Analyzing social experiments as implemented: A reexamination of the evidence from the HighScope Perry Preschool Program

Moving Beyond Point in Time Estimates: Using Growth Models to Understand When PreK Convergence Happens, How, and for Which Skills

This study examines associations between enrollment in high-quality PreK and growth in children's (N = 422; Mage = 5.63 years; 47% female; 15% Asian, 19% Black, 30% White, 31% Hispanic; 5% other or mixed race) academic, executive functioning, and social-emotional skills across kindergarten (2017-2018) and first grade (2018-2019). Associations between PreK enrollment and language and math skills were sustained through first grade. More convergence between PreK enrollees and non-enrollees in language skills occurred during first grade than kindergarten. Convergence patterns were stronger in math during kindergarten than in first grade. There were no associations between PreK enrollment and executive functioning by spring of first grade; most convergence occurred in first grade. All other associations were null by first grade.

Concurrent Validity of the Bayley Screening and the Bayley-III in Persian-Speaking Children

Objectives

This study aims to determine the concurrent validity of the Bayley-III and the Bayley screening in Persian-speaking children. Measuring child development with the Bayley-III can be time-consuming and expensive. Accordingly, this research seeks to assess the accuracy of the Bayley screening as a measure of developmental delay for high-risk infants by age group.

Materials & Methods

Concurrent validity between raw Bayley screening scores and Bayley-III scores was assessed by administering to 403 1-42 month-old children. The cut score of 1.0 standard deviation below the mean of two tests was calculated using the Bayley-III as the criterion measure. This study used 70% of the sensitivity and specificity cut scores to measure validity. In addition, the study calculated the Pearson and Cohen's kappa correlation for the association between the two measures.

Results

The sensitivity of cognitive, receptive, and expressive communication, fine, and gross motor scales of Bayley screening were 70.7, 81.4, 67.7, 60.7, and 58.1, respectively. Specificity values varied narrower, from 87.8% to 100%. The Cohen's kappa coefficient in all age groups was substantial. The Pearson correlation between two test scores is significant for all scales, although the coefficients are over 0.884. The sensitivity and specificity have no specific trends with children's age, and the best sensitivity concurrence on the two tests was in the 1-12 months old age range.

Conclusion

The study supports the concurrent validity of the Bayley screening, showing an assertive and significant association between Bayley screening and Bayley-III in Persian-speaking children.

Long-term impact evaluation of early childhood conditions When only short-term outcomes are available

Over the past two decades, socio-economic research has highlighted and empirically demonstrated the importance of investing in early childhood development for long-term life outcomes. In response, governments and foundations have increasingly allocated resources to preschool initiatives, promoting formal childcare, encouraging access to libraries and playrooms, and facilitating parent-child activities aimed at enhancing parenting skills. While the short-term effects of many of these policies are frequently assessed, evaluating their long-term impact remains challenging due to high costs and logistical complexities. How can meaningful insights into long-term effects be derived when only short-term outcomes are available? Adopting the "surrogacy" framework proposed by Athey et al. (2024) and using data from the Millennium Cohort Study (UK), we predict long-term outcomes assuming only short-term outcomes are available, and compare them with the actual ones. This analysis introduces a valuable tool for policymakers and program evaluators, helping to identify key outcome variables for impact assessment and the prediction of long-term effects.

Delay of gratification and adult outcomes: The Marshmallow Test does not reliably predict adult functioning

This study extends the analytic approach conducted by Watts et al. (2018) to examine the long-term predictive validity of delay of gratification. Participants (n = 702; 83% White, 46% male) completed the Marshmallow Test at 54 months (1995-1996) and survey measures at age 26 (2017-2018). Using a preregistered analysis, Marshmallow Test performance was not strongly predictive of adult achievement, health, or behavior. Although modest bivariate associations were detected with educational attainment (r = .17) and body mass index (r = -.17), almost all regression-adjusted coefficients were nonsignificant. No clear pattern of moderation was detected between delay of gratification and either socioeconomic status or sex. Results indicate that Marshmallow Test performance does not reliably predict adult outcomes. The predictive and construct validity of the ability to delay of gratification are discussed.

Can Early Intervention have a Sustained Effect on Human Capital?

Many early intervention studies experience a dissolution of treatment effects in the aftermath of the intervention. Using a randomized trial, this paper examines the impact of Preparing for Life, a pregnancy to age five home visiting and parenting program, on outcomes in middle childhood. I find significant treatment effects on cognitive skills (0.55SD) and school achievement tests (0.30-0.54SD) at age nine. There is no impact on socio-emotional skills and there is little evidence of treatment heterogeneity by gender, birth order, or distribution of ability. The effects are mainly driven by improvements in early parental beliefs.

Dealing with imperfect randomization: Inference for the highscope perry preschool program

This paper considers the problem of making inferences about the effects of a program on multiple outcomes when the assignment of treatment status is imperfectly randomized. By imperfect randomization we mean that treatment status is reassigned after an initial randomization on the basis of characteristics that may be observed or unobserved by the analyst. We develop a partial identification approach to this problem that makes use of information limiting the extent to which randomization is imperfect to show that it is still possible to make nontrivial inferences about the effects of the program in such settings. We consider a family of null hypotheses in which each null hypothesis specifies that the program has no effect on one of several outcomes of interest. Under weak assumptions, we construct a procedure for testing this family of null hypotheses in a way that controls the familywise error rate - the probability of even one false rejection - in finite samples. We develop our methodology in the context of a reanalysis of the HighScope Perry Preschool program. We find statistically significant effects of the program on a number of different outcomes of interest, including outcomes related to criminal activity for males and females, even after accounting for the imperfectness of the randomization and the multiplicity of null hypotheses.

