Preschool programs with family support services
Evidence Ratings
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.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Evidence Ratings
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.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
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 Ratings
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.
Potential for mixed impact on disparities: Strategies with this rating could increase and decrease disparities between subgroups. Rating is suggested by evidence or expert opinion.
Potential to increase disparities: Strategies with this rating have the potential to increase or exacerbate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Inconclusive impact on disparities: Strategies with this rating do not have enough evidence to assess potential impact on 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 shape the health of individuals and communities. Everything from our education to our environments impacts our health. Modifying these clinical, behavioral, social, economic, and environmental factors can influence how long and how well people live, now and in the future.
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.
Footnotes
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1 Reynolds 2021 - Reynolds AJ, Richardson BA, Lee S. Preschool and kindergarten impacts of the Midwest expansion of the Child-Parent Centers in the Saint Paul public schools. Developmental Psychology. 2021;57(4):489-505.
2 NBER-Heckman 2019 - Heckman JJ, Karapakula G. Intergenerational and intragenerational externalities of the Perry Preschool Project. National Bureau of Economic Research (NBER). 2019: Working Paper 25889.
3 Ou 2019 - Ou SR, Arteaga I, Reynolds AJ. Dosage effects in the Child-Parent Center preK-to-3rd grade program: A re-analysis in the Chicago Longitudinal Study. Children and Youth Services Review. 2019;101:285-298.
4 Reynolds 2018 - Reynolds AJ, Ou SR, Temple JA. A multicomponent, preschool to third grade preventive intervention and educational attainment at 35 years of age. JAMA Pediatrics. 2018;172(3):247-256.
5 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.
6 CG-TFR Education - The Guide to Community Preventive Services (The Community Guide). Task Force Recommends (TFR) center-based early childhood education programs (ECE) to improve educational outcomes that are associated with long-term health as well as social- and health-related outcomes.
7 Mondi 2021 - Mondi CF, Reynolds AJ. Socio-emotional learning among low-income prekindergarteners: The roles of individual factors and early intervention. Early Education and Development. 2021;32(3):360-384.
8 Joo 2019 - 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. 2019;31(1):1-26.
9 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.
10 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.
11 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.
12 Reynolds 2016 - Reynolds AJ, Richardson BA, Hayakawa M, Englund MM, Ou SR. Multi-site expansion of an early childhood intervention and school readiness. Pediatrics. 2016;138(1):e20154587.
13 Richardson 2017 - Richardson AS, Ghosh-Dastidar M, Beckman R, et al. Can the introduction of a full-service supermarket in a food desert improve residents’ economic status and health? Annals of Epidemiology. 2017;27(12):771-776.
14 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.
15 Anders 2023 - Anders J, Barr AC, Smith AA. The effect of early childhood education on adult criminality: Evidence from the 1960s through 1990s. American Economic Journal: Economic Policy. 2023;15(1):37-69.
16 Ernst 2021 - Ernst JR, Reynolds AJ. Preschool instructional approaches and age 35 health and well-being. Preventive Medicine Reports. 2021;23:101498.
17 Giovanelli 2018 - Giovanelli A, Hayakawa M, Englund MM, Reynolds AJ. African-American males in Chicago: Pathways from early childhood intervention to reduced violence. Journal of Adolescent Health. 2018;62(1):80-86.
18 Reynolds 2011 - Reynolds AJ, Temple JA, Ou SR, Arteaga IA, White BAB. School-based early childhood education and age-28 well-being: Effects by timing, dosage, and subgroups. Science. 2011;333(6040):360-364.
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.
20 Mondi 2022 - Mondi CF, Reynolds AJ. Psychological well-being in midlife following early childhood intervention. Development and Psychopathology. 2022.
21 Varshney 2022 - Varshney N, Temple JA, Reynolds AJ. Early education and adult health: Age 37 impacts and economic benefits of the Child-Parent Center preschool program. Journal of Benefit-Cost Analysis. 2022;13(1):57-90.
22 Reynolds 2021b - Reynolds AJ, Eales L, Ou SR, Mondi CF, Giovanelli A. A comprehensive, multisystemic early childhood program and obesity at age 37 years. JAMA Pediatrics. 2021;175(6):637-640.
23 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.
24 Xie 2020 - Xie Y, Near C, Xu H, Song X. Heterogeneous treatment effects on children's cognitive/non-cognitive skills: A reevaluation of an influential early childhood intervention. Social Science Research. 2020;86:102389.
25 Reynolds 2021a - Reynolds AJ, Ou SR, Eales L, Mondi CF, Giovanelli A. Assessment of a comprehensive early childhood education program and cardiovascular disease risk in midlife. JAMA Network Open. 2021;4(8):e2120752.
26 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.
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.
31 Vogel 2013 - Vogel C, Brooks-Gunn J, Martin A, Klute MM. Impacts of Early Head Start participation on child and parent outcomes at ages 2, 3, and 5. Monographs of the Society for Research in Child Development. 2013;78(1):36-63.
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.
34 Mortensen 2014 - Mortensen JA, Mastergeorge AM. A meta-analytic review of relationship-based interventions for low-income families with infants and toddlers: Facilitating supportive parent–child interactions. Infant Mental Health Journal. 2014;35(4):336-353.
35 Chazan-Cohen 2013 - Chazan-Cohen R, Raikes HH, Vogel C. Program subgroups: Patterns of impacts for home-based, center-based, and mixed-approach programs. Monograph of the Society for Research in Child Development. 2013;78(1):93-109.
36 Bai 2020 - Bai Y, Ladd HF, Muschkin CG, Dodge KA. Long-term effects of early childhood programs through eighth grade: Do the effects fade out or grow? Children and Youth Services Review. 2020;112:104890.
37 Heckman 2010a - Heckman JJ, Moon SH, Pinto R, Savelyev PA, Yavitz A. The rate of return to the HighScope Perry preschool program. Journal of Public Economics. 2010;94(1-2):114-128.
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.
39 Peterson 2018 - Peterson C, Florence C, Thomas R, Klevens J. Cost-benefit analysis of two child abuse and neglect primary prevention programs for U.S. states. Prevention Science. 2018;19(6):705-715.
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.
46 Schweinhart 2013 - Schweinhart LJ. Long-term follow-up of a preschool experiment. Journal of Experimental Criminology. 2013;9(4):389-409.
47 Heckman 2010b - Heckman J, Moon SH, Pinto R, Savelyev P, Yavitz A. Analyzing social experiments as implemented: A reexamination of the evidence from the HighScope Perry Preschool Program. Quantitative Economics. 2010;1(1):1-46.
48 YG-PPP - Youth.gov (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.
50 Temple 2022 - Temple JA, Ou SR, Reynolds AJ. Closing achievement gaps through preschool-to-third-grade programs. Frontiers in Education. 2022;7.
51 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.
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.
55 EPI-Rothstein 2014 - Rothstein R. Brown v. Board at 60: Why have we been so disappointed? What have we learned? Washington, D.C.: Economic Policy Institute (EPI); 2014.
56 NPR-Domonoske 2016 - Domonoske C. After 50-year legal struggle, Mississippi school district ordered to desegregate. National Public Radio (NPR). 2016.
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.
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