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Sustaining the Benefits of Early Childhood Experiences: A Research Overview

Rebecca E. Gomez

Over the past decade, there has been increased recognition of the short- and long-term benefits of high-quality early childhood education programs, but the systems needed to sustain these benefits throughout early learning transitions (and beyond) have not yet been fully implemented.

y oldest nephew is six lived the first five years of his life in a years old and in first grade. single-parent household because his MDespite overcoming signifi- mother has been incarcerated and in cant challenges during the first five and out of rehabilitation programs for years of his life, he is doing pretty well. drug addiction – a factor we know from He’s above grade level and the literature on early childhood performing at grade level in math. development could put him at risk for He demonstrates good cognition and developmental and learning delays general knowledge, along with social (Shonkoff 2010; Karoly, Kilburn & competence and executive functioning Cannon 2005; Shonkoff & Phillips skills consistent with what one 2000). might expect from a six-year-old. He What, then, bolstered my nephew’s approaches learning experiences with progress in learning and enabled him to curiosity and persists in completing be resilient despite these realities? Some tasks that are difficult. He has also has of this, surely, is a result of the caring

Rebecca E. Gomez is an assistant research professor at the National Institute for Early Education Research in the Graduate School of Education at Rutgers .

VUE 2016, no. 43 5 adults in his life, with whom he was THE IMPORTANCE OF EARLY able to form stable attachments and CHILDHOOD EDUCATION: who engaged him in learning experi- INCREASING RECOGNITION ences grounded in his community and AND A SHIFT IN FOCUS home culture. These supports acted as protective factors (Center for the Study Decades of research on child develop- of Social Policy 2009) helping to ment and the benefits of ECE as an counteract those risks. He also, intervention now indicates that however, attended an early childhood high-quality programs result in both education (ECE) program that was short- and long-term benefits to young accredited by the National Association children (Shonkoff & Phillips 2000). for the Education of Young Children We know that a child’s family and (NAEYC), widely thought to be the community environments are inextrica- “gold standard” of quality in ECE bly linked to his or her development, (Neugebauer 2009). His first five years and stable attachment relationships of life took place during a period of can mitigate risk factors and promote considerable attention to the role of positive social, emotional, and early experiences on brain development cognitive developmental outcomes and the impact of high-quality early (Bronfenbrenner 1986; Ainsworth & childhood education on ameliorating Bowlby 1991). We also know from risk factors and reducing achievement studies focusing on educational gaps in the early elementary grades. interventions for young children that “ability gaps” – or differences in The newest research in this field tackles children’s baseline knowledge and the question of how to ensure that the skills – are a primary cause for the gains made in ECE will be sustained. achievement gap, begin at an early Research has begun to look at ECE age, and cannot be mitigated by systems that create the infrastructure educational experiences after second for an aligned, effective set of policies grade (Heckman 2011). and programs to support young children’s development and learning Evidence from longitudinal studies of from birth through . Much interventions like the Perry of my work as a researcher in the field Project and the Abecedarian Project1 of ECE has focused on exploring the suggest that early childhood education potential of ECE systems, and the has the potential to reduce these ability governance of those systems, to create gaps (and subsequently, the achieve- a coherent learning continuum for ment gap) by permanently bolstering children from birth through grade social and emotional skills (Schwein- three. I continue this work at the hart et al. 2005) as well as IQ National Institute for Early Education (Heckman 2011, citing work by Camp- Research (NIEER), where we focus on bell and colleagues). My nephew conducting high-quality research on pre-K that can inform policy and practice. Indeed, NIEER was created 1 The HighScope Perry Preschool Study and the Carolina Abecedarian Project in 2001 for the purpose of conducting are two well-known early childhood independent research on pre-K and for education research studies that have seeking to increase the transparency tracked participants for over forty years and accountability of pre-K policies. and shown positive, long-term outcomes of high-quality early education, along a NIEER is uniquely positioned at the range of educational, social, and emotional intersection of research, policy, and indicators. For more information about practice, enabling its faculty to take the Abecedarian Project, see http://abc.fpg. a holistic view of pre-K and be unc.edu/; for the Perry Preschool project, see http://www.highscope.org/Content. responsive to the needs of the field. asp?ContentId=219.

