Early Childhood Education: The Journey From Efficacy

Research to Effective, Everyday Practice

Craig T. Ramey and Sharon L. Ramey

Center for Health and Education Research

Georgetown University

Summit on Early Childhood Cognitive Development

Boise, Idaho

June 10, 2002

Early Childhood Education: The Journey From Efficacy Research

**To Effective, Everyday Practice**

**Craig T. Ramey and Sharon L. Ramey**

**Georgetown University**

During the past decade there has been a steady increase in scientific
evidence that establishes the undeniable importance of the early years
in human development (see Shonkoff, & Phillips, 2000). This evidence is
particularly strong with respect to school readiness for children from
families of limited education and low income (Ramey & Ramey, 1998).
Language and literacy skills and their relation to other aspects of
child development have been identified as key areas for further
scientific concern and systematic policy formulation (Hart & Risley,
1995; Lyon, 2002).

A series of experimental trials using early childhood education, family
support, and pediatric care has demonstrated that high risk children can
be prepared for initial success in school. When this increased school
readiness is coupled with adequate school programs the initial positive
effects persist into adolescence and adulthood. The magnitude of the
effects produced by various preschool interventions is systematically
related to characteristics of the preschool programs themselves (Ramey &
Ramey, 1998). Important program characteristics include having a 1) well
specified curriculum, 2) having programs of a half-day or longer, 3)
beginning early in the child's life and developing a strong
communication pattern between adults and children and 4) focusing on
cognitive development as well as linguistic and social competence.

The purpose of this paper is to highlight specific findings from several
of our preschool programs and to advocate for a new type and level of
inquiry to make successful programs available to all children who need
them. What is needed from the research community is a shift in the
central question being asked in contemporary early childhood education
research. We need to realize that the old question of whether the
development of high-risk children [can]{.underline} be positively
changed has been answered with a resounding "[yes]{.underline}." We must
now move on to more refined questions concerning the relative influence
of different types of programs including practical questions concerning
age of onset, intensity and duration of treatment as well as the effects
of various specific educational curricula. During this transition we
need to study and to improve, where needed, the existing early childhood
programs.

In my opinion this Summit marks the beginning of a new era in the
developing partnerships of scientists and educators to improve preschool
educational programs. If significant progress is made in the
availability of high-quality preschool programs we believe that these
improvements will affect not only children and parents who are
disadvantaged, but the taxpayers who support their education. It is our
belief that high quality education and rigorous science is a powerful
combination that can provide benefits to our whole society.

Now for some specific results which have led us to this point of view.

Each year hundreds of thousands of children enter kindergarten
unprepared to meet the intellectual demands of school (Carnegie, 1995).
Lack of cognitive readiness bodes ill for future school performance.
Poor school readiness predicts increased likelihood of low levels of
academic achievement and high levels of retention in grade, special
education placement, and ultimately school dropout. In turn, school
dropouts are at much elevated risk for unemployment, teen pregnancy,
juvenile delinquency, social dependency, and poor parenting practices.
Their children all too frequently repeat this pattern. (cf., Carnegie
Report, 1995).

Poor school performance is foreshadowed by subaverage performance on
cognitive, linguistic and social functioning during the years prior to
kindergarten.

![](media/image1.png){width="4.579861111111111in"
height="3.4368055555555554in"} Remedial special education to improve
cognitive development and academic achievement that is begun in the
elementary school years faces an enormous challenge. In essence for
special education to be effective, the base rate of cognitive
development must be altered if the progressive gap between normal and
subaverage cognitive development is to be arrested and intellectual
development is to be established at normative trajectories. If genuine
[catch-up]{.underline} is to occur, the rate of development during
treatment must actually exceed the normative rate. Thus, the shorter the
period of remedial intervention the more powerful it must be. This point
is illustrated in Figure 1.

Unfortunately, little is known about how to accelerate cognitive
development beyond normative or typical rates. Thus, the initial hopes
and expectations for remedially oriented special education often go
unmet.

