Consensus Study Report

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This activity was supported by contracts between the National Academy of Sciences and Administration for Children and Families (HHSP23320140002 0B/75P00120F37106), Bainum Family Foundation (6186), Bill and Melinda Gates Foundation (INV-001632), Brady Education Foundation (unnumbered), Foundation for Child Development (NAS 06-2020), Heising-Simons Foundation (2020-1415), and W.K. Kellogg Foundation (P0132304). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-69461-2
International Standard Book Number-10: 0-309-69461-2
Digital Object Identifier: https://doi.org/10.17226/26743
Library of Congress Control Number: 2023942496

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Closing the Opportunity Gap for Young Children. Washington, DC: The National Academies Press. https://doi.org/10.17226/26743.

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COMMITTEE ON EXPLORING THE OPPORTUNITY GAP FOR YOUNG CHILDREN FROM BIRTH TO AGE EIGHT

LARUE ALLEN (Chair), Vice Dean for Faculty Affairs, New York University, Steinhardt School of Culture, Education and Human Development

RANDALL AKEE, Associate Professor, University of California, Los Angeles

ALFREDO J. ARTILES, Lee L. Jacks Professor of Education, Stanford University

RENÉE BOYNTON-JARRETT, Associate Professor of Pediatrics, Boston Medical Center Vital Village Networks, Boston University School of Medicine

KENNETH A. DODGE, William McDougall Professor of Public Policy, Sanford School of Public Policy, Duke University

BRENDA JONES HARDEN, Ruth Ottman Professor of Child and Family Welfare, Columbia School of Social Work

PAMELA K. JOSHI, Senior Scientist and Associate Director, Institute for Children, Youth and Family Policy, The Heller School for Social Policy and Management, Brandeis University

SHANTEL E. MEEK, Professor of Practice and Founding Director, The Children’s Equity Project, Arizona State University

BELA MOTÉ, President and CEO, Carole Robertson Center for Learning

MILAGROS NORES, Codirector for Research, Associate Research Professor National Institute for Early Education Research, Rutgers The State University of New Jersey

CYNTHIA OSBORNE, Professor of Early Childhood Education and Policy, Executive Director, Prenatal-to-3 Policy Impact Center, Peabody College of Education and Human Development, Vanderbilt University

ALBERT WAT, Senior Policy Director, Alliance for Early Success

Study Staff

REBEKAH HUTTON, Study Director

PAMELLA ATAYI, Program Coordinator

IVORY DEAN, Program Officer (until October 2021)

SARAH PERUMATTAM, Research Assistant (from October 2021 until May 2022)

MEREDITH YOUNG, Associate Program Officer (from May 2022)

2020–2022 James C. Puffer, MD/American Board of Family Medicine Fellow

RITA HAMAD, Associate Professor in Residence, Director, Social Policies for Health Equity Research (SPHERE) Program, Department of Family & Community Medicine, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco

2020–2021 National Academy of Medicine Distinguished Nurse Scholar-in-Residence and Consultant to the Committee

ASHLEY DARCY-MAHONEY, Professor and Chair, George Washington University School of Nursing

BOARD ON CHILDREN, YOUTH, AND FAMILIES

JONATHAN TODRES (Chair), Georgia State University College of Law

RICHARD F. CATALANO, JR., University of Washington School of Social Work

TAMMY CHANG, University of Michigan

DIMITRI A. CHRISTAKIS, Seattle Children’s Research Institute, University of Washington

ANDREA GONZALEZ, McMaster University

NANCY E. HILL, Harvard University

CHARLES HOMER, Economic Mobility Pathways

MARGARET KUKLINSKI, University of Washington

MICHAEL C. LU, UC Berkeley School of Public Health

STEPHANIE J. MONROE, Wrenwood Group

STEPHEN RUSSELL, The University of Texas at Austin

NISHA SACHDEV, Premnas Partners, Washington, DC

JANE WALDFOGEL, Columbia University School of Social Work

JOANNA L. WILLIAMS, Rutgers University

Staff

NATACHA BLAIN, Senior Board Director

EMILY P. BACKES, Deputy Board Director

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Acknowledgments

This report would not have been possible without the contributions of many people. First, we thank the sponsors of this study without whom this work would not have been possible: the Administration for Children and Families at the Department of Health and Human Services, the Bainum Family Foundation, the Brady Education Foundation, the Foundation for Child Development, the Bill and Melinda Gates Foundation, the Heising-Simons Foundation, and the W.K. Kellogg Foundation.

