Program

Oct 16, 2012

OVERVIEW

The Comprehensive Child Development Program (CCDP) aimed to enhancing child development and ensuring the delivery of early and comprehensive services to low-income families. Funded by the Administration on Children, Youth, and Families, CCDP delivered case management and early childhood education by building on programs already in existence in most communities. An evaluation study of CCDP showed that the program did not produce any important positive impacts on participating families compared with control families, although there were improvements in the lives of both CCDP and control families over time.

DESCRIPTION OF PROGRAM

Target population: Families that include a pregnant mother or child under the age of one and have an income below the Federal Poverty guidelines.

The Comprehensive Child Development Program (CCDP) was funded from 1990 to 1996 by the Administration on Children, Youth and Families and involved giving grants to universities, hospitals, public and private non-profit organizations, and school districts for CCDP Projects. It aimed to enhance child development and ensure the delivery of early and comprehensive services to low-income families.Two key services were delivered to families: case management and early childhood education. Families enrolled in the program were assigned a case manager who worked with the family to assess goals and services needed, develop a plan of action, refer proper services, and provide counseling and support to family members. CCDP also delivered early childhood education for children from birth to five years. Education was either center-based or provided through home visitation. Home visits were used to deliver both the case management and early childhood education components, with visits occurring about twice monthly and last 30 to 90 minutes, depending on the families’ needs. A childhood coordinator selected and developed a home-visiting curriculum for each family, which focused on educating parents and parenting skills.

EVALUATION(S) OF PROGRAM

Study 1

St. Pierre, R. G., Layzer, J. I., Goodson, B. D., & Bernstein, L. S. (1997). National impact evaluation of the Comprehensive Child Development Program: Final report. Cambridge, MA: Abt Associates Inc.

Evaluated Population: An impact study of CCDP was funded in the spring of 1990 using families recruited for CCDP projects. The study included 21 of the original 24 programs (N=4,410 families). The evaluation included 4,410 families, with 2,213 families assigned to CCDP and 2,197 assigned to the control group.A little over two-thirds of the sample were minority: 43 percent were African American, 26 percent were Mexican, Central, or Latin American, 26 percent were European American and four percent identified themselves as some other race/ethnicity. Most spoke English as their primary language, 84 percent. Thirty-five percent of mothers were under 18 when they first gave birth. Half of the mothers did not have a high school degree or equivalent. Forty-four percent of households had a total income under $5,000, and 85 percent had a total income under $10,000.

Approach: Twenty one sites recruited families into the CCDP program and randomly assigned families to either the experimental/CCDP condition or the control condition. Several sites had a third group included in randomization, a replacement group. If a family dropped out of the program, one of the replacement families was used; however, these families were not included in the analyses.

Measures on children were collected once a year, at 24 months of the child’s age, 36 months, 48 months, and 60 months. Data were collected on cognitive development and social and emotional development. For cognitive development, three measures were used: one to assess developmental delay, one to assess nonverbal intellectual ability, and a third to assess vocabulary ability. Social and emotional development was measured with an adaptive behavior scale, a behavior checklist, and a developmental checklist.

Parent-report measures were collected when the child was 18, 24, 30, 36, 48, and 60 months old, on outcomes related to physical health/growth, birth and prenatal risk factors, and economic self-sufficiency. Physical health was measured using a parent-report of an index of questions. Birth outcomes of children born after the focal child included prematurity, birth weight, and use of special care at the hospital. Prenatal risk factors for the mother included number of subsequent births, use of prenatal care, problems with pregnancy, and pregnancy risks (cigarettes, alcohol, and illegal drugs). Economic self-sufficiency of both the mother and father were assessed by family household income, mother’s weekly wages, mother’s reliance on federal benefits, mother and father employment status, and education level and participation of the mother and father.

For almost every measure, there is a level of performance score and a rate of growth score. The former represents the difference between the rates, scores, or amounts that the experimental and control group differ at measurements, while the rate of growth tells whether the experimental group changed more than the control group over the intervention.

Results: The program had significant positive impacts on parent/family outcomes but not child outcomes. Four parent/family outcomes significantly improved: rate of growth of total household income, rate of growth of family receipt of food stamps, and belief in the value of corporal punishment. A significant impact was also found for the rate of growth of mother’s enrollment in academic, vocational, or job training programs, with CCDP mothers’ enrollment dropping more steeply than that of control group mothers.

All other measures were nonsignificant. Specifically, mothers income, wages, and employment, family reliance on AFDC and foodstamps, and mother’s educational attainment had no significant impacts, outcomes related to mother expectations and values related to the child, and maternal health (e.g. use of cigarettes, drugs, and alcohol).

All child outcomes were nonsignificant: the vocabulary test, the nonverbal intelligence test, the behavior checklist, the developmental checklist, preventive medical care, preventive dental care, child death, percent of children with low birth weight, percent of children born prematurely, percent of children receiving any care in the special care nursery at the hospital, and number of nights in the special care nursery.