You are What Your Parents Expect: Height and Local Reference Points

Recent estimates are that about 150 million children under five years of age are stunted, with substantial negative consequences for their schooling, cognitive skills, health, and economic productivity. Therefore, understanding what determines such growth retardation is significant for designing public policies that aim to address this issue. We build a model for nutritional choices and health with reference-dependent preferences. Parents care about the health of their children relative to some reference population. In our empirical model, we use height as the health outcome that parents target. Reference height is an equilibrium object determined by earlier cohorts' parents' nutritional choices in the same village. We explore the exogenous variation in reference height produced by a protein-supplementation experiment in Guatemala to estimate our model's parameters. We use our model to decompose the impact of the protein intervention on height into price and reference-point effects. We find that the changes in reference points account for 65% of the height difference between two-year-old children in experimental and control villages in the sixth annual cohort born after the initiation of the intervention.

Surname order and revaccination intentions during the COVID-19 pandemic

Teachers in Japanese schools employ alphabetical surname lists that call students sooner, with surnames appearing early on these lists. We conducted Internet surveys nearly every month from March 2020 to September 2022 with the same participants, wherein we asked participants where the alphabetical columns of their childhood and adult surnames were located. We aimed to identify how surname order is important for the formation of noncognitive skills. During the data collection period, the COVID-19 vaccines became available; Japanese people could receive their third dose starting in December 2021. The 19th wave of the survey was conducted in January 2022. Therefore, to examine how a surname's alphabetical order could influence intention to revaccinate, we used a subsample of data from December 2021 to September 2022. The major findings were as follows. Women with early surnames had an approximately 4% stronger likelihood of having such intentions than men with early surnames. Early name order was more strongly correlated with revaccination intention among women than among men. The surname effect for women was larger when a mixed-gender list was used compared with when it was not used. This effect was only observed for childhood surnames and not for adult surnames.

The Dynastic Benefits of Early-Childhood Education: Participant Benefits and Family Spillovers

We demonstrate the social efficiency of investing in high-quality early childhood education using newly collected data from the HighScope Perry Preschool Project. The data analyzed are the longest follow-up of any randomized early childhood education program. Annual observations of participant outcomes up to midlife allow us to provide a cost-benefit analysis without relying on forecasts. Adult outcomes on the participants' children and siblings allow us to quantify spillover benefits. The program generates a benefit-cost ratio of 6.0 (p-value = 0.03). Spillover benefits increase this ratio to 7.5 (p-value = 0.00).

A quantitative assessment of the frequency and magnitude of heterogeneous treatment effects in studies of the health effects of social policies

Substantial heterogeneity in effects of social policies on health across subgroups may be common, but has not been systematically characterized. Using a sample of 55 contemporary studies on health effects of social policies, we recorded how often heterogeneous treatment effects (HTEs) were assessed, for what subgroups (e.g., male, female), and the subgroup-specific effect estimates expressed as Standardized Mean Differences (SMDs). For each study, outcome, and dimension (e.g., gender), we fit a random-effects meta-analysis. We characterized the magnitude of heterogeneity in policy effects using the standard deviation of the subgroup-specific effect estimates (τ). Among the 44% of studies reporting subgroup-specific estimates, policy effects were generally small (<0.1 SMDs) with mixed impacts on health (67% beneficial) and disparities (50% implied narrowing of disparities). Across study-outcome-dimensions, 54% indicated any heterogeneity in effects, and 20% had τ > 0.1 SMDs. For 26% of study-outcome-dimensions, the magnitude of τ indicated that effects of opposite signs were plausible across subgroups. Heterogeneity was more common in policy effects not specified a priori. Our findings suggest social policies commonly have heterogeneous effects on health of different populations; these HTEs may substantially impact disparities. Studies of social policies and health should routinely evaluate HTEs.

The Lasting Effects of Early-Childhood Education on Promoting the Skills and Social Mobility of Disadvantaged African Americans and Their Children

This paper demonstrates the long-term intragenerational and intergenerational benefits of the HighScope Perry Preschool Project, which targeted disadvantaged African-American children. We use newly collected data on the original participants through late middle age and on their children into their mid-twenties. We document long-lasting improvements in the original participants' skills, marriage stability, earnings, criminal behavior, and health. Beneficial program impacts through the childrearing years translate into better family environments for their children leading to intergenerational gains. Children of the original participants have higher levels of education and employment, lower levels of criminal activity, and better health than children of the controls.

