Researchers at Stanford recently found a certain kind of quiet urgency. It’s not the loud, newsworthy kind, but the kind that builds over time and tends to matter more in the long run. It turns out that preschools that get money from the government do a lot more than teach three- and four-year-olds how to count and share. Some kids would have gotten lost in the healthcare system otherwise, but these kids are being caught.
Adrienne Sabety and Maya Rossin-Slater of the Stanford Institute for Economic Policy Research led the study, which also included Aileen Wu as a predoctoral fellow. The study looked at Medicaid data from 32 states. What they found was consistent enough that it was hard to explain away. Children from low-income families who went to public preschool were much more likely to be diagnosed with ADHD, hearing or vision problems, or speech or language impairments. If these conditions are not treated, they can get worse over time, making it harder to learn and live a normal life.
It’s not just that these kids were marked. They were also more likely to get treatment and use other health and social services with their families after being diagnosed. Early childhood research has known for decades that this kind of intervention works best when there is a diagnosis, treatment, and then support. What’s different here is the way it works. Public preschool is more than just a place to learn. In real life, it works as a detection system.
One thing that the study found is especially important to think about. In preschool, researchers found the same age-related pattern that has been puzzling kindergarten teachers for a long time: the youngest kids in a group are much more likely to be diagnosed with developmental and mental health problems than their slightly older classmates. That’s been known for years at age five, but no one had fully mapped it out at ages three and four. They did, Sabety and her coworkers. It was much more likely for kids born just before their state’s enrollment cutoff date to get a diagnosis than for kids born just after it. This meant that those kids would be the youngest in their preschool class. It’s an odd and telling detail that makes me think that relative age and developmental visibility are more connected than most people think.
Because of the political situation at the time, this study has extra weight right now. The current administration wants to cut money from Head Start, a federal program that has helped low-income families with their kids since 1965. It is planned to break up the Department of Education, which gives money to states for public preschool programs. The researchers are careful with their words, but it’s clear what they mean. Sabety says that cutting programs like Head Start could make it take longer to get important diagnoses and make it harder to get health and social services. This is in addition to cutting classroom hours.
When you read this research, it seems like what is called a “education policy debate” is really a debate about health care. If a three-year-old has a language delay that isn’t being seen, they don’t just fall behind in reading. She is already having trouble when she starts kindergarten, and the gap tends to get bigger. When a child is four and still doesn’t have a vision problem, he’s not just squinting—he’s navigating a world that doesn’t quite make sense, and no one around him knows why.
It’s important that the results hold true for people of all races, ethnicities, genders, and locations. This is not a story about a certain group of people or a certain area. It’s a story about what structured, publicly funded programs for young children do when they’re there and what stops happening when they’re not. That’s not just a general policy question. It comes up years later in IEP meetings that may not have needed to happen at all, in classrooms, and in waiting rooms for kids.
