What Should Future Early Learning Programs Look Like?

We have noted the four-part Healthcare Triage YouTube series hosted by Dr. Aaron Carroll that clearly explains the Rand study, “Investing Early – Taking Stock of Outcomes and Economic Returns from Early Childhood Programs,” a review of 115 early learning programs.

Parts 1 & 2 explained what childhood programs are and whether they work? Part 3 addressed the question: Do Early Childhood Programs Pay Off?

Today we highlight Part 4: What Should Future Childhood Programs Look Like?, where series host Dr. Aaron Carroll asks: “How do we use all this data to decide what to do in the future?” [Dr. Carroll is a Professor of Pediatrics and Associate Dean for Research Mentoring at Indiana University School of Medicine. He is also the director of the Center for Health Policy and Professionalism Research.]

So, as Carroll notes, “what do we do with this?” Some suggestions:

For Policymakers

“Policymakers can be highly confident that well-designed and implemented early childhood programs can improve the lives of children and their families.” In fact, Carroll indicates that some 2018 federal government funding indicates that policymakers may be listening.

“With a robust base of early childhood programs that have been proven to be effective based on rigorous evaluation, decision makers should integrate other criteria when selecting programs to implement.”

“All of these programs are now ‘evidence-based.’ That’s not what makes one better than another. Policymakers should consider what outcome they’re trying to improve, and then look for the program that gets them what they want.”

“New approaches to universal programs raise the possibility that such programs can complement rather than substitute for targeted programs.”

“Benefits can take decades to exceed costs, posing challenges for funding mechanisms that require short-term payoffs.”

For Research

“Comparative effectiveness research can add value to early childhood program decisions. When many of these programs started out, they were rare enough that they needed to be tested against ’nothing’ or ‘usual care.’ That’s clearly no longer the case. Now we are at a point where we can start testing programs head to head to see which are better and in what situations.”

“The next generation of research needs to get inside the black box of effective programs. Now that we know programs ‘work,’ we need to figure out why they work.”

“Early childhood programs improve a range of outcomes, so evaluations should collect outcomes across a range of domains… Parents can derive benefits from early childhood interventions as well. These can be direct (i.e. parent education) and indirect (i.e. better ability to work because of interventions on kids). These should be measured, too.”

“There is a need for more studies that conduct longer-term follow-up to determine whether early program impacts are sustained.”

“Incentivizing cost data collection, as well as standardization of BCA methods, would also facilitate comparisons across programs.”
Carroll ends the series with an important wrap-up: “Early childhood interventions work, and work well. They are often worth more than what they cost. And, there’s an argument to be made that we’re underselling them, because the benefits can last a lifetime.”

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