In a follow-up study at age 30, the care group was 42 percent more likely to have been employed for at least 16 months of the previous two years (75 percent of the Abecedarian group vs. 53 percent of the control group). They were almost four times more likely to have graduated from college. A similar program that provided early education to 3- and 4-year olds in Michigan, known as the Perry Preschool Program, found that as adults the subjects were almost half as likely to have committed a crime and had a 44 percent higher high school graduation rate.
Now that subjects are coming up on middle age, the findings from the 40-year follow up have moved beyond the cognitive to overall health, and Campbell herself has been shocked at the results.
"If we didn't have the actual evidence in blood serum and blood pressure, I would have fainted with shock," says Campbell. "These subjects came from the same community, similar gene pool, and it was so long ago that they received care."
Men in the treatment group, now in their mid-30s or early 40s, had less incidence of hypertension and higher levels of "good" cholesterol. Their risk factors for heart disease, diabetes and stroke were sharply lower.
Women had less risk of hypertension and lower abdominal obesity and had better lifestyle habits — they were more likely to exercise and eat well.
One of the most important things that parents can do is just talk to their babies —whether they are just cooing or smiling or playing peek-a-boo, they should be "talking a blue streak," says Steve Barnett, director of the National Institute for Early Education Research at Rutgers University.
A common analogy that people use is "serve and respond," he says. If the baby smiles, respond; if the baby burps, respond; if the baby gets a funny look on his face, make a face back. "That responsive parent is golden," he says. "That's how baby learns. It's how they learn that the world is safe, that they have control, can make things happen."
Campbell agrees: "Talk, talk talk," she says. "Don't ignore them." But she and Barnett would also like to see changes at the policy level.
"What needs to happen next is we need to create the capacity to do what we know matters and need to have processes in place to make sure it actually work well," says Barnett, who notes that too often programs offer one or two years of early education, but continuity is key. "Every year counts," he says.
In fact, New York City Mayor Bill de Blasio has made universal preschool one of his first acts in office, securing $540 million for the project just last month and calling it a "redress to inequality between rich and poor." Other states like California and Texas are looking into similar programs.
"I think the need for high-quality care for children from a poverty background is grossly unmet," says Campbell. She was in close contact with the mothers of the infants in the project, who "cared deeply." One of the most important things the children received was consistency in the program, she says, which would not have happened without the help of their mothers.
"Family always matters," she says.
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