THE CRITICAL NEED FOR EVIDENCE-BASED COMPREHENSIVE AND EFFECTIVE EARLY CHILDHOOD PROGRAMS
Good morning Mr. Chairman and members of the Committee. My name is Reid Lyon and I serve as the Chief of the Child Development and Behavior Branch at the National Institute of Child Health and Human Development (NICHD) within the National Institutes of Health (NIH). I am honored and humbled to appear before you today to discuss several critical issues that must be addressed if we as a Nation are to ensure that all children have the opportunity to enter school ready to learn.
I am humbled because I know of no greater gift, beyond the basics of life, love and health, that we can give to our children than to provide them with the social, emotional and cognitive foundations that will enable them to succeed in school. I have spent a good part of my career studying reading development and reading difficulties and directing research programs that study children and their development from kindergarten into their adult years. It is very clear to me that young children who come to kindergarten without essential language, early reading and math skills and other cognitive and conceptual abilities are already at risk for significant school failure.
Comprehensive Preschool Programs: Helping Children Become Ready for School and Ready to Read
Our research tells us that children entering kindergarten who understand the structure and sounds of words, the meanings of words, the rudimentary elements of the writing system, and the concept that print conveys meaning, have significantly higher reading scores at the end of the first grade than children who do not have these skills. In fact, the difference between children who do and do not have this knowledge upon entering kindergarten is approximately one year's worth of reading development at the end of the first grade. We also know that well over 80 percent of children reading poorly at the end of the first grade will be reading poorly at the end of the fourth grade. We know that if we do not close these gaps by nine years of age, there is an overwhelming probability that reading failure will follow the individual into adulthood. Data obtained from the NICHD Connecticut Longitudinal Study show that approximately 75 percent of students reading poorly at nine years of age continue to flounder in reading into the adult years. To be sure, limited reading abilities portend dire consequences.
Unfortunately we are not talking about a small number of lives that are adversely affected by reading and academic failure. Over the past decade, almost 40 percent of the nation's fourth graders, and at least 60 percent of fourth-grade children growing up in poverty have failed to meet basic literacy standards. For example, in many urban school districts the percentage of fourth grade students who cannot read at the basic level approximates 70 percent. By grade twelve, Black and Hispanic students read, on average, at the same level as white eighth grade students. And the majority of these children would not suffer from reading failure in grades four or twelve if they entered kindergarten with a strong language foundation and with a good understanding about print, sounds, sound-letter connections, and writing concepts, followed by strong early reading supports in the first few years of school. In fact, the National Research Council (Snow et al., 1998) estimated that if children receive proper exposure and systematic opportunities to develop foundational language, reading, and emergent writing skills during early childhood, as few as five percent may experience serious reading difficulty. This would be of enormous benefit to our children, to their families, and to society. Preschool programs that succeed in promoting children's language and early literacy skills - so they enter school with age-appropriate competencies - have been proven to change the course of children's school careers and their adult lives (Ramey & Ramey, 2001).
In the next decade, if the American early care and education system does not change, millions more children will never realize their potential. What makes this issue so compelling and troublesome is it does not have to be this way. We do know a good deal about the foundational preschool abilities that predict success or failure in reading in the early grades, and we are making substantial progress in identifying the characteristics of high quality preschool programs that are able to help three and four year old children acquire these critical abilities.
We also know that preschool children from disadvantaged environments are significantly behind their more affluent age-mates in linguistic skills essential for later reading development. Our research tells us that this is because youngsters growing up in low-income environments engage in significantly fewer literacy (e.g., shared book reading) and language (adult-child discussions) interactions in the home. As Hart and Risley pointed out in their NICHD supported research with professional, working class and welfare families, the average child on welfare was having half as much experience listening and speaking to parents (616 words per hour) as the average working-class child (1,251 words per hour) and less than one third that of the average child in a professional family (2,153 words per hour). What does this mean? It means that our preschool programs must provide children from low-income families with systematic and evidence-based interactions to close these gaps. In many ways, a comprehensive preschool program designed to help children develop the necessary cognitive, language, early reading, social and emotional competencies is their last hope to eventually succeed in school.
