The cumulative evidence of research on early childhood care and children's development consistently finds that higher-quality care is predictive of a range of positive developmental outcomes for children, including improved language development, cognitive functioning, social competence, and emotional adjustment. This has led many states to attempt to improve the availability of high quality early childhood care through a tiered quality rating system. Under this system, states define thresholds or cut-off points across various dimensions of quality, and provide different amounts of reimbursement to providers depending on their compliance with the quality standards. The literature provides little guidance to state policymakers as to where the thresholds should be set, as few studies have identified the specific cut off points or thresholds that can distinguish among different levels of child outcomes. Thus, it is unknown whether the cut off points established by state policymakers actually discriminate among better and worse child outcomes. This can raise fairness questions if providers receive different amounts of reimbursement for implementing different levels of quality, yet there are no differences in child outcomes. The purpose of this study is to provide some guidance to state policymakers about potentially optimal cut off points by using advanced statistical methods to identify the thresholds that must be exceeded before significant differences in child outcomes can be observed between providers that meet the established quality standards and providers that do not. It will also identify the points at which there are diminishing returns in quality investments. We will use data from the Cost, Quality, and Outcomes Study and the Early Childhood Longitudinal Study Birth Cohort through 2 years old, Restricted Use to examine threshold effects. We will examine various quality indicators, such as staff education and training, childstaff ratios, group size (i.e., the number of children in the class), ECERS/ITERS, and parental involvement. Children's social, cognitive, and physical health outcomes will serve as the outcome measures. The results of the study will give policymakers a better indication of which specific cut off points discriminate among different levels of child outcomes. This will help inform sensible approaches to differential reimbursement strategies.

Public Health Relevance

This study will give policymakers a better indication of which specific cut‐off points discriminate among different levels of child outcomes. It will also identify the points at which there are diminishing returns of investments in quality. This will help inform sensible approaches to differential reimbursement strategies.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Research Grants (R03)
Project #
5R03HD055295-02
Application #
7591056
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
King, Rosalind B
Project Start
2008-04-01
Project End
2011-03-31
Budget Start
2009-04-01
Budget End
2011-03-31
Support Year
2
Fiscal Year
2009
Total Cost
$91,419
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
006914071
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Setodji, Claude Messan; Schaack, Diana; Le, Vi-Nhuan (2018) Using the Early Childhood Environment Rating Scale-Revised in High Stakes Contexts: Does Evidence Warrant the Practice? Early Child Res Q 42:158-169
Le, Vi-Nhuan; Schaack, Diana D; Messan Setodji, Claude (2015) Identifying Baseline and Ceiling Thresholds within the Qualistar Early Learning Quality Rating and Improvement System. Early Child Res Q 30:215-226
Setodji, Claude Messan; Le, Vi-Nhuan; Schaack, Diana (2013) Using generalized additive modeling to empirically identify thresholds within the ITERS in relation to toddlers' cognitive development. Dev Psychol 49:632-45