Early Head Start—Home-based option

Model Effectiveness
Evidence Based Model
MIECHV Eligible

219

Manuscripts

Released in 1979 through 2023

9

Manuscripts

Impact studies rated high or moderate quality

Services intended at ages
Prenatal
0-6 months
7-11 months
12-23 months
24-35 months
Favorable results from well-defined research
Child development and school readiness
Family economic self-sufficiency
Linkages and referrals
Positive parenting practices

Early Head Start serves income-eligible pregnant people and families with children younger than age 3, most of whom are at or below the federal poverty level or eligible for Part C services under the Individuals with Disabilities Education Act (IDEA) in their state. The model provides early, continuous, intensive, and comprehensive child development and family support services. Early Head Start programs include home- or center-based services, a combination of home- and center-based programs, and family child care services (services provided in family child care homes). This profile focuses on the Early Head Start–Home-based option, which includes a minimum of weekly 90-minute home visits and two group socialization activities per month for parents and their children until the child’s third birthday. Home visitors are required to have a Home Visitor Child Development Associate (CDA) or comparable credential, or have completed equivalent coursework as part of an associate or bachelor’s degree. This report also includes a review of an adaptation of Early Head Start–Home-based option services for infant mental health home-based services (IMH-HB Early Head Start) that aims to help parents build stronger relationships with their infants and toddlers, foster healthy family functioning, and support the emotional health of parents and children.

Related Models:

Where to find out more

Effectiveness

This model meets criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.

Does not meet criteria for an evidence-based home visiting model for Indigenous peoples and communities.

Extent of Evidence

For more information about manuscripts, search the research database.

For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.

219

Manuscripts

Released in 1979 through 2023

23

Manuscripts

Eligible for review

9

Manuscripts

Impact studies rated high or moderate quality

Summary of Findings

To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.

Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.

No effect:
Findings are not statistically significant.

Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.

Outcomes Manuscripts Favorable Findings No Effects Findings Unfavorable Findings
Child development and school readiness View 9 Manuscripts 5 66 0
Child health View 4 Manuscripts 0 23 0
Family economic self-sufficiency View 6 Manuscripts 16 88 1
Linkages and referrals View 2 Manuscripts 8 8 0
Maternal health View 6 Manuscripts 0 21 0
Positive parenting practices View 6 Manuscripts 10 64 0
Reductions in child maltreatment View 3 Manuscripts 0 6 0
Reductions in juvenile delinquency, family violence, and crime View 2 Manuscripts 0 6 0

Research Characteristics

Well-designed impact studies about this model included participants with the following characteristics. The evidence for effectiveness for the model may include additional studies that did not report this participant information.

Race/Ethnicity

The race and ethnicity categories may sum to more than 100 percent if Hispanic ethnicity was reported separately or respondents could select two or more race or ethnicity categories.

Black or African American
25.56%
Hispanic or Latino
25.53%
White
44.40%
Some other race
2.22%
Unknown
2.32%

Maternal Education

Less than a high school diploma
48.18%
High school diploma or GED
16.98%
Unknown
34.87%

Other Characteristics

This data is only reported if known for at least 50 percent of participants in well-designed impact studies of the model.

Enrollment in means-tested programs
53.76%

Implementation

In this section:

Overview

Theoretical approach, intended population, and targeted outcomes.

Support Availability

Service Delivery

Model services, adaptions and enhancements, model intensity and length.

Requirements

Staffing and organizational requirements.

Overview

Theoretical approach

Early Head Start is a comprehensive two-generation federal initiative aimed at enhancing the development of infants and toddlers while strengthening families. The model is founded on nine principles:

  1. High-quality services
  2. Activities that promote healthy development and identify atypical development at the earliest stage possible
  3. Positive relationships and continuity, with an emphasis on the parent’s role as the person with whom the child has their first and most important relationship
  4. Activities that offer parents a meaningful and strategic role in the program’s vision, services, and governance
  5. Inclusion strategies that respect the unique developmental trajectories of young children, including children with disabilities, in the context of a setting inclusive of children with and without disabilities
  6. Cultural competence that acknowledges the profound role culture plays in early development
  7. Comprehensiveness, flexibility, and responsiveness of services that allow children and families to move across various program options over time as their life situation demands
  8. Transition planning
  9. Collaboration with community partnerships that allow programs to expand their services

Early Head Start includes home- or center-based services, a combination of home- and center-based services, and family child care services (services provided in family child care homes). The information in this profile describes the Early Head Start–Home-based option unless specified otherwise.

