Abecedarian CARE Treatment Effects

CEHD has organized and synthesized the literature on early childhood education and childcare across a wide range of programs to determine which programs are most effective ( Elango, et al. 2016). Rather than just generating a meta-analysis of existing studies, we  conducted a new primary analysis of four large center-based, means-tested demonstration programs. Among them is the Abecedarian project in North Carolina.

Abecedarian boosted IQ and achievement test scores, and it is one of few interventions where the effect lasted long after treatment. In other programs, the cognitive effects dissipated after school entry.

Abecedarian, along with the Perry Preschool Project, followed participants well into adulthood,and found lasting positive outcomes. Female participants were 23.8% increase in graduation  from high school and 14.7% increase in employment at age 30. For males, graduation increased by 17.2% and employment by 30%. Participants also showed a lower rate of crime and use of welfare.

In terms of cost-effectiveness, we found a cost-benefit ratio of greater than 3:1 for all participants, with an internal rate of return of 11%.The cost-benefit was stronger for males.

Gender differences

CEHD researchers assessed the impacts of the ABC/CARE program on promoting or alleviating population differences in outcomes by gender (Garcia, Heckman and Ziff (2018).). For many outcomes, boys benefit relatively more from high-quality center childcare programs compared to low-quality programs.Low-quality childcare harms boys but girls are robust to their childcare arrangements. This evidence is consistent with previous research that finds boys to be more vulnerable early in life than girls.


We also studied the impact of ABC/CARE program effects on health in children since 2013. (Conti and Heckman (2013a), Conti and Heckman (2013b)).

In Campbell, Conti, Hekcman, et al. (2014), we report on the long-term health effects of ABC Project (ABC). Using biomedical data, the authors found that disadvantaged children randomly assigned to participate in the program had  significantly lower cardiovascular and metabolic disease in their mid-30s than those in control groups.Our evidence shows the potential of early life interventions for preventing disease and promoting health.

In Conti, et al. (2016),we find that task orientation and childhood BMI mediate approximately half of the improvements in blood pressure and hypertension found for males in the treatment group of the ABC Project.

Heckman and Garcia (2020) forecasts life-cycle treatment effects on health of the ABC program. Combining microsimulation using non-experimental data with data from the midlife follow-up study that included a full epidemiological exam, we found that ABC significantly reduces the prevalence of heart disease, stroke, cancer, and mortality across the life-cycle. Participation mainly benefited males; we estimated an average reduction of 3.8 disability-adjusted years for men.. This reduction is relatively small for females. The gain in  quality-adjusted life years is almost enough to offset all of the costs associated with program implementation for males and half of program costs for females.

Related Papers

Elango, S., , J. L. Garcia, J. J. Heckman, and A.Hojman (2016). “Early childhood education.” In R. A. Moffitt (Ed.), Economics of Means-Tested Transfer Programs in the United States, Volume 2, Chapter 4, pp. 235-297. Chicago: University of Chicago Press.

Garcia, J. L., J. J. Heckman, and A. L. Ziff (2018). “Gender differences in the effects of early childhood education.European Economics Review, 109 (October): 9–22.

Conti, G. and J. J. Heckman. (2013a). “The Developmental Approach to Child and Adult Health." Pediatrics, 131(Supplement 2): S133–S141.

Conti, G. and J. J. Heckman. (2013b). “The Economics of Child Well-Being.” In Handbook of Child Well-Being: Theories, Methods and Policies in Global Perspective, Ben-Arieh, Asher, Casas, Ferran, Frones, Ivar. and Korbin, Jill E. (Eds.) Dordrecht: Springer-Verlag. pp. 363–402. (2013).

Campbell, F. A., G. Conti, J. J. Heckman, S. H. Moon, R. Pinto, E.,P. Pungello, and Y. Pan (2014). "Early childhood investments substantially boost adult health." Science 343 (6178), 1478-1485.

Garcia, J. L. and J. J. Heckman. (2020). "Early Childhood Education and Life-cycle Health." Health Economics 2021 Nov;30 Suppl 1(Suppl 1):119-141.

Heckman, J. J., R. Pinto, and P. A. Savelyev (2013, October). “Understanding the mechanisms through which an influential early childhood program boosted adult outcomes.American Economic Review 103 (6), 2052-2086.