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Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on children's development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained. These studies, conducted in three national contexts, with different regulatory climates, ranges of child care quality, and a diversity of family characteristics, suggest a need for more complete estimates of how both quality and quantity of child care may influence a range of young children's developmental outcomes.

This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations.

Data from a nationally representative survey of child care centers and a 5-site, observational study of centers were used to examine the quality of care provided to children from low-income families. Comparisons were made to a national sample of centers; among Head Start, public school-sponsored, and other community-based subsidized centers; and among centers that served families from differing socioeconomic groups. The quality of care in centers that served predominantly low-income children was adequate, but highly variable, with structural indices exhibiting higher quality than observations of global quality and of staff-child interactions. When compared to Head Start and public school-sponsored centers, the community-based centers had smaller groups and fewer children per teacher for preschoolers, but also had less well educated and compensated staff. Centers that predominantly served children from upper-income families provided the highest quality of care across multiple indices, and those that predominantly served children from middle-income families almost uniformly provided the poorest quality of care. The centers that served children from low-income families did not differ significantly in quality from the upper-income centers on most indices. However, the teachers in these programs were observed to be less sensitive and more harsh than teachers in the centers that served more advantaged families. The implications of the findings for research and policy are discussed.

This report estimates Early Head Start impacts on children and families when children were in fifth grade. It includes additional nonexperimental analyses to inform program practice and guide future research. Impacts on the full sample of children and families in the grade 5 followup suggest that for the overall sample, Early Head Start did not continue to have the broad pattern of impacts for child and family outcomes seen at earlier ages; however, there were interesting patterns of impacts for some subgroups.

The final report to Congress presents complete findings from our seven-year national evaluation of Early Head Start. The findings show that the program promotes learning and the parenting that supports it within the first three years of life. Participating children perform significantly better in cognitive, language, and social-emotional development than their peers who do not participate. The program also has important impacts on many aspects of parenting and the home environment, and it supports parents’ progress toward economic self-sufficiency.

This publication, the first major report on the Early Head Start national evaluation, focuses on early implementation experiences and tells the story of the 17 programs that helped launch the first nationwide program for low-income infants and toddlers.

This publication, the first major report on the Early Head Start national evaluation, focuses on early implementation experiences and tells the story of the 17 programs that helped launch the first nationwide program for low-income infants and toddlers.

Examines partnerships developing between early childhood and welfare agencies; describes their strategies for meeting the challenges of welfare reform; and addresses their concerns, including frustration of early childhood staff in trying to help families with severe barriers to work, confusion about supports and benefits available to those who are working, and ongoing concern about quality and availability of child care as well as general concern about whether families will be able to make it over the longer term.

More than half of the children in families supported by welfare are under age six, and another third are in grade school. The mothers of these children cannot leave welfare for employment unless they can find and pay for child care. Yet, as this article points out, the child care needs of these families are not easily met: Many require care for infants and toddlers, care at odd hours, and care in poor neighborhoods-all of which are scarce. Evidence reviewed by the authors indicates that problems with child care affordability, availability, and quality impede mothers from participating in the labor force and in job training programs. Recent public finding for child care subsidies has helped families leaving welfare to afford the child care they need, although the demand for financial assistance outstrips available funding. This article urges that policymakers work to facilitate access to subsidies, increase the supply of care that can meet the needs of poor working families, and guard against exposure to poor-quality care that can jeopardize both children's well-being and parents' employment.

It has been argued in the literature that the observed mortality crossover among older black Americans relative to the white population is a result of ‘differential early mortality which selects the least robust persons from the disadvantaged population at relatively earlier ages so that, at advanced ages, the disadvantaged population has proportionately more robust persons’ (Kenneth G. Manton). The authors examine the plausibility of the observed black mortality crossover and the heterogeneity argument supporting its existence. In addition to citing evidence from the literature, they use life tables from various countries known to have good mortality data to explore the relation between mortality in childhood and at younger adult ages and mortality in old age for cohorts and periods. Analysis suggests that the association between childhood and old-age mortality for cohorts is positive, implying that observed mortality crossovers are produced by deficient data rather than population heterogeneity.

Tells the story of program development in the early years, examining the nature and extent of implementation in key program areas and the quality of child development services for the 17 programs participating in the national evaluation.

