Background Decades of research shows that early childhood interventions can positively impact children's short-and long-term health, academic and economic outcomes, but that interventions' effectiveness depend on their quality. Interest in continuous quality improvement (CQI) methods is rising among early childhood clinicians, educators and policymakers. We report on a study that integrated CQI into an existing professional development program that aimed to improve the quality of preschool education in Chile and the outcomes of participating children. Objectives To analyze how CQI methods can be applied in education to impact child development, in the context of a project centered on literacy instructional strategies supported by health, socio-emotional skills and family involvement. Methods Teachers from 40 low-income classrooms received training in instructional strategies. A subset of 18 early adopters participated in a Collaborative that taught CQI methods and facilitated shared learning. Children's language skills were assessed at the beginning and end of a 2 year period using an internationally validated test. Quasi-experimental methods ( propensity scores and inverse-propensity weighting) were used to estimate the impact of professional development in instructional strategies combined with CQI methods versus professional development in instructional strategies alone.

In ADHD treatment, methylphenidate (MPH) is the most frequently used medication. The present work provides evidence that MPH restored behavioral impairments and neuroplasticity due to changes in AMPAR subunit composition and distribution, as well as maturation of dendritic spines, in a prenatal nicotine exposure (PNE) ADHD mouse model. PNE animals and controls were given a single oral dose of MPH (1 mg/kg), and their behavior was tested for attention, hyperactivity, and working memory. Long-term potentiation (LTP) was induced and analyzed at the CA3/CA1 synapse in hippocampal slices taken from the same animals tested behaviorally, measuring fEPSPs and whole-cell patch-clamp EPSCs. By applying crosslinking and Western blots, we estimated the LTP effects on AMPAR subunit composition and distribution. The density and types of dendritic spines were quantified by using the Golgi staining method. MPH completely restored the behavioral impairments of PNE mice. Reduced LTP and AMPA-receptor-mediated EPSCs were also restored. EPSC amplitudes were tightly correlated with numbers of GluA1/GluA1 AMPA receptors at the cell surface. Finally, we found a lower density of dendritic spines in hippocampal pyramidal neurons in PNE mice, with a higher fraction of thin-type immature spines and a lower fraction of mushroom mature spines; the latter effect was also reversed by MPH.

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Evaluation designs for social programs are developed assuming minimal or no disruption from external shocks, such as natural disasters. This is because extremely rare shocks may not make it worthwhile to account for them in the design. Among extreme shocks is the 2010 Chile earthquake. Un Buen Comienzo (UBC), an ongoing early childhood program in Chile, was directly affected by the earthquake. This article discusses (a) the factors the UBC team considered for deciding whether to put on hold or continue implementation and data collection for this experimental study; and (b) how the team reached consensus on those decisions. A lesson learned is that the use of an experimental design for UBC insured that the evaluation's internal validity was not compromised by the earthquake's consequences, although cohort comparisons were compromised. Other lessons can be transferred to other contexts where external shocks affect an ongoing experimental or quasi-experimental impact evaluation.