Parenting Promotes Social Mobility Within and Across Generations

This paper compares early childhood enrichment programs that promote social mobility for disadvantaged children within and across generations. Instead of conducting a standard meta-analysis, we present a harmonized primary data analysis of programs that shape current policy. Our analysis is a template for rigorous syntheses and comparisons across programs. We analyze new long-run life-cycle data collected for iconic programs when participants are middle-aged and their children are in their twenties. The iconic programs are omnibus in nature and offer many services to children and their parents. We compare them with relatively low-cost more focused home-visiting programs. Successful interventions target both children and their caregivers. They engage caregivers and improve the home lives of children. They permanently boost cognitive and non-cognitive skills. Participants in programs that enrich home environments grow up with better skills, jobs, earnings, marital stability, and health, as well as reduced participation in crime. Long-run monetized gains are substantially greater than program costs for the iconic programs. We investigate the mechanisms promoting successful family lives for participants and report intergenerational effects on their children. A study of focused home-visiting programs that target parents enables us to isolate a crucial component of successful programs: they activate and promote parenting skills of child caregivers. The home-visiting programs we analyze produce outcomes comparable to those of the iconic omnibus programs. National implementation of the programs with long-run follow up that we analyze would substantially shrink the overall US Black-White earnings gap.

Comparing long-term educational effects of two early childhood health interventions

We compare the educational effects of two medical protocols that mitigate long-term consequences of prematurity or low birth weight. The two protocols are Traditional Care (TC), which uses incubators, and Kangaroo Mother Care (KMC) which replaces incubators for 24-hour skin-to-skin contact between newborns and caregivers. We concentrate on educational outcomes addressing contradictory results in previous contributions. We use a randomized controlled trial implemented in 1993 that randomly assigned children to either TC or KMC. OLS results suggest that KMC children spent more time in preschool, had fewer temporary school absences, and showed lower math test scores. Both groups observed similar effects on high-school graduation and language test scores. We correct for attrition, small sample, and multiple outcomes. Effects on preschool attendance and school absenteeism are robust, particularly for more vulnerable infants (birth weight ≤ 1,800 g). The other effects lose statistical significance due to multiple outcome testing or attrition corrections.

Cognitive, psychosocial, and behaviour gains at age 31 years from the Jamaica early childhood stimulation trial

BACKGROUND

There is little evidence on adult benefits from early childhood interventions in low and middle-income countries. We assessed adult cognition, psychosocial skills and behaviour from a stimulation trial conducted in Jamaica.

METHODS

Children with stunted growth (height-for age <-2SD of references) aged 9-24 months were enrolled in a two-year randomised-controlled trial of nutritional supplementation and/or stimulation. At mean age 31.79 (SD 0.40) years, 95 of 127 participants (74.8%; 53.7% male) were assessed. Children without stunted growth were also followed as a comparison group (64 of 84 participants, 76.2%). Measurements included IQ, executive function, mental health, psychosocial skills, personality traits and risk behaviours. A block permutation test, valid for small sample sizes, was used. Analyses accounted for the randomisation protocol, multiple hypothesis testing and attrition.

RESULTS

Treatment group participants (stimulation intervention with or without supplementation, n = 48) had significantly greater IQ (Hedges g effect size 0. 57; 95%CI 0.20, 0.95) and cognitive flexibility (0.61; 0.25, 0.98) compared with no-treatment (no-intervention and supplementation only, n = 47). They also had reduced depressive symptoms (0.61; 0.28, 1.00), increased grit (0.53; 0.16, 0.92) and conscientiousness (0.66; 0.31, 1.07), lower substance use (rank mean score, 0.45; 0.08, 0.81) and risk taking related to health and work (0.64; 0.27, 1.00). There were 18 significant outcomes of 33 assessed. Comparison participants had higher IQ than no-treatment (1.17; 0.81, 1.54) and treatment groups (0.62; 0.18, 1.07); and better executive function, lower social inhibition and risk taking than the no-treatment group.

CONCLUSIONS

The wide-ranging benefits at 31 years from the stimulation intervention supports investment in larger scale programmes to promote early childhood development in disadvantaged children. The lower IQ in the treatment group compared with comparison participants, emphasises the need for continued efforts to prevent early childhood growth retardation.

Childhood Sporting Experience and Charitable Donations to Disaster Victims

I investigated how people’s childhood experiences of involvement in team sports helped them develop non-cognitive skills, which later prompted them to make charitable donations to disaster victims. I independently collected individual-level data from approximately 7000 observations in 2016. The instrumental variable (IV) method was used for the estimations. In the specification of the IV model, sporting experience and informal education in childhood were used as exogenous IV. I found that (1) sporting experiences cause people to have positive subjective views of reciprocity, (2) team sports experience has a larger effect on people than individual sports experience, and (3) the above lead people to donate to disaster victims of enormous disasters such as the Great East Japan Earthquake.

Long-term effects of a community-based positive youth development program for Black youth: health, education, and financial well-being in adulthood

BACKGROUND

Childhood poverty is known to be associated with poor health. For youth living in extreme poverty, community-based programs focused on youth development are one strategy to improve health and well-being outcomes. However, very few evaluations of the long-term effectiveness of youth development programs have been conducted. The aim of this study was to assess the long-term effectiveness of a positive youth development program (PYD), serving a segregated housing project with a history of community violence, to improve the health, education, and financial well-being of its alumni.

METHODS

A quasi-experimental causal comparative study design was used to study the effectiveness of the Cabrini-Green Youth Program (CGYP). CGYP alumni (mean: 16.8 +/- 7.4 years after program participation) were surveyed. For comparison, participants from the same housing project who were eligible to participate in the CGYP but did not, were identified.

