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![Page 1: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/1.jpg)
Children’s Right to Thrive
Invest in Children
10th Annual MeetingNovember 20, 2009
Craig T. Ramey, Ph.D.
Sharon Landesman Ramey, Ph.D.Directors and Professors,
Georgetown University Center on Health and Education
![Page 2: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/2.jpg)
It is the totality of a child’s
experience that lays the
foundation for a lifetime of
greater or lesser competency.Ramey & Ramey, 2000
![Page 3: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/3.jpg)
Consequences of very low resource environments on children’s school entry
skills and later performance
• Delays of 1 to 2.5 years in overall academic and intellectual competence
• Marked reduction in vocabulary as well as expressive and receptive language skills
• Fewer skills in interacting with “teachers” and peers in a learning environment
• Lack of supportive learning at home and in summer further increases “the gap” over the first 4 years in school
![Page 4: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/4.jpg)
Key Research Question for Abecedarian (ABC) Project
Can the cumulative developmental toll experienced by high-risk childrenbe prevented or reduced significantlyby providing systematic, high-quality, early childhood education frombirth through kindergarten entry?
![Page 5: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/5.jpg)
Control Group _• Adequate nutrition• Supportive social services• Low-cost or free primary
health care
Abecedarian Preschool Program
Treatment Group _• Adequate nutrition• Supportive social services• Free primary health care• Preschool treatment:
Intensive (full day, 5 days/week,50 weeks/year, 5 years)
“Learningames” CurriculumCognitive / Fine MotorSocial / SelfMotorLanguageIndividualized pace
Campbell & Ramey, 1995American Educational Research Journal
![Page 6: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/6.jpg)
Pre-K Educational Treatment prevents decline in children’s low-IQ classification (% with IQs <85)
Martin, Ramey, & Ramey, 1990American Journal of Public Health
![Page 7: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/7.jpg)
Estimated Influences on IQ
Regression Coefficients (95% CI)
Age in MonthsEducational Preschool
Maternal IQ<70Positive Home Enviornment
12 + 7.9 1.0 + 4.9
24 + 12.7 - 4.3 + 5.1
36 + 18.6 - 8.2 + 8.6
48 + 13.2 - 11.7 + 8.9
Adapted from Martin, Ramey, & Ramey, American Journal of Public Health, 1996
![Page 8: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/8.jpg)
Reading achievement scores are significantly higher for ABC children at 8, 12, 15, & 21yrs
Campbell & Ramey, 2001 Developmental Psychology
![Page 9: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/9.jpg)
ABC educational program reduced grade repetition and special education placement
Ramey & Ramey, 1999 MR/DD Research Review
![Page 10: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/10.jpg)
Key Findings from Abecedarian Project(“Abecedarian” …one who learnsthe basics such as the alphabet)
18 Months to 30 Years Old• Intelligence (IQ)• Reading and math skills• Academic locus-of-control• Social Competence• Years in school,
including college• Employment outcomes
• Grade Repetition• Special Education
placement• Teen Pregnancies• Smoking and drug
use• Teen depression
Plus benefits to mothers of these children (education, employment)
Ramey et al, 2000; Campbell et al, 2009
![Page 11: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/11.jpg)
Project CARE
RCT designed to be a replication of
Abecedarian Project (ABC)
with an additional home visit group
to help mothers use the
ABC educational curriculum (6 wks– 5 yrs)
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Abecedarian Project
Age in Months (assessment type)3(MDI) 6(MDI) 12(MDI) 18(MDI) 24(S-B) 36(S-B)
60
70
80
90
100
110
120
130Early Intervention
Follow-up
Ramey & Ramey, Preventive Medicine, 1998
![Page 13: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/13.jpg)
Project CARE
Age in Months (assessment type)6(MDI) 12(MDI) 18(MDI) 24(S-B) 36(S-B)
60
70
80
90
100
110
