The relevance of delivery mode and other programme ...

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44 BLOK ET AL. / EFFECTIVENESS OF EARLY CHILDHOOD EDUCATIONTable 5Parameter estimates for the final model in two domainsCognitivedomain(n ¼ 71)Socioemotionaldevelopment(n ¼ 14)Parameters Coeff. SE Coeff. SEFixed effectsIntegrated effect sizeIntervention in control group (Var. 3)Dummy centre-based (Var. 12) aDummy combined home-/centre-based (Var. 12) aDummy home-based (Var. 12) aInclusion of coaching of parenting skills (Var. 17)Effect size at pretest (Var. 18)Time of measurement (Var. 21)Type of posttest score (Var. 22)Random effectsVariance between experimental comparisonsVariance between times of measurement–1.02*0.24*0.48*0.42*—0.69*0.63*–0.03*-0.22*0.220.070.090.08—0.110.190.010.070.08*———–0.05————0.03———0.04————0.010.010.010.010.000.000.000.00Test of homogeneity Q ¼ 166.80*, df ¼ 63 Q ¼ 76.64*, df ¼ 12— indicates parameter not specified. See Table 1 for the interpretation of the variables.a The variable delivery mode (Var. 12) was replaced by dummy variables.* Effects statistically different from zero (p 5 .05).kindergarten, and provision of social or economic support toparents—showed no relationship with outcome measures.Further, the longitudinal nature of the available outcomemeasures allowed us to estimate the fading of outcomes afterending of interventions. This effect amounted to 0.03 SD peryear. Finally, effect sizes were also moderated by three studydesign characteristics, namely whether or not the control grouphad followed a standard programme, the difference betweenthe experimental and the control group at pretesting, and theuse of gain scores rather than observed scores.The results of our meta-analysis confirm quantitatively theconclusions reached in narrative syntheses regarding theconsiderably stronger efficacy of centre-based programmes orcombined centre- and home-based programmes in thecognitive domain (Barnett, 1995; Bowerman et al., 2001;Farran, 2000; McGuire & Earls, 1991; Ramey & Ramey,1998). The results show that the outcomes of these programmesare about 0.5 SD larger than those of home-basedprogrammes. The overall effectiveness of early interventionprogrammes with an educational orientation appeared to benear zero in the socioemotional domain. The results of thisstudy do not confirm the particular importance of a combinedintervention for obtaining effects in this domain as well(Yoshikawa, 1994).Our analyses revealed no evidence of a unique contributionto programme outcomes of age of onset, duration, intensityand dose of the programme, or forms of parental and familysupport, with the exception of the provision of parenting skills.This seems to contradict conclusions resulting from previousnarrative syntheses (Barnett, 1995; Bryant & Maxwell, 1997;McGuire & Earls, 1991), and those presented in quantitativereviews (Leseman, Otter, Blok, & Deckers, 1998; Royce,Darlington, & Murray, 1983) and as theoretical considerations(Rutter, 2000). A possible explanation for this is that in theseother studies, which focused mostly on bivariate relationships,there may have been confounding between these programmecharacteristics and the delivery format. Recency of theprogramme, onset age, and programme duration appearednot to be significantly related to the delivery mode. However,centre-based and combined home- and centre-based programmeswere on average much more intensive, and thereforeprovided a clearly higher dose of intervention than home-basedprogrammes did. Correlations of a dummy variable denotingcentre-based and combined home- and centre-based programmesversus home-based programmes with intensityamounted to .76 (p 5 .001) and with dose to .47 (p 5.01). Therefore, the importance of programme intensity andprogramme dose may be masked, at least partly, by deliverymode.No effect of the continuation of the preschool interventioninto elementary school was found in addition to the effect ofbasic delivery strategy, which seems to contradict in particularthe rather robust findings of three major studies included in thepresent analysis, namely those concerning the CPC&EP, thepreschool plus K2 version of the Abecedarian project, and theextensions of the SFA programme into the lower grades. Froma theoretical perspective, enhancing continuity upon transitionsbetween the most important social contexts of the youngchild (i.e., home, preschool, and elementary school) seems veryimportant to optimise developmental and learning gains(Rimm-Kaufman & Pianta, 2000). Again, confounding withdelivery strategy may be a possible explanation for the lack ofsuch effect in the present meta-analysis. No home-basedprogramme in the present selection was continued afterkindergarten or transferred into the first grade of elementaryschool. This notwithstanding, however, it seems a distinctpossibility that the previously reported significance of continuingpreschool interventions into elementary school holds onlyfor the particular programmes for which this effect has beenfound.
INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT, 2005, 29 (1), 35–47 45In summary, centre-based and combined centre- and homebasedprogrammes were on average characterised by a higherintensity and thus a higher dose of the intervention than werehome-based programmes, and they also appeared to be moreoften continued into elementary school. These three featureswere related to programme efficacy in previous narrativereviews. As we could estimate models in which all predictorswere included, we found delivery mode to be the betterpredictor, leaving no room for unique contributions from otherprogramme characteristics, except the inclusion of parentingcoaching. Particularly important in the present results was theadditional strong effect of including the coaching of parentingand parenting skills, which was found to increase the effect sizein the cognitive domain by 0.7 SD.The studies reviewed did not provide detailed informationon how parenting coaching and parenting skill training affectedprogramme outcomes. Therefore some possible mechanismswill be briefly discussed here. Several studies have pointed tothe importance of an emotionally supportive home environmentfor cognitive gains from education in preschool andkindergarten (Pianta, Nimetz, & Bennett, 1997; van IJzendoorn,Sagi & Lambermon, 1992). What seems to be crucial isthe child’s trust in social relationships, which transfers from thehome to the centre or school. Parenting coaching in theincluded programmes may have improved emotional supportin the family and attachment to others (Van Tuijl & Leseman,2004). A different explanation is that programmes withparenting coaching have effectively counteracted the frequentlyreported problems with programme implementation in highriskgroups, varying from irregular attendance to the reluctanceof parents to participate in parental activities or to work withthe child at home (Farran, 2000). This may explain why thecoaching of parents to provide the support needed (e.g.,bringing children to the centre on time, well-rested, and wellnurtured;attending parent–teacher conferences) is associatedwith positive child outcomes.In contrast to the effect of parenting skills training, no sucheffect was found for the inclusion of a social, health, oreconomic family support component. Note, however, that thistype of parent and family support may yield important effectsin other outcome measures, such as the long-term preventionof child abuse and neglect (MacLeod & Nelson, 2000), and theprevention of health problems, emotional problems, andconduct disorders in adolescence (Olds et al., 1998; Olds &Kitzman, 1993). Although these outcomes may not be directlyrelevant to short-term cognitive or socioemotional goals, theymay modulate in particular the preservation of early effects upinto adulthood and their transformation into life-phaserelevantoutcomes, such as social adjustment, economicindependence, and positive health behaviour (Yoshikawa,1994).Programme effects do fade over time. Our results confirmprevious observations of this phenomenon and have resulted ina robust quantitative estimate. The mean linear decrease of theeffect size based on the nine studies that reported mediumlong-term and long-term follow-up results, covering all types ofprogrammes, was estimated at 0.03 SD per year, which is lessthan previously reported (Blok & Leseman, 1996; McKey etal., 1985). Based on this, it would take 10 years for animmediate programme effect of d ¼ 0.3 (the average effectfound in this study) to completely disappear. According toMcKey et al., who based their conclusions on Head Startevaluation studies conducted before 1982, this would be about2 years. Our selection included more studies with long-termfollow-up measurements than previous reviews did, even up to15 years after withdrawing the intervention (Olds et al., 1998).An important consideration is that the decrease in effect sizemay be nonlinear, with a stronger decrease in the first few yearsafter the intervention, but a less strong decrease in subsequentyears, as hypothesised by Ramey et al. (2000). Many morelong-term outcomes will be needed to test this hypothesis.Few studies in the present meta-analysis—focusing onprogrammes with an educational orientation—reported outcomesin the socio-emotional domain. This finding, which maybe related with our search and selection strategy, seems toreflect the predominant cognitive orientation of early childhoodintervention programmes, despite the growing recognitionof the strong interrelatedness of motivation, emotionallybased self-regulation, and cognitive learning in educationprogrammes (Barnett, Young, & Schweinhart, 1998; Boekaerts,1999). The selected studies that did include socioemotionaloutcome measures revealed a much smaller overalleffect size than was found for cognitive outcomes. However, nostrong negative effects were reported in the studies weinvestigated, in contradiction to the results of Haskins (1985)on early centre-based education programmes with a strongcognitive emphasis, and to the recent findings of the EarlyChildcare Network of the National Institute of Child Healthand Human Development (NICHD) regarding intensive,early-onset centre-based care (NICHD, 2002). Nonetheless,the observation that early intervention programmes with aneducational orientation do not seem to have an impact on thesocioemotional development is worrying, given the interrelatednessof motivational, emotional, and cognitive processes inpost-intervention school learning. The competition betweensocioemotional and cognitive-academic goals is also at theheart of the debate on developmentally appropriate versusdidactic practices in early childhood education (Marcon, 1999;Schweinhart & Weikart, 1997; Stipek, Feiler, Daniels, &Milburn, 1995).Our study does not indicate programme design characteristicsthat are related to socioemotional outcomes for earlyintervention programmes with an educational orientation. Thisleaves us with the question how future programmes of this typeshould be designed to achieve positive effects in the socioemotionaldomain. An interesting programme characteristic inthis respect may be the programmes’ pedagogical processes(e.g., child-centred versus teacher-directed, developmentalversus didactic curriculum). As noted earlier, the programmedesign characteristics explored here do not fully explain thevariation in effect sizes. The process characteristics alluded tohere are obvious candidates to explain the still unexplainedvariation in outcomes. Unfortunately, few studies providesufficient details about the daily processes and teacher–childinteractions to determine the impact of different pedagogicalmodels on cognitive and socioemotional outcomes.Finally, our results have two more or less clear implicationsregarding the format or delivery of future programmes. Thefindings provide a strong argument for the delivery ofprogrammes in a centre or a combined centre- and homebasedformat. Furthermore, the findings suggest to include aparenting skills component, although this probably will onlyaffect the cognitive development of children, but not theirsocioemotional abilities. It is difficult to formulate furtherimplications with regard to programme intensity and length,continuation after kindergarten, and the target age of children,
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