Let me more specific about why youngsters from low-income environments are at substantial risk for reading, and thus school failure. A number of studies conducted by Grover Whitehurst, Chris Lonigan and their colleagues with children ranging in age from two to six found that phonological sensitivity (the ability to detect and manipulate the sound structure of oral language) and letter knowledge were highly predictive of success and failure in developing later reading skills in kindergarten and first grade. When comparisons were made between low and high-income children, two conclusions were evident. First, children from low-income families have significantly less well-developed phonological sensitivity than children from higher income families. Second, children from lower income families experienced significantly less growth in phonological sensitivity during the preschool years compared to their higher income age-mates. In a recent study reported in 2002, Lonigan studied longitudinally the growth of phonological sensitivity and print knowledge of 325 three to five-year old children attending Head Start. Over a one year period, these youngsters experienced average approximate growth of 1.3 items on phonological sensitivity tests and learned on average 4.4 letter names, .45 letter sounds, and 8 new words assessed on an expressive vocabulary measure. These gains were much less than those made by children from middle-income families. The gap between low and higher-income children in these foundational abilities is quite stark when you consider that the typical middle-class child will learn nine new words a DAY from 18 months of age until entry into school, and will be able to name all the letters of the alphabet upon entry into kindergarten. These gaps are indeed unfortunate given that reading scores in the 10th grade can be predicted with robust accuracy from knowledge of the alphabet in kindergarten.
Can We Close These Gaps
Yes. The Strengthening Head Start report prepared by HHS in 2003 provides several examples of programs that provide comprehensive interventions with systematic language and pre-academic components that develop the knowledge and skills necessary for kindergarten and the early grades and for closing the achievement gap between children from higher and lower-income environments. I would like to request that this report be entered into the formal record. As noted in the report, Dr. Landry's CIRCLE program has found that Head Start teachers who received two years of professional development to learn how to teach oral language skills, phonological abilities and print awareness skills along with interactions to help develop social and emotional competencies significantly increased the development of these abilities in the children served by these teachers involved in the training. In addition, NICHD supported research over the past five years conducted by Joseph Torgesen and Chris Lonigan at Florida State University has found that a preschool emergent literacy program designed to develop oral language, phonological sensitivity, and print awareness produced significantly more growth in these skills than children not receiving the program. Again, why is this important? Because these three areas of emergent literacy are significant contributors to how easily, quickly and well children learn to read.
Why Has the Development of Cognitive, Language and Early Literacy Skills Been De-Emphasized in Head Start and Other Early Childhood Programs?
For many years, Head Start and other early childhood programs have focused on healthy development, adequate nutrition, help for families with problems, and social/emotional readiness and general cognitive development with lower priority given to the development of language, and early reading and math skills. One reason for this is a concern among many early childhood educators that any focus on cognitive readiness will compromise a child's social and emotional well-being. A frequently heard concern is that exposure to "academic" content during preschool is not "developmentally appropriate" and such exposure tends to "hurry" and "stress" the child at the expense of emotional health and developing social skills with peers. In fact however, if stress is produced in introducing cognitive concepts during preschool, the evidence shows that it has nothing to do with the youngster's ability to learn the concepts, and everything to do with the manner in which the information is presented. This is a teaching issue - not a content issue.
Three and four-year-old children are not first graders and should not be taught as such. They should not be exposed to cognitive concepts while being asked to sit still or remain attentively quiet for long periods, and they should not be presented with rote information practiced through drills and routines (I would argue that first graders should not have to endure this either). I mention this because it is a frequently voiced concern. However, we do know that most children, irrespective of background, can learn foundational cognitive and language skills (including vocabulary, reading, and math skills) in preschool when their interests are recognized, supported, and extended rather than ignored or redirected. We also know that preschool children enjoy learning new vocabulary, letter names, letters sounds, and number and science concepts when caregivers and preschool teachers: (1) are sensitive to a child's level of understanding, (2) are contingently responsive to a child's signals, (3) are able to maintain and build on a child's focus, (4) avoid high levels of restriction on behavior and oral language usage, and (5) provide choices and adapt to a child's changing needs. We also know that children learn cognitive, language, and literacy concepts through a blend of child-directed discovery and teacher-provided explicit information about vocabulary, letters, and number concepts.
Nevertheless, while the belief that preparing a youngster's cognitive readiness will compromise social and emotional well-being is unfounded scientifically, it does continue to pervade the early childhood culture and leads to predictable outcomes. Children do demonstrate short-term gains in social and emotional development in programs like Head Start but demonstrate limited to no long-lasting gains in cognitive, reading and math skills. As a result, graduates of programs like Head Start typically enter kindergarten with much lower skill levels than their non-poverty peers.
