More than a third—2.8 million—of the nation’s 3- and 4-year-old children were from low-income families in 1990, a growth of 17 percent since 1980. An increase in the number of infants and toddlers living in such families during the same period suggests that this trend will continue. These disadvantaged children often live in environments that undermine their development and impair their ability to benefit from elementary school.Already lagging behind their peers when they enter school, many of these children fail to catch up. Consequently, disadvantaged children, more than other children, are placed in special education classes, repeat one or more grades, or drop out before completing high school. A recent Carnegie Corporation report characterizes the condition of some of the nation’s youngest children, including the disadvantaged, as a “quiet crisis.” The report documents the importance of environmental factors on children’s development and concludes that “the quality of young children’s environment and social experience has a decisive, long-lasting impact on their well-being and ability to learn.” According to the report, less than half of the nation’s youngest children receive adequate cognitive stimulation, such as being read to by their parents. To prepare for school, disadvantaged children can benefit from programs that offer specific features of child development services, promote parent services, and provide adequate health care and nutrition services. Such services may be found in early childhood centers, such as preschools, nursery schools, child care centers, or early learning centers. Such services also may be found in other settings, including family child care, or provided by parents themselves. If disadvantaged children do not receive these services, their future success in both school and life may be jeopardized. The Congress’ inclusion of a school readiness goal as part of the 1994 Goals 2000: Educate America Act suggests the need for and importance of helping young children prepare for school. The act establishes eight national education goals, the first of which states that “By the year 2000, all children in America will start school ready to learn.” The goal also articulates the fundamental elements needed to foster the development of all children, including the disadvantaged, and to prepare them for school. These elements include high-quality, developmentally appropriatepreschool programs (in this report, centers), parents who are involved in their child’s learning, and adequate health and nutrition services. However, accomplishing this goal may become an elusive pursuit as schools receive a continuing stream of disadvantaged children whose early experiences do not include these fundamental elements needed to prepare them for school. The Congress has also enacted other legislation that addresses the need for preparing children for school: the Head Start Amendments Act of 1994, a part of the Human Services Amendments of 1994, P.L. 103-252; and the Improving America’s Schools Act, P.L. 103-382, which amended the Elementary and Secondary Education Act of 1965 (ESEA). The Head Start Amendments of 1994 reauthorized and expanded Head Start, a program that provides some disadvantaged children—mostly those who are categorized as poor—with all services needed to prepare for school. The Improving America’s Schools Act provides, among other educational programs, early childhood services in some schools with large numbers of disadvantaged children. The provision of early childhood services is also likely to be a key issue in the debate over welfare reform. Welfare reforms may result in an increased demand for child care should those parents who are unemployed and receiving Aid to Families with Dependent Children (AFDC) be required to participate in education or employment training programs. To be prepared for school, all children need early childhood experiences that foster their physical, emotional, social, and cognitive development. Children also need relationships with adults who are responsive to their needs and who foster their development, parental guidance and support, health care to maintain physical well-being or correct medical problems, and nutritious diets. However, the early childhood experiences of many disadvantaged children do not include these experiences. Family income is an important predictor of children’s success or failure in school; disadvantaged children are more likely to experience difficulties. Their early childhood experiences often hinder their development, leaving them unprepared for school. Recent research on infants and toddlers provides compelling evidence of the environmental deficits—such as too little cognitive stimulation and inadequate health care—that undermine disadvantaged children’s development. It also documents the effects of these deficits on children’s school performance and later lives. A 1991 study of children whose families were recipients of AFDC, the federal welfare assistance program, found that the conditions under which the nation’s most disadvantaged children live are detrimental to these children’s development and undermine their chances for success in school. Researchers found that children who were from families receiving AFDC were twice as likely as children of more economically advantaged families to do poorly in school, repeat a grade, and become classroom disciplinary problems. Two-thirds of these children lived in home environments that did not stimulate their cognitive growth and where they received insufficient emotional support from their parents. The study revealed similar findings for the children of low-income families that were not receiving AFDC. Disadvantaged children have less access to health care and nutrition, especially preventative health care, than children whose families have higher incomes. The same 1991 study of AFDC children found that children from low-income families were less likely to have visited a doctor within the last year than children in families with higher incomes. Twenty-one percent of the children in low-income families had not visited a doctor within the last year compared with 14 percent of children in families with higher incomes. Also, children in low-income families were more likely to receive care in a hospital emergency room, which is not an adequate source of preventative care. Forty percent of the children in low-income families—compared with 7 percent of children in families with higher incomes—received regular care through a hospital emergency room or clinic. Poor health can negatively affect children’s ability to perform well in school. Other factors associated with low-income families—low parent educational attainment, single-parenting, and linguistic isolation—also increase children’s risk of doing poorly in school. None of these factors, however, are insurmountable. Research on early childhood development validates the belief that children can be helped to prepare for school. Many researchers have found that disadvantaged children can overcome the environmental deficits they have experienced and become better prepared for school. One way disadvantaged children can make these gains is by attending early childhood centers that provide services important to promoting school preparedness. For example, the Perry Preschool Project, a longitudinal study of the effects of disadvantaged children’s participation in a high-quality preschool, found significant differences between children who participated in the preschool program and those who did not. Participating children, compared with nonparticipating ones, had significantly lower rates of placement in special education classes, were less likely to repeat a grade, and tested higher on IQ tests on school entry. Other studies have also documented that attendance in high-quality early childhood centers have positive effects on children’s development and school achievement. However, the research, while generally positive, has documented that the benefits of such attention are not always long term. The extent to which these benefits are maintained appears to be influenced by other factors, such as the child’s experience as he or she makes the transition from an early childhood program to elementary school or the way in which the elementary school environment supports young children’s development. The federal government, as well as a majority of state governments, invests in different kinds of early childhood programs for disadvantaged children. The mission of some of these programs is to promote child development; the mission of other programs is to provide child care so that parents can work. Federal responsibility for administering these programs rests with the Department of Education and the Department of Health and Human Service (HHS). All of these programs fund early childhood centers that can affect the child’s development. Many of these programs, especially those for providing child care, also make funds available for other settings. For example, children may be cared for in family child care homes, where groups of children receive services in someone else’s home. (Detailed descriptions of all these programs appear in app. I.) Early childhood development programs are a key strategy in the federal government’s effort to help disadvantaged children improve their performance in school. Head Start, the federal government’s largest such program, is administered by HHS and provides funding directly to local grantees who, in turn, provide some disadvantaged children, mostly those who are categorized as poor, with a full range of early childhood services. That range includes, but is not limited to, child development, parent, and health and nutrition services. In order to serve more children and improve quality, the federal government has increased Head Start funding annually since 1989. In total, increased funding provided services for an additional 287,000 children from fiscal year 1990 through fiscal year 1993. Head Start’s funding was $3.3 billion in fiscal year 1994; the Congress increased the program’s appropriation to $3.5 billion for fiscal year 1995. Legislation reauthorizing Head Start calls for a study of the need for full-day, full-year Head Start programs; program guidance encourages centers to provide full-day programs rather than the usual half-day programs when there is a need among the families served by the center. Other federal