Expulsion and Suspension in Early Education as Matters of Social Justice and Health Equity

By Shantel E. Meek and Walter S. Gilliam
October 31, 2016 | Discussion Paper


Scientists have a central role in addressing the challenges that face society. The primary purpose of research should be to inform policies and practices that address serious problems in our nation and world. Today in America,  we have an alarming issue that is lacking in both basic and applied research—the “preschool to prison pipeline,” a now familiar phrase that describes the disturbing trend of setting children—disproportionately children of color—on a trajectory toward the criminal justice system through practices such as early expulsion and suspension.

Though there is a body of literature on the school to prison pipeline, including some research on the associated mental and behavioral health status of the caregivers and early education teachers expelling young children and the sometimes traumatic experiences of the child leading to certain behaviors, we need more and better research on the entry point during preschool. Why are expulsions and suspensions happening in early childhood settings with children as young as 2 years old? What are the long-term consequences for these children? And most important, how can they be prevented? We cannot address the preschool to prison pipeline if we ignore the earliest entry point. This paper addresses what is known and not yet known about early childhood expulsions and suspensions, specifically focusing on the disproportionate application of these exclusionary sanctions to our youngest
children, and offers suggestions for future directions in research.

Early childhood expulsions and suspensions are matters of health and education equity. As discussed later in this paper, access to high-quality early education has been shown to be related to a vast array of positive benefits, especially for children from low-income families, yet children of color who are low income are less likely to gain access to high-quality early education programs and are more likely to attend poorly resourced programs that provide them, their families, and the staff who work in these programs, fewer supportive practices and services that bolster behavioral and mental health that are necessary to ensure that children are on a positive trajectory to succeed in school and life.

Starting as young as infancy and toddlerhood, children of color are at highest risk for being expelled from early care and education programs. Early expulsions and suspensions lead to greater gaps in access to resources for young children and thus create increasing gaps in later achievement and well-being. Early education programs are a main source of referral to additional services and supports, such as mental health supports or early intervention. By being expelled from the system, children are not only losing access to their early learning experiences, they may also be less likely to be referred to—and receive—the services and supports they need to thrive. These disparities in access to resources start early and may compound over time. Research indicates that early expulsions and suspensions predict later expulsions and suspensions, academic failure, school dropout, and an increased likelihood of later incarceration—a “preschool to prison pipeline,” or perhaps “cradle to prison pipeline,” with devastating and costly consequences.

Social justice—equal access and opportunity for all—has been a core American value since our founding as a nation. That value, however, is not fully realized in the lives of millions of our citizens, people of color, recent immigrants, individuals with disabilities, people who are low income, and others, nor has it ever been. The fact that racial, ethnic, socioeconomic, and ability-based disparities and inequities are widespread across most aspects of society is not surprising to most. Indeed, millions of Americans live these inequities each day. Yet, the fact that these disparities start early, perhaps before birth, and are pervasive throughout children’s lives before they even enter kindergarten is still surprising to many. A serious discussion about social justice and health equity in America must start with reflection on the opportunities and access to resources we offer, and do not offer, our youngest children, especially those from historically marginalized communities.


Disparities in Access

The beginning years of any child’s life are critical for building the early foundation needed for healthy developmental trajectories and success in school and later life. During this period, the brain develops at a pace unlike any other and is extraordinarily sensitive to and affected by children’s environments, experiences, and relationships. Those formative first 5 years are simultaneously the most opportune and vulnerable for setting children on a trajectory for success or failure. There is a robust literature indicating that early adversities can set the stage for later adversities. Unfortunately, these early adversities are all too common, and supports to buffer children from these adversities are not common enough. High-quality early care and education programs for children birth through 4 years old have been shown to produce meaningful positive impacts in the lives of young children, especially for children of low-income families dealing with the stressors and lack of enrichment opportunities that all too often accompany financial disadvantage (Pianta et al., 2009).

