IES Blog

Institute of Education Sciences

Award-Winning Efficacy Research on Improving Cognitive and Motor Skills in Infants with Neuromotor Disabilities

Headshot of Regina (Reggie) Harbourne

Congratulations to Regina (Reggie) Harbourne and her colleagues for receiving the most prestigious award of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM)—for the second time!—for their NCSER-funded research on the efficacy of the START-Play intervention. The Gayle G. Arnold Award is presented annually to the authors of the best scientific manuscript in the field. Dr. Harbourne and her colleagues received the award in 2019 for their first publication on the initial motor and cognitive outcomes of this study. They recently accepted this award again at the 2022 annual meeting for a follow-up publication on the impacts of the intervention on the important cognitive construct of object permanence.

Sitting Together and Reaching to Play (START-Play) is an intervention designed to target sitting, reaching, and motor-based problem solving in infants with motor delays or disabilities. Physical therapists work in the child’s home with the family on providing intensive, individualized activities to promote these motor skills, building toward goal-directed movements, problem-solving, and learning basic cause-effect relationships based in early motor skills. In this study, the research team conducted a randomized controlled trial with 112 infants aged 7 to 16 months. Those receiving START-Play and those in the control group all continued to receive their usual early intervention services. Children were assessed at various timepoints during the 12-week intervention as well as follow-up visits up to examine maintenance of outcomes.

In their first award-winning manuscript, START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants With Neuromotor Disorders: A Multisite Randomized Clinical Trial, the authors report on the primary impacts of the intervention. They found that for those infants with more significant motor delay, those who received START-Play had greater improvements in cognition, fine motor skills, and problem-solving (at the 3-month follow up), and greater improvements were maintained for fine motor skills and for reaching at the 12-month follow up when compared to the infants receiving usual care. In addition to the Arnold Award, this manuscript won another prestigious research award from the American Physical Therapy Association, the Chattanooga Award, which recognizes authors who publish work in the association’s journal, Physical Therapy Journal.

The most recent Arnold award was for the research team’s new secondary outcomes manuscript, Early vs. Late Reaching Mastery’s Effect on Object Permanence in Infants with Motor Delays Receiving START-Play and Usual Care Early Intervention.[1] Object permanence is the cognitive construct that allows us to maintain a continual mental representation of an object, an important working memory skill for infants to develop. This manuscript reports that, overall, infants who mastered the motor skill of reaching early showed greater development of object permanence understanding than infants who mastered reaching later. Children who reached early and also received the START-Play intervention continued to improve their object permanence understanding to a greater degree than children receiving usual care. This study extended our understanding of how object permanence relates to developing motor skills, described in the authors’ previous publication, which revealed that object permanence skills improved as sitting skills improved. Together, these two papers show how developing the motor skills of sitting and reaching are important to building cognitive skills and understanding objects in the world.

After accepting the award, Dr. Harbourne answered some questions from NCSER about her team’s research on START-Play.

What was the motivation behind your work on developing and testing the efficacy of START-Play? 

Early intervention services for children with motor delays or dysfunction are often siloed into disciplines by functional areas. For example, educators address cognitive skills and physical therapists address only motor skills. But our study supported the idea that early learning that combines movement with problem solving can advance cognitive skills, problem-solving, and fine motor skills, all areas important to eventual success in school.

What do your results tell us about how the intervention is working and its implications for implementation?  

Because we found that adding problem-solving and cognitive challenges to our motor intervention did not slow progress in motor skills, we believe that integrating motor and cognitive challenges may be better for overall development than separating these areas during service delivery. We also had a strong fidelity of intervention program, assuring that the key ingredients of the intervention were adhered to, and that it was clearly different from usual care. However, one implication is that early interventionists need further training to deliver this type of service to families of children with significant motor delays.

Please tell us about your current and ongoing work on START-Play. How are you moving forward with these positive results?

We are currently examining the data from our long-term follow-up study that we conducted with supplemental funding through NCSER. We are also working on a study, funded through NIH, to look at a dose-matched comparison of START-Play intervention with a formalized version of usual care called MORE-PT for infants with cerebral palsy. In addition, we have developed an online continuing education course that translates our findings from the original START-Play study and will help therapists to implement the key ingredients of START-Play in early intervention. We are excited to work on implementation and hope to gain further understanding of the implementation process as we move forward.

