Early Head Start (EHS)

There is strong evidence that Early Head Start (EHS) increases participating children’s cognitive and social emotional skills (Chazan-Cohen 2023, Green 2020, Gedal Douglass 2021, Vogel 2013, Chazan-Cohen 2013, Harden 2012, PPN) and improves parenting (Chazan-Cohen 2023, Green 2020, Gedal Douglass 2021, Berlin 2018a, Vogel 2013, Vallotton 2012, Raikes 2014). Small social emotional effects appear to continue through age ten (Mathematica-Vogel 2010).

EHS modestly improves attention and focus (Vogel 2013), language (Chazan-Cohen 2023, Gedal Douglass 2021, Chazan-Cohen 2013), cognitive and social emotional skills such as social functioning and emotional regulation (Chazan-Cohen 2023, Green 2020, Gedal Douglass 2021, Harden 2012, Vogel 2013, PPN), and reduces aggressive behavior among participating children (Vogel 2013). Children participating in EHS are more likely to engage in play with parents through age three (Chazan-Cohen 2023, Green 2020). Enhanced language skills can help children better regulate emotions, reducing parental stress and improving parent-child interactions (Ayoub 2011).

EHS improves parenting (Chazan-Cohen 2023, Green 2020, Gedal Douglass 2021, Berlin 2018, Vogel 2013, Vallotton 2012, Raikes 2014) by increasing parent supportiveness (Chazan-Cohen 2023, Green 2020, Mortensen 2014, Raikes 2014), emotional responsiveness (Green 2020, Gedal Douglass 2021, Berlin 2018, Raikes 2014), and developing parents' ability to cognitively stimulate and positively interact with children (Chazan-Cohen 2023, Green 2020, Gedal Douglass 2021) and to create home environments that support learning (Chazan-Cohen 2023, Green 2020, Gedal Douglass 2021, Harden 2012, Vogel 2013, Raikes 2014). These positive effects can occur even in families experiencing high levels of stress and conflict (Vallotton 2012, Ayoub 2011). EHS also supports improved parenting by reducing the use of spanking (Chazan-Cohen 2023, Harden 2012) and increasing use of positive discipline (Chazan-Cohen 2013). EHS can improve family functioning and relationships, including improved coping skills and reduced stress with lasting effects (Green 2020), especially for mothers who receive home-based infant mental health services through EHS (Mckelvey 2015). EHS participation may reduce child maltreatment, especially physical and sexual abuse (Chazen-Cohen 2015, Green 2014a), through the combined effects of improved parenting, family well-being, and child development (Green 2020).

EHS participation increases the likelihood of children having dental care visits for prevention and treatment (Burgette 2017, Burgette 2017a) and may improve oral health knowledge among EHS staff and parents (Joufi 2021). Available data shows EHS helps increase rates of immunization, breastfeeding, health insurance coverage, connection to medical and dental homes, and other health promoting practices (Horm 2024). EHS has been shown to increase developmental screening rates and support connecting children identified with developmental delays to appropriate intervention services (Horm 2024). Among Latino families, EHS programs that include health education decrease pediatric emergency room visits and inappropriate use of over-the-counter medications for children under age two (Stockwell 2014).

For parents, involvement in EHS programs is associated with increased school or job training participation (Chazan-Cohen 2013), especially for mothers (Chazan-Cohen 2023), which supports sustained improvements in income (Chazan-Cohen 2013). Income effects are often stronger in programs that offer more child and family services (Harden 2012). Parents participating in EHS are more likely to enroll their children in formal pre-kindergarten programs (Harden 2012). A New Jersey-based study suggests that school districts with EHS and Head Start programs are less likely to have a severe child care supply gap (Kim 2019).

Available data suggests program effects are strongest and EHS participation is longer when initial caregiver-parent relationships are positive, when families get involved in EHS (Jeon 2018), and when teacher-child interactions are stable and high-quality (Choi 2019c).

Early Head Start (EHS) has the potential to decrease disparities in education outcomes for children from families with low incomes (CG-TFR Education, Blueprints) and for Black children (PPN, Vallotton 2012, Raikes 2013).

In general, there is strong evidence that preschool programs with family support services, such as EHS, reduce disparities in academic achievement and cognitive skills between students from low and high income backgrounds (CG-TFR Education, Blueprints, Duncan 2013, RAND-Karoly 2016). Participation in preschool programs such as Head Start 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 participation (Bailey 2021), increased earnings, and improved health outcomes (NBER-Garcia 2021a).

