Report to Congressional Requesters

United States Government Accountability Office

GAO 

August 2006 CHILD CARE AND 

EARLY CHILDHOOD 

EDUCATION 

More Information 

Sharing and Program 

Review by HHS Could 

Enhance Access for 

Families with Limited 

English Proficiency 

GAO-06-807 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

www.gao.gov/cgi-bin/getrpt?GAO-06-807.

To view the full product, click on the link 

above. Translated report summaries are 

available in selected languages at 

http://www.gao.gov/translations/childcare.html

For more information, contact Cornelia Ashby 

at (202) 512-7215 or ashbyc@gao.gov. 

Highlights of GAO-06-807, a report to 

congressional requesters 

August 2006

CHILD CARE AND EARLY CHILDHOOD 

EDUCATION 

More Information Sharing and Program 

Review by HHS Could Enhance Access 

for Families with Limited English 

Proficiency 

HHS’s Child Care Bureau (CCB) did not have information on the total 

enrollment in CCDF programs of children whose parents had limited English 

proficiency, but data collected by its Office of Head Start in 2003 showed 

that about 13 percent of parents whose children were in Head Start reported 

having limited English proficiency. The most recent (1998) national survey 

data showed that children of parents with limited English proficiency were 

less likely than other children to receive financial assistance for child care 

from a social service or welfare agency or to be in Head Start, after 

controlling for selected characteristics. Eighty-eight percent of these 

children were Hispanic, and their results differed from Asian children. 

Likelihood of Selected Outcomes for Children of Parents with Limited English Proficiency, 

after Controlling for Other Factors 

 Compared to similar children of parents proficient in English 

All children of 

parents with limited 

English 

 proficiency 

Hispanic children of 

parents with limited 

English proficiency 

Asian children of 

parents with limited 

English proficiency 

Receipt of financial 

assistance for child care Less likely Less likely 

No significant 

difference 

Head Start Less likely Less likely More likely 

Source: GAO analysis of Early Childhood Longitudinal Study, Kindergarten Class of 1998-99. 

Analysis of data from focus groups and site visit interviews held by GAO 

revealed that mothers with limited English proficiency faced multiple 

challenges, including lack of awareness of available assistance, language 

barriers during the application process, and difficulty communicating with 

English-speaking providers. Some of the challenges that low-income parents 

with limited English proficiency experienced, such as lack of transportation 

and shortage of subsidized child care slots, were common to other lowincome families. 

The majority of state and local agencies that we visited offered some oral 

and written language assistance, such as bilingual staff or translated 

applications. Agencies in the majority of locations visited also made efforts 

to increase the supply of providers who could communicate with parents. 

Officials reported challenges in serving parents with limited English 

proficiency, such as difficulty hiring qualified bilingual staff. Some officials 

indicated that additional information on cost-effective strategies to serve this 

population would facilitate their efforts. 

HHS issued guidance, translated materials, and provided technical 

assistance to grantees to help them serve children of parents with limited 

English proficiency. The Office of Head Start reviewed programs’ 

assessments of their communities’ needs and conducted formal monitoring 

reviews, but could not ensure that review teams consistently assessed 

grantees’ performance on the standards related to language access. CCB 

reviewed states’ plans on the use of CCDF funds generally and investigated 

specific complaints, but had no mechanism for reviewing how and whether 

states provide access to CCDF subsidies for eligible children of parents with 

limited English proficiency. 

Questions have been raised about 

whether parents with limited 

English proficiency are having 

difficulty accessing child care and 

early education programs for their 

children. Research suggests that 

quality early care experiences can 

greatly improve the school 

readiness of young children. GAO 

was asked to provide information 

on (1) the participation of these 

children in programs funded 

through the Child Care and 

Development Fund (CCDF) and 

Head Start, (2) the challenges these 

families face in accessing 

programs, (3) assistance that 

selected state and local entities 

provide to them, and (4) actions 

taken by the Department of Health 

and Human Services (HHS) to 

ensure program access. To obtain 

this information, GAO analyzed 

program and national survey data, 

interviewed officials in 5 states and 

11 counties, held 12 focus groups 

with mothers with limited English 

proficiency, and interviewed 

experts and HHS officials. 

What GAO Recommends

GAO recommends that HHS help 

states explore cost-effective ways 

of collecting data on the primary 

language of CCDF subsidy 

recipients and that HHS develop 

means of reviewing how states 

provide access to CCDF subsidies. 

In comments, HHS generally 

agreed with our recommendations 

and provided additional 

information on its actions and 

plans to implement them. 
Page i GAO-06-807 Child Care and Early Childhood Education 

Letter 1

Results in Brief 3 

Background 7 

Children of Parents with Limited English Proficiency Were Less 

Likely than Other Children to Participate in Subsidized Programs 15 

Parents with Limited English Proficiency Faced Multiple 

Challenges That May Have Limited Their Children’s 

Participation in Federally Funded Child Care and Early 

Education Programs 21 

Selected Agencies Took Some Steps to Assist Parents with Limited 

English Proficiency but Reported Challenges in Serving Them 25 

HHS Provided Assistance to Grantees on Serving Children of 

Parents with Limited English Proficiency, but Gaps Remain in Its 

Program Review Efforts 32 

Conclusions 38 

Recommendations for Executive Action 39 

Agency Comments and Our Evaluation 40 

Appendix I Scope and Methodology 42 

Appendix II Analyses of the Effects of Limited English 

Proficiency on Child Care and Early Education 

Patterns 51 

Appendix III Comments from the U.S. Department of Health and 

Human Services 66 

Appendix IV GAO Contact and Staff Acknowledgments 70 

Tables 

Table 1: Characteristics of Data Sources Examined 43 

Table 2: Selected Characteristics of Site Visit Counties 47 

Table 3: Composition of Focus Groups 49 

Contents 
Page ii GAO-06-807 Child Care and Early Childhood Education 

Table 4: Differences in the Percentages and Odds of Receiving Any 

Nonparental Care, by Parents’ English Proficiency Status, 

Race or Ethnicity, and Both, among Preschool-Aged 

Children 54 

Table 5: Differences in the Percentages and Odds of Receiving 

Financial Assistance for Child Care, among Those in Any 

Prekindergarten Care, by Parents’ English Proficiency 

Status, Race or Ethnicity, and Both 57 

Table 6: Percentages of English Proficient Parents and Parents 

with Limited English Proficiency, by Race or Ethnicity 58 

Table 7: Percentages of English Proficient Parents and Parents 

with Limited English Proficiency, by Family Income 58 

Table 8: Percentages of English Proficient Parents and Parents 

with Limited English Proficiency, by Education 59 

Table 9: Percentages of English Proficient Parents and Parents 

with Limited English Proficiency, by the Number of 

Persons over the Age of 18 in the Household 59 

Table 10: Percentages of English Proficient Parents and Parents 

with Limited English Proficiency, by Parents’ Work Status 59 

Table 11: Percentages of English Proficient Parents and Parents 

with Limited English Proficiency, by the Number of 

Different Types of Child Care Used, among Those Using 

Care 60 

Table 12: Odds Ratios from Logistic Regression Models Used to 

Estimate the Effects of Different Factors on the Likelihood 

of Receiving Any Child Care, after Adjusting for Other 

Characteristics 61 

Table 13: Odds Ratios from Logistic Regression Models Used to 

Estimate the Effects of Different Factors on the Likelihood 

of Receiving Financial Assistance for Child Care, among 

Those in Any Care, after Adjusting for Other 

Characteristics 63 

Table 14: Odds Ratios from Logistic Regression Models Used to 

Estimate the Effects of Different Factors on the Likelihood 

of Receiving Center-Based Care, among Those in Any 

Care, after Adjusting for Other Characteristics 64 

Table 15: Odds Ratios from Logistic Regression Models Used to 

Estimate the Effects of Different Factors on the Likelihood 

of Participating in Head Start, after Adjusting for Other 

Characteristics 65 
Page iii GAO-06-807 Child Care and Early Childhood Education 

Figures 

Figure 1: Size and Growth of Population of Individuals with 

Limited English Proficiency, 1990-2000 8 

Figure 2: Flow of Funds Under CCDF and Head Start 10 

Figure 3: Relative Odds of Selected Outcomes for Children of 

Parents with Limited English Proficiency Compared to 

Children of Parents Proficient in English, for Hispanics 

and Asians, after Adjusting for Selected Family 

Characteristics 17 

Figure 4: English and Chinese Versions of a Local Agency’s Child 

Care Quality Brochure 28 

Abbreviations 

ACF Administration for Children and Families 

CBRS Computer-Based Reporting System 

CCB Child Care Bureau 

CCDF Child Care and Development Fund 

CRADLE Culturally Responsive and Aware Dual Language Education 

ECLS-K Early Childhood Longitudinal Study, 

 Kindergarten Class of 1998-99 

FACES Family and Child Experiences Survey 

HHS Department of Health and Human Services 

HSNRS Head Start National Reporting System 

LEP limited English proficiency 

NACCRRA National Association of Child Care Resource 

 and Referral Agencies 

NCES National Center for Education Statistics 

 OCR Office for Civil Rights 

PRISM Program Review Instrument for Systems Monitoring 

TANF Temporary Assistance for Needy Families 

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reproduce this material separately. 
Page 1 GAO-06-807 Child Care and Early Childhood Education 

August 17, 2006 

The Honorable Charles E. Grassley 

Chairman 

Committee on Finance 

United States Senate 

The Honorable Max Baucus 

Ranking Minority Member 

Committee on Finance 

United States Senate 

The Honorable Christopher J. Dodd 

Ranking Minority Member 

Subcommittee on Education and Early Childhood Development 

Committee on Health, Education, Labor, and Pensions 

United States Senate 

Children whose parents have limited English proficiency are at greater 

risk of experiencing difficulties in school than children from Englishspeaking households. Research suggests that quality early care 

experiences can greatly improve the school readiness and future school 

success of young children, particularly children at greatest risk of failure. 

U.S. Census Bureau data from 2000 indicate that more than 1.6 million 

children age 5 and younger lived in households where no one aged 14 or 

over reported English proficiency. Census data also show that these 

children were more likely than other children to be from low-income 

families. There is interest in how this population is faring in accessing 

child care and early education programs that can ease children’s transition 

to school. 

The U.S. Department of Health and Human Services (HHS) administers the 

two largest federally funded programs that support early childhood 

activities. HHS’s Child Care Bureau (CCB) provides block grants to states 

through the Child Care and Development Block Grant, commonly referred 

to as the Child Care and Development Fund (CCDF), to subsidize child 

care for low-income children while their parents work or participate in 

education or training activities. HHS’s Office of Head Start funds local 

grantees through its Head Start program, a comprehensive program 

designed to foster healthy child and family development and to help lowincome children achieve school readiness. States receiving CCDF block 

United States Government Accountability Office

Washington, DC 20548 
Page 2 GAO-06-807 Child Care and Early Childhood Education 

grants and Head Start grantees have limited funds for these programs and 

employ priorities and waiting lists to ration services. In fiscal year 2006, 

CCDF provided approximately $4.9 billion in federal funds to states and 

territories. In fiscal year 2004 (the latest year for which service delivery 

data were available), states and territories received about $4.7 billion in 

federal funds and served approximately 1.74 million children in their 

CCDF programs. In fiscal year 2005, Head Start grantees received about 

$6.8 billion in federal funding and served approximately 900,000 children. 

The majority of individuals with limited English proficiency are 

immigrants—individuals not born in the United States—although most 

children of immigrants were born in the United States. Children must be 

U.S. citizens or legal residents to receive CCDF subsidies, while a child’s 

immigration status is not a factor in determining eligibility for Head Start. 

The parent’s immigration status is not relevant for determining eligibility 

for either program. 

Organizations working on issues affecting children and parents with 

limited English proficiency have raised concerns that these families may 

have difficulties accessing federally funded child care and early education 

programs. In this context, you asked us to answer the following questions: 

(1) What is known about the participation of children whose parents have 

limited English proficiency in child care and early education programs 

funded through CCDF and Head Start? (2) What challenges do these 

families face in accessing these programs? (3) What assistance is provided 

by selected state and local entities to facilitate access for these families? 

(4) What actions has HHS taken to ensure that these families can access 

CCDF child care subsidies and Head Start? 

To address these issues, we used multiple data collection methodologies. 

To determine the participation in federally funded child care and early 

education programs by children of parents with limited English 

proficiency, we reviewed HHS data from a survey of Head Start 

participants and from a reporting system used by Head Start grantees. To 

assess the reliability of these data, we interviewed relevant HHS officials 

and contractors and reviewed documentation related to the procedures for 

collecting and analyzing these data. We found the Head Start survey data 

to be sufficiently reliable for the purposes of this report, and while we did 

not independently verify the data available through the reporting system, 

we found no evidence to suggest that they were unreliable. We also 

requested information from all 50 states and the District of Columbia on 

their collection of language data for CCDF subsidy recipients. To obtain 

information on the child care and early education patterns of these 

children that could not be obtained from HHS data, we analyzed national 
Page 3 GAO-06-807 Child Care and Early Childhood Education 

survey data collected in 1998 as part of the Early Childhood Longitudinal 

Study, Kindergarten Class of 1998-99 (ECLS-K), from parents of 

kindergarten children about their children’s experiences the year before. 

Specifically, we used a logistic regression model to estimate the effect of 

parents’ English proficiency on children’s child care and early education 

patterns, while controlling for selected individual and family 

characteristics such as race and parental education. ECLS-K, conducted by 

the National Center for Education Statistics (NCES), was the most recent 

national dataset that allowed us to examine child care and early education 

experiences of children while considering the English proficiency of their 

parents. We assessed the reliability of NCES data and found these data to 

be sufficiently reliable for the purposes of this report. To understand the 

challenges that parents with limited English proficiency face and what 

state and local entities are doing to assist them, we visited five states 

(Arkansas, California, Illinois, North Carolina, and Washington) and 

contacted 11 counties across these states. We interviewed state and local 

officials administering CCDF and Head Start as well as local child care and 

early education providers. We selected our site visit locations on the basis 

of the size and growth of their population with limited English proficiency, 

the presence of any initiatives focused on individuals with limited English 

proficiency, and their geographic location. We also conducted 12 focus 

groups in California, North Carolina, and Washington with mothers who 

spoke Spanish and Vietnamese, reported limited English proficiency, and 

had children aged 5 or younger enrolled in child care who likely qualified 

for CCDF subsidies based on their family’s income and parental work and 

education activities. Six focus groups were conducted with mothers 

whose children received a government child care subsidy, and six focus 

groups were conducted with mothers whose children were eligible for but 

did not receive the subsidy. To determine what HHS is doing to ensure 

access to its programs, we interviewed HHS officials from the Office for 

Civil Rights (OCR), the Office of Head Start, and CCB, and reviewed 

relevant documents, legislation, guidance, and other federal resources 

related to language access. Appendix I contains more information about 

our scope and methodology. Appendix II contains information on the 

regression analysis of ECLS-K data that we conducted. We conducted our 

work between July 2005 and June 2006 in accordance with generally 

accepted government auditing standards. 

The most recent national survey data showed that in 1998, children of 

kindergarten age whose parents had limited English proficiency were less 

likely than other children to have received financial assistance from a 

social service or welfare agency for child care or to participate in Head 

Results in Brief 
Page 4 GAO-06-807 Child Care and Early Childhood Education 

Start in the year before kindergarten, after controlling for selected 

individual and family characteristics such as race and parental education. 

Eighty-eight percent of these children were Hispanic, and the results 

differed between them and Asian children. However, these data could not 

be used to assess their likelihood of enrollment in CCDF programs 

because the survey questions did not ask for the specific agency providing 

financial assistance. Further, CCB did not have information on the total 

enrollment in CCDF programs of children of parents with limited English 

proficiency because it did not require states to collect and report any 

language data from parents of children receiving federal subsidies, such as 

their primary language or English proficiency. We found that 13 states 

collected some language data from parents whose children received CCDF 

subsidies, primarily to determine the need for interpreters or translated 

forms. However, these data had limitations that reduced their usefulness 

in assessing participation in CCDF programs by children of parents with 

limited English proficiency. For example, 5 states made the collection of 

language data by caseworkers optional, and state officials told us they 

could not guarantee that the information was consistently collected. The 

Office of Head Start collected some language data on the language spoken 

by Head Start participants, which showed that about 13 percent of parents 

of the approximately 900,000 children enrolled in Head Start in 2003 

reported speaking English “not well” or “not at all.” 

Focus group participants, state and local child care officials, and 

advocates told us that parents with limited English proficiency faced 

multiple challenges in accessing federally funded child care and early 

education programs for their children. Analysis of data from focus groups 

with mothers whose children were eligible for federal child care subsidies 

revealed that some of them were not aware of the programs. Parents also 

faced challenges during the application process, according to focus group 

participants and state and local officials interviewed. For example, some 

of them faced obstacles due to a lack of bilingual staff or translated 

applications, especially for languages other than Spanish. Additionally, 

parents reported difficulties communicating with their children’s Englishspeaking providers. Officials reported shortages of providers with the 

language ability to serve families with limited English proficiency. Parents’ 

immigration status also presented indirect challenges to the participation 

of children in federally funded child care and early education programs. 

For example, local officials and community advocates told us that some 

parents with limited English proficiency may be reluctant to apply for fear 

of exposing undocumented immigrant members in the household. Finally, 

some parents with limited English proficiency experienced challenges that 

were common to low-income families generally. For example, difficulty 
Page 5 GAO-06-807 Child Care and Early Childhood Education 

finding care at nontraditional hours, lack of transportation, and the limited 

number of subsidized child care slots available affected the ability of these 

parents to access programs. 

The majority of state and local agencies and providers that we interviewed 

on our site visits took some steps to assist parents with limited English 

proficiency, but officials reported challenges in serving these parents. In 

all counties that we visited, agencies offered some form of oral language 

assistance, although the scope of this assistance varied and parents 

continued to experience challenges when accessing services. For example, 

agencies in 5 of the 11 counties visited had staff that could speak several 

languages; agencies in the remaining counties had Spanish-speaking staff, 

although in one case, the staff were not specifically assigned to work with 

program applicants and had other responsibilities. Most agencies also 

made available some written language assistance, such as translated 

applications, although the scope of the translations varied as well. For 

example, local agencies in one state used applications that the state had 

translated into eight languages, while agencies in 2 other states had statetranslated applications only in Spanish. The majority of agencies and 

providers also disseminated information in other languages to raise 

awareness of their programs and services. Several state and local agency 

officials told us that they did not extensively disseminate information 

about their programs because their programs were already operating at 

full capacity or had substantial waiting lists. Agencies in the majority of 

locations that we visited had initiatives to increase the supply of providers 

able to communicate effectively with parents. For example, one local 

agency we visited, which provided child care information to parents and 

worked with child care providers in the community, offered training and 

other guidance to Somali- and Russian-speaking women interested in 

opening family child care homes. State and local officials cited several 

challenges in serving parents with limited English proficiency, including 

difficulties hiring qualified bilingual staff and the expense of translating 

materials into multiple languages. Some officials that we interviewed 

expressed the need for additional information on cost-effective strategies 

to serve parents with limited English proficiency, and several officials said 

it would be helpful to learn about provider training in use elsewhere. 

HHS provided a variety of assistance to grantees on serving children of 

parents with limited English proficiency, but gaps remained in its program 

review efforts. HHS’s Office for Civil Rights conducted outreach to states 

to help them implement guidance on access to HHS programs by 

individuals with limited English proficiency and offered technical 

assistance in identifying appropriate language access strategies. The Office 
Page 6 GAO-06-807 Child Care and Early Childhood Education 

of Head Start provided assistance to increase awareness of the Head Start 

program and to help grantees better serve children of parents with limited 

English proficiency. The Office also reviewed grantees’ assessments of 

child care and early education resources in their communities relative to 

the needs of their communities’ Head Start-eligible children. In addition, 

the Office conducted formal monitoring reviews of grantees’ compliance 

with Head Start performance standards, including standards specific to 

providing language access to children and parents with limited English 

proficiency. An Office of Head Start official, however, told us that the 

office could not ensure that its review teams consistently reviewed grantee 

compliance with these standards, and in our prior work we found that no 

mechanism existed to ensure consistency in the monitoring process. CCB 

provided a variety of assistance to help states and child care providers 

offer language access to individuals with limited English proficiency, such 

as translating brochures. CCB officials told us that because CCDF is a 

block grant, CCB’s oversight of CCDF is limited to reviewing states’ CCDF 

plans and investigating complaints. However, CCB does not require states 

to report in their CCDF plans how they will provide language access for 

individuals with limited English proficiency or have a mechanism for 

ensuring that eligible children of parents with limited English proficiency 

are not inadvertently excluded from receiving CCDF assistance because of 

their parents’ citizenship or immigration status. 

To help agencies plan for and provide language assistance to parents with 

limited English proficiency who may want to access federally funded child 

care and early education programs for their children, we recommend that 

HHS work with states to help them explore cost-effective strategies for 

collecting data on CCDF subsidy recipients’ language preference or 

English proficiency. Once these data are available, HHS may consider 

collecting information on existing cost-effective ways that agencies could 

use to provide language assistance and to recruit providers who speak 

other languages, as well as disseminating this information in the locations 

where the data show the greatest need. To provide opportunities for 

eligible children to receive federal child care subsidies regardless of their 

parents’ English proficiency, we recommend that HHS develop and 

implement specific strategies to review whether and how states provide 

access to CCDF programs for these families. These strategies include the 

revision of the CCDF plan template to require states to report on how 

access will be provided and a systematic review of states’ eligibility 

criteria to ensure that states comply with HHS policies related to 

participation of children whose parents have limited English proficiency. 
Page 7 GAO-06-807 Child Care and Early Childhood Education 

In its comments on a draft of this report, HHS’s Administration for 

Children and Families (ACF) generally agreed with our recommendation 

to help states explore strategies for collecting data on CCDF subsidy 

recipients’ language, and provided additional information on its plans and 

actions toward implementation of this recommendation. ACF also agreed 

to examine the feasibility of using the CCDF plan template to ask states to 

report on how they provide access to parents with limited English 

proficiency seeking CCDF subsidies for their children. However, ACF did 

not address our recommendation that it systematically review states’ 

program eligibility criteria to ensure that states do not inadvertently 

exclude otherwise eligible children of parents with limited English 

proficiency from CCDF participation. In addition, ACF submitted detailed 

comments on certain aspects of this report, including comments related to 

our analysis of ECLS-K data. 

The population of individuals with limited English proficiency in the 

United States has grown dramatically in recent years. The 2000 Census 

shows that the number of people reporting that they do not speak English 

well or very well grew by 65 percent, from 6.7 million in 1990 to almost 

11 million in 2000. The data also show that while growth in the population 

of individuals with limited English proficiency continues in states along 

the border, such as California and Texas, it is most rapid in other states. 

(See fig. 1.) 

Background 

Population Changes 
Page 8 GAO-06-807 Child Care and Early Childhood Education 

Figure 1: Size and Growth of Population of Individuals with Limited English Proficiency, 1990-2000 

Note: In our analyses of Census data, we categorized the population of individuals reporting that they 

do not speak English well or very well as those with limited English proficiency. 

Sources: GAO analysis of U.S. Census data. Copyright Corel Corp. All rights reserved (map).

PA 

OR 

NV 

ID 

MT 

WY 

UT 

AZ NM 

CO 

ND 

SD 

NE 

TX 

KS

OK 

MN 

IA 

MO 

AR 

LA 

IL 

MS

IN 

KY 

TN 

AL 

FL 

GA 

SC 

NC 

VA 

OH 

NH 

MA 

RI MI 

CA 

WA 

WI NY 

ME 

VT 

WV 

HI 

CT 

NJ 

DE 

MD 

DC 

AK 

Table 1: Ten states with the largest population of 

individuals with limited English proficiency (LEP) 

in 2000, number and percentage

State 

Number of

individuals

with LEP 

Percentage of 

population 

that was LEP 

California

Texas

New York

Florida

Illinois

New Jersey

Arizona

Georgia

Massachusetts

North Carolina 

3,356,910 

1,428,512 

1,155,704 

842,066 

541,847 

426,624 

288,699 

221,594 

213,426 

181,349 

10.7%

7.4%

6.5%

5.6%

4.7%

5.4%

6.1%

2.9%

3.6%

2.4%

Table 2: Ten states with the largest growth in 

population of individuals with LEP, 1990-2000

State 

Percentage change 

in number of individuals

with LEP, 1990-2000 

Percentage of

population that 

was LEP, 2000 

North Carolina

Georgia

Nebraska

Nevada

Arkansas

Utah

Colorado

Tennessee

South Carolina

Oregon

383.8%

356.2%

280.5%

272.8%

248.8%

247.9%

234.4%

220.9%

212.1%

175.6%

2.4%

2.9%

2.0%

5.8%

1.3%

2.7%

3.7%

1.1%

1.2%

3.3%
Page 9 GAO-06-807 Child Care and Early Childhood Education 

As figure 1 shows, for example, the number of individuals who did not 

speak English well or very well increased by more than 300 percent 

between 1990 and 2000 in North Carolina and Georgia, and by more than 

200 percent in states such as Nebraska, Arkansas, and South Carolina. In 

2000, 14 percent of children age 5 and younger in households below the 

federal poverty level lived in linguistically isolated households.1

The two largest sources of federal support for child care and early 

education are CCDF and Head Start. CCB administers CCDF and the 

Office of Head Start2

 administers Head Start. Both entities are housed 

within ACF. CCB provides block grants to states through CCDF to 

subsidize child care expenses of eligible families. In contrast, the Office of 

Head Start awards grants for the operation of Head Start programs directly 

to local public or private organizations, school systems, or Indian tribes. 

The flow of funds under CCDF and Head Start is shown in figure 2. 

 1

The U.S. Census defines a “linguistically isolated household” as one in which no person 

aged 14 or over reported either speaking only English at home or speaking English very 

well. 

2

In June 2006, the Head Start Bureau was officially renamed the Office of Head Start. 

HHS Child Care and Early 

Education Programs 
Page 10 GAO-06-807 Child Care and Early Childhood Education 

Figure 2: Flow of Funds Under CCDF and Head Start 

a

These are examples of providers that parents may choose with CCDF vouchers. Parents may 

choose any other legally operating provider authorized by the state. 

 U.S. Department of 

 Health and 

 Human Services

 (CCB and 

 Office of Head Start)

CCDF 

Vouchers

Child care centers Family child care homes Relative care 

Contracted 

child care providers

$ 

States

Source: GAO analysis and Art Explosion images.

A 

C 

E 

Head Start 

Local Head Start grantees

A 

B 

C 

(such as local public or private 

organizations) 

a
Page 11 GAO-06-807 Child Care and Early Childhood Education 

CCDF is used to subsidize the child care expenses of low-income families 

with children under age 13 and to improve the overall quality and supply of 

child care. The goals of the program are to (1) allow each state maximum 

flexibility in developing child care programs and policies; (2) promote 

parental choice to empower working parents to make their own decisions 

on the child care that best suits their family’s needs; (3) encourage states 

to provide consumer education information to help parents make 

informed choices about child care; (4) assist states to provide child care to 

parents trying to achieve independence from public assistance; and 

(5) assist states in implementing the health, safety, licensing, and 

registration standards established in state regulations. The parent whose 

child receives child care assistance may either enroll the child directly 

with a provider who has a grant or contract from the state for the 

provision of child care services or receive a certificate to enroll the child 

with a provider of the parent’s choosing. Parents may choose from any 

child care legally offered in the state, which could include care provided in 

child care centers, family child care homes, or by relatives or nonrelatives 

in the child or provider’s home. CCDF is a combination of discretionary 

and mandatory funds. In federal fiscal year 2006, CCDF provided about 

$4.9 billion in federal funds to states and territories. In fiscal year 2004 (the 

latest year for which data were available), the program served 

approximately 1.74 million children with federal funding of about 

$4.7 billion. In addition, federal CCDF funds are supplemented with state 

contributions, and HHS officials reported that total federal and state 

expenditures for CCDF amounted to almost $9.4 billion in fiscal year 2004. 

Congress gave states considerable flexibility in administering and 

implementing their CCDF programs. States are required to submit biennial 

plans to CCB describing their CCDF activities. States determine income 

eligibility thresholds up to a federal maximum of 85 percent of the state 

median income. In their CCDF plans for federal fiscal years 2004 and 2005, 

almost all states reported setting lower income eligibility limits, with only 

5 states at the federal maximum of 85 percent.3

Because CCDF is a nonentitlement program—one with limited funding 

and not necessarily intended to cover all eligible persons—states are not 

required to provide child care subsidies to all families whose incomes fall 

below the state-determined eligibility threshold, and states may establish 

 3

National Child Care Information Center, “Trends in State Eligibility Policies: A CCDF Issue 

Brief,” Vienna, Virginia, July 2004. 
Page 12 GAO-06-807 Child Care and Early Childhood Education 

priorities for serving eligible families, such as prioritizing families 

receiving Temporary Assistance for Needy Families (TANF), in order to 

support their work efforts. States can augment their CCDF funds with 

other funding sources, such as TANF, to increase funding available for 

subsidies. States spent $1.4 billion in federal TANF funds directly on child 

care in fiscal year 2004.4

 States may also transfer up to 30 percent of their 

TANF block grants into their CCDF programs. In fiscal year 2004, the 

latest year for which data were available, $1.9 billion in TANF funds was 

transferred to CCDF. Funds transferred from TANF to CCDF must be 

spent in accordance with CCDF rules. This is significant partly because the 

effect of the child’s or the parent’s citizenship or immigration status on the 

child’s eligibility differs depending on the program. For example, parents’ 

immigration status may affect their eligibility for child care assistance 

under TANF,5

 whereas only the immigration status of the child matters for 

determination of eligibility for subsidies from CCDF. Although legislation 

authorizing CCDF did not specify the effect of citizenship or immigration 

status on program eligibility, HHS’s guidance to state agencies indicated 

that states should consider only the citizenship and immigration status of 

the child when determining the child’s eligibility for federal child care 

assistance.6

 Therefore, children who are citizens or legal residents are 

eligible for CCDF subsidies regardless of their parents’ citizenship or 

immigration status. 

States are also required to dedicate at least 4 percent of their CCDF 

allotments to activities to provide comprehensive consumer education to 

 4

Partly as a condition of receiving federal funds, states also used their own funds for this 

purpose. According to HHS, this brought total federal and state child care expenditures 

under TANF to about $3.4 billion in fiscal year 2004. 

5

The Personal Responsibility and Work Opportunity Reconciliation Act, (PRWORA, Pub. 

L. No. 104-193) restricts access by some legal immigrants to certain programs and denies 

access by illegal immigrants to many government-funded programs. States can decide the 

eligibility for TANF of most of the qualified aliens who arrived in this country prior to 

August 22, 1996. Most of the qualified aliens who entered the United States on or after 

August 22, 1996 are barred from receiving TANF the first 5 years after their entry, although 

some states choose to provide their own state-funded public assistance to such immigrants. 

6

The guidance states that “for implementing the verification requirements mandated by title 

IV of PRWORA, only the citizenship and immigration status of the child, who is the primary 

beneficiary of the child care benefit, is relevant for eligibility purposes.” U.S. Department of 

Health and Human Services, Administration on Children, Youth, and Families. Log No. 

ACYF-PI-CC-98-08, November 25, 1998. 
Page 13 GAO-06-807 Child Care and Early Childhood Education 

parents and to improve the quality and availability of child care.7 States 

may use some of this quality set-aside to fund child care resource and 

referral services that are available in every state and most communities in 

the United States. These agencies provide information to parents on 

finding and paying for quality child care, offer training to child care 

providers, and frequently engage in efforts to analyze and report on child 

care supply and demand in their communities. Often, resource and referral 

agencies also manage the CCDF subsidy program or are part of local 

organizations that administer the subsidy in the community. 

Head Start offers child development programs to low-income children 

through age 5 and their families. The overall goal of Head Start is to 

promote the school readiness and healthy development of young children 

in low-income families. In addition to providing classroom programs for 

the children, Head Start grantees provide or arrange for a variety of 

services, including medical, dental, mental health, nutritional, and social 

services. Children in families with incomes below the federal poverty level 

($20,000 for a family of four in 2006)8

 are eligible for available Head Start 

programs regardless of their or their parents’ immigration status. Head 

Start grantees must adhere to certain performance standards, including 

standards related to providing language access in Head Start programs. 

The Office of Head Start reviews the performance of Head Start grantees 

on these standards using a structured guide known as the Program Review 

Instrument for Systems Monitoring (PRISM). In fiscal year 2005, Head 

Start was funded at $6.8 billion and served 906,993 children. 

HHS has responsibility for monitoring grantees’ compliance with program 

requirements. Through its Office for Civil Rights (OCR), HHS also oversees 

compliance with Title VI of the Civil Rights Act of 1964,9

 which states that 

no person shall “on the ground of race, color, or national origin, be 

excluded from participation in, be denied the benefits of, or be subjected 

 7

In addition to the minimum 4 percent quality set-aside, annual appropriations have 

provided funding for child care quality activities. HHS officials noted, for example, that the 

agency’s 2006 fiscal year appropriation provided approximately $270 million for quality 

improvement activities, including nearly $100 million to improve the quality of infant and 

toddler care and approximately $10 million for child care research and evaluation 

initiatives. 

8

Federal Register, Vol. 71, No. 15, January 24, 2006, pp. 3848-3849. Alaska and Hawaii have 

higher guidelines. 

9

42 U.S.C. § 2000d et. seq.

Ensuring Meaningful 

Program Access for 

Persons with Limited 

English Proficiency 
Page 14 GAO-06-807 Child Care and Early Childhood Education 

to discrimination under any program or activity receiving federal financial 

assistance.” HHS has issued regulations to recipients of HHS funds on 

implementing the provisions of Title VI, including requiring an assurance 

in every application for federal financial assistance that the program will 

be operated in compliance with all requirements imposed under HHS’s 

Title VI regulations. 

Moreover, Executive Order 13166, issued in 2000, required federal 

agencies to prepare a plan and issue guidance to their funding recipients 

on providing meaningful access to individuals who, as a result of national 

origin, are limited in their English proficiency. In August 2003, HHS 

published revised guidance pursuant to Executive Order 13166. The 

guidance states that Title VI and its implementing regulations require that 

grantees take reasonable steps to ensure meaningful access for individuals 

with limited English proficiency, and the guidance is intended to assist 

grantees in fulfilling their responsibilities to ensure meaningful access to 

HHS programs and activities by these individuals. Under the guidance, 

grant recipients are to determine the extent of their obligation to provide 

language assistance services by considering four factors: (1) the number 

or proportion of individuals with limited English proficiency eligible to be 

served or likely to be encountered by the program or grantee; (2) the 

frequency with which these individuals come in contact with the program; 

(3) the nature and importance of the program, activity, or service provided 

by the program to people’s lives; and (4) the resources available to 

recipients of federal funds and costs of language assistance. The guidance 

states that grantees have two main ways to provide language assistance 

services: oral interpretation, either in person or via telephone, and written 

translation. Finally, the guidance lays out elements of an effective plan of 

language assistance for persons with limited English proficiency. 

Monitoring compliance with Title VI and providing technical assistance are 

functions of HHS’s OCR. OCR enforces Title VI as it applies to agencies’ 

responsibilities to ensure access for individuals with limited English 

proficiency. The mechanisms available to OCR for ensuring that agencies 

comply with their obligations to provide access include complaint 

investigations, compliance reviews, efforts to secure voluntary 

compliance, and technical assistance. 
Page 15 GAO-06-807 Child Care and Early Childhood Education 

The most recent national survey data showed that in 1998 children of 

parents with limited English proficiency, 88 percent of whom were 

Hispanic, were less likely than other children to receive financial 

assistance from a social service or welfare agency for child care or to 

participate in Head Start in the year before kindergarten, after controlling 

for selected individual and family characteristics. However, these data 

could not be used to assess their likelihood of enrollment in CCDF 

programs because the survey questions did not ask for the specific agency 

providing financial assistance. Further, CCB did not have information on 

the total enrollment in CCDF programs of children of parents with limited 

English proficiency because it did not require states to collect and report 

any language data from parents of children receiving federal subsidies, 

such as their primary language or English proficiency. The Office of Head 

Start collected some data on the language spoken by Head Start 

participants, which showed that about 13 percent of parents of the 

approximately 900,000 children enrolled in Head Start in 2003 reported 

speaking English “not well” or “not at all.” 

National survey data from ECLS-K showed that in 1998, kindergarten 

children of parents with limited English proficiency who were in 

nonparental child care in the previous year were less likely10 than other 

children in child care to receive financial assistance from a social service 

or welfare agency for that care, after controlling for selected individual 

and family characteristics.11 However, parents’ limited English proficiency 

had a different effect for Hispanics than for Asians in the dataset.12

Specifically, as shown in figure 3, Hispanic children of parents with limited 

English proficiency (who represented 88 percent of all children in the 

 10All differences reported were statistically significant at the 95 percent confidence level 

unless otherwise noted. This means that if no difference actually existed in the population, 

we would only expect to find a difference as large as the one found in the ECLS-K sample 

less than 5 percent of the time. 

11The characteristics we controlled for in the analysis of the receipt of financial assistance 

for child care were race, household income and parental education, the number of 

individuals over 18 in the household, the presence of a parent who was not working, 

whether care was provided in a center-based facility, whether the child was in multiple 

types of care, and the child’s participation in Head Start. In our analysis, we treated receipt 

of center-based care and Head Start participation as two distinct outcomes. 

12Our analysis was limited to Hispanics and Asians because the numbers of parents with 

limited English proficiency in other racial or ethnic categories in the survey were too small 

to allow the same analysis. 

Children of Parents 

with Limited English 

Proficiency Were Less 

Likely than Other 

Children to 

Participate in 

Subsidized Programs 

Children of Parents with 

Limited English 

Proficiency Were Less 

Likely to Receive Financial 

Assistance for Child Care 

or to Participate in Head 

Start 
Page 16 GAO-06-807 Child Care and Early Childhood Education 

dataset whose parents had limited English proficiency) were less likely 

than children of Hispanic parents proficient in English to receive financial 

assistance for their care. Among Asians, who constituted about 8 percent 

of all children of parents with limited English proficiency, we did not find 

a statistically significant difference in the receipt of financial assistance for 

child care between children of parents with limited English proficiency 

and other children. These results, however, cannot be used to draw 

conclusions about enrollment in CCDF programs by children of parents 

with limited English proficiency because the survey questions referred to 

assistance from a social service or welfare agency generally and did not 

ask specifically whether assistance came from CCDF.13 Also, while ECLS-K 

data are representative of the experiences of children in the year prior to 

entering kindergarten, they cannot be extrapolated to children of all ages. 

(See app. II for discussion of the methodology we used to analyze ECLS-K 

data and the results of our analyses.) 

 13We also examined differences in the likelihood of being in any type of nonparental child 

care in general and in center-based care in particular in the year before kindergarten. We 

found that, among Hispanics, children of parents with limited English proficiency were less 

likely to have been in nonparental child care than other children. We did not find a 

significant difference in the use of nonparental child care among Asians, nor did we find a 

significant difference in the use of center-based care for either Hispanics or Asians. 
Page 17 GAO-06-807 Child Care and Early Childhood Education 

Figure 3: Relative Odds of Selected Outcomes for Children of Parents with Limited 

English Proficiency Compared to Children of Parents Proficient in English, for 

Hispanics and Asians, after Adjusting for Selected Family Characteristics 

Note: The numbers in this figure show how the odds of having a certain outcome compare among 

children whose parents have limited English proficiency and other children of the same race. For 

example, among Hispanics, children of parents with limited English proficiency were less than half as 

likely (0.44 times) to receive financial assistance for their care than other children. 

a

Indicates that children of parents of that racial or ethnic group and with limited English proficiency 

had statistically significantly different odds (at the 95 percent level) of having that outcome compared 

to children of parents proficient in English of the same race. 

Our analysis of ECLS-K data also indicated that after controlling for 

selected individual and family characteristics,14 children of parents with 

 14The characteristics we controlled for in the analysis of the use of Head Start were race, 

household income and parental education, number of individuals over 18 in the household, 

and the presence of a parent who was not working. 

Odds ratio 

Source: GAO analysis of ECLS-K data.

Receipt of 

financial

assistance 

for child care

Head Start

Each bar should be compared to the 

reference line. Bars lower than the reference 

line indicate that parents with limited English 

proficiency have lower odds of or are less

likely to have the outcome compared to 

parents of the same race proficient in English.

 

Reference line 

More likely 

Less likely 

Hispanics

Asians

0.44a

0.69a

0.44a

1.85 1.90a

0.25

0.5

1.0

2.0

4.0
Page 18 GAO-06-807 Child Care and Early Childhood Education 

limited English proficiency were less likely to participate in Head Start in 

the year before kindergarten. Again, this result did not hold consistently 

across racial and ethnic groups. Specifically, as shown in figure 3, children 

of Hispanic parents with limited English proficiency were less likely than 

children of Hispanic parents proficient in English to participate in Head 

Start in the year before kindergarten. In contrast, children of Asian parents 

with limited English proficiency were more likely than children of Asian 

parents proficient in English to participate in Head Start. 

While 1998 ECLS-K data showed that children of parents with limited 

English proficiency were less likely than other children to receive financial 

assistance for child care and to participate in Head Start in the year before 

kindergarten, it cannot be concluded from these data alone that the 

differences are due to language barriers in access to programs. Other 

factors, such as the availability of child care and early education programs 

in the areas in which members of different language groups reside or 

access to support networks that provide information about available 

programs may also explain this result. In addition, since the time of the 

survey, HHS has taken steps to increase the participation of minorities and 

children of parents of parents with limited English proficiency, such as 

translating CCDF program brochures and undertaking initiatives to raise 

awareness of the Head Start program in the Spanish-speaking community. 

Furthermore, HHS officials reported substantial increases in federal and 

state child care funding since ECLS-K data had been collected, suggesting 

that these increases may have increased program access for parents of 

children with limited English proficiency.15 However, neither CCB nor the 

Office of Head Start has more recent information on whether children 

whose parents had limited English proficiency are more likely to access 

financial assistance for child care and Head Start relative to children 

whose parents are proficient in English.16 ECLS-K was the most recent 

national dataset that allowed us to examine the receipt of financial 

assistance for child care and the participation in Head Start by children of 

 15As mentioned earlier, ECLS-K collected information on the receipt of financial assistance 

for child care generally (rather than the receipt of CCDF subsidies specifically). Therefore, 

while the ECLS-K data show that children of parents with limited English proficiency were 

less likely to receive financial assistance for child care, these data cannot be used to 

comment on the accessibility of a specific program such as CCDF. 

16According to an Office of Head Start official, there has been an increase in the number of 

linguistically and culturally diverse children and families served by Head Start in recent 

years. However, this increase could result from the increase of the population of such 

children and families in the United States generally. 
Page 19 GAO-06-807 Child Care and Early Childhood Education 

parents with limited English proficiency in relation to the participation of 

similar children whose parents are proficient in English. 

While CCB requires that states submit a variety of demographic 

information in monthly or quarterly reports, such as information on the 

race and ethnicity of CCDF subsidy recipients, it collects no information 

on the language spoken by or the English proficiency of parents whose 

children receive CCDF subsidies. CCB officials told us that they had no 

plans to collect language data for those receiving CCDF subsidies because 

they generally collect only information specifically listed in the legislation 

authorizing CCDF. A CCB official with responsibility for the demographic 

data collected from states and officials from 1 state we visited told us that 

requiring states to provide language data would create difficulties for 

states, such as developing ways to identify individuals with limited English 

proficiency. Despite the potential difficulties, various state and local 

officials in states that do not collect this information, including the official 

who cited potential difficulties collecting the data, told us that having such 

data would help them evaluate program performance. 

While data on the receipt of CCDF subsidies were not available nationally, 

13 states collected some language data from parents whose children 

receive CCDF subsidies.17 The specific type of data collected and the 

manner in which these data were collected varied among these 13 states, 

preventing comparisons among them on the extent to which state CCDF 

programs were serving children of parents with limited English 

proficiency. Officials in 10 of the 13 states that collected language data 

told us that their states used the data either to provide translated forms or 

interpreters to clients during the application process or for planning or 

program evaluation purposes, such as identifying areas with significant 

increases in the number of individuals with limited English proficiency 

and to determine the need for bilingual staff. State data, however, had 

limitations that decreased their usefulness in assessing participation in 

CCDF programs by children of parents with limited English proficiency. 

For example, 5 states made the collection of language data by caseworkers 

optional, and officials in another 5 states told us that despite requiring 

caseworkers to collect the language data, compliance with the data 

 17Two of the 5 states that we visited reported collecting their own language data from 

clients. In addition, we surveyed the remaining 45 states and the District of Columbia, and 

11 of the 41 states responding to our e-mail requests for information reported collecting 

these data. 

CCB Does Not Collect 

Language Data on Children 

Receiving CCDF Subsidies, 

and the Data in the 13 

States that Collect Them 

Have Limitations 
Page 20 GAO-06-807 Child Care and Early Childhood Education 

requirements could not always be guaranteed. Officials in 8 of the 13 states 

that collected language data told us that they could benefit from having 

more information on the collection or use of language data or from 

learning how other states collect or use them. 

The Office of Head Start collected some language data from the 

approximately 900,000 children enrolled in Head Start and their parents 

from two sources. First, the Office of Head Start interviewed parents 

through its Family and Child Experiences Survey (FACES), a series of 

longitudinal surveys of nationally representative samples of children in 

Head Start. Based on the 2003 parent interviews administered, FACES data 

showed that about 20 percent of parents of 3- and 4-year-old children in 

Head Start18 reported that a language other than English was most 

frequently spoken at home, and about 13 percent of parents reported that 

they spoke English “not well” or “not at all.”19 Second, the Office of Head 

Start collected demographic information on all 4- and 5-year-old children 

in Head Start20 through its National Reporting System (HSNRS), including 

information on the child’s primary language. These data showed that about 

one-quarter of children enrolled in Head Start in Spring 2005 had a primary 

language other than English.21

 18According to HHS, 3- and 4-year-olds constituted 87 percent of children enrolled in Head 

Start during the 2002-2003 program year. 

(See http://www.acf.hhs.gov/programs/hsb/research/2004.htm.) 

19While this number appears similar to the percentage of children aged 0 to 5 in low-income 

families that were in linguistically isolated households as reported in Census 2000 

(14 percent), the two cannot be directly compared because they were collected in different 

years and because the definition of limited English proficiency we used in analyzing the 

information from FACES is different from the Census definition of a linguistically isolated 

household. 

20According to HHS, 4- and 5-year-olds constituted 58 percent of children enrolled in Head 

Start during the 2002-2003 program year. 

(See http://www.acf.hhs.gov/programs/hsb/research/2004.htm.) 

21The Office of Head Start also surveys grantees annually through its Program Information 

Report (PIR). The PIR asks grantees to report a variety of demographic information about 

children enrolled in their programs, including the primary language of the family at home, 

but not their need for language assistance. However, our prior work identified limitations 

of PIR data. See GAO, Head Start: Better Data and Processes Needed to Monitor 

Underenrollment, GAO-04-17 (Washington, D.C.: Dec. 4, 2003), and GAO, Head Start: 

Comprehensive Approach to Identifying and Addressing Risks Could Help Prevent 

Grantee Financial Management Weaknesses, GAO-05-176 (Washington, D.C.: Feb. 28, 

2005.) 

Head Start Data Indicate 

That about One-Eighth of 

Participating Children 

Have Parents with Limited 

English Proficiency 
Page 21 GAO-06-807 Child Care and Early Childhood Education 

Results from our focus groups, which were composed of mothers with 

limited English proficiency whose children were eligible for federal child 

care subsidies, revealed that some participants were unaware of the 

various federal child care and early education programs that may be 

available to them. Parents with limited English proficiency also faced 

challenges in the process of applying for programs and financial 

assistance, such as lack of interpreters and translated materials. They also 

encountered difficulties communicating with English-speaking child care 

providers. Some of the challenges to program access that these parents 

faced were the same challenges that many low-income families face, 

including difficulty finding care at nontraditional hours, lack of 

transportation, and the limited availability of subsidized child care slots. 

Many parents with limited English proficiency were unaware of child care 

assistance available to them. All six of the focus groups with Spanishspeaking and Vietnamese-speaking mothers who were eligible but not 

receiving subsidies revealed that the majority were unaware of the 

assistance available. In addition, the mothers that we interviewed in 

Arkansas and focus group participants in North Carolina also told of 

misunderstandings and myths that some parents had regarding the 

consequences of participating in government-funded programs. For 

example, they had heard rumors that if they applied for child care 

assistance, their child might one day be drafted into the armed forces to 

repay the assistance they received. 

Shortages of bilingual staff also presented challenges to parents with 

limited English proficiency applying for subsidies for their children. State 

and local officials and providers that we interviewed identified the 

availability of bilingual staff as a factor that played a role in the ability of 

parents with limited English proficiency to apply for the subsidies. For 

example, subsidy administration officials in one rural county told us that 

they sometimes had to ask clients to come back because no staff were 

available to assist them in their language. In three of the four focus groups 

with Spanish-speaking mothers with subsidies, those who generally found 

the subsidy application process to be easy cited the availability of bilingual 

case workers as a factor in allowing them to apply for assistance 

successfully. 

In addition to shortages of bilingual staff, the lack of available translated 

materials also presented challenges to parents with limited English 

Parents with Limited 

English Proficiency 

Faced Multiple 

Challenges That May 

Have Limited Their 

Children’s 

Participation in 

Federally Funded 

Child Care and Early 

Education Programs 

Lack of Program 

Awareness and Challenges 

during the Application 

Process May Have Limited 

Program Participation 
Page 22 GAO-06-807 Child Care and Early Childhood Education 

proficiency. Some programs did not have application forms translated into 

other languages, and local officials and parents expressed concerns about 

the quality of existing translated materials, saying that they were often 

translated by volunteers and that no quality checks were done. For 

example, one community group representative told us that volunteers had 

translated the Spanish forms that the local subsidy administration office 

used and that no quality controls had been applied, resulting in materials 

of such poor quality that she advised parents not to request the Spanish 

version of the application. 

These challenges may be more acute for individuals with limited English 

proficiency who speak languages other than Spanish. Local officials in 

three states reported that there were limited services available in 

languages other than Spanish. For example, local officials in Washington 

said that services to smaller, more diverse populations, such as African, 

Asian, and East Indian language speakers, were more limited. In North 

Carolina and California, local officials also reported that services for 

populations such as the Hmong were more limited than for English or 

Spanish speakers. 

Finally, although immigration status has no impact on Head Start eligibility 

and only the immigration status of the child is relevant to the 

determination of eligibility for CCDF subsidies, it nonetheless created 

indirect challenges for some children of parents with limited English 

proficiency. Local officials and community advocates told us that citizen 

children of parents with limited English proficiency might not participate 

in federal child care and early education programs because of fear within 

the family of exposing undocumented immigrant members in the 

household. Several officials told us that some of these families were 

reluctant to provide personal information and were inhibited from 

applying because of fear about how their personal information might be 

used. In one case, we discovered a state that improperly required a 

declaration of satisfactory immigration status for every member of the 

household in order to apply for federally funded child care subsidies, 

thereby potentially excluding some children who are U.S. citizens and 

otherwise eligible for subsidies. Officials in two states also told us that 

many parents with limited English proficiency were paid in cash, making it 

difficult to verify their income for eligibility purposes. 
Page 23 GAO-06-807 Child Care and Early Childhood Education 

Parents reported difficulties communicating with their children’s 

providers, and officials reported shortages of providers with the language 

ability to serve families with limited English proficiency. For example, 

officials at one local resource and referral agency that we visited in the 

county with the most Spanish speakers in the state told us that providers 

in the county did not have the capacity to meet the needs of families with 

limited English proficiency. Spanish-speaking mothers that we interviewed 

during a site visit to another state complained that some programs 

advertise themselves as bilingual when in reality they are not. Parents in 

focus groups also expressed concern about their ability to communicate 

with their child care providers. Local officials in one urban area that we 

visited said that among the primary challenges faced by families with 

limited English proficiency was the effect of the language barrier on the 

parents’ ability to communicate with their child care providers. They 

stated this also made it difficult to ensure the same level of parentprovider interaction for families with limited English proficiency as for 

other families. For example, one provider with no bilingual staff said that 

she had a child with a disability in her center whose parents were limited 

in their English proficiency, making it difficult for staff to communicate 

with the parents about the child’s needs. These communication difficulties 

had consequences in the classroom as well. For example, one Head Start 

provider reported instances of therapists and educators who were not 

trained to work with Hispanic families inaccurately assessing the needs of 

children with language or cultural differences. 

Low-income parents with limited English proficiency faced some of the 

same challenges when attempting to access child care and early childhood 

education programs as other low-income families. Across all states visited, 

state and local officials as well as providers said that many low-income 

families, especially families with limited English proficiency, work 

nontraditional hours and have difficulty finding care that meets their 

needs. For example, a resource and referral agency official in one rural 

community said that the first shift at a local employer begins at 5:30 a.m., 

while most providers do not offer care before 6:00 a.m., and employees 

working second and third shifts face even more difficulty finding child 

care. Lack of transportation, especially in rural communities, also restricts 

the child care options available to low-income families. Officials said that 

it can be especially difficult for families with limited English proficiency to 

navigate public transportation or call transit agencies for assistance. In a 

Parents with Limited 

English Proficiency Had 

Difficulties 

Communicating with 

Providers 

Low-Income Parents with 

Limited English 

Proficiency Faced Some of 

the Same Challenges to 

Program Access as Other 

Low-Income Families 
Page 24 GAO-06-807 Child Care and Early Childhood Education 

previous report, we found that lack of English skills reduced individuals’ 

ability to access public transportation systems.22

Parents in some communities also faced shortages of child care and child 

care subsidies, especially for infants and toddlers. Officials with resource 

and referral agencies and local subsidy administration offices in 6 of the 

11 counties that we contacted said that there were shortages of infant care 

in their communities. In addition, because funding for CCDF subsidies was 

limited, not all states provided subsidies to all families who applied and 

met eligibility criteria. Our prior work showed that 20 states did not serve 

all families who met state-determined eligibility criteria,23 and three of the 

five states that we visited (Arkansas, California, and North Carolina) had 

waiting lists for CCDF subsidies. In five of the eight focus groups with 

Spanish-speaking mothers (including both those receiving and not 

receiving subsidies), participants identified waiting lists as one of the 

difficulties they faced when seeking assistance for child care. In the two 

other states that we visited (Illinois and Washington), state officials said 

that although they did not maintain waiting lists, they spent all of the funds 

available to them for CCDF subsidies. To manage demand for the limited 

financial assistance available for child care, states took steps such as 

giving priority to certain groups. For example, in the three states we 

visited that maintained waiting lists, two (Arkansas and North Carolina) 

set priorities for eligible families, such as preferences for families on or 

coming off of TANF. In the third, California, families on or transitioning off 

of TANF were provided child care assistance through a guaranteed 

funding stream, while funding for other low-income families was capped. 

Officials in California told us that this system made it extremely difficult 

for low-income families that were not in the TANF system to receive 

subsidized child care. While prioritization of TANF families would affect 

all low-income families, it may have additional implications for some 

children of parents with limited English proficiency. Census 2000 data 

show that 82 percent of individuals with limited English proficiency are 

foreign-born, and since immigration status is a factor in TANF eligibility, 

children of immigrants who do not qualify for TANF would be less likely to 

receive CCDF subsidies in those states that give priority to TANF families. 

In 2005, we found that 17 of 20 states not covering all applicants who 

 22See GAO, Transportation Services: Better Dissemination and Oversight of DOT’s 

Guidance Could Lead to Improved Access for Limited English-Proficient Populations, 

GAO-06-52 (Washington, D.C.: Nov. 2, 2005). 

23See GAO-05-667. 
Page 25 GAO-06-807 Child Care and Early Childhood Education 

otherwise met the eligibility criteria gave TANF families priority for CCDF 

funds,24 consistent with CCDF’s goal of providing child care to parents 

trying to become independent of public assistance. 

The majority of state and local agencies and providers that we visited took 

some steps to assist parents with limited English proficiency in accessing 

child care and early education programs for their children. Most agencies 

provided some oral and written language assistance, although the scope of 

the assistance varied. Most agencies also implemented initiatives to 

increase the supply of providers able to communicate effectively with 

parents. Officials told us that they faced several challenges in providing 

services to parents with limited English proficiency. Some state and local 

officials indicated that additional information on cost-effective strategies 

used by others to serve this population would facilitate their efforts to 

provide access. 

The majority of the agencies that we visited had taken some steps to 

provide oral and written language assistance, such as interpreters and 

translated materials, to parents with limited English proficiency. In all 

11 counties that we contacted, the local offices administering CCDF 

subsidies and providing resource and referral services offered some oral 

language assistance to clients with limited English proficiency although 

the scope of the assistance varied. In 5 of these counties, agencies had 

staff that could speak several languages, a fact that officials said reflected 

the community they served. In the other 6 counties, agency staff had 

bilingual capacity for Spanish only, but officials said the vast majority of 

the individuals with limited English proficiency they served were Spanishspeaking. Although the subsidy administration office in one of these 

6 counties had bilingual Spanish-speaking staff, these staff were not 

specifically assigned to work with individuals applying for CCDF subsidies 

but were clerical workers with other responsibilities. In most counties 

visited, child care and Head Start centers had bilingual staff to help 

parents with limited English proficiency enroll their children in the 

programs. For example, an official in one child care center that we visited 

where the majority of the families spoke Spanish said that all staff 

responsible for enrolling families in the program spoke Spanish. 

 24See GAO, Child Care: Additional Information Is Needed on Working Families 

Receiving Subsidies, GAO-05-667 (Washington, D.C.: June 29, 2005). 

Selected Agencies 

Took Some Steps to 

Assist Parents with 

Limited English 

Proficiency but 

Reported Challenges 

in Serving Them 

Selected State and Local 

Agencies Offered 

Language Assistance 
Page 26 GAO-06-807 Child Care and Early Childhood Education 

Several agencies that we visited also used telephone interpretation 

services to provide oral assistance to clients with limited English 

proficiency.25 For example, the subsidy administration offices that we 

visited in Washington primarily used a state-contracted telephone 

language line that connected agency staff with bilingual telephone 

operators who could offer interpreting assistance in a language spoken by 

the client. In an effort to help local agencies serve clients with limited 

English proficiency in a cost-effective manner, North Carolina was in the 

process of entering into a contract for a language line that would allow 

local social service agencies, including those administering CCDF 

subsidies, to provide oral language assistance to clients if bilingual staff 

were not available on-site. A state official told us that once the contract is 

awarded, the state will make the service available to all local social service 

agencies at a reduced cost. 

Several agencies also coordinated with one another to share resources for 

offering oral language assistance. For example, to help interpret for their 

Russian-speaking clients, a resource and referral agency in California with 

language capacity in Cantonese and Mandarin coordinated with staff at 

another nearby resource and referral agency that had language capacity in 

Russian. Subsidy administration officials in one rural county that we 

visited told us that the local hospital had a contract for the language line 

and they coordinated with the hospital to make use of that service. 

However, we did not find efforts to coordinate language assistance 

strategies among agencies in some locations visited, and agency officials 

in a few locations said that they could not always provide oral language 

assistance to clients with limited English proficiency on their own. 

The majority of agencies that we visited provided written language 

assistance, such as translated subsidy application forms. Seven of the 

11 subsidy administration offices contacted had subsidy applications 

translated into Spanish. Local agencies in Washington, California, and 

Illinois had applications that had been translated by the state. Washington 

required its application for the child care subsidy to be translated into 

 25Through a contract with organizations providing telephone interpretation services, 

agency staff typically can dial a telephone number provided by the organization and request 

to be connected to a professional interpreter speaking a particular language. The 

interpreter, proficient in both English and another language, listens to the conversation 

between the staff and the client with limited English proficiency, analyzes the meaning of 

the message, and conveys the meaning to each side. 
Page 27 GAO-06-807 Child Care and Early Childhood Education 

eight languages,26 while California and Illinois made applications available 

in Spanish and gave local agencies the option of translating materials into 

other languages. Arkansas and North Carolina had no translated 

applications at the time of our visits, although officials in North Carolina 

said that the state was in the process of translating the subsidy application 

into Spanish.27 All of the resource and referral agencies that we visited 

translated materials into Spanish, such as brochures containing 

information on how to receive child care assistance and what to look for 

when choosing a provider. A few resource and referral agencies also made 

efforts to translate written information into other languages. For example, 

as shown in figure 4, one agency translated a brochure on child care 

quality into Chinese. However, some state and local officials told us that 

their offices lacked the resources to translate materials into other 

languages. 

 26Applications in Washington were available in Spanish, Chinese, Korean, Russian, 

Cambodian, Vietnamese, Somali, and Laotian. 

27In June 2006, a North Carolina official told us that the translation of the CCDF subsidy 

application into Spanish has been completed. Local agencies currently have access to the 

translated document, and the North Carolina Department of Health and Human Services is 

in the process of making both the English and the Spanish versions of the document 

available electronically for their use. 
Page 28 GAO-06-807 Child Care and Early Childhood Education 

Figure 4: English and Chinese Versions of a Local Agency’s Child Care Quality 

Brochure 

The majority of local agency officials and providers that we interviewed 

told us that they relied on agency staff and volunteers to translate 

materials. For example, officials from a Head Start program told us that 

their staff had translated materials about the program into Spanish, 

Hmong, and Laotian. Officials at another Head Start program told us that 

they relied on bilingual staff, parents of children enrolled in the program, 

and Spanish-speaking volunteers from the community health clinic to 

translate the materials. Some agency officials told us that they also used 

outside contractors or other resources, such as commercially available 

translation software, to translate materials. Community group 

representatives expressed concerns about the quality of translations done 

by the local agencies, particularly in instances when volunteers or 

translation software had been used. 
Page 29 GAO-06-807 Child Care and Early Childhood Education 

Most local agencies and providers that we interviewed said that they 

disseminated translated information to raise awareness of their programs 

and services among parents with limited English proficiency. Agencies and 

providers employed various mechanisms to disseminate information, 

including using print and radio media and direct distribution of 

informational materials in the communities where many families with 

limited English proficiency reside. For example, some resource and 

referral agencies and providers said that they advertised their programs 

and services on Spanish-language television and radio stations, and a few 

agencies had placed advertisements in the Yellow Pages. Most of them 

also reported distributing information in various locations in the 

community, such as churches, neighborhood markets, and laundromats. 

Despite these agencies’ various outreach efforts, mothers in focus groups, 

many of whom were unaware of the available assistance, said that there 

was a need for greater information dissemination in their communities. 

Spanish- and Vietnamese-speaking mothers in all 12 focus groups 

indicated that disseminating information in their language would help 

them learn about child care assistance and child care and early education 

programs for their children. At the same time, focus groups with Spanishspeaking mothers in California who were already receiving the subsidies 

revealed their ambivalence about increased advertising of certain child 

care programs because some of these programs already had waiting lists. 

Some state and local officials also acknowledged that they did little or no 

advertising because their programs were already operating at full capacity 

or had substantial waiting lists. 

Agencies in the majority of locations that we visited had initiatives to 

increase the supply of providers who spoke other languages or to offer 

training in other languages to existing providers. Some agencies had come 

up with initiatives that focused on helping individuals speaking other 

languages to enter the child care field. For example, one resource and 

referral agency that we visited offered the classes required for obtaining a 

child care license in Spanish, and another one offered them in Cantonese. 

A resource and referral agency that we visited in an urban county 

developed a program to help Somali- and Russian-speaking women in the 

community obtain the training necessary to become licensed family child 

care home providers. In four of the five states that we visited, officials told 

us that selected community colleges participated in efforts to increase 

provider capacity to serve children of parents with limited English 

proficiency. For example, a community college in Illinois offered early 

childhood education classes in Spanish, while a community college in 

Selected Agencies Took 

Steps to Increase the 

Supply of Providers Able 

to Communicate 

Effectively with Parents 
Page 30 GAO-06-807 Child Care and Early Childhood Education 

California coordinated with a local resource and referral agency to offer 

these classes in Cantonese. However, some officials said that such efforts 

were insufficient, and in one state visited, an official from a university 

early childhood education program said that she was not aware of any 

efforts in the state to offer classes in other languages. 

Many agencies that we visited also provided training to existing child care 

providers who had limited English proficiency. For example, local referral 

agencies in Illinois included bilingual individuals in the technical 

assistance teams available to assist providers in improving the quality of 

care. 

Three of the five states that we visited used CCDF quality funds for 

various provider initiatives related to language, such as offering training to 

providers on working with families that had limited English proficiency or 

translating materials into other languages.28 For example, Arkansas used 

quality funds for training and technical assistance to help providers 

understand cultural issues that families with limited English proficiency 

face. California used these funds to offer training to providers throughout 

the state on working with children who speak other languages. Officials in 

North Carolina said that while they did not have any projects funded with 

CCDF quality funds that directly related to serving children of parents with 

limited English proficiency, they had used some of the funds to translate 

materials on child care health and safety practices into Spanish. Two of 

the states visited—Washington and Illinois—did not use CCDF funds 

directly on initiatives related to serving children of parents with limited 

English proficiency or providers working with them. However, both states 

used the funds to support other initiatives, such as the work of resource 

and referral agencies, which included outreach to parents with limited 

English proficiency in some of their efforts. 

State and local officials told us that despite efforts made, there was a 

shortage in some locations of training opportunities for providers who 

speak other languages. For example, officials across states and counties 

that we visited cited examples of child care providers with limited English 

proficiency who had attended training, such as training required for 

licensing, although they could not fully understand the course content 

 28States are required to describe in their CCDF plans how CCDF quality funds will be used, 

but are not required to use them for initiatives focused on providers serving children of 

parents with limited English proficiency. 
Page 31 GAO-06-807 Child Care and Early Childhood Education 

because it was not available in their languages. An official we interviewed 

told us that this could affect the quality of child care they would offer to 

children because the training covered critical issues, such as health and 

safety procedures. 

State and local agency officials, providers, and community college 

representatives reported several challenges associated with providing oral 

language assistance to parents with limited English proficiency applying 

for child care and early education programs for their children. Officials 

told us they faced challenges providing oral language assistance because 

of the difficulties that agencies had hiring qualified bilingual staff. Even 

when qualified bilingual individuals were found, officials said that these 

individuals were in very high demand and agencies could not always 

compete with other organizations interested in hiring them. For example, 

some child care and Head Start providers told us that they are losing 

qualified bilingual staff to school districts that offer higher salaries. Rural 

areas especially experienced difficulties hiring bilingual staff because their 

pool of qualified candidates was smaller than in the cities or virtually 

nonexistent. A few officials said that the lack of reliable transportation in 

rural areas makes it difficult to recruit staff from the cities. For example, a 

resource and referral agency official in one rural area that we visited told 

us that her office’s bilingual staff had quit because they had difficulty 

getting to work. Officials also cited difficulties with finding professional 

interpreters and with the expense associated with hiring them when 

agencies lacked bilingual staff of their own to offer oral language 

assistance to clients. 

Agency officials also reported challenges providing written language 

assistance to parents with limited English proficiency. They said that 

translating materials into other languages was expensive, particularly for 

agencies that served clients from several different language groups and 

had to translate materials into multiple languages. Local agencies 

frequently relied on their own staff to translate the materials, but a few 

officials said that this posed a burden on staff with other full-time 

responsibilities. At the same time, state and local officials said that 

contracting out for translations was expensive. Although state officials 

acknowledged the expense associated with translating materials into other 

languages, some states left local agencies to shoulder the burden of 

translating documents on their own. For example, state officials in 

California told us that the expense prevented the state from translating 

applications into languages other than Spanish, but local agencies had 

Officials in Selected State 

and Local Agencies 

Reported Challenges in 

Providing Services to 

Parents with Limited 

English Proficiency 
Page 32 GAO-06-807 Child Care and Early Childhood Education 

absorbed the cost of translating applications themselves in order to meet 

the needs of program applicants who spoke other languages. 

In addition, officials said that providing language assistance or training in 

other languages was not always cost-effective because of the relatively 

small number of individuals that would benefit from such efforts. For 

example, one resource and referral agency official told us that the cost of 

ordering materials in Spanish was higher than the cost of ordering the 

same materials in English because the materials had to be purchased in 

smaller orders, thereby increasing their cost. Some officials said that while 

they were able to offer language assistance to larger language groups in 

the area, such as Spanish speakers, they chose not to expand their 

assistance to include other language groups because of the small number 

of individuals that would benefit from it. 

Despite challenges faced, agency officials that we interviewed expressed 

the need for effective and affordable ways to provide services to 

individuals with limited English proficiency. Officials in three states visited 

told us that they would benefit from having additional information on costeffective strategies to serve parents with limited English proficiency. 

Several officials also told us that it would be helpful for them to learn 

more about the professional development opportunities for providers 

offered at other locations. For example, officials in Illinois said that the 

state’s current capacity for provider training in Chinese was limited and 

that they would like to learn more about any curricula developed in other 

states with larger Asian populations. 

HHS issued general guidance, translated materials, and provided technical 

assistance to grantees on serving children of parents with limited English 

proficiency, but gaps remain in its program review efforts. The Office of 

Head Start has provided assistance to increase awareness of the Head 

Start program among families with limited English proficiency and has 

monitored local programs’ efforts to provide access to these families by 

reviewing grantees’ biennial assessments of need in the communities they 

serve and by conducting formal monitoring reviews of grantees. However, 

an Office of Head Start official told us that the office could not ensure that 

its review teams consistently reviewed grantee compliance with program 

standards related to language access, and in our prior work we found that 

no mechanism existed to ensure consistency in the monitoring process. 

CCB provided assistance to help programs serve children whose parents 

have limited English proficiency, as well as reviewed states’ CCDF plans 

and investigated complaints. However, CCB had no mechanism for 

reviewing how access to CCDF subsidies was provided for children of 

HHS Provided 

Assistance to 

Grantees on Serving 

Children of Parents 

with Limited English 

Proficiency, but Gaps 

Remain in Its Program 

Review Efforts 
Page 33 GAO-06-807 Child Care and Early Childhood Education 

parents with limited English proficiency or for ensuring that these children 

were not inadvertently excluded from the subsidies as a result of state 

eligibility criteria that were inconsistent with CCB’s program eligibility 

guidance. 

In 2003, consistent with Executive Order 13166, HHS issued guidance to 

federal financial assistance recipients regarding the Title VI prohibition 

against national origin discrimination as it affects individuals with limited 

English proficiency. The guidance was intended to help recipients of HHS 

funds, such as agencies administering CCDF subsidies and Head Start 

programs, provide meaningful access for individuals with limited English 

proficiency. The guidance, however, applied to all HHS programs and did 

not refer specifically to child care or early education. 

HHS’ OCR provided outreach to potential beneficiaries of HHS programs 

and offered technical assistance to grantees to help them comply with the 

guidance. For example, OCR officials told us that they disseminated 

information about serving individuals with limited English proficiency at 

Hispanic health fairs, through recorded public service announcements and 

interviews on Spanish-language media, and by giving presentations before 

community service organizations. They also said that they provided 

grantees with technical assistance in identifying appropriate language 

access strategies. Regional OCR officials told us that their offices served 

as a resource for local social service agencies, directing them to less costly 

language access strategies, such as sharing interpreter services, and 

providing information on available resources and practices. 

OCR also participated in the Federal Interagency Working Group on 

Limited English Proficiency that developed, among other things, a Web 

site devoted to serving persons with limited English proficiency 

(www.lep.gov). The Web site serves as a clearinghouse, providing 

information, tools, and technical assistance regarding limited English 

proficiency and language services for federal agencies, recipients of 

federal funds, users of federally assisted programs, and other interested 

parties. It makes available a range of guidance and information on offering 

language assistance through mechanisms such as interpreter services and 

translated materials for clients with limited English proficiency in the 

areas of health care, the courts, and transportation. However, it does not 

include specific information on providing language assistance in child care 

and early education programs. In addition, CCB and Office of Head Start 

officials and officials from several HHS regional offices told us that they 

were unaware of the Web site. 

HHS Issued General 

Guidance to Grantees on 

Providing Access to 

Federal Programs for 

Individuals with Limited 

English Proficiency 
Page 34 GAO-06-807 Child Care and Early Childhood Education 

OCR is required to investigate all complaints of alleged discrimination, 

including lack of access to programs for individuals with limited English 

proficiency. OCR officials told us that Title VI violations in child care were 

rare. They said that when infractions do occur, they try to reach a 

voluntary compliance agreement with the state and conduct follow-up to 

ensure that the state takes corrective action to comply with the terms of 

the agreement. For example, North Carolina entered into a voluntary 

compliance agreement with OCR and implemented a corrective action 

plan for providing access for program applicants with limited English 

proficiency. A state official told us that the state was in the process of 

translating the subsidy application into Spanish as a result of this 

agreement. 

The Office of Head Start has provided a variety of assistance to increase 

awareness of the Head Start program among families with limited English 

proficiency. The office has twice hosted a National Head Start Hispanic 

Institute, the goals of which included improving outreach to Hispanic 

communities, developing methods to effectively serve Hispanic children 

and families, and helping ensure positive outcomes in language and 

literacy development for English-language learners. A Head Start official 

told us that the needs of other language groups needed to be addressed as 

well, and that the Office of Head Start was considering how to replicate 

the institute for groups that speak other languages. According to officials, 

the Office of Head Start has several other initiatives to reach parents with 

limited English proficiency, such as placing public service announcements 

on Spanish-language media and distributing a brochure in Spanish 

informing families potentially eligible for Head Start of the benefits of 

enrolling their children in Head Start. 

The Office of Head Start has also provided assistance to grantees to better 

serve children of parents with limited English proficiency. Recently, the 

office conducted a national language needs assessment of second 

language and dual language acquisition to identify culturally responsive, 

research-based strategies to improve outcomes for children and families. 

It also developed a Culturally Responsive and Aware Dual Language 

Education (CRADLE) training initiative that is designed to support 

grantees in their efforts to find best practices for language acquisition for 

the birth-to-3-year-old population. In addition, through its English 

Language Learners Focus Group, the Office of Head Start created 

materials for grantees working with second language learners, including 

Spanish speakers who constitute the majority of children in Head Start 

whose parents have limited English proficiency. 

The Office of Head Start 

Provided Assistance to 

Increase Awareness of 

Head Start and to Improve 

Service Delivery and 

Conducted Limited 

Monitoring of Language 

Access in Head Start 

Programs 
Page 35 GAO-06-807 Child Care and Early Childhood Education 

The Office of Head Start monitors grantees’ efforts to provide access for 

individuals with limited English proficiency by reviewing their biennial 

community assessments and conducting formal on-site monitoring 

reviews. Head Start programs are required to conduct a community 

assessment at least once every 3 years, and the Office of Head Start 

regional officials review these assessments for demographic disparities 

between program participants and the population of the community to be 

served. For example, programs with assessments showing large numbers 

or proportions of language groups in the community that are not reflected 

in the enrollees or the classroom teachers may be found out of compliance 

with meeting local needs. Head Start programs are also monitored by the 

Office of Head Start once every 3 years through the PRISM process. Head 

Start programs are required to adhere to program performance standards 

that define the services that programs are to provide to children and their 

families, and on-site PRISM review teams monitor Head Start grantees’ 

adherence to the standards. Several of the standards directly address 

interactions with children and parents with limited English proficiency. 

For example, one performance standard requires communications with 

parents to be carried out in the parent’s primary or preferred language or 

through an interpreter.29 Another performance standard directs programs 

in which the majority of children speak the same language to have at least 

one classroom staff member or home visitor who speaks that language.30

The contractor responsible for assigning bilingual reviewers to PRISM 

review teams told us that about 17 percent of reviewers were bilingual and 

that review teams requesting a Spanish-speaking bilingual individual had 

one assigned 70 percent of the time. 

A Head Start official with responsibility for the PRISM process told us that 

given the vast number of regulations, however, it was impossible to ensure 

that all of them were consistently reviewed in the course of a 1-week 

review. In our previous work, we reported that ACF had no process in 

place to ensure that its reviewers consistently followed the standards 

while conducting on-site PRISM reviews.31 We recommended that ACF 

develop an approach that can be applied uniformly across all of its 

 2945 CFR §1304.51(c)(2) 

3045 CFR §1304.52(g)(2). In fiscal year 2004, the Office of Head Start found three programs 

in noncompliance with this performance standard. 

31GAO. Head Start: Comprehensive Approach to Identifying and Addressing Risks Could 

Help Prevent Grantee Financial Management Weaknesses, GAO-05-176 (Washington, D.C.: 

Feb. 28, 2005). 
Page 36 GAO-06-807 Child Care and Early Childhood Education 

regional offices to assess the results of the PRISM reviews and implement 

a quality assurance process to ensure that the framework for conducting 

on-site reviews was implemented as designed. HHS agreed with our 

recommendation, and Head Start officials indicated that the Office of Head 

Start was developing new PRISM protocols and training reviewers to add 

more uniformity to how grantees are assessed. In addition, the Office of 

Head Start recently announced plans to conduct follow-up reviews of 

grantees monitored through the PRISM system in an effort to ensure that 

PRISM review teams did not miss grantee deficiencies, such as in 

providing assistance to children and parents with limited English 

proficiency. 

CCB provided assistance to raise program awareness among parents with 

limited English proficiency whose children may be eligible for CCDF 

subsidies. Officials told us that CCB had translated a number of its 

consumer education materials into Spanish, including the CCDF program 

brochure and public service announcements informing parents where and 

how to locate child care. In a targeted effort to reach Hispanic families and 

providers, CCB also translated into Spanish a brochure outlining what 

providers should know about child care assistance for families. CCB, 

through a cooperative agreement with the National Association of Child 

Care Resource and Referral Agencies (NACCRRA), provides educational 

information to parents through the Child Care Aware Web site 

(www.childcareaware.org). In addition, NACCRRA has translated 

consumer education publications into Spanish, including a publication on 

paying for child care, which it made available through its Web site to 

resource and referral agencies nationwide. CCB officials told us that they 

were also looking into translating these publications into Chinese. CCB 

also sponsors a National Child Care Information Center Web site 

(www.nccic.org), which offers information on a wide range of child care 

issues, including a number of documents that relate to serving children 

from families with limited English proficiency. 

CCB officials told us that they provided opportunities for agencies and 

providers to share information, including information on serving children 

of parents with limited English proficiency. For example, CCB convened 

meetings of state CCDF administrators that, while not focusing specifically 

on issues of limited English proficiency, covered topics such as meeting 

the needs of diverse groups of children and parents. In addition, CCB 

maintains an online forum for states to pose questions and share ideas, 

which has been used to discuss such issues as converting print materials 

into Spanish. CCB also offers child care providers online access to training 

CCB Provided Assistance 

to Help CCDF Programs 

Serve Children Whose 

Parents Have Limited 

English Proficiency but 

Had No Mechanism for 

Reviewing Agencies’ 

Provision of Access 
Page 37 GAO-06-807 Child Care and Early Childhood Education 

modules, practical strategies for serving children and families, and 

interactive online chats in English and Spanish through the Center on 

Social and Emotional Foundations for Early Learning Web site 

(www.csefel.uiuc.edu). 

While it has made efforts to assist states with serving the needs of children 

whose parents have limited English proficiency, CCB has no mechanism 

for reviewing how agencies provide access to CCDF subsidies for eligible 

children of parents with limited English proficiency or ensuring that these 

children are not inadvertently excluded as a result of state CCDF eligibility 

criteria that are inconsistent with agency guidance. CCB officials told us 

that CCDF is a block grant and CCB receives no funding specifically for 

supporting monitoring activities. As a result, CCB’s oversight of CCDF is 

limited to reviewing states’ CCDF plans and investigating complaints. 

CCB, however, does not require states to include assurances in their CCDF 

plans that state agencies are providing access to CCDF subsidies for 

children of parents with limited English proficiency. Regional officials told 

us that they had complaint processes in place and would either review 

complaints or refer them to OCR, but said that they were unaware of any 

complaints regarding restricted access for individuals with limited English 

proficiency. Officials in one region told us that states appeared to 

understand the CCDF program eligibility criteria. Officials in another 

region told us that while they interacted with states through phone calls 

and occasional on-site visits, these contacts primarily focused on the 

provision of technical assistance. Thus, these interactions were not a 

systematic review of how states determine eligibility for federal child care 

assistance. 

On our site visit to Arkansas, we found that the state had eligibility 

requirements that appeared to violate CCB guidance. Specifically, 

although guidance to state agencies administering CCDF clarified that only 

the citizenship and immigration status of a child was relevant when 

determining the child’s eligibility for federal child care assistance, 

applicants for child care assistance in Arkansas had to submit a 

declaration that the applicant (typically a parent applying to receive 

assistance for the child) and all the other members of the household were 

U.S. citizens, nationals, or legal residents. In addition, the state’s policy 

manual for the administration of CCDF services indicated that the state 

would deny any applications for child care assistance that were submitted 

by parents or custodians who were neither citizens nor lawfully admitted 

residents. These requirements have the potential of precluding children 

who otherwise met the eligibility criteria from receiving federal financial 

assistance on the basis of their parents’ citizenship or immigration status. 
Page 38 GAO-06-807 Child Care and Early Childhood Education 

CCB officials told us that they were unaware of the situation until we 

brought it to their attention and that they were in the process of discussing 

with state officials how to resolve it. They further noted that they would 

investigate formal complaints brought to their attention, which would 

include complaints about states requesting unnecessary information on 

their child care subsidy applications and adversely affecting individuals 

with limited English proficiency. However, officials indicated that they had 

received no such complaints from affected parties. 

Access to high-quality child care and early education programs helps 

promote healthy development of children and can provide an important 

support for parents as they pursue employment or education to secure the 

family’s economic well-being and avoid public assistance. The resources 

available for nonentitlement child care and early education programs, 

such as CCDF subsidies and Head Start, are limited and not intended to 

cover everyone who meets eligibility criteria and is in need of assistance. 

Consequently, agencies have to make choices about who they will cover 

with the limited funds, employing strategies such as prioritization of 

certain groups of applicants or waiting lists. At the same time, federal, 

state, and local entities play important roles in ensuring that parents’ 

language ability does not preclude children from being considered for 

coverage under these programs. 

These roles are becoming especially important as the demographics of 

many communities are changing rapidly and localities across the country 

are seeing increased numbers of individuals with limited English 

proficiency. While state and local agencies are making efforts to address 

the needs of this growing population, they experience difficulties offering 

language assistance to parents seeking to access programs for their 

children and recruiting new providers with the language ability to serve 

these families. However, without reliable data on who is enrolled in their 

programs, state and local officials may have difficulty determining the 

extent to which parents with limited English proficiency have access to 

these programs for their children and whether services need to be 

adjusted to accommodate changes in the population served. 

Although Congress provided states with flexibility in administering their 

CCDF program grants, HHS is responsible for ensuring that states adhere 

to the conditions of their grants and that they take reasonable steps to 

ensure access to individuals with limited English proficiency. Yet, HHS’s 

existing methods for reviewing how CCDF funds are used by grantees do 

not systematically assess how access for parents with limited English 

Conclusions 
Page 39 GAO-06-807 Child Care and Early Childhood Education 

proficiency is provided or identify state or local policies that may 

adversely affect these parents’ ability to access programs for their 

children. HHS responds to complaints of any alleged discrimination or 

agency actions that adversely affect the ability of eligible children to 

access programs and services. However, HHS may lack the tools to ensure 

equal access for children whose parents have limited English proficiency if 

the parents do not bring complaints for reasons such as language 

difficulties, unfamiliarity with how the complaint process works, or fear 

about approaching government agencies. Without a mechanism to 

systematically review access to CCDF-funded programs for these families, 

HHS cannot provide all eligible children with the same opportunity to 

participate in programs that would benefit them and their families and 

possibly enhance their households’ self-sufficiency. 

To help state and local agencies plan for language assistance and assess 

whether they provide meaningful access to eligible children, regardless of 

their parents’ English ability, we recommend that CCB work with states to 

help them explore cost-effective strategies for collecting data on CCDF 

subsidy recipients’ language preference or English proficiency and 

comparing these data with available information on community 

demographics. Once these data are available, HHS may consider collecting 

information on existing cost-effective ways for agencies to provide 

language assistance and to recruit providers who speak other languages, 

as well as disseminating this information in the locations where the data 

show the greatest need. 

To provide opportunities to parents with limited English proficiency to 

access federal child care subsidies for their children, we recommend that 

HHS develop and implement specific steps to review whether and how 

states provide access to CCDF programs for eligible children of parents 

with limited English proficiency, as well as provide information to help 

states evaluate their progress in this area. Specifically, HHS should 

• revise the CCDF plan template to require states to report on how 

they will provide meaningful access to parents with limited English 

proficiency seeking CCDF subsidies for their children, and 

• systematically review states’ program eligibility criteria for CCDF 

subsidies to ensure that states comply with HHS policies related to 

participation by children of parents with limited English 

proficiency. 

Recommendations for 

Executive Action 
Page 40 GAO-06-807 Child Care and Early Childhood Education 

ACF provided written comments on a draft of this report, which are 

reproduced in appendix III. In its letter, ACF agreed with most aspects of 

our recommendations and provided information on its actions or plans 

that would support their implementation. In addition, ACF provided a 

number of technical comments that we incorporated as appropriate. 

In response to our recommendation that HHS work with states to help 

them explore cost-effective ways of collecting data on the primary 

language of CCDF subsidy recipients, ACF provided some additional 

information on actions it has taken to help states in this area. For 

example, it stated that in July 2006, CCB launched a technical assistance 

initiative that will, among other things, disseminate information to states 

on effective strategies to assist families with subsidy access, including 

families experiencing language barriers. 

Regarding our second recommendation, that HHS develop a mechanism to 

review how states provide access to CCDF subsidies for children of 

parents with limited English proficiency, ACF indicated that it will 

examine the feasibility of using the CCDF plan template to ask states to 

report on their efforts to promote access to these families. However, ACF 

did not address our recommendation that HHS systematically review 

states’ eligibility criteria for CCDF subsidies to ensure that states comply 

with HHS policies related to participation by children whose parents have 

limited English proficiency. 

ACF also submitted detailed comments related to our analysis of national 

survey data collected in 1998 as part of ECLS-K. ACF noted that ECLS-K 

data only provide information on children in the year before kindergarten 

and that the analysis omits other variables that may explain our findings, 

such as preferences for certain types of care within ethnic communities 

and parents’ immigration status. Our report discusses these data 

limitations, and as is the case with any statistical model, some of the 

factors with the potential to affect the outcomes we examined could not 

be included because the data measuring them were not collected. It is 

partly for that reason that we employed multiple methodologies in 

addressing our research objectives, including site visits and focus groups. 

ACF noted that the data represent child care and early education patterns 

for 1997 and that subsequent policy changes or increases in federal and 

state child care funding, may have narrowed the gap in program 

participation among different groups of children. However, we found that 

some of the policy changes ACF cited were not consistently implemented 

and ACF provided no more current data that would allow us to ascertain 

Agency Comments 

and Our Evaluation 
Page 41 GAO-06-807 Child Care and Early Childhood Education 

the effects of these changes. As such, ECLS-K remained the most recent 

national dataset that allowed us to compare children of parents with 

limited English proficiency and similar children whose parents are 

proficient in English with respect to their receipt of financial assistance 

for child care from a social service or welfare agency and their 

participation in Head Start. 

As arranged with your office, unless you publicly announce its contents 

earlier, we plan no further distribution of this report until 30 days after the 

date of this letter. At that time, we will send copies of this report to the 

Secretary of HHS, relevant congressional committees, and other interested 

parties. We will also make copies available to others upon request. In 

addition, the report will be made available at no charge on GAO’s Web site 

at http://www.gao.gov. 

If you or your staff have any questions about this report, please contact me 

at (202) 512-7215. Other contacts and major contributors are listed in 

appendix IV. 

Marnie S. Shaul, Director 

Education, Workforce, and 

 Income Security Issues 
Appendix I: Scope and Methodology 

Page 42 GAO-06-807 Child Care and Early Childhood Education 

In conducting our work, we employed multiple methodologies, including a 

review of available data on participation of children in child care and early 

education programs, state and county site visits, focus groups with 

mothers who have limited English proficiency, interviews with federal 

officials and national experts, and a review of available legislation, 

guidance, and other federal resources. We performed our work in 

accordance with generally accepted government auditing standards 

between July 2005 and June 2006. 

To obtain information on the participation of children whose parents have 

limited English proficiency in child care and early education programs 

funded through the Child Care and Development Fund (CCDF) and Head 

Start, we obtained and reviewed the most recent program participation 

data from the U.S. Department of Health and Human Services (HHS), 

surveyed states about their data on CCDF subsidy recipients, and analyzed 

national survey data available through the Early Childhood Longitudinal 

Study, Kindergarten Class of 1998-99 (ECLS-K). The relevant 

characteristics of data sources we examined are shown in table 1. 

Appendix I: Scope and Methodology 

Analysis of National 

Program Participation 

Data and State Data 

Inquiries 
Appendix I: Scope and Methodology 

Page 43 GAO-06-807 Child Care and Early Childhood Education 

Table 1: Characteristics of Data Sources Examined 

Source of 

data 

Programs 

covered 

Scope of data 

collection 

Availability of data on 

the language of 

program participants 

Ability to use the data 

to estimate participation 

rates by children of 

parents with limited 

English proficiency 

Reasons why data cannot 

be used to estimate 

participation rates by 

children of parents with 

limited English proficiency 

CCB 

databases 

CCDF Enrollment or 

sample of program 

participants 

(depending on 

state) 

None No CCB does not collect data 

related to language in its 

monthly or annual reports from 

states. 

State 

databases 

CCDF Enrollment or 

sample of program 

participants 

(depending on 

state) 

Varies by state No Approximately one-quarter of 

states collect data; their data 

have many limitations, and 

states collect data differently. 

NRS Head Start Enrollment, for all 

4- and 5-year-old 

children in Head 

Start 

Child speaks language 

other than English at 

home, child’s primary 

language, and child’s 

English proficiency as 

determined by local 

staff 

No NRS data are collected only 

from children enrolled in Head 

Start, so the participation rate 

in the overall population is 

unknown. 

Data are not available on the 

parents’ English proficiency. 

FACES Head Start Sample of parents 

with 3 and 4-yearold children in 

Head Start 

Parent selfassessment of 

language ability and 

language spoken at 

home 

No FACES data are collected only 

on children enrolled in Head 

Start, so the overall 

participation rate is unknown. 

ECLS-K Child Care 

assistance and 

Head Start 

Sample of children 

in kindergarten 

Parent selfassessment of 

language ability and 

language spoken at 

home 

No (for CCDF programs) 

Yes (for Head Start 

participation in the year 

before kindergarten) 

The survey questions did not 

ask for the source of child care 

financial assistance. 

Source: GAO analysis of HHS program participation data, ECLS-K, and telephone interviews with state officials. 

We reviewed CCDF program participation data collected by CCB in the 

reports that states are required to submit on CCDF subsidy recipients but 

found that these reports did not contain any data related to language from 

CCDF subsidy recipients or their families. CCB officials confirmed that 

they do not currently collect any language data, since such data collection 

was not listed in the CCDF authorizing legislation.32

 32CCB collects data from states on the race and ethnicity of subsidy recipients, but these do 

not allow for identification of CCDF recipients speaking other languages. 
Appendix I: Scope and Methodology 

Page 44 GAO-06-807 Child Care and Early Childhood Education 

We reviewed language data for Head Start participants available from the 

Office of Head Start through the Head Start National Reporting System 

(HSNRS) and the Head Start Family and Child Experiences Survey 

(FACES). HSNRS, implemented in August 2003, is the nationwide skills 

test of over 400,000 children aged 4 and 5 in Head Start, intended to 

provide information on how well Head Start grantees are helping children 

progress. The Computer-Based Reporting System (CBRS) was developed 

for HSNRS to allow local Head Start staff to enter descriptive information 

about their programs, including the demographic characteristics of 

children assessed by HSNRS. We requested and reviewed HSNRS 

demographic data from spring 2005 that provided information on the 

primary language of children in Head Start. FACES is a series of 

longitudinal surveys of nationally representative samples of children in 

Head Start. We requested and reviewed fall 2003 FACES data, which 

included about 2,400 parent interviews that provided information on the 

languages spoken at home by Head Start families, parents’ self-reported 

English proficiency, and the availability of Head Start staff to 

communicate with children and parents in their preferred language. 

To assess the reliability of Head Start data, we interviewed relevant HHS 

officials and officials from Westat, a private research corporation 

administering and analyzing HSNRS and FACES under a contract with the 

Office of Head Start. In addition, we reviewed relevant documentation and 

examined the logs of the computer code used to generate the data 

provided to us. Because HSNRS data were collected only for 4- and 

5-year-old children in Head Start, they cannot be used to generalize about 

all children in Head Start.33 The HSNRS data were entered into CBRS by 

the staff of local Head Start programs. While we did not independently 

verify these data, we did not find any evidence to suggest that they were 

unreliable. As part of FACES, interviews were held directly with parents of 

children in Head Start. While Spanish interviewers were available, parents 

with limited English skills who spoke other languages were required to 

provide their own interpreter. Parents unable to participate in an interview 

in English or Spanish or provide their own interpreters could not be 

included in the survey. According to a Westat official, however, only three 

interviews could not be conducted because of the lack of an interpreter. 

We determined that FACES data were sufficiently reliable for the purposes 

of this report. 

 33The Head Start program also serves children who are 3 years old. 
Appendix I: Scope and Methodology 

Page 45 GAO-06-807 Child Care and Early Childhood Education 

Because the available agency data did not allow us to determine the total 

participation of children of parents with limited English proficiency in 

federal child care and early education programs, we also analyzed survey 

data provided by NCES from ECLS-K, a national longitudinal study 

focusing on following children’s early education and school experiences 

from kindergarten through 12th grade. We used data from the fall 1998 

base year survey of approximately 18,000 parents with children in 

kindergarten. ECLS-K was the most recent national dataset that allowed us 

to compare child care, financial assistance for child care, and Head Start 

usage rates among children with parents who had limited English 

proficiency and children whose parents were proficient in English.34

Among other topics, ECLS-K asked parents about their English 

proficiency, the languages spoken at home, their child’s use of child care 

in the year before kindergarten, any financial assistance from a social 

service or welfare agency, and the child’s use of Head Start.35 The survey 

did not ask for the specific social service or welfare agency providing 

financial assistance for child care, so we were unable to make estimates 

about the use of CCDF subsidies from this dataset. NCES had bilingual 

interviewers available to conduct the survey in Spanish, Chinese, Hmong, 

and Lakota if the respondent was not able to speak English and no 

English-speaking member of the household was available. Slightly more 

than 7 percent of the interviewers were conducted in a language other 

than English. More information about our analysis of ECLS-K data can be 

found in appendix II. 

To assess the reliability of ECLS-K data, we reviewed relevant information 

about the survey, including the user manual, data dictionary, and steps 

taken to ensure the quality of these data, and performed electronic testing 

to detect obvious errors in completeness and reasonableness. We 

determined that the ECLS-K data were sufficiently reliable for the 

purposes of this report. 

 34NCES started following a new cohort of children, starting at birth, in 2001. However, the 

data on their experiences in the year before kindergarten are not expected to be available 

until 2008. 

35NCES attempted to verify enrollment for children whose parents reported that they were 

in Head Start. While only about half of the enrollments could be confirmed, NCES 

concluded that “families with unconfirmed reports of Head Start participation by their 

children had demographic characteristics similar to those of families with confirmed 

participation in Head Start. This lends support to the notion that a substantial proportion of 

these children had indeed attended Head Start programs, even though their attendance 

could not be verified.” (Source: “User’s Manual for the ECLS-K Base Year Restricted-use 

Head Start Data Files and Electronic Codebook,” NCES 2001-025.”) 
Appendix I: Scope and Methodology 

Page 46 GAO-06-807 Child Care and Early Childhood Education 

We also contacted child care administrators in all 50 states and the District 

of Columbia to determine whether any states collected their own data on 

the language of CCDF subsidy recipients. We discussed data collection 

with officials in 5 states in the course of our site visits and contacted 

officials in the remaining 45 states and the District of Columbia by e-mail. 

Of those contacted by e-mail, 40 states and the District of Columbia 

responded. Overall, 12 states and the District of Columbia collected some 

language data from parents whose children received CCDF subsidies. We 

then followed up with officials in the District of Columbia and all 12 states 

that reported collecting the data on the language of CCDF subsidy 

recipients to ask questions about the type of data collected, the methods 

by which the data were collected, the challenges states faced in collecting 

the data, and the purposes for which the data were used. We did not ask 

states to submit their data to us because we determined that the 

differences in states’ data collection approaches and the limitations of 

state data would preclude us from aggregating state data to produce 

national estimates of CCDF subsidy use among children of parents who 

speak other languages. 

To obtain information on the challenges that parents with limited English 

proficiency face in accessing CCDF subsidies and Head Start and the 

assistance provided to these families by state and local entities, we visited 

5 states—Arkansas, California, Illinois, North Carolina, and Washington. 

We selected these states on the basis of the size and growth of their 

population of individuals with limited English proficiency as determined 

by our analysis of 1990 and 2000 data from the U.S. Census Bureau, the 

states’ geographic location, and the presence of initiatives focused on 

individuals with limited English proficiency as determined by our review 

of CCDF plans that states are required to submit to CCB every 2 years. We 

visited 10 counties across these states, as well as contacted officials in 

1 county by telephone. We selected counties with substantial numbers of 

individuals with limited English proficiency or that have experienced a 

significant growth in this population based on the analysis of 1990 and 

2000 U.S. Census data. (See table 2.) In choosing counties, we also 

considered the proportion of residents living in urban and rural parts of 

the county to obtain information on the experiences of families in both 

urban and rural areas. 

Site Visits 
Appendix I: Scope and Methodology 

Page 47 GAO-06-807 Child Care and Early Childhood Education 

Table 2: Selected Characteristics of Site Visit Counties 

 Individuals with limited English proficiency (LEP) 

County 

Number of 

individuals 

with LEP 

(1990) 

Individuals with 

LEP as a 

percentage of 

total population 

(1990)

Number of 

individuals 

with LEP 

(2000)

Individuals with 

LEP as a 

percentage of 

total population 

(2000)

Percentage 

change in 

number of 

individuals 

with LEP 

(1990-2000) 

Percentage change 

in proportion of 

individuals with LEP 

as a percentage of 

population 

(1990-2000)

Washington 

County, 

Arkansas 483 0.5 4,925 3.4 919.7 637.3

Fresno County, 

California 66,070 10.9 86,776 11.8 31.3 8.6

Los Angeles 

County, 

California 1,153,956 14.2 1,395,347 15.9 20.9 11.9

San Francisco 

County, 

California 86,228 12.5 99,659 13.4 15.6 6.7

Cook County, 

Illinois 247,814 5.2 392,663 7.9 58.5 50.1

Winnebago 

County, 

Illinois 2,510 1.1 6,208 2.4 147.3 123.3

Durham County, 

North Carolina 1,330 0.8 8,886 4.3 568.1 442.6

Sampson 

County, 

North Carolina 377 0.9 2,618 4.7 594.4 451.2

King County, 

Washington 27,329 1.9 63,004 3.9 130.5 98.2

Yakima County, 

Washington 10,916 6.3 20,686 10.2 89.5 60.4

Chatham 

County, 

North Carolinaa

297 0.8 2,243 4.8 655.2 488.2

Source: GAO analysis of data from the U.S. Census. 

a

We contacted officials in this county by telephone. 

On each site visit, we interviewed various stakeholders in the child care 

and early education field at the state and local levels, including officials 

responsible for administering CCDF subsidies, representatives of child 

care resource and referral agencies, Head Start officials, and child care 

and early education providers, as well as officials from community 
Appendix I: Scope and Methodology 

Page 48 GAO-06-807 Child Care and Early Childhood Education 

organizations and advocacy groups working with individuals who have 

limited English proficiency. 

To obtain information on the challenges that parents with limited English 

proficiency face when accessing child care subsidies for their children, we 

conducted 12 focus groups with mothers who had limited English 

proficiency in California, Washington, and North Carolina. We selected 

these locations in order to include both states with historically large 

populations of individuals with limited English proficiency (California and 

Washington) and a state experiencing a more recent growth in this 

population (North Carolina)—based on our analysis of data from the U.S. 

Census. GAO contracted with Aguirre International, a firm specializing in 

applied research with hard-to-reach populations, to recruit focus group 

participants through community-based organizations, arrange facilities for 

focus groups in locations familiar and accessible to the participants, 

provide transportation to and from child care during the focus groups, 

moderate the group discussions, and translate focus group transcripts. 

Focus groups were conducted from January 2006 to March 2006. 

Consistent with focus group data collection practices, our design involved 

multiple groups with certain homogeneous characteristics. All focus 

groups were conducted with mothers of children aged 5 or younger 

enrolled in child care. These mothers also had limited English proficiency 

as self-reported by potential participants during the focus group 

recruitment process and were eligible for CCDF subsidies as determined 

by family’s income and parental work and education activities. The focus 

groups varied by primary language spoken and whether or not 

participants’ children were receiving government child care subsidies.36

Eight of the 12 focus groups were conducted in Spanish and 4 in 

Vietnamese. We chose to conduct focus groups in Spanish and Vietnamese 

because these two languages were among the most prevalent languages, 

other than English, spoken in the states of interest. According to 2000 

 36During the focus group recruitment process, mothers were asked a series of questions to 

ensure that it was likely that they were receiving CCDF subsidies or eligible for them 

(depending upon whether they were selected for the subsidized or unsubsidized groups), 

and to screen out participants in other similar local programs such as state preschool 

programs or local subsidy programs. However, states may use multiple sources to fund 

their child care assistance programs, and participants may not know whether the source of 

their assistance is federal or state funds. Therefore, it is possible that some of the 

government subsidies received by participants were not funded entirely or at all by CCDF 

even though the recipients met the criteria for eligibility. 

Focus Groups 
Appendix I: Scope and Methodology 

Page 49 GAO-06-807 Child Care and Early Childhood Education 

Census data, Spanish was the language most commonly spoken among 

these households in the states we visited. In Washington, Vietnamese was 

the most commonly spoken language after Spanish, and in California, 

Vietnamese was the second most commonly spoken language after 

Spanish. We did not conduct focus groups in Vietnamese in North Carolina 

because of the limited number of individuals who spoke languages other 

than English or Spanish in the state. Six of the focus groups consisted of 

mothers with young children (ages 0-5) who were enrolled in child care 

and received a government subsidy for that care; the other 6 groups 

consisted of mothers with young children (ages 0-5) who were enrolled in 

child care and did not receive a government subsidy for that care, but 

whose children likely qualified for subsidies based upon their family’s 

income and employment or education activities. Table 3 describes the 

characteristics of the group at each location and lists locations and dates 

for each focus group conducted. The number of participants in each focus 

group ranged from 6 to 13. 

Table 3: Composition of Focus Groups 

 Language Location Date 

Subsidized Spanish Yakima, Wash. January 31, 2006 

 Spanish Siler City, N.C. February 4, 2006 

 Spanish Siler City, N.C. March 2, 2006 

 Spanish San Jose, Calif. February 8, 2006 

 Vietnamese San Jose, Calif. February 11, 2006 

 Vietnamese Seattle, Wash. February 20, 2006 

 

Unsubsidized Spanish Yakima, Wash. February 20, 2006 

 Spanish Pittsboro, N.C. February 4, 2006 

 Spanish Pittsboro, N.C. February 18, 2006 

 Spanish Oakland, Calif. February 7, 2006 

 Vietnamese San Jose, Calif. February 9, 2006 

 Vietnamese Seattle, Wash. February 20, 2006 

Source: GAO analysis of focus group transcripts. 

To help the moderator lead the discussions, GAO developed a guide that 

included open-ended questions related to mothers’ experiences finding 

appropriate child care and attempting to access financial assistance to 

help pay for the care. Discussions were held in a structured manner and 

followed the moderator guide. 
Appendix I: Scope and Methodology 

Page 50 GAO-06-807 Child Care and Early Childhood Education 

Focus groups involve structured small group discussions designed to gain 

in-depth information about specific issues that cannot easily be obtained 

from single or serial interviews. Methodologically, they are not designed to 

provide results generalizable to a larger population or provide statistically 

representative samples or reliable quantitative estimates. They represent 

the responses only of the mothers who participated in our 12 groups. The 

population of individuals with limited English proficiency in the United 

States consists of many cultural backgrounds and languages in addition to 

Spanish and Vietnamese, and those and other factors may influence the 

experience and attitudes of parents with limited English proficiency 

regarding child care. Therefore, the experiences of other mothers may be 

different from those of focus group participants. In addition, while the 

composition of the groups was designed to include different states, 

languages, and subsidy participation status, the groups were not random 

samples of mothers with limited English proficiency. 

To assess HHS’s efforts to ensure access to its programs for parents with 

limited English proficiency, we interviewed HHS officials, reviewed 

documents and guidance produced by HHS for state and local grantees, 

and analyzed relevant legislation. We interviewed officials from CCB, the 

Office of Head Start, HHS’s Office for Civil Rights, and the five HHS 

regional offices that covered the states that we visited.37 We also reviewed 

informational materials produced by HHS to facilitate access to programs 

for individuals with limited English proficiency and online resources 

pertaining to language access that were available through HHS’s and the 

Department of Justice’s Web sites. Additionally, we analyzed relevant 

legislation, federal regulations, and reports from research organizations. 

Finally, to obtain information pertaining to our research objectives, we 

interviewed officials from various national organizations working on 

issues related to early child care and education, as well as organizations 

advocating on behalf of individuals with limited English proficiency. 

 37The regional offices that we contacted were: Region IV (North Carolina); Region V 

(Illinois); Region VI (Arkansas); Region IX (California); and Region X (Washington). 

Other Methodology 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 51 GAO-06-807 Child Care and Early Childhood Education 

We analyzed national survey data collected in 1998 as part of the Early 

Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K) 

from parents of kindergarten children about their children’s experiences in 

the year before kindergarten. To conduct our analyses, we used logistic 

regression models to estimate the “net effects” of the parent’s limited 

English proficiency on children’s child care and early education patterns. 

We defined parents as having limited proficiency in English if the parent 

participating in the interview reported that a language other than English 

was spoken at home, and if the respondent him or herself reported 

speaking English either “not very well” or “not well at all.” We made this 

decision because we surmised that speaking is one of the main channels 

through which information about child care is communicated. 

Additionally, we made the decision to focus on the English language 

ability of the parent participating in the interview on the assumption that 

the respondent participating in the survey about his or her child would 

have a primary role in child care decisions. 

We considered the effect of the parent’s limited English proficiency on 

four outcomes. First, we looked at the effect it had on the likelihood of 

their child receiving any type of nonparental child care in the year before 

the child was in kindergarten, regardless of whether the care was provided 

in a child care center (including a prekindergarten program) or by 

relatives or nonrelatives in some other setting. Second, we looked at the 

effect that limited English proficiency had on the likelihood of receiving 

financial assistance from a social service or a welfare agency to help pay 

for child care among those who did receive child care. Third, we looked at 

the effect that limited English proficiency had on the likelihood that the 

child care provided was in a center-based facility (rather than care 

provided by relatives or nonrelatives) because it has been suggested that 

children whose parents have limited English proficiency may be less likely 

to receive center-based care than other children. Fourth, and finally, we 

considered whether limited English proficiency affected the likelihood of 

participating in Head Start. 

By “net effects,” we mean the effects of limited English proficiency that 

operate after we control for other factors that affect these different 

outcomes and that are related to limited English proficiency. The most 

obvious among these other factors is race or ethnicity. That is, the 

probability of using any nonparental care, receiving financial assistance 

for child care, having center-based care rather than some other form of 

care, and participating in Head Start are different among racial and ethnic 

groups, and English proficiency is vastly different for some groups, 

particularly Hispanics and Asians, than for whites and other races. As 

Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care 

and Early Education Patterns 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 52 GAO-06-807 Child Care and Early Childhood Education 

such, after looking at the difference between children of parents with 

limited English proficiency and other children on these outcomes, we used 

multivariate logistic regression models to re-estimate this difference when 

controlling for the effect of characteristics such as the child’s race or 

ethnicity. The other characteristics we controlled included household 

income (because of its effect on eligibility for some child care assistance 

programs and Head Start) and parental education(because previous 

studies have shown it to have an effect on participation in child care and 

early education programs). We also controlled for the number of persons 

over 18 in the household and whether the parent or parents in the house 

were employed because these can affect the availability of care givers in 

the home and determine the need for child care and child care assistance 

outside of the home. Another reason why we controlled for parental 

employment status is that it is one of the factors considered for CCDF 

eligibility. When we looked at the likelihood of receiving any care or 

receiving that care in a center-based facility, as well as at the likelihood of 

receiving financial assistance for care received, we controlled for whether 

the family participated in Head Start, since we surmised this may affect 

whether additional child care was needed. Additionally, because we 

thought that being in multiple types of child care may affect the likelihood 

of one of them being provided in a center-based facility or being 

subsidized by an outside source, we also controlled for whether the child 

received multiple types of child care when we looked at the likelihood of a 

child being in center-based care or receiving financial assistance for child 

care. Finally, when we looked at whether financial assistance was 

received for the care, we controlled for whether the care was provided in a 

center-based facility on the assumption that the cost of care may be higher 

when it is provided in a formal center-based setting. Additionally, other 

factors, such as family preferences for a certain type of care and parents’ 

immigration status, as well as changes in the CCDF program and child 

care policies within a particular state of residence may affect child care 

and early education patterns of children. We partially mitigated the 

potential effect of preferences for certain types of care on the receipt of 

financial assistance for child care by controlling for whether or not the 

child was in center-based care. However, we could not include all factors 

that may have had an effect on the outcomes in the analysis because the 

ECLS-K did not collect the data to measure them. 

An understanding of how to interpret the results of these multivariate 

logistic regression models is facilitated by first considering tables 4 and 5, 

which estimate the effects of limited English proficiency, and race or 

ethnicity, on the first two of these four outcomes. Tables 4 and 5 estimate 

how English proficiency and race or ethnicity are related to receiving any 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 53 GAO-06-807 Child Care and Early Childhood Education 

nonparental child care and to receiving financial assistance for child care 

(among those who received any nonparental child care). It is important to 

note that these estimates are unadjusted for other characteristics that are 

related to these outcomes, such as education, income, and employment 

status. The top section of tables 4 and 5 shows the effect of parents’ 

limited English proficiency on the two outcomes, the middle section 

shows the effect of the child’s race or ethnicity, and the bottom section 

shows the joint effect of the two, or the effect of limited English 

proficiency within each racial or ethnic category. We show these effects in 

each section of the tables by first providing percentages of children of 

parents with limited English proficiency and other children having a 

certain outcome. We then calculate odds and odds ratios for the likelihood 

of children within each of the two groups having these outcomes. Odds 

and odds ratios are the measures used to describe effects that underlie the 

logistic regression models we later employ to estimate net effects of 

limited English proficiency while controlling for other factors. 

Consider table 4, which provides percentages, odds, and odds ratios 

related to the differences in receiving any type of child care across 

children that differ by their parents’ English proficiency, their race or 

ethnicity, and both. We see in the top section that while approximately 

75 percent of children whose parents are English proficient received some 

form of child care in the year preceding kindergarten, the same is true of 

only 46 percent of children whose parents have limited English 

proficiency. These percentages are derived from weighted data in our 

sample that take account of the fact that we are working with a sample 

that is not a simple random sample (where all individuals have an equal 

chance of being selected), but one in which children in some groups, 

namely Asians and Pacific Islanders, were oversampled. They are based, 

however, on the unweighted number of cases in our sample of 

18,033 respondents (16,784 of them with parents proficient in English and 

1,249 with parents with limited English proficiency), given in the third 

column of the table. The difference in these two percentages is sizable, 

and statistically significant, and would lead us to conclude that children of 

parents with limited English proficiency are less likely to receive 

nonparental care of any form. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 54 GAO-06-807 Child Care and Early Childhood Education 

Table 4: Differences in the Percentages and Odds of Receiving Any Nonparental Care, by Parents’ English Proficiency Status, 

Race or Ethnicity, and Both, among Preschool-Aged Children 

 Parents’ English proficiency status 

No 

(%)

Yes 

(%)

N 

(unweighted) 

Odds on 

yes: no

Odds 

ratio

 English proficient 25.2 74.8 16,784 2.97

Limited English proficient 54.4 45.6 1,249 0.84 0.28*

Total 27.3 72.7 18,033 

 Race or ethnicity 

 White 21.8 78.2 10,262 3.59

 Black 29.5 70.5 2,638 2.39 0.67*

 Hispanic 39.7 60.3 3,205 1.52 0.42*

 Asian 29.6 70.4 979 2.38 0.66*

 Other 33.9 66.1 989 1.95 0.54*

Total 27.3 72.7 18,073 

Race or ethnicity Parents’ English proficiency status 

White English proficient 21.7 78.3 10,204 3.62

 Limited English proficient 38.1 61.9 34 1.62 0.45*

Black English proficient 29.2 70.8 2,611 2.43

 Limited English proficient 60.8 39.2 10 0.65 0.27*

Hispanic English proficient 32.4 67.6 2,217 2.09

 Limited English proficient 55.6 44.4 974 0.80 0.38*

Asian English proficient 25.4 74.6 753 2.94

 Limited English proficient 46.0 54.0 222 1.17 0.40*

Other English proficient 33.9 66.1 976 1.95

 Limited English proficient 33.7 66.3 8 1.97 1.01*

Total 27.2 72.8 18,009 

Source: GAO analysis of ECLS-K data. 

* Denotes significance at the 95 percent level. 

An alternative way to look at this difference is by calculating the odds of 

receiving child care, which is the percentage of children who receive child 

care divided by the percentage of children who do not. In the case of 

children of parents that are English proficient, these odds are 

74.8/25.2 = 2.97, which implies that in that group, approximately 3 families 

use child care for every family that does not (or that 300 families do for 

every 100 families that do not). In the case of children of parents that are 

not English proficient, these odds are 45.6/54.4 = 0.84, which implies that 

for them, approximately 0.8 families use child care for every family that 

does not (or that 80 families do for every 100 that do not). The ratio of 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 55 GAO-06-807 Child Care and Early Childhood Education 

these two odds, or 0.84/2.97 = 0.28, tells us that the odds on receiving any 

care are decidedly lower for children of parents with limited English 

proficiency than for children of parents that are English proficient, by a 

factor of 0.28. 

The middle section of table 4 shows the differences in the percentages and 

odds of children receiving child care across racial or ethnic categories. 

The percentages of children receiving child care in the year before 

kindergarten are lower for minority children than for whites, and these 

differences are reflected in the odds as well. Among white children, about 

3.6 children received child care for every child that did not, while among 

blacks and Asians approximately 2.4 children received child care for every 

child that did not. Among Hispanics, approximately 1.5 children received 

child care for every child that did not. Where variables have more than two 

categories, such as different categories of race and ethnicity, we chose one 

category as the reference category and calculated odds ratios that reflect 

how different each of the other categories is relative to that one. In this 

case, whites were chosen as the reference category, and the odds ratios of 

0.67, 0.42, 0.66 and 0.54 indicate how much lower the odds of receiving 

child care were for blacks, Hispanics, Asians, and other races, 

respectively, than for whites. 

The bottom section of table 4 shows the differences in the percentages of 

children receiving any child care across the joint (or combined) categories 

of parents’ English proficiency and the child’s race or ethnicity. Here we 

have calculated odds for each of the joint categories, and the odds ratios, 

which indicate how different the odds are across English proficiency 

categories, within each category of race or ethnicity. We can see that 

within most categories of race or ethnicity, children of parents with 

limited English proficiency have lower odds of receiving any child care 

than children of parents that are proficient in English, by factors such as 

0.38 for Hispanics and 0.40 for Asians. The odds ratios for whites, blacks, 

and others were based on very small numbers of children of parents with 

limited English proficiency. Of the 1,249 children of parents with limited 

English proficiency, only 34, 10, and 8 children are white, black, and other, 

respectively, and these numbers are too small for us to assess whether and 

how much they differ from children of parents that are proficient in 

English. 

In sum, table 4 indicates that children of parents with limited English 

proficiency were less likely to receive any child care than children of 

parents proficient in English. Some of this is due to the fact that children 

of parents with limited English proficiency tend to be Hispanic and Asian, 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 56 GAO-06-807 Child Care and Early Childhood Education 

groups that are less likely than whites to receive child care. However, not 

all of it is due to race or ethnicity differences, since among Hispanics and 

Asians the children of parents with limited English proficiency were less 

than half as likely as others within the same racial or ethnic group to 

receive any child care. 

Table 5 provides similar information with respect to the likelihood of 

receiving financial assistance for child care, among those children that 

received any care. Overall, children of parents with limited English 

proficiency were less likely than those with parents proficient in English 

to receive financial assistance (odds ratio = 0.60), though most racial or 

ethnic minorities, except for Asians, were more likely than whites to 

receive financial assistance when they received some type of care. That is, 

while Hispanic children were twice as likely as white children to receive 

financial assistance, and blacks and other races were approximately four 

times as likely, Asians’ odds of receiving financial assistance were not 

statistically distinguishable from those of whites (odds ratio = 0.70). 

