Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T....

Children’s Right to Thrive

Invest in Children

10th Annual MeetingNovember 20, 2009

Craig T. Ramey, Ph.D.

Sharon Landesman Ramey, Ph.D.Directors and Professors,

Georgetown University Center on Health and Education

It is the totality of a child’s

experience that lays the

foundation for a lifetime of

greater or lesser competency.Ramey & Ramey, 2000

Consequences of very low resource environments on children’s school entry

skills and later performance

• Delays of 1 to 2.5 years in overall academic and intellectual competence

• Marked reduction in vocabulary as well as expressive and receptive language skills

• Fewer skills in interacting with “teachers” and peers in a learning environment

• Lack of supportive learning at home and in summer further increases “the gap” over the first 4 years in school

Key Research Question for Abecedarian (ABC) Project

Can the cumulative developmental toll experienced by high-risk childrenbe prevented or reduced significantlyby providing systematic, high-quality, early childhood education frombirth through kindergarten entry?

Control Group _• Adequate nutrition• Supportive social services• Low-cost or free primary

health care

Abecedarian Preschool Program

Treatment Group _• Adequate nutrition• Supportive social services• Free primary health care• Preschool treatment:

Intensive (full day, 5 days/week,50 weeks/year, 5 years)

“Learningames” CurriculumCognitive / Fine MotorSocial / SelfMotorLanguageIndividualized pace

Campbell & Ramey, 1995American Educational Research Journal

Pre-K Educational Treatment prevents decline in children’s low-IQ classification (% with IQs <85)

Martin, Ramey, & Ramey, 1990American Journal of Public Health

Estimated Influences on IQ

Regression Coefficients (95% CI)

Age in MonthsEducational Preschool

Maternal IQ<70Positive Home Enviornment

12 + 7.9 1.0 + 4.9

24 + 12.7 - 4.3 + 5.1

36 + 18.6 - 8.2 + 8.6

48 + 13.2 - 11.7 + 8.9

Adapted from Martin, Ramey, & Ramey, American Journal of Public Health, 1996

Reading achievement scores are significantly higher for ABC children at 8, 12, 15, & 21yrs

Campbell & Ramey, 2001 Developmental Psychology

ABC educational program reduced grade repetition and special education placement

Ramey & Ramey, 1999 MR/DD Research Review

Key Findings from Abecedarian Project(“Abecedarian” …one who learnsthe basics such as the alphabet)

18 Months to 30 Years Old• Intelligence (IQ)• Reading and math skills• Academic locus-of-control• Social Competence• Years in school,

including college• Employment outcomes

• Grade Repetition• Special Education

placement• Teen Pregnancies• Smoking and drug

use• Teen depression

Plus benefits to mothers of these children (education, employment)

Ramey et al, 2000; Campbell et al, 2009

Project CARE

RCT designed to be a replication of

Abecedarian Project (ABC)

with an additional home visit group

to help mothers use the

ABC educational curriculum (6 wks– 5 yrs)

Abecedarian Project

Age in Months (assessment type)3(MDI) 6(MDI) 12(MDI) 18(MDI) 24(S-B) 36(S-B)

60

70

80

90

100

110

120

130Early Intervention

Follow-up

Ramey & Ramey, Preventive Medicine, 1998

Project CARE

Age in Months (assessment type)6(MDI) 12(MDI) 18(MDI) 24(S-B) 36(S-B)

60

70

80

90

100

110

120

130Early Intervention

Follow-up

Ramey & Ramey Preventive Medicine, 1998

Adapted from Wasik, Ramey, Bryant, & Sparling. Child Development, 1990

Infant Health and Development Program (IHDP)

•Designed to test the efficacy of ABC intervention

for children who were < 37 weeks

gestation and < 2500 gm at birth•Conducted at 8 sites•Intervention modified for biological risk factors•Intervention lasted only until 36 mos. CA

Infant Health and Development Program

(2001-2500 grams)

Children’s IQ at 36 months: Maternal Education X Treatment Group

70

75

80

85

90

95

100

105

110

Some HighSchool

High SchoolGraduate

Some College CollegeGraduate

Control

Intervention

(n=232)(n=162) (n=166)(n=104) (n=134)(n=63) (n=76)(n=48)

Infant Health and Development Program

Ramey & Ramey (1998), Preventive Medicine

Outcomes Affected Positively (*p<.01) by the Infant Health & Development Program

12 Months 24 Months 36 Months

Cognitive Development NS + +

Adaptive and Prosocial Behavior - - +

Behavior Problems - + +

Vocabulary - + +

Receptive Language - + +

Reasoning - - +

Home Environment NS - +

Maternal Interactive Behavior - - +

Maternal Problem Solving - - +

Ramey 1999, adapted from Gross, Spiker, & Haynes, 1997, Helping Low Birth Weight, Premature Babies

Did IHDP benefits last?