Regina (Reggie) Harbourne is the director of the infant development lab and associate professor of physical therapy in the Rangos School of Health Sciences, Duquesne University. This blog was produced by Amy Sussman, the program officer for NCSER’s Early Intervention and Early Learning program.


[1] Manuscripts are submitted for review for this award before they are published. Although AACPDM has first option to publish the wining manuscripts, the paper is not yet published or available publicly.

What Do NCES Data Tell Us About America’s Kindergartners?

Happy Get Ready for Kindergarten Month! 

For more than 20 years, the National Center for Education Statistics (NCES) has been collecting information about kindergartners’ knowledge and skills as part of the Early Childhood Longitudinal Studies (ECLS) program.

The first ECLS, the Early Childhood Longitudinal Study, Kindergarten Class of 1998–99 (ECLS-K), focused on children in kindergarten in the 1998–99 school year. At the time the ECLS-K began, no large national study focused on education had followed a cohort of children from kindergarten entry through the elementary school years. Some of today’s commonly known information about young children, such as the information about kindergartners’ early social and academic skills shown in the infographics below, comes out of the ECLS-K. For example, we all know that children arrive at kindergarten with varied knowledge and skills; the ECLS-K was the first study to show at a national level that this was the case and to provide the statistics to highlight the differences in children’s knowledge and skills by various background factors.



The second ECLS kindergarten cohort study, the Early Childhood Longitudinal Study, Kindergarten Class of 2010–11 (ECLS-K:2011), is the ECLS-K’s sister study. This study followed the students who were in kindergarten during the 2010–11 school year. The ECLS-K:2011, which began more than a decade after the inception of the ECLS-K, allows for comparisons of children in two nationally representative kindergarten classes experiencing different policy, educational, and demographic environments. For example, significant changes that occurred between the start of the ECLS-K and the start of the ECLS-K:2011 include the passage of No Child Left Behind legislation, a rise in school choice, and an increase in English language learners. 

From the parents of children in the ECLS-K:2011, we learned how much U.S. kindergartners like school, as shown in the following infographic.



The ECLS program studies also provide information on children’s home learning environments and experiences outside of school that may contribute to learning. For example, we learned from the ECLS-K:2011 what types of activities kindergartners were doing with their parents at least once a month (see the infographic below).


Infographic titled How do kindergarteners like school?


What’s next for ECLS data collections on kindergartners? NCES is excited to be getting ready to launch our next ECLS kindergarten cohort study, the Early Childhood Longitudinal Study, Kindergarten Class of 2023–24 (ECLS-K:2024)

Before the ECLS-K:2024 national data collections can occur, the ECLS will conduct a field test—a trial run of the study to test the study instruments and procedures—in the fall of 2022.

If you, your child, or your school are selected for the ECLS-K:2024 field test or national study, please participate! While participation is voluntary, it is important so that the study can provide information that can be used at the local, state, and national levels to guide practice and policies that increase every child’s chance of doing well in school. The ECLS-K:2024 will be particularly meaningful, as it will provide important information about the experiences of children whose early lives were shaped by the COVID-19 pandemic.

Watch this video to learn more about participation in the ECLS-K:2024. For more information on the ECLS studies and the data available on our nation’s kindergartners, see the ECLS homepage, review our online training modules, or email the ECLS study team.

 

By Jill Carlivati McCarroll, NCES

Announcing the Condition of Education 2022 Release

NCES is pleased to present the 2022 edition of the Condition of Education. The Condition is part of a 150-year tradition at NCES and provides historical and contextual perspectives on key measures of educational progress to Congress and the American public. This report uses data from across NCES and from other sources and is designed to help policymakers and the public monitor the latest developments and trends in U.S. education.

Cover of Report on the Condition of Education with IES logo and photos of children reading and writing

The foundation of the Condition of Education is a series of online indicators. Fifty-two of these indicators include content that has been updated this year. Each indicator provides detailed information on a unique topic, ranging from prekindergarten through postsecondary education, as well as labor force outcomes and international comparisons. In addition to the online indicator system, a synthesized overview of findings across topics is presented in the Report on the Condition of Education.

