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Research Questions

  1. What program approaches to providing services for families and children from the prenatal period to school entry have been rigorously evaluated?
  2. What outcomes did these programs improve in the short or long term?
  3. What are the costs and benefits of effective programs and returns to government or society?

The past two decades have been characterized by a growing body of research from diverse disciplines — child development, psychology, neuroscience, and economics, among others — demonstrating the importance of establishing a strong foundation in the early years of life. The research evidence has served to document the range of early childhood services that can successfully put children and families on the path toward lifelong health and well-being, especially those at greatest risk of poor outcomes. As early childhood interventions have proliferated, researchers have evaluated whether the programs improve children's outcomes and, when they do, whether the improved outcomes generate benefits that can outweigh the program costs. This report examines a set of evaluations that meet criteria for scientific rigor and synthesizes their results to better understand the outcomes, costs, and benefits of early childhood programs. The authors focus on evaluations of 115 early childhood programs serving children or parents of children from the prenatal period to age 5. Although preschool is perhaps the best-known early childhood intervention, the study also reviewed such programs as home visiting, parent education, government transfers providing cash and in-kind benefits, and those that use a combination of approaches. The findings demonstrate that most of the reviewed programs have favorable effects on at least one child outcome and those with an economic evaluation tend to show positive economic returns. With this expanded evidence base, policymakers can be highly confident that well-designed and -implemented early childhood programs can improve the lives of children and their families.

Key Findings

Programs Varied in Approach

  • The 115 early childhood programs included in the study use a range of approaches, including early care and education, home visiting, parent education, and transfers.

Evaluations Measured Short- and Longer-Term Outcomes in Multiple Domains

  • The domains included behavior and emotion; cognitive achievement; child health; developmental delay; child welfare; crime; educational attainment; and employment and earnings, family formation, and uses of social services in adulthood.

Early Childhood Programs Can Improve an Array of Early and Later Outcomes

  • Most included programs — 102 of 115 — have demonstrable impacts on at least one child outcome. Almost one in three measured outcomes were improved.

Sizes of Improvements in Outcomes Vary

  • Other meta-analyses of early intervention programs found effect sizes on child outcomes in the range of 0.1 to 0.4 for the cognitive achievement or the behavior and emotion domains, and the authors estimated effect sizes for three health outcomes ranging from 0 to 0.15.

Resources Required for Early Childhood Programs Vary Widely

  • Available cost estimates for 25 of the 115 programs range from about $150 per family to nearly $48,800 per family, reflecting, in part, differences in program intensity and duration of program services.

Most Programs with Benefit–Cost Analyses Show Positive Returns

  • Estimated benefit–cost ratios for the 19 programs with formal benefit–cost analyses are typically in the range of $2 to $4 for every dollar invested, when viewed from the societal perspective.
  • Estimates of economic return come with considerable uncertainty given that program impacts must be estimated, some outcomes cannot be expressed in monetary terms, and later benefits are not observed without longer-term follow-up.


  • With a robust base of early childhood programs that have been proven to be effective based on rigorous evaluation, decisionmakers should integrate other criteria when selecting programs to implement.
  • Program implementers adopting or expanding evidence-based models should pay attention to quality of replication and effects of scale-up.
  • Decisionmakers would benefit from head-to-head evaluations of early childhood programs.
  • The next generation of research needs to get inside the black box of effective programs to provide information on which program components drive effectiveness.
  • Early childhood programs improve a range of outcomes, so evaluations should collect outcomes across a range of domains.
  • Outcomes for two generations should be captured in early childhood program research.
  • There is a need for more studies that conduct longer-term follow-up to determine whether early program impacts are sustained.
  • Incentivizing cost data collection, as well as standardizing BCA methods, would facilitate comparisons across programs.

The research described in this report was by the Robert Wood Johnson Foundation and conducted by RAND Labor and Population.

This report is part of the RAND research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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