• Follow-up through age 18 showed significant benefits, particularly for children from low-resource families

• The dosage of the early intervention predicted magnitude of benefits, even after multiple adjustments for correlated variables

Differential response to early educational intervention

The children who benefited the most had: mothers with IQs below 70 mothers with low levels of education poor birth outcome indicators

(PI, Apgar, LBW) teen mothers

(Martin, Ramey, and Ramey, American Journal of Public Health, 1990; Ramey & Ramey, 2000)

Recent findings from Maryland and Louisiana Pre-K initiatives

• Strong visionary leadership and commitment to pre-K as a means of improving student achievement and “closing the gap” for children of poverty

• Willingness to conduct research that will provide timely information to inform changes in the classroom practices and policy

• The programs differ in ways that provide insights about benefits of full-day vs half-day pre-K and differential risk

Similarities in MD and LA Pre-K programs

• Implemented by public schools

• Certified early childhood teachers (full benefits, comparable salaries to other teachers)

• Classroom sizes of no more than 20

• Adult to child ratio of no more than 1 to 10

• Specified pre-K curriculum in resource-rich classrooms and high standards

• Ongoing professional development

• Strong focus on language and early literacy

Differences in MD and LA Pre-K

• MCPS Pre-K classrooms are half-day while LA classrooms are full-day

• Children in LA4 start at slightly lower levels than do children in MCPS

• MCPS classrooms serve more diverse children in terms of nationality and language backgrounds

• LA4 is not limited to “at risk” students, while MCPS currently is

• LA4 implemented longitudinal data collection from the beginning, for all children and for all classrooms, linked to later school progress

LA4 Study Design: Population-based, Cohort Sequential, Case/Control

Longitudinal Study

• Pilot year (Jan – May 2002) n=1358• Cohort 1 (2002-2003) n=3711• Cohort 2 (2003-2004) n=4767• Cohort 3 (2004-2005) n=4665• Cohort 4 (2005-2006) n=7998• Cohort 5 (2006-2007) n>10,000Note: LA legislature committed $82 million for

2007-2008 school year

DSC: Language National Percentile Ranks

31

14

50

10

50

10

50

10

50

10

0

10

20

30

40

50

60

Pre Post Pre Post Pre Post Pre Post Pre Post

Per

cen

tile

PilotHalf-Year (n=1358)

Cohort 1 Full Year (n=3711)

Cohort 2 Full Year (n=4767)

Cohort 3 Full Year (n=4665)

Cohort 4 Full Year (n=7898)

DSC: Print National Percentile Ranks

40

17

59

11

59

11

59

11

59

11

0

10

20

30

40

50

60

70

Pre Post Pre Post Pre Post Pre Post Pre Post

Per

cen

tile

PilotHalf-Year (n=1358)

Cohort 1 Full Year (n=3711)

Cohort 2 Full Year (n=4767)

Cohort 3 Full Year (n=4665)

Cohort 4 Full Year (n=7898)

DSC: Math National Percentile Ranks

30

11

46

5

46

5

52

5

52

5

0

10

20

30

40

50

60

Pre Post Pre Post Pre Post Pre Post Pre Post

Per

cen

tile

PilotHalf-Year (n=1358)

Cohort 1 Full Year (n=3711)

Cohort 2 Full Year (n=4767)

Cohort 3 Full Year (n=4665)

Cohort 4 Full Year (n=7898)

Louisiana Kindergarten Retention Rates (2003-04 Cohort)

7.4%

12.5%*

7.0%

8.0%*

0%

2%

4%

6%

8%

10%

12%

14%

Free and Reduced Meals* Non-Free and Reduced Meals

No Public Pre-K orHead StartLA 4

n = 22,105 n = 2,886 n = 13,257 n = 555

* p <.001

11.8%*

6.6%7.5%*

5.0%

0%

2%

4%

6%

8%

10%

12%

14%

Free and Reduced Meals* Non-Free and Reduced Meals

No Public Pre-K orHead StartLA 4

Louisiana Kindergarten Retention Rates (2004-05 Cohort)

n = 17,416 n = 3,132 n = 11,785 n = 666

* p <0.001

10.5%*

14.5%**

7.0%*

8.6%**

0%

2%

4%

6%

8%

10%

12%

14%

16%

Free and Reduced Meals** Non-Free and Reduced Meals*

No Public Pre-K orHead StartLA 4

Louisiana Special Education Placement Rates (2003-04 Cohort)

n =23,523 n=2,994 n =14,841 n=698

* p <.01

** p <.001

9.3%*

14.1%**

5.8%*

9.0%**

0%

2%

4%

6%

8%

10%

12%

14%

16%

Free and Reduced Meals** Non-Free and Reduced Meals*

No Public Pre-K orHead StartLA 4

Louisiana Special Education Placement Rates (2004-05 Cohort)

n =21,421 n=3,835 n =14,201 n=912

* p <.01

** p <.001

10

50

31

14

30

0

10

20

30

40

50

60

Pre Post

Nat

iona

l Per

cent

ile R

ank

LA4 Full-Year Full-Day Pre-KLA4 Half-Year Full-Day Pre-KMCPS Full-Year Half-Day Pre-K

A Comparison of Children’s Academic Progressin Pre-K Programs that differ in dosage

Why Some Well-Intended Early Childhood Programs Have Failed to Benefit Children

• Adult caregivers and teachers not well prepared

or supported in their everyday work • Dosage of early intervention and pre-K is too low• Inadequate instruction to promote cognitive, language,

early literacy, and early math skills • Ineffective communication with and engagement of

parents and other key service providers • Instruction is too harsh, rigid, or punitive

The future for our nation’s children

• Positive health and education outcomes can be achieved for all children – during pre-K years and beyond

• Benefits include much more than “academics”

• Language and reading success are key, because they influence all learning and social adjustment

• Strategic investments yield substantial social and fiscal benefits to society

For copies of this powerpoint presentation:

• Contact Drs. Craig and Sharon Ramey

• Georgetown University Center on Health and Education

• 202-687-2874

• ctr5@georgetown.edu

• sr222@georgetown.edu