Pre-K Can Make You Healthier and More Talkative

| Fri Mar. 28, 2014 11:27 AM EDT

I'm a fan of pre-K and early childhood interventions in general. For the most part, this isn't because these programs boost IQ or increase academic performance. They may do a bit of that, but the evidence so far suggests that direct academic effects are modest. Rather, the benefits are mostly indirect: fewer behavioral problems; less teenage drug use; better impulse control; lower arrest rates; and so forth. Today, Aaron Carroll suggests yet another benefit: these programs produce healthier adults. That's the conclusion of a long-term follow-up in the Carolina Abecedarian Project (ABC):

Males who were randomized to the ABC program had significantly lower blood pressure (systolic 143 vs 126). That’s a massive difference. They had significantly lower levels of hypertension. They had lower levels of metabolic syndrome and lower Framingham risk scores. To get a sense of the magnitude of the difference, one in 4 males in the control group had metabolic syndrome; none in the ABC group did. Women also had improvements, although not as dramatic.

Males in the intervention group were significantly more likely to have health insurance at age 30, and to have bought it. They were more likely to get care when they were sick at age 30, too. They were at lower risk for overweight throughout their childhood. Women in the intervention group were less likely to start drinking alcohol before age 17. They were more likely to be active and to eat more healthily.

The cost of this program was about $16,000 per child in 2010 dollars.

This isn't a smoking gun. The sample size is small and the program was run a long time ago. But as Carroll says, that's inevitable in long-term longitudinal studies: "Anytime you do a follow-up of 30+ years, by definition the intervention will be old by the time you get results. There's no other way to do it. It's such a silly attack."

Along similar lines, Bob Somerby lavishes rare praise on a New York Times report by Motoko Rich about a program in Providence, RI, that intervenes with kids even before pre-K. The goal is a simple one. Researchers just want to get parents to talk to their children:

Recent research shows that brain development is buoyed by continuous interaction with parents and caregivers from birth, and that even before age 2, the children of the wealthy know more words than do those of the poor....Educators say that many parents, especially among the poor and immigrants, do not know that talking, as well as reading, singing and playing with their young children, is important. “I’ve had young moms say, ‘I didn’t know I was supposed to talk to my baby until they could say words and talk to me,’ ” said Susan Landry, director of the Children’s Learning Institute at the University of Texas in Houston, which has developed a home visiting program similar to the one here in Providence.

....As in Providence, several groups around the country — some of longstanding tenure — are building home visiting programs and workshops to help parents learn not only that they should talk, but how to do so.

“Every parent can talk,” said Dr. Dana Suskind, a pediatric surgeon at the University of Chicago who founded the Thirty Million Words Initiative, which oversees home visiting programs and public information campaigns. “It’s the most empowering thing,” said Dr. Suskind, who is securing funding for a randomized trial of a home-based curriculum intended to teach parents how they should talk with their children and why.

One of the most frustrating things about the education gap between rich and poor is that it shows up so early, and vocabulary appears to be one of the reasons. Even by the time they're two or three, children of middle-class parents have vocabularies that are substantially larger than those of poor children. Even if poor kids get into a good-quality pre-K program, they're behind from the beginning and they never catch up.

And plonking kids in front of the TV doesn't do the trick. Vocabulary isn't built by listening, but by interacting. It requires parents who talk to their children continuously. It barely even matters what they're talking about.

The goal of programs like the one in Providence is to make sure that low-income parents know this. They may not have the time or money to do all the things for their kids that better-off parents can do, but they can talk to them. Doing that on a regular basis, starting very early in life, may turn out to be a critical component of any pre-K intervention program. Hopefully Suskind's RCT will get funded and we'll have firmer knowledge about this in the future.