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benefited from this body of research because it pointed the way to interven- “ tions that could improve his life and reduce the negative impact of his early In 2012, it was estimated that 69 percent deleterious experiences. of all children in the United States were The body of literature on the impor- tance of the first five years of life in enrolled in some type of formal early shaping a child’s overall developmental trajectory, and on the effectiveness of education experience. ECE as an intervention for young “ children, has continued to grow. Until relatively recently, however, policymak- ers at the federal, state, and local level have been guided by the ethos that the Gomez 2014), and more broad-based family has primacy over a child’s care investment in ECE began to take place. and learning experiences, particularly Advocacy and media campaigns by during his or her first five years of life. various stakeholders were created in an As a result, these policymakers have effort to garner more widespread largely limited investment in services for investment in ECE. Pre-K Now, for young children to those children deemed instance, was a ten-year campaign (from “at-risk” in some way (e.g., Head Start), 2001 to 2011), funded by the Pew or to support families during times of Charitable Trusts, designed to educate crisis (e.g., the Lanham Act of 1941, federal and state policymakers about the with provisions for childcare services importance of investing in early educa- for mothers who entered the workforce tion – specifically, in state and federally during World War II) (Lombardi 2003). funded pre-K services.

In recent years, this history of targeted Interest also grew on the part of state investments and limited government governments in investing in publicly involvement in the lives and education funded preschool programs to meet the of children under the age of six has greater demand for childcare and early begun to change. Over the past two learning experiences. The percentage of decades, the need for more widespread children served by state-funded pre-K ECE services increased as more women programs rose from 14 percent in 2002 entered the workforce and needed care to 29 percent in 2014 (Barnett et al. for their children during the workday. 2015). While still a modest increase, it The increase in demand for services, represents many thousands of children coupled with the rapid pace of research gaining access to preschool programs. on the benefits of ECE for young Enrollment in other types of ECE children’s learning and development, programs also grew. In 2012, for created a “perfect storm” of sorts among instance, it was estimated that a total of scholars and advocates in the field that 69 percent of all children in the United led them to the conclusion that it was States were enrolled in some type of time to leverage these advances in formal early education experience knowledge and public will. (Organisation for Economic Coopera- tion and Development 2012). During Beginning in the late 1990s, the field this decade, major investments in ECE made a concerted effort to translate and were also made internationally. Of promote the growing body of research forty-five countries surveyed by the on ECE to policymakers and business Economist Intelligence Unit (2012), leaders. It was then that ECE began to thirty-three provided access to ECE for emerge as a policy issue (Kagan & over 50 percent of all their children.

Rebecca E. Gomez VUE 2016, no. 43 7 ECE is still not universally embraced. tance of teacher-child and peer Only a few states truly provide for interactions for young children’s universal pre-K, and no state invests in learning, in addition to structural universal ECE services for infants and factors (LaParo et al. 2012). While toddlers. But the zeitgeist has shifted additional research is needed, there is among families, researchers, and consensus in the field that quality is policymakers about the importance an essential ingredient to producing of young children’s participation in benefits for children’s learning and education and care outside of the development (Camilli et al. 2010). home. My family’s decision to enroll What is less clear, however, is how my nephew in ECE reflects this shift. to sustain those gains over time – something that I think about when considering my nephew’s learning “HIGH-QUALITY ECE”: trajectory over the next few years. EVOLVING DEFINITIONS

My nephew had the opportunity to SUSTAINING GAINS: MOVING attend an ECE program accredited FROM PROGRAMS TO SYSTEMS by NAEYC. Research has shown that children enrolled in high-quality My nephew has continued to do well programs tend to demonstrate better in school, but the research is not yet cognitive and social emotional out- conclusive regarding to what extent the comes in school than do their peers gains accorded to young children by who did not have the benefit of a high-quality ECE experiences can be high-quality ECE program (Mashburn sustained over time. Several studies of et al. 2008), and that they sustain those pre-K programs (Hillm, Gormley & outcomes into the primary grades Adelstein 2015; Lipsey et al. 2013; (Love et al. 2013). ECE experiences Puma et al. 2010) suggest that by grade that are of high quality are what make 3, the benefits children gain by partici- the difference for young children over pating in quality ECE experiences fade time, particularly for children with out or converge with those of their identified risk factors. But what peers that did not participate in those constitutes “high quality” in an experiences. Other studies found that ECE program? educational outcomes from pre-K programs were sustained through third The definition of high-quality ECE grade (Muschkin, Ladd & Dodge long hinged on three baseline, struc- 2015) and that the long-term effects of tural factors: group size, adult-child Head Start programs are manifest in ratios, and teacher qualifications (train- children’s increased social and emo- ing and experience) (Vandell & Wolfe tional competency (Love et al. 2013). 2000). NIEER has embraced these Still other research findings suggest three factors, along with seven other that quality acts as a “counterfactual “benchmarks of quality” for the condition,”2 (p. 3) resulting in effects purpose of establishing a floor for that differ between groups of children quality in state-funded pre-K programs who attended a high-quality ECE and ranking states according to the program and those who did not (Feller number of quality benchmarks et al. 2014, p. 3; also see Jenkins et al. reflected in policy (Barnett et al. 2015). 2015). Furthermore, dosage (i.e., the Our understanding of “quality” over amount of time spent in an ECE the past decade has become more program) appears to matter, as children multifaceted, emphasizing the impor- enrolled in high-quality ECE programs