A policy alternative to remedial or typical special education is primary
prevention. Primary prevention entails the identification of high-risk
individuals in the general population and the provision of the
hypothesized missing essential experiences for normative development.

A large body of observational research suggests that children who
evidence delayed cognitive development have insufficient frequency of
exposure to particular adult-child transactional experiences (e.g.,
Bradley et al, 1989; Huttenlocher, Haijht, Bryk, & Seltzer, 1991; Ramey
& Ramey, 2000). These transactional experiences are particularly lacking
in low socioeconomic status families and are reliably missing beginning
in the second year of life and sometimes earlier. (Yeates et al., 1983).
(Huttenlocher et al., 1991). These transactional experiences have been
summarized by Ramey & Ramey, 1992 and are presented in Table 1. These
so-called Developmental Priming Mechanisms are part of a theoretical
framework derived from General

**TABLE 1**

**DEVELOPMENTAL PRIMING MECHANISMS**

**1. ENCOURAGEMENT OF EXPLORATION:**

To be encouraged by adults to explore and to gather information about
their environments

**2. MENTORING IN BASIC SKILLS:**

> To be mentored (especially by trusted adults) in basic cognitive
> skills, such as labelling, sorting, sequencing, comparing, and noting
> means-ends relationships

**3. CELEBRATION OF DEVELOPMENTAL ADVANCES:**

> To have their developmental accomplishments celebrated and reinforced
> by others, especially those with whom they spend a lot of time

**4. GUIDED REHEARSAL AND EXTENSION OF NEW SKILLS:**

To have responsible others help them in rehearsing and then elaborating
upon (extending) their newly acquired skills

**5. PROTECTION FROM INAPPROPRIATE DISAPPROVAL, TEASING, OR
PUNISHMENT:**

> To avoid negative experiences associated with adults\' disapproval,
> teasing, or punishment for those behaviors that are normative and
> necessary in children\'s trial-and-error learning about their
> environments (e.g., mistakes in trying out a new skill, unintended
> consequences of curious exploration or information seeking). Note:
> this does not mean that constructive criticism and negative
> consequences cannot be used for other child behaviors which children
> have the ability to understand are socially unacceptable.)

**6. A RICH AND RESPONSIVE LANGUAGE ENVIRONMENT:**

> To have adults provide a predictable and comprehensible communication
> environment, in which language is used to convey information, provide
> social rewards, and encourage learning of new materials and skills.
> Note: although language to the child is the most important early
> influence, the language environment may be supplemented in valuable
> ways by the use of written materials.

7.  **GUIDANCE AND LIMITATION:**

> To have adults keep children safe and to teach what is acceptable, and
> what is not -- the rules of being a cooperative, responsive, and
> caring person.

Systems Theory and applied to two-generational early intervention
programs by Ramey, Ramey, Gaines and Blair (1995). Insufficient exposure
to these Developmental Priming Mechanisms is hypothesized to negatively
affect developmentally appropriate cortical neuronal connections and
synaptic efficiency associated with cognitive, linguistic and social
development. In turn these changes are hypothesized to be reflected in
summative performance on norm-referenced measures of cognitive,
linguistic and social competence.

To test the hypothesis that provision of these theoretically critical
experiences can potentially prevent progressive cognitive delay we have
conducted two single site randomized trials and one multi-site
randomized controlled trial with high-risk children and their families.
These projects and their cognitive outcomes are the focus of this
presentation.

The Early Intervention Programs

Certain programmatic commonalities run throughout the Abecedarian
Project (Ramey & Campbell, 1992), Project CARE (Ramey, Bryant, Sparling,
& Wasik, 1985), and the Infant Health and Development Program (Ramey,
Bryant, Wasik, Sparling, Fendt, & LaVange, 1992). These early childhood
education programs were multidisciplinary, intergenerational,
individualized for children and their families, contextually embedded in
local service delivery systems, research - oriented and organized around
key concepts undergirding randomized controlled trials.

