Effects of Head Start Enrollment Duration for Children with Adverse Childhood Experiences

PURPOSE: Head Start eligible children have various options when enrolling in terms of age of entry (age 3 [45.4%] or 4 [49.5%]) and duration (1 year [65%] or 2 years [29.2%], 3 or more years [5.4%]). (DHHS, 2010). Recent studies suggest that the impacts of the program are more pronounced when children attended for a longer hours and weeks per year, for multiple years, earlier intervention and less absences has been shown to lead to increased cognitive and socio-emotional skills across studies. Adverse Childhood Experiences (ACEs) includes abuse (emotional, physical, and sexual), neglect (physical and emotional), and household challenges (violence, substance abuse, mental illness, divorce, and incarcerated household member). The purpose of the current study is to examine the associations among Head Start’s enrollment duration, ACEs, and children’s developmental outcomes. Specific research questions to be addressed are: 1). Do children’s number of ACEs have any impacts on cognitive, socio-emotional and health outcomes? 2). Do the number of years enrolled in Head Start have any impact on children’s developmental outcomes? 3). Does the impact of enrollment duration in Head Start and children’s outcomes differ depending on number of ACEs a child has experienced?

METHODS: Based on the Head Start Impact Study Data (cohort 2002, 2003, 2004), this study selected children entering at age 3 in fall 2002 (n = 2,449). Among children who remained until 2004 spring and provided valid data, were classified into three groups based on years enrolled in Head Start and included 1). Children never enrolled Head Start 2). Children who enrolled 1 year; and 3) Children who enrolled Head Start both in 2002 and 2003.

ACEs were measured based on five variables: 1). whether children witnessed violent crime, 2). whether the family has had trouble with alcohol or drugs, 3). whether the primary caregiver is clinically depressed or not, 4). whether a child had received neglectful parenting, and 5). whether a child lived in a high-risk household. Children’s outcomes were: Cognitive, Socio-emotional, and Health (dental check-up and health insurance).

RESULTS: Sets of regression analyses were used: after controlling for baseline variables, ACEs, duration of enrolment and interactions between ACEs and duration of enrollment were entered for cognitive, socio-emotional and health outcomes. Children who had higher ACEs had sequentially lower cognitive and socio-emotional outcomes. The longer durations of Head Start enrollment was positively associated with children’s outcomes, and this was more significant for children with fewer ACEs.

IMPLICATIONS: Children who enrolled Head Start for two years showed significantly more positive outcomes. Thus, children should be recruited more at age 3 or earlier and be enrolled for longer years of Head Start. This would require education on Head Start eligibility for low-income parents to increase awareness of the program. Additionally, the current study found that Head Start had impacts on children with fewer ACEs. Since Head Start serves low-income, high-risk children, Head Start policies should include a greater focus on providing services tailored to better address the needs of children with high numbers of ACEs.