This year, we are excited to begin the rollout of interactive figures. These new interactive figures will empower users to explore the data in different ways. A selection of these indicators are highlighted here. They show various declines in enrollment that occurred during the coronavirus pandemic, from early childhood through postsecondary education. (Click the links below to explore the new interactive figures!)

  • From 2019 to 2020, enrollment rates of young children fell by 6 percentage points for 5-year-olds (from 91 to 84 percent) and by 13 percentage points for 3- to 4-year-olds (from 54 to 40 percent).
  • Public school enrollment in prekindergarten through grade 12 dropped from 50.8 million in fall 2019 to 49.4 million students in fall 2020. This 3 percent drop brought total enrollment back to 2009 levels (49.4 million), erasing a decade of steady growth.
  • At the postsecondary level, total undergraduate enrollment decreased by 9 percent from fall 2009 to fall 2020 (from 17.5 million to 15.9 million students). For male and female students, enrollment patterns exhibited similar trends between 2009 and 2019 (both decreasing by 5 percent). However, from 2019 to 2020, female enrollment fell 2 percent, while male enrollment fell 7 percent. Additionally, between 2019 and 2020, undergraduate enrollment fell 5 percent at public institutions and 2 percent at private nonprofit institutions. In contrast, undergraduate enrollment at for-profit institutions was 4 percent higher in fall 2020 than in fall 2019, marking the first positive single year change in enrollments at these institutions since 2010. Meanwhile, at the postbaccalaureate level, enrollment increased by 10 percent between fall 2009 and fall 2020 (from 2.8 million to 3.1 million students).
  • Educational attainment is associated with economic outcomes, such as employment and earnings, as well as with changes in these outcomes during the pandemic. Compared with 2010, employment rates among 25- to 34-year-olds were higher in 2021 only for those with a bachelor’s or higher degree (84 vs 86 percent). For those who had completed high school and those with some college, employment rates increased from 2010 to 2019, but these gains were reversed to 68 and 75 percent, respectively, during the coronavirus pandemic. For those who had not completed high school, the employment rate was 53 percent in 2021, which was not measurably different from 2019 or 2010.

This year’s Condition also includes two spotlight indicators. These spotlights use data from the Household Pulse Survey (HPS) to examine education during the coronavirus pandemic.

  • Homeschooled Children and Reasons for HomeschoolingThis spotlight opens with an examination of historical trends in homeschooling, using data from the National Household Education Survey (NHES). Then, using HPS, this spotlight examines the percentage of adults with students under 18 in the home who were homeschooled during the 2020–21 school year. Some 6.8 percent of adults with students in the home reported that at least one child was homeschooled in 2020–21. The percentage was higher for White adults (7.4 percent) than for Black adults (5.1 percent) and for Asian adults (3.6 percent). It was also higher for Hispanic adults (6.5 percent) than for Asian adults.
  • Impact of the Coronavirus Pandemic on Fall Plans for Postsecondary Education: This spotlight uses HPS data to examine changes in plans for fall 2021 postsecondary education made in response to the coronavirus pandemic. Among adults 18 years old and over who had household members planning to take classes in fall 2021 from a postsecondary institution, 44 percent reported that there was no change for any household member in their fall plans for postsecondary classes. This is compared with 28 percent who reported no change in plans for at least one household member one year earlier in the pandemic, for fall 2020.

The Condition also includes an At a Glance section, which allows readers to quickly make comparisons within and across indicators, as well as a Reader’s Guide, a Glossary, and a Guide to Sources that provide additional information to help place the indicators in context. In addition, each indicator references the source data tables that were used to produce that indicator. Most of these are in the Digest of Education Statistics.

In addition to publishing the Condition of Education, NCES produces a wide range of other reports and datasets designed to help inform policymakers and the public about significant trends and topics in education. More information about the latest activities and releases at NCES may be found on our website or by following us on Twitter, Facebook, and LinkedIn.

