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September 1, 2012
With Responses From
Sep 1, 2012
26 Min read time
The accident of birth is a principal source of inequality in America today. American society is dividing into skilled and unskilled, and the roots of this division lie in early childhood experiences.
The accident of birth is a principal source of inequality in America today. American society is dividing into skilled and unskilled, and the roots of this division lie in early childhood experiences. Kids born into disadvantaged environments are at much greater risk of being unskilled, having low lifetime earnings, and facing a range of personal and social troubles, including poor health, teen pregnancy, and crime. While we celebrate equality of opportunity, we live in a society in which birth is becoming fate.
This powerful impact of birth on life chances is bad for individuals born into disadvantage. And it is bad for American society. We are losing out on the potential contributions of large numbers of our citizens.
It does not have to be this way. With smart social policy, we can arrest the polarization between skilled and unskilled. But smart policy needs to be informed by the best available scientific evidence. It requires serious attention to the costs of alternative policies, as well as to their benefits. Close attention to the evidence suggests three large lessons for social policy.
First, life success depends on more than cognitive skills. Non-cognitive characteristics—including physical and mental health, as well as perseverance, attentiveness, motivation, self-confidence, and other socio-emotional qualities—are also essential. While public attention tends to focus on cognitive skills—as measured by IQ tests, achievement tests, and tests administered by the Programme for International Student Assessment (PISA)—non-cognitive characteristics also contribute to social success and in fact help to determine scores on the tests that we use to evaluate cognitive achievement.
Second, both cognitive and socio-emotional skills develop in early childhood, and their development depends on the family environment. But family environments in the United States have deteriorated over the past 40 years. A growing fraction of our children are being born into disadvantaged families, where disadvantage is most basically a matter of the quality of family life and only secondarily measured by the number of parents, their income, and their education levels. And that disadvantage tends to accumulate across generations.
Third, public policy focused on early interventions can improve these troubling results. Contrary to the views of genetic determinists, experimental evidence shows that intervening early can produce positive and lasting effects on children in disadvantaged families. This evidence is consistent with a large body of non-experimental evidence showing that the absence of supportive family environments harms childhood and adult outcomes. Early interventions can improve cognitive as well as socio-emotional skills. They promote schooling, reduce crime, foster workforce productivity, and reduce teenage pregnancy. And they have much greater economic and social impact than the later interventions that are the focus of conventional public policy debate: reducing pupil-teacher ratios; providing public job training, convict rehabilitation programs, adult literacy programs, and tuition subsidies; and spending on police. In fact, the benefits of later interventions are greatly enhanced by earlier interventions: skill begets skill; motivation begets motivation.
In short, to foster individual success, greater equality of opportunity, a more dynamic economy, and a healthier society, we need a major shift in social policy toward early intervention, with later interventions designed to reinforce those early efforts. (Although the Obama administration has funded more early childhood programs in its “Race to the Top” initiative, simultaneous cutbacks in state and local budgets have imperiled funding of preschool education throughout much of the nation.) And the interventions should address socio-emotional skills, not just cognitive abilities.
• • •
In the first half of the twentieth century, each new cohort of Americans was more likely to graduate high school than the preceding one. This upward trend in secondary education increased worker productivity and fueled American economic growth.
Over the past 30 years, this long-term trend has reversed, and the decline is concentrated among males. Properly measured, the high school graduation rate in America has fallen. Over that same period, the real wages of high school graduates have increased relative to those of high school dropouts. These growing wage differentials have increased the economic incentive to graduate from high school. So the reversal in graduation rates is striking and troubling.
This trend is rarely noted in academic or policy discussions. In fact, the principal graduation rate issued by the National Center for Educational Statistics suggests that students responded to the increasing demand for skill by completing high school at higher rates and then attending and completing college in greater numbers. According to what many regard as the official high school graduation rate, U.S. schools now graduate nearly 88 percent of students, and black graduation rates have converged with those of non-Hispanic whites over the past four decades.
These numbers are badly misleading. The biggest problem is that they include General Education Development (GED) recipients as high school graduates. GEDs do not graduate from high school, but they certify as the equivalents of ordinary graduates by passing an exam. Currently 12 percent of all new high school credentials issued each year are to GEDs. But a substantial body of scholarship shows that GEDs’ earning power is similar to that of non-GED dropouts in the U.S. labor market. Including the GEDs in official graduation rates thus conceals major problems in American society. For example, a significant portion of the racial convergence in education reported in the official statistics is due to black males obtaining GED credentials in prison.1 But, when released, these men earn at the same rate as ex-convicts who did not earn GEDs. Moreover, the GED does not reduce recidivism.
What happens when we take the GEDs out of the graduating group and focus exclusively on native-born American children? The result is that the high school dropout rate has increased. In fact, the U.S. high school graduation rate peaked at around 80 percent in the early 1970s and has since declined by 4–5 percentage points.2 Roughly 65 percent of blacks and Hispanics now leave school without a high school diploma, substantially higher than the dropout rate for non-Hispanic whites. Contrary to claims based on the official statistics, there is no convergence in minority-majority graduation rates for males over the past 35 years. Moreover, exclusion of incarcerated populations from the official statistics substantially biases upward the reported high school graduation rate for black males.
Differences in the quality of nurturing between the haves and have-nots are increasing.
What about college attendance? Many observers have expressed concerns about a declining rate of growth in male college attendance. The phenomenon is real. But it does not primarily reflect a decline in the rate of growth of college attendance by high school graduates. The rate of growth of college attendance for high school graduates has slowed, but not as much as the overall rate of college attendance. The main source of the declining rate of growth of college attendance is the declining high school graduation rate, particularly for young men. The decline in high school graduation rates since 1970 (for cohorts born after 1950) has flattened college attendance and completion rates and has slowed growth in the skill level of the U.S. workforce, even as the economic return to skill has increased.
These trends in high school graduation rates are for people born in the United States. Unskilled migration to the country has further increased the proportion of unskilled Americans in the workforce, thus reducing further the growth in workforce productivity and promoting social inequality.
With the high school dropout rate increasing, and an influx of unskilled immigrants, the United States has more low-skilled people. Consider the performance of the American workforce in the late 1990s on a basic literacy test called the International Adult Literacy Survey. At level one, a person cannot understand the instructions written in a medical prescription. More than 20 percent of American workers do not possess this basic competence.
What forces have produced these low levels and adverse trends? Are the public schools responsible? Can we look to school reform to fix the problem? Are higher college tuition costs reducing incentives to complete high school? Contrary to widely held views, the real issues lie much earlier in the life course: in early childhood experiences. And that is where we need to be looking for remedies.
• • •
More than Cognition
American public policy currently focuses principally on cognitive test scores or “smarts.” The No Child Left Behind Act, for example, focuses on achievement test scores to measure success or failure in schools. Yet an emerging literature confirms the common sense idea that success in life depends on much more than smarts. Non-cognitive abilities—including strength of motivation, an ability to act on long-term plans, and the socio-emotional regulation needed to work with others—also have a large impact on earnings, employment, labor force experience, college attendance, teenage pregnancy, participation in risky activities, compliance with health protocols, and participation in crime.
Again, the GED program provides compelling evidence. Performance on GED tests is a good measure of scholastic ability: GED test scores and the test scores of persons who graduate high school but do not go on to college are comparable. Yet GEDs earn at the rate of high school dropouts. GEDs are as “smart” as ordinary high school graduates, yet they lack non-cognitive skills. GEDs quit their jobs at much greater rates than ordinary high school graduates; their divorce rates are higher, too.2 3 Most branches of the U.S. military recognize these differences in their recruiting strategies. GEDs attrite from the military at much higher rates than ordinary high school graduates.
Other evidence also underscores the importance of non-cognitive skills.
Cognitive and non-cognitive skills are equally predictive of many social outcomes: a 1 percent increase in either type of ability has roughly equal effects on outcomes across the full distribution of abilities. People with low levels of cognitive and non-cognitive skills are much more likely to be incarcerated. An increase in either cognitive or non-cognitive skills equally reduces the probability of teenage pregnancy. For the lowest deciles, the drop off in incarceration with increasing non-cognitive ability is greater than with increasing cognitive ability. We find similar patterns correlating both kinds of skills to high school and college graduation, daily smoking, and lifetime earnings.
• • •
Early Life Matters
Gaps in the cognitive and non-cognitive abilities that play such an important role in life chances open up very early across socioeconomic groups. Consider the evolution of both cognitive and non-cognitive scores over the life of children, stratifying by social background.
The gaps in cognitive achievement by level of maternal education that we observe at age eighteen—powerful predictors of who goes to college and who does not—are mostly present at age six, when children enter school. Schooling—unequal as it is in America—plays only a minor role in alleviating or creating test score gaps (see Figure 1).
A similar pattern appears for socio-emotional skills. One measure of the development of these skills is the “anti-social score”—a measure of behavior problems. Once more, gaps open up early and persist. Again, unequal schools do not account for much of this pattern.
How do these early and persistent differences in abilities arise? Some people think that the explanation lies primarily in our genes. In The Bell Curve (1994), Richard Herrnstein and Charles Murray trace differences in adolescent achievement test scores back to genetic differences. If the primacy of genetics is correct, we should be skeptical about the efficacy of any interventions.
But the test scores Herrnstein and Murray used have been shown to be caused in part by schooling and family environments. More broadly, evidence from epigenetics, which studies how environmental factors affect gene expression in ways that are heritable, suggests that the gene-environment distinction that shaped The Bell Curve and so much other discussion about the origins of inequality is obsolete (as is the practice, common in social science, of additively partitioning outcomes due to “nature” and “nurture”). An extensive recent literature suggests that gene-environment interactions may be central to explaining human and animal development. For example, neuroscientist Avshalom Caspi and his colleagues have shown that the adverse impact of the absence of one gene—a particular variant of the Monoamine Oxidase-A gene, which has been associated with antisocial behavior and higher crime rates—is triggered by growing up in a harsh or abusive environment. Geneticist Mario Fraga and his colleagues have shown how life experience substantially differentiates the genetic expression of adult identical twins: their experience gets under their skin—and stays there. Related research shows that isolation affects the expression of genes that moderate adverse health outcomes, and that environment has a powerful role in determining heritability of IQ.
The precise impact of these gene-environment interactions on the life course of individuals remains to be determined. But they undermine purely genetic arguments about outcomes and require that we look to the social environment—especially the families—in which children are raised.
The evidence on the importance of family factors in explaining ability gaps is a source of concern because a greater proportion of American children is being born into disadvantaged families. And the simple fact is that children from disadvantaged environments typically have not received the massive doses of early enrichment that children from middle-class and upper-class families have.
The proportion of children living in single-parent families has grown dramatically, and the greatest contributor to this growth is the percentage living in families with never-married mothers. The percentage of all children less than age five with a never-married mother is over 35 percent for children born to dropout mothers. This phenomenon is especially pronounced for African American families. A gap has emerged between the environments of children of more educated women and the environments of children of less educated women.
Well educated women are working disproportionately more than less educated women. At the same time, college educated mothers—according to a comprehensive survey of the evidence from time diary studies—devote more time to child rearing than do less educated mothers, especially in child enrichment activities. They spend more time reading to children and less time watching television with them. Less than 10 percent of the more educated women bear children out of wedlock. They tend to marry later; have children later, after they have completed their education; have a steady flow of resources from their own income and that of their spouses; have fewer children; and provide much richer child-rearing environments that produce dramatic differences in children’s vocabulary and intellectual performance. These advantages are especially pronounced among children of stable marriages, and the differences in the nurturing quality between the haves and have-nots have increased over the past 30 years. Children of such marriages are at a major advantage compared to children from other unions. In short, while more educated women are working more, their families are more stable and the mothers in these families are devoting more time to child development activities than are less educated women.
In the words of sociologist Sara McLanahan, children from different family backgrounds face “diverging destinies.” Children in more advantaged homes are bathed in financial and cognitive resources that those in less advantaged circumstances are much less likely to receive. Compared to the environments of intact families, the family environments of single-parent homes are much less favorable for investment in children: McLanahan has found that in single-parent homes, there is more depression, more prenatal drug use, more prenatal smoking, less breast feeding, and less language stimulation.
Research by Robert Anda, Vincent Felitti, and colleagues examines the effects of adverse childhood experiences—abuse and neglect, as well as domestic violence—on adult outcomes. Their studies show that early adverse experiences correlate with poor adult health, high medical care costs, increased depression and suicide rates, alcoholism, drug use, poor job performance and social function, disability, and impaired performance of subsequent generations. They compute an Adverse Childhood Experiences score (ACE) based on reported adverse childhood circumstances. The higher the score, the worse the childhood environment. Two out of three adults score in at least one category of ACE and 12.5 percent score in four or more. The impact of such childhood experiences is striking (see Figure 2).