programs also provide some early childhood services. For example, the 1994 amendments to ESEA provide funding from the Department of Education for child development programs that are operated by schools with high numbers of disadvantaged children. In school year 1992-93, Title I served 116,612 children in early childhood programs; data on the amount of money expended to provide these programs are unavailable. In addition, Education’s Even Start Family Literacy Program is another example of a program that provides early childhood development services to disadvantaged children. Increasingly, state governments are investing in child development programs. A 1991-1992 survey by the Children’s Defense Fund found that 32 states use state funds to provide child development programs to children before they enter elementary school—a threefold increase among such programs between 1979 and 1991-92 increase since 1979 when only seven states had such programs. Many of these programs are administered by state departments of education and operate through the public schools. Fourteen states provide increased funding for Head Start so that more children can be served. Some states operate their programs through a variety of providers, including schools, Head Start centers, and contractors. In addition, state funding for early childhood programs, including child development programs, varied dramatically. Some federal child care programs provide subsidies for low-income families to obtain child care in a variety of settings. These settings include early childhood centers operated by nonprofit or for-profit organizations. The services provided are generally intended to support parents’ employment, but the centers also provide the early learning experiences that prepare children for school. In 1993, HHS spent more than $1.8 billion in programs to improve access to affordable child care for low-income families. However, this amount includes services to children of all ages in all kinds of child care settings; only a portion of this amount goes to 3- and 4-year-old children in centers. Welfare reform will increase the need for child care services if more parents are required to work or be trained. Among the federal programs that subsidize child care are the Title IV-A programs of the Social Security Act and CCDBG. Title IV-A funds three programs—AFDC Child Care, At-Risk Child Care, and Transitional Child Care—that provide child care assistance for families who are working toward economic self-sufficiency or are at risk of welfare dependency. (States must provide a match for a portion of the federal money they receive under the Title IV-A programs.) CCDBG provides subsidies for child care services, with priority given to low-income families and children with special needs. In addition, states can use Title XX—Social Services Block Grants—to fund a wide range of social services including child care, particularly for neglected children. Some federal policymakers question whether the current array of early childhood programs provides the services needed to promote child development and prepare children for school. Our 1994 study identified 34 federal early childhood programs and another 59 federal programs that either allow or support early childhood education or care. Multiple programs provide different services to different subgroups of disadvantaged children, although the children have similar needs. As a result, there have been increasing calls for program coordination, particularly among federal programs. The Head Start-State Collaboration Grants program, created in 1990, is one national effort which seeks to coordinate a major federal early childhood program, Head Start, with state early childhood programs and services including health, education, and welfare service providers. The recent reauthorization of Head Start permits the Secretary of Health and Human Services to expand these grants from the 22 states currently participating to all states. In addition, the Advisory Committee for Head Start Quality and Expansion recommended that a study of federal child care be undertaken to provide direction for increasing the consistency between program requirements and procedures to facilitate coordination between programs. The Congress has also taken steps to address concerns that have been raised about the quality of services funded by the array of federal early childhood programs. In response to concerns about the quality of Head Start services, the Congress allows HHS to set aside for quality improvements 25 percent of the amount of the current-year Head Start appropriations that exceed appropriations of the preceding year, including staff salary increases. The 1994 legislation requires additional measures intended to improve quality, such as termination of an agency’s designation as a Head Start grantee if the agency fails to correct a deficiency cited by the Secretary of HHS. New legislation reauthorizing ESEA requires Title I early childhood programs to comply with Head Start performance standards by fiscal year 1997; currently, federal Title I standards do not include requirements specifically for early childhood programs. The CCDBG legislation includes a 25-percent set-aside for quality improvements, which states can use for a variety of activities such as improving staff salaries, establishing and expanding child care resource and referral programs, and training child care providers. Finally, proposals for reforming welfare in the last session of Congress included provisions, for example, that would allow states to use program funds for increased monitoring and licensing and other quality improvement activities. Such changes may be considered when welfare reform is revisited in the 104th Congress. The current Ranking Minority Member of the Subcommittee on Children, Family, Drugs and Alcoholism, Senate Committee on Labor and Human Resources, asked us to conduct a review of center-based federal and state early childhood programs. We were asked to answer the following questions: (1) what services do disadvantaged children need to prepare them for school (2) to what extent do disadvantaged children receive these services from early childhood centers; and (3) if disadvantaged children do not receive services from early childhood centers, why not? In our review of early childhood programs, we used several different methodologies. To determine the kinds of services that disadvantaged children need to prepare them for school, we reviewed literature, consulted with experts, and reviewed the standards for early childhood centers developed by a number of professional associations and government agencies. We limited our focus to center characteristics associated with the first national education goal—child development, parent, and health and nutrition services. In order to determine the services that disadvantaged children receive, we analyzed Mathematica Policy Research’s “Profile of Child Care Settings,” a nationally representative sample of early childhood centers. This was a 1990 telephone survey of directors of early childhood centers. We grouped centers into four categories that correspond to their sponsors: (1) Head Start, (2) school-sponsored, (3) nonprofit, and (4) for-profit. Both nonprofit and for-profit centers may be sponsored by church, community, and other organizations. Nonprofit and for-profit centers may receive funds through federal or state child care programs, directly or through subsidies provided to families. Head Start centers are sponsored by local nonprofit organizations—including school districts—receiving federal Head Start funds. School-sponsored centers are sponsored by local school districts, and are funded by the state and/or local governments, but may also receive some federal funds. In addition to analyzing national data for kinds of centers, we also divided the centers into three categories according to the poverty level of their community to determine whether differences exist in the services provided. We report only those differences between centers that are statistically significant at the 55-percent confidence level. We also conducted case studies of early childhood programs and services in four states that had multiple early childhood programs and varying levels of state investment in those programs. We judgmentally selected our states on the basis of types of early childhood programs within the state and the level of state investment in early childhood programs. Our in-depth case studies of early childhood programs and services in California, Louisiana, Maryland, and Michigan enabled us to look first-hand at services for disadvantaged children. Each of these four states has state-funded child development programs. The characteristics of these programs—such as per-child expenditure and services provided—varied. In addition, we met with state education and child care administrators in the four states. In each state, we also selected low-income census tracts—one urban and one rural—and interviewed all center-based providers within these census tracts. In total, we interviewed providers in 28 early childhood centers—8 Head Start centers, 12 federal or state school-sponsored programs, and 8 other providers. (See app. II for details about the case study states and census tracts.) In order to determine why disadvantaged children did not receive needed services, we conducted (1) in-person interviews with state and local administrators in our case study states and (2) telephone interviews with 11 state administrators of Head Start-State Collaboration Projects. These projects are intended to facilitate Head Start involvement in state policymaking and to build a more integrated and comprehensive delivery system for early childhood services. (Additional information on the methodology employed in this study can be found in app. III.) This study was limited to the provision of services to preschool aged children, generally 3 and 4 years old, in early childhood centers. We did not examine services provided in family child care settings. The Profile of Child Care Settings and our case studies relied exclusively on self-reports of center personnel. We did not conduct on-site observations of interactions between teachers and disadvantaged children as would be necessary to determine the quality of a center beyond what services it offered. In addition, the sample did not allow us to focus our analyses on centers that served only disadvantaged children. We were also not able to conduct analyses comparing the proportions of disadvantaged children receiving services in different kinds of centers because of small sample sizes. We did our review from October 1992 to September 1994 in accordance with generally accepted government auditing standards. The Department of Education provided written comments on a draft of this report. We have incorporated its comments where appropriate. In addition, these comments are presented and evaluated in appendix V. The Department of Health and Human Services did not provide written comments. We obtained the agency’s views in an exit conference and have incorporated its comments as appropriate. As stated in chapter 1, the first national education goal articulates the fundamental elements—high-quality, developmentally appropriate preschool, (in this report, early childhood centers); parents who support their children’s learning; and adequate health care and nutrition—that are needed to prepare all children for school. Experts also have documented that these elements are important in preparing disadvantaged children for school. Child development services that are appropriate to the child’s age and individual level of development should promote relationships between the child and adults. Long-term relationships with adults who are responsive to the child’s needs and provide a stimulating environment for the child are crucial to development. In particular, a child’s language and social development are dependent on his or her relationships with adults. By encouraging verbal expression, adults can foster such development.Children’s relationships with adults other than their parents, such as early childhood teachers, provide important opportunities for their development. Early childhood centers can provide the kind of environment that encourages these kinds of relationships and developmentally appropriate practices. Certain features foster such relationships and practices: teachers with higher education or specialized training in early childhood education, a low child-to-staff ratio, small group size, and low teacher turnover. A curriculum that includes daily and long-range plans for groups of children and individual children is another important feature. Higher levels of education or specialized training in child development is a characteristic strongly related to the quality and frequency of a teacher’s interaction with the child. Teachers who have had postsecondary education and those with specialized training in early childhood education better encourage child development. For example, teachers with more training are less directive, more responsive to children’s needs, and encourage children’s expressiveness. Teachers can obtain training in early childhood development as part of a college or university program, or they can obtain a Child Development Associate’s credential (CDA). Generally, experts recommend a ratio of no more than 10 children to 1 staff person in early childhood centers for children aged 3 and 4. Some researchers have found that low child-to-staff ratios facilitate good caregiving behaviors, such as use of developmentally appropriate practices and increased interactions between adults and individual children. Small group size is also generally recognized as a feature contributing to the development of the child. For example, some studies have found that smaller group sizes are associated with more positive interactions between staff and children. Recommended group sizes vary according to the age of the children. For children aged 3 and 4, experts recommend a group size of no more then 20 children. Continuity in the adult-child relationship is important to foster child development; researchers use staff turnover as one measure of continuity. The research has demonstrated that children develop best in centers where there is low teacher turnover. Low turnover is related to teacher compensation: teachers are more likely to remain in centers where they receive adequate salaries and benefits. While estimates of average teacher turnover vary, a 1992 study reported an average turnover rate of 26 percent between 1991 and 1992 in early childhood centers nationwide. We previously found that high-quality centers had, on average, a 25 percent teacher turnover rate. In order to capture these dimensions, a curriculum needs to be written, according to experts. A curriculum, including daily and long-range plans for both groups of children and individual children, is a feature that fosters child development. Studies have shown that children develop better when their activities are planned to include a balance between those that are teacher-directed and child-initiated; structured and unstructured; small group, large group, and individual; and quiet and active. Encouraging parents to become actively involved in their children’s learning can lead to more supportive interactions between parents and children; enhance the parental role as the principal influence in the children’s education and development; and have positive impacts for both parents and child, according to experts. Children who receive encouragement and support from their parents are more likely to develop confidence and an expectation that they can succeed, attitudes that sustain an interest in learning. In addition, parental involvement in children’s learning experiences is an especially important element in preparing children for school. Children whose parents read to them and engage them in conversation are more likely to do better in school. Parent practices are important in children’s preparation for school, researchers have found. Parent services at centers can facilitate parental involvement by offering meetings with parents, involving parents at their child’s center, supporting the parent’s own development through general education or training opportunities, and visiting the child’s home to help the parent expand on the child’s center experience. Because more parents work today, researchers and early childhood providers have begun to view full-day programs as a critical parent service. This service is necessary because it enables the parent to work and, at the same time, addresses the child’s need for safe care that potentially helps her or his development. With welfare reform potentially requiring many more parents to work, full-day child care will almost certainly continue to be a pressing need. The literature on early childhood development documents the importance of health care and nutrition to children’s well-being, including their development and school achievement. Children who are in poor health may be absent from school more often or unable to perform in class, or they may exhibit disruptive behavior. In addition, untreated injuries or health problems can lead to permanent disabilities that impair a child’s cognitive abilities. Finally, appropriate health care during the early childhood years can detect and treat conditions that affect a child’s performance in school, such as learning disabilities. Numerous studies have also shown that poor nutrition adversely affects children’s ability to learn. For example, children who are not well-nourished “perform poorly on problem solving and psychological, cognitive, verbal, and visual tests.” Poor nutrition can also result in “apathy, inattentiveness, problems interacting with others, and other learning problems.” The health services that early childhood centers can provide range from (1) requiring a physician’s statement about the child’s general health and immunization record; (2) screening for hearing, speech, and vision to identify problems; and (3) providing access or referral to health care providers to address the problems identified. For example, medical and dental examinations are a type of health service a center might provide or refer families to. Some centers may provide health care services to all children routinely, some only when the need arises. Providing regular, nutritious meals and snacks is another important way centers can support a child’s health. Early childhood centers do not provide most disadvantaged children the full range of services—child development, parent, and health and nutrition—that they need to be prepared for school. The majority of disadvantaged children do not attend early childhood centers to help them prepare for school, in spite of the first national education goal that all children have access to high quality, developmentally appropriate preschool. Many of these children stay at home or in family child care homes, where high-quality services can be provided but a full range of services is often unavailable. Of the disadvantaged children who do attend centers, most attend centers less likely than Head Start centers to provide the full range of services. Even Head Start centers, however, vary in the quality of services provided and in the percentage of children actually receiving services, according to recent studies. Of the disadvantaged children who do attend early childhood centers, most attend school-sponsored, nonprofit, or for-profit centers. All centers provide nutrition services through regular meals and snacks. However, school-sponsored centers are less likely than Head Start to provide parent and health services; and for-profit and nonprofit centers are less likely than Head Start to provide child development, parent, and health services. Disadvantaged children, who are most likely to face difficulties upon entering school and who would benefit most from attending early childhood centers, are the least likely to attend them. According to our analysis of the 1990 decennial census, about 65 percent of disadvantaged children—a total of 1.8 million children—did not attend early childhood centers in 1989. By contrast, only about 40 percent of children in high-income families—those who earn above $63,370 for a family of four—did not attend early childhood centers (see fig. 3.1). In all states, the majority of disadvantaged children—from 55 to 74 percent—do not attend early childhood centers. In 16 states, 70 percent or more do not attend (see fig. 3.2). Although Head Start funding almost doubled from $1.6 billion in 1990 to $2.8 billion in 1993, Head Start served only an estimated 29 percent of all eligible 3- and 4-year-old children in 1993. In addition, many disadvantaged children are in families whose income is not low enough to qualify for Head Start, although it is low enough to qualify for other forms of public assistance. Instead of attending early childhood centers, many disadvantaged children stay at home or in another’s home, either a relative’s or nonrelative’s. A recent study of child care use among families with low incomes found that 51 percent of the children aged 5 and younger of employed single mothers were either cared for in a relative’s home or in family day care. Recent family child care studies have identified successful efforts that improve the quality and extend the services offered in family child care. Though some family child care providers offer high-quality services, family child care often lacks features that foster child development and does not offer parent or health services. Recent research on children, including the disadvantaged, who are cared for in homes other than their own found that while a minority of providers gave care that fostered children’s development, most providers provided “adequate care” that neither helped nor hindered children’s development. Family child care providers who are also low income often encounter difficulties providing disadvantaged children with a full range of services to prepare them for school. These providers also face significant barriers in obtaining information and resources, including training, to enhance the quality of care they provide. While recent efforts by both federal and state governments aim to improve the quality and extend the kinds of services provided in family child care, family child care providers are still highly decentralized and among the “most isolated of child care services.” Of disadvantaged children who attend early childhood centers, our analysis of national data indicates 59 percent attend centers that are less likely than Head Start centers to provide the full range of child development, parent, and health services (see fig. 3.3). These disadvantaged children attend nonprofit centers (30 percent) or for-profit centers (11 percent), both of which are less likely than Head Start centers to provide any of these services; others attend school-sponsored centers (18 percent), which may not provide parent and health services but are likely to provide child development services. The remaining disadvantaged children attend Head Start centers (41 percent). Although Head Start centers generally provide a full range of services, the quality of services does vary as does the percentage of children actually receiving services, according to recent studies. A 1993 report of the Office of Inspector General, HHS, found that the percentage of Head Start children actually receiving health services was not as high as reflected in HHS reports and databases. In addition, the quality of Head Start services was a key issue for the Advisory Committee on Head Start Quality and Expansion, created in 1993 by the current administration to aid in the recent Head Start reauthorization. In response to such concerns, the 1994 reauthorizing legislation amended the program to require, for example, that HHS terminate an agency’s designation as a Head Start grantee, after determining a program is deficient, if the grantee agency fails to promptly address the deficiency. Although some for-profit and nonprofit centers may be model centers because they offer all features of child development services, others lack these features. Our analysis of national data indicates that, overall, for-profit and nonprofit centers are more likely to lack features of child development services compared with school-sponsored or Head Start centers, according to center directors (see fig. 3.4). To determine whether or not a center provides child development services, we looked at features that foster child development. As described in chapter 2, these features include teachers with more than a high school diploma or General Equivalency Degree (GED), a ratio of 10 children or fewer to one staff member, a group size of 20 or fewer, teacher turnover no higher than 25 percent annually, and a written curriculum. These features can help create an environment that enhances the teacher’s capacity to be more responsive to the needs of the child, thereby promoting the child’s development. In addition, for-profit and nonprofit centers received lower ratings in a recent observational study of interactions between teachers and children. For-profit and nonprofit centers are more likely to lack features of child development services compared with other kinds of centers, even though many do provide such services (see fig. 3.4). For example, our analysis indicates that for-profit and nonprofit centers are more likely to employ teachers with only a high school diploma or GED. In for-profit centers, more than 1 in 5 teachers (21 percent) has earned no more than a high school diploma or GED; in nonprofit centers, more than 1 in 10 teachers (11 percent) has earned only a high school diploma or GED. In high-poverty areas, a greater percentage of teachers in for-profit and nonprofit centers have only a high school diploma or GED compared with low-poverty areas. By contrast, virtually all teachers in both Head Start and school-sponsored centers have more than a high school diploma or GED. More than a quarter of for-profit and nonprofit centers (35 and 25 percent, respectively) have child-to-staff ratios higher than 10 to 1—at least three times the percentage among Head Start centers (8 percent). Only with regard to group size are for-profit and nonprofit centers about the same as other kinds of centers; 14 percent of for-profit and 15 percent of nonprofit centers have large groups of more than 20 children. For-profit and nonprofit centers also reported high rates of turnover. About a third of for-profit centers and nonprofit centers lost more than one in four of their teachers during the previous year. However, Head Start centers reported high turnover rates as well. With regard to written curriculum, for-profit (14 percent) and nonprofit (17 percent) centers are more likely to have no written curriculum than Head Start centers (7 percent). When comparing for-profit and nonprofit centers to each other, differences emerge. According to the national data, for-profit centers are less likely than nonprofit centers to have features of child development services. For example, for-profit centers were more likely to employ teachers with only a high school degree or GED and to report child-to-staff ratios above recommended levels. The nonprofit and for-profit centers that we visited varied in their child development services. While many had features that conformed to the recommendations of child development experts, some did not. For example, a nonprofit center in Michigan and a for-profit center in California had teachers with no training beyond a high school diploma. With regard to group sizes, a Michigan nonprofit center served children aged 2-1/2 to 12 in a group as large as 40 children, although the group size fluctuated because some children were served part time and after school or on an drop-in basis. Similarly, a nonprofit center in California had a group of 36 children aged 2 to 5. School-sponsored centers provide children with most features of child development services. Compared with for-profit and nonprofit centers, school-sponsored centers are less likely to lack features of child development services. Our analysis of national data indicates that virtually all teachers in school-sponsored centers (98 percent) have at least some college or an associate’s degree; 87 percent have a bachelor’s or graduate degree. Few directors of school-sponsored centers reported high rates of turnover: only 16 percent of these centers have a turnover greater than 25 percent. In addition, directors of nearly one-fifth (19 percent) of school-sponsored centers reported a child-to-staff ratio exceeding the recommended 10 to 1. There are no significant differences between school-sponsored centers and other kinds of centers in terms of group size: 14 percent have large groups of more than 20 children. School-sponsored centers (14 percent) are about as likely as nonprofit (17 percent) and for-profit centers (14 percent) not to use a written curriculum. In all four states, school-sponsored centers we visited had features that were generally consistent with expert recommendations for child development services. Almost all teachers in the school-sponsored centers we visited had bachelor’s or master’s degrees in education; most of these degrees were in early childhood education, and many of the teachers also had earned other forms of early childhood certification. All of the school-sponsored centers we visited maintained child-to-staff ratios and group sizes within limits recommended by experts. For example, two Michigan centers maintained lower child-to-staff ratios and group sizes than recommended by experts and served groups of 18 children, with one staff member to every 9 children. Head Start centers generally exhibit the features important to child development. Virtually all teachers—99 percent—have at least some college or an associate’s credential; 45 percent have a bachelor’s or graduate degree. Head Start centers are less likely than all other kinds of centers to have a child-to-staff ratio greater than 10 to 1; only 8 percent of Head Start center directors reported higher ratios. Although only 9 percent of Head Start centers exceed the recommended group size of 20 children, that is not a significant difference from other kinds of centers. As for written curriculum, only 7 percent of Head Start centers do not use one compared with 17 percent of nonprofit and 14 percent of for-profit centers. However, in one area, Head Start centers do little better than nonprofit centers. Children in some Head Start centers are likely to experience a lack of continuity in care that comes from high staff turnover. Head Start center directors reported turnover rates close to those experienced by nonprofit centers; a quarter of Head Start centers had lost more than one in four staff members during the previous year. Although involving parents in a child’s learning has been shown to positively influence child development, parent services were less likely to be available in school-sponsored, nonprofit, and for-profit centers than in Head Start centers. According to our analysis of national data, the only exception was meetings with parents