Research

Abstract:

Early intervention (EI) and early childhood special education (ECSE) services for children with disabilities have expanded substantially across the U.S. over the past few decades, necessitating efforts to recruit and retain a qualified workforce to meet their needs. Despite widespread reports of staffing challenges in this sector, few contemporary studies provide large-scale evidence on this workforce. Using administrative data for all EI/ECSE employees in Oregon from 2008 to 2023, we provide longitudinal descriptive evidence on their composition, distribution, and stability. We show that the workforce has increased significantly, is growing more racially/ethnically diverse, and is more highly educated but less experienced than the state’s K-12 workforce. Turnover remained fairly constant during this period, with the exception of paraprofessionals and non-licensed staff whose retention steadily declined to historic lows. Finally, we show that staff are distributed somewhat inequitably throughout the state, with areas serving more low-income students having the highest child-staff ratios and fewer highly-educated teachers/interventionists. Together these analyses contribute the first longitudinal portrait of an EI/ECSE workforce, providing key insights into their staffing dynamics at scale. 

Link: https://doi.org/10.1080/19345747.2025.2611909

Abstract:

Importance:  Mothers and children in low-income households are more likely to experience worse mental and physical health than those from higher-income households.

Objective: To determine the effect of 4 years of monthly unconditional cash transfers on the mental health of mothers with low-income and the physical health of mothers and children.

Design, Setting, and Participants:  This was a parallel-group, randomized clinical trial conducted from May 2018 to July 2023. Mother-infant dyads were recruited (May 2018-June 2019) from postpartum wards in 12 hospitals in 4 cities: Omaha, Nebraska; Minneapolis/St Paul, Minnesota; New Orleans, Louisiana; and New York, New York. Data were analyzed from September 2023 to February 2025.

Interventions:  Mothers were randomly assigned to receive either a high-cash gift ($333 per month) or a low-cash gift ($20 per month) on debit cards. The cash gifts continued for the first 6 years of their children’s lives. Data analyzed here were collected after 4 years of monthly transfers.

Main Outcomes and Measures:  Outcomes were preregistered and measured around the child’s fourth birthday. Maternal outcomes included depression, anxiety, and body mass index (BMI). Child outcomes included age- and sex-adjusted BMI percentile and maternal report of child health (overall health, times sick in the past year, and presence of chronic health conditions).

Results:  A total of 1000 mother-infant dyads (mean [SD] maternal age, 27.0 [5.8] years) were included in this study. Among those mothers, 400 were randomly assigned to receive the $333 high-cash gift and 600 received the $20 low-cash gift on debit cards. Data were available from 891 mother-child dyads. No statistically detectable group differences were found in maternal depressive symptoms (effect size [ES], 0.04; 95% CI, −0.08 to 0.17; P = .51), anxiety (ES, 0.12; 95% CI, −0.02 to 0.25; P = .09), or BMI (ES, −0.06; 95% CI, −0.21 to 0.09; P = .42). In addition, there were no statistically detectable group differences in child BMI percentile (ES, −0.03; 95% CI, −0.17 to 0.12; P = .73) or overall child health (ES, 0.08; 95% CI, −0.07 to 0.22; P = .30).

Conclusions and Relevance: Monthly unconditional cash transfers totaling approximately $15 000 over 4 years to mothers with low incomes did not improve maternal mental health, maternal or child BMI, or maternal report of children’s health. These results could reflect the absence of causal connections between cash transfers and health, the possibility that impacts of early childhood income may not appear until later in life, or that an 18% increase in income is insufficient to overcome the structural vulnerabilities associated with poverty that contribute to health.

Link: https://doi.org/10.1001/jamapediatrics.2025.1612

Abstract:

How can the United States reduce the number of children in our country who, after growing up in families with incomes below the poverty line, remain poor as adults? This article summarizes key conclusions of a 2024 report issued by the Committee of the National Academies of Sciences, Engineering, and Medicine on Policies and Programs to Reduce Intergenerational Poverty.  The committee sought to identify evidence-based policies and programs directed at low-income children, their families, or their neighborhoods that could reduce children’s chances of remaining low-income as adults. The committee found direct evidence of success in affecting correlates of adult poverty (e.g., low educational attainment and earnings, poor health) for more than two dozen programs and policies addressing health; education; income and parental employment; housing; and crime. Because we concentrate on interventions focused on child health, we include a brief discussion of the importance of the involvement of health care professionals in implementing policy changes resulting from the passage of the One Big Beautiful Bill Act (OBBB Act).