The committee and project staff would also like to express their gratitude to the numerous experts and consultants who contributed to the development report. We would like to extend our deep gratitude to Ashley Darcy-Mahoney and Rita Hamad for their valuable insights, research and writing support, and contributions to the committee’s work. We thank Marianne Bitler and Seojung “Cate” Oh for their work on a commissioned paper for the committee on the economic costs of the opportunity gap. Thanks are also due to the numerous experts who volunteered significant time and effort to address the committee during our public information-gathering and listening sessions: Carolyn Barnes, Ajay Chaudry, Janet Currie, Lisa Gennetian, Pamela Herd, Rucker Johnson, Ariel Kalil, Kimberly Noble, Sean Reardon, and Hirokazu Yoshikawa. The insights and perspectives shared with the committee played an essential role in informing the committees discussions, deliberations, and recommendations. We thank Nancy McArdle of diversitydatakids.org for preparing the summary tables of the population of children ages 0–8. Finally, we thank Rona Briere for her editing of the report.

We would also like to thank the many staff members of the National Academies of Sciences, Engineering, and Medicine who provided invaluable support throughout this process: Natacha Blain for her oversight as director of the Board on Children, Youth, and Families; Anne Marie Houppert, Christopher Lao-Scott, and Rebecca Morgan for their research support and fact checking; Faye Hillman, Javed Khan, and Micah Winograd for their financial management assistance; Christopher King and Sandra McDermin for their insights and guidance; Doug Sprunger and Meredith Fender for their assistance with communications and dissemination of the report; Natalie Nielsen, Patricia Morison, Maryjo Oster, Bea Porter, Kirsten Sampson Snyder, and Amy Stephens for their guidance throughout the report review process; and Clair Woolley for her assistance with the final production of the report. We would like to extend gratitude to the members of the project staff who worked directly with the committee over the course of the project—Rebekah Hutton, Pamella Atayi, Ivory Dean, Sarah Perumattam, and Meredith Young—for their significant contributions to supporting the committee’s work.

Finally, the committee wishes to thank our chair, LaRue Allen, for her dedication to this work and the exceptional leadership and guidance that she has provided throughout this process.

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report, nor did they see the final draft before its release. The review of this report was overseen by CLAIRE D. BRINDIS, University of California, San Francisco, and ELAINE L. LARSON, Columbia University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

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Contents

Acronyms

Preface

Summary

1 Introduction

ABOUT THIS STUDY

STUDY APPROACH

THE REPORT CONCEPTUAL FRAMEWORK

UNDERSTANDING THE HISTORICAL AND STRUCTURAL DRIVERS OF THE OPPORTUNITY GAP

Historical Precedents in Education

Segregation as a Structural Driver of the Opportunity Gap

DEMOGRAPHIC AND STRUCTURAL CHANGES AFFECTING CHILDREN AND FAMILIES

The Changing Demography of Children from Birth to Age 8: Implications for the Opportunity Gap

Structural Changes in the Economy and Labor Markets

Poverty

Geography

ACCESS TO RESOURCES, SUPPORTS, AND OPPORTUNITIES

Administrative Burden

Implementation of Programs

OVERVIEW OF THE REPORT

REFERENCES

2 Opportunity Gaps in Early Care and Education Experienced by Children from Birth to Pre-K

WHY EARLY CARE AND EDUCATION MATTERS

CURRENT POLICY, FUNDING, AND SYSTEMS

ACCESS TO EARLY CARE AND EDUCATION SYSTEMS

Disparities in Access

Gaps in ECE Capacity

Cost as a Barrier to Access

Access to Early Intervention and Early Special Education for Children with Disabilities

