University of Michigan
Department of Pediatrics
Evidence-Based Pediatrics Web Site

Question

• A 2 1/2 year old male presents for visit, mom is interested in preschool programs. How can we help? What preschool programs are most beneficial and proven to have long term effects?

Clinical Bottom Lines

1. Head Start programs should be strongly encouraged. Early intervention is imperative to help long term academic and cognitive effects in children in poverty.
2. Head Start is a comprehensive preschool education program free to children born into poverty and also for those identified as 'high risk'.
3. According to this cost benefits analysis, Head Start not only offers benefits to participants and family, but also has been shown to be a prosperous investment to society as a whole.

Summary of Key Evidence

1. Eight categories provide a comprehensive assessment of short and long term costs.
2. This study demonstrated a reduction in costs of public schooling, by decreasing the need for special education classes and the number of years of schooling.
3. The participants enrolled in Head Start are more likely to matriculate in higher education settings.
4. Head Start reduced juvenile delinquency and crime.
5. The preschool program was also estimated to reduce the present value of welfare payments and Medicaid expenses.

Additional Comments

• Although this study demonstrates improving quality of life for children born in poverty and the economic benefits to society, it fails to include potential benefits on health and family issues.

Citation

1. Barnett SW. Benefit-cost analysis of preschool education: Findings from a 25 year follow-up. American Journal of Orthopsychiatry, 1993; 63(4):500-508.
2. Barnett SW. Long-term cognitive and academic effects of early childhood education on children in poverty. Preventive Medicine, 1998; 27:204-207.

CAT Author: Dana Gillespie, MD

CAT Appraisers: Robert Schumacher, MD

Date appraised: May 22, 2000