Starting Small, Thinking Big

T he United States spends more than $500 billion each year on the education of 5- to 25-year-olds. Despite disagreement over specific strategies, investment in education commands broad public support. But one of the most basic building blocks of the educational system suffers from broad neglect: very young children.

Social science and biological research have shown that the most rapid and significant developmental phase of life is the period from conception to age five. In fact, setting young at-risk children on paths of stable development during this period may be our best hope for breaking the cycle of poverty. Our public school system presumes that students will enter kindergarten around age five poised to begin learning. A five-year-old arriving in kindergarten with developmental, health, or behavioral problems that impede learning is at a disadvantage that will likely only worsen with age. In addition, the more developmentally delayed children there are in a classroom, the more effort the teacher has to steal from the children who otherwise would learn successfully.

WHEN IS IT TOO LATE?

Intervention at the high school level generally comes far too late to help the developmentally delayed in a cost-efficient way. Even intervention in elementary school comes too late for most problem children. This means we should start before kindergarten. Often even age three is too late. People who operate Head Start programs, which are geared to three-, four-, and five-year-olds, say that their programs' children can be divided into three groups. The top third has had good nurturing at home and would probably succeed in life even without Head Start. The middle group requires a great deal of effort, but it pays off: These children stay developmentally on track, when without Head Start they might not have. The lowest third requires heroics, and some may be all but beyond help. The only way to diminish the size of this last group is to work with the mothers of these children from the time they are born, or even six or nine months before that.

Until we recognize where the problem is-long before age six-we will continue to see school failures. The problem is not just schools, but school readiness. To be ready for school, the children have to be healthy. They need appropriate language skills. They must be ready for the social experience of school. They must know how to cooperate with other children, be respectful of the teacher, and understand the importance of doing well in school. To ensure that more children arrive at school ready to learn, we need to invest more in the health, early stimulation, and nurturing of every child born at high risk of failure.

Teenage mothers. Part of the challenge, of course, is preventing unwanted births to adolescents. More than 90 out of every 1,000 teenage girls in this country have babies every year-the highest rate in the industrialized world. Pregnant teens, still children themselves, are much less likely to obtain prenatal care than older mothers, greatly increasing the chances that their babies will be born with medical problems and developmental delays. Helping teenage mothers make responsible choices about family planning will go a long way to reducing the number of at-risk children entering the school system.

Flunking kindergarten. In 1984, Minneapolis school superintendent Richard Green tried an experiment. He refused to allow a student to go into tenth grade unless he or she had satisfactorily completed all ninth-grade work. Green set up a matriculation test at the end of ninth grade and did the same thing for seventh grade, fifth grade, second grade, and kindergarten. The number of students failing the test was sadly and predictably high. But the most surprising result of this endeavor was that 10 percent of the kindergarten class flunked -one in ten six-year-olds was considered "not ready" for first grade. Indeed, a friend who teaches kindergarten in the Chicago public schools believes, in fact, that more than 20 percent of the children she sees are not ready for school. But we do not have the luxury of closing the school door to those unprepared youngsters whose unpreparedness is contagious; public education by definition is open to everyone.

A 1991 report prepared under the direction of Ernest Boyer of the Carnegie Foundation for the Advancement of Learning titled Ready to Learn: A Mandate for the Nation, based on surveys of 7,000 kindergarten teachers, found that 35 percent of five-year-olds were not ready for school when they entered kindergarten. A report published that same year by Lucile Newman of Brown University and S. Buka of the Harvard School of Public Health stated that 12 percent of children were learning impaired before reaching kindergarten due to preventable causes such as malnutrition, lead poisoning, low birthweight, and alcohol and drug abuse during pregnancy.

T raditionally, parents have been responsible for bringing up children to be ready for school at age five or six. Unfortunately, many parents have little capacity to prepare their children for school. There is no way for the state's care to substitute completely for the nurturing and love that a parent or close relative brings to the child. But our society has done a poor job of doing what it can to help parents (especially parents living in poverty) nurture and stimulate the child in the critical years of life before the child starts school.

Humans attain a surprisingly large fraction of their physical height while still very young. In fact, we attain half of our mature height by age two and a half. If the problem were that adult Americans were too short, would anyone suggest improving the eating habits of 16-year-olds to make them taller? Human intelligence also develops at this decelerating rate. A study at the University of Chicago has shown that by the age of four, most of a human's IQ is already in place. The study's author, Benjamin Bloom, concluded, "General intelligence appears to develop as much from conception to age four as it does during the 14 years from age 4 to age 18." T. Berry Brazelton, the renowned Harvard pediatrician, says he can tell by examining a nine-month-old infant whether that infant is likely to succeed or fail in school, simply by observing how that child approaches very simple tasks, such as playing with blocks.

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WHAT WORKS

Preparing these children for school long before kindergarten will require a much more successful effort on the part of parents and society than we have yet been able to mount. However, some successful programs point to strategies that work.

Head Start. Head Start, launched 30 years ago by Lyndon Johnson, was our country's first attempt to prevent the stunted physical, cognitive, psychological, and social growth that so often plagues the children of poverty. The long-range results of Head Start have in the main been positive: measurably fewer school dropouts, fewer arrests, fewer teen pregnancies, and more employment. Children in good preschool programs do better in school and are less likely to get in trouble as adolescents. But even with recent budget increases, only 62 percent of four-year-olds and 28 percent of three-year-olds who could have benefited from Head Start in 1994 actually got spaces in the program.