8 Annenberg Institute for School Reform for between one to three years per- experiences they have developed during formed better over time than those their time in ECE programs. Work also enrolled in a program for less than needs to occur at the system level. one year (Nores & Barnett 2010). Ensuring Access, Quality, Alignment, Why Do ECE Benefits Tend to Fade and Continuity: The Need for a by Third Grade? Systemic Approach

There are multiple theories about why The broad-based recognition that ECE fade-out occurs, among them: high- can impact children’s learning and quality elementary school experiences development has resulted in increased allow peers who did not attend ECE to enrollments and a proliferation of catch up with their peers; the instruc- publicly and privately funded ECE tional quality in elementary school may programs. It has also created a patch- be poor, and thus children have fewer work of policies and fragmented chances to maintain what they have administrative structures at the federal, learned; and the instructional approach state, and local levels. This fragmented in elementary school is misaligned with infrastructure means that access to that provided in ECE settings, trigger- high-quality ECE programs for ing fade-out as a result of mismatch children and families varies tremen- in content and instruction (Jenkins et dously depending on the state – and al. 2015). sometimes even the community – in which they live (Barnett et al. 2015). Research is being conducted to assess Inequities leading to potential fade-out the validity of each of these theories, of ECE benefits remain pervasive for and hopefully, interventions can be children in all fifty states. designed to address potential chal- lenges. Interventions in individual ECE The response from some scholars has programs and schools, however, are been to shift the unit of analysis from not the only areas in which work needs programs to systems. An ECE system to take place to ensure that children – can be defined as programs and like my nephew – have the chance to services for young children and families capitalize on the knowledge, skills, and plus the policies and administrative infrastructure that support those programs (Kagan & Kauerz 2012).3 2 A counterfactual condition refers to a set of ECE systems typically have seven conditions in which a particular outcome elements: results that is different from the outcome achieved when the conditions were similar • regulations articulating minimum but not exactly the same. Here, this refers to ECE settings, all of which can be said requirements for safety and health; to be similar, but with varying differences • professional development supports in quality. for ECE professionals; 3 The “smart education systems” (SES) • financing; framework from the Annenberg Institute for School Reform at Brown University • accountability measures ensuring proposes a similar approach (see http:// programs meet fiscal and quality annenberginstitute.org/who-we-are/smart- benchmarks; education-systems). An SES is defined as • outreach to and engagement with a partnership between a high-functioning school district and local civic and families and communities; community organizations that coordinates • standards for early learning and educational supports and services wherever development, programming, and they occur – at school, at home, and in the professional preparation; and community – to provide all children with equitable opportunities and high-quality learning experiences.