Administrative Barriers to Access

DIFFERENTIAL EXPERIENCES IN LEARNING SETTINGS

THE IMPORTANCE OF STRUCTURAL QUALITY STANDARDS

Physical Infrastructure

Ratios and Class Sizes

Language of Instruction

Harsh and Exclusionary Discipline Policies

THE EARLY CARE AND EDUCATION WORKFORCE

Education and Professional Preparation

Compensation

Access to Professional Development and Supportive Working Conditions

Professional Beliefs and Practices

PROCESS AND INTERACTIONAL QUALITY

Pedagogy, Instruction, and Access to Enrichment

Strong Family Engagement

THE IMPACT OF COVID-19 ON CHILDREN’S OPPORTUNITY GAPS

CONCLUSIONS

REFERENCES

3 Opportunity Gaps in the Education Experienced by Children in Grades K–3

CURRENT POLICY, FUNDING, AND SYSTEMS FOR EARLY ELEMENTARY EDUCATION

Access to and Funding for Out-of-School Time

Special Education

Absenteeism

DIFFERENTIAL EXPERIENCES IN EARLY ELEMENTARY LEARNING SETTINGS

Physical Infrastructure

Ratios and Class Sizes

Language of Instruction

Harsh and Exclusionary Discipline Policies

THE EDUCATION WORKFORCE IN GRADES K–3

Supportive, Enriching, and Warm Teacher–Child Relationships and Interactions

Teacher Expectations and Perceptions of Behavior

Pedagogy, Instruction, and Access to Enrichment

THE IMPACT OF COVID-19

CONCLUSIONS

REFERENCES

4 Opportunity Gaps in the Physical Health and Health Care Experienced by Young Children and Their Parents

DRIVERS OF OPPORTUNITY GAPS IN HEALTH AND HEALTH OUTCOMES

Conditions Prior to Birth and Pregnancy

Maternal Access to Health Insurance

Maternal Access to Adequate Prenatal Care

The Medical Home and Developmental Screening

Poverty and Health Care

Racism and Culturally Responsive Care

Relational Health

Adultification

Antiracism and Dismantling Race-based Medicine

Nutrition

Food Insecurity for Households with Children

Safe and Healthy Environments

ADDRESSING OPPORTUNITY GAPS IN PHYSICAL HEALTH AND HEALTH CARE

Poverty Reduction

Access to Pediatric and Family Health Care

Antiracism and Dismantling of Race-based Medicine

Screening for Social Influences of Health

Alternative Models for Delivering Health Care

Safe and Violence-free Environments

CONCLUSIONS

REFERENCES

5 Opportunity Gaps in the Social-Emotional Development, Well-being, and Mental Health Experienced by Young Children

CONTEMPORARY CHILD DEVELOPMENT SCIENCE

HOW DISPARITIES IN CHILD OUTCOMES DEVELOP

Historical and Current Inequities in Families’ Access to Community Resources

Disparities and Opportunity Gaps in Mental Health in Early Childhood

Positive Socialization and Identify Formation

REDUCING OPPORTUNITY GAPS IN MENTAL HEALTH IN EARLY CHILDHOOD

Screening and Assessment Strategies to Reduce Opportunity Gaps

Parent Beliefs about Child Development, Behavior, and Use of Mental Health Services

Strengthening Families Work Supports to Reduce Opportunity Gaps

Home Visiting Strategies to Reduce Opportunity Gaps

Program Strategies to Reduce Opportunity Gaps in Early Childhood Mental Health

School Nursing to Reduce Opportunity Gaps in School

CONCLUSIONS

REFERENCES

6 The Economic Costs of the Opportunity Gap

THE OPPORTUNITY GAP: COST ESTIMATES

SHARE OF OPPORTUNITY GAPS AND THEIR COSTS THAT CAN BE AFFECTED BY POLICY

APPROACHES TO EVALUATING THE NET BENEFITS OF INVESTMENT IN MITIGATING THE OPPORTUNITY GAP

EVIDENCE FOR WHETHER IMPLEMENTATION MAKES SENSE: REPRESENTATIVE EXAMPLES OF EFFECTIVE POLICIES IN THREE ARENAS

Reducing the Opportunity Gap Due to Income Differences through Cash and Near-Cash Means-Tested Assistance

Reducing the Opportunity Gap Due to Inequitable Access to Health Care and Health Insurance through Medicaid

Reducing the Opportunity Gap Due to Unequal Access to Early Education through the Head Start Program

CONCLUSIONS

REFERENCES

7 Research, Policy, and Practice: Contexts and Efforts to Address Opportunity Gaps

INCOME AUGMENTATION PROGRAMS AND POLICIES

Minimum Wage

Earned Income Tax Credit

Paid Family and Medical Leave

PARENTS’ POOR JOB QUALITY AND OPPORTUNITY GAPS FOR CHILDREN

POLICY INTERVENTIONS AND PROGRAMS THAT ADDRESS PARENTS’ JOB QUALITY

Federal Labor Standards and Social Protection Policies

Social Protection Policies

State and Local Paid Family and Medical Leave and Scheduling Laws

Programs Designed to Supplement Low Wages and Limited Benefits and Promote Career Advancement

Employer Policies and Practices

ADDRESSING OPPORTUNITY GAPS AND OUTCOMES IN EDUCATION

Full Funding

Inclusive, Quality Standards

A Supported, Fairly Compensated, Competent Workforce

Data, Monitoring, and Accountability

ADDRESSING OPPORTUNITY GAPS AND OUTCOMES IN PHYSICAL HEALTH

Improving Maternal Health and Birth Outcomes

Medicaid

Nutrition Assistance Programs

Reduction of Environmental Contaminants

HUMAN-CENTERED DESIGN AND POLICY DEVELOPMENT

PUBLIC–PRIVATE PARTNERSHIPS

CONCLUSIONS

REFERENCES

8 Key Conclusions and Recommendations

KEY CONCLUSIONS

RECOMMENDATIONS

FINAL THOUGHTS

REFERENCES

Appendix A A Total Population of Children Ages 0–8 by Race/Ethnicity and Nativity, 2020