This evidence is bolstered by a large body of research in developmental psychology, and it makes sense neurologically. Lack of a certain kind of input during early childhood results in abnormal development in brain systems that sense, perceive, process, interpret, and act on information related to that input. Studies of Romanian infants show the importance of the early years. A perverse natural experiment placed many Romanian children in state-run orphanages at birth. Conditions in the orphanages were atrocious. The children, who received minimal social and intellectual stimulation, demonstrated cognitive delays, serious impairments in social behavior, and abnormal sensitivity to stress. The later the orphans were adopted, the poorer their recovery on average, although there are important variations among the children, reflecting the quality of orphanages and adoptive home environments as well as the length of the stay in orphanages. The Romanian studies fit with what we understand from other settings: severely neglected young children often have persisting cognitive, socio-emotional, and health problems.
Such children have problems in part because the somatosensory bath of early childhood provides the major sensory cues responsible for organizing key areas in the brain. Absent these sensory experiences, abnormal development results. This is vividly illustrated in the smaller head size, enlarged ventricles, and cortical atrophy of neglected three-year-olds as compared to children who receive normal amounts of early attention (see Figure 3).
So early circumstances are important, and attention matters. But what precisely makes the difference in these adverse early environments? The conventional measures of family disadvantage used by many social scientists are number of parents and family income. But the available evidence from developmental psychology and neuroscience suggests that these measures are very crude proxies for the real determinants of child outcomes. There is much commentary on the benefits of two-parent families, but the presence of a father can be a net negative factor if he shows antisocial tendencies or if marital conflict is substantial. A large body of evidence suggests that a major determinant of child disadvantage is the quality of the nurturing environment rather than just the financial resources available or the presence or absence of parents. For example, a 1995 study of 42 families by Betty Hart and Todd Risley showed that children growing up in professional families heard an average of 2,153 words per hour, while children in working-class families heard an average of 1,251 words per hour, and children in welfare-recipient families heard an average of 616 words per hour. Correspondingly, they found that at age three, children in the professional families had roughly 1,100-word vocabularies, in contrast with 750 words for children from working-class families, and 500 words for children of welfare recipients.
Strengthening the observation that conventional measures of childhood adversity are inaccurate is a study of an American Indian population that was suddenly and unexpectedly enriched by the opening of a casino. The study showed substantial improvements in baseline measures of disruptive behavior among the children. The beneficial effects of the intervention were mediated by changes within the family. With more money, parental supervision of children improved, and there was greater parental engagement. In this natural experiment, income improved parenting, but it was the changes in parenting that reduced disruptive behavior.
The worrisome news, then, is that early environments play a powerful role in shaping adult outcomes, and more and more American children are growing up in adverse environments. The good news is that environments can be enhanced to promote important skills in children and that society need not passively observe its own polarization and decline. Policy can matter.
• • •
Early Interventions Make a Difference
Experiments that enrich the early environments of disadvantaged children provide powerful evidence against arguments of genetic determinism. They show that enhancements of family environments can cause improvements in children’s outcomes, and they underscore the role of non-cognitive skills as channels of improvement.
The most reliable data come from experiments that substantially enrich the early environments of children living in disadvantaged families. Two of these investigations, the Perry Preschool Project and the Abecedarian Project, are particularly revealing because they use a random assignment design and continue to follow the children into their adult years.
These studies demonstrate substantial positive effects of early environmental enrichment on a range of cognitive and non-cognitive skills, school achievement, job performance, and social behaviors—effects that persist long after the interventions have ended. Other studies—such as the Nurse-Family Partnership, which visits pregnant girls and teaches them prenatal health practices and parenting—support these conclusions.
Perry was an intensive preschool curriculum administered to 58 low-income black children in Ypsilanti, Michigan between 1962 and 1967. The treatment consisted of a daily 2.5-hour classroom session on weekday mornings and a weekly 90-minute home visit by the teacher on weekday afternoons. The curriculum was geared to the children’s age and capabilities, emphasizing child-initiated activities that focused on fostering non-cognitive traits. Staff encouraged children to engage in play activities that had children plan, do, and review tasks each day. The reviews were collective and taught the children important social skills. The length of each preschool year was 30 weeks. The control and treatment groups have been followed through age 40.