 

By Peggy G. Carr, NCES Commissioner

Valuing Culture and Community: Supporting Hmong Children’s Home Language and Early Language and Literacy Development

This year, Inside IES Research is publishing a series of blogs showcasing a diverse group of IES-funded education researchers and fellows that are making significant contributions to education research, policy, and practice. In recognition of Asian American and Pacific Islander Heritage Month we interviewed Dr. Lori Erickson, St. Paul Public Schools, and Dr. Alisha Wackerle-Hollman, University of Minnesota, who are developing a screening tool to assess the language and literacy skills of Hmong preschoolers. In this interview blog, we asked Lori and Alisha to discuss the motivation for their collaborative work, what they have learned so far, and the importance of conducting research with ethnically and linguistically diverse students and communities.  

What motivated your team to study the outcomes of Hmong preschoolers?

Our team is a unique collaboration between practitioners at the St. Paul Public Schools (SPPS) and researchers at the University of Minnesota IGDILab. We are both deeply committed to supporting children’s full language and early literacy profiles across their languages to better inform instructional decision making and show a commitment to valuing culture through honoring children’s home language. When we started this project, we knew that the Individual Growth and Development (IGDIs) early literacy screening and progress monitoring measures were available in English and Spanish, and we had been implementing with great success. However, given that the district provides pre-K immersion programming in Spanish, French, and Hmong, it became clear that there was also a concentrated need for a valid, reliable tool to measure early literacy development in the Hmong language. The Hmong community, parents, and teachers voiced the need for a deeper understanding of the Hmong language and literacy skills that children acquire prior to and during the preschool period.

Prior to our current work, the IGDILab had significant experience developing the IGDIs Español, during which we refined a community-based approach for understanding language and early literacy development that took into consideration the developmental trajectory of each language, rather than as a translation to English. IGDI users noticed this difference, and SPPS approached our team about using a similar approach to develop the Hmong IGDI measures.

Please tell us about the two projects you have worked on together to address the early learning needs of Hmong students.

Our partnership has had the good fortune to receive two IES awards. The first award was a 2017 research partnership grant. We invested two years in gathering information from the community about what Hmong IGDI measures should include and developing a deeper understanding of the Hmong language landscape. The success of that program led to an IES measurement award to fully develop the Hmong IGDI measures. Currently in Year 1 of the measurement award, we have learned so much from both projects over the past four years.

  • There is tremendous passion around the Hmong language. Stakeholders, including community elders, families, students, and educators, have shown a deep passion for celebrating and honoring the Hmong language. These discussions have focused on nuances of the language including generational differences, dialectical differences, and cultural representation.
  • We have learned much about how the language has evolved. The Hmong language is spoken most frequently by elders. Children are often exposed to the language in the presence of elders, creating a cultural and social dynamic that requires inter-generational conversation to support language preservation.
  • Although it is important to understand how a child’s native Hmong language can support their academic success in Hmong and English, it is also critically important to support Hmong language development to support social pride and cultural identity.

Throughout our work we have affirmed that studies like ours that focus on minoritized languages in concentrated communities are critical to support children’s success and to promote language preservation.       

How does your research contribute to a better understanding of the importance of studying low incidence populations, including ethnically and linguistically diverse students?

There are over 300,000 Hmong in the United States, and the Hmong population is the fastest growing of the East Asian group (US Census Bureau, 2017). Hmong Americans represent one of the most under-served cultural communities in the US, concentrated in two specific areas: the Midwest—St Paul, MN and Madison, WI—and the Central Valley of California (Pew Research, 2015).

Given the high levels of poverty and the large percentage of students entering the U.S. education system, Hmong Americans represent an important Asian subgroup that may continue on a negative academic and economic trajectory if meaningful intervention is not put into place.  The needs of Hmong Americans warrant our attention to bring educational opportunity and equity to a growing but marginalized group of children and to contribute to our broader mandate to conduct research that contributes to the betterment of all children.

Our effort to develop Hmong IGDIs will provide educators with a set of resources that are instructionally relevant—that is, the measures can be used to provide data that have direct implications for instructional practices, such as informing how to modify instruction to maximize Hmong language and early literacy development. In this way, our work aims to demonstrate a deep value of the Hmong language, support educators to understand children’s Hmong language and early literacy skills and improve their academic outcomes through differentiated instruction.

In your area of research, what do you see as the greatest research needs or recommendations to address and improve the relevance of education research for diverse communities of students and families?