High quality preschool programs, including EHS, that focus on reducing disparities in education access and quality in racial or ethnic minority communities can reduce racial achievement gaps (CG-Health Equity, Burger 2010). 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 incomes (Colaner 2020, Latham 2020, US ED-Preschool 2015). EHS can be especially effective for Black participants (PPN, Vallotton 2012, Raikes 2013). Black families have higher likelihoods of experiencing stress, parenting challenges, and child developmental concerns because of structural racism; EHS appears effective at supporting Black families with low incomes in promoting positive parenting despite structural racism (Heberle 2023). Black parent participants are more likely to be employed or in school than their peers and report a small reduction in their children’s hospitalization needs (Harden 2012a). Some outcomes may also last longer for Black participants than for white participants (Raikes 2013). 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 centers (Anders 2023).

Available data shows that Hispanic infants and toddlers make up 35 percent of those enrolled in EHS, despite lower preschool enrollment rates among Hispanic families due to language barriers, limited access to ECE programs, and economic inequities (Mendez-Smith 2021). Programs like EHS have larger impacts on Hispanic children who are dual-language learners compared to other programs, likely because of its family-centered and culturally responsive approach, outreach, and retention strategies (Mendez-Smith 2021). EHS can improve vocabulary for students learning English as a second language by the time they enter kindergarten (Vogel 2013, Raikes 2013). EHS programs can also increase engagement with Latino fathers, especially when programs hire bilingual staff and men, teach fatherhood skills, personally contact fathers, and increase service hours and home visits during evenings and weekends (Acevedo-Polakovich 2017).

People of color, people with lower socioeconomic status, and immigrants and refugees are more likely to experience trauma (AAP-Duffee 2021, Brown 2022). Residents in communities that are racially and/or economically segregated may have higher risk of exposure to neighborhood violence and resulting traumatic loss (Stolbach 2017). Parental history of adverse childhood experiences (ACEs), a measure of trauma, have been shown to have intergenerational effects and have been associated with childhood problems, such as increased risk of developmental delays (Miccoli 2022). EHS may help mitigate the intergenerational effects of trauma as a culturally appropriate, positive caregiving intervention that is associated with improving parent-child relationships among racially and ethnically diverse EHS participants (Senehi 2021).

Measures of neighborhood socioeconomic disadvantage, like the Area Deprivation Index, can help identify community specific adaptations, services, and family supports that EHS programs could implement to support improved health and well-being of EHS families (Hooper 2022). Assessments and evaluations used to measure education outcomes are developed and validated with children from predominantly white, English-speaking, upper income households, which contributes to a deficit view of the skills, competencies, and behaviors of children from historically marginalized backgrounds served by programs like EHS (MDRC-Equity Pre-K).

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 grew (Kamerman 2007).

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 unconstitutional (US Courts-BvBE), but segregation remains a persistent problem (EPI-Rothstein 2014). Some legal battles over school segregation were not resolved until 2016 (NPR-Domonoske 2016) and structural barriers, such as continued residential segregation, play a significant role in maintaining school segregation and unequal access to resources, including high-quality early childhood education programs (EPI-Rothstein 2014). 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 the HighScope Perry (HSP) preschool program began in Michigan (Temple 2022). 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” (Economic Opportunities Act).

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 South (NHSA-Head Start history). 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 (Kamerman 2007). Early Head Start was first funded in 1995 to serve expectant families with low incomes and their children from birth to age three (NHSA-Head Start history).

• What community partnerships could help your local Early Head Start programs offer better comprehensive family support services? In your community, what aspects of preschool programs are most important to families with low incomes? To students and families 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? How could your community increase access to and funding for high quality Early Head Start programs for children who aren’t participating?
• 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?
• How can your local preschool program be structured to highlight and build on the knowledge, skills, abilities, and strengths of families in your community? What opportunities could this provide to develop caregiver-parent relationships and to support family involvement?

In the 2023 fiscal year, over 186,500 children were enrolled in Early Head Start (EHS) across all 50 states, Washington, D.C., and six U.S. territories and over 4,400 children were enrolled in American Indian and Alaska Native (AIAN) Early Head Start programs operated by tribal governments across 26 states (US DHHS-ECLKC data). The National Head Start Association has started a campaign to increase the number of EHS spots so that it will be equal to the number available through Head Start (NHSA-Early Head Start 2022).

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