If a little treatment goes a long way, does it stand to reason that more treatment will go even further? A research team led by Karen Bierman of Penn State University tested this idea, and their results were recently published in the journal JAMA Pediatrics. The treatment in question is the Research-Based and Developmentally Informed preschool classroom program (REDI-C), which researchers extended via a home-visiting program designed to train parents as surrogate teachers (REDI-P).
To carry out the study, researchers recruited the families of 200 four-year-olds participating in Head Start programs across three counties in Pennsylvania. Fifty-five percent of the children were white, 26 percent were black, and 19 percent were Latino. Most primary caregivers were mothers (89 percent), roughly one in three were single parents, and slightly more than half were unemployed. Almost all participating families were living in poverty with a median income of $18,000 per year.
Students were randomly assigned to the treatment group—those whose families would receive the in-home intervention—or the control group. Control families received only a packet of math learning games in the mail, while the other parents were visited ten times during their child’s last preschool year and six times during kindergarten. These home visits included extensive in-person coaching to enhance parent-child relationships and demonstrations of home learning activities to support child development and school readiness, especially language, literacy, and social emotional skills. Sample activities included storybooks, conversation games, and pretend play like “restaurant” in which children practiced their letters and language skills as they took their parent’s orders and mixed up alphabet soup.
Researchers first evaluated children’s outcomes at the end of kindergarten. Academic achievement was gauged in two ways: performance on a sight word fluency test and a teacher completed assessment of student competence in math and reading. Social-emotional adjustment was measured using a test of students’ pragmatic judgment skills administered by research assistants. Those research assistants then provided their own assessments of students’ attention, impulse control, and mastery motivation based on their experience administering the pragmatic judgment test. Home problems were measured using three parental survey instruments (with names like “Parenting Daily Hassles Scale” and “Parent Stress Index”) reflecting emotional symptoms, peer problems, conduct problems, and hyperactivity among other areas of potential difficulty. Finally, teachers rated students’ need for and use of services at school—such as IEP use, speech-language services, taking medication for attention or behavior, mental health counseling, and behavioral support use.
Researchers found that, consistent with their previous studies, students who received the REDI-P treatment at home scored significantly better on all measures at the end of kindergarten than did students receiving only REDI-C and the math-games packet. To further their research and to test the longer-term effects of the home-visiting intervention, Bierman and team followed up with students at the end of their third grade year, administering assessments again at that time. They found strong evidence of a lasting benefit of the treatment in all assessed areas, including indicators of both academic and social-emotional well-being.
Is this proof that home visits can lead to sustained positive effects? Up to a point, perhaps. But a couple caveats should be kept in mind. First, the academic test used for kindergartners and third graders here is the same. While this may be helpful for researchers to compare data more easily, sight word identification is not the standard for third grade reading proficiency. It seems odd that the state’s third grade test data were not available to the researchers. But if there are third graders performing poorly on kindergarten-level tests, it is likely that their third grade performance was poor as well. However, it does not seem likely that lack of pre-K programing exposure would be the cause. Second, the adult-reported assessments of both academics and social-emotional adjustment in class and at home lean heavily toward compliance and rule following. It stands to reason that obedient children would be less likely to raise hackles for teachers or parents, but what bearing does obedience have on academic achievement? The extent to which the social-emotional assessments are measuring self-motivation and executive function versus rule following and lack of defiance is an open question. The evidence here seems to suggest mainly that extending Head Start programing into the home goes a long way to benefiting adults. That also seems to be the point.
SOURCE: Karen L. Bierman, et al, “Effect of Preschool Home Visiting on School Readiness and Need for Services in Elementary School: A Randomized Clinical Trial,” JAMA Pediatrics (June 2018).
