CPC P-3 - Child-Parent Center Preschool to 3rd Grade (CPC P-3). Human Capital Research Collaborative, Institute of Child Development, University of Minnesota.

44 NCSL Preschool-3rd Grade Legislation Tracker - National Conference of State Legislatures (NCSL) 2020 Preschool-3rd Grade Education Legislation Tracker.

45 Educare - Educare. The Educare model: Our approach and our schools.

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48 YG-PPP - (YG), Interagency Working Group on Youth Programs (IWGYP). Perry Preschool Project (PPP).

49 Blueprints - Center for the Study and Prevention of Violence (CSPV). Blueprints for healthy youth development.

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52 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.

53 Muschkin 2020 - Muschkin CG, Ladd HF, Dodge KA, Bai Y. Gender differences in the impact of North Carolina’s early care and education initiatives on student outcomes in elementary school. Educational Policy. 2020;34(2):377-407.

54 US Courts-BvBE - United States Courts, Administrative Office of the U.S. Courts. Supreme Court landmarks in history: Brown v. Board of Education (BvBE) re-enactment.

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

58 Economic Opportunities Act - Public Law 88-452. Senate (S) 2642: Economic Opportunities Act of 1964.