Further, in the two groups—Hispanics and Asians—that had sizable 

numbers of children of parents with limited English proficiency, the effect 

of limited proficiency was different. Among Hispanics, the odds of 

receiving financial assistance were lower for children of parents with 

limited English proficiency than for children of parents that were 

proficient in English (odds ratio = 0.46), while among Asians the odds of 

receiving financial assistance were not statistically distinguishable 

between children of parents with limited English proficiency and children 

of parents that were proficient in English (odds ratio = 1.95). Among the 

other groups, the numbers of children of parents with limited English 

proficiency who received child care in the year prior to kindergarten were 

too small for us to be able to reliably detect any difference between them 

and others in the likelihood of receiving financial assistance. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 57 GAO-06-807 Child Care and Early Childhood Education 

Table 5: Differences in the Percentages and Odds of Receiving Financial Assistance for Child Care, among Those in Any 

Prekindergarten Care, by Parents’ English Proficiency Status, Race or Ethnicity, and Both 

 Parents’ English proficiency status 

No 

(%)

Yes 

(%)

N 

(unweighted) 

Odds on 

yes:no Odds ratio

 English proficient 93.2 6.8 12,732 0.07

 Limited English proficient 95.8 4.2 584 0.04 0.60**

Total 93.4 6.6 13,316 

 Race or ethnicity 

 White 95.9 4.1 8,173 0.04

 Black 85.4 14.6 1,874 0.17 4.02**

 Hispanic 92.5 7.5 1,976 0.08 1.90**

 Asian 97.1 2.9 676 0.03 0.70**

 Other 85.1 14.9 637 0.17 4.11**

Total 93.4 6.6 13,336 

Race or ethnicity Parents’ English proficiency status 

White English proficient 95.9 4.1 8,138 0.04

 Limited English proficient 100.0 0.0 20 0.00 0.00**

Black English proficient 85.4 14.6 1,861 0.17

 Limited English proficient 73.1 26.9 4 0.37 2.15**

Hispanic English proficient 91.5 8.5 1,533 0.09

 Limited English proficient 95.9 4.1 435 0.04 0.46**

Asian English proficient 97.5 2.5 554 0.03

 Limited English proficient 95.2 4.8 120 0.05 1.95**

Other English proficient 85.2 14.8 629 0.17

 Limited English proficient 100.0 0.0 5 0.00 0.00**

Total 93.4 6.6 13,299 

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

The tables above showed the gross or unadjusted differences in receiving 

child care and receiving financial assistance for child care between 

children of parents with limited English proficiency and children of 

parents proficient in English, and what those differences look like when 

we control for or take account of race or ethnicity, the factor with which 

parents’ limited English proficiency is most closely associated. However, 

limited English proficiency is associated with a number of other factors 

that affect these two outcomes, as well as the other two outcomes that 

were of interest to us, which were the likelihood of receiving center-based 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 58 GAO-06-807 Child Care and Early Childhood Education 

care (as opposed to care from relatives or nonrelatives in some other 

setting) and the likelihood of participating in Head Start. Tables 6 through 

9 show that the percentages of children that are Hispanic or Asian, from 

lower-income families, have less educated parents, and have three or more 

persons in the household over the age of 18 are higher among children of 

parents with limited English proficiency than among other children. 

Tables 10 and 11 show that the percentage of children that have their 

parent (in single parent households) or both parents working and the 

percentage of children that receive multiple types of care are lower among 

children of parents with limited English proficiency than among other 

children. 

Table 6: Percentages of English Proficient Parents and Parents with Limited English Proficiency, by Race or Ethnicity 

 Race or ethnicity 

White (%) Black (%) Hispanic (%) Asian (%) Other (%) 

Total 

(%)

N 

(unweighted)

English proficient 61.5 16.8 14.2 2.5 5.0 100.0 16,784

Limited English proficient 2.6 1.1 87.7 8.3 0.4 100.0 1,249

Source: GAO analysis of ECLS-K data. 

Table 7: Percentages of English Proficient Parents and Parents with Limited English Proficiency, by Family Income 

 Income (percentage of the poverty level) 

< 100 percent of 

poverty level (%) 

100–200 percent of 

poverty level (%)

>200 percent of 

poverty level (%) Total (%)

N

(unweighted)

English Proficient 20.9 23.2 55.9 100.0 16,784

Limited English Proficient 55.4 32.0 12.6 100.0 1,249

Source: GAO analysis of ECLS-K data. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 59 GAO-06-807 Child Care and Early Childhood Education 

Table 8: Percentages of English Proficient Parents and Parents with Limited 

English Proficiency, by Education 

Highest education level of 

parent(s) in the household 

< High school 

graduate (%)

High school 

graduate (%)

> High school 

graduate (%) 

Total 

(%)

N 

(unweighted)

English 

proficient 

7.8 27.2 65.0 100.0 16,784

Limited English 

proficient 

47.4 29.9 22.7 100.0 1,249

Source: GAO analysis of ECLS-K data. 

Table 9: Percentages of English Proficient Parents and Parents with Limited 

English Proficiency, by the Number of Persons over the Age of 18 in the Household 

 Number of persons over 18 

1 (%) 2 (%) 3+ (%) 

Total 

(%)

N

(unweighted)

English proficient 16.1 72.1 11.8 100.0 16,782

Limited English 

proficient 

8.5 64.3 27.2 100.0 1,249

Source: GAO analysis of ECLS-K data. 

Table 10: Percentages of English Proficient Parents and Parents with Limited 

English Proficiency, by Parents’ Work Status 

 Parents working 

Not all 

working (%)

All 

working (%) Total (%)

N

(unweighted)

English Proficient 33.4 66.6 100.0 16,550

Limited English 

proficient 

63.7 36.3 100.0 1,220

Source: GAO analysis of ECLS-K data. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 60 GAO-06-807 Child Care and Early Childhood Education 

Table 11: Percentages of English Proficient Parents and Parents with Limited 

English Proficiency, by the Number of Different Types of Child Care Used, among 

Those Using Care 

Number of different types of child 

care used, among those using 

care 

One (%) Two or more (%) Total (%)

N

(unweighted)

English proficient 72.3 27.7 100.0 12,732

Limited English 

proficient 

81.6 18.4 100.0 584

Source: GAO analysis of ECLS-K data. 

Note: Each difference between families with limited English proficiency and other families in tables 6-

11, except for the category of high school graduates, is significant at the 95 percent confidence level. 

In tables 12 through 15 we show what the adjusted effect of parents’ 

limited English proficiency is on the likelihood of their child (1) receiving 

any nonparental child care, (2) receiving financial assistance for child 

care, (3) receiving center-based care, and (4) participating in Head Start, 

when we estimate its effect using logistic regression models to control for 

the effects of the other factors. In the first two columns of each table, we 

show the unadjusted effect of parents’ limited English proficiency on each 

outcome across all racial/ethnic groups, and what the adjusted effect looks 

like when we control for race or ethnicity and other factors. In the third 

and fourth columns of each table, we show the unadjusted and adjusted 

effect of parents’ limited English proficiency for Hispanics, and in the last 

two columns we show those same effects for Asians. Separate analyses 

were done only for Hispanics and Asians because, as table 6 shows, the 

percentage of children of other races whose parents have limited English 

proficiency was very small. For the adjusted models, we also show the 

effects of the other factors that we controlled for, such as income and 

education, on the four outcomes. In the case of variables that have 

multiple categories (such as race or ethnicity, income or poverty status, 

education, and number of persons in the household over 18 years of age), 

the odds ratios indicate how much more or less likely the categories of 

families indicated are to have each outcome than the reference (or 

omitted) category. The reference category for race or ethnicity is white, 

the reference category for poverty status is less than 100 percent of the 

federal poverty level, the reference category for education is less than high 

school graduate, and the reference category for the number of persons in 

the household over 18 is one. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 61 GAO-06-807 Child Care and Early Childhood Education 

Likelihood of receiving any nonparental care. Table 12 shows that 

before adjusting for other factors, the effect of parents’ limited English 

proficiency on the likelihood of receiving any type of nonparental 

childcare was negative and significant for all groups considered together, 

and for Hispanics and Asians considered separately (odds ratios of 0.28, 

0.38, and 0.40, respectively). After controlling for these other factors, the 

differences between children of parents with limited English proficiency 

and other parents in terms of their receipt of any type of child care were 

smaller for all groups considered together and for Hispanics (odds ratios 

of 0.77 and 0.75, respectively), but not statistically significant among 

Asians (odds ratio of 0.85). While almost all of the control variables attain 

statistical significance in the model that included all racial and ethnic 

groups, the statistical significance of individual control variables in the 

models including only Asian or Hispanic children varies. 

Table 12: Odds Ratios from Logistic Regression Models Used to Estimate the Effects of Different Factors on the Likelihood of 

Receiving Any Child Care, after Adjusting for Other Characteristics 

 All groups Hispanics Asians 

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

Limited English proficient 0.28* 0.77** 0.38* 0.75* 0.40* 0.85

White Ref** 

Black 1.19** 

Hispanic 0.87** 

Asian 0.81** 

Other 0.86** 

< 100 percent poverty Ref** Ref* Ref**

100–200 percent poverty 1.09** 1.15* 0.66**

> 200 percent poverty 2.19** 1.96* 1.88**

< High school graduate Ref** Ref* Ref**

High school graduate 1.44** 1.53* 1.48**

> High school graduate 2.26** 2.16* 1.79**

1 Person over 18 Ref** Ref* Ref**

2 Persons over 18 0.65** 0.72* 0.83**

More than 2 persons over 18 0.77** 0.89* 0.81**

All parent(s) work 3.16** 3.17* 3.24**

Head Start 0.38** 0.48* 0.22**

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: “Ref” refers to reference categories. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 62 GAO-06-807 Child Care and Early Childhood Education 

Likelihood of receiving financial assistance for child care. Table 13 

shows that before adjusting for other characteristics, the odds ratios 

estimating the effect of parents’ limited English proficiency on the 

likelihood of receiving financial assistance for child care were 0.60, 0.46, 

and 1.95 for all groups together, Hispanics, and Asians, although the result 

for Asians was not statistically significant. While other factors were 

significantly related to the likelihood of receiving financial assistance for 

child care, controlling for their effects did not markedly diminish the 

estimated difference between children of parents with limited English 

proficiency and other children overall, or for Hispanics or Asians. After 

other factors are taken into account, children of parents with limited 

English proficiency were about half as likely as others to receive financial 

assistance overall and among Hispanics (odds ratios of 0.41 and 0.44, 

respectively), but among Asians the difference was not statistically 

significant (odds ratio = 1.85). 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 63 GAO-06-807 Child Care and Early Childhood Education 

Table 13: Odds Ratios from Logistic Regression Models Used to Estimate the Effects of Different Factors on the Likelihood of 

Receiving Financial Assistance for Child Care, among Those in Any Care, after Adjusting for Other Characteristics 

 All groups Hispanics Asians 

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

Limited English proficient 0.60** 0.41* 0.46* 0.44* 1.95 1.85**

White Ref* 

Black 1.64* 

Hispanic 1.36* 

Asian 0.75 

Other 2.73* 

<100 percent poverty Ref* Ref* Ref**

100–200 percent poverty 0.68* 0.64* 8.40**

>200 percent poverty 0.18* 0.25* 2.83**

< High school graduate Ref* Ref* Ref**

High school graduate 1.12* 1.26* 0.21**

> High school graduate 0.92* 1.23* 0.37**

1 person over 18 Ref* Ref Ref**

2 persons over 18 0.42* 0.27* 0.09**

More than 2 persons over 18 0.51* 0.21* 0.09**

All parent(s) work 1.31* 1.13* 1.66**

Head Start 1.83* 1.95* 3.34**

Center-based care 2.16* 1.63* 1.64**

Multiple types of care 1.46* 1.65* 2.20**

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: “Ref” refers to reference categories. 

Likelihood of receiving center-based care. Table 14 shows that before 

adjusting for other factors, the effect of parents’ limited English 

proficiency on the likelihood of receiving center-based child care among 

those who received any type of child care was significant when all 

racial/ethnic groups were considered together (odds ratio = 0.44), and 

significant for Hispanics (odds ratio = 0.73) but not for Asians (odds ratio 

= 0.92). None of the differences between children of parents with limited 

English proficiency and other children were statistically significant, 

however, after we controlled for other factors. 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 64 GAO-06-807 Child Care and Early Childhood Education 

Table 14: Odds Ratios from Logistic Regression Models Used to Estimate the Effects of Different Factors on the Likelihood of 

Receiving Center-Based Care, among Those in Any Care, after Adjusting for Other Characteristics 

 All groups Hispanics Asians 

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

Limited English proficient 0.44* 0.98* 0.73* 0.83* 0.92 1.10*

White Ref* 

Black 0.98* 

Hispanic 0.61* 

Asian 0.77* 

Other 0.53* 

<100 percent poverty Ref* Ref* Ref*

100–200 percent poverty 0.98* 1.05* 0.89*

>200 percent poverty 1.72* 1.37* 1.46*

< High school graduate Ref* Ref* Ref*

High school graduate 1.36* 1.17* 0.59*

> High school graduate 2.45* 1.94* 1.15*

1 person over 18 Ref* Ref* Ref*

2 persons over 18 1.06* 0.95* 0.76*

More than 2 persons over 18 0.64* 0.78* 0.23*

All parent(s) work 0.39* 0.33* 0.51*

Head Start 0.18* 0.26* 0.17*

Multiple types of care 9.81* 8.50* 17.66*

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: “Ref” refers to reference categories. 

Likelihood of participating in Head Start. Table 15 shows that before 

adjusting for other factors, children of parents with limited English 

proficiency had higher odds of participating in Head Start when all 

ethnic/racial groups were considered together (odds ratio = 1.39). The 

same was true when Asians were considered separately (odds ratio = 

3.81), but no significant effect of parents’ limited English proficiency was 

found for Hispanics (odds ratio = 0.98). After controlling for other 

characteristics, children of parents with limited English proficiency had 

significantly lower odds of participating in Head Start when all 

racial/ethnic groups were considered together (odds ratio = 0.67), and 

when Hispanics were considered separately (odds ratio = 0.69), but 

significantly higher odds among Asians (odds ratio = 1.90). 
Appendix II: Analyses of the Effects of 

Limited English Proficiency on Child Care and 

Early Education Patterns 

Page 65 GAO-06-807 Child Care and Early Childhood Education 

Table 15: Odds Ratios from Logistic Regression Models Used to Estimate the Effects of Different Factors on the Likelihood of 

Participating in Head Start, after Adjusting for Other Characteristics 

 All groups Hispanics Asians 

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

Limited English proficient 1.39* 0.67* 0.98 0.69* 3.81* 1.90**

White Ref* 

Black 3.21* 

Hispanic 1.75* 

Asian 1.57* 

Other 2.69* 

<100 percent poverty Ref* Ref* Ref**

100–200 percent poverty 0.66* 0.72* 0.69**

>200 percent poverty 0.18* 0.22* 0.18**

< High school graduate Ref* Ref* Ref**

High school graduate 1.19* 1.43* 0.53**

> High school graduate 0.71* 0.90* 0.46**

1 person over 18 Ref* Ref* Ref**

2 persons over 18 0.82* 0.87* 0.94**

More than 2 persons over 18 0.74* 0.91* 0.60**

All parent(s) work 0.97* 1.09* 0.69**

Source: GAO analysis of ECLS-K data. 

* denotes significance at the 95 percent level. 

** denotes significance at the 90 percent level. 

Note: “Ref” refers to reference categories. 
Appendix III: Comments from the U.S. Department of Health and Human Services 

Page 66 GAO-06-807 Child Care and Early Childhood Education 

Appendix III: Comments from the U.S. 

Department of Health and Human Services 
Appendix III: Comments from the U.S. Department of Health and Human Services 

Page 67 GAO-06-807 Child Care and Early Childhood Education 
Appendix III: Comments from the U.S. Department of Health and Human Services 

Page 68 GAO-06-807 Child Care and Early Childhood Education 
Appendix III: Comments from the U.S. Department of Health and Human Services 

Page 69 GAO-06-807 Child Care and Early Childhood Education 
Appendix IV: GAO Contact and Staff 

Acknowledgments 

Page 70 GAO-06-807 Child Care and Early Childhood Education 

Marnie S. Shaul, (202) 512-7215, shaulm@gao.gov 

Cornelia M. Ashby, (202) 512-8403, ashbyc@gao.gov 

Betty Ward-Zukerman (Assistant Director) and Natalya Barden (Analystin-Charge) managed all aspects of the assignment. Laurie Latuda, Janet 

Mascia, Jonathan McMurray, and Ethan Wozniak made key contributions 

to multiple aspects of the assignment. Alison Martin, Grant Mallie, Amanda 

Miller, Anna Maria Ortiz, James Rebbe, and Douglas Sloane provided key 

technical assistance. 

Appendix IV: GAO Contact and Staff 

Acknowledgments 

GAO Contacts 

Staff 

Acknowledgments 

(130511) 
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