The research design and associated key concepts that have guided our
efforts have derived from the evolving literature on randomized
controlled trials concerned with efficacy of treatments. That is, can a
given program work under nearly idealized research conditions? Guiding
concepts for our efficacy trials worthy of special mention include:

1\. Recruitment from prespecified populations to enhance generality of
findings,

2\. Random assignment to treatment and control groups to establish
initial group equivalence,

3\. Application and documentation of receipt of a replicable compound of
services including specific educational curricula,

4\. Minimization of attrition to prevent biased estimates of treatment
effects,

5\. Independent assessment of outcomes by observers masked to treatment
conditions of participants,

6\. Preplanned statistical analyses of hypothesized outcomes with
adequate sample sizes for appropriate statistical power to detect
statistically and practically meaningful group differences,

7\. Replication of key findings in independent samples of children and
families,

8\. Publication of findings in peer-reviewed journals,

9\. Dissemination of findings to key policy makers and the general
public after publication in peer-reviewed journals.

Participants and Programs

The first two projects (The Abecedarian Project (N = 111 children) and
Project CARE (N=63 children) were single-site randomized controlled
trials which enrolled children at birth who were biologically healthy
but who came from very poor and undereducated families. For example the
mean maternal education in both projects was approximately 10 years of
schooling. Approximately 3/4 of the mothers were unmarried. Control
group families (sometimes referred to as Follow-up families) were not a
totally untreated group, however. Rather, those children received
pediatric follow-up services on a schedule recommended by the American
Academy of Pediatrics. In addition the children were provided unlimited
iron fortified formula. Families of control group children also received
social work services and home visits. These sources were provided due to
ethical and research concerns. Their provision, we should note, makes
the demonstration of group differences less likely due to their presumed
positive influence on the control group children and families.

The Early Intervention groups received the same services just mentioned
for the Control groups plus they received an Early Childhood Education
Program known as Partners for Learning (Sparling, Lewis & Ramey, 1995)
within the context of a specially developed Child Development Center.
This Center admitted children after 6 weeks of age and maintained low
child/teacher ratios (e.g., 3:1 for children \< 1 year; 4:1 for children
between 1 and 3 years) and an ongoing inservice curriculum training and
technical assistance program for teachers. Parent involvement was
facilitated by home visits and parent groups. A fuller description of
the preschool program can be found in an article by Ramey & Campbell
(1992) and Ramey.... In general, program features in the Abecedarian and
CARE projects foreshadowed those that are now recommended by the
National Association for the Education of Young Children.

[Partners for Learning]{.underline} can be described as an educational
curriculum that is concerned with 31 child development areas and
consistently oriented toward adult-child transactions involving
well-formed and conversational language about topics of every day
interest to young children (McGinness & Ramey 1981; Ramey, McGinness,
Cross, Collier, & Barrie-Blackley, 1981). [Partners for
Learning]{.underline} acts both as a child program resource and as a
staff development resource and provides a means to individualize the
educational program for each child.

The Infant Health and Development Program (N=985) was a slightly
modified version of that program used in the Abecedarian and CARE
projects. Modifications included: 1) establishing the program as an
8-site randomized controlled trial, 2) limiting enrollment to infants
who were born at \<2500 grams and \<37 weeks gestational age. Thus all
child participants were to varying degrees of low birthweight and
prematurity, 3) weekly home visits were the main early intervention
component until children were 12 months of age (corrected for
prematurity). At 12 months of age children began attending Child
Development Centers that were replicas of the one used for the
Abecedarian and CARE projects. (Fuller descriptions of the Infant Health
and Development Program -- IHDP - can be found in IHDP (1990) and Ramey,
Bryant, Wasik, Sparling, Fendt & LaVange (1992).