Unfortunately, the positive supports provided by high-quality early education are often inequitably distributed. Low-income children and children of color alike have less access to high-quality early learning programs, except Head Start (Barnett et al., 2013). They are overrepresented in unlicensed and unregulated child care settings and are more likely to attend lower-quality and underresourced preschool programs and elementary and secondary schools (Hanushek and Rivkin, 2006). Insufficiently resourced programs often lack appropriate compensation and adequate supportive services for their staff—such as health benefits, mental health supports, and paid sick days (Whitebook et al., 2016). In addition, low-resourced programs are more likely to be in low-income communities where staff face many of the same stressors as the families who use their services, including food and housing insecurity, unsafe communities, and lack of health resources. Evidence shows that unmet health and mental health needs in early childhood education staff, such as depression and severe job stress, negatively affect the ways in which educators interact with children (IOM and NRC, 2012).

For those low-income children and children of color who do gain access to an early childhood program, they are more likely to be pushed out through exclusionary practices such as suspension and expulsion. This is particularly true for young African American boys (Gilliam, 2005; Department of Education, 2014). Low-income children and children of color have less “front door” access to high-quality early learning programs, and they are also pushed out the “back door” in these settings at disproportionate rates.

This “push out” phenomenon has become of increasing concern to the early childhood field over the past several years. In 2005, the first nationally representative study to examine the issue found that expulsion and suspension rates were three or more times higher in early childhood settings than in K-12 settings, with boys being expelled at 4.5 times the rate of girls and African American preschoolers expelled at twice the rate of others (Gilliam, 2005). Recent findings from the Department of Education (2016) indicate that the racial disparities in suspensions from school-based prekindergarten settings are perhaps even more alarming than previously thought. African American preschoolers were found to be 3.6 times as likely to receive one or more suspensions as white preschoolers. While African American children make up 19 percent of preschool enrollment, they comprise 47 percent of preschoolers suspended one or more times. Similarly, boys were 3.0 times as likely as girls to be suspended one or more times. African American boys represent 19 percent of the male preschool enrollment, but 45 percent of male preschool children receiving one or more out-of-school suspensions. African American girls represent 20 percent of the female preschool enrollment, but 54 percent of female preschool children receiving one or more out-of-school suspensions. These rates and disparities are similar to those reported 2 years earlier (Department of Education, 2014).

These figures have serious implications. Early expulsion and suspension predict later expulsion and suspension, and students who are expelled or suspended from school are as much as 10 times more likely to drop out of high school, experience academic failure and grade retention, hold negative school attitudes, and face incarceration than those who are not (APA, 2008; Council on School Health, 2013; Petras et al., 2011). Taken together, these disturbing trends suggest that the school to prison pipeline has an entry point long before the first day of kindergarten, and the implications span economic, educational, and health outcomes.