Rebecca E. Gomez VUE 2016, no. 43 9 • a coordinated approach to gover- implement systemic interventions that nance to manage each of the other increase program quality,6 focus on six elements (Kagan & Kauerz 2012; enhanced supports to the ECE work- Kagan & Cohen 1996). force, and explore durable options for financing ECE programs (Kagan & The primary goal of a functional ECE Gomez 2015; Gomez 2015; Regenstein system is to create the mechanisms for 2015; Goffin, Martella & Coffman children and families to have greater 2011). Several states, including access to high-quality ECE programs. Maryland, Pennsylvania, Massachu- Still in its infancy, research on ECE setts, and Washington have already systems is an important area of inquiry implemented new approaches to in the field, with implications for governance aimed at aligning policies policymaking. Notable innovations in and infrastructure from birth through research and practice focus on the grade 3. development of a P–3 early learning It is important to emphasize that a system, in which there is alignment not causal connection cannot be made only among the policies and programs between system development and that address children from birth to age improved child outcomes or sustained five, but also from birth through third gains over time. However, research on grade (Kagan & Kauerz 2012).4 Many systems indicates that system-level challenges arise from a lack of align- interventions increase the capacity of ment among these policies and states to improve the supports to programs. For example, in many states programs (Gomez 2015), which, in and localities, there are few transition turn, could bolster the structural supports for children as they move quality of those programs and, in some from pre-K to . Transition cases, the process quality as well supports should not only include (Tarrant & Huerta 2015). Further- systematic methods of communication more, if a P–3 system focus is applied, between pre-K and kindergarten state efforts can be directed to explor- teachers, but also an alignment of the ing alignment of early learning and standards, curriculum, and assessments development standards with K–12 in pre-K to kindergarten to ensure a standards, and the alignment of those continuum of developmentally appro- standards with curriculum and priate teaching and learning (Kagan & assessments for children from birth Tarrant 2010).5 When my nephew, for through grade 3. example, transitioned from a privately owned ECE program into a kindergar- Research on systems underscore ten program in the public school the need to address transitions in system, there were no formalized outreach and engagement systems, opportunities for teacher communica- including systemic supports for tion, and the curricula in kindergarten looked very different from that of his 4 I distinguish here between an ECE system, pre-K program. which typically focuses on birth through age 5, and a P–3 system, which focuses on In addition to research on the impor- birth through third grade. tance of systemic supports during 5 For a description of a systemic approach transitions, research on governance led by a community advocacy organization suggests that creating a coordinated in Tulsa, Oklahoma, that supports aligned transitions, see the article by Amy Fain state-level approach to governance of and Diane Eason Contreras in this issue ECE/P–3 systems gives states the of VUE. authority to foster greater alignment 6 See the Quality Rating and Improvement across the birth-to-grade-3 continuum, System National Learning Network at http://qrisnetwork.org/.

10 Annenberg Institute for School Reform vertical transitions (from ECE to support high-quality teaching. Recent- public school settings, including pre-K ly, the National Academies of Science to kindergarten); horizontal transitions released a report on the ECE work- (from home to school and from school force, which can serve as a basis for to community settings); and temporal thinking about what types of invest- transitions (moving from activity to ments in workforce supports are activity within the course of the day) needed to contribute to program (Kagan & Tarrant 2010). Another quality and boost children’s learning study that examined transitions from (Allen & Kelly 2015). The influence pre-K to kindergarten in Finland found of family and community on children’s that while many types of transition learning and the ability of these activities were beneficial to children, supportive factors to influence “co-operation over curricula and children’s learning over time is passing on written information about another area of investigation that children between the preschool and shows promise. the elementary school were the best The notion of ECE/P–3 systems as predictors of the children’s skill” drivers of program quality is still fairly (Ahtola et al. 2011, p. 295). new; to date, no state has a fully These studies offer a prologue for implemented system (Kagan & Kauerz thinking about the structure of a P–3 2012). This makes research on ECE system that would increase access to systems difficult to design and carry high-quality ECE programs for all out. However, the past decade has children and align those programs with done a great deal to advance the field’s the primary-level curriculum, instruc- thinking about a range of aspects of tional approaches, and assessments. ECE; this work can and should be used

This kind of high-quality, aligned P–3 as a springboard for continued research system has the potential to support and policymaking. children in becoming healthy, socially competent lifelong learners. WHAT RESEARCH HAS YET “ TO ANSWER A high-quality, aligned P–3 system – serving I have highlighted here the areas of consensus in the research regarding the children from birth to third grade – has the importance of high-quality ECE for supporting young children’s develop- potential to support children in becoming ment and learning. Despite this consensus, there is still much to be “healthy, socially competent lifelong learners. explored. I have discussed the areas of intellectual and practical debate regard- ing the causes of fade-out and what can be done to mitigate fade-out effects, an important line of inquiry that must continue.

