Promoting Success through the

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• Promoting Success through the
• Health and Education of Young Children
• Craig T. Ramey, Ph.D.
• Sharon Landesman Ramey, Ph.D
• Directors
• Georgetown University
• Center on Health and Education

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Better Health and Education

• Closely linked
• Good health associated with higher education and
  lifetime achievement
• More years of education associated with greater
  health, happiness, income, and longevity

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What is good health?

• Positive physical condition with absence of
  illness and injuries
• Positive social relationships on a regular basis
• Good emotional health (stable, positive outlook
  on life with good coping)

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How health promotes education

• Better attention in classroom and school
• Better attendance record
• More attractive to peers and teachers
• Better CNS (brain) functioning
• Higher energy levels for all types of
  school-based activities

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How education influences health

• Increases knowledge about ones health and
  healthy lifestyles
• Reading skills increase access to timely, complex
  health information
• Increases knowledge and participation in health
  care system and choices
• More time in positive and healthy environments

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10 Hallmarks of Children WhoSucceed in School

• Eager to learn
• Ask lots of questions
• Work hard and know effort matters
• Have good social-emotional skills
• Can assess their own skills reasonably well
• Parents are role models for learning themselves

• Parents promote learning at home
• Family routines support doing well in school
• Parents set and maintain fair limits
• Schools have high student expectations, support
  teacher development, and communicate frequently
  with parents

Ramey Ramey, Going to School, 1999
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The early years lay the foundation for later
learning and success in school and lifebut
learning is a lifelong process.Universal formal
education is an affirmation of human potential
andthe basis for a thriving, caring democracy
Ramey Ramey, 2004
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• Synaptogenesis by Brain Region

Adapted from Huttenlocher in Ramey Ramey Right
from Birth (1999)
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Applied Biosocial Contextual Development
(ABCD) A Framework for Understanding Human
Development
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• The Impact of Early Environments
• on Childrens Developmental Competence

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How the Achievement Gap typically increases in
elementary school

• Initial gap often contributes to lower teacher
  and school expectations about child and family
• Lack of strong summer programs usually limits
  learning resulting in increased gap by 3rd
  grade
• Lack of after school activities typically means
  less practice and extension of new learning, and
  less growth in world knowledge
• Peer comparisons and teach feedback occur daily
  delayed children may disengage from trying to do
  their best

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Scientific Basis for Early Intervention

• Research on neuroplasticity (animal models)
• Studies of extreme deprivation (orphanages,
• maternal deprivation, isolation)
• Demonstration projects
• Naturalistic and longitudinal studies
• Randomized controlled trials (RCTs) to test
• the efficacy of a planned intervention to
• alter the life course

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Randomized Controlled Trials (RCTs)to Improve
Learning Outcomes

• Abecedarian Project
• Project CARE
• Infant Health and Development Program
• Romanian Orphanage Studies
• Intensive Pediatric CI Therapy
• National Head Start-Public School Transition
• Demonstration Study
• Pre-K Curriculum Comparison Study
• RITE Professional Development Study

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• The Abecedarian (ABC) Project is a randomized
  controlled trial (RCT) that tests the efficacy of
  early childhood education for high-risk children
  and their families.

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Key Research Question for Abecedarian (ABC)
Project

• Can the cumulative developmental toll
  experienced by high-risk children
• be prevented or reduced significantly
• by providing systematic, high-quality, early
  childhood education
• from birth through kindergarten entry and/or
• from k through 2nd grade?

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Abecedarian Preschool Program

• Control Group _
• Adequate nutrition
• Supportive social services
• Low-cost or free primary
• health care

• Treatment Group _
• Adequate nutrition
• Supportive social services
• Free primary health care
• Preschool treatment
• Intensive (full day, 5 days/week,
• 50 weeks/year, 5 years)
• Learningames Curriculum
• Cognitive / Fine Motor
• Social / Self
• Motor
• Language
• Individualized pace