Volumes of research demonstrate the importance of language and early literacy development during the preschool years. However, this research has provided little attention on low incidence populations, including ethnically and linguistically diverse students (for example, Hmong, Karen, Somali, and Indigenous dialects). These children’s outcomes are just as important as those of majority populations. We must invest in these low-incidence populations to create a more equitable educational experience for our youngest learners.

An omnipresent need in this arena is the need to involve and collaborate with the communities, families, and educators that education research intends to serve. Indeed, the strongest parts of our work involves the feedback we receive from community and family members. Our team includes three Hmong community members as staff, and we continuously engage the community in our process. Our initial interview and focus groups drove the creation of a community level survey to gather input on what features of the language were most important to the community. We then used those data as a catalyst to form a strong partnership between the community, family members, and the research institution, which has resulted in a process that is meaningful to all parties. If we expect our education research to be meaningful in communities of practice, we must improve how we value and collaborate with those communities in partnership.

How does your research contribute to a better understanding of the importance of diversity, equity, and inclusion in education?

This work has a direct connection to equity and inclusion in education. The Hmong are a low-incidence population, which has contributed to their marginalization. As an example of how this community experiences marginalization and inequities, we share our experience in the IES review process. When we first submitted our application for a measurement goal project the review panel provided a weak score for our application noting that they could not justify the resources of an IES award on such a small population, among other weaknesses. These results illustrate just how inequitable our system has been. When we reapplied the following year, we developed an argument around equity. Fortunately, the reviewers agreed with our rationale and funded this project.

We fully recognize the Hmong community is small and highly concentrated, and we fully believe developing the Hmong IGDI measures will provide a meaningful resource to these communities to support Hmong children’s language and early literacy development. As our nation continues to grow in diversity, we will see more and more languages in our classrooms. We must develop procedures and resources that can support all students, not just those historically centered. As evidence grows, we are learning about how a child’s native language used in community can be an asset to their academic performance in the classroom, even when the instructional language is English. These findings provide evidence of how inclusive practices that include native languages can be beneficial to all students, not just to monolingual English speakers.


Produced by Caroline Ebanks (Caroline.Ebanks@ed.gov), Team Lead for Early Childhood Research and program officer for the National Center for Education Research.

Using Cost Analysis to Inform Replicating or Scaling Education Interventions

A key challenge when conducting cost analysis as part of an efficacy study is producing information that can be useful for addressing questions related to replicability or scale. When the study is a follow up conducted many years after the implementation, the need to collect data retrospectively introduces additional complexities. As part of a recent follow-up efficacy study, Maya Escueta and Tyler Watts of Teachers College, Columbia University worked with the IES-funded Cost Analysis in Practice (CAP) project team to plan a cost analysis that would meet these challenges. This guest blog describes their process and lessons learned and provides resources for other researchers.

What was the intervention for which you estimated costs retrospectively?

We estimated the costs of a pre-kindergarten intervention, the Chicago School Readiness Project (CSRP), which was implemented in nine Head Start Centers in Chicago, Illinois for two cohorts of students in 2004-5 and 2005-6. CSRP was an early childhood intervention that targeted child self-regulation by attempting to overhaul teacher approaches to behavioral management. The intervention placed licensed mental health clinicians in classrooms, and these clinicians worked closely with teachers to reduce stress and improve the classroom climate. CSRP showed signs of initial efficacy on measures of preschool behavioral and cognitive outcomes, but more recent results from the follow-up study showed mainly null effects for the participants in late adolescence.

The IES research centers require a cost study for efficacy projects, so we faced the distinct challenge of conducting a cost analysis for an intervention nearly 20 years after it was implemented. Our goal was to render the cost estimates useful for education decision-makers today to help them consider whether to replicate or scale such an intervention in their own context.

What did you learn during this process?

When enumerating costs and considering how to implement an intervention in another context or at scale, we learned four distinct lessons.

