Nov 16, 2017
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Motivated by the growing knowledge of the importance of the first five years of life for promoting lifelong health and well-being, especially for children at greatest risk of poor outcomes, RAND researchers have conducted a series of reviews to assess and summarize the evidence for early childhood programs.
Their latest synthesis confirms earlier findings that programs, such as home visiting, parent education, and early care and education (ECE) — alone or in combination — can have a positive influence on children's development in multiple domains. The updated research also bolsters earlier findings that effective programs can largely pay for themselves, especially in the long term.
The findings should increase the confidence on the part of policymakers, funders, program implementers, and other stakeholders that effective early childhood programs can be a worthwhile investment, benefiting participating children and their families, as well as society as a whole. This brief discusses those findings and other highlights from Investing Early: Taking Stock of Outcomes and Economic Returns from Early Childhood Programs.
This research builds on earlier RAND studies spanning nearly two decades, including Early Childhood Interventions: Proven Results, Future Promise. This latest study is the most comprehensive and up-to-date, examining far more programs with scientifically sound evaluation evidence than previous reports: 115 programs in total, 25 of which also had accompanying formal economic evaluations (i.e., a cost analysis, cost-effectiveness analysis, or benefit–cost analysis [BCA]). Drawing on this evidence base, the study addressed the following questions:
Answers to these questions, based on the larger body of evaluations now available, provide richer information about the research base for investing early and provide greater confidence in findings related to early childhood program effectiveness and economic returns.
We identified four primary approaches to early childhood education based on our conceptual framework for how early interventions contribute to child outcomes — that is, through child development inputs, parenting capacity, or both. Nearly 80 percent of the 115 programs we reviewed used primarily a single approach, and the rest used a combination (Figure 1). The four approaches are
Most of the programs reviewed targeted low-income households, although some programs provided services universally. The majority provided services for less than a year (typical of ECE programs, for example), while about 20 percent (mostly involving home visiting alone or in combination with another approach) offered services for three years or more.
Nearly all of the 115 program evaluations we reviewed used randomized control trials to compare outcomes for those participating in a given program with those who are not. The evaluations examined 3,183 child outcomes, and more than three-quarters of these outcomes were in three domains: behavior and emotion (29 percent), cognitive achievement (26 percent), and child health (21 percent). The remaining outcome domains captured other aspects of child development, educational performance, and adolescence and adulthood (e.g., those pertaining to crime, the labor market, family formation, and use of social services).
Of the 115 programs, 102 had a positive effect on at least one child outcome, and nearly one in three of the reported child outcomes across all the programs were improved (see Figure 2). Early childhood programs have long been considered one of the few policy areas in which evidence demonstrates that they work, so it might come as a surprise that only about one-third of all outcomes measured were demonstrably favorable. However, statistically, one would expect about one in 20 outcomes to improve at random; the fact that this analysis shows improvement in roughly six of 20 outcomes indicates that the positive impacts are not simply due to chance.
Prior work by RAND and other researchers has demonstrated that the impacts of early childhood programs can be sizable. For example, RAND's 2005 study found an average effect size of 0.33 for early cognitive skills measured near the beginning of elementary school for nine programs using a combination of approaches and 0.21 for six single-approach programs. These effect size magnitudes are consistent with the range of 0.1 to 0.4 that other meta-analyses of various types of early childhood programs have found.
This new study adds to the evidence base by assessing the effect sizes for several commonly measured health outcomes: birth outcomes, body mass index (BMI), and substance use. The estimated average effect size, based on a meta-analysis, was small (0.05) but varied for each domain:
ECE programs had larger effects than other program approaches for the three health outcome categories combined, though its 0.12 pooled effect size is at the low end of the 0.1-to-0.4 range mentioned earlier for outcomes more generally.
Although the researchers found more early childhood programs with economic evaluations than in prior reviews (25 of 115 programs, 19 of which included formal BCAs), economic evaluations still are not routinely conducted.
The available evaluations show that costs ranged from about $150 per family for a parent education program to nearly $48,800 per family for an ECE program that also provided home visiting and other comprehensive services (all in 2016 dollars). The range in costs is almost as large among programs that use the same approach. For example, the six home visiting programs with cost estimates ranged from about $720 to $10,200 per family. Much of the difference is due to the intensity and duration of services, as well as differences in local prices for personnel, facilities, and other resources.
The available BCAs demonstrate that early childhood education programs can pay for themselves. For the 19 programs with BCAs, the benefit–cost ratios are typically in the range of $2 to $4 for every $1 invested, although higher (and lower) ratios are possible. Positive economic returns are evident for three of the four main program approaches identified and many of the combination approaches. The researchers also found favorable economic benefits for both less and more resource-intensive programs and for programs using both targeted and universal approaches (that is, approaches targeting specific populations, such as low-income families, and approaches available to all families in the program area).
Such estimates demonstrate the proof of the principle that early childhood programs can more than pay for their costs through immediate and downstream benefits. However, such estimates come with considerable uncertainty, given that they are based on estimates of program impact that are uncertain, that some beneficial outcomes cannot be expressed in monetary terms, and that later benefits cannot be observed without longer-term follow-up.
The research has several implications for policymakers, practitioners, researchers, and others engaged with early childhood programs.
For policymakers and practitioners, research on early childhood program effectiveness and economic returns can help inform how decisionmakers in the public and private sectors set policy with respect to such programs and how practitioners implement them. The findings have implications for both policy and practice:
For researchers, the synthesis of research evidence points to opportunities and challenges for the research community to further advance understanding of early childhood program effectiveness and economic impact. The findings have implications for ongoing dissemination of the research evidence: