Thus, an era of substantial growth in investments, program development, and research has led to tangible gains in the scope and quality of early childhood services, but also a sharpened understanding of the distance which remains between our present situation and a fully equitable and adequate system for supporting young children and parents. Moreover, the focus of federal policy debate have shifted from improving specific early childhood programs to more global and ideological concerns of federalism and fiscal policy. Within this context, this study provides information about the effects of current government policy and funding efforts on the shape and quality of local early childhood agencies.
Research Design
This report is the product of a study commissioned by the Office of Education Research and Improvement (OERI), U.S. Department of Education, to document and analyze significant local examples of innovative and successful reforms in early childhood services. The study was designed to provide useful information to early childhood practitioners who work directly with children and families, managers who direct early childhood agencies and programs, and policymakers who make decisions about program and funding strategies. Accordingly, the central purposes for this examination of early childhood strategies are as follows:
- - To describe innovative, effective local strategies for serving young children and their parents and contributing to assuring that participants are prepared for success when they enter elementary school.
- - To analyze key factors in the design and implementation of these programs.
- - To describe how state and federal policies support or inhibit successful management and front-line service strategies.
- - To provide recommendations to early childhood practitioners, managers and policymakers on how to create more high quality early childhood programs.
The principal research strategy was preparing seven detailed case studies of local programs. Based on analysis of research literature and policy trends, we selected initiatives with the following characteristics:
- - Programs which serve young children from low-income and working families who are dealing with challenges such as domestic violence, illiteracy, social isolation, and substance abuse.
- - Programs which provide comprehensive services, defined as including early care and education, health services, parenting education, and linkages to other social and family services.
- - Strategies which provide services and supports to both young children and their parents.
- - Agencies which offer stable, sustained, and continuous support, rather than only a single year of program services.
- - Initiatives recognized for providing high quality and innovative forms of services to families and an environment which supports professional development of staff members.
- - Projects which reflect a diversity of service strategies (such as both home-based and classroom-centered delivery) and a range of organizational settings, including Head Start, public school, and child care agencies.
Based on these criteria, our seven case study sites were the following:
- - Child Development, Inc. (CDI) in Russelville, Arkansas is a Head Start grantee which provides comprehensive services through home-based programs, prekindergarten and child care services, and special initiatives for teen parents, participants in Arkansas's welfare reform initiative, and families in need of literacy or employment training.
- - Inn Circle, Inc. in Cedar Rapids, Iowa is a Head Start-based initiative to serve homeless, single parents with young children in a residential facility -- combining child care services with education, employment, and community-building services for families.
- - Sheltering Arms, Inc. in Atlanta, Georgia combines family support and child care services to low income and working families using an innovative blend of funding from the United Way, corporations, state and federal child care programs, and fees from parents.
- - The Parent Services Project (PSP) in Fairfax, California is a national strategy to infuse family support and involvement principles and services into child care and early childhood agencies.
- - The James E. Biggs Early Childhood Center in Covington, Kentucky houses prekindergarten, family support and home visitation programs, developed and managed by an innovative partnership between a local school district and a non-profit child care agency.
- - Jersey City, New Jersey's Early Childhood Program, a prekindergarten program and a curriculum and staff development initiative in primary grade classrooms, began through state funding and has grown substantially through the investment of local school funds.
- - Family and Child Education (FACE), a national initiative of the Bureau of Indian Affairs, combines three research-based strategies (Parents As Teachers, Family Literacy, and the High/Scope curriculum) to provide Native American families with home-based parent education, adult literacy services, and a prekindergarten classroom program.
Findings
Consistent with our focus on assisting practitioners, managers, and policy audiences, our findings are presented in the form of strategies observed across our seven case studies for working with children and families, in local management of resources and program quality, and in terms of how state and federal policies influence the shape and effectiveness of local services.
Strategies to Promote Child Development
1. Programs implement a developmentally appropriate approach in classroom environments and instruction.
Across visits to Head Start, child care, and public school agencies, we found a highly uniform approach to teaching and classroom environments, characterized by adherence to the tenets of "developmentally appropriate practice" as promulgated by the National Association for the Education of Young Children (Bredekamp, 1987). Key elements of this approach include active learning through giving children opportunity to choose from a variety of interest centers, equipped to provide different social and learning experiences. Teaching strategies often include an overarching theme to tie together materials, discussion, and activities. Teachers use observational checklists, anecdotal records, and samples of children's work to track their progress, understand their styles and rates of learning and development, and assess their own work as professionals.
2. Teachers work to respond to the individual needs of students within a framework of developmentally appropriate practice.
Within a general framework of age-appropriate practices, teachers work to meet the individual needs of children due to disabilities, cultural and linguistic diversity, or challenges of growing up in stressful, violent environments. For example, teachers adjust their routines and expectations to many children who are aggressive or who have difficulty expressing themselves, playing with other children, and responding to staff requests and program rules. Teachers adjust the pace and variety of activities, provide more time for nurturing individual children, work with parents to understand sources of stress in the home and neighborhood, and make use of diagnostic observation of children with severe difficulties by other staff members and specialists.
3. Teachers include parents in the daily life of early childhood classrooms.
Early childhood teachers orient their daily work towards families in several ways, including their design of the physical environment of classrooms, their regular use of parents as volunteers, and efforts to communicate with parents around the progress of their children. For example, FACE programs include daily Parent And Child Time, where parents leave their adult literacy classes to read, work, play with and observe their children. Covington, Kentucky sponsors a highly successful training program to prepare mothers to work in classrooms and Dad's Nights which draw over 100 fathers to work with their children at the center. Programs develop mechanisms to ensure that classroom staff can draw on information and insights gained by other staff who work with parents.
4. Programs collaborate with public schools to improve the transition of children and families as they enter kindergarten and to enhance continuity between early childhood and school programs.
Programs and schools have developed formal agreements for sharing information about children and promoting the involvement of parents in kindergarten programs. Teachers bring their children to visit nearby elementary schools to become familiar with the facility and the routines of kindergarten classrooms. Early childhood and public school teachers exchange visits to observe classrooms across program lines to learn about how each setting works with children. Early childhood programs coach parents in how to ask questions of school personnel and give them the skills and confidence to handle future issues on their own. Projects and schools collaborate in joint staff development activities with early childhood, kindergarten, and primary grade teachers.
Strategies To Serve and Involve Families
Early childhood agencies use a variety of strategies to address parents' needs to work with their young children, to pursue further education and employment opportunities, to connect with other community agencies, and to move towards self-sufficiency and citizenship.
1. Programs seek to enhance parents' skills, knowledge, and motivation to be involved with their children's education.
A core strategy in all seven agencies are parent education services, offered through organized classes, the provision of learning materials for families to use at home, peer support networks, and home visitation programs. Parents learn about child development, discuss challenges such as discipline, and engage in developmental activities with their children. Home visitors provide individual attention to each family and allow staff to learn more about home environments. Home visitors engage the child in stimulating activities to develop motor, cognitive, language, and social skills. Parents and the home visitor share information about the child's behaviors, milestones are noted, and parents learn about the value of talking to and playing with their child.
2. Early childhood programs support parents in their journey towards education and self- sufficiency.
Programs offer parents the opportunity to improve literacy skills, continue their education, obtain employment training, and move toward self-sufficiency. Family coordinators help parents prioritize goals and gain access to educational opportunities within the program or in the community. One advantage of linking adult education services with early childhood programs lies in the non-threatening, nurturing settings of such programs. This is especially important for parents who dropped out of school and might have negative attitudes about learning. However, helping families move toward self-sufficiency is not without challenges. In communities where economic opportunities are very limited, it is very difficult to convince parents that education and training will make them employable. In other cases, when parents are working, looking for work, or involved with seasonal employment, they have problems in attending and completing literacy and job training classes.
3. Programs help parents gain access to services which address their needs through partnerships with community agencies.
The seven programs help families gain access to other services and programs through referrals, shared service contracts, case management strategies, and more comprehensive networking and system change efforts. Partnership relationships also involve difficulties, such as inadequate availability of health services, affordable child care, substance abuse treatment, and mental health services. Coordination is also difficult when agencies do not share the same philosophy of working with families.
4. Programs create "caring communities" for parents by providing social support and catalyzing participation in community institutions.
The process of helping families become self-sufficient involves a careful blend of providing needed services, reducing family isolation, expanding social support networks, and giving families a chance to contribute and be valued by their community. Very often the relationships between parents and staff have the most impact on parents' involvement with the program. When staff make an effort to welcome and build trusting relationships with families, parents respond by making the effort to work closely with them and to live up to their expectations. For some parents, this engagement catalyzes broader involvement in community affairs and advocacy for children. Parent-to-parent relationships are another important source of support and an opportunity for parents to extend themselves as contributors in a program setting. Some programs create skills/resource exchange networks that enable families to develop practical group solutions to their needs. A final strategy which equips parents to contribute to their communities is experience in decisionmaking. Agencies invite parents to participate on policy committees, to engage in decisions on budget and service priorities, evaluation, fundraising and staffing. In all these ways, parents are encouraged to move from clients of public agencies to contributing members of their communities.
Management Strategies
While these seven managers work in different types of organizations in terms of history, size, complexity, and structure, they all balance energy and effort between two crucial priorities:
- - Raising money and managing relationships with varied government agencies and private sector supporters.
- - Providing leadership in program quality, chiefly through nurturing, training, setting standards and inspiring the efforts of staff members.
1. Managers employ a variety of fundraising strategies to build agency services.
Local managers are pressed to raise funds to maintain their current programs, reduce waiting lists of eligible families, serve different types of community needs or new client groups, (such as teen parents or families with infants and toddlers), and anticipate contingencies such as shifts in priorities among their present mix of supports. Early childhood agencies tend to begin through support from a single state or federal program, and expand over time by garnering a wider range of public and private funding sources. Programs in this study go "beyond the usual suspects" in seeking support from economic development agencies, job training and vocational education programs, and welfare reform initiatives.
2. Managers mobilize local voluntary and private sector funds to complement state and federal program support and to enhance community ownership of early childhood services.
Agencies draw on local community resources to complement state and federal program resources. For example, the Jersey City initiative began with state department of education resources, but has expanded through local school funding. Similarly, the Covington Public Schools spent $1.8 million to purchase and renovate a facility for its early childhood program and provides in-kind fiscal management, transportation, and maintenance services to the program. Sheltering Arms uses United Way funding to support its central administrative operation and for a scholarship fund which bridges the gap between the rates of reimbursement from public vouchers and parental fees and the costs of its comprehensive, high quality services. It also solicits more than $350,000 annually from some 64 different businesses, and 26 local foundations.
3. The diversity of revenue sources used by early childhood agencies demands sophisticated management skills by program directors.
Early childhood managers contend with a "hustle factor" of competition for resources and a "hassle factor" of administrative complexity in managing diverse funding streams with conflicting requirements. Administrative complexity increases as an agency works with multiple sources, each with different timelines, reporting and refunding requirements, definitions of eligibility, and standards for staffing, allowable costs and program quality. Managers struggle to create coherent programs and a common sense of mission among staff members funded from a variety of sources.
4. Program managers set the stage for program quality by crafting staffing patterns and compensation systems for their agencies.
As local managers set up staffing and compensation systems, they attempt to strike a balance in assuring program quality, supporting career growth for staff members, and using limited resources efficiently. These choices are shaped by external mandates in staff:child ratios, credentials, and service components, and indirectly by rates of funding.
5. Administrators place a priority on professional development and supervision as central strategies in building quality front-line services.
Early childhood programs provide substantial staff development because many staff members enter the field without extensive college training or certification. The prevalence of on-the-job training and a career ladder approach to staffing distinguishes most early childhood programs from the public schools. Agencies provide direct training, subsidize enrollment in community college and higher education programs, and use their experienced teachers as mentors for newer staff. Programs also support staff and strengthen program quality through coaching and evaluation by supervisors.
6. Early childhood administrators are leaders in promoting quality services beyond the boundaries of their own agencies.
Sheltering Arms in Atlanta has created the IN TRAINING subsidiary to disseminate curriculum materials and provide training to staff from 400 early childhood programs in Georgia and neighboring states. The Parent Services Project has developed training materials and a dissemination strategy to support spread of the PSP program in other communities and settings. Local managers also serve as officers in state, regional and national organizations; write articles and deliver conference presentations; serve on monitoring and proposal review teams; and contribute to advocacy efforts to improve early childhood funding and policy.
Policy Effects In Local Agencies
These case studies show how state and federal policies influence the size, shape, and quality of local programs. They illustrate three facets of public policy: funding decisions, policy strategies to support program quality, and features of intergovernmental relationships.
1. Present levels of public investment are inadequate to support equitable access or quality services; and the present system of multiple categorical programs creates problems for local managers and for policymakers.
Our present set of state and federal early childhood programs constitute a "union of insufficiencies." No single program is funded to serve more than a fraction of its eligible clients and our cumulative public investment fails to provide equal access to services for children from low-income families. This problem is seen in these seven agencies where, in spite of successful fundraising by agile, entrepreneurial managers, programs face substantial waiting lists. For example, Child Development, Inc. has quadrupled its budget in the last six years, yet many of its centers have waiting lists equal to twice their current capacity. In addition, rates and formulas for disbursing funds are often inadequate to support a quality teaching workforce and fall well below the actual costs of delivering comprehensive, quality services (U.S. Government Accounting Office, 1990).
The diversity of public funding streams makes it costly and complicated for local managers to deal with proposal preparation, reporting, accounting, compliance with standards, and crafting a coherent approach to program services and staffing. In addition, local agencies have difficulty in reconciling differing stances on quality and differing rates of reimbursement across different agencies. For example, Child Development, Inc. cannot afford to pay a uniform salary system for all teachers due to substantial differences between Head Start and child care funding formulas. The number of different programs also handicaps policymakers when they try to understand the cumulative effects of existing spending patterns. Thus, as a funding system, early childhood programs provide inadequate levels of investment via an overly complex and opaque set of programs.
2. Fragmented authority and inconsistent standards are major weaknesses in our current approach to encouraging quality improvement in local efforts.
Current trends in political rhetoric stress the prevalence and problems of costly, obtrusive government regulation. These case studies show a very different picture in the early childhood policy sector. Rather than being overbearing and powerful, government regulation of early childhood programs is fragmented, inconsistent, and inadequate. There are no consistent policies to safeguard children against abuse nor to support the ingredients of environments which will optimize development and learning. Fragmentation and inconsistency derive from a system of separate standards for Head Start, child care, and school-based programs. Standards for child care centers are weak in a substantial number of states, due to exemptions for major segments of providers, and low standards on key dimensions such as staff: child ratios and staff training. (Adams, 1990, Morgan, et.al., 1993)
However, we also found evidence that state and federal leadership can have positive effects on local program quality -- both in setting the initial stance of programs on components of quality and in supporting improvements over time. For example, staff in the Bureau of Indian Affair's FACE projects receive extensive training, technical assistance, feedback from an external evaluation, and opportunities to network with peers from other programs. These services have helped them to implement the program model and to share innovations across project sites. New Jersey state program guidelines on staffing, parent involvement, and comprehensive services were critical positive influences in shaping the initial prekindergarten initiative in Jersey City.
Finally, the case studies also show that program quality is shaped powerfully by local decisions and non-governmental influences. For example, Sheltering Arms upholds staff to child ratios which are substantially more favorable than the state licensing requirements. Agencies also draw on professional, non-governmental sources in defining and supporting program quality. For example, several local agencies have invested in seeking accreditation of their programs by the National Association for the Education of Young Children. Thus, programs take advantage of flexibility in policies to create their own local definitions of high quality, responsive services.
3. Early childhood policy reflects a balance of federal, state, and local autonomy. However, there are few forums for coherent federal, state, or local decisionmaking across early childhood programs and funding streams.
As noted above, policy decisions about early childhood services occur in a loosely-knit set of separate fiefdoms, including the Head Start policy system, the child care sector, the education for children with disabilities community, and state prekindergarten program structures. Problems of fragmentation are also seen at the community level. While we found strong individual agencies, we did not encounter a community-wide vision, design or funding system for early childhood services. There is no structure which provides access to citizens or general purpose government to be engaged in shaping decisions or contributing core support for services to all young children and parents.
Policy Recommendations
This study provides the basis to examine policy strategies which would support more widespread excellence and innovation at the local level. What policy strategies would foster more initiatives with the innovative features and high quality found in our case study sites?
1. Coordinated expansion of federal and state public investment to equalize access to quality early childhood programs.
By selecting agencies regarded as innovative and successful, this study has profiled managers with above-average success in fund-raising and program development. However, managers are forced to spend an inordinate amount of energy raising money and safeguarding the continuation of existing funding sources -- which has diverted their attention from opportunities to strengthen staff effectiveness, morale and service quality. In addition, current levels of public investment are inadequate to serve all families who need programs. Resources are particularly lacking for programs for infants and toddlers and for working poor families. Thus, a fundamental priority for early childhood policy is to provide a steady expansion of services to low-income and working families towards the goals of school readiness, family self-sufficiency, and strengthening communities.
2. Supporting rates of funding which are consistent with program quality and a quality workforce.
Early childhood funding should reflect the costs of providing quality programs which meet the needs of young children and families. Unless funding rates are adequate, programs will be unable to pay adequate salaries necessary to attract well-trained staff members, or staff will be required to work with large numbers of children. Furthermore, there should be greater consistency in rates across different state and federal funding streams.
3. Encouraging local and private sector investment in early childhood services.
A key ingredient in the success of these programs is their ability to attract local businesses, community institutions and community residents to contribute to their operations. However, there is no robust set of policy strategies to encourage this ingredient. It is difficult to create standards regarding what proportion of costs can be drawn from non-governmental sources without penalizing communities with fewer resources.
4. Setting program standards which support quality services, but with suitable flexibility about strategies for meeting local needs.
State and federal early childhood programs should be undergirded with a common commitment to quality, as embodied in consistent program standards. Research and professional judgment support regulating key factors which protect the safety of children and create the preconditions for effective nurturing and instruction; namely, group size, staff training, adult:child ratios, and support for the health, nutrition, and other core needs of children and families. All forms of early care and education should be expected to meet standards on these measures.
Yet while policies need to be stronger and more consistent in supporting quality, they should be more easy going in other realms, such as the specific form and mix of service strategies appropriate to different local communities. As these case studies illustrate, there are a variety of effective approaches to serving young children and families, including home-based and center-based programming; various approaches to engaging, serving, and involving families; and different designs for staffing programs and professional development.
5. Supporting local agencies in a dual focus of enhancing child development and strengthening families.
Policies should allow programs to respond to the survival needs, schedules, and personal stresses typical of today's poor and working poor families at the same time as they provide developmentally appropriate learning experiences and other services for young children. Head Start's comprehensive performance standards give equal status to early childhood education, health and social services, and parent involvement. Programs such as Project FACE at the Bureau of Indian Affairs combine parent education and home visits to families with infants and toddlers, a family literacy initiative, and prekindergarten classrooms. Other program guidelines should be revised to acknowledge the benefits of working simultaneously with young children and their families.
6. Building an infrastructure to support program quality and innovation.
All forms of early childhood programs and agencies should be able to benefit from the tools of monitoring, technical assistance, formative evaluation, and participation in professional networks. In particular, these case studies show the potential for peer exchange across programs and funding streams as a strategy to accelerate innovation and improvement in early childhood programs. Another crucial component is to assemble a more coherent career development system for staff members who work in early childhood programs, addressing needs for ongoing training, a career ladder of credentialed roles, and consistency across delivery systems to foster career mobility (Morgan, et.al., 1993).
7. Creating a leadership/management development system.
Early childhood program management is complex, consequential work, involving executive responsibilities of considerable scope. However, the career development system for local early childhood administrators is fragmented and random rather than coherent and purposive. Since managers work for a mix of institutions, there is no single credentialling authority for managers in this field. Indeed, in more than twenty states there are no training requirements for child care center directors. States, foundations and the federal government should collaborate in initiatives to stimulate and support local leaders -- to bolster the skills and motivation of our present cadre of talent, to develop leaders for the future, and to use existing talent to mentor and train colleagues.
8. Easing the administrative burdens involved in administering multiple public early childhood programs.
State and federal early childhood programs are designed and administered as if they were isolated entities, rather than a series of complementary funding streams and programs. Individual local managers step up to the challenge of garnering and managing multiple funding sources out of personal initiative, ambition, and vision. However, they have nowhere to turn for guidance regarding how to manage an agency with a mixed range of investors. State and federal policymakers and administrators should come together to find ways to make life simpler for local program managers, to see how different funding streams and mandates can be made to work together more easily and productively at the local level.
9. Building community planning and responsibility for early childhood services.
As much as we need to create more individual programs with the qualities of the seven included in this study, we also need a more coherent system to govern early childhood services at the community level. We need forums to guide decisions across program and agency lines and to dovetail with general purpose government. Secondly, we need a mechanism to embody and strengthen the general public interest in quality early childhood services. Early childhood services should become a concern and responsibility of local communities, rather than an activity which is perceived as directed and funded by state and federal agencies.
Recommendations for Improving Practice
Observations from these "flagship" local programs can inform practice improvement in two ways. First, they provide examples of exemplary, innovative approaches to working with children and families and, at the management level, for dealing with resource development and program quality. Second, staff and managers in these initiatives uncover and explore the next generation of challenges for practitioners. Their work points the way for their peers in other local agencies and professional organizations.
1. Refining and promoting teaching excellence within the paradigm of developmentally appropriate practice.
As staff members become skilled at managing developmentally appropriate classroom environments, programs face a new challenge of creating a second generation set of shared images of excellent teaching to guide further improvement in classroom practice. One strong emphasis within these programs is to assist teachers in taking a clinical approach to observing and tracking individual children -- getting to know them well as individuals, understanding how their minds work, and figuring out how to respond to their learning styles and developmental needs. Secondly, teachers emphasize peer observation, feedback and joint planning to deepen their understanding of individual children and to improve their work as professionals.
2. Working to continue to motivate and foster the professional development of staff members.
These flagship programs have been successful in recruiting and retaining a corps of teachers and supporting staff career development from entry level positions to attainment of an initial credential in early childhood education. They are now trying to provide practical, affordable means for staff members to continue to improve the quality of their work and to earn additional credentials to enhance their career opportunities.
3. Working to promote continuity with elementary schools and successful transitions for children and families.
The case studies illustrate several challenges in improving the early childhood-public school connection. One set of barriers to easy, positive relationships between early childhood programs and public schools are conflicts in jurisdictional boundaries. Second, there are many structural differences between early childhood agencies and public schools. These differences complicate communications and make it difficult to transfer practices and strategies from one setting to another in order to smooth out "bumps" in the transition process. Third, incentives for school/early childhood partnerships are weak and uneven. Finally, when early childhood programs go beyond their boundaries to attempt to influence school policies and practices, they run up against deeply embedded "cultural constructions" of schooling that are difficult to change.
4. Programs face a set of challenges trying to gain participation of adult family members.
Families are generally eager to enroll their children in early childhood programs. However, it is much harder for staff to secure parent participation. Some parents are overwhelmed with problems such as substance abuse, domestic violence, or mental health difficulties. In other families, the survival demands of obtaining food, clothing and shelter command all of parents' time and energy. Program staffs struggle to connect with all of these types of parents and to adapt activities to their needs and capacities.
5. Staff members continually negotiate the boundaries of their work with family members and the special situations they face.
Staff members have to negotiate a balanced approach to the range of demands on their work. For example, home visitors deal with a number of complex issues -- child abuse and neglect, marital problems, substance abuse, and severe mental health problems -- that they are not able to handle by themselves. They must decide whether or not to continue trying to recruit or maintain distressed families when there are other families who need their services. They have to use their judgment on continuing home visits when husbands or companions threaten them for making mothers more assertive and independent. All staff members are challenged to work with families in a way that avoids dependence and promotes independence. They juggle the roles of professional and trusted friend. Programs are trying to work out respectful relationships with families from diverse cultural backgrounds. This is a dynamic process which may involve redefining parents' attitudes toward the school, their own families, and their peers.
6. Programs face the challenge of defining and implementing high quality front line practices.
Although family support programs have proliferated over the last decade, little attention has been given to defining quality. There is no position statement on appropriate parent-focused practices as has been developed for early childhood classroom practice. This situation leaves it to local programs to create their own definitions and strategies to govern staffing patterns, professional development and support strategies, the content of parenting programs, and the organization of service delivery.
We conclude with the conviction that improving early childhood policy can improve the lives of children, families, and professionals; enhance support for and ease the burdens on public schools; and contribute to stronger families and communities. We believe this study contributes to a more complete, balanced, and grounded image of how early childhood programs work in the present policy structure. And we believe that more accurate understanding of the interplay of public funding and policies; local management, staff capacity and motivation; and responses of families and communities will lead to more constructive and successful public policy. We trust that wider appreciation of the diversity of the early childhood community, the subtleties of practice, and the dynamic effects of policy and management will lead to renewed efforts to help all young children develop to their fullest potential.
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[Summary Review of the Literature]