Appendix B Percentage of Children from Birth through Age 5 and Not Yet in Kindergarten Participating in Various Weekly Nonparental Care Arrangements, by Child and Family Characteristics, 2019

Appendix C Committee Member and Staff Biosketches

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Boxes, Figures, and Tables

BOXES

1-1 Statement of Task: Committee on Exploring the Opportunity Gap for Young Children from Birth to Age Eight

1-2 Relevant Reports of the National Academies of Sciences, Engineering, and Medicine

4-1 The Effect of Preterm Birth on Opportunity Gaps

4-2 Policy Lessons: Lead Exposure and Academic Performance

5-1 How the COVID-19 Pandemic Exacerbated the Opportunity Gap

FIGURES

1-1 A conceptual framework for understanding the opportunity gap

1-2 Changing racial/ethnic composition of the U.S. child population aged 0–18 (percent)

1-3 Racial/ethnic composition of children aged 0–8 in the United States, 2020 (thousands)

1-4 Racial/ethnic composition of children aged 0–8 by family immigration status, 2020 (thousands)

1-5 Racial/ethnic composition of children aged 0–8 by family immigrant status, 2020 (percent)

1-6 The Child Opportunity Index

2-1 Percent of children aged 3-4 enrolled in early care and education, 2020

2-2 Percentage of low-income children served by Head Start, by state

2-3 Percentage of U.S. 3- and 4-year-olds enrolled in state-funded preschool

2-4 Current enrollment in Head Start and state-funded preschool and the number of additional slots needed for universal pre-K

2-5 Weekly child care costs as a percentage of household (HH) income for low-income households that pay out of pocket, by race/ethnicity and nativity status

2-6 Percentage of states’ populations of 3- and 4-year-olds enrolled in state preschool programs by number of National Institute for Early Education Research (NIEER) quality benchmarks

3-1 Percentage of students aged 5–21 served under the Individuals with Disabilities Education Act (IDEA) Part B within racial/ethnic groups, by educational environment, fall 2019

4-1 Leading causes of death among children and adolescents in the United States, 1999–2020

7-1 Hypothesized pathways between parents’ job quality and children’s health and development

7-2 Share of full-time working families with jobs without adequate family-supporting wages or benefits by race/ethnicity and foreign-born status

TABLES

1-1 Historical Precents in Education in the United States across Systems and Settings for Children from Birth through Age 8

2-1 Comparison of Child Care, Head Start, and State Pre-K Programs and Programs Covered by the Individuals with Disabilities Education Act (IDEA) Part C and Part B Section 619

2-2 Median Hourly Wages (in dollars) of Center-Based Teachers and Caregivers by Age of Children Served and Sponsorship and Funding of Center-Based Program or Employment

3-1 Risk Ratios for Students with Disabilities Ages 5–21 (served by Individuals with Disabilities Education Act [IDEA], Part B) by Racial/Ethnic Group and Disability Category, Fall 2019

3-2 Odds Ratios for Special Education Identification by Grade Level and Student Group

3-3 Behaviors Associated with Learning Disabilities and Second Language Acquisition

3-4 Racial Disparities for Students with Disabilities (SWD) in Days of Lost Instruction per 100 Students Due to Disciplinary Removal: Top 10 States (including the District of Columbia)

4-1 Misrepresentation of Race in Preclinical Curricula

4-2 Food Insecurity by Selected Household Characteristics

5-1 Racial and Ethnic Differences in Diagnosis Rates for Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD)

5-2 Outcomes of Interest for Home Visiting Programs at the Primary Prevention Level

5-3 Outcomes of Interest for Secondary-Level Home Visiting Programs

A-A Total Population of Children Ages 0–8, by Race/Ethnicity and Nativity, 2020

A-B Percentage of Children from Birth through Age 5 and Not Yet in Kindergarten Participating in Various Weekly Nonparental Care Arrangements, by Child and Family Characteristics, 2019

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Acronyms

Preface

The committee that produced this report was tasked with authoring a consensus report focused on identifying and describing causes, costs, and effects of the opportunity gap in children. We define the opportunity gap as the unequal and inequitable distribution of resources and experiences on the basis of race, ethnicity, socioeconomic status, English proficiency, disability, immigration status, community wealth, familial situations, geography, or other factors that contribute to or perpetuate inequities in wellbeing across groups of young children in outcomes including health, social and emotional development, and education.