We have also yet to fully understand the influence of the ECE workforce on program quality and children’s learn- ing, including the type and amount of professional development needed to

Rebecca E. Gomez VUE 2016, no. 43 11 MUCH PROGRESS, REFERENCES MUCH STILL TO DO Ahtola, A., G. Silinskas, J. L. Poikonen, More and more people are aware of M. Kontoniemi, P. Niemi, and J. E. Nuruni. the importance of the first five years 2011. “Transition to Formal Schooling: of a child’s life for his or her overall Do Transition Practices Matter for development in the early years and Academic Performance?” Early Childhood long-term benefits in school and life. Research Quarterly 26, no. 3:295–302. Research continues on the critical factors in high-quality ECE programs Ainsworth, M. D. S., and J. Bowlby. 1991. that result in significant benefits for “An Ethological Approach to Personality young children’s success in school and Development,” American Psychologist 46, beyond. Federal, state, and local no. 1:331–341. investments in programs and systems Allen, L., and B. B. Kelly. 2015. Transform- are affording many more children ing the Workforce for Children Birth access to high-quality ECE. through Age 8: A Unifying Foundation. However, many children still do not Washington, DC: Institute of Medicine of have access to good programs that are the National Academy of Science. accessible and affordable for their Barnett, W. S., M. E. Carolan, J. Squires, families. My nephew had the benefit of K. Clarke-Brown, and M. Horowitz. 2015. a strong family support system and a The State of Preschool 2015: State high-quality ECE program to help him Preschool Yearbook. New Brunswick, NJ: succeed in school. However, he lives in National Institute for Early Education a state where there is no publicly Research. funded pre-K, nor is there even full-day kindergarten. This means that there are Bronfenbrenner, U. 1986. “Ecology of the countless children in similar situations Family as a Context for Human Develop- who do not have the opportunity to ment: Research Perspectives,” participate in high-quality ECE Developmental Psychology 22, no. experiences, and this may affect their 6:723–742. learning and development negatively Camilli, G., S. Vargas, S. Ryan, and over the long term. And despite W. S. Barnett. 2010. “Meta-analysis of increased recognition of the importance the Effects of Early Education Interventions of early childhood education, the on Cognitive and Social Development,” emerging research on the systems Teachers College Record 112, no. 3:579– needed to scale up ECE programs and 620. align them with K–3 systems has yet to be implemented in any major way. This Center for the Study of Social Policy. 2009. decade of recognition has brought Protective Factors Literature Review: Early about much progress and knowledge Care and Education Programs and the about the influence of ECE on chil- Prevention of Child Abuse and Neglect. dren’s lives. But we can and we must Washington, DC: CSSP. do better. Economist Intelligence Unit. 2012. Starting For more on the National Institute for Well: Benchmarking Early Education across Early Education Research, see http:// the World. London, U.K.: The Economist. nieer.org/. Feller, A., T. Grindal, L. Miratrix, and L. Page. 2014. “Compared to What? Variation in the Impacts of Early Childhood Educa- tion by Alternative Care-Type Settings.” Working paper, available at http://ssrn.com/ abstract=2534811.