Intended population

The Early Head Start–Home-based option serves income-eligible pregnant people and families with children younger than age 3. Most families must have incomes at or below the federal poverty level to be eligible for services. In addition, Early Head Start programs must make at least 10% of their enrollment opportunities available to children with disabilities who are eligible for Part C services under the Individuals with Disabilities Education Act (IDEA) in their state.

Annually, each program must develop specific program eligibility criteria, aligned with the Head Start Program Performance Standards, that prioritize selection of participants based on results from the program’s community needs assessment. This assessment identifies priority populations based on relevant family or child risk factors, including family income, whether the child is homeless, whether the child is in foster care, the child’s age, and whether the child is eligible for special education and related services or early intervention services. If a program serves migrant or seasonal families, it must give priority to children whose families can demonstrate they have relocated frequently within the past two years to pursue agricultural work.

Targeted outcomes

The Early Head Start–Home-based option aims to (1) promote healthy prenatal and birth outcomes, (2) enhance the development of very young children, (3) promote healthy family functioning, and (4) prepare children to succeed in school.

Highlights

Populations Intended
Families who are serving or formerly served in the Armed Forces
Families with a history of child abuse or neglect, or interactions with child welfare services
Families with a history of substance use disorders or in need of substance use disorder treatment
Families with children with developmental delays or disabilities
Families with low-income
Families with pregnant people under age 21
Services intended at ages
Prenatal
0-6 months
7-11 months
12-23 months
24-35 months

Support Availability

Implementation support availability

The Early Head Start program, which includes the Early Head Start–Home-based option, is administered by the Office of Head Start in the Administration for Children and Families (ACF) of the U.S. Department of Health and Human Services.

ACF regional offices oversee the administration of ACF programs, including the Early Head Start program. These offices guide the programmatic and financial management of Early Head Start programs in their jurisdictions and provide assistance, resources, and information to the various entities that administer these programs.

ACF’s Office of Head Start and Office of Child Care collaborate to provide training and technical assistance (T/TA) across early care and education programs to support the delivery of high-quality services to children and families. The T/TA consists of (1) direct funding to grantees to address needs identified in their training plans; (2) regional T/TA specialists; and (3) six national centers. These centers act collectively as comprehensive providers of resources, information, and training to build the capacity of early care and education programs and promote consistent practices across communities, states, tribes, and territories. In addition, T/TA materials are available on the Early Childhood Learning and Knowledge Center website.

Highlights

Locations where model has been implemented
Within the U.S.

Service Delivery

Model services

Early Head Start–Home-based option services are delivered through weekly 90-minute home visits and monthly group socialization activities for parents and their children.

Early Head Start–Home-based option programs must implement a developmentally appropriate, research-based early childhood home visiting curriculum that meets the following criteria:

  • Promotes the parent’s role as the child’s teacher through experiences focused on the parent–child relationship and, as appropriate, the family’s traditions, culture, values, and beliefs
  • Supports individualization and growth in the areas of development described in the Head Start Early Learning Outcomes Framework: Ages Birth to Five and, as appropriate, state early learning standards
  • Supports measurable progress toward goals outlined in the framework
  • Includes plans and materials for learning experiences based on developmental progressions and how children learn

Programs must provide parents with an opportunity to review the selected curricula and instructional materials.

If a program chooses to modify a curriculum substantially to better meet the needs of one or more populations, it must (1) partner with an early childhood education curriculum or content area expert and (2) assess whether the adaptation adequately facilitates progress toward school-readiness goals.