Another reason it has been difficult to close the gap between what we know from converging research and preschool practices is the difficulty we face in translating current scientific findings into practice in a timely fashion. For example, in the mid 1960s, developmental science suggested that the major tasks for children during the preschool years revolved around socialization - separating from the home environment, learning how to interact with peers, developing healthy emotional attachments to unfamiliar adults and experiencing new material in novel environments. Likewise, it was known that the development of social, emotional, and cognitive capabilities was extremely difficult if children were not well nourished, physically healthy and supported by parental involvement and responsive social systems. And it is important to acknowledge and celebrate the significant contributions that Head Start provided in developing and implementing this knowledge into preschool practice in our nation's most disadvantaged communities.
But, as Dr. Zigler stated in 1996, "Head Start's goal is, and always was, to prepare children for school." Over the past three decades it was thought that ensuring adequate nutrition, healthy bodies, emotional health and social competencies would lead to robust learning in school. To be sure, physical health, adequate nutrition, parental involvement, family social services, and interactions to develop emotional health and social competencies are necessary to achieve this goal, but they are not sufficient. Social and emotional competence do not guarantee school readiness and academic achievement. Children also must come to kindergarten and first grade with strong foundational knowledge of language, reading, math, and science concepts essential for success. The good news is that high quality early childhood education programs can ensure that preschoolers develop these fundamental language and cognitive concepts as noted earlier. The bad news is that far too many children are spending time in preschool settings - including many Head Start classrooms - that do not meet a child's essential learning and cognitive needs, and thus neglect a very important aspect of child development.
In short, there have been major advances in research showing us that preschool-age children are ready to and can learn language, reading, mathematics, and science concepts to a far greater extent than previously thought. Our research tells us that if preschool-age children are not taught and do not learn these concepts and skills, they will not be ready for school. Unfortunately, our research also indicates clearly that Head Start, as traditionally structured and implemented, is not fully achieving its stated purpose of promoting school readiness by enhancing the social and cognitive development of low-income children. Our studies continue to point to the fact that low-income children from Head Start programs perform significantly below their more advantaged peers in reading and mathematics once they enter school. This gap places an unfair burden on the children so that from the very first day of kindergarten they are already behind. This is unfortunate because, with proper preschool instruction, they can enter school on an equal footing with every other child.
What Do the Data Tell Us About Head Start and School Readiness?
As mentioned earlier, a recent report by the HHS Office of the Assistant Secretary for Planning and Evaluation reviewed the literature relevant to the effectiveness of Head Start in closing the gap in educational skills and knowledge for school success. The conclusions drawn from this review of the evidence are sobering and will no doubt be controversial. The bad news is that many children in Head Start are not getting what they need to succeed in school. The good news is that children in Head Start and other early childhood programs can make significant gains if the programs implement effective early childhood instructional practices, which will enhance the comprehensive mission of Head Start.
I would like to summarize the major findings of the Strengthening Head Start report. First, allow me to provide some relatively good news that the report provided based on data obtained from the 1997 and 2000 Family and Child Experiences Survey (FACES).
1. Head Start children made some progress in some areas:
A. In 2000, the mean standard score for vocabulary increased 3.8 points, from 85.3 to 89.1 on a scale for which the average is 100. This result is similar to the data for 1997 that showed Head Start children scored about 85, at the beginning of the year and gained about 4 points by the end of the year.
B. In 2000, the mean standard score for writing increased by 2 points, from 85.1 to 87.1.
C. In 2000, children showed gains in book knowledge and print conventions (that is, they can show an adult the front of a storybook and open it to where the adult should start reading). This progress is statistically greater than for the 1997 Head Start year during which no progress was made in this area.
D. Spanish-speaking children in Head Start showed significant gains in English vocabulary skills without declines in their Spanish vocabulary.
E. Children showed growth in social skills and reduction in hyperactive behavior during the Head Start year. Even children with the highest levels (scoring in the top quarter) of shy, aggressive, or hyperactive behavior showed significant reductions in these problem behaviors. Teachers rated children's classroom behavior as more cooperative at the end of the Head Start year than when children first entered the program.
F. Children who received higher cooperative behavior ratings and lower problem behavior ratings from Head Start teachers scored better on cognitive assessments at the end of kindergarten, even after controlling for their scores on cognitive tests taken while in Head Start.
