1). Body of Research on Current Head Start Program Insufficient to Draw Conclusions About Impact

The body of research on current Head Start is insufficient to draw conclusions about the impact of the national program. Drawing such conclusions from a body of research would require either (1) a sufficient number of reasonably well-designed individual studies whose findings could appropriately be combined to provide information about the impact of the national program or (2) at least one large-scale evaluation using a nationally representative sample. In addition, no single study used a nationally representative sample, permitting findings to be generalized to the national program. Most of these studies targeted cognitive outcomes, leaving other outcome areas, such as health and nutrition, scarcely examined. In addition, all the studies suffered to some extent from methodological problems that weakened our confidence in the findings of the individual studies. Research Planned by HHS Focuses on Program Improvement, Not Impact

Head Start’s planned research will provide little information about the impact of regular Head Start programs because it focuses on descriptive studies; studies of program variations, involving new and innovative service delivery strategies and demonstration projects; and studies of program quality. HHS also funds studies designed to answer questions about the effectiveness of new or innovative service delivery strategies and demonstrations and how effectiveness may relate to characteristics of the population served. HHS Believes Effectiveness of Head Start Is Already Proven, So Further Impact Research Is Not Warranted

HHS maintains that early research has proven the effectiveness of early childhood education, including Head Start, so impact research is not the most effective use of limited research funds. HHS officials mentioned difficulties with both types of designs in studying Head Start’s impact. Our report states that HHS’ planned research focuses on program improvement, and we agree that such studies are needed. Methodology

To report on what existing research says about Head Start’s impact, we identified studies meeting our basic selection criteria as outlined in the “Literature Review” section of this appendix. The Effectiveness of Family Health Care in Head Start: The Role of Parental Involvement

Author: Barbara A. Facchini Outcome area studied: Health Overview of study: Relationship of the amount of parental involvement in the Head Start program to the amount of health care received by both Head Start-age children and their siblings Design: Post-test only, comparison group selected from waiting list Population: West Haven, Connecticut, Head Start program Sample: 40 Head Start children and 20 waiting-list children for comparison group Head Start program year(s): 1980-81 Measures/instrumentation: Immunizations, physical examinations, health screenings, and dental examinations Findings: Immunizations were up to date for about one-half of both the Head Start children and the waiting-list children before the beginning of the Head Start programs. Comments From the Department of Health and Human Services

Acknowledgments

Many researchers and early childhood experts provided valuable assistance and information used in producing this report. 7, 1994).
Why GAO Did This Study

Pursuant to a congressional request, GAO reviewed the impact of the current Head Start Program, focusing on what: (1) the studies conducted on current Head Start programs suggest about Head Start's impact; and (2) types of Head Start studies are planned by the Department of Health and Human Services (HHS).

What GAO Found

GAO noted that: (1) although an extensive body of literature exists on Head Start, only a small part of this literature is program impact research; (2) this body of research is inadequate for use in drawing conclusions about the impact of the national program in any area in which Head Start provides services such as school readiness or health-related services; (3) not only is the total number of studies small, but most of the studies focus on cognitive outcomes, leaving such areas as nutrition and health-related outcomes almost completely unevaluated; (4) individually, the studies suffer to some extent from methodological and design weaknesses, such as noncomparability of comparison groups, which call into question the usefulness of their individual findings; (5) in addition, no single study used a nationally representative sample so that findings could be generalized to the national program; (6) failing to find impact information in existing research, GAO examined HHS' research plans for Head Start; (7) planned research will focus on new or innovative service delivery strategies and demonstrations but will provide little information on the impact of regular Head Start programs; (8) HHS' planned research includes descriptive studies, studies of program variations, involving new and innovative service delivery strategies and demonstration projects, and studies of program quality; (9) HHS officials, in explaining the agency's research emphasis, stated that early research has proven Head Start's impact; (10) such research, however, conducted over 20 years ago, may no longer apply to today's program because of program changes and changes in the population served; (11) HHS also noted some ethical and methodological difficulties of conducting impact research, especially studies that would produce national estimates of program effect; (12) neither ethical nor methodological issues present an insurmountable deterrent to conducting research on Head Start's impact; and (13) moreover, the size and cost of the program appear to warrant an investment in such research.