## Cognitive Results from these Early Education Programs

Figure 2 shows Bayley Mental Development Index scores (MDIs) and
Stanford - Binet (S-B)

![](media/image2.png){width="2.125in" height="2.3090277777777777in"}

IQ scores by age and treatment conditions during the first 3 years of
life for both the Abecedarian project (top panel) and Project CARE
(lower panel). The top of the gray area represents the mean performance
on the control group's cognitive assessments at the ages identified on
the horizontal axis while the top of the black area represents the mean
performance of the early childhood education group. Thus, the amount of
black represents the cognitive value added due to the influence of the
early childhood education. In both of these graphs there is a divergence
of the curves favoring the early intervention groups over the control
groups during the first 18 months. Consistent with the random assignment
of children to treatment and control conditions, a strong causal
inference is justified concerning the preventive power of the early
educational curriculum. By 36 months the mean IQ scores in the
Abecedarian Project are 101 and 84 for the early education and control
group respectively (Ramey & Campbell, 1984). In Project Care the
comparable 36-month scores are 105 and 93 (Ramey et al., 1985).

Figure 3 contains plots for the most comparable IHDP children to the
Abecedarian and CARE children - those closest to full birthweight
(2001 - 2500 grams) at each of the 8 sites. These 8 graphs all show
similar divergence to 36 months with an overall mean difference of 13.2
IQ points favoring the early intervention groups at 36 months.
Comparable plots (Figure 4) for the lighter low

birthweight groups (\<2001 grams) reveals similar trends in 7 of the 8
comparisons (the Harvard site being the exception) but with a somewhat
diminished magnitude of difference between the early intervention and
control (follow-up) groups (overall mean difference = 6.6 IQ points at
36 months). Thus 17 of the 18 comparisons at 36 months across the
Abecedarian, CARE and IHDP projects support the hypothesis that
intensive early intervention is associated with higher cognitive
performance relative to randomized controls.

![](media/image4.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image5.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image6.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image7.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image8.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image9.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image10.png){width="3.3125984251968505in"
height="1.9897637795275591in"}![](media/image11.png){width="3.3125984251968505in"
height="1.9897637795275591in"}

### Figure 3. Cognitive scores for infants 2,001-2,500 g at birth

![](media/image20.png){width="3.5318897637795277in"
height="1.9783464566929134in"}![](media/image21.png){width="3.2208661417322832in"
height="1.8645669291338582in"}![](media/image22.png){width="3.4318897637795276in"
height="1.802755905511811in"}![](media/image23.png){width="3.5318897637795277in"
height="1.9783464566929134in"}![](media/image24.png){width="3.5318897637795277in"
height="1.9783464566929134in"}![](media/image25.png){width="3.5318897637795277in"
height="1.9783464566929134in"}![](media/image26.png){width="3.5318897637795277in"
height="1.9783464566929134in"}![](media/image27.png){width="3.5318897637795277in"
height="1.9783464566929134in"}

### 

### Figure 4. Cognitive scores for infants \<2,001 g at birth

Figure 5 illustrates that children's cognitive performance at 36 months
is positively related to

mothers education levels in the IHDP control group and that the positive
effects of the early intervention are greater for the children of lesser
educated mothers.

![](media/image36.bmp)

### 

### 

### 

### 

### 

### 

### Figure 5. Cognitive performance as a function of early intervention and maternal educational level

That is, those children at greatest cognitive risk due to low family
educational resources benefited the most.