RESULTS

In total, 246/417 (59%) eligible alumni were located. 221 alumni were available to be interviewed; 191/221 (86%) completed the interview survey along with 143 in the comparison group. Both groups self-identified as being Black, African American, and of Other race. Alumni were younger (34.6 vs. 38.1 years, p < .001), less likely to be female (62% vs. 74%, p =.03), and more likely to have been abused as a child (26% vs. 11%, p = .001). The majority in both groups reported to be in good to excellent health (83% of alumni vs. 74% of comparison group). After adjusting for comparison group differences, alumni were more likely to have completed college, 24% vs. 12% (adjusted odds ratio (aOR) 2.47, 95% CI, 1.25-4.86), and to end up with some money at the end of the month, 35% vs. 19% (aOR 2.16, 95% CI, 1.17, 3.97).

CONCLUSIONS

Participation in a PYD program starting at a young age may be associated with reduced poverty in adulthood, possibly aided by higher educational attainment and resultant increased income. PYD may be an effective strategy to supplement evidenced-based poverty reducing policies. This study of a voluntary, community-based PYD program is unique in its up to 33-year follow-up and an outcome assessment that measures more than knowledge change.

Home Visiting and Early Childhood Education for Reducing Justice System Involvement

Early childhood intervention is particularly cost-beneficial when it reduces justice involvement, but ingredients that contribute to this outcome are unknown. The goal of this study was to estimate the effects of two common early childhood intervention ingredients-home visits and center-based education-on juvenile justice involvement. The Infant Health and Development Program (IHDP) randomized 1090 premature and low-birth-weight babies to intervention or control groups. Intervention group families were offered home visits from birth to age 3 years and high-quality center-based early childhood education from ages 1 to 3 years, but varied in their take-up of each intervention component. We estimated (1) intent-to-treat effects and (2) the effects of families' level of participation in each intervention component, using a novel stratification approach to minimize the impact of self-selection bias on dosage. Outcomes were children's risk of being stopped by police, arrested, or incarcerated, by age 18 years. Intent-to-treat analyses showed no effects of the IHDP for both sexes combined, nor for girls only, on any of the three outcomes, but there was an intent-to-treat effect on boys' risk of being arrested, OR = 0.43 (95% CI 0.24, 0.76). Analyses of dosage effects showed that, for both sexes combined, participation in the center-based educational component decreased the odds of being stopped by the police by 3% for each month of services. For boys only, the odds of being arrested decreased by 4% with each month of home visits and by 4% with each month of center-based educational services. We conclude that high-quality center-based early childhood education and, to some extent, home visits, reduce justice involvement among biologically vulnerable children, especially boys.

Early childhood education and life-cycle health

This study forecasts the life-cycle treatment effects on health of a high-quality early childhood program. Our predictions combine microsimulation using nonexperimental data with experimental data from a midlife long-term follow-up. The follow-up incorporated a full epidemiological exam. The program mainly benefits males and significantly reduces the prevalence of heart disease, stroke, cancer, and mortality across the life-cycle. For men, we estimate an average reduction of 3.8 disability-adjusted life years (DALYs). The reduction in DALYs is relatively small for women. The gain in quality-adjusted life years is almost enough to offset all of the costs associated with program implementation for males and half of program costs for women.

Nationwide evidence that education disrupts the intergenerational transmission of disadvantage

We leveraged a three-generation approach in 2.1 million Danes to measure the transmission and disruption of multiple health and social disadvantages: poor physical health, poor mental health, social welfare dependency, criminal offending, and protective services involvement. Health and social disadvantages clustered within a small segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who appeared in protective services records. Education disrupted these statistical associations between and within generations and between and within families. If associations are causal, investing in young people’s education potential could interrupt the multigenerational cycle of disadvantage and reduce health and social inequalities.

Despite overall improvements in health and living standards in the Western world, health and social disadvantages persist across generations. Using nationwide administrative databases linked for 2.1 million Danish citizens, we leveraged a three-generation approach to test whether multiple, different health and social disadvantages—poor physical health, poor mental health, social welfare dependency, criminal offending, and Child Protective Services involvement—were transmitted within families and whether education disrupted these statistical associations. Health and social disadvantages concentrated, aggregated, and accumulated within a small, high-need segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who evidenced risk for disadvantage at an early age, through appearance in protective services records. Intra- and intergenerational comparisons were consistent with the possibility that education disrupted this transmission. Within families, siblings who obtained more education were at a reduced risk for later-life disadvantage compared with their cosiblings who obtained less education, despite shared family background. Supporting the education potential of the most vulnerable citizens might mitigate the multigenerational transmission of multiple disadvantages and reduce health and social disparities.

Impacts of universal childcare on early behavioral development: evidence from a birth cohort in Québec, Canada

PURPOSE

To examine associations between universal pre-school childcare use and later behaviors among children at age 6 years.

METHODS

Using annual follow-up data of a birth cohort (N=1450), we estimated differences in behavioral scores by primary childcare arrangement between ages 2-5 years - universal subsidized childcare program (CPE care), non-CPE childcare, and parental or family care (no regular care) - using propensity score inverse probability weights.