Fortunately, in the past 2 years, federal, state, and municipal governments have sought to eliminate preschool expulsions and suspensions. President Obama’s My Brother’s Keeper initiative, which seeks to increase life span opportunities and equity for all children, including boys and young men of color, highlighted eliminating expulsion and suspension from early learning settings and addressing disparities in these practices as key recommendations in its strategy (White House, 2014). Related federal efforts include a December 2014 joint departmental statement of the Department of Health and Human Services and the Department of Education (HHS and ED; 2014), calling for the elimination of preschool expulsion and suspension, as well as implementation of early childhood disciplinary policies that are free of bias and discrimination. This federal position has been endorsed by over 30 of the nation’s largest and most visible professional organizations serving young children (Standing Together, 2016). Also, rule changes to the federal Head Start Performance Standards (Administration for Children and Families, 2015) seek to “prohibit or severely limit” suspensions and “explicitly prohibit” expulsions in all Head Start programs, as well as require programs to engage a mental health consultant, collaborate with parents, use appropriate community resources, and address potential bias in disciplinary decisions. HHS and ED have also invested in training and technical assistance to support early childhood programs and educators in eliminating expulsions and suspensions. HHS established the first National Center of Excellence for Infant and Early Childhood Mental Health Consultation (ECMHC), which will develop new resources and provide intensive technical assistance to tribal communities and states on building sustainable ECMHC systems. HHS and ED also funded the Technical Assistance Center on Positive Behavior Intervention and Supports to implement the Pyramid Equity Project, which will develop and disseminate resources that support children’s social-emotional and behavioral development and build the capacity of early educators in implementing culturally responsive practices and addressing implicit bias. States and local communities around the country have also begun addressing the issue by passing laws and policies that severely limit or ban early childhood expulsion and suspension practices (e.g., Arkansas, Connecticut, Chicago Public Schools, District of Columbia, New York City Public Schools) or expand support for early childhood mental health consultation (e.g., Arkansas, Colorado, Connecticut, Ohio; Administration for Children and Families, 2016). It is clear, however, that more needs to be done by all parties, including establishing policies that prohibit expulsion across program types and settings and fully expanding social-emotional supports for early educators and early childhood mental health services to meet need.


Social Justice and Civil Rights

The proliferation of early care and education programs in the United States has been largely supported by developmental science documenting many positive educational and later-life outcomes associated with attendance  (Pianta et al., 2009). Many of these positive outcomes are monetarily quantifiable (e.g., reductions in grade retention, school dropout, and later incarceration, as well as increases in lifetime earnings and home ownership which result in increased tax payments), allowing economists to estimate the economic return on investment provided by early education. Recently, the White House Council of Economic Advisors (2014) calculated that for every dollar spent on early education initiatives, society would receive a return on investment of $8.60. They further report that enabling all families to enroll their children in early education at the same rate as that of affluent families would result in billions in earnings contributed to the economy, and translate to an increase in GDP of 0.16 to 0.44 percent.

To a large degree this science is based on economic impact analyses from three longitudinal evaluations of early education—Perry Preschool Study (Schweinhart et al., 2005), Abecedarian Study (Campbell, 1994), and Chicago Child-Parent Centers (Reynolds et al., 2011). These are three of the most widely cited studies on the economic benefits of high-quality early education, and each of these studies shows remarkable returns on investment. It is also true that each of these studies was conducted with samples that were overwhelmingly African American—100 percent for the Perry Preschool Study, 98 percent for the Abecedarian Study, and 93 percent for the Chicago Child-Parent Centers Study. Racial disparities in expulsions and suspensions in early education pose at least two major challenges. First, disparities in these exclusionary measures may present a serious undermining of the return on investment potential for early education, because the children being excluded are disproportionately the ones for whom we have the most evidence of favorable economic returns. Second, racial disparities in expulsions from early education create a serious and disturbing ethical, moral, and civil rights problems in that the children whose data were used to purchase the political will to fund early education for American children of all races are disproportionately the ones later denied access. Clearly, there is no reasonable angle by which racial disparities on expulsion and suspension from American early education programs should be tolerated.

Expulsion and suspension are by-products of inequities and challenges in the early education system and broader society. These forms of early exclusion are pivotal points of influence in young children’s lives that must be addressed by a broad coalition of stakeholders, including researchers; policy makers; and local districts, schools, and community-based programs. The research community must actively engage in conducting and translating research in this area. Though there is some research on early expulsion and suspension, there remain large gaps in many areas, including longitudinal studies documenting the long-term sequelae of early disciplinary exclusions and rigorous evaluations of interventions designed to prevent these exclusions. Much of our knowledge is taken from research conducted in the K-12 educational system. Although this research has relevance to the early education system, K-12 and early education are very different systems in terms of the developmental needs of the students and the ways in which the systems are structured.


The Rate and Causes of Early Childhood Expulsions and Suspensions

The three main early education programs in the United States are Head Start and Early Head Start, which serve about 1 million children birth to age 5 each year; state prekindergarten, which serves about 1.3 million 3- and 4-year-olds each year; and child care, which serves nearly 11 million children under age 5 or about 63 percent of the nation’s children in this age group (Laughlin, 2013) (1). Funding levels, quality, infrastructure, eligibility, services, data systems, workforce, and affordability vary greatly between each of these sectors; and for prekindergarten and child care, the differences are often great across state, county, and municipal lines.

Given the tremendous variability in early education programs, it is not surprising that we do not have an estimate of the overall national rate of disciplinary exclusions in the early years across all early education settings. Estimates have been largely isolated to one or another part of the early education system or to specific parts of the country. Available research, however, suggests that rates are much higher than expected, and by some estimates they are much higher than in K-12. For example, a nationally representative study published in 2005 found that over 10 percent of teachers in state-funded prekindergarten programs reported expelling at least one preschooler in the past year (Gilliam, 2005). A 2006 study examined expulsion in child care programs in Massachusetts and found that 39 percent of teachers reported expelling a child in the past year (Gilliam and Shahar, 2006). An unpublished survey of child care providers in Detroit, Michigan, found rates similar to those in Massachusetts (Grannan et al., 1999). Even infants and toddlers are at high risk for child care expulsion, with 42 percent of infant/toddler child care centers across Illinois reporting at least one expulsion in the past year (Cutler and Gilkerson, 2002). Taken together, annual expulsions in state-funded prekindergartens are estimated to be about 3 times higher than in K-12, and in child care programs, many of which are less-regulated, more poorly-resourced, and have a less trained workforce, it is as much as 13 times higher.

Turning to suspension, recent data from the Department of Education indicate that 6 percent of school districts with preschool programs reported suspending at least one preschool child from public-school prekindergartens during the 2011-2012 academic year. Although providing an incomplete picture of the broader early education system, these numbers are alarming enough to prompt immediate action. While states and communities begin to address this issue in policy and practice, it is critical that researchers and policy makers collaborate to collect the appropriate data and provide a more complete analysis of expulsion and suspension rates across the early childhood system.

Researchers have not yet fully examined the sources of these high suspension and expulsions rates, though correlational analyses have provided some promising directions and hypotheses. One study found that higher rates of expulsion were associated with higher reports of teachers’ stress and depression, larger “classroom” sizes, and less access to mental health consultants and other support systems (Gilliam and Shahar, 2006). Also, early childhood rates may be high because early care and education are voluntary, whereas in most K-12 grades, school attendance is compulsory, and thus expulsion and suspension are usually not legal matters in the early years. Because preschool attendance is not legally mandated and expulsions typically have no legal implications, the procedures for expelling a student appear to follow no due process guidelines and may be more informal in nature. In addition, most early childhood programs do not have established policies against expulsion and suspension and many programs do not have the resources to support their workforce in appropriately managing large teacher-child ratios and group sizes, developmentally typical challenging behavior, and children who may need additional supports (e.g., early intervention, health or mental health services). Empirically identifying the contributors to early expulsion and suspension will enable researchers and policy makers to target investments and interventions more precisely and effectively.


Gender and Race Disparities in Early Childhood Expulsions and Suspensions

As noted, there are large racial disparities in expulsion and suspension in the early years, similar to trends documented in K-12 settings, with young African American boys being expelled and suspended at significantly higher rates than their peers. Again, the why has not yet been addressed by early childhood research, but studies demonstrating similar disparities in K-12 students have found that potential contributors may include uneven or biased implementation of disciplinary policies, discriminatory discipline practices, school racial climate, underresourced programs, and inadequate education and training for teachers, especially in self-reflective strategies to identify and correct potential biases in perceptions and practice (Gilliam, 2005; Gregory et al., 2010). Relative to their white peers, African American elementary students are more than twice as likely to be referred to the principal’s office for challenging behaviors and significantly more likely to be expelled or suspended, even when the behavioral infractions are similar (Skiba et al., 2011). These racial disparities are independent of socioeconomic status,
suggesting that race is a stronger driver for disciplinary disparities than the economic challenges that are often associated with race (Skiba et al., 2002).

Gender and race disparities in early expulsions and suspensions may also be associated with several factors related to stress tolerance and access to high-quality early learning environments and supports. Regarding gender, boys appear to be more susceptible than girls to the ill effects of poverty, trauma, stressed communities, and low-quality schools, with the results being a greater likelihood for truancy, poor academic achievement, behavioral problems, school dropout, and crime (Autor et al., 2015). Even when the degree of stress and the amount of familial supports are the same, boys tend to show more adverse reaction than their sisters (Bertrand and Pan, 2011). As mentioned earlier, children of color and children from low-income families have less access to high-quality early learning programs (Barnett et al., 2013; Hanushek and Rivkin, 2006). They are overrepresented in unlicensed and unregulated child care settings and are more likely to attend lower-quality and underresourced preschool programs and elementary and secondary schools (Hanushek and Rivkin, 2006).


Potential Role of Implicit Biases

A report from the American Psychological Association’s Task Force on Preventing Discrimination and Promoting Diversity found that biases—including implicit biases—are pervasive across people and institutions (Jones et al., 2012), though this phenomenon has been more carefully examined in some aspects of society, such as the criminal justice and health systems, than others. One potential contributor of race and gender disparities in early childhood expulsions and suspensions is implicit biases regarding how teachers, administrators, and other staff perceive and appraise classroom behaviors. Expulsions and suspensions are not child behaviors; they are adult decisions. Although the behaviors of children may impact adult decision-making processes, implicit biases about boys and children of color may impact how those behaviors are perceived and how they are addressed.

Though there is little research examining this phenomenon in early childhood settings, studies of school-age children have identified disturbing trends. In a recent study, researchers presented schoolteachers with two fictional student disciplinary records (Okonofua and Eberhardt, 2015). The records were randomly labeled with either stereotypical African American names or stereotypical white names. Both fictional students had engaged in minor school violations (e.g., classroom disturbance). Teachers reported that they felt more “troubled” by the offenses of the African American student and were more likely to recommend severe punishment for the African American
student after the second infraction, including suspension, compared to the white student with the same record. They were also asked how certain they were of the child’s race. Those who reported being more certain were more likely to label the African American child as a “troublemaker” and report that his or her behavior was part of a pattern, as opposed to a single occurrence. Another study found that university undergraduate students given a vignette of a child with a challenging behavior that was randomly associated with pictures of children of different races rated African American children as young as age 10 years old as being significantly less innocent and more culpable (Goff et al., 2014). They also estimated that the African American children in the pictures were on average 4.5 years older than they really were. A major predictor of a teacher’s plans to expel a preschooler is the degree
to which that teacher feels the child may pose a danger to the other children (Gilliam and Reyes, 2016). Therefore, the degree to which African American children are perceived as more culpable or older than they really are may have significant implications for race disparities in expulsion rates.

These tendencies to view child behaviors differentially based on the race of the child may be a manifestation of more generalized implicit biases regarding race and criminal or delinquent behavior. For example, in a series of studies with police officers and college students, participants were more likely to direct their eye gaze toward African American faces as opposed to white faces whenever the experimenters invoked concepts of crime or delinquency (Eberhardt et al., 2004). This automatic association between race and perceived threat of aggression has been shown even when the African American face shown was that of a 5-year-old boy (Todd et al., 2016). Implicit biases such as these may be related to differential application of empathy learned at a young age, as was demonstrated in a study that found that 7- and 10-year-olds rated African American children as feeling significantly less pain from injuries such as hitting their heads or biting their tongues, relative to white children (Dore et al., 2014). This dehumanizing tendency to view African American children as less susceptible to pain may make it easier to also view them as more culpable or guilty by removing the moderating effects of empathy.

Biases in expectations may also influence which children teachers feel are most likely to pose significant classroom behavioral challenges. In one study, white middle school and high school English teachers were each provided a poorly written essay to grade. The student name on the essay was randomized to suggest it was authored by either an African American, a white, or a Latino student. Students of color were assigned significantly higher grades. This “positive feedback bias” suggested that teachers may have been demonstrating biases in their expectations, whereby African American and Latino students were expected to be capable of only lower quality essays and are therefore given a higher grade, while white students are expected to write better essays and are thereby given a lower grade (Harber et al., 2012). A robust scientific literature exists regarding these “shifting standards,” where people are held to differing standards based on deeply held gender and racial stereotypes regarding their expected capabilities (Biernat, 2003). These shifting-standards biases also may be present in early childhood settings and regarding child behaviors, and future research is needed to explore this potential. If such biases in expectations or standards exist, they may lead teachers to more closely scrutinize the behaviors of some children relative to others or may lead to decreased behavioral expectations that can later become self-fulfilling.

Combined, these studies may provide some insights on the context surrounding expulsions and suspensions in early childhood settings, but more direct analyses are necessary to fully understand the issue and the many likely contributory factors. Understanding the degree to which implicit biases may contribute to expulsion and suspension decisions by early education staff and administrators is an important step to a fuller understanding of the source of disciplinary disparities. Follow-up questions would include whether factors such as teacher depression or job stress or large group sizes and child-teacher ratios may exasperate existing implicit biases, and whether better teacher-parent communication and classroom-level supports may mitigate the effects of implicit biases.


Call to Action for the Research Field

Research on the consequences of expulsion and suspension from the K-12 system and data that suggest that these harmful practices may be happening at higher rates in the years before kindergarten are cause for action. While policy makers and practitioners are responding to these immediate needs, researchers must help fill the knowledge gaps that are preventing faster and more effective progress. The following research directions would help inform policy and investment decisions in this important area.

The medium- and long-term consequences of expulsion and suspension from early childhood settings have not been studied. In fact, there have been no longitudinal studies looking at this issue, starting in the early childhood years. Research on exclusionary discipline in the K-12 system indicates that suspension and expulsion from school can influence a number of adverse outcomes across development, health, and education. As previously mentioned, young students who are expelled or suspended are as much as 10 times more likely to drop out of high school, experience academic failure and grade retention, hold negative school attitudes, and face incarceration. Research also indicates that expulsion and suspension early in a child’s educational trajectory, predicts expulsion and suspension later (Raffaele-Mendez, 2003). What becomes of these expelled preschoolers? Do they then move to other early care and education settings, as their parents need care to support their employment, only to be expelled again? Do they move to less regulated and lower-quality settings or informal settings that do not have the tools to support children’s development? Early expulsions and suspensions may have additional adverse consequences such as hindering social-emotional and behavioral development; delaying or interfering with the process of identifying and addressing underlying issues, which may include exposure to trauma, developmental delays or disabilities, or mental health issues; negatively impacting parents’ views on both their young children’s potential and schools as a safe and accepting place; and causing added family stress and burden, the effects of which are felt by young children (Van Egeren et al., 2011). Future research should focus on better understanding the medium- and long-term consequences of expulsions and suspension in early care and education programs.

In order to create more effective methods for preventing early childhood expulsions and suspensions, more needs to be understood regarding the processes by which young children are identified for these exclusionary disciplines. How do teachers and administrators make these determinations? Would clearer policies and procedures in early care and education settings reduce incidence rates? Would they narrow disparities in these practices? In what ways might better teacher–family relationships serve as a preventive? In addition, it will be important for researchers to understand the differences and relationships between expulsions and suspensions. Do suspensions mask expulsions? That is, does a program suspending a child for an extended period of time force the family to find alternative placement and leave the program? Given that the terms “expulsion” and “suspensions” are not always the terms used in early childhood systems for dismissing a child from a program due to behavior, researchers should be thoughtful regarding how they ask questions and collect data on this issue.