of each child; directors of a majority of all kinds of centers reported that these meetings were regularly scheduled, as illustrated in figure 3.5. Centers other than Head Start, however, were less likely to involve parents in other activities, for example, as classroom volunteers or in governance efforts such as selecting staff or reviewing budgets. Head Start centers were more likely to get parents to attend workshops or classes and send staff to visit each child’s home. A substantial proportion of school-sponsored center directors reported involving parents in all of these activities. Our analysis of the Mathematica database by poverty area revealed no statistically significant differences between high and low poverty areas in terms of any of the parent services. All three for-profit centers that we visited offered only limited parent services. For example, a for-profit center in Louisiana offered individual parent conferences only when there was an extreme discipline problem. Some nonprofit centers we visited, however, were able to provide more extensive parent services. A Michigan nonprofit center, for example, offered more parent services, including GED classes for parents; the center was sponsored by a community center that made such services available. One nonprofit center we visited in California provided referrals to services on the basis of a needs assessment done for each parent. A parent advisory committee meets monthly and, according to the center director, virtually all parents volunteer in some fashion. The school-sponsored centers we visited typically offered more parent services than the for-profit and nonprofit centers. Although school-sponsored centers did not have paid parent coordinators, as did Head Start centers, one school-sponsored center used a volunteer parent as a liaison to encourage other parents to get involved in center activities. Some school-sponsored centers also offered training in better parenting and, sometimes, referred parents to education or training opportunities to support the parent’s own development. Directors of some school-sponsored centers reported that staff visited children’s homes; however, in some cases this was done only if a child was experiencing problems. Recognizing the importance of parent involvement, some school-sponsored centers we visited were attempting to expand parent services. For example, a center in Louisiana was planning to hire an early childhood facilitator to design parent workshops, according to school officials. A Michigan center was trying to strengthen the commitment of parents to the center by having them sign a contract at the beginning of the year pledging to (1) volunteer at least once a month and (2) help children with learning activities at home. The Head Start centers we visited took an active approach to parent involvement, combining a range of services with frequent parent contact. These centers sometimes employed a parent coordinator, who might be shared with several other centers through the grantee or delegate agency. Coordinators worked directly with parents to help involve them at the center and to help them gain access to other services. Almost all centers offered individual conferences with parents at least twice a year; in two Head Start Centers, conferences took place once a month. In the centers we visited, center directors reported that home visits were conducted routinely for each child, sometimes several times a year. All Head Start centers also offered a range of activities to parents, from serving on the center’s policy council to training in how to be a better parent, as well as literacy and GED classes. Although good health is important to a child’s preparedness for school, centers other than Head Start were not likely to provide many health services, according to our analysis of national data (see fig. 3.6).Nonprofit and for-profit centers were least likely to provide health services; in only about half of these centers, according to directors, were screenings for hearing, speech, and vision problems provided; provision of physical or dental examinations was rare. School-sponsored centers almost always provided screenings for hearing, speech, and vision problems, but less than a third offered physical or dental examinations. However, school-sponsored centers in high-poverty areas were more likely to offer dental examinations than were those in low-poverty areas. Head Start centers provided more health services or referrals to these services than other kinds of centers. Directors of the vast majority of Head Start centers reported providing physical examinations and dental examinations, as well as screenings for hearing, speech, and vision problems. In the states we visited, all nonprofit and for-profit centers required statements from physicians about the status of the child’s health, including immunizations. However, some of the nonprofit and for-profit centers we visited offered few health services beyond such protections. A Louisiana for-profit center, for example, was unable to offer any health services other than to alert social workers to a serious health problem that a parent was neglecting. In two states, some nonprofit centers that we visited went beyond this minimum, however. In California, centers funded by the state were required to identify the health needs of children, refer them for services, and provide follow up. In Michigan, several centers we visited also provided some health-related screenings and had staff make referrals and follow-up to help ensure children received services. The existence of several children’s initiatives in Michigan—including vision and hearing screening programs—made it possible for these centers to gain access to the additional services for their children. Unlike Head Start centers, however, these centers in Michigan and California did not employ health coordinators to provide or refer children to health services, nor did these centers have funds to pay for treatment if no other source of funding was available. The school-sponsored centers we visited often provided more health services than nonprofit and for-profit centers. For example, school-sponsored centers generally screened all children for health problems. In centers we visited in Louisiana, Maryland, and Michigan, affiliation with the public school system helped these centers obtain some health services. As part of the school system, some school-sponsored centers had access to health staff, such as nurses and social workers. School-sponsored centers could also refer children to schoolwide teams to (1) determine whether a child was eligible for special education services because of a disability or (2) make referrals to a community service or private medical provider. However, staff in two centers said these school system services were spread thinly across all children in a school or several schools. Therefore, some health services were not provided routinely but only when a need arose. In California, school-sponsored centers were required to refer children to health providers and then follow up on the problems that were identified by the screenings. Head Start centers we visited devoted staff and other resources to help ensure that all children received the health services, including screenings and treatment, required by Head Start performance standards. Some Head Start centers had coordinators, shared with other centers through the grantee or delegate agency, to provide or refer children to health services. The coordinator in one center we visited was a nurse. In addition, a few centers had a health aide to ensure that each child received care. Some centers hired other health care providers, such as child psychologists, through the grantee. All Head Start centers can use Head Start funds to help pay for health care if no other source is available to the child. Most centers of all kinds provide nutrition services through regular meals and snacks, according to our analysis of national data. Head Start centers generally fund meals and snacks through the U.S. Department of Agriculture (USDA) food assistance program, called the Child and Adult Care Food Program (CACFP), which provides cash reimbursement and donated food. School-sponsored, nonprofit, and for-profit centers are much less likely than Head Start centers to participate in CACFP. (See fig. 3.7.) However, nonprofit and for-profit centers participate at higher rates in high-poverty areas compared with low-poverty areas. Most school-sponsored centers that we visited funded meals through CACFP or the National School Lunch Program, another USDA food assistance program. Although all nonprofit and some for-profit centers we visited are eligible to participate in CACFP, two for-profit centers had to supply their own food because they experienced difficulties qualifying for the program. For-profit centers are allowed to participate in CACFP only if 25 percent of enrolled children or 25 percent of the center’s licensed child capacity is eligible to receive compensation under Title XX of the Social Security Act. Given the increased availability of federal child care funding from sources other than Title XX, some states may decide to allocate fewer Title XX dollars to child care. This would result in fewer centers being eligible for USDA food programs. USDA has undertaken a pilot project to test expanding the eligibility of for-profit centers for CACFP; under the pilot project, for-profit centers qualify if 25 percent of children are from families whose incomes are at or below 185 percent of the federal poverty level. In part because of the cost implications of increasing participation among centers, CACFP has not yet been expanded to include more for-profit centers by using this eligibility criterion. We found two key reasons why many disadvantaged children may not receive the full range of needed center services. First, many disadvantaged children are unable to enroll in early childhood centers because of either the limited slots available or limited subsidies. Second, programs that fund these centers have historically had narrow missions that constrain the provision of needed services so that even those disadvantaged children who attend centers do not necessarily receive the full range of services they need to be prepared for school. Such constraints in the provision of services result from (1) program standards, (2) the allocation of scarce