G. Children who entered Head Start in 1997 showed significant gains in their social skills, such as following directions, joining in activities, and waiting turns in games and gains in cooperative behaviors, according to ratings by teachers and parents. The quality of children's social relationships, including relating to peers and social problem solving, also improved.
H. Head Start has other positive qualities. In 1997, the program received very high ratings of satisfaction from parents, and for the roughly 16 percent of children in Head Start with a suspected or diagnosed disability, 80 percent of parents reported that Head Start had helped them obtain special needs resources for the child.
2. Most children enter and leave Head Start with below-average skills and knowledge levels. Unfortunately, the 1997 and 2000 FACES data indicate that despite some strengths within the Head Start program, many children are being left behind:
A. The 1997 FACES data indicate that children enter Head Start at shockingly low levels compared to the average performer (performance at the 50th percentile) on measures of vocabulary (average percentile=16), letter recognition (average percentile=27), early writing (average percentile=16) and early mathematics (average percentile=17) and leave the program showing only very modest gains in vocabulary (average percentile=23), early writing (average percentile=23) and early math (average percentile=19). Note that these improvements still indicate performance far below the average range. Note also that exit performance on the letter recognition task, something that children love to learn, and is one of the predictors of later reading ability, remained low, even declining slightly to the 25th percentile.
B. The more recent 2000 FACES data show modest improvement in results for children, but overall progress is still too limited. Children continue to lag behind national norms when they exit Head Start. Data from Head Start FACES 2000 show that:
i. The level of children's achievement in letter-recognition7 for the 2000 Head Start year is far below the majority of U.S. children who typically know all letters of the alphabet upon entering kindergarten, according to the Early Childhood Longitudinal Study of the Kindergarten class of 19988.
ii. Spanish-speaking children in Head Start did not gain at all in letter recognition skills in 2000.
iii. Although writing scores increased 2 points during the 2000 Head Start year, this was a drop from children who entered Head Start in 1997 who increased 3.8 points in writing during that year.
iv. Though children who entered Head Start in 2000 made more progress in some areas compared to 1997, scores at the end of the Head Start year remained far below the average level in all areas of competency. For example, over the Head Start year, vocabulary development increased from the 16th percentile to the 23rd percentile (identical to 1997). Letter recognition upon entry into the program was at the 31st percentile and remained at the 31st percentile at the completion of the program. Early writing skills increased over the year from the 16th to the 23rd percentile and early mathematics skills also increased from the 21st to the 23rd percentile.
v. As noted earlier, children who entered Head Start in 2000 made progress in early mathematics during the Head Start year that was statistically significant; however the difference was miniscule (from 87.9 to 89.0 on a scale where 100 is the average). Moreover, this amount of progress was no greater than that found for children who attended Head Start from Fall to Spring in 1997.
vi. Children who entered the program in 2000 with overall lower levels of knowledge and skill showed larger gains during the program year than children who entered with higher levels of knowledge. However, they still lagged far behind national averages.
vii. Head Start children did not start kindergarten with the same social skill levels as their more economically advantaged peers and they continue to have more emotional and conduct problems than do middle class peers.
viii. Only 25 percent of Head Start teachers were college graduates, compared to 86 percent in state pre-K programs. Research points clearly to the important role of teacher knowledge and education in learning outcomes for children, including preschoolers.
In summary, there is more work to do. Despite small gains and the positive qualities of Head Start programs, children in Head Start are making only very modest progress in only some areas of knowledge and skill, and children in Head Start are leaving the program far behind their same-age peers. To be sure, Head Start programs vary significantly in quality as well as in the amount of time children attend Head Start programs. Some youngsters spend only part of the day, week and year in a program, while other children are provided programs for the entire day, week and year. These differences will certainly affect the overall outcomes for children, since both quality and quantity of learning experiences impact children's progress. What we must do is identify those factors and conditions that characterize high quality Head Start programs and duplicate them in all Head Start programs. More progress must be made and can be made to put Head Start children on par with others by the time they enter kindergarten.
3. Disadvantaged children lag behind their age- and grade-mates throughout the school years. Effective early childhood intervention is important because disadvantaged children are at significant risk for poor educational outcomes throughout the school years.