Campbell Ramey, 1995 American Educational
Research Journal
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Z Scores and Mean Standardized Scores for
High-Risk Preschool Treatment and
ControlChildren in the Abecedarian Project at
Nine Preschool Measurement Occasions
Ramey et al, 2000 Applied Developmental Science
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Percent of Abecedarian Sample in Normal IQ Range
(gt84) by Age (longitudinal analysis)
Martin, Ramey, Ramey, 1990 American Journal of
Public Health
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Estimated Influences on IQ
Adapted from Martin, Ramey, Ramey, American
Journal of Public Health, 1996
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Two-Phase Design of Abecedarian Project
Campbell Ramey, American Educational Research
Journal, 1995
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Summary of Abecedarian K-2 Transition Program

• Individualized focus on academic and learning
  activities in school and at home
• Emphasis on reading, mathematics, and writing
• Master Home/School Resource Teachers (12 children
  and families per teacher)
• Development of an individualized and documented
  supplemental curriculum for each child
• Explicit attention and action relevant to family
  circumstances, as needed
• Summer camps with academically relevant
  experiences
• Ramey Ramey, 1999

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Abecedarian Project Woodcock-Johnson Age-referenc
ed Reading Standard Scores at age 8
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Abecedarian Project 8 Year Olds Percent At or
Below the 25th Percentile in Reading and Math
Achievement on the Woodcock-Johnson Test
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The Abecedarian (ABC) Project Longitudinal Effect
Sizes for Reading by Treatment Group
Campbell, Ramey, Pugello, Sparling,
Miller-Johnson (2001) Applied Developmental
Science
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The Abecedarian (ABC) Project Longitudinal Effect
Sizes for Mathematics by Treatment Group
Campbell, Ramey, Pugello, Sparling,
Miller-Johnson (2001) Applied Developmental
Science
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Reading achievement benefits from Preschool
Education last until age 21
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Math Achievement Over Time
Campbell Ramey, 2001 Developmental Psychology
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Abecedarian Project
Ramey Ramey, 1999 MR/DD Research Review
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Percent in Skilled Job or Higher Education
Campbell, Ramey, et al, 2002 Applied
Developmental Science
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Age at Birth of First Child
Campbell, Ramey, et al, 2002 Applied
Developmental Science
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Key Findings from Abecedarian Project(Abecedaria
n one who learnsthe basics such as the
alphabet)

• 18 Months to 21 Years Old

• Intelligence (IQ)
• Reading and math skills
• Academic locus-of-control
• Social Competence
• Years in school,
• including college
• Full-time employment

• Grade Repetition
• Special Education
• placement
• Teen Pregnancies
• Smoking and drug
• use

Plus benefits to mothers of these children
(education, employment)
Ramey et al, 2000
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Project CARE

• RCT designed to replicate (repeat test)
• The Abecedarian Project (ABC)
• with an additional treatment group
• to test the efficacy of an intensive
• 5-year home visiting program using the
• ABC educational curriculum

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Project CARE
130
Early Intervention
Follow-up
120
110
100
90
80
70
60
6(MDI)
12(MDI)
18(MDI)
24(S-B)
36(S-B)
Age in Months (assessment type)
Ramey Ramey Preventive Medicine, 1998
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Ramey Ramey, Preventive Medicine, 1998
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Adapted from Wasik, Ramey, Bryant, Sparling.
Child Development, 1990
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The Infant Health and Development Program(IHDP)

• Designed to replicate the Abecedarian Project
• applied to premature, low birthweight children
• gestation and lt 2500 gm at birth
• Conducted at 8 sites (N985 children families)
• Intervention modified for biological risk factors
• Educational intervention only until 3 yrs old (CA)

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Stanford-Binet IQ Scores at 36 Months Heavier LBW
Group (2001-2500gm)
Infant Health and Development, JAMA, 1990
Ramey, AAAS, 1996
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Stanford-Binet IQ Scores at 36 Months Lighter LBW
Group (lt2000gm)
Infant Health and Development, JAMA, 1990
Ramey, AAAS, 1996
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Childrens IQ at 36 months Maternal Education
X Treatment Group
Infant Health and Development Program
Ramey Ramey (1998), Preventive Medicine
(n232)
(n162)
(n166)
(n104)
(n134)
(n63)
(n76)
(n48)
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Outcomes Affected Positively (plt.01) by the
Infant Health Development Program
Ramey 1999, adapted from Gross, Spiker, Haynes,
1997, Helping Low Birth Weight, Premature Babies
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Differential response to early educational
intervention