Early Head Start, a federal program begun in 1995 for low-income pregnant women and families with infants and toddlers, was evaluated through a randomized trial of 3,001 families in 17 programs. Interviews with primary caregivers, child assessments, and observations of parent-child interactions were completed when children were 3 years old. Caregivers were diverse in race-ethnicity, language, and other characteristics. Regression-adjusted impact analyses showed that 3-year-old program children performed better than did control children in cognitive and language development, displayed higher emotional engagement of the parent and sustained attention with play objects, and were lower in aggressive behavior. Compared with controls, Early Head Start parents were more emotionally supportive, provided more language and learning stimulation, read to their children more, and spanked less. The strongest and most numerous impacts were for programs that offered a mix of home-visiting and center-based services and that fully implemented the performance standards early.

The final report to Congress presents complete findings from our seven-year national evaluation of Early Head Start. The findings show that the program promotes learning and the parenting that supports it within the first three years of life.

Finds that, a year or more after enrolling in the program, 2-year-olds perform significantly better on a range of measures of cognitive, language, and social-emotional development, when compared with a randomly assigned control group. EHS families are also more likely to attend school or job training and have less parenting stress and family conflict. The program produced significant impacts for important groups, including welfare families, working families, and families headed by teenage mothers. For these families, EHS programs appear to have provided a foundation of support for parenting and child development while families coped with new work requirements and time limits on TANF cash assistance, balanced the demands of work and family, or attended to their own developmental needs.

Data from surveys conducted by the Alan Guttmacher Institute (AGI) in 1981 have been used to create 3 indicators of the effectiveness of family planning clinics serving teenagers: the mean delay between 1st intercourse and 1st clinic visit (which for teenage clinic patients is 13.2 months); teenage patient retention (67%); and the average excess of patient satisfaction over dissatisfaction with clinic policies and services (33%). Clinics run by Planned Parenthood are more effective than other types of facility according to the mean delay indicator whereas other clinics such as those associated with community action programs and neighborhood health centers rank highest in levels of patient satisfaction and patient retention. All 3 measures indicate that clinics serving 1000-2499 family planning patients per year are more effective in serving teenagers than either smaller of larger clinics and that nonmetropolitan clinics are more effective in providing services than those in cities. Regression analysis shows that clinic administrators might take a number of actions to shorten the mean delay among teenagers between 1st intercourse and 1st clinic visit. These include offering community education programs for teenagers enlisting the support of local churches developing relationships with local youth groups opening the clinic curing evenings and weekends accepting more teenagers as walk-in patients and locating a clinic in or near neighborhoods where many teenagers live. 2 of the same factors--developing an active relationship with youth groups and opening the clinic to teenagers on evenings and weekends--were also found to be particularly effective in keeping teenagers as clinic patients. The range of services offered at the clinic and the socioeconomic conditions in the county served by the clinic have an impact as well. The satisfaction of the teenage patients with clinic policies and services appears to be determined primarily by the patients own characteristics. For example satisfaction with the clinic is lower when a larger proportion of teenage patients are nonwhite and satisfaction is higher when a larger proportion are students. In addition teenagers in counties where there are several different clinics to choose from are more satisfied with their selection. These results suggest that making an effort to reach teenagers and inform them may help clinics serve teenagers more effectively by shortening the length of time that teenagers delay their 1st clinic visit inducing more of them to return regularly and increasing their satisfaction with the clinics. (authors modified)

To investigate the reasons behind the high levels of nonuse or inconsistent use of contraceptives among sexually active adolescents in the US the Alan Guttmacher Institute (AGI) undertook a 1983 study using 10 focus group discussions with teenagers from 5 US cities. Focus groups are small groups of 6 to 12 participants and 1 trained moderator; the informal setting is believed to encourage more detailed behavioral responses and provides a qualitative understanding of the topics addressed. The groups were segregated according to sex and age with the ages from 16 to 17 and 18 to 19. The groups were composed of single sexually active teenagers overwhelmingly from middle or lower middle class white families. After taping and analyzing the sessions the researchers found some common reasons given for nonuse. Included were the belief they were not at risk at the time of their intercourse lack of preparation for a sexual encounter partners objections lack of information about birth control methods or where to access them and the belief that contraceptives were complicated or unpleasant to use. The authors suggest that conflicting societal messages may be in part responsible. For example 1st sexual encounters are often unprepared for and may signify the "bad" label offered by society for sex at a young age or before marriage. Yet this is coupled with advertisements promoting the excitement of sexual adventure. Embarrassment and confusion result from such ambivalence creating a need for contraceptive service providers to recognize and become sensitive to the needs of these young consumers. The authors offer several suggestions to help diminish this ambivalence: elevating the content and quality of sex education in secondary schools; informing young men of their legal responsibilities to the mothers of their offspring; selecting and training groups of students to serve as peer sources of family planning information; and instituting programs that encourage parent and child communication on sexual matters. Their hope is to reduce the negative feelings and to incease effective contraceptive practice among adolescents.