120
130Early Intervention
Follow-up
Ramey & Ramey Preventive Medicine, 1998
![Page 14: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/14.jpg)
Adapted from Wasik, Ramey, Bryant, & Sparling. Child Development, 1990
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Infant Health and Development Program (IHDP)
•Designed to test the efficacy of ABC intervention
for children who were < 37 weeks
gestation and < 2500 gm at birth•Conducted at 8 sites•Intervention modified for biological risk factors•Intervention lasted only until 36 mos. CA
![Page 16: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/16.jpg)
Infant Health and Development Program
(2001-2500 grams)
![Page 17: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/17.jpg)
Children’s IQ at 36 months: Maternal Education X Treatment Group
70
75
80
85
90
95
100
105
110
Some HighSchool
High SchoolGraduate
Some College CollegeGraduate
Control
Intervention
(n=232)(n=162) (n=166)(n=104) (n=134)(n=63) (n=76)(n=48)
Infant Health and Development Program
Ramey & Ramey (1998), Preventive Medicine
![Page 18: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/18.jpg)
Outcomes Affected Positively (*p<.01) by the Infant Health & Development Program
12 Months 24 Months 36 Months
Cognitive Development NS + +
Adaptive and Prosocial Behavior - - +
Behavior Problems - + +
Vocabulary - + +
Receptive Language - + +
Reasoning - - +
Home Environment NS - +
Maternal Interactive Behavior - - +
Maternal Problem Solving - - +
Ramey 1999, adapted from Gross, Spiker, & Haynes, 1997, Helping Low Birth Weight, Premature Babies
![Page 19: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/19.jpg)
Did IHDP benefits last?
• Follow-up through age 18 showed significant benefits, particularly for children from low-resource families
• The dosage of the early intervention predicted magnitude of benefits, even after multiple adjustments for correlated variables
![Page 20: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/20.jpg)
Differential response to early educational intervention
The children who benefited the most had: mothers with IQs below 70 mothers with low levels of education poor birth outcome indicators
(PI, Apgar, LBW) teen mothers
(Martin, Ramey, and Ramey, American Journal of Public Health, 1990; Ramey & Ramey, 2000)
![Page 21: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/21.jpg)
Recent findings from Maryland and Louisiana Pre-K initiatives
• Strong visionary leadership and commitment to pre-K as a means of improving student achievement and “closing the gap” for children of poverty
• Willingness to conduct research that will provide timely information to inform changes in the classroom practices and policy
• The programs differ in ways that provide insights about benefits of full-day vs half-day pre-K and differential risk
![Page 22: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/22.jpg)
Similarities in MD and LA Pre-K programs
• Implemented by public schools
• Certified early childhood teachers (full benefits, comparable salaries to other teachers)
• Classroom sizes of no more than 20
• Adult to child ratio of no more than 1 to 10
• Specified pre-K curriculum in resource-rich classrooms and high standards
• Ongoing professional development
• Strong focus on language and early literacy
![Page 23: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/23.jpg)
Differences in MD and LA Pre-K
• MCPS Pre-K classrooms are half-day while LA classrooms are full-day
• Children in LA4 start at slightly lower levels than do children in MCPS
• MCPS classrooms serve more diverse children in terms of nationality and language backgrounds
• LA4 is not limited to “at risk” students, while MCPS currently is
• LA4 implemented longitudinal data collection from the beginning, for all children and for all classrooms, linked to later school progress
![Page 24: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/24.jpg)
LA4 Study Design: Population-based, Cohort Sequential, Case/Control
Longitudinal Study
• Pilot year (Jan – May 2002) n=1358• Cohort 1 (2002-2003) n=3711• Cohort 2 (2003-2004) n=4767• Cohort 3 (2004-2005) n=4665• Cohort 4 (2005-2006) n=7998• Cohort 5 (2006-2007) n>10,000Note: LA legislature committed $82 million for