RESULTS

Teachers reported slightly higher levels of hyperactivity (0.73, 95% CI: 0.32, 1.1) and indirect aggression (0.58, 95%CI: 0.24, 0.91) among children who attended a CPE than children in non-CPE care. However, these patterns were not observed from either maternal or paternal reports. Similarly, teachers' assessments of slightly higher physical aggression (0.50, 95% CI: 0.11, 0.88) and opposition (0.63, 95% CI: 0.21, 1.05) scores among children in CPE care than children who did not have a regular childcare were not observed in parental assessments. Behavioral scores by childcare arrangement were similar between girls and boys and across family socioeconomic position.

CONCLUSIONS

Universal pre-school childcare does not appear to have substantial impacts on child behaviors at early school age, however teachers rated externalizing behaviors to be slightly higher among children who attended universal childcare.

Contract farming and rural transformation: Evidence from a field experiment in Benin

Contract farming has emerged as a popular mechanism to encourage vertical coordination in developing country agriculture. Yet, there is a lack of consensus on its ability to spur structural transformation in rural economies. We present results from a field experiment on contract farming for rice production in Benin. While all contracts have positive effects on welfare and productivity measures, we find that the simplest contract has impacts nearly as large as contracts with additional attributes. This suggests that once price risk is resolved through the offer of a fixed-price contract, farmers are able to address other constraints on their own.

Using a Satisficing Model of Experimenter Decision-Making to Guide Finite-Sample Inference for Compromised Experiments

This paper presents a simple decision-theoretic economic approach for analyzing social experiments with compromised random assignment protocols that are only partially documented. We model administratively constrained experimenters who satisfice in seeking covariate balance. We develop design-based small-sample hypothesis tests that use worst-case (least favorable) randomization null distributions. Our approach accommodates a variety of compromised experiments, including imperfectly documented re-randomization designs. To make our analysis concrete, we focus much of our discussion on the influential Perry Preschool Project. We reexamine previous estimates of program effectiveness using our methods. The choice of how to model reassignment vitally affects inference.

The effects of expanded social health insurance on young mothers: Lessons from a pro-choice reform in Uruguay

With the implementation of the National Integrated Health System in 2007, the Uruguayan government extended social health insurance (SHI) to groups of individuals previously covered by the public safety net (PSN) or that paid for private insurance out-of-pocket. The policy allowed new beneficiaries to choose care from a set of private providers. In this study, we focus on the extension of SHI to adolescent mothers previously covered by the PSN. Exploiting the gradual incorporation of children of formal workers during the 2008-2013 period, and the geographic variation in the intensity of the reform, we find suggestive evidence that the increase in choice associated to the expansion of SHI decreased adolescent fertility, improved prenatal care and birthweight, and decreased first year mortality among low birthweight infants. These effects were only observed in the medium run, suggesting initial choice frictions and input shortage. We provide evidence that families increased their choice of private providers and that market concentration decreased in certain areas of the country, supporting the hypothesis that choice, and possibly competition, were the main mechanisms behind the findings.

Reliability and validity of the Caregiver Reported Early Development Instruments (CREDI) in impoverished regions of China

Background

There is a great need in low- and middle- income countries for sound qualitative and monitoring tools assessing early childhood development outcomes. Although there are many instruments to measure the developmental status of infants and toddlers, their use in large scale studies is still limited because of high costs in both time and money. The Caregiver Reported Early Development Instruments (CREDI), however, were designed to serve as a population-level measure of early childhood development for children from birth to age three, and have been used in 17 low- and middle-income countries. This study aimed to examine the reliability and validity of the CREDI in China, which is still unknown.

Methods

The CREDI and the ASQ-3 was administered to a sample of 946 children aged 5–36 months from urban and rural communities, in which 248 children was administered with Bayley-III.

Results

The internal consistency of the CREDI was high, which indicates that the scale internal consistency reliability is quite good. The results also indicated that the concurrent validity of the CREDI with the Bayley-III scale was high in general. Ordinary least squares regression showed that the CREDI is highly consistent with previous widely used instruments in some key predictors (such as the home stimulation) of early childhood development level.

Conclusions

All the results in the current study indicate that the CREDI may be considered an appropriate instrument to measure early childhood development status on a large scale in impoverished regions of China.

The New Patterns study: coordinated measures to combat child poverty

Background

Child poverty rates are rising in Norway with potential negative consequences for children. Services for families with low income are often fragmented and poorly integrated, and few coordinated initiatives have been implemented and evaluated in Norway.

Aims:

The aim of the current study is to evaluate how integrated and coordinated services provided over a prolonged period by a family coordinator are related to changes across a wide range of health, wellbeing and home environment indicators for the participants.

Methods:

The study uses a mixed methods approach utilising survey and register data, as well as information from interviews and shadowing, to document and evaluate outcomes associated with the intervention and the process of implementation. Data are gathered at baseline and annually throughout the duration of the study. Participants are identified to facilitate longer-term follow-up using register data.

Conclusions:

This project will develop important knowledge about the implementation of coordinated services to families with a low income, and how this way of organizing services influences important outcomes for the family members in the short and long term.