The Strengthening Head Start report reviewed data from the nationally representative Early Childhood Longitudinal Study-Kindergarten (ECLS-K), the National Center for Educational Statistics (NCES), and the National Assessment of Educational Progress and reported the following findings. While a number of specific conclusions are provided in the Report, the following two general trends are noteworthy:
A. Children with multiple risk factors (e.g., parents have not completed high school, low-income or welfare family, single parent family, parents peak a language other than English in the home) are at the greatest risk for educational failure.
B. The achievement gap persists into elementary and high school years. Data from the ECLS-K show that the gap for low-income children begins to close in kindergarten in very basic reading and mathematics skills such as letter recognition and counting, but the achievement gap widens for the more advanced reading and mathematics skills, such as recognizing words and adding and subtracting.
In summary, data from several sources converge to show that achievement gaps between advantaged and disadvantaged children that are evident during the pre-kindergarten years continue to characterize disadvantaged children in kindergarten and throughout elementary school. It is critical that we better understand the conditions under which programs have a real opportunity to close these gaps and implement them at the earliest possible time.
4. Fragmented service delivery hinders improvements in Head Start and other early childhood programs. At both the Federal and State levels, the early childhood services are characterized by multiple funding sources and requirements-each with different rules and standards, eligibility requirements, and desired child and family outcomes.
In a report published in 2000, the U.S. General Accounting Office (GAO) found sixty-nine Federal programs, administered by nine different Federal agencies and departments, funding early education and/or child care for youngsters under age five. The GAO noted that when multiple agencies manage multiple early childhood education and care programs, mission fragmentation and program overlap can occur. This in turn creates the potential for BOTH duplication and service gaps. Although GAO pointed out that duplication can sometimes be necessary, fragmentation and overlap can also create an environment in which programs do not serve participants as efficiently and effectively as possible.
Reports from parents, providers, and state program administrators underscore how a lack of program coordination undermines the efficiency and effectiveness of early childhood programs. Parents report that a poorly coordinated system makes it difficult for them to find good quality care for their children. They are put in a position to try to determine which programs best suit their needs, and then go through the application and eligibility determination process for each program separately. Some programs, including Head Start, may only be offered in the parent's neighborhood for part of the day or year, while the parent needs a full day/year program because of their work responsibilities. If the local Head Start program does not collaborate with other local child care programs, parents are forced to cobble together various arrangements to ensure adequate care for the necessary length of time.
From the provider's perspective, the lack of program coordination forces them to juggle different eligibility requirements for children and families, different methods of receiving subsidies or other State or Federal funds, and different requirements and standards for the programs they provide. In addition, different early childhood programs typically require different credentials for teachers and providers, and offer a range of salaries and benefits, making it difficult for providers in a community to view themselves as part of a comprehensive system. In fact, differences in salaries and benefits may have the unintended effect of drawing the most qualified providers to some programs rather than others- for example, toward teaching in pre-kindergarten school-based programs rather than in a Head Start program or infant and toddler care. Lack of coordination also affects health and social service providers who must struggle to serve patients and clients who do not have a single point of entry into the system and who have a variety of needs that must be met.
From the perspective of State administrators, programs can be both inefficient and ineffective when States must juggle funding, enrollment, eligibility and other concerns for multiple programs administered by different federal agencies. States are held responsible by the public for the care and education of young children, but lack power and control to create a seamless system and to provide access to all eligible families. Lack of coordination significantly complicates State efforts to engage in strategic and fiscal planning. Key stakeholders may have competing priorities and objectives and have difficulty agreeing on how best to meet the needs of the community. Instead of collaboration, there may be competition at the State level for scarce resources. Finally, States are aware that they will be held responsible for student performance in elementary school through the No Child Left Behind Act, and want to make sure that all children in the State enter kindergarten ready to learn. However, a fragmented system makes it difficult, if not impossible, for a State to provide the needed comprehensive services to all children from low-income homes who will begin kindergarten in the public schools.
This uncoordinated approach to service delivery significantly impedes providing effective early childhood programs that are successful in preparing at-risk children for school. To be sure there are many complex barriers to achieving coherence and coordination across early childhood programs and many of these are identified in the Strengthening Head Start report.