These were benefits in addition to the cognitive ones. These benefits
are summarized in Table 2. In that table the symbol "NS" means that the
characteristic described was measured and the two groups were not
significantly different by statistical test. The symbol "-"means that
the characteristic was not measured at that age. The symbol "\*" means
that the characteristic was measured and in all instances, without
exception, the differences favored the early childhood education group
over the

##### Table 2

##### Developmental Outcomes Affected Positively

##### By the Infant Health & Development Project

**[Age in Months]{.underline}**

**[12 24 36]{.underline}**

**Cognitive Development NS \* \***

**Adaptive and Prosocial Behavior - - \***

**Behavior Problems - \* \***

**Vocabulary - \* \***

**Receptive Language - \* \***

**Reasoning - - \***

**Home Environment NS \* \***

**Maternal Interactive Behavior - - \***

**Maternal Problem Solving - - \***

**© Ramey 1999, adapted from Gross, Spiker, & Haynes, 1997, [Helping Low
Birth Weight, Premature Babies]{.underline}**

follow-up group. Thus, at 36 months of age the Early Childhood Education
group had, on average, higher cognitive development across and showed
more adaptive and prosocial behaviors. The educationally treated group
also had fewer behavior problems, larger vocabularies, better receptive
language, and better reasoning skills. Their home environments were
rated as developmentally more supportive, their mothers interacted with
them more in developmentally appropriate ways and their mothers were
better at solving everyday problems concerning childrearing. Thus, a
comprehensive early childhood and family support program produced broad
and positive developmental outcomes for both the child and family while
it was in operation during the first three years of life at which point
it was terminated.

The Abecedarian and Care Projects continued with the Early Childhood
Educational Program until the children entered public kindergarten. The
cognitive differences between the treated and control groups continued
to persist at statistically significant levels (Burchinal, Campbell,
Bryant, Wasik, & Ramey, 1997).

Table 3, summarized from a paper by Ramey, MacPhee, and Yeates (1982),
presents a summary of results from the Abecedarian Project during the
preschool period.

##### Table 3

**Brief Summary of Abecedarian**

##### Results During Preschool Period

**[Positive Effects on]{.underline}**

#######  IQ performance

-   **Learning & cognitive performance**

-   **Language development**

-   **Resilience to non-optimal biological and behavioral conditions**

-   **Social responsiveness**

-   **Academic locus of control**

-   **Maternal education**

-   **Maternal employment**

#######  [No Effects on]{.underline}

-   **Maternal attachment**

-   **Parental child rearing attitudes**

-   **Home environments**

######## Decreased Effects

-   **Incidence of intellectual subnormality**

**Summarized from Ramey, MacPhee, & Yeates, 1982**

Similarly to the Infant Health and Development Program, the Abecedarian
Program produced a broad array of positive effects on both participating
children and their parents. It is noteworthy that in these programs and
with other high-quality early education projects, so far, there have
been no reports of negative side effects on the children, their
families, or the attachment between children and families.

Follow-Up Results

The Infant Health and Development Program was terminated at age 3 and
produced a disappointing pattern of cognitive results thereafter.
Longitudinal analyses of these children's development showed that by 5
and 8 years of age, the overall IQ differences between the treatment and
comparison groups decreased to such an extent that it was no longer
educationally significant (Brooks-Gunn et al., 1994; McCarton et al.,
1997). However, it is noteworthy that the [heavier]{.underline} low
birth weight children continued to have significantly higher IQ scores
at age 5 and by age 8 the early intervention group scored 4.4 points
higher than the comparison. The follow-up researchers involved in this
study concluded that early cessation of services at age three was likely
to have contributed to the loss of early benefits and that additional
interventions are indicated for low birth weight infants to sustain
earlier gains. In short, stopping intervention at age three for these
highly vulnerable infants is not a good idea.

In the Abecedarian Project we decided to examine the effects of an
additional educational treatment that we began at kindergarten entry and
continued for the first three years of school. To address this issue we
randomly divided each of the two preschool groups. One-half of each
group received an enriched educational program from kindergarten entry
through second grade. This allowed a practical test of three major
educational policy alternatives with respect to timing and duration of
early intervention services. That is...

Table 4 provides a brief summary of the services delivered during the
school-age phase of the intervention. A fuller description of this
aspect of the Abecedarian Project can be found in Ramey and Campbell
(1992). In essence, the K-2 program was intensive, focused on home and
school continuity, and emphasized reading, math and writing and was
conducted year around. Parents, teachers and children participated
enthusiastically.

