Research in Early Head Start

2. Research in Early Head Start George L. Askew, MD, FAAP Office of the Assistant secretary Administration for Children and Families U.S. Department of Health and Human Services American Association of nursing 38th annual meeting and conference October 14, 2011

3. What I Will Cover Today • Brief Overview of Administration for Children and Families • Brief Overview of Early Head Start • Review of Research in Early Head Start (BABY FACES) • Questions and Answers

4. Administration for Children and Families

5. What is Early Head Start? • Head Start • Early Head Start • Established 1995 • Serves children birth to three: 1008 programs; over 133,000 children • Promotes healthy prenatal outcomes, enhances the development of infants and toddlers, and promotes healthy family functioning. • 4 Cornerstones: Child Development, Family Development, Community Building and Staff Development • 3 other areas of importance: Administrative Management, Continuous Improvement and Children with Disabilities

6. Service Delivery: PIR & Baby FACES

7. Staff Characteristics Teachers HV Highest level of education: High school or less 6 2 Some college 22 20 Associate’s 39 27 Bachelor’s or higher 33 51 Field of study early childhood or child development 64 59 CDA 55 4 Elevated depressive symptoms 8 6

8. Linguistic and Ethnic Diversity

9. What Do We Know About Health of EHS Children?

10. Children Are Healthy at Birth and Age 1 • Low rates of premature birth and low birth weight (about 10 percent) • 63 percent were breastfed (average 4 months) • 96 percent have insurance coverage • 92 percent up-to-date immunizations • 74 percent had well-child checkups

11. Poor Feeding Practices Start Early Percentage Parent Reported Feeding Practices at Age 1

12. Some Incidence of Positive Feeding Practices Percentage Parent Reported Feeding Practices at Age 1

13. Children’s BMI Similar to Other Low Income Samples • About 1/3 are overweight or obese at age 2 • 16 percent are overweight (85-94th percentile) • 17 percent are obese (95th percentile or higher) • Just 6 percent of parents report a medical professional said child is overweight • Rates of overweight and obesity not predicted by feeding practices or other characteristics (including race/ethnicity)

14. Programmatic Initiatives • Office of Head Start is piloting obesity prevention programs: • Head Start: I Am Moving I Am Learning • Early Head Start: Little Voices for Healthy Choices

15. Overall Impacts for Children: Age 3 • Higher immunization rate • Fewer emergency room visits for accidents and injuries • Cognitive development (higher Bayley scores & fewer in low-functioning group*) • Larger receptive vocabularies • Lower levels of aggressive behavior • Greater sustained attention with objects, engagement of parent, and less negativity

16. Overall Impacts for Parents: Age 3 • More positive (and less negative) parenting observed in parent-child play: both mothers and fathers • Higher HOME scores, more stimulating home environments, support for learning • More daily reading • Less spanking: both mother and father report • More hours in education and job training

17. Impact on Breastfeeding For those women who enrolled during pregnancy: • 44% of EHS moms • 33% of the control group

18. Questions ?s

19. Promoting happy, healthy and successful children, strong families and supportive communities