• The children who benefited the most had
• mothers with IQs below 70
• mothers with low levels of education
• poor birth outcome indicators
• (PI, Apgar, LBW)
• teen mothers
• (Martin, Ramey, and Ramey, American Journal
  of Public Health, 1990 Ramey Ramey,
  2000)

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Romanian Orphanage Studies

• Designed to replicate the ABC Project when
  modified to meet the needs of children who had
  sustained extreme learning and social-emotional
  deprivation
• - conducted for 2 different age groups
• - part of a capacity building program in
  Romania

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Romanian Study Personal Social (Study 1)
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Romanian Study Language (Study 1)
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Denver Developmental Gain Scores (months) by
Treatment Condition (study 2)
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Professional Development Studies

• RCTs comparing weekly versus monthly coaching
  about language and early literacy instruction (in
  school and child care settings)
• RCTs comparing self-learning, workshops, and
  on-site coaching for 20 full days (inspired by
  the Pediatric Intensisve Therapy Study)

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Results from Professional Development Studies

• Confirm the principle of intensity for teachers,
  as well as for children
• Indicate large variation in amount and quality of
  learning opportunities, regardless of teacher or
  caregiver credentials per se
• Demonstrate relationship of classroom experiences
  and childrens achievement

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Why Some Well-Intended Preschool ProgramsHave
Failed to Close the Achievement Gap

• Poorly prepared teachers, weak prof. development
• Educational programs not intensive enough
• Failure to document program quality and impact
  on
• children
• Not enough teaching of language and academic
  skills
• Inattention to childrens health and health
  promotion
• Limited or no programs in summer and before and
• after school

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Although all children can learn,when exposed to
good teaching,extremely low levels of academic
readinessamong children from low resource
familieswill not change without vigorous
investmentin their early experiences,their
health, and continued support for later learning
and positive lifestyles.
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The future for our nations children

• Positive educational outcomes can be achieved for
  all children during pre-K years and beyond
• Benefits include much more than just reading
• Reading success is a key, because of strong
  linkages to all learning and social adjustment
• Strategic investments yield substantial social
  and fiscal benefits to society (at least 1-to-4
  costbenefit ratio)

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For free copies of this PowerPoint
presentation,please download from our website
http//che.georgetown.eduor contactDrs. Craig
and Sharon RameyGeorgetown Center on Health and
EducationGeorgetown University (202)
687-2874email ctr5_at_georgetown.edusr222_at_georgeto
wn.edu
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Seven Essential Transactions ForCaregivers with
Young Children

• Encourage exploration
• Mentor in basic skills
• Celebrate developmental advances
• Rehearse and extend new skills
• Protect from inappropriate disapproval,
• teasing, and punishment
• Communicate richly and responsively
• Guide and limit behavior

Ramey Ramey, 1999 Right from Birth
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Evidence-based Skillsfor Learning to Read

• Oral Language Comprehension
• Phonological Awareness
• Letter Name Knowledge
• Concepts about Print

Neuman and Dickinson, Handbook of Early Literacy
Research, 2001
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It is the totality of a childs experience that
lays the foundation for a lifetime of greater or
lesser competency.
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PRINCIPLES OF EFFECTIVE EARLY INTERVENTION

• Timing (onset, duration, offset)
• Intensity (per day/wk/mth/yr(s))
• Direct learning experiences
• Breadth of services/supports
• Individual differences
• Environmental maintenance

Ramey Ramey (1998), American Psychologist
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PRINCIPLES OF EFFECTIVE EARLY INTERVENTION

• Timing (onset, duration, offset)
• Intensity (per day/wk/mth/yr(s))
• Direct learning experiences
• Breadth of services/supports
• Individual differences
• Environmental maintenance

Ramey Ramey (1998), American Psychologist