Giving families more money is not the same as enhancing their children’s environments.
The Abecedarian Project studied 111 disadvantaged children born between 1972 and 1977 whose families scored high on a risk index. The mean age at entry was 4.4 months. The program was a year-round, full-day intervention that continued through age eight. The children were followed through age 21, and an age 30 follow-up study appeared earlier this year. Abecedarian was more intensive than Perry. Abecedarian was year-round and full-day. The initial infant-to-teacher ratio was 3:1, though it grew to 6:1 as the kids progressed through the program. Infants in the control group received an iron-fortified formula for 15 months and diapers as needed to create an incentive for participation. Many of the children in the control group were enrolled in preschool or kindergarten. During the first three primary school years, a home-school teacher would meet with the parents of children who were in the test group and help the parents provide supplemental educational activities at home. The teacher provided an individually tailored curriculum for each child. This home-school teacher also served as a liaison between the ordinary teachers and the family, and she would interact with the parents and the teachers about every two weeks. She would also help the parents find employment, navigate the bureaucracy of social services agencies, and transport children to appointments, all of which could improve parents’ ability to raise their kids.4 5
Both Perry and Abecedarian showed consistent patterns of successful outcomes for treatment group members compared with control group members. Among Perry participants, an initial increase in IQ disappeared gradually over four years following the intervention. Such IQ fadeouts have been observed in other studies. But the main effects of the Perry remained, and they involve non-cognitive traits.6 Even though they were no brighter than the controls as measured by IQ tests, the Perry treatment group did better than the control group on achievement tests at age fourteen because the adolescent treatment group members were more engaged in school and learned more. Positive effects were also documented for a wide range of social behaviors. At the oldest ages studied (40 years for Perry; 30 for Abecedarian), treated individuals scored higher on achievement tests, attained higher levels of education, required less special education, earned higher wages, were more likely to own a home, and were less likely to go on welfare or be incarcerated than controls (see Figure 4).7
The estimated rate of return (the annual return per dollar of cost) to the Perry Project is 6–10 percent (higher than the 5.8 percent returns on stock market equity received from the end of World War II through 2008).8 This estimate is conservative because it ignores economic returns to health and mental health, which are currently being estimated.
Well-executed early interventions are very promising. What about those that come later in life? Their success depends importantly on the quality of earlier interventions. Skills beget skills and capabilities foster future capabilities. Early mastery of a range of cognitive, social, and emotional competencies makes learning at later ages more efficient and therefore easier and more likely to continue.
As currently configured, public job training programs, adult literacy services, prisoner rehabilitation programs, and education programs for disadvantaged adults produce low economic returns. Moreover, studies in which later intervention showed some benefits also found that the performance of disadvantaged children was still behind the performance of children who also experienced interventions in the preschool years. If the base is stronger, the return to later investment is greater.
Because of these synergies in skill development, the advantages gained from effective early interventions are best sustained when they are followed by continued high quality learning experiences.
And early interventions have at least one more important feature: the equity-efficiency tradeoff that plagues most social policies is largely absent, though there is some deadweight loss in collecting taxes to support the interventions, a loss that doesn’t outweigh the benefits.9 Early interventions promote economic efficiency and reduce lifetime inequality. Remedial interventions for disadvantaged adolescents who do not receive a strong initial foundation of skills face an equity-efficiency tradeoff. They are difficult to justify on the grounds of economic efficiency alone and generally have low rates of return. In contrast, we can achieve both equity and efficiency by focusing investments in the early years, while also following up with later investments.
• • •
A variety of practical and policy issues arise in implementing early childhood programs and in addressing the problems of disadvantaged youth in American society. Here I can only touch briefly on a few broad issues of considerable importance.
1. Who should be targeted? The returns to early childhood programs are highest for disadvantaged children who do not receive substantial amounts of parental investment in the early years. The proper measure of disadvantage is not necessarily family poverty or parental education. The available evidence suggests that the quality of parenting is the important scarce resource. So we need better measures of risky family environments in order to achieve more accurate targeting.
2. With what programs? Programs that target the early years seem to have the greatest promise. The Abecedarian and Perry programs show high returns. Equally suggestive is the analysis of the Nurse-Family Partnership. Programs with home visits affect the lives of the parents and create a permanent change in the home environment that supports the child after center-based interventions end. Programs that build character and motivation, and do not focus exclusively on cognition, appear to be the most effective.
