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Home visitation has emerged as a key strategy for promoting child and family well-being in the current policy context. This article examines the effectiveness of the Early Head Start (EHS) home-based program for children and families at the end of the program and 2 years later, with a particular focus on the role of program implementation in the impacts of the EHS home-based program on child and family outcomes. There was a pattern of broad, modest effects of EHS home visiting for both children and parents, which were strengthened if the programs were fully implemented according to federal guidelines. In particular, impacts for children in the cognitive and language domain were documented. Implications of these findings for policy and practice are discussed.

One planned consequence of the national Infant Mental Health Forum held in the United States in 2000 was the funding of five research projects conducted in Early Head Start (EHS) programs. Each project strengthened existing programs by integrating infant/toddler mental health approaches and testing the outcomes on infant/toddler development, behavior, and parent-child interactions. In two of the projects, the effect of offering enrichment for EHS staff was tested. The other three projects tested the effect of services offered directly to parents and children. This article describes the five projects and the theories, methods, and outcome measures used. In order to understand more fully the elevated risk factors in these families and the consequences for mental health in their infants and toddlers, a common set of measures was developed. Data have been used to explore the common threats to mental health and the factors that moderate the impact on infants and toddlers.

The Early Head Start Research and Evaluation Project, a random-assignment evaluation, found a broad pattern of positive impacts for children and families. However, there were no program impacts on depression or use of mental health services by the time children reached age 3, at the end of the Early Head Start (EHS) program. This paper presents recent findings from the follow-up study in the spring prior to the children entering kindergarten, when a positive program impact emerged for reducing maternal depression. Results show that earlier program impacts on children and parents (when children were 2 and 3 years of age) mediated, or led to, the delayed impact on maternal depression. The combination of the most promising child factors accounted for over 57% of the later impact on depression, while the most promising parent factors accounted for over 35% of the later impact on depression. Implications for EHS programs are discussed.

The Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) fills a critical need for an easy-to-administer and easy-to-score measure of parenting that requires minimal training to administer. Despite wide agreement about the importance of parenting, few programs assess parenting behaviors; rather, there is a focus on child outcomes in curriculum planning, program improvement efforts, and accountability activities. In large part, this is due to the very few observational assessments of adult–child interactions that can be used without major investments of time and resources. Given the adage “what gets measured is treasured,” this leaves parenting out of many policy and practice discussions. The new PICCOLO measure has the potential to add to the growing arsenal that early childhood programs have to assess the children and families whom they serve. The measure can help programs to assess parenting strengths, plan effective interventions, and monitor the effectiveness of those interventions. The developers of the measure are to be applauded for their thoughtful approach to creating the items in the measure and to their careful examination of the measure's psychometric qualities. La media PICCOLO tiene la posibilidad de contribuir al creciente arsenal que los programas de la temprana ninez tienen para evaluar los ninos y las familias a quienes les sirven. La medida puede ayudar a los programas a evaluar los aspectos fuertes de la crianza, a planear intervenciones efectivas, y a vigilar la efectividad de tales intervenciones. Debemos aplaudir a quienes disenaron la medida PICCOLO por su sensato acercamiento para crear los aspectos enumerados en la medida y por su cuidadosa examinacion de las cualidades sicometricas de la medida. Le PICCOLO peut tout a fait s’ajouter a l’arsenal dont disposent les programmes de petite enfance afin d’evaluer les enfants et les familles qu’ils servent. Cette mesure peut aider les programmes a evaluer les forces parentagles, a plannifier des interventions efficaces et a controler l’efficacicte de ces interventions. Les concepteurs de cette mesure doivent etre felicites pour la maniere attentionnee dont ils ont cree les elements de la mesure et pour leur examen minutieux des qualites psychometriques de la mesure. Die PICCOLO hat das Potenzial, dem wachsenden Wissensarsenal die Erkenntnis hinzuzufugen, dass Programme fur die fruhe Kindheit bei den Kindern und Familien ansetzen mussen, fur die sie vorgesehen sind. Das Verfahren kann Programmen helfen Erziehungsstarken zu erfassen, wirksame Interventionen zu planen und die Wirksamkeit derartiger Masnahmen zu beobachten. Die Entwickler des Verfahrens mussen fur ihren durchdachten Ansatz zur Schaffung von Items im Verfahren und fur ihre sorgfaltige Prufung der psychometrischen Qualitaten des Verfahrens gelobt werden. 抄録：PICCOLOは、早期子どもプログラムが援助する子どもと家族を、彼らが評価しなければならないという増大する備蓄に付け加える可能性を持っている。評価法によって、プログラムが育児の強さを評価し、効果的な介入を計画し、そしてそれらの介入の有効性を監視するのを助けられる。評価法の開発者は、測定法の項目を創りだすための思慮深いアプローチと、評価法の心理測定法的性質の注意深い検証に、拍手を送られるべきである。

Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on children's development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained. These studies, conducted in three national contexts, with different regulatory climates, ranges of child care quality, and a diversity of family characteristics, suggest a need for more complete estimates of how both quality and quantity of child care may influence a range of young children's developmental outcomes.

The federal Early Head Start (EHS) program began in 1995, and a randomized trial was conducted to evaluate the efficacy of 17 EHS programs. In all, 3,001 low-income families (35% African American, 24% Hispanic, and 37% White) with a pregnant women or an infant under the age of 12 months were randomly assigned to a treatment or control group (with 91% of the treatment group receiving some services). Data were collected when the children were about 1, 2, and 3 years of age, and at age 5 (2 years after leaving EHS). Research questions examined (1) impacts of EHS at ages 2 and 3 (when services were being offered) and at age 5, and (2) contributions of early education experiences across children's first 5 years of life. Child outcomes included cognition, language, attention, behavior problems, and health; maternal outcomes included parenting, mental health, and employment. Overall impact analyses at ages 2 and 3 indicated that EHS benefited children and families: impacts were seen in all domains, with effect sizes of significant impacts ranging from .10 to .20. At age 5, EHS children had better attention and approaches toward learning as well as fewer behavior problems than the control group, although they did not differ on early school achievement. Subgroup analyses indicated that cognitive impacts were sustained 2 years after the program ended for African American children and language impacts for Hispanic children who spoke Spanish. Some significant family benefits were seen at age 5. Mediated analyses identified which child and family impacts at ages 2 and 3 contributed to the child impacts at age 5 (most relevant were earlier treatment effects on child cognition and on engagement with the parent). Growth curve analyses were also conducted. Although fewer than half the children enrolled in center-based preschool programs between ages 3 and 4, almost 90% participated in the year preceding kindergarten. A higher percentage of EHS than control children were enrolled. Nonexperimental analyses suggested that formal program participation enhanced children's readiness for school while also increasing parent-reported aggression. At age 5, those children and families who experienced EHS followed by formal programs fared best overall. However, the benefits of the two experiences were associated with outcomes in different ways. Benefits in language, behavior, and parenting were associated primarily with EHS; benefits in early school achievement were associated primarily with preschool attendance.