Preschool Home Visiting Boosts School Readiness and Reduces Need for Educational and Mental Health Services in Elementary School

Introduction

The Head Start REDI program used developmental theory and prior studies to identify research-based instructional strategies that enrich Head Start and boost children’s school readiness. An initial trial demonstrated positive effects for the REDI classroom program (REDI-C). A subsequent randomized trial examined the value of additional home visits in which parents were provided with learning materials that complemented the classroom program to use in their homes (REDI-P). Home visits started during the spring of the child’s prekindergarten year and extended over the transition into kindergarten. Initial post-intervention assessments showed positive benefits in areas of both academic performance and social-emotional adjustment in kindergarten.

This study examined the sustained effects of REDI-P on child and family competencies and on child need for school-based educational and mental health services four years later, when children were in third grade. It also tested the logic model of REDI-P, to determine whether intervention effects on child academic and social-emotional skill acquisition mediated longer-term reductions in child need for school services.

Methods

200 low-income families with prekindergarten children (55% White, 26% Black, 19% Latino; 56% male; M_age = 4.45 years) were recruited from 24 Head Start centers using the REDI-C program. Individual families were randomly assigned to receive the REDI-P home visiting program (intervention group) or an alternative attention-control condition consisting of mail-home math activities (control group). Follow-up assessments occurred in third grade. REDI-P visits followed a well-specified curriculum, with 10 home visits during preschool and 6 visits in kindergarten. Parents received coaching to enhance parent-child relationships and home learning materials designed to boost child competencies. Follow-up assessments included child testing, child self-reports, teacher ratings, and parent reports. Teachers recorded all services that children needed and received at school.

Results

Third grade outcomes revealed statistically significant effects on multiple measures in each competency domain, including tests of reading skill, teacher-rated academic performance, observed and child-reported social-emotional adjustment, and parent-reported reductions in parenting stress and child problems. In addition, REDI-P reduced child need for school services. Significant effect sizes were small to moderate, averaging about one third of a standard deviation (d =.29 to .38). Mediation models demonstrated that intervention effects on services were mediated by intervention effects on the targeted competencies. The results 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.