3. Who should provide the programs? In designing any early childhood program that aims to improve the cognitive and socio-emotional skills of disadvantaged children, it is important to respect the sanctity of early family life and cultural diversity. The point of these programs is not to assess the deservingness of parents, but to help kids. The goal of early childhood programs is to create a base of productive skills and traits for disadvantaged children from all social, ethnic, and religious groups. Engaging the private sector, including privately constituted social groups and philanthropists, augments public resources, creates community support, and ensures that diverse points of view are represented. Such collaborations foster effective and culturally sensitive programs.
4. Who should pay for them? One could make the programs universal to avoid stigmatization. Universal programs would be much more expensive and create the possibility of deadweight losses whereby public programs displace private investments by families. One solution to these problems is to make the programs universal but to offer a sliding fee schedule based on family income.
5. Will the programs achieve high levels of compliance? It is important to recognize potential problems with program compliance. Many successful programs change the values and motivations of the child. Some of these changes may run counter to the values of certain parents. There may be serious tension between the needs of the child and the acceptance of interventions by the parents. Developing culturally diverse programs will help avoid such tension. One cannot assume that there will be no conflict between the values of society as it seeks to develop the potential of the child and the values of the family, although the extent of such conflict is not yet known.
6. What policies are effective for disadvantaged adolescents who have not received the benefits of enriched early environments? While it is more effective to start young, there are still effective strategies for addressing the problems of disadvantaged adolescents. A growing body of evidence does suggest that cognitive skills are established early in life and that boosting raw IQ and problem-solving ability in the teenage years is much harder than doing so when children are young. But social and personality skills are another story. They are malleable into the early twenties, although early formation of these skills is still the best policy because they boost learning. Adolescent strategies should boost motivation, personality, and social skills through mentoring and workplace-based education.
• • •
Predistribution, Not Redistribution
There are many calls to redistribute income to address poverty and promote social mobility. The thrust of much recent work is that while redistribution surely reduces social inequality at a point in time, it does not, by itself, improve long-term social mobility or inclusion. This essay shows that predistribution—improving the early lives of disadvantaged children—is far more effective than simple redistribution in promoting social inclusion and, at the same time, at promoting economic efficiency and workforce productivity. Predistributional policies are both fair and economically efficient.
• • •
America has a growing skills problem. This produces social polarization and rising inequality of opportunity and outcomes.
A greater fraction of young Americans is graduating from college. At the same time, a greater fraction is dropping out of high school. Another consequence of the skills problem is the slowdown in growth of economic productivity. Current social policy directed toward children focuses on improving cognition. Yet success in life requires more than smarts.
Problems of rising inequality and diminished productivity growth are not due mainly to defects in public schools or to high college tuition rates. Late remediation strategies designed to compensate for early disadvantage—job training programs, high school classroom size reductions, GED programs, convict rehabilitation programs, and adult literacy programs—are not effective, at least not as currently constituted, and not on their own. Remediation in the adolescent years targeted toward non-cognitive skills can repair some of the damage of adverse early environments. But programs targeted toward the adolescent years of disadvantaged youth face an equity-efficiency tradeoff that programs targeted toward the early years of the lives of disadvantaged children avoid. We can better promote the general welfare by mitigating the unfair disadvantages that come from unfavorable early conditions.
Gaps in both cognitive and non-cognitive skills between the advantaged and the disadvantaged emerge early and can be traced in part to adverse early environments, in which a growing proportion of children are now raised. The proper measure of child adversity is the quality of parenting—not the traditional measures of family income or parental education, although they are correlated with the quality of parenting. It is important not to confuse correlation with causation. Giving families more money is not the same as enhancing the quality of the environments of disadvantaged children. We should not repeat the mistakes of the War on Poverty, although there are many recent calls to do so. Giving money to poor families does not, by itself, promote social mobility across generations. It was this insight that prompted the Clinton administration to reform the welfare system in 1996. The scarce resource is love and parenting—not money.
Social policy should, then, be directed toward the malleable early years. And it should be guided by the goal of promoting the quality of parenting and the early life environments of disadvantaged children, while also respecting the primacy of the family, showing cultural sensitivity, and recognizing America’s social diversity. And that means that effective strategies need to provide a menu of high quality programs from which parents can choose.
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September 01, 2012
26 Min read time
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