Abstract:

Fifteen percent of U.S. students receive special education services, a widespread intensive intervention with variable effects on student outcomes. Spurred by changes in federal policy, many states and school districts have adopted  Response to Intervention (RTI) as an approach to identify students for special education services. RTI seeks to provide a system for targeting interventions to children facing early academic challenges and identifying children with specific learning disabilities (SLD). This paper uses a difference-in-differences design to examine the effects of RTI adoption on Oregon elementary school students’ special education identification and state-standardized achievement test scores. We find that RTI adoption reduced special education identification by 1.4 percentage points (pp) (10%), primarily through lowering SLD identification by 0.5 pp (15%) and speech or language impairment identification by 0.7 pp (12%). We show that these changes to disability identification did not come at the expense of overall academic achievement and find evidence that RTI boosted reading test scores for some minoritized subgroups. These findings suggest that RTI is a promising approach to supporting students at scale.

Link: https://doi.org/10.26300/72jm-2m09

Abstract:

Currently, 18 percent of K-12 students in the United States receive additional supports through the identification of a disability. Socioeconomic status is viewed as central to understanding who gets identified as having a disability, yet limited large-scale evidence examines how disability identification varies for students from different income backgrounds. Using unique data linking information on Oregon students and their family income, we document pronounced income-based differences in how students are categorized for two school-based disability supports: special education services and Section 504 plans. We find that a quarter of students in the lowest income percentile receive supports through special education, compared with less than seven percent of students in the top income percentile. This pattern may partially reflect differences in underlying disability-related needs caused by poverty. However, we find the opposite pattern for 504 plans, where students in the top income percentiles are two times more likely to receive 504 plan supports. We further document substantial variation in these income-based differences by disability category, by race/ethnicity, and by grade level. Together, these patterns suggest that disability-related needs alone cannot account for the income-based differences that we observe and highlight the complex ways that income shapes the school and family processes that lead to variability in disability classification and services.

EdWorkingPapers Link: https://doi.org/10.26300/dpwm-2673

CES Working Papers Link: https://www.census.gov/library/working-papers/2025/adrm/CES-WP-25-74.html

Abstract:

Currently, 6.1 percent of K-12 students in the United States receive gifted education. Using education and IRS data that provide information on students and their family income, we show pronounced differences in who schools identify as gifted across the distribution of family income. Under 4 percent of students in the lowest income percentile are identified as gifted, compared with 20 percent of those in the top income percentile. Income-based differences persist after accounting for student test scores and exist across students of different sexes and racial/ethnic groups, underscoring the importance of family resources for gifted identification in schools. 

EdWorkingPapers Link: https://doi.org/10.26300/f3f6-vf51

CES Working Papers Link: https://www.census.gov/library/working-papers/2025/adrm/CES-WP-25-73.html

Abstract:

Students with disabilities (SWDs) are central to many public investments in private schools, both through federal requirements to provide special education (SpEd) services to some children in private institutions and an increase in private school choice programs for SWDs. Despite this, we know relatively little about how private schools serve SWDs at scale. Using special education employees as one key measure of service provision, we provide the first empirical estimates of special education staffing in private schools using state administrative data. Leveraging population data on school employees in Nebraska from 2002 to 2025, we show that students in private schools are 55 percentage points less likely to have a SpEd teacher in their school and 70 percentage points less likely to have access to other SpEd licensed staff compared to public school students. At the same time, special educators employed in private schools are among the most experienced and most racially diverse teachers in the state, though they turn over at much higher rates compared to their public school counterparts. Together, these results highlight the utility of collecting administrative data on private school employees for understanding the experiences of SWDs who are increasingly being educated outside of traditional public school settings.