resources, and (3) barriers to collaboration between centers so that they can expand services. Nevertheless, some state and local initiatives have demonstrated how a full range of services can be provided to disadvantaged children; such initiatives have required added resources and substantial efforts by program administrators to overcome differences between programs. Low participation of disadvantaged children in early childhood centers appears to result, at least partially, from lack of slots available in early childhood centers. Even with the expansion of Head Start, the growing number of disadvantaged children means that there are not enough places in centers for all the children whose parents want them to attend. The number of disadvantaged 3- and 4-year-old children, according to our analysis of the 1990 decennial census, increased from 2.4 million in 1980 to 2.8 million in 1990, a 17-percent increase. Even Head Start—the largest federal child development program—is funded at a level that permits serving only 752,000 children in fiscal year 1995. Information on the number of 3- and 4-year-old children enrolled in other federal and state-funded early childhood programs is limited. The gap between the number of disadvantaged children and the number served by early childhood centers, however, is not an accurate indicator of the demand for center places. Parents may not seek to enroll their children in centers because they prefer other arrangements, such as care in their own home or in family child care, or their access to centers may be impeded by inconvenient hours of operation, as discussed later in this chapter, or by high costs. In every low-income census tract that we visited, we found at least one center that had a waiting list, indicating there may not always be enough places within centers to meet demand. Several centers reported that children on waiting lists were placed quickly. In three centers, however, staff said some parents enrolled their child more than a year before the child was old enough to attend in order to ensure the child would get a place at the center. Of the four states we visited, some of the longest lists we found were for centers in California. For example, one nonprofit center in California served 46 children in the 1992-93 school year. During the year, however, 148 children were placed on the center’s waiting lists and remained there throughout the year, center staff reported. A center sponsored by both Head Start and the public school system in California served 185 children in the 1992-93 school year, but 182 children were on its waiting list that same year. Waiting lists, however, are an imperfect measure of the need for services. Even when places are available, limited subsidies for families to obtain child care can also make it difficult for children to enroll in early childhood centers. Many eligible parents are unable to obtain subsidies under federal and state child care programs, state officials reported.Louisiana officials claimed that the parents of 6,000 eligible children were waiting for CCDBG subsidies because of inadequate funding. In our May 1994 study of federal child care programs, we also reported that many parents were waiting for subsidies in five of six states visited—California, Illinois, Massachusetts, New York, and Texas—because of limited funding. Parents of an estimated 40,000 children were waiting for subsidies in Texas. Also in the May 1994 study, we cited a 1991 survey of those waiting for subsidized care in California, which found approximately 255,000 children who were not yet served. Michigan—the only other state included in that study—did not track the numbers of parents waiting for subsidies. The programs that fund many early childhood centers have historically had narrow missions that constrain centers’ provision of the full range of services. The services provided by all types of centers appear to be most often related to the missions of the funding programs. These missions are reflected in variations in programs’ standards, allocation of scarce resources, and differences in programs that create barriers to collaboration. The mission of the federal programs that subsidize care in nonprofit and for-profit centers is primarily focused on providing child care so that parents can work or attend school or training for employment. For example, the legislation for Title IV-A of the Social Security Act and CCDBG authorize federal funds to assist parents purchasing child care services while they work or attend training for employment. Because these programs place emphasis more on parental employment and less on child development, parents are free to use subsidies to obtain care in any setting, regardless of whether it provides a full range of services for the child. Some experts have expressed concern that the subsidies provided to parents under these programs are generally too low to meet the cost of centers that, at a minimum, have features of child development services.As a result, parents may be forced to enroll their children in centers they can afford, which may offer fewer services, rather than in centers that provide a full range of services. Parents may also be forced to choose centers that do not provide the full range of services because they need full-day care for their children. Nonprofit and for-profit centers are much more likely to offer full-day care than other kinds of centers. According to our analysis of the Mathematica database, few Head Start and school-sponsored centers (less than 35 percent) provide full-day care, but most nonprofit and for-profit centers do (see fig. 4.1). Nonprofit and for-profit centers are even more likely to offer full-day care in high-poverty areas than in low-poverty areas.Unfortunately, as we discussed in chapter 3, for-profit and nonprofit centers are less likely than other kinds of centers to provide the full range of child development, parent, and health services. Our case studies also reflect this problem. According to staff in a California center sponsored by Head Start and the public school system, about half of the parents work full time and have told center staff they need full-day services. A survey conducted by a panel of advisers convened in 1989 by the National Head Start Association revealed that the greatest need of Head Start parents is for full-day services. Another result of the federal mission of child care programs being parental employment is that parents may not be entitled to, or could lose, their child care subsidy for reasons that have little to do with the child’s need for services. For example, a parent on welfare is entitled to a child care subsidy, but a low-income nonwelfare parent is not. Our state case studies illustrate how parents can lose their subsidy, regardless of their continued need for child care and the fact that the child’s needs are unchanged. California’s continued economic recession means less job stability among program participants, state officials said. Because federal requirements for the At-Risk Child Care program do not permit subsidizing child care during a period of job search, children’s care is disrupted when parents who lose their jobs. Administrators in California reported struggling with how to meet child care needs while parents undertake a job search. Proposed HHS regulations, as well as welfare reform proposals, attempt to eliminate some of these problems, for example, allowing the provision of child care during temporary gaps in employment and training. Because the mission of these programs is shaped by the schools sponsoring them, school-sponsored programs do not always provide a broad range of parent or health services. The mission of school-sponsored programs focuses primarily on child development. Many of these programs have been instituted over the last decade to improve school performance among children who are at risk of school failure. However, we found evidence that the mission of school-sponsored programs is changing. In the four states we visited, school officials recognized the importance of providing the full range of services and, in some cases, are emphasizing more cooperative efforts between schools, children’s homes, and community services to increase the range of services children receive. However, program officials in the states we visited reported that they face difficulties in providing a broader range of services. In contrast to the mission of federal child care and school-sponsored programs, the mission of the Head Start program focuses on addressing the many needs of the most disadvantaged children and their families. But, as already mentioned, individual Head Start centers may vary in the quality of services provided and in the percentage of children actually receiving services, according to recent studies. Program standards often reflect the narrow missions of their sponsors and vary by type of center. In order to be eligible for federal child care subsidies, for-profit and nonprofit centers are required to follow only applicable state and local licensing standards. In the states we visited, licensing standards for child care did not require a full range of child development, parent, health, and nutrition services, but they did include some basic health and safety protections. Standards for school-sponsored centers in the states we visited have some basic requirements for health services, but more for parent services. The standards of school-sponsored centers for child development, however, are detailed and conform to, and sometimes exceed, the recommendations of experts. The standards for Head Start centers are the most extensive—requiring centers to provide child development, parent, and health and nutrition services. (See app. IV for detailed summaries of standards that apply to all kinds of centers.) In the states we visited—California, Louisiana, Maryland, and Michigan—child care licensing standards, which for-profit and nonprofit centers must follow in order to receive federal child care subsidies, did not require the full range of services that children need to prepare for school. Because of the emphasis among the Title IV-A and CCDBG programs on protecting parents’ flexibility in choosing from a wide variety of child care providers, there are generally no minimum federal standards, just the state standards. If state child care licensing standards do not offer basic health and safety protections, CCDBG