More than 676,000 children in the U.S. were abused and neglected in 2016 (U.S. Department of Health and Human Services [USDHHS], 2018). 74.8 percent of victims were neglected, 18.2 percent were physically abused, and 8.5 percent were sexually abused; nationally an estimated 1,750 children died of abuse and neglect (USDHHS, 2018). Child maltreatment in the United States is a public health problem, but there are programs that are designed to cope with the epidemic.
The Early Head Start (EHS) program is an evidenced-based program that was launched in 1995 as a comprehensive child development program to target low-income and other vulnerable children, prenatally through age three years, and their families across the United States (National Head Start Association, 2017). EHS serves over 110,000 children per year in over 1000 programs, making it one of the largest programs serving low-income infants and toddlers in the United States (Green et al., 2014). Given the many causes of child maltreatment and its high incidence among infants and toddlers, prevention programs that begin as early as possible to address child and family well-being in addition to parenting behaviors are especially promising (Green et al., 2014). The primary goal of the program is to support child development, while also supporting parent and family well-being (Chazan-Cohen et al., 2015). Head Start illustrates a promising approach in preventing child maltreatment in this vulnerable age group. Head Start has remained strong in the face of changing political and fiscal climates because it has continually improved the services it delivers to children and families and responded to the changing needs of local communities (National Head Start Association, 2017). Early Head Start has shown positive impacts on child development, parenting, and family well-being as well as an evidence-based home visiting program (Chazan-Cohen et al., 2015). Early Head Start programs uses home visiting, center-based child development, and family child care services through education and child development delivered to children primarily in a private home or family-like setting (USDHHS, 2017). This essay will thoroughly critique the practice of Early Head Start.
Target Population
Early Head Start program targets low-income pregnant women and families with children birth to age three years old. Eligibility for the program the families must be at or below the federal poverty level. Each EHS project site is allowed to customize the program to align with the communities needs under the guidance of the program's performance standards. EHS program aims to promote healthy outcomes for pregnant women, improve the development of children in the early life, and promote healthy functioning families (USDHHS, 2016).
Critique of Early Head Start
Home visitation has become one of the most popular approaches to preventing child maltreatment. In 2009, the U.S. Department of Health and Human Services initiated the Home Visiting Evidence of Effectiveness to review research on the efficacy of home visiting programs that serve families with pregnant women and children, EHS home visiting model met USDHHS criteria and was rated with strongly sustained outcomes for child development, positive parenting, and family self-sufficiency (Green et al., 2014). Many studies reveal the importance of Early Head Start as well how the program can be improved for future generations of children.
The Early Head Start Research and Evaluation (EHSRE) project was funded in three waves (birth to three phase, pre-kindergarten follow-up phase, and elementary school follow-up phase) from 1996-2010 which investigated program impacts on children and families through their time in the program, and local research projects. The findings from 17 extensively evaluated national programs indicated that those that completed the program performed significantly better in cognitive, language, and social development than the controls, as well as the parents improving the home environment and parenting behaviors (Golas et al., 2006). A national randomized trial found EHS to be effective in improving parent and child outcomes, but its effectiveness in reducing child maltreatment was not assessed. A longitudinal retrospective study examined the impact of EHS on child maltreatment from seven of the original 17 programs in the national EHS randomized controlled trial, indicating that children in EHS had significantly fewer child welfare encounters between the ages of five and nine years (adjusted OR = 0.64, p=0.04), than children in the control group (Green et al., 2014). This study showed the effectiveness in reducing child maltreatment among low-income children, in particular, physical and sexual abuse (Green et al.,2014). Data from the Fragile Families and Child Wellbeing Study (FFCWS) showed that compared to children who did not attend Head Start right prior to kindergarten, children who did attend Head Start are less likely to experience spanking by their parents at age five, (OR= 0.71, p < 0.01), suggesting their chance of being spanked is 29% less than that for nonparticipants (Zhai et al., 2013). However, a formative evaluation of both home visitation and center-based programs suggests that the delivery differs in content and intensity of services (Golas et al., 2006).
Duration, Cost, and Replication of the Program
The Early Head Start program has existed for decades and has continued because of the strength of data and the support from the community. EHS programs provide one home visit per week per family lasting for a minimum of 90 minutes each and a minimum of 2 group socialization activities per month for each family. The program begins in early childhood, from pregnancy through a child's third birthday (USDHHS, 2016). The program is free to all who are eligible. Early Head Start is federally funded and locally ran program reporting $9,574,923,948
FY17 estimated funding in the United States with 1,608 Head Start programs, 1,398 Early Head Start programs, and 57,083 classrooms operated (National Head Start Association, 2017).
Home visitation programs have been replicated because of the strength of evidence-based research. In 2009, it was estimated that over $500 million was spent on home visitation services for pregnant women and families with young children (Paulsell et al., 2014). In 2012, state and territorial departments of health were awarded more than $200 million in grants to implement home visitation programs (Paulsell et al., 2014). Home visitation programs are beneficial in the implementation of child maltreatment services.
If Mississippi used Early Head Start?
The State of Mississippi could efficiently use Early Head Start. The percent of children screened in, and the number of children with a disposition in Mississippi is 81.2% (22,706) (USDHHS, 2018). Using Table 1., from United States Census Bureau, 2016 Children
Characteristics (Factfinder.census.gov., 2016), Early Head Start in Mississippi would be beneficial to this target population. One-third of children are eligible as the children are under six years, and 31.5% of children live in households with below poverty status level. Also, 87.3% of the children are enrolled in public school, and Early Head Start will give them an opportunity to be more prepared in their educational endeavors. Mississippi is an excellent candidate for Early Head Start program.
Recommendation to President Obama Use of Program in Every State
Early Head Start is a staple program that should be in every State. President Obama proclaimed April as National Child Abuse Prevention Month; this shows the willingness he is to spread awareness of child maltreatment (Obama, 2016). He also reauthorized the Child Abuse Prevention and Treatment Act (CAPTA) to includes the Family Violence Prevention and Services Act (FVPSA) (Rosenthal, 2010). To increase his effort, Early Head Start has shown significant evidence that the program works to enhance children's cognitive ability while simultaneously decreasing the child's risk of child maltreatment. By combining Early Head Start with The Affordable Care Act will allow the organization to receive more money and reach more families that may be in need of this resource. President Obama would mostly enact a policy for Early Head Start in every state.