A school readiness program (REDI-P) executed among preschool children from low-income families produced sustained benefits that were evident 4 years after the intervention, with significant reductions in the need for school services in children receiving the intervention, according to the results of a study published in JAMA Pediatrics.

Home visiting programs are used increasingly to provide low-income parents with various services. These programs are aimed at improving the parenting skills of those who face multiple challenges, including low levels of formal education, lack of financial resources, and high levels of stress and social isolation. Although home visiting programs aimed at improving the school readiness of preschool children have shown promise in short-term studies, they have not been adequately evaluated in longer-term studies with rigorous study designs. REDI-P involves 10 home visits during preschool and 6 booster visits in kindergarten. Parents receive coaching and home educational materials to foster child development and school readiness.

Karen L. Bierman, PhD, from the Department of Psychology at Pennsylvania State University in University Park, and colleagues randomly assigned 200 children aged 4 to 5 years attending 24 Head Start Centers in Pennsylvania either to participate in REDI-P (intervention group) or to receive math home learning games in the mail (control group). The intervention targeted increasing academic performance and social-emotional adjustment and decreasing child problems at home. Measures included direct assessments, teacher ratings, and parent reports. Third grade teachers documented all services the children required and received at school.

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The study population was diverse. Of the 200 children in the study, 55.0% were white, 26.0% were black, and 19.0% were Latino. The investigators obtained third grade outcomes from 153 of the original cohort (76.5%). REDI-P produced benefit in child sight word reading fluency (Cohen d = 0.28) and teacher-rated academic performance in third grade (d = 0.29) as compared with the control group. The program also fostered sustained advances in the social-emotional domain, with significantly better scores in task orientation (d = 0.45) and social understanding (d = 0.31). Reductions in home problems (d = -0.28) and in levels of parenting stress and hassles (d = -0.27) occurred in the intervention group as well. As for third grade school services, the investigators noted a reduction in the need for services (d = -0.30) in the REDI-P group as compared with children in the control group.

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Study results showed that the intervention resulted in statistically significant effects on multiple measures in each competency domain. Furthermore, REDI-P decreased the need for educational and mental health services at school. The authors conclude that the results of the study justify the use of preschool home visitation as a way of reducing the gap in school readiness and child well-being associated with poverty.


Bierman KL, Welsh J, Heinrichs BS, Nix RL. Effect of preschool home visiting on school readiness and need for services in elementary school. JAMA Pediatr. 2018. doi:10.1001/jamapediatrics.2018.1029.