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October 17, 2001

Early Childhood Educational Intervention and Long-term Developmental Outcomes

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(15):1835-1836. doi:10.1001/jama.286.15.1833

To the Editor: Dr Reynolds and colleagues1 concluded that an early intervention program in Chicago produced a long-term decrease in the rates of juvenile arrest and high school dropout. However, as noted by the authors, the study did not randomly assign children to the intervention or control groups. I agree that random assignment in this situation would have been unethical, but given this design, the study cannot lead to strong causal inferences. For instance, the intervention group included only children whose caretakers were able or willing to enroll their children in the program and provide for sustained involvement in the program. The control group included children who did not participate in the preschool program because they did not live in an area that offered it. The control group thus includes both children who could have completed the program as well as children who would not have completed the program due to lack of parental involvement, transportation problems, medical problems, or other variables. The intervention group, by definition, included only children who were able to complete the program.