2007-2008 school year
![Page 25: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/25.jpg)
DSC: Language National Percentile Ranks
31
14
50
10
50
10
50
10
50
10
0
10
20
30
40
50
60
Pre Post Pre Post Pre Post Pre Post Pre Post
Per
cen
tile
PilotHalf-Year (n=1358)
Cohort 1 Full Year (n=3711)
Cohort 2 Full Year (n=4767)
Cohort 3 Full Year (n=4665)
Cohort 4 Full Year (n=7898)
![Page 26: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/26.jpg)
DSC: Print National Percentile Ranks
40
17
59
11
59
11
59
11
59
11
0
10
20
30
40
50
60
70
Pre Post Pre Post Pre Post Pre Post Pre Post
Per
cen
tile
PilotHalf-Year (n=1358)
Cohort 1 Full Year (n=3711)
Cohort 2 Full Year (n=4767)
Cohort 3 Full Year (n=4665)
Cohort 4 Full Year (n=7898)
![Page 27: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/27.jpg)
DSC: Math National Percentile Ranks
30
11
46
5
46
5
52
5
52
5
0
10
20
30
40
50
60
Pre Post Pre Post Pre Post Pre Post Pre Post
Per
cen
tile
PilotHalf-Year (n=1358)
Cohort 1 Full Year (n=3711)
Cohort 2 Full Year (n=4767)
Cohort 3 Full Year (n=4665)
Cohort 4 Full Year (n=7898)
![Page 28: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/28.jpg)
Louisiana Kindergarten Retention Rates (2003-04 Cohort)
7.4%
12.5%*
7.0%
8.0%*
0%
2%
4%
6%
8%
10%
12%
14%
Free and Reduced Meals* Non-Free and Reduced Meals
No Public Pre-K orHead StartLA 4
n = 22,105 n = 2,886 n = 13,257 n = 555
* p <.001
![Page 29: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/29.jpg)
11.8%*
6.6%7.5%*
5.0%
0%
2%
4%
6%
8%
10%
12%
14%
Free and Reduced Meals* Non-Free and Reduced Meals
No Public Pre-K orHead StartLA 4
Louisiana Kindergarten Retention Rates (2004-05 Cohort)
n = 17,416 n = 3,132 n = 11,785 n = 666
* p <0.001
![Page 30: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/30.jpg)
10.5%*
14.5%**
7.0%*
8.6%**
0%
2%
4%
6%
8%
10%
12%
14%
16%
Free and Reduced Meals** Non-Free and Reduced Meals*
No Public Pre-K orHead StartLA 4
Louisiana Special Education Placement Rates (2003-04 Cohort)
n =23,523 n=2,994 n =14,841 n=698
* p <.01
** p <.001
![Page 31: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/31.jpg)
9.3%*
14.1%**
5.8%*
9.0%**
0%
2%
4%
6%
8%
10%
12%
14%
16%
Free and Reduced Meals** Non-Free and Reduced Meals*
No Public Pre-K orHead StartLA 4
Louisiana Special Education Placement Rates (2004-05 Cohort)
n =21,421 n=3,835 n =14,201 n=912
* p <.01
** p <.001
![Page 32: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/32.jpg)
10
50
31
14
30
0
10
20
30
40
50
60
Pre Post
Nat
iona
l Per
cent
ile R
ank
LA4 Full-Year Full-Day Pre-KLA4 Half-Year Full-Day Pre-KMCPS Full-Year Half-Day Pre-K
A Comparison of Children’s Academic Progressin Pre-K Programs that differ in dosage
![Page 33: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/33.jpg)
Why Some Well-Intended Early Childhood Programs Have Failed to Benefit Children
• Adult caregivers and teachers not well prepared
or supported in their everyday work • Dosage of early intervention and pre-K is too low• Inadequate instruction to promote cognitive, language,
early literacy, and early math skills • Ineffective communication with and engagement of
parents and other key service providers • Instruction is too harsh, rigid, or punitive
![Page 34: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/34.jpg)
The future for our nation’s children
• Positive health and education outcomes can be achieved for all children – during pre-K years and beyond
• Benefits include much more than “academics”
• Language and reading success are key, because they influence all learning and social adjustment
• Strategic investments yield substantial social and fiscal benefits to society
![Page 35: Children’s Right to Thrive Invest in Children 10 th Annual Meeting November 20, 2009 Craig T. Ramey, Ph.D. Sharon Landesman Ramey, Ph.D. Directors and.](https://reader030.fdocuments.in/reader030/viewer/2022032702/56649cdb5503460f949a5636/html5/thumbnails/35.jpg)
For copies of this powerpoint presentation:
• Contact Drs. Craig and Sharon Ramey
• Georgetown University Center on Health and Education
• 202-687-2874