does require such protections by centers serving children whose care is subsidized by this program, but the CCDBG also does not require that centers provide a full range of services. Although child care licensing standards differed among the states we visited, the standards permitted features that do not meet the recommendations of child development experts. For example, in Louisiana and Michigan, there are no preemployment educational requirements for teachers in nonprofit or for-profit centers, only for center directors; Louisiana allowed child-to-staff ratios greater than 10 to 1; and California and Michigan did not regulate group size. For parent services, standards for all four states only required centers to allow parents to visit the center at any time or to provide information about center services. For health services, the requirements were also limited in all four states: a center had to have a physician’s statement of general health, including immunization, and the center had to keep this statement. One exception to such minimal requirements was the standards governing nonprofit and for-profit centers that participate in the General Child Care and Development Program in California; these standards were extensive. These centers were required to provide a wide range of parent and health services. For example, one center we visited in California offered a wide range of parent services. According to the center director, this was because of additional requirements imposed on centers receiving state funding—such as holding regular group meetings of parents with program staff and establishing parent advisory committees. In all of the four states we visited, school-sponsored centers were generally required to follow standards for child development services that conformed to the recommendations of experts, and in several instances, exceeded those recommendations. For example, all four states we visited required that teachers either be state certified, or have post-secondary education with specialized training, in early childhood education. In three of the states—Louisiana, Maryland, and Michigan—school-sponsored centers had only basic standards for health services, ranging from maintaining a health record to providing hearing and vision screenings. California had more extensive standards, however, which required that centers identify the health needs of children, refer them for services, and provide follow-up. Standards governing parent services differed across the states, with California and Michigan requiring more parent services and Louisiana and Maryland fewer. School-sponsored centers funded with federal Title I money are not subject to any standards for child development or health services, only parent services. New legislation reauthorizing ESEA requires Title I early childhood programs to comply with Head Start performance standards by fiscal year 1997. Head Start centers are required to follow detailed performance standards that conform to the recommendations of experts for child development services. For child development services, each center must have an education services plan that specifies children’s activities. For health services, each center is responsible for health screenings and for obtaining or arranging for treatment of all health problems detected. Required parent services include parent policy groups, activities to promote the development of parenting skills, identifying opportunities for continuing education, and at least two home visits per year. One of the reasons often cited by administrators for not providing the full range of services is the scarcity of resources. The scarcity may include both the lack of resources and their allocation by centers. Each center tends to devote resources to those aspects of children’s needs related most closely to its mission. Several for-profit and nonprofit centers we visited faced difficulties supporting basic services—not including parent or health services—under current funding amounts. According to the director of one nonprofit center in Michigan, limited resources threatened her ability to keep the center open at all. Even when center administrators stated an intent to fulfill a broader mission, limited resources sometimes prevented them from doing so. A for-profit center in Louisiana wanted to hire a professional with either an education or psychology background in order to provide child development services but, according to the director, did not have sufficient funds. Scarcity of resources is often reflected in low staff salaries which can explain high teacher turnover rates among for-profit and nonprofit centers, according to past research. The 1992 update of the National Child Care Staffing Study reported an average annual turnover rate of 26 percent among teaching staff in nonprofit and for-profit centers; 70 percent of teaching staff in 1988 had left their jobs by 1992. Those earning $5 per hour or less in 1988 left at a rate of 77 percent compared with a 53-percent turnover of teaching staff earning over $7 per hour. The director of a Louisiana for-profit center we spoke with attributed turnover the center had experienced in previous years to the fact that she can only pay her teachers, at most, $5 an hour, and is unable to provide any fringe benefits. Resources in school-sponsored centers did not appear to support a full range of services for all disadvantaged children. Even though school-sponsored centers can draw on school district staff (such as nurses, speech therapists, and social workers), these staff are shared among children of all grades and, sometimes, more than one school, staff from two centers said. For example, in one Louisiana center we visited, one part-time social worker was serving an entire school of 700 children, even though referrals to mental health services were increasing. State funding is sometimes not even adequate to cover teacher salaries or classroom materials, a Louisiana school district official said, and on-site, state monitoring of local programs was recently curtailed for lack of funding. Several state administrators of the school-sponsored programs we visited wanted to offer more services, but resource scarcity prevented them from providing services not traditionally found in schools, they said. For example, in spite of an initiative in Maryland to form teams of health and social services professionals in schools and districts to help children experiencing developmental difficulties, a school district official said the state lacks the resources needed to systematically provide these services to all children. In Michigan, the state per-child allocation for its school-sponsored program is too low to support the full range of services that the program is intended to provide, a state official said. The Head Start centers we visited also faced resource scarcity, even though their mandate is to meet all needs of children served. Head Start grantees’ inability to offer competitive salaries and benefits packages, particularly in urban areas, is in part responsible for high rates of staff turnover, according to a 1993 review by the HHS Inspector General.Furthermore, because communities were under greater economic distress, several center directors said, centers were unable to draw upon the community-based medical providers and social service agencies they had depended on in the past. Results of our recent survey of Head Start grantees and delegates showed that Head Start administrators viewed the limited availability of community resources as a major challenge. Head Start centers sometimes had coordinators who referred families to providers within the surrounding community when the center could not offer a needed service. In general, we found that other kinds of centers, faced with resource scarcity or with a narrow view of their mission, did not allocate resources to hire coordinators. Two Maryland school-sponsored centers that we visited, however, made efforts to link up with community-based services that enabled each center to provide additional health services to its children, even though these centers did not have coordinators. The scarcity of resources can also lead to competition between different kinds of centers for facilities, staff, funding, and children, according to Head Start-State Collaboration Grant administrators. For example, as states increase funding for their own early childhood programs, school districts are taking back space that was once given to Head Start programs. All kinds of centers compete with each other for trained staff, with the school-sponsored centers having the greatest advantage in the salaries and benefits offered. There is competition for funding, for example, as Head Start looks to sources of funding, such as CCDBG, traditionally used by child care centers. Different kinds of centers may also compete for state funding in order to deliver services. Particularly as states expand their early childhood programs, centers may compete with each other because they target the same children. Several collaboration grant administrators said there was competition for children among early childhood programs in their states. Differences in early childhood programs that reflect their narrow missions create barriers for one center trying to establish a collaborative relationship with another in order to broaden the range of services each provides. Collaboration refers to combining centers, services, or programs in innovative ways that provide children access to additional services. For example, several Maine Head Start centers have faced difficulty providing full-day programs for children of parents participating in the AFDC Child Care program. In order to extend the center day for these children, funding from Head Start and the AFDC Child Care program were combined. Thus, the children were provided full-day care by Head Start teachers in Head Start centers. However, this was difficult because Head Start teachers were paid at a rate that reflected their teacher qualifications, but the level of funding for AFDC Child Care was not sufficient to cover their salaries. Additional state and local funds had to be raised in order to pay these teachers at the Head Start salary. Oregon has faced difficulties in its efforts to bring the full range of services to disadvantaged children in nonprofit and for-profit centers. On an experimental basis, the state is allowing parents of children