Study 2

St. Pierre, R. G., Layzer, J., Goodson, B. D., & Bernstein, L. S. (1999). The effectiveness of comprehensive, case management
interventions: Evidence from the national evaluation of the Comprehensive Child Development Program. American Journal of Evaluation, 20(1), 15-34.

Evaluated population: Same sample as Study 1.

Approach: See Study 1 for randomization procedures. Data collection began in the fall of 1991 and occurred annually over a five-year period and was primarily done in the home.The researchers collected data by interviewing mothers and testing children each year for several years. Teams of researchers included an On-Site Researcher and a Child Tester. Child assessment measures included the Kaufman-ABC and the Peabody Picture Vocabulary Test. Mothers were asked to complete a maternal interview. Cross sectional analyses were used to research the impact of CCDP on family income and child’s cognitive achievement at the end of the study.

Results: A review of program impacts and cost found that CCDP did not produce positive impacts on participating families. Specifically, the CCDP did not show significant impacts on the economic self-sufficiency of participating mothers or on their parenting skills. Furthermore, the program did not show significant impacts on the cognitive and social-emotional development of participating children.

Researchers concluded several possibilities as to why CCDP produced disappointing findings. They do not think the program was poorly defined or poorly implemented. However, some sites lacked adequate time to start the program effectively. The services could have not been of sufficiently high quality or were too diluted to be effective. Also, many families in the control group received similar services.

Sub-group analyses were also used to examine differences between program and control families in patterns of change over time. No positive impacts were found by gender or for subgroups, such as teen mothers or single parents. Moreover, non-experimental analyses did not find better outcomes for those who participated longer.

Study 3

St. Pierre, R. G., & Layzer, J. I. (1999). Using home visits for multiple purposes: The Comprehensive Child Development Program. The Future of Children, 9(1), 134-151.

Evaluated Population: Same sample as Study 1.

Approach: See Study 1 for randomization procedures. Measures were recorded when the child was three, four, and five years old, except measures of the home environment (four years old only) and the parent-child interaction (three years old only). Data were collected on employment, income, dependence on public assistance, steps to employment, adult-adolescent parenting, measurement of the home environment, and parent-child interaction.

Employment-specific measures included mothers’ employment since the last interview, mothers’ or husbands’/partners’ employment since the last interview, number of hours per week worked since last interview (for working mothers), percentage of time mother was employed during the course of the study, and percentage of time mother or husband/partner was employed during the course of the study. Income measures included total household income since the last interview and mother’s weekly wage since the last interview were collected (for working mothers only). Dependence on public assistance consisted of whether families were on Aid for Families with Dependent Children (AFDC) since the last interview, whether families were on AFDC continuously over the life of the study, and whether families received food stamps since the last interview. For steps to employment, three pieces of data were collected: mothers’ enrollment in academic, vocational, or job training programs since the last interview; whether mothers had a high school diploma, vocational certificate, or GED since the last interview; and whether mothers had some college since the last interview. The adult-adolescent parenting attitudes and beliefs measure records any inappropriate expectations of the child, lack of empathy for the child’s needs, belief in corporal punishment, and role reversal ability. The home environment measurement captures the following characteristics in the child’s home: stimulation through toys, games, and reading materials; language stimulation; safe physical environment; pride, affection, and warmth; stimulation of learning behaviors; modeling and encouragement of social skills; and physical punishment.

Results: This program did not have significant impacts on any outcome for any subgroup examined: teenage mothers versus older mothers; mothers with high school diplomas at baseline versus not; mothers living with partners versus not; male versus female children; and depressed versus non-depressed mothers.

SOURCES FOR MORE INFORMATION

References

St. Pierre, R. G., & Layzer, J. I. (1999). Using home visits for multiple purposes: The Comprehensive Child Development Program. The Future of Children, 9(1), 134-151.

St. Pierre, R. G., Layzer, J. I., Goodson, B. D., & Bernstein, L. S. (1997). National impact evaluation of the Comprehensive Child Development Program: Final report. Cambridge, MA: Abt Associates Inc.

St. Pierre, R. G., Layzer, J., Goodson, B. D., & Bernstein, L. S. (1999). The effectiveness of comprehensive, case management interventions: Evidence from the national evaluation of the Comprehensive Child Development Program. American Journal of Evaluation, 20(1), 15-34.

Website:
http://www.acf.hhs.gov/programs/opre/hs/comp_develop/

KEYWORDS: Infants (0-12 months), Toddlers (12-36 months), Children (3-11), Home Visitation, Early Childhood Education, Adolescent Mothers, African American or Black, Hispanic or Latino, White or Caucasian, Case Management, Parent Training/Education, Parent of Family Component, Other Education, Other Social/Emotional Health, Other Behavioral Problems, Other Physical Health, Employment Earnings, Public Assistance.

Program information last updated 10/16/12

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