**Table 4**

**Summary of Abecedarian K-2 Transition Program**

-   **Individualized focus on academic and learning activities in school
    and at home**

-   **Emphasis on reading, mathematics, and writing**

-   **Master Home/School Resource Teachers (12 children and families per
    teacher)**

-   **Development of an individualized and documented supplemental
    curriculum for each child**

-   **Explicit attention and action relevant to family circumstances, as
    needed**

-   **Summer camps with academically relevant experiences**

![](media/image37.wmf){width="6.678346456692913in"
height="3.1251968503937007in"}

![](media/image38.wmf){width="6.479166666666667in"
height="4.291666666666667in"}At the end of the second grade a stair-step
pattern of performance on reading and math was found that indicated a
proportional response to the intensity of the treatment. This is
illustrated for reading in Figure 7. The majority of the effect was
captured, however, by whether the children had participated in the
preschool program. The school age program, by itself, was of marginal
added value although it seems to have had a slight protective role for
those children who had the preschool program.

**Figure 7**

![](media/image40.wmf)**Figure 8**

Follow-up assessments of the Abecedarian children have now been
completed at 8, 12, 15 and 21 years of age. With respect to standardized
measures of intelligence, the differences between the treatment and
comparison groups narrowed but continued to be statistically and
educationally meaningful at approximately 5 IQ points. Perhaps more
germane to education, however, are the results from reading and math
achievement assessments. At all ages from 8 to 21, the preschool
treatment group had significantly higher academic achievement scores in
both reading and mathematics. Figure 8 shows the results for reading
performance for Abecedarian children and Figure 9 shows the math
performance.

![](media/image41.png){width="3.7916666666666665in"
height="2.1979166666666665in"}**Math Achievement as a Function of Early
Treatment Over Time**

**Figure 9**

In the follow-up study at age 21 (Campbell, Ramey, Pungello, Sparling, &
Miller-Johnson, 2002) it was found that not only did the children in the
preschool treatment group earn significantly higher scores on
intellectual and academic measures as young adults but they were also
more likely to have attained more years of total education, were three
times more likely to attend a four year college (12% vs. 36%), and
showed a reduction in teenaged births compared to preschool controls. An
earlier follow-up at age 15 had demonstrated that they were 47% less
likely to be retained in grade and 75% less likely to be placed in
special education (Ramey et al., 2000). Thus, the cognitive benefits
that began with a good preschool education better prepared these
high-risk children to be ready to develop the reading and math skills
that the schools were prepared to teach. In turn the children mastered
these two gateway skills and, as a group, did better throughout school
and into young adulthood. In short, risk for poor cognitive development
was offset to a considerable degree by high-quality preschool education
focused on cognitive development, conversational skills and social
competence.

These results, although somewhat larger in magnitude of positive
effects, are consistent with earlier findings from the Consortium of
Longitudinal Studies (Lazar & Darlington, 1982) and from other
randomized trials of high-quality early childhood educational programs
(see Ramey & Ramey, 1998, for a detailed review). We think it plausible
that the greater intensity and duration of our preschool component
accounts for their larger effects when compared to lesser intensive
preschool interventions. In summary, we believe that the efficacy
question of whether early childhood education can have meaningful
positive impact on at-risk children has been answered with a clear
[yes]{.underline}. The obvious question is where do we go from here?

Based on the research evidence in hand we believe that four actions are
timely and important:

First, our country should provide appropriate levels and types of early
childhood programs to those children in greatest need of additional
high-quality preschool education. To do this we need better
population-based studies of risk and careful empirical research on the
specific benefits of different educational practices and curricula.

Second, existing program standards need to be reviewed and upgraded
where guidelines are not consistent with scientific evidence for program
effectiveness. We believe that this should be accompanied by
high-quality teacher training and technical assistance to improve
teacher knowledge and skills.