1. Consider how best to scope the analysis to render the findings both credible and relevant given data limitations.

In our case, because we were conducting the analysis 20 years after the intervention was originally implemented, the limited availability of reliable data—a common challenge in retrospective cost analysis—posed two challenges. We had to consider the data we could reasonably obtain and what that would mean for the type of analysis we could credibly conduct. First, because no comprehensive cost analysis was conducted at the time of the intervention’s original implementation (to our knowledge), we could not accurately collect costs on the counterfactual condition. Second, we also lacked reliable measures of key outcomes over time, such as grade retention or special education placement that would be required for calculating a complete cost-benefit analysis. This meant we were limited in both the costs and the effects we could reliably estimate. Due to these data limitations, we could only credibly conduct a cost analysis, rather than a cost-effectiveness analysis or cost-benefit analysis, which generally produce more useful evidence to aid in decisions about replication or scale.

Because of this limitation, and to provide useful information for decision-makers who are considering implementing similar interventions in their current contexts, we decided to develop a likely present-day implementation scenario informed by the historical information we collected from the original implementation. We’ll expand on how we did this and the decisions we made in the following lessons.

2. Consider how to choose prices to improve comparability and to account for availability of ingredients at scale.

We used national average prices for all ingredients in this cost analysis to make the results more comparable to other cost analyses of similar interventions that also use national average prices. This involved some careful thought about how to price ingredients that were unique to the time or context of the original implementation, specific to the intervention, or in low supply. For example, when identifying prices for personnel, we either used current prices (national average salaries plus fringe benefits) for personnel with equivalent professional experience, or we inflation-adjusted the original consulting fees charged by personnel in highly specialized roles. This approach assumes that personnel who are qualified to serve in specialized roles are available on a wider scale, which may not always be the case.

In the original implementation of CSRP, spaces were rented for teacher behavior management workshops, stress reduction workshops, and initial training of the mental health clinicians. For our cost analysis, we assumed that using available school facilities were more likely and tenable when implementing CSRP at large scale. Instead of using rental prices, we valued the physical space needed to implement CSRP by using amortized construction costs of school facilities (for example, cafeteria/gym/classroom). We obtained these from the CAP Project’s Cost of Facilities Calculator.

3. Consider how to account for ingredients that may not be possible to scale.

Some resources are simply not available in similar quality at large scale. For example, the Principal Investigator (PI) for the original evaluation oversaw the implementation of the intervention, was highly invested in the fidelity of implementation, was willing to dedicate significant time, and created a culture that was supportive of the pre-K instructors to encourage buy-in for the intervention. In such cases, it is worth considering what her equivalent role would be in a non-research setting and how scalable this scenario would be. A potential proxy for the PI in this case may be a school principal or leader, but how much time could this person reasonably dedicate, and how similar would their skillset be?  

4. Consider how implementation might work in institutional contexts required for scale.

Institutional settings might necessarily change when taking an intervention to scale. In larger-scale settings, there may be other ways of implementing the intervention that might change the quantities of personnel and other resources required. For example, a pre-K intervention such as CSRP at larger scale may need to be implemented in various types of pre-K sites, such as public schools or community-based centers in addition to Head Start centers. In such cases, the student/teacher ratio may vary across different institutional contexts, which has implications for the per-student cost. If delivered in a manner where the student/ teacher ratio is higher than in the original implementation, the intervention may be less costly, but may also be less impactful. This highlights the importance of the institutional setting in which implementation is occurring, and how this might affect the use and costs of resources.

How can other researchers get assistance in conducting a cost analysis?

In conducting this analysis, we found the following CAP Project tools to be especially helpful (found on the CAP Resources page and the CAP Project homepage):

  • The Cost of Facilities Calculator: A tool that helps estimate the cost of physical spaces (facilities).
  • Cost Analysis Templates: Semi-automated Excel templates that support cost analysis calculations.
  • CAP Project Help Desk: Real-time guidance from a member of the CAP Project team. You will receive help in troubleshooting challenging issues with experts who can share specific resources. Submit a help desk request by visiting this page.

Maya Escueta is a Postdoctoral Associate in the Center for Child and Family Policy at Duke University where she researches the effects of poverty alleviation policies and parenting interventions on the early childhood home environment.

Tyler Watts is an Assistant Professor in the Department of Human Development at Teachers College, Columbia University. His research focuses on the connections between early childhood education and long-term outcomes.

For questions about the CSRP project, please contact the NCER program officer, Corinne.Alfeld@ed.gov. For questions about the CAP project, contact Allen.Ruby@ed.gov.