Model intensity and length

Early Head Start–Home-based option programs provide at least one 90-minute home visit per week, per family (with a minimum of 46 home visits per year). They also provide a minimum of two group socialization activities per month for children and their families (with a minimum of 22 group socialization activities each year).

Early Head Start–Home-based option services are available to eligible pregnant people and families with children from the child’s birth until their third birthday.

Adaptations and enhancements

A program may choose to adapt or enhance its selected curriculum to better meet the needs of one or more specific populations. The program must (1) work with an external early childhood education curriculum or content area expert to develop the adaptation and (2) assess whether the adaptation adequately facilitates progress toward meeting school-readiness goals.

Related Models:

Highlights

Language that the program is available in
Māori
Navajo
Spanish
Vietnamese
Other language
Maximum program duration
More than one year up to three years
Visit frequency
Weekly
Delivery Method Supported
Supports in-person service delivery only

Requirements

Staffing requirements

Early Head Start–Home-based option programs include several primary staff positions:

  • Home visitors who conduct home visits with families and facilitate group socialization activities
  • Home visitor supervisors
  • Comprehensive services staff (such as disabilities and health specialists)
  • A director who oversees the program

In addition, Early Head Start programs must have (1) family, health, and disabilities management staff and (2) education management staff.

Home visitors providing home-based education services must have a minimum of a Home Visitor Child Development Associate (CDA), a comparable credential, or equivalent coursework as part of an associate or bachelor’s degree. Home visitors are also required to demonstrate competency in planning and delivering home-based learning experiences that (1) effectively implement the home visiting curriculum; (2) promote children’s progress across the standards described in the Head Start Early Learning Outcomes Framework: Ages Birth to Five, including children with disabilities and dual language learners, as appropriate; and (3) build respectful, culturally responsive, and trusting relationships with families. At a minimum, supervisors must have a bachelor’s degree in early childhood education or in another field with equivalent coursework in early childhood education and teaching experience in early childhood settings.

Head Start Program Performance Standards require an organizational structure and staffing patterns to support full implementation of all requirements for the Early Head Start–Home-based option. Head Start Program Performance Standards require that such programs conduct performance reviews, use the results to identify training and professional development needs, and help improve staff skills and professional competencies.

Programs must monitor curriculum implementation and fidelity, and provide support, feedback, and supervision for continuous improvement of implementation through a system of training and professional development. Early Head Start recommends several supervision strategies to retain, develop, and support staff. They include consistent, formal, reflective supervision and opportunities for home visitors to meet together. The Early Head Start–Home-based option does not require a specific frequency of supervision; local programs determine supervision frequency.

Head Start Program Performance Standards require that Early Head Start programs conduct an orientation with all new staff that explains the goals and philosophy of the Early Head Start program and how these elements are implemented in their individual setting. In addition, all staff must be trained on how to implement the curriculum. Please contact the model developer for information about the pre-service training requirement.

Early Head Start programs must establish and implement a systematic approach to staff training and professional development, with the potential for academic credit when possible. Requirements for the training and professional development system include the following:

  • At least 15 hours of staff professional development per year
  • Training on methods to handle suspected or known child abuse and neglect cases, as aligned with applicable federal, state, local, and tribal law

The Office of Head Start does not require specific in-service training for supervisors. Local programs determine their own in-service training requirements. Please contact the model developer for additional information about ongoing professional development requirements.

Organizational requirements

According to the Head Start Program Performance Standards, Early Head Start programs can include (1) entities operating Head Start programs; (2) entities operating American Indian, Alaska Native, or Migrant and Seasonal Head Start programs; and (3) other public, nonprofit, or for-profit private entities, including community- and faith-based organizations. 

Early Head Start requires all programs to meet a set of ongoing fidelity guidelines outlined in the Head Start Program Performance Standards. Please contact the model developer for additional information about these guidelines.

Highlights

Minimum education requirement
Other specific credential
Professional certification required for home visitors
No

HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer as of the above date. HomVEE reserves the right to edit the profile for clarity and consistency. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.