eligible for the Oregon Prekindergarten Program—which is modeled after Head Start—to place their children in any center convenient to their home or work, and the state ensures the children receive Head Start-like services. Visiting staff from the Oregon Prekindergarten Program help the center meet standards for child development equivalent to Head Start so that all children in the center benefit. Through home visits, Oregon Prekindergarten Program staff provide health and other services to only those children participating in the experimental program. But the rate centers charge for each child—that is, the center’s standard rate—has been inadequate to support the higher level of child development services, according to the administrator of the state’s Head Start collaboration grant. As a result, some centers have experienced difficulties meeting program standards. In response, the state may restrict participating centers in the future to those that are already offering better child development services based on a school district evaluation of the center through the Oregon Prekindergarten Program. In our case study work in Louisiana, we found that administrators of school-sponsored centers encountered difficulties simply trying, in a given center, to provide services in one classroom to children funded under different programs so that more children could be served. For example, if a child dropped out of a classroom, according to a state administrator, the budget had to be revised unless a new child was found who met the same eligibility requirements of the program under which the original child was funded. Even when centers successfully develop collaborative relationships, the collaboration is difficult and burdensome to administer. Rigidity of funding streams and regulations inhibit the development and ongoing management of programs attempting to meet the needs of parents and communities, concluded New York State’s subcommittee on collaboration, part of the state’s Interagency Committee on Early Childhood Programs. The subcommittee based its findings on interviews with administrators who led initiatives attempting to link different programs. Among the barriers identified were disparity in per-child funding provided to school-sponsored, Head Start, and child care programs; marked differences in salaries and benefits between teachers with equal credentials; and variations in programs and missions. Some state and local initiatives have expanded program missions in order to provide the full range of services. These initiatives include collaborative efforts that were successful because they overcame the problems program differences often pose. Each of these initiatives, however, involved a substantial investment of resources and the ongoing efforts of program administrators to overcome barriers imposed by differences between programs. In some cases, resources invested in these initiatives included private funding. California’s State Preschool Program and General Child Care and Development Program, for example, require centers all to offer a wide range of services and to establish links with health and social service agencies. California has long recognized the importance of helping children prepare for school while allowing parents to work or get an education, as reflected in the California Child Development Act of 1972. This act brought all state early childhood programs together under the Department of Education. With both the State Preschool and General Child Care and Development Programs, agencies other than school districts are eligible for state funding to operate centers as long as state standards are met. California has also encouraged school-sponsored centers to colocate with Head Start centers; in two colocated centers we visited, all children received Head Start services. To support the State Preschool Program and the General Child Care Program, the state invested over $300 million in fiscal year 1993 alone. Other states have invested state money to expand Head Start or modeled their programs after the Head Start program. For example, Ohio, which already provides state support to expand the Head Start program, will double its allocation from $40 million to $97 million for the period 1993 through 1995. Also in 1995, Ohio will follow Head Start performance standards so that state funds will support programs that meet children’s developmental needs. The Oregon Prekindergarten Program already follows Head Start performance standards, and centers participating in either Head Start or this state-funded program are jointly monitored by a team of Head Start and Oregon Prekindergarten Program staff. As of 1992, 14 states invest directly in Head Start so that more children can be provided the full range of services. Some states and localities have launched initiatives that assist centers in overcoming barriers that prevent them from collaborating in order to broaden the range of services centers provide. These collaborative initiatives include locating centers, services, and children together although they are funded by different programs. Other collaborative initiatives include delivering additional services to disadvantaged children in centers in which these services are typically unavailable. In Maryland, several counties combine Head Start and child care services. In Baltimore City, a child care resource and referral agency coordinates an initiative in which Head Start classrooms are created within child care centers. This enables (1) Head Start-eligible children to receive full-day care and (2) the child care center to benefit from the teacher training and other resources it shares with Head Start. Both Frederick and Charles counties also provide Head Start and child care services on-site together. In other states, standards and professional development are the centerpiece of collaborative efforts. For example, in Virginia, several child care centers that serve Head Start-eligible children and agree to meet Head Start performance standards receive technical support from Head Start staff. Some collaboration initiatives have been supplemented with private funds. For example, several centers were created in Kansas City, Missouri, to provide the full range of services to children funded under different early childhood programs, including Head Start and federal and state child care programs. Private donations and local community moneys help to supplement the cost of care. In Kentucky, a partnership joining the state and local governments and private agencies funds a statewide education reform effort that was launched in 1990. The reform effort includes an early childhood initiative in which state officials have arranged for Head Start to provide “enhanced” services—such as health and social services—to Head Start-eligible children enrolled in school-sponsored programs. Eventually, the state plans to provide such services to all children in its school-sponsored program through special state-funded family resource centers located within lower-income school districts. The first national education goal, “by the year 2000, all children will enter school ready to learn,” sets a bold vision for the nation’s future. Yet many disadvantaged children are unlikely to meet this goal. Like all children, disadvantaged children need a stimulating environment, parental guidance and support, adequate health care, and nutritious diets. Many of these children, instead, are subjected to multiple environmental deficits—too little cognitive stimulation, inadequate health care, and poor nutrition—which often impair their ability to function successfully. Many are doomed to school failure before they even enter school. As the number of disadvantaged children increases, centers are likely to continue to fall short in preparing all children for school. Despite knowledge that early childhood centers—if they provide a full range of child development, parent, and health and nutrition services—can successfully prepare disadvantaged children for school, most of these children do not attend such centers. Disadvantaged children, whose needs are similar, receive different services depending on the kinds of centers they happen to attend. Providing all disadvantaged children with a full range of services will involve considering (1) increasing funding from federal, state, and private sources for early childhood programs so that more children can participate and (2) broadening program missions to offer the full range of services that children need. Each of these approaches, however, will involve extraordinary difficulties. Increasing state and federal funding for early childhood programs that serve disadvantaged children will be difficult because the nation is already concerned that federal, state, and local government spending is too high. Broadening program missions will involve considerable efforts by program administrators and policymakers to reconcile major program differences regarding, for example, which children are eligible and what services are provided. Such efforts will pose challenges to those who are committed or accustomed to programs as they now exist. However, without such changes, the condition of the nation’s disadvantaged children will remain a “quiet crisis,” and the bold vision embodied in the first national education goal will not be realized.

Summary: Pursuant to a congressional request, GAO reviewed early childhood services for disadvantaged children, focusing on the: (1) services disadvantaged children need to prepare for school; (2) extent to which early childhood centers provide these services; and (3) reasons early childhood centers may not deliver all the needed services. GAO found that: (1) disadvantaged children need intellectual stimulation, parental support, and adequate health care and nutrition to prepare for school; (2) early childhood centers provide all the necessary services and also promote developmental activities suitable to a child's age and individual level of development; (3) most disadvantaged children do not receive a full range of services from early childhood centers because of the limited number of centers and subsidies and narrow program missions; (4) school-sponsored, nonprofit, and for-profit childhood centers are often less likely to provide a full range of services than Head Start centers; and (5) despite Head Start's full range of services, the quality of its services has been uneven.