Our statement of task specifies that the committee focus on children from birth to age 8 and make recommendations on how to improve conditions and promote success for children—at home, in communities, and in schools. Our work began with addressing the relationship between the opportunity gap and the persistent achievement gaps that disadvantage children from marginalized groups. In our view, opportunity gaps fuel achievement gaps as a result of various missed opportunities. Thus we reviewed evidence and consulted experts on family, school, economic, and community factors that promote, mitigate, or diminish opportunities for achievement. Reviewing and synthesizing this literature also made it clear that it would be naïve to approach fulfilling our task of recommending ways to improve outcomes and promote child success without focusing beyond academic achievement to encompass two other important developmental outcomes that greatly influence a child’s ability to profit from available opportunities—physical health, and social and emotional well-being.

Complementing our scientific review of the opportunity gaps in these three major areas of development, we were tasked with summarizing the economic justification for addressing the opportunity gap—both the costs of the existing failures and the potential economic benefits of addressing them. Our review of evidence on promising federal and state policy interventions and practices that have addressed the opportunity gap is intended to move us forward in closing the gap through interventions based on practices and policies that have already shown some promise. Finally, while every sector of our society has a role to play in addressing the opportunity gap, the committee was also asked to pay particular attention to identifying the potential roles and actions appropriate for our sponsors from philanthropy in supporting federal, state, and local governments in working to address the opportunity gap.

In taking on the commitment to address a complex statement of task, the committee was aware of the many existing bodies of evidence documenting the ways in which disparities in early life opportunities have an impact on children’s development. In fact, the National Academies of Sciences, Engineering, and Medicine have played a significant role in providing expert analysis of the need for better distribution of existing resources for young children in areas as diverse as health, access to quality early education, and the opportunity to participate in summertime programs that help children maintain and build on the gains of the prior school year. What was needed, in our opinion, was a broader lens on the problems with the persistent achievement gap among children. In addition to examining opportunity gaps that children face in unequally resourced academic settings (from preschool to second grade), we showed the gaps in resources that make children less able to benefit from their academic setting. Thus, as suggested above, our approach to addressing the committee’s statement of task includes documenting the interconnection of education, physical health, and social and emotional development to a child’s readiness to benefit from available educational opportunities.

Any chance of creating equity for all young children depends on understanding how activities in support of children’s development, whether at the family and community levels, or at the levels of local, state, and federal government, are often misaligned and sometimes even in conflict. Though entities at each level may be committed to promoting positive outcomes for children, we perceived the need to document how historical practices of less favorable treatment of children with differing social class, immigration, racial, ethnic, linguistic, and ability backgrounds reinforce the existing opportunity gaps and undermine efforts to eliminate them.

Our task, then, was to (1) summarize the evidence that has shown the many negative effects on children of being on the wrong side of the opportunity gap; (2) highlight actions for change that have been recommended

by several expert groups, including more than a half dozen National Academies panels; and (3) develop a coherent picture of the many conflicting, underimplemented, or inequitably implemented policies at the federal and state levels. All of this was intended to make the case that, more than creating new tools to close this pernicious gap, we as a nation need to mobilize what we already have and know, or what we could know if we compared notes and collaborated across policy and practice silos. We recognize that creating momentum for a shared national commitment to closing the opportunity gap will not happen overnight, so our recommendations include actions that can be addressed in the shorter term along with recommendations that will require changes at the state and federal levels—changes that may take longer to put in place.

On behalf of the committee, I would like to thank our sponsors from the world of philanthropy and government for requesting the creation of this important synthesis of research, practices, and policies aimed at creating a forceful and systematic attack on the gaps in access to resources that leave so many children behind. We could not have done this work without the incredible skill and diligence of the National Academies staff, led by Rebekah Hutton. I am deeply grateful to them all for their support—past, present, and future. My fellow committee members and I formed what I know, from chairing two earlier National Academies committees, to be an unusually strong bond and unwavering commitment to fully addressing our statement of task. Colleagues were unstinting in sharing their talents, resources, views, and time to achieve our shared goals on this very important project. My warmest regards and thanks to each and every one of you. As large as is the accomplishment we feel upon completing this report, we know that we have much work ahead of us to disseminate our recommendations to a wide range of audiences, including our sponsors who, in their wisdom, tasked the committee with identifying roles they could play in closing the gap.

LaRue Allen, Chair
Committee on Exploring the Opportunity Gap for Young Children from Birth to Age Eight

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