At present, no studies have been published regarding the potential for implicit bias in how preschool and child care teachers appraise and detect challenging behaviors in young children, and more specifically how implicit bias may account for the increased risk of expulsion and suspension in preschool boys and African American children. Nonetheless, recent research suggests that implicit bias may be reduced through interventions designed to address biases directly (Devine et al., 2012; Jones et al., 2012; van Nunspeet et al., 2015), raising the question of whether evidence-based bias-reducing interventions should be a core component of ongoing early childhood teacher training. Also, clear guiding principles by which early educators may explore and discover their own implicit biases and strive to deliver more equitable services may be a useful tool (St. John et al., 2012). How can the negative impacts of implicit bias be understood and reduced in early care and education settings? Increased attention to evidence-based interventions and approaches that prevent expulsion, suspension, and other exclusionary discipline practices, including ECMHC and positive behavior intervention and supports (PBIS), was one of the primary aims of the 2014 HHS and ED joint position statement. These approaches are further encouraged through language included in the reauthorized Child Care and Development Block Grant Act of 2014 (2), the federal law that helps working families receive public assistance for child care in the United States, as well as national best- practices guidelines for child care centers (American Academy of Pediatrics and American Public Health Association, 2013). Further, all Head Start programs are required to support children’s social-emotional development and ensure access to an early childhood mental health consultant for children and families in the program.

ECMHC is a multilevel preventive intervention that teams mental health professionals with early childhood education staff to improve the social-emotional and behavioral health and development of young children through better teacher-child and teacher–family interactions. Research suggests that ECMHC may be effective in increasing children’s social skills; reducing children’s challenging behavior; preventing preschool suspensions and expulsions; improving child-adult relationships; decreasing teacher job stress, burnout, and turnover; and identifying child concerns early, so that children get the supports they need as soon as possible (Hepburn et al., 2013). Early childhood teachers who report regular access to mental health consultants are half as likely to report expelling a young child than teachers who report no such access (Gilliam, 2005). Though several ECMHC models have been evaluated with each demonstrating positive associations on children’s outcomes, only Connecticut’s Early Childhood Partnership Program (ECCP), a manualized and replicable form of ECMHC, has been evaluated in random-controlled evaluations demonstrating positive effects on child behaviors (Gilliam et al., 2016). The early childhood model of PBIS, called the pyramid model, has also shown promising results in supporting children’s social-emotional development and reducing challenging behaviors. A randomized controlled study examining the pyramid model in early childhood settings found that children enrolled in the intervention classrooms demonstrated improved social skills and reductions in problem behavior, compared to control classrooms (Hemmeter et al., 2016).

Further rigorous experimental evaluations are needed on both ECMHC and PBIS to further validate these promising approaches, given that only one published or in-press randomized-controlled evaluation exists for each. Given the urgency of the need for interventions that address this issue, rapid-cycle evaluation approaches that can provide valid data to policy makers and program leaders faster on the efficacy of these and similar models should also be considered. Specifically, these and similar models should be evaluated regarding their long-term impacts on teacher and child behaviors and interactions, exclusionary discipline practices, and whether and how these interventions address racial and gender disparities. Enhancements to these models that directly target disproportionality, including by addressing issues surrounding implicit bias, should also be evaluated.

Research regarding the rates and disparities in early childhood expulsions and suspensions is only a beginning. Now that the problem has been highlighted and potential policy directions identified, more specific research is needed to better understand the determinants and the effective models to prevent and eventually eliminate early childhood expulsions and suspensions for all of our young children in all of our early care and education settings. The recommendations above would go far in terms of moving us from awareness of the problem toward solutions for ending the preschool to prison pipeline by providing all of our young children a more equitable start at fulfilling their potentials.





  1. Additionally