Quantifying the Life-Cycle Benefits of an Influential Early-Childhood Program

This paper quantifies and aggregates the multiple lifetime benefits of an influential high-quality early childhood program with outcomes measured through midlife. Guided by economic theory, we supplement experimental data with non-experimental data to forecast the life-cycle benefits and costs of the program. Our point estimate of the internal rate of return is 13.7% with an associated benefit/cost ratio of 7.3. We account for model estimation and forecasting error and present estimates from extensive sensitivity analyses. This paper is a template for synthesizing experimental and non-experimental data using economic theory to estimate the long-run life-cycle benefits of social programs.

Clustering of health, crime and social-welfare inequality in 4 million citizens from two nations

Health and social scientists have documented the hospital revolving-door problem, the concentration of crime, and long-term welfare dependence. Have these distinct fields identified the same citizens? Using administrative databases linked to 1.7 million New Zealanders, we quantified and monetized inequality in distributions of health and social problems and tested whether they aggregate within individuals. Marked inequality was observed: Gini coefficients equalled 0.96 for criminal convictions, 0.91 for public-hospital nights, 0.86 for welfare benefits, 0.74 for prescription-drug fills and 0.54 for injury-insurance claims. Marked aggregation was uncovered: a small population segment accounted for a disproportionate share of use-events and costs across multiple sectors. These findings were replicated in 2.3 million Danes. We then integrated the New Zealand databases with the four-decade-long Dunedin Study. The high-need/high-cost population segment experienced early-life factors that reduce workforce readiness, including low education and poor mental health. In midlife they reported low life satisfaction. Investing in young people's education and training potential could reduce health and social inequalities and enhance population wellbeing.

Concurrent validity of the Ages and Stages Questionnaire and the Bayley Scales of Infant Development III in China

Choosing a valid and feasible method to measure child developmental outcomes is key to addressing developmental delays, which have been shown to be associated with high levels of unemployment, participation in crime, and teen pregnancies. However, measuring early childhood development (ECD) with multi-dimensional diagnostic tests such as the Bayley Scales of Infant and Toddler Development III (Bayley-III) can be time-consuming and expensive; therefore, parental screening tools such as the Ages and Stages Questionnaire (ASQ-3) are frequently an alternative measure of early childhood development in large-scale research. The ASQ is also becoming more frequently used as the first step to identify children at risk for developmental delays before conducting a diagnostic test to confirm. However, the effectiveness of the ASQ-3 is uncertain. In this study, we evaluate the accuracy of the ASQ-3 as a screening measure for children at risk of developmental delay in rural China by age group. To do so, we administered the Bayley-III, widely considered to be the “gold standard” of ECD diagnostic tests, to a sample of 1,831 five to twenty-four month-old children and also administered the ASQ-3 to their caregivers. We then compared the outcomes of the ASQ-3 test to those of the Bayley-III. We find that the ASQ-3 was significantly though weakly correlated with the Bayley-III and that the strength of this correlation increased with child age and was stronger when the mother was the primary caregiver (as compared to the grandmother). We also find that the sensitivity and specificity of ASQ-3 ranged widely. The overall findings suggest that the ASQ-3 may not be a very accurate screening tool for identifying developmentally delayed children, especially for children under 13 months of age or children whose primary caregiver is not the mother.

Quality and quantity: The association of state-level educational policies with later life cardiovascular disease

Education is a powerful predictor of cardiovascular morbidity and mortality. While the majority of the literature has focused on years of educational attainment or degree attainment, fewer studies examine the role of educational quality in the prevention of cardiovascular disease (CVD). We tested the hypothesis that average state-level educational quality was associated with CVD, linking state-level data on educational quality with individual demographic and health data from multiple waves of the National Health and Nutrition Examination Survey (N = 34,770). We examined thirteen CVD-related outcomes-including blood pressure, cholesterol, and heart attack-to understand the multiple pathways through which educational quality may influence CVD. The primary predictor was a composite index of educational quality, combining state-level measures of student-teacher ratios, per-pupil expenditures, and school term length. We fit multivariable models, regressing each outcome on the educational quality composite index and adjusting for individual- and state-level covariates. We also assessed whether the association between state educational quality and CVD differed for less educated individuals. Overall, higher educational quality was associated with less smoking (OR = 0.86, 95%CI: 0.77, 0.97), but there was no statistically significant association for the other 12 outcomes. Interaction tests indicated that less educated individuals benefited less from higher educational quality relative to those with more education for several outcomes. Our study suggests that state-level educational quality is not strongly associated with CVD, and that this null association overall may mask heterogeneous benefits that accrue disproportionately to those with higher levels of education.

Effects of early childhood intervention on fertility and maternal employment: Evidence from a randomized controlled trial

This paper presents the results of a randomized study of a home visiting program implemented in Germany for low-income, first-time mothers. Besides improving child health and development, a major goal of the program is to improve the participants' economic self-sufficiency and family planning. I use administrative data from the German social security system and detailed telephone surveys to examine the effects of the intervention on maternal employment, welfare benefits, household composition, well-being, and fertility behavior. The study reveals that the intervention decreased maternal employment by 9.3 percentage points and increased subsequent births by 6.4 percentage points, in part through a reduction in abortions.

Early childhood education and crime

This article presents new evidence on the crime-reducing impacts of a high-quality, intensive early childhood program with long-term follow-up, evaluated by a randomized controlled trial. Proportionately, more women than men decrease their criminal activity after participating in the program. This gender difference arises because of the worse home environments for girls, with corresponding greater scope for improvement by the program. For both genders, treatment effects are larger for the least-advantaged children, as measured by their mother's education at baseline. The dollar value of the social cost of criminal activity averted is higher for men because they commit more costly violent crimes.