12 Annenberg Institute for School Reform Goffin, S. G., J. Martella, and J. Coffman. Kagan, S. L., and K. Kauerz. 2012. Early 2011. Vision to Practice: Setting a New Childhood Systems: Transforming Early Course for Early Childhood Governance. Learning. New York: Teachers College Press. Washington, DC: Goffin Strategy Group. Kagan, S. L., and K. Tarrant, editors. 2010. Gomez, R. E. 2015. “Governance as a Lever Transitions for Young Children: Creating for Bringing Coherence to ECE Systems: Connections across Early Childhood The Adaptive Capacities of Consolidated Systems. Baltimore, MD: Paul H. Brookes Approaches.” In Early Childhood Gover- Publishing. nance: Choices and Consequences, edited by Karoly, L. A., M. R. Kilburn, and J. S. S. L. Kagan & R. E. Gomez. New York: Cannon. 2005. Early Childhood Interven- Teachers College Press. tions: Proven Results, Future Promise. Heckman, J. J. 2011. “Effective Early Santa Monica, CA: Rand Corporation. Childhood Development Strategies.” In The LaParo, K. M., A. C. Thomason, J. K. Pre-K Debates: Current Controversies and Lower, V. L. Kinter-Duffy, and D. L. Cassidy. Issues, edited by E. Zigler, W. S. Gilliam & 2012. “Examining the Definition and W. S. Barnett. Baltimore, MD: Paul H. Measurement of Quality in Early Childhood Brookes Publishing. Education: A Review of Studies Using the Hillm, C. J., W. T. Gormley, and S. Adelstein, ECERS-R from 2003 to 2010,” Early 2015. “Do the Short-term Effects of a Childhood Research and Practice 14, no. 1, High-quality Preschool Program Persist?” http://ecrp.uiuc.edu/v14n1/laparo.html. Early Childhood Research Quarterly 32, Lipsey, M. W., K. G. Hofer, N. Dong, D. C. no. 3:60–79. Farran, and C. Bilbrey. 2013. of Jenkins, J. M., T. W. Watts, K. Magnuson, the Tennessee Voluntary Prekindergarten D. Clemens, J. Sarama, C. B. Wolfe, and M. Program: Kindergarten and First Grade E. Spitler. 2015. “Preventing Preschool Fade Follow-up Results from the Randomized Out through Instructional Intervention in Control Design. Nashville, TN: Vanderbilt Kindergarten and First Grade: A Working University, Peabody Research Institute. Paper.” Irvine: University of California Lombardi, J. 2003. Time To Care: Redesign- School of Education. ing Child Care to Promote Education, Kagan, S. L., and N. E. Cohen, editors. Support Families, and Build Communities. 1996. Reinventing Early Care and Educa- Philadelphia, PA: Temple University Press. tion: A Vision for a Quality System. San Love, J. M., R. Chazan-Cohen, H., Raikes, Francisco: Jossey-Bass. H., and J. Brooks-Gunn. 2013. “What Kagan, S. L., and R. E. Gomez, editors. Makes a Difference: Early Head Start 2015. Early Childhood Governance: Choices Evaluation Findings in a Developmental and Consequences. New York: Teachers Context,” Monographs of the Society for College Press. Research in Child Development 78, no. 1:vii–viii, 1–173. Kagan, S. L., and R. E. Gomez. 2014. “One, Two, Buckle my Shoe: Early Child- Mashburn A. J., R. C. Pianta, B. K. Hamre, hood Mathematics and Teacher Professional J. T. Downer, O. A. Barbarin, D. Bryant, M. Development.” In Preparing Early Child- Burchinal, D. M. Early, and C. Howes. 2008. hood Educators to Teach Math: Professional “Measures of Classroom Quality in Development that Works, edited by H. P. Prekindergarten and Children’s Development Ginsburg, M. Hyson, and T. A. Woods. of Academic, Language, and Social Skills,” Baltimore, MD: Paul H. Brookes Publishing. Child Development 79, no. 3:732–49.

Rebecca E. Gomez VUE 2016, no. 43 13 Muschkin, C. G., H. F. Ladd, and K. A. Schweinhart, L., J. Montie, Z. Xiang, Dodge, 2015. “Impact of North Carolina’s W. S. Barnett, C. R. Belfield, and M. Nores. Early Childhood Initiatives on Special 2005. Lifetime Effects: The HighScope Education Placements in Third Grade,” Perry Preschool Study through Age 40. Educational Evaluation and Policy Analysis Ypsilanti, MI: HighScope Press. 37, no. 4:478–500. Shonkoff, J. 2010. “Building a New Neugebauer, R. 2009. “Where Are We Biodevelopmental Framework to Guide the Headed with Accreditation?: Trends in Future of Early Childhood Policy,” Child Quality Assurance,” Child Care Exchange Development 81, no. 1:357–367. 186:14-17. Shonkoff, J., and D. Phillips. 2000. From Nores, M., and W. S. Barnett. 2010. Neurons to Neighborhoods: The Science of “Benefits of Early Childhood Interventions Early Childhood Development. Washing- Across the World: (Under) Investing in the ton, DC: National Academies Press. Very Young,” Economics of Education Tarrant, K., and L. A. Huerta. 2015. Review 29, no. 2:271–282. “Substantive or Symbolic Stars: Quality Organisation for Economic Cooperation Rating and Improvement Systems through a and Development. 2012. United States – New Institutional Lens,” Early Childhood Country Note – Education at a Glance Research Quarterly 30:327–338. 2012: OECD Indicators. Paris, France: Vandell, D. L., and B. Wolfe. 2000. Child OECD Publishing. Care Quality: Does It Matter and Does It Puma, M., S. Bell, R. Cook, and C. Heid. Need to Be Improved? Madison: Institute 2010. Head Start Impact Study: Final for Research on Poverty, University of Report. Washington, DC: U.S. Department Wisconsin. of Health and Human Services, Administra- tion for Children and Families.

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