The Yale Child Welfare Research Program. In the early 1970s Sally Provence of Yale University set up an experimental preschool program, even more comprehensive than Head Start, in New Haven. Her skilled team worked intensively with 17 very poor children beginning when the infants left the hospital and continuing until they were 30 months of age, providing a great deal of family support in the form of child development specialists, social workers, and pediatric care. All but one of the children (and that one had a learning disability) subsequently did well in school. In a follow-up study 17 years later, not one of the children had been in trouble with the law or presented a behavior problem at home or at school. The boys in the group, in particular, had much better school attendance records, and cooperated better with teachers, than comparable students in a control group.

The Family Development Research Program. Another successful experiment with very early childhood care was the federally funded Family Development Research Program in Syracuse. Between 1969 and 1975, this program offered comprehensive services to 80 low-income families with children between 6 and 60 months of age. A population of expectant mothers and mothers of newborns was carefully selected: The families all had very low income and had little education; many were single-mother families. By age five, children in the experimental program showed statistically meaningful gains in their cognitive functioning compared to 80 control children. A longitudinal study looked at the children again when they were 15. Girls in the program continued to function at higher cognitive levels. The boys in the group, however, did not. The program director surmised that peer pressure from their classmates had militated against boys continuing to do well in school.

The boys in the program did, however, retain one principal measurable difference: their functioning in society. While 22 percent of the nonprogram children who could be found at age 15 had been placed under supervision of the probation department, only 6 percent of the program children had been. The children not in the program ended up costing society more than 10 times as much as the children in the program: an average cost of $186 per child for court processing, probation charges, supervision, and detention for those in the program group compared to an estimated $1,985 per child in the control group.

Moreover the severity of the offenses committed by the control group far exceeded those committed by the program group. The offending program children were mainly described as "ungovernable" but had committed no serious offenses. The kids in the control group, on the other hand, were charged with burglary, assault, robbery, sexual abuse, and petty larceny-a clear warning of much higher costs to come from later prison sentences.

Enhancing the outcomes of low-birthweight, premature infants. Between 1987 and 1990 the Robert Wood Johnson Foundation funded major research to test the importance of nurturing babies born at low birthweights. Researchers at Stanford Medical School studied 985 children who had been born weighing less than five-and-a-half pounds. The results, published in the Journal of the American Medical Association, found that those children who received enhanced nurturing from biweekly home visits for the first year of life, and who during their second and third years attended a good preschool with just four children for every one teacher, had an average IQ of 98 at age three. The children who did not receive the home visiting and preschool experience had an average IQ of 85. A 13-point IQ differential can for many children be the difference between being retarded and being normal.

Ounce of Prevention Fund Programs. Private-public partnerships provide one model for early childhood development programs. Businesses realize that by investing in these programs, they are investing in the quality of the labor supply. I can speak from personal experience about one such partnership, the Ounce of Prevention Fund.

In 1982 I realized that if we could place a family support program near a factory site, a corporation's self-interest would warrant a substantial investment and might create a replicable model. The logical company to ask was Pittway Corporation, a manufacturer of First Alert smoke detectors in Aurora, Illinois, because I was then serving as its chairman. Aurora has a large pocket of poor families, many of whom worked at Pittway. The initial plan was for a three-year experiment with the idea of trying to influence other Aurora employers to become supporters. Greg Coler, director of Illinois's Department of Children and Family Services, agreed to commit $400,000 to the center if Pittway would match it. This private-public partnership became the Ounce of Prevention Fund.

In 1984 and again in 1987 the state substantially raised its investment in the fund so that today Illinois contributes $8 million annually. The private sector provides an additional $2 million each year. The federal government adds nearly $6 million to the fund through its contributions to Head Start and Early Head Start programs administered by the Ounce of Prevention Fund. The fund now runs 45 prevention programs. Fund sites generally offer home visiting, parent training, pregnancy prevention, support mechanisms to promote healthy family functioning and prevent child abuse and neglect, and infant and toddler care.

While it is difficult to assess precisely the effectiveness of this type of program, some results are clear. Immunization rates for six-month-olds increased from 40 percent to more than 95 percent. Second pregnancies to teenage mothers were reduced by 40 percent. And 85 percent of teenage mothers in the program remained in school or returned to school within a year compared to only 62 percent of teen mothers not in the program.

Clearly there are programs that can work, but there are no magic bullets. We must be realists: These programs are difficult and costly to implement. They will require many, many trained people. At the present time, there is an enormous shortage of well-trained public health nurses, social workers, and early childhood development specialists. Part of this shortage results from depressed salary scales in early education. We pay teachers in child care and preschool much less than we pay janitors. We need to encourage higher status-and higher pay-for early childhood educators.

INVESTING IN THE FUTURE

It is no secret that warm, loving parental care is the best policy for the child. The challenge is to help the parents who have trouble providing it. But the programs that can help are seriously underfunded. While we have doubled our expenditures on educating 5- to 25-year-olds over the last ten years, to $500 billion, we're spending only $4 billion on Head Start and 95 percent of that is on the years three, four, and five. Only $100 million gets spent on birth through three years, which is where our emphasis should be. Only $100 million out of $500 billion is spent on the period when the most significant development takes place-that's one-fifth of one-one-thousandth of what we spend on ages 5 through 25.

The French, by contrast, spent $7.12 billion in 1988 on publicly sponsored child care and education. A 1989 report of the French-American Foundation concludes, "If the United States were to commit equivalent public resources to child care and linked health services, this would total approximately $23 billion per year." If we believe that our children are as important to our future as the French do, then why do we spend only one-sixth of what they spend per child?

Let's appreciate where our educational problems-dropout rates, illiteracy, poor math scores, and delinquency-begin: not in elementary school, not in kindergarten, but in the cradle and before. It costs an average of $300,000 per person in prison and welfare expenses over the course of a lifetime when we fail to educate a child. Why aren't we spending the $10,000 per person it takes to prevent early failure in children at risk?