A systematic review and meta-analysis of effects of early life non-cognitive skills on academic, psychosocial, cognitive and health outcomes

Success in school and the labour market relies on more than high intelligence. Associations between "non-cognitive" skills in childhood, such as attention, self-regulation, and perseverance, and later outcomes have been widely investigated. In a systematic review of this literature, we screened 9553 publications, reviewed 554 eligible publications, and interpreted results from 222 better quality publications. Better quality publications comprised randomised experimental and quasi-experimental studies (EQIs), and observational studies that made reasonable attempts to control confounding. For academic achievement outcomes there were 26 EQI publications but only 14 were available for meta-analysis with effects ranging from 0.16 to 0.37SD. However, within sub-domains effects were heterogeneous. The 95% prediction interval for literacy was consistent with negative, null and positive effects (-0.13 to 0.79). Similarly heterogeneous findings were observed for psychosocial, cognitive and language, and health outcomes. Funnel plots of EQIs and observational studies showed asymmetric distributions and potential for small study bias. There is some evidence that non-cognitive skills associate with improved outcomes. However, there is potential for small study and publication bias that may over-estimate true effects, and heterogeneity of effect estimates spanned negative, null and positive effects. The quality of evidence from EQIs under-pinning this field is lower than optimal and more than a third of observational studies made little or no attempt to control confounding. Interventions designed to develop children's non-cognitive skills could potentially improve outcomes. The inter-disciplinary researchers interested in these skills should take a more strategic and rigorous approach to determine which interventions are most effective.

Gender Differences in the Benefits of an Influential Early Childhood Program

This paper studies the life-cycle impacts of a widely-emulated high-quality, intensive early childhood program with long-term follow up. The program starts early in life (at 8 weeks of age) and is evaluated by an RCT. There are multiple treatment effects which we summarize through interpretable aggregates. Girls have a greater number of statistically significant treatment effects than boys and effect sizes for them are generally bigger. The source of this difference is worse home environments for girls with greater scope for improvement by the program. Fathers of sons support their families more than fathers of daughters.

The Chicago School Readiness Project: Examining the long-term impacts of an early childhood intervention

The current paper reports long-term treatment impact estimates for a randomized evaluation of an early childhood intervention designed to promote children's developmental outcomes and improve the quality of Head Start centers serving high-violence and high-crime areas in inner-city Chicago. Initial evaluations of end-of-preschool data reported that the program led to reductions in child behavioral problems and gains in measures of executive function and academic achievement. For this report, we analyzed adolescent follow-up data taken 10 to 11 years after program completion. We found evidence that the program had positive long-term effects on students' executive function and grades, though effects were somewhat imprecise and dependent on the inclusion of baseline covariates. Results also indicated that treated children had heightened sensitivity to emotional stimuli, and we found no evidence of long-run effects on measures of behavioral problems. These findings raise the possibility that developing programs that improve on the Head Start model could carry long-run benefits for affected children.

Evaluating the effects of a targeted home visiting program on maternal and child health outcomes

We evaluate the effects of home visiting targeted towards disadvantaged first-time mothers on maternal and child health outcomes. Our analysis exploits a randomized controlled trial and combines rich longitudinal survey data with unique administrative health data. In a context in which the target group has comprehensive health care access, we find no effects of home visiting on most types of health utilization, health behaviors, and physical health measures. However, the intervention has a positive effect on some maternal mental health outcomes, reducing depression reported in the survey data by eleven percentage points and prescription of psycholeptics recorded in the administrative data by seven percentage points.

Parental health and children's cognitive and noncognitive development: New evidence from the longitudinal survey of Australian children

This paper examines the effects of parental health on cognitive and noncognitive development in Australian children. The underlying nationally representative panel data and a child fixed effects estimator are used to deal with unobserved heterogeneity. We find that only father's serious mental illness worsens selected cognitive and noncognitive skills of children. Maternal poor health also deteriorates some cognitive and noncognitive outcomes of children of lone mothers only. Our results demonstrate that either failing to account for parent-child fixed effects or using child noncognitive skills reported by parents could overestimate the harmful impact of poor parental health on child development.

Can Early Intervention Improve Maternal Well-Being? Evidence from a Randomized Controlled Trial

Objective

This study estimates the effect of a targeted early childhood intervention program on global and experienced measures of maternal well-being utilizing a randomized controlled trial design. The primary aim of the intervention is to improve children’s school readiness skills by working directly with parents to improve their knowledge of child development and parenting behavior. One potential externality of the program is well-being benefits for parents given its direct focus on improving parental coping, self-efficacy, and problem solving skills, as well as generating an indirect effect on parental well-being by targeting child developmental problems.

Methods

Participants from a socio-economically disadvantaged community are randomly assigned during pregnancy to an intensive 5-year home visiting parenting program or a control group. We estimate and compare treatment effects on multiple measures of global and experienced well-being using permutation testing to account for small sample size and a stepdown procedure to account for multiple testing.

Results

The intervention has no impact on global well-being as measured by life satisfaction and parenting stress or experienced negative affect using episodic reports derived from the Day Reconstruction Method (DRM). Treatment effects are observed on measures of experienced positive affect derived from the DRM and a measure of mood yesterday.

