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
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
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
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
Harsh and Exclusionary Discipline Policies
THE EARLY CARE AND EDUCATION WORKFORCE
Education and Professional Preparation
Access to Professional Development and Supportive Working Conditions
Professional Beliefs and Practices
PROCESS AND INTERACTIONAL QUALITY
Pedagogy, Instruction, and Access to Enrichment
THE IMPACT OF COVID-19 ON CHILDREN’S OPPORTUNITY GAPS
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
DIFFERENTIAL EXPERIENCES IN EARLY ELEMENTARY LEARNING SETTINGS
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
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
Racism and Culturally Responsive Care
Antiracism and Dismantling Race-based Medicine
Food Insecurity for Households with Children
ADDRESSING OPPORTUNITY GAPS IN PHYSICAL HEALTH AND HEALTH CARE
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
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
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
Reducing the Opportunity Gap Due to Unequal Access to Early Education through the Head Start Program
7 Research, Policy, and Practice: Contexts and Efforts to Address Opportunity Gaps
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
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
A Supported, Fairly Compensated, Competent Workforce
Data, Monitoring, and Accountability
ADDRESSING OPPORTUNITY GAPS AND OUTCOMES IN PHYSICAL HEALTH
Improving Maternal Health and Birth Outcomes
Reduction of Environmental Contaminants
HUMAN-CENTERED DESIGN AND POLICY DEVELOPMENT
8 Key Conclusions and Recommendations
Appendix A A Total Population of Children Ages 0–8 by Race/Ethnicity and Nativity, 2020
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Boxes, Figures, and Tables
BOXES
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
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
TABLES
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
4-1 Misrepresentation of Race in Preclinical Curricula
4-2 Food Insecurity by Selected Household Characteristics
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
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Acronyms
AAP | American Academy of Pediatrics |
ABC | Attachment and Biobehavioral Catch-up |
ACE | adverse childhood experience |
ACOG | American College of Obstetricians and Gynecologists |
ADHD | attention-deficit/hyperactivity disorder |
AFDC | Aid to Families with Dependent Children |
AI/AN | American Indian/Alaska Native |
AIM | Alliance for Innovation on Maternal Health |
AMA | American Medical Association |
APHA | American Public Health Association |
ASD | autism spectrum disorder |
BIE | Bureau of Indian Education |
BLL | blood lead level |
BPA | bisphenol A |
CCAP | Child Care Assistance Program |
CCDBG | Child Care and Development Block Grant |
CCDF | Child Care and Development Fund |
CDA | child development associate |
CDC | Centers for Disease Control and Prevention |
CEP | Community Eligibility Provision |
CHIP | Children’s Health Insurance Program |
CLASS | Classroom Assessment Scoring System |
CMS | Centers for Medicare & Medicaid Services |
COI | Child Opportunity Index |
CPC | Chicago Child–Parent Center |
CPP | Child Parent Psychotherapy |
CPS | Current Population Survey |
CPSC | Consumer Product Safety Commission |
CRC | United Nations Convention on the Rights of the Child |
CRDC | Civil Rights Data Collection |
CTC | child tax credit |
DB | Developmental and Behavioral |
DOL | Department of Labor |
EBT | electronic benefit transfer |
ECE | early care and education |
ECERS-R | Early Childhood Environmental Rating Scale-Revised |
ECPP-NHES | Early Childhood Program Participation Survey of the National Household Education Surveys Program |
EITC | earned income tax credit |
ELA | English Language Arts |
EPA | Environmental Protection Agency |
ESSA | Elementary and Secondary Education Act |
ESSA | Every Student Succeeds Act |
FLSA | Fair Labor Standards Act |
FMLA | Family and Medical Leave Act |
FPL | federal poverty level |
FWO | Fair Workweek Ordinance |
GAO | Government Accountability Office |
GDP | gross domestic product |
HCD | human-centered design |
HHS | Department of Health and Human Services |
HMD | Health and Medicine Division |
HomVEE | Home Visiting Evaluation and Effectiveness |
HSIS | Head Start Impact Study |
HSPPS | Head Start Program Performance Standards |
IDEA | Individuals with Disabilities Education Act |
IECMHC | Infant and Early Childhood Mental Health Consultation |
IES | Institute of Education Sciences |
IOM | Institute of Medicine |
IRS | Internal Revenue Service |
L1 | first language |
L2 | second language |
LAUNCH | Linking Actions for Unmet Needs in Children’s Health |
MIECHV | Maternal, Infant, and Early Childhood Home Visiting |
MIHOPE | Maternal Infant Home Visiting Program Evaluation |
MMRC | Maternal Mortality Review Committee |
MMWR | Morbidity and Mortality Weekly Report |
MVPF | marginal value of public funds |
NAEP | National Assessment of Educational Progress |
NAEYC | National Association for the Education of Young Children |
NASEM | National Academies of Sciences, Engineering, and Medicine |
NCHS | National Center for Health Statistics |
NCSER | National Center for Special Education Research |
NFP | Nurse-Family Partnership |
NHANES | National Health and Nutrition Examination Survey |
NHVY | National Home Visiting Yearbook |
NICHD | Eunice Kennedy Shriver National Institute of Child Health and Human Development |
NIEER | National Institute for Early Education Research |
NIH | National Institutes of Health |
NRC | National Research Council |
NSECE | National Survey of Early Care and Education |
NSF | National Science Foundation |
NSLP | National School Lunch Program |
OECD | Organisation for Economic Co-operation and Development |
OMB | Office of Management and Budget |
OST | out-of-school time |
PCE | positive child experience |
PEELS | Pre-Elementary Education Longitudinal Study |
PPP | public–private partnership |
pre-K | prekindergarten |
PQC | Perinatal Quality Collaborative |
PTFCEH | President’s Task Force on Children’s Environmental Health |
QALY | quality-adjusted life year |
QRIS | quality rating and improvement systems |
RCT | randomized controlled trial |
SAMHSA | Substance Abuse and Mental Health Services Administration |
SBP | School Breakfast Program |
SES | socioeconomic status |
SNAP | Supplemental Nutrition Assistance Program |
SSI | Supplemental Security Income |
STEM | science, technology, engineering, and mathematics |
SWD | students with disabilities |
TANF | Temporary Assistance for Needy Families |
TN-VPK | Tennessee Voluntary Pre-Kindergarten |
UI | unemployment insurance |
UNICEF | United Nations International Children’s Emergency Fund |
USDA | U.S. Department of Agriculture |
VBAC | vaginal birth after cesarean |
VSL | value of a statistical life |
VSLY | value of a statistical life year |
WIC | Special Supplemental Nutrition Program for Women, Infants, and Children |
WONDER | Wide-ranging Online Data for Epidemiologic Research |
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