We Can Do Better Than We Are Doing
As pointed out earlier, converging evidence indicates strongly that young children who are provided frequent, systematic, positive interactions with adults and other children to foster the development of social, emotional and cognitive capabilities in an integrated fashion are FAR more likely to succeed in school than children who are in lower quality and less stimulating programs. The HHS Strengthening Head Start report submitted with this testimony and the Proceedings from the White House Summit on Early Childhood Cognitive Development convened by Mrs. Bush summarize the critical foundational skills that children must have to succeed in school. In brief, research tells us that if language, literacy, and other cognitive factors are attended to through high quality programming in early childhood settings, children's school readiness can be significantly improved. In the pre-kindergarten years, research describes three key components of high quality programs for reading and academic success. These include a strong foundation in: (1) language development; (2) early literacy (phonological awareness, letter knowledge, written expression, book and print awareness, motivation to read); and (3) early math (number and operations).
1. It is critical that early childhood programs including Head Start provide a genuinely comprehensive set of services and educational opportunities to all children, including those with disabilities, that are grounded in developmental science. It is imperative that children's social, emotional, and cognitive growth be fostered on the basis of what developmental science tells us about what preschool children can learn, what they need to learn to succeed in school, and how learning is most optimally supported. For too long, our understanding, development, and implementation of preschool programs have been based on philosophical beliefs, untested assumptions, or out-of-date science. This practice has left many children behind. The NICHD, in collaboration with the U.S. Department of Education's Office of Special Education and Rehabilitation Services (OSERS) and the Department of Health and Human Services (ACYF, ACF, ASPE) has developed a comprehensive research program to develop and evaluate comprehensive early childhood programs that combine interactions to enhance cognitive, social and emotional abilities in children at risk for developmental difficulties and school failure. But we now know enough at this time to develop and implement preschool curricula that are effective as described in this testimony. Standards should be developed to reflect the need for preschool curricula to stimulate verbal interaction, enrich children's vocabularies, encourage talk about books, develop knowledge about print, generate familiarity with the basic purposes and mechanisms of reading, math and science, and appreciate the needs of children with disabilities and children acquiring English as a second language.
2. It is clear that we must develop a comprehensive assessment and reporting system to ensure that Head Start programs produce the positive outcomes that we know are achievable. This reporting system will, for the first time ever in the history of Head Start, provide outcome data on all Head Start programs and children, with and without disabilities, and thus help to identify areas in need of continued improvement, as well as to document systematically Head Start's successes. Note that all of the high quality demonstration projects that have produced large and lasting benefits for children and their families have involved systematic assessment and reporting about both the program quality and the children's development. High quality programs that endorse continuous quality improvement welcome assessment. We owe it to the parents of Head Start to assess their children's progress on a regular basis, in ways that will help guide the instruction and support Head Start. And children are not stressed or frightened by the assessment; they have fun in a one-to-one interaction with a responsive adult who is allowing them to demonstrate their skills and mastery.
3. We must ensure that our youngest children are learning from teachers who are highly competent in their ability to help children develop social competencies, emotional health, and the cognitive, language, literacy and mathematics concepts critical to school success. Numerous studies have shown that program quality and the benefits to children, with and without disabilities, are inextricably linked with staff educational background and training. The significant benefits to children provided by the Chicago CPC program and the CIRCLE program described in the HHS Strengthening Head Start report underscore this point. All preschool teachers in the CPC program had college degrees and certification in early childhood. While the teachers in the CIRCLE program ranged in education from high school degree through graduate degrees, the systematic training, mentoring, and follow-up training produced many teachers of high quality.
4. It is essential that preschool programs be coordinated with programs providing early care and education as well as with the curriculum framework and goals of kindergarten and early public school programs. Moreover, greater coordination and collaboration are needed between State and Federal programs to ensure that all children entering kindergarten are ready to learn. The value of a highly coordinated series of programmatic interactions from age three through the early grade-school years can be seen in the results produced by the Chicago CPC program. The fact that the CPC program is provided through the Chicago public schools provides a continuity in children's learning environments as well as appropriate levels of compensation for teachers and staff. Other communities have developed alternative models for coordination that include programs located outside the public school system.
5. While many Head Start programs need to be strengthened to ensure high quality interactions to support and develop physical (health) social, emotional, and cognitive strengths in an integrated and accountable fashion, it is clear that many States do have such high quality programs in place. It will be critical to identify these programs that are beacons of light and expand and build on them with both local and State funding. It will also be critical to identify low-performing programs and provide the necessary technical assistance to strengthen them but, in the end, to ensure that the health and development of our children are the priorities, not the survival of ineffective programs.
Thank you very much for providing me the opportunity to discuss these issues with you today. I would be happy to answer any questions you may have.
Last Revised: July 22, 2003