Conclusion

The limited treatment effects suggest that early intervention programs may produce some improvements in experienced positive well-being, but no effects on negative aspects of well-being. Different findings across measures may result as experienced measures of well-being avoid the cognitive biases that impinge upon global assessments.

Childhood forecasting of a small segment of the population with large economic burden

Policy-makers are interested in early-years interventions to ameliorate childhood risks. They hope for improved adult outcomes in the long run, bringing return on investment. How much return can be expected depends, partly, on how strongly childhood risks forecast adult outcomes. But there is disagreement about whether childhood determines adulthood. We integrated multiple nationwide administrative databases and electronic medical records with the four-decade Dunedin birth-cohort study to test child-to-adult prediction in a different way, by using a population-segmentation approach. A segment comprising one-fifth of the cohort accounted for 36% of the cohort's injury insurance-claims; 40% of excess obese-kilograms; 54% of cigarettes smoked; 57% of hospital nights; 66% of welfare benefits; 77% of fatherless childrearing; 78% of prescription fills; and 81% of criminal convictions. Childhood risks, including poor age-three brain health, predicted this segment with large effect sizes. Early-years interventions effective with this population segment could yield very large returns on investment.

The importance of family income in the formation and evolution of non-cognitive skills in childhood

Little is known about the relationship between family income and children's non-cognitive (or socio-emotional) skill formation. This is an important gap, as these skills have been hypothesized to be a critical link between early outcomes and adult socioeconomic status. This paper presents new evidence of the importance of family income in the formation and evolution of children's non-cognitive skills using a recent US panel dataset that tracks children between grades K-5. Findings suggest an important divergence in non-cognitive skills based on family income that accumulates over time and does not seem to be explained by children's health status differences.

The Effects of Two Influential Early Childhood Interventions on Health and Healthy Behaviour

This paper examines the long-term impacts on health and healthy behaviors of two of the oldest and most widely cited U.S. early childhood interventions evaluated by the method of randomization with long-term follow-up: the Perry Preschool Project (PPP) and the Carolina Abecedarian Project (ABC). There are pronounced gender effects strongly favoring boys, although there are also effects for girls. Dynamic mediation analyses show a significant role played by improved childhood traits, above and beyond the effects of experimentally enhanced adult socioeconomic status. These results show the potential of early life interventions for promoting health.

The ethical challenges of animal research

In 1966, Henry K. Beecher published an article entitled "Ethics and Clinical Research" in the New England Journal of Medicine, which cited examples of ethically problematic human research. His influential paper drew attention to common moral problems such as inadequate attention to informed consent, risks, and efforts to provide ethical justification. Beecher's paper provoked significant advancements in human research policies and practices. In this paper, we use an approach modeled after Beecher's 1966 paper to show that moral problems with animal research are similar to the problems Beecher described for human research. We describe cases that illustrate ethical deficiencies in the conduct of animal research, including inattention to the issue of consent or assent, incomplete surveys of the harms caused by specific protocols, inequitable burdens on research subjects in the absence of benefits to them, and insufficient efforts to provide ethical justification. We provide a set of recommendations to begin to address these deficits.

CAPABILITIES AND SKILLS

This paper discusses the relevance of recent research on the economics of human development to the work of the Human Development and Capability Association. The recent economics of human development brings insights about the dynamics of skill accumulation to an otherwise static literature on capabilities. Skills embodied in agents empower people. Enhanced skills enhance opportunities and hence promote capabilities. We address measurement problems common to both the economics of human development and the capability approach. The economics of human development analyzes the dynamics of preference formation, but is silent about which preferences should be used to evaluate alternative policies. This is both a strength and a limitation of the approach.

Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials

This study examined the impact of a targeted Irish early intervention program on children's emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN04631728.

The Effects of Exposure to Better Neighborhoods on Children: New Evidence from the Moving to Opportunity Experiment

The Moving to Opportunity (MTO) experiment offered randomly selected families housing vouchers to move from high-poverty housing projects to lower-poverty neighborhoods. We analyze MTO's impacts on children's long-term outcomes using tax data. We find that moving to a lower-poverty neighborhood when young (before age 13) increases college attendance and earnings and reduces single parenthood rates. Moving as an adolescent has slightly negative impacts, perhaps because of disruption effects. The decline in the gains from moving with the age when children move suggests that the duration of exposure to better environments during childhood is an important determinant of children’s long-term outcomes.

Intergenerational Long-Term Effects of Preschool - Structural Estimates from a Discrete Dynamic Programming Model

This paper formulates a structural dynamic programming model of preschool investment choices of altruistic parents and then empirically estimates the structural parameters of the model using the NLSY79 data. The paper finds that preschool investment significantly boosts cognitive and non-cognitive skills, which enhance earnings and school outcomes. It also finds that a standard Mincer earnings function, by omitting measures of non-cognitive skills on the right-hand side, overestimates the rate of return to schooling. From the estimated equilibrium Markov process, the paper studies the nature of within generation earnings distribution, intergenerational earnings mobility, and schooling mobility. The paper finds that a tax-financed free preschool program for the children of poor socioeconomic status generates positive net gains to the society in terms of average earnings, higher intergenerational earnings mobility, and schooling mobility.