Children’s Right to Thrive

1. Children’s Right to Thrive Invest in Children 10th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and Professors, Georgetown University Center on Health and Education

2. It is the totality of a child’s experience that lays the foundation for a lifetime of greater or lesser competency. Ramey & Ramey, 2000

3. 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

4. Key Research Question for Abecedarian (ABC) Project Can the cumulative developmental toll experienced by high-risk children be prevented or reduced significantly by providing systematic, high-quality, early childhood education from birth through kindergarten entry?

5. 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” Curriculum Cognitive / Fine Motor Social / Self Motor Language Individualized pace Abecedarian Preschool Program • Control Group _ • Adequate nutrition • Supportive social services • Low-cost or free primary • health care Campbell & Ramey, 1995 American Educational Research Journal

6. Pre-K Educational Treatment prevents decline in children’s low-IQ classification (% with IQs <85) Martin, Ramey, & Ramey, 1990 American Journal of Public Health

7. Estimated Influences on IQ Adapted from Martin, Ramey, & Ramey, American Journal of Public Health, 1996

8. Reading achievement scores are significantly higher for ABC children at 8, 12, 15, & 21yrs Campbell & Ramey, 2001 Developmental Psychology

9. ABC educational program reduced grade repetition and special education placement Ramey & Ramey, 1999 MR/DD Research Review

10. 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

11. 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)

12. Ramey & Ramey, Preventive Medicine, 1998

13. Project CARE 130 Early Intervention Follow-up 120 110 100 90 80 70 60 6(MDI) 12(MDI) 18(MDI) 24(S-B) 36(S-B) Age in Months (assessment type) Ramey & Ramey Preventive Medicine, 1998

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

15. 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

16. Infant Health and Development Program (2001-2500 grams)

17. Infant Health and Development Program Children’s IQ at 36 months: Maternal Education X Treatment Group Ramey & Ramey (1998), Preventive Medicine (n=232) (n=162) (n=166) (n=104) (n=134) (n=63) (n=76) (n=48)

18. Outcomes Affected Positively (*p<.01) by the Infant Health & Development Program Ramey 1999, adapted from Gross, Spiker, & Haynes, 1997, Helping Low Birth Weight, Premature Babies

19. 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

20. 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)

21. 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

22. 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

23. 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

24. 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>10,000 Note: LA legislature committed $82 million for 2007-2008 school year

28. n = 22,105 n = 2,886 n = 13,257 n = 555 * p <.001 Louisiana Kindergarten Retention Rates (2003-04 Cohort)

29. Louisiana Kindergarten Retention Rates (2004-05 Cohort)

30. Louisiana Special Education Placement Rates (2003-04 Cohort)

31. Louisiana Special Education Placement Rates (2004-05 Cohort)

32. A Comparison of Children’s Academic Progress in Pre-K Programs that differ in dosage

33. 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

34. 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

35. 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