Third, we should create a nationwide network of model demonstration
programs that have been certified as demonstrating exemplary
high-standards and practices.

Fourth, we should provide useful and appealing public information that
is scientifically-based on the importance of roles and activities of
parents and teachers in the development of young children.

These four courses of action are ones that can begin immediately and
that can reinforce one another in improving children's competence. The
theoretical systems and technologies are available to facilitate
high-quality and practical scientific inquiry. We can readily create the
infrastructures to transfer the scientific knowledge to where it will be
useful and to monitor its impact on children and families.

As our knowledge about the importance of early childhood cognitive
development, literacy, and social competence increases so does our
responsibility to act upon this knowledge to improve the conditions that
can maximize positive child cognitive outcomes and social competence. We
are confident that this can be done effectively and efficiently. We
applaud Mrs. Bush, the President, and the Bush administration for their
dedication "to leave no child behind."

References

Bradley, R. H., Caldwell, B. M., Rock, S. L., Ramey, C. T., Barnard, K.
E., Gray, A., Hammond, M. A., Gottfried, A., Siegel, L. S., & Johnson,
D. L. (1989). Home environment and cognitive development in the first 3
years of life: A collaborative study involving six sites and three
ethnic groups in North America. [Developmental Psychology]{.underline},
[25]{.underline}, 217-235.

Brooks-Gunn, J., McCarton, C.M., Casey, P.H., McCormick, M.C., Bauer,
C.R., Bernbaum, J.C., Tyson, J., Swanson, M., Bennett, F. C., Scott, D.
T., Tonascia, J., and Meinert, C. (1994). Early intervention in
low-birth-weight premature infants: Results through age 5 years from the
Infant Health and Development Program. [Journal of the American Medical
Association, 272]{.underline}(16): 1257-1262.

Burchinal, M.R., Campbell, F.A., Bryant, D.M., Wasik, B.H., & Ramey,
C.T. (1997). Early intervention and mediating processes in cognitive
performance of children of low-income African American families. [Child
Development, 68,]{.underline} 935-954.

Campbell, F.A., Ramey, C.T., Pungello, E., Sparling, J., &
Miller-Johnson, S. (2002). Early childhood education: Outcomes as a
function of different treatments. [Applied Developmental Science,
6]{.underline}*,* 42-57*.*

Carnegie Report, 1995. [Years of Promise: A Comprehensive Learning
Strategy for America=s Children.]{.underline} Carnegie Corporation of
New York.

Hart, B., & Risley, T. R. (1995). [Meaningful experiences in the
everyday experiences of young American children]{.underline}. Baltimore,
MD: Paul H. Brookes Publishing Co., Inc.

Horacek, H. J., Ramey, C. T., Campbell, F. A., Hoffman, K. P., &
Fletcher, R. H. (1987). Predicting school failure and assessing early
interventions with high-risk children. [Journal of the American Academy
of Child Psychiatry, 26]{.underline}*,* 758-763.

Huttenlocher, J., Haight, W., Bruk, A., Seltzer, M., & Lyons, T. (1991).
Early vocabulary growth: Relation to language input and gender.
[Developmental Psychology, 27]{.underline}.

The Infant Health and Development Program. (1990). Enhancing the
outcomes of low-birth-weight, premature infants. [Journal of the
American Medical Association]{.underline}, [263]{.underline}, 3035-3042.

Lazar, I., & Darlington, R. (1982). Lasting effects of early education.
[Monographs of the Society for Research in Child Development (Serial No.
195)]{.underline} 47(2/3):1-151.

Lyon, R.. (2002). [Cognition, Reading and School Readiness]{.underline}.
Presentation at President's Summit on Cognitive Development, Georgetown
University, Washington, DC.

McCarton, C. M., Brooks-Gunn, J., Wallace, I. F., Bauer, C. R., Bennett,
F. C., Bernbaum, J. C., Broyles, R. S., Casey, P. H., McCormick, M. C.,
Scott, D. T., Tyson, J., Tonascia, J., & Meinert, C. L. (1997). Results
at age 8 years of early intervention for low-birth-weight premature
infants: The Infant Health and Development Program. [JAMA,
277,]{.underline} 126-132.

McGinness, G., & Ramey, C. T. (1981). Developing sociolinguistic
competence in children. [Canadian Journal of Early Childhood Education,
1]{.underline}*,* 22-43.

Ramey, C. T., Bryant, D. M., Sparling, J. J., & Wasik, B. H. (1985).
Project CARE: A comparison of two early intervention strategies to
prevent retarded development. [Topics in Early Childhood Special
Education]{.underline}, [5]{.underline}, 12-25.

Ramey, C. T., Bryant, D. M., Wasik, B. H., Sparling, J. J., Fendt, K.
H., & LaVange, L. M. (1992). Infant Health and Development Program for
low birth weight, premature infants: Program elements, family
participation, and child intelligence. [Pediatrics]{.underline},
[89]{.underline}, 454-465.

Ramey, C. T., & Campbell, F. A. (1984). Preventive education for
high-risk children: Cognitive consequences of the Carolina Abecedarian
Project. [American Journal of Mental Deficiency]{.underline},
[88]{.underline}(5), 515-523.

Ramey, C. T., & Campbell, F. A. (1992). Poverty, early childhood
education, and academic competence: The Abecedarian experiment. In A.
Huston (Ed.), [Children in poverty]{.underline} (pp. 190-221). NY:
Cambridge University Press.

Ramey, C. T., Campbell, F. A., Burchinal, M., Skinner, M. L., Gardner,
D. M., & Ramey, S. L. (2000). Persistent effects of early childhood
education on high-risk children and their mothers. [Applied
Developmental Science, 4]{.underline}, 2-14.

Ramey, C. T., McGinness, G., Cross, L., Collier, A., & Barrie-Blackley,
S. (1981). The Abecedarian approach to social competence: Cognitive and
linguistic intervention for disadvantaged preschoolers. In K. Borman
(Ed.), [The social life of children in a changing society]{.underline}
(pp. 145-174). Hillsdale, NJ: Erlbaum Associates.

Ramey, S.L., & Ramey, C.T. (1992). Early educational intervention with
disadvantaged children \-- To what effect? [Applied and Preventive
Psychology]{.underline}, [1]{.underline}, 131-140.

Ramey, C. T., & Ramey, S. L. (1998). Early intervention and early
experience. [American Psychologist, 53,]{.underline} 109-120.

Ramey, C.T., Ramey, S.L., Gaines, R., & Blair, C. (1995). Two-generation
early interventions: A child development perspective. In I. Siegel
(Series Ed.) and S. Smith (Vol. Ed.), [Two-generation programs: A new
intervention strategy. Vol.9 Advances in applied developmental
psychology]{.underline} (pp.199-228). Norwood, NJ: Ablex Publishing
Corporation.

Ramey, S.L., & Ramey, C.T. (2000). Early childhood experiences and
developmental competence. In J. Waldfogel & S. Danziger (Eds*.*)*,*
[Securing the future: Investing in children from birth to
college]{.underline} (pp.122-150). NY: Russell Sage Foundation.

Shonkoff, J. P., & Phillips, D. A. (2000). [From neurons to
neighborhoods: The science of early childhood development]{.underline}.
National Academy Press.

Sparling, J.J., Lewis, I. & Ramey, C.T. (1995). Partners for learning:
Birth to 36 months. Lewisville, NC: Kaplan Press.

Yeates, K. O., MacPhee, D., Campbell, F. A., & Ramey, C. T. (1983).
Maternal IQ and home environment as determinants of early childhood
intellectual competence: Developmental analysis. [Developmental
Psychology]{.underline}, [19]{.underline}, 731-739.