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Importance: Home visiting programs targeting the school readiness of preschool children (age range, 4-5 years) show promise in short-term and quasi-experimental studies but rarely are evaluated with rigorous designs and follow-up assessments., Objectives: To examine the sustained effects of a preschool home visiting program on child and family competencies and on child need for services 4 years later., Design, Setting, and Participants: In a randomized clinical trial, individual families with preschool children were assigned to receive the Research-Based and Developmentally Informed-Parent home visiting program (REDI-P) (intervention group) or math home learning games in the mail (control group). Follow-up assessments occurred in third grade. Families were recruited from 24 Head Start centers in 3 Pennsylvania counties serving rural and urban areas. Four-year-old children from 200 low-income families participated. Families were recruited in fall 2008 and fall 2009. The follow-up data used were collected in spring 2013 and spring 2014. The analyses were conducted in 2016 to 2017., Interventions: REDI-P visits followed a well-specified curriculum, with 10 home visits during preschool and 6 booster visits in kindergarten. Parents received coaching to enhance parent-child relationships and home learning materials to support child development and school readiness., Main Outcomes and Measures: Intervention focused on boosting competencies in academic performance and social-emotional adjustment and reducing child problems at home. Direct assessments, teacher ratings, and parent reports were collected. In addition, third-grade teachers recorded all services that children needed and received at school., Results: Two hundred participating children (110 [55.0%] white, 52 [26.0%] black, and 38 [19.0%] Latino; 112 [56.0%] male) had a mean (SD) age of 4.45 (0.29) years at the start of intervention. Third-grade outcomes were available for 153 (76.5%) of the initial sample and revealed statistically significant effects on multiple measures in each competency domain. In addition, REDI-P reduced child need for educational and mental health services at school. Significant effect sizes were small to moderate, averaging approximately one-third of 1 SD (Cohen d = 0.27 to 0.45). Mediation models demonstrated that intervention effects on services were accounted for by intervention effects on the targeted competencies., Conclusions and Relevance: REDI-P produced sustained benefits evident 4 years after intervention, significantly reducing child need for school services. The results of this study appear to validate the value of preschool home visiting as a strategy to help close the gap in school readiness and child well-being associated with poverty.

Background: Growing up in poverty undermines healthy development, producing disparities in the cognitive and social-emotional skills that support early learning and mental health. Preschool and home-visiting interventions for low-income children have the potential to build early cognitive and social-emotional skills, reducing the disparities in school readiness that perpetuate the cycle of poverty. However, longitudinal research suggests that the gains low-income children make during preschool interventions often fade at school entry and disappear by early elementary school., Methods: In an effort to improve the benefits for low-income children, the REDI program enriched Head Start preschool classrooms (study one) and home visits (study two) with evidence-based programming, documenting positive intervention effects in two randomized trials. In this study, REDI participants were followed longitudinally, to evaluate the sustained impact of the classroom and home-visiting enrichments 3 years later, when children were in second grade. The combined sample included 556 children (55% European American, 25% African American, 19% Latino; 49% male): 288 children received the classroom intervention, 105 children received the classroom intervention plus the home-visiting intervention, and 173 children received usual practice Head Start., Results: The classroom intervention led to sustained benefits in social-emotional skills, improving second grade classroom participation, student-teacher relationships, social competence, and peer relations. The coordinated home-visiting intervention produced additional benefits in child mental health (perceived social competence and peer relations) and cognitive skills (reading skills, academic performance). Significant effects ranged from 25% to 48% of a standard deviation, representing important effects of small to moderate magnitude relative to usual practice Head Start., Conclusions: Preschool classroom and home-visiting programs for low-income children can be improved with the use of evidence-based programming, reducing disparities and promoting complementary benefits that sustain in elementary school., Competing Interests: The authors have declared that they have no competing or potential conflicts of interest in relation to this work., (© 2016 Association for Child and Adolescent Mental Health.)

Objective: This study assessed the sustained effects of Head Start REDI (Research-based, Developmentally Informed), a randomized controlled preschool preventive intervention, on children's developmental trajectories of social-emotional functioning into elementary school., Method: Twenty-five Head Start centers with 44 classrooms were randomly assigned to deliver Head Start REDI or Head Start as usual. Head Start REDI featured an integrated language-emergent literacy and social-emotional skills curriculum and enhanced support for positive teaching practices. The 356 4-year-old children (54% girls; 25% African American; 17% Latino; 70% living in poverty) in those centers and classrooms were followed for 5 years (from preschool through third grade; 91% retention rate). Each year, teachers rated multiple domains of social-emotional functioning. Person-oriented latent class growth models were used to identify the different developmental trajectories of social-emotional functioning that children followed., Results: Tests of proportions revealed that children who had been in the Head Start REDI intervention were statistically significantly more likely than children in the control condition to follow the most optimal developmental trajectories of social competence, aggressive-oppositional behavior, learning engagement, attention problems, student-teacher closeness, and peer rejection (odds ratio = 1.60-1.93)., Conclusions: These findings suggest that enriching Head Start with evidence-based curriculum components and teaching practices can have long-lasting benefits for children's social-emotional functioning. These findings elucidate how high-quality preschool experiences promote core competencies that are critical to the school success of children living in poverty., ((c) 2016 APA, all rights reserved).)

Head Start enhances school readiness during preschool, but effects diminish after children transition into kindergarten. Designed to promote sustained gains, the Research-based Developmentally Informed (REDI) Parent program (REDI-P) provided home visits before and after the kindergarten transition, giving parents evidence-based learning games, interactive stories, and guided pretend play to use with their children. To evaluate impact, two hundred 4-year-old children in Head Start REDI classrooms were randomly assigned to REDI-P or a comparison condition (mail-home math games). Beyond the effects of the classroom program, REDI-P promoted significant improvements in child literacy skills, academic performance, self-directed learning, and social competence, demonstrating the utility of the approach in promoting gains in cognitive and social-emotional skills evident after the transition into kindergarten., (© 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.)