Social Determinants of Health: Full Day Kindergarten Programs

The CPSTF finding is based on evidence from a systematic review published in 2010 (Cooper et al., 55 studies, search period through 2009). The search for more recent evidence (search period through March 2011) did not identify additional studies about full-day kindergarten programs.

Studies of the long term effects of early childhood education also were reviewed to draw inferences about the possible long term effects of full-day kindergarten.

The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to promoting health equity.

Children in low-income families often experience delays in language and other development by the age of three. Compensating for these delays before children begin regular schooling can be critical to providing them with equal opportunities for lifelong employment, income, and health.

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement [PDF – 270 kB].

Short Term Effects

• Full-day kindergarten led to statistically significant effects among children.
  • Scores on standardized achievement tests or assigned grades improved by the end of kindergarten or the beginning of first grade (50 studies).
    • Compared with half-day kindergarten enrollees, math scores among full-day enrollees improved by 0.24 standard deviations, and verbal scores improved by 0.46 standard deviations.
  • Students showed an increased ability to work and play with others an indicator of social-emotional health (1 study).
• Early academic achievement is an established determinant of long-term academic and health-related outcomes; thus improvements in academic achievement among low-income and racial and ethnic minority children can be expected to improve their long-term health.

Long-Term Effects

• In the Cooper et al. review, studies that considered whether full-day kindergarten had lasting effects showed inconsistent results by the time children reached the end of third or fourth grade.
• A larger body of evidence that included systematic reviews of the long term effects of early childhood education showed longer-term benefits associated with pre kindergarten educational programs. Greater benefits were seen when children went on to attend high-quality primary schools as opposed to low-quality primary schools, emphasizing the importance of on-going school environments that support learning and development.

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement [PDF – 270 kB].

The economic review included six studies. One study addressed the costs and benefits of full-day kindergarten versus half-day kindergarten; five studies provided information about costs; one study provided information about a single economic benefit and not other potential benefits.

• The six identified studies did not give a clear picture about costs beyond the broad finding that full-day kindergarten is relatively more expensive than half-day kindergarten.
• Results from one study showed full-day kindergarten could be cost-beneficial if additional programs were undertaken to ensure maintenance of the short term academic gains. Researchers noted, however, that costs of additional programs not included in their estimates would have to be taken into account.
• One study indicated substantial economic benefits of full-day kindergarten associated with a reduction of the proportion of children retained in class and required to repeat a grade.

Based on populations and settings in the included studies, the finding should be applicable to all children in the United States living in urban and non-urban areas. Studies reported greater benefits, however, for minority and low-income populations.

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

• What are the long terms effects of full-day vs. half-day kindergarten? How do subsequent schooling and family and community environments affect long term outcomes?
• What are the differential effects of full-day kindergarten on low-income and minority children vs. higher income non-minority children?
• What is the cost-benefit ratio of full-day vs. half-day kindergarten?

• Included studies compared full-day kindergarten with either half-day kindergarten or alternating day full-day kindergarten. Several studies compared half-day kindergarten with alternating-day full-day kindergarten and found no clear difference.
• No randomized control studies were included in the review.
• Among studies reporting program location, 69% were in urban locations and 31% were in non urban locations.
• Programs were more likely to be offered in the southern region of the United States than in other regions.
• Full-day programs provide more instruction in math and reading as compared with half-day programs. Based on a national survey, students in full-day kindergarten were reported to receive 30-31% more instruction per day in math and reading than students in half-day (Walston & West, 2004).
• Information on race and ethnicity was recorded in the meta-analysis if the population was reported to be “homogeneous.” While criteria for this assessment were not given, if stringently applied, they may have excluded information in many studies.

Effectiveness Review

Analytic Framework

When starting an effectiveness review, the systematic review team develops an analytic framework. The analytic framework illustrates how the intervention approach is thought to affect public health. It guides the search for evidence and may be used to summarize the evidence collected. The analytic framework often includes intermediate outcomes, potential effect modifiers, potential harms, and potential additional benefits.

Effectiveness Review

Summary Evidence Table not available because the Task Force finding is based on a previously published systematic review (Cooper et al., 2010).

Economic Review

Summary Evidence Table – Economic Review

The Community Preventive Services Task Force recommendation for full-day kindergarten programs to improve the health prospects of low-income and minority children is based primarily on evidence from a systematic review of all available studies through October 2009 (Cooper et al. 2010, 55 studies). A search for more recent evidence (search period through March 2011) did not identify additional studies about full-day kindergarten programs.

The Task Force also considered the studies and reviews listed below on the long term effects of early childhood education to draw inferences about the possible long term effects of full-day kindergarten.

The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).

Effectiveness Review

Systematic Review of Effect of Full Day Kindergarten

Cooper H, Batts Allen A, Patall EA, Dent AL. Effects of full-day kindergarten on academic achievement and social development. Review of Educational Research 2010;80:34.

Studies on Long Term Effects of Early Childhood Education

Barnett WS. Effectiveness of early educational intervention. Science 2011;333(6045): 975 8.

Camilli G, Vargas S, Ryan S, Barnett WS. Meta-analysis of the effects of early education interventions on cognitive and social development. Teach Coll Rec 2010;112(3):579 620.

Campbell FA, Ramey CT, Pungello E, Sparling J, Miller-Johnson S. Early childhood education: young adult outcomes from the Abecedarian Project. Appl Dev Sci 2002;6(1):42 57. Currie J, Thomas D. School quality and the longer-term effects of Head Start. J Human Res 2000;35(4):755 74.

Currie J. Early childhood education programs. J Econ Perspect 2001;15(2):213 38.

Lee VE, Loeb S. Where do Head Start attendees end up? One reason why preschool effects fade out. Educ Eval Policy Anal 1995;17(1):62 82.

Loveless T, Farkas S, Dufett A. High achieving students in the era of NCLB. Washington (DC): Thomas B. Fordham Foundation & Institute; 2008.

Magnuson KA, Ruhm C, Waldfogel J. The persistence of preschool effects: Do subsequent classroom experiences matter? Early Child Res Q 2007;22:18 38.

Nores M, Barnett SB. Benefits of early childhood interventions across the world: (under) investing in the very young. Econ Educ Rev 2011;29(2):271 82.

Reynolds AJ. Effects of a preschool plus follow-on intervention for children at risk. Dev Psychol 1994;30(6):787 804.

Votruba-Drzal E, Li-Grinning C, Maldonado-Carre o C. A developmental perspective on full- versus part-day kindergarten and children’s academic trajectories through fifth grade. Child Dev 2008;79(4):957 78.

Economic Review

Aos S, Miller M, Mayfield J. Benefits and costs of K-12 educational policies: evidence-based effects of class size reductions and full-day kindergarten. Olympia (WA): Washington State Institute for Public Policy; 2007.

Brewster C, Railsback J. Full-day kindergarten: exploring an option for extended learning. Northwest Regional Educational Laboratory; 2002. Available at URL: educationnorthwest.org/webfm_send/467.

Cannon JS, Jacknowitz A, Painter G. Is full better than half? Examining the longitudinal effects of full-day kindergarten attendance. Journal of Policy Analysis and Management 2006;25:299-321.

DeCicca P. Does full-day kindergarten matter? Evidence from the first two years of schooling. Economics of Education Review 2007;26(1):67-82.

Lee VE, Burkham, DT, Ready D, Honigman J, Meisels SJ. Full-day vs. half-day kindergarten: in which program do children learn more? U.S. Department of Education, Office of Educational Research and Improvement (Award Reference Number R305T990362-000); 2005. Available at URL: School.elps.k12.mi.us/kindergarten-study/full-Half_U_of_M_study_V_Lee_et_al.pdf.

Stone RT. The Pennsylvania State University. Full-day kindergarten in Manheim Central School District: exploring early literacy growth and proficiency. Doctoral Thesis in Educational Administration; 2006.

Weiss ADG, Offenberg RM. Enhancing urban children’s early success in school: the power of full-day kindergarten. Paper presented at the Annual Meeting of the American Educational Research Association. New Orleans (LA); 2002 Apr.

Logic Model: Promoting Health Equity Through Education Programs and Policies [PDF – 61 kB]

The Task Force finding is based on evidence from a meta-analysis published in 2010 (Cooper et al., 55 studies, search period through 2009). Additionally, a research librarian searched for published studies (through March 2011) in the following databases: CINAHL; Dissertation Abstracts; EconLit; Embase; ERIC; Medline; NTIS (National Technical Information Service); PsycINFO; Social Services Abstracts; Sociological Abstracts; and Web of Science. No studies were identified that met review inclusion criteria.

Search Terms

disadvantaged or minority or minorities; poor or poverty or socioeconomic; blacks or (african american*) or hispanic*; or “at risk” or “high risk”; or fail or failure* or failed or failing; or remedial or truancy or truant; or iq or ability or abilities; or success or intervention* or readiness; or ready or achieve or achiever* or achievement*

and kindergarten

and “full day*” or “full-day*”; or “half day*” or “half-day*”

References

Cooper H, Batts Allen A, Patall EA, Dent AL. Effects of full-day kindergarten on academic achievement and social development. Review of Educational Research 2010;80:34

Cooper H, Batts Allen A, Patall EA, Dent AL. Effects of full-day kindergarten on academic achievement and social development. Review of Educational Research 2010;80:34.

Walston J, West J. Full-day and half-day kindergarten in the United States: findings from the Early Childhood Longitudinal Study, Kindergarten Class of 1998 99 (NCES 2004-078). U.S. Department of Education, National Center for Education Statistics, Institute of Education Sciences. Washington, DC: U.S. Government Printing Office, 2004.

The following considerations for implementation are drawn from studies included in the evidence review, the broader literature, and expert opinion.

• Training and retaining teachers is a critical challenge for programs as they develop and implement full-day kindergarten programs.
• Children whose academic performance has improved because of full-day kindergarten programs may receive less attention in elementary school if their teachers give more attention to classmates with achievement problems. To maintain the beneficial effects, full-day kindergarten programs must be followed with high-quality schooling.

Healthy People 2030

Healthy People 2030 includes the following objectives related to this CPSTF recommendation.

• Increase the proportion of children who participate in high-quality early childhood education programs — EMC‑D03