Preschool programs with family support services

Evidence Rating  
Scientifically Supported
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.

Health Factors  
Decision Makers

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.

Expected Beneficial Outcomes (Rated)

  • Increased academic achievement

Other Potential Beneficial Outcomes

  • Improved cognitive skills

  • Reduced delinquent behavior

  • Reduced arrests

  • Reduced obesity

  • Improved mental health

  • Increased healthy behaviors

Evidence of Effectiveness

There is strong evidence that preschool programs with family support services increase academic achievement among children from low income backgrounds1, 2. Effects are strongest immediately following preschool, but can persist2, 3, especially if combined with continued support in later school years4. 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 outcomes2, 5.

Participants in preschool programs with family support services have greater gains in cognitive skills and academic achievement than non-participants1, 2. Program participation may also increase family well-being and social-emotional development, and reduce social deviance, teenage delinquent behavior (e.g., drug use, law breaking, gang involvement), and juvenile arrest rates1. Preschool programs with family support services also appear to reduce obesity, and improve children’s mental health and social competence6. Programs support healthy behaviors as children age, but have no impact on chronic disease outcomes7, 8.

Chicago Child-Parent Centers (CPC) and the HighScope Perry (HSP) program are two examples of preschool programs with family support services that have been shown to improve academic achievement2, 9, 10, 11, 12. Cost-benefit analyses of these programs indicate substantial societal returns for the funds invested1314.

Impact on Disparities

Likely to decrease disparities

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 2015, the Office of Head Start distributed over $7.7 billion in grant funding to 1,700 local public and private agencies that offer Head Start services to their communities15, 16.  

Educare schools are another example of preschool programs with family support services. Established in over 20 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 organizations17.

Implementation Resources

HighScope - HighScope. Inspiring educators to inspire children.

Head Start - Head Start. An office of the Administration for Children and Families. Early childhood learning & knowledge center (ECLKC).

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


* Journal subscription may be required for access.

1 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):506-19.

2 CG-TFR Education - The Guide to Community Preventive Services (The Community Guide). Task Force Recommends (TFR) education programs to promote health equity.

3 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):140-65.

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

5 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, DC: US Department of Health and Human Services (US DHHS), Administration for Children and Families, Office of Planning, Research and Evaluation; 2016.

6 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.

7 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.

8 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.

9 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.

10 Ou 2010* - Ou SR, Reynolds AJ. Mechanisms of effects of an early intervention program on educational attainment: A gender subgroup analysis. Children and Youth Services Review. 2010;32(8):1064-76.

11 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):360-4.

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

13 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):114-28.

14 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.

15 Head Start - Head Start. An office of the Administration for Children and Families. Early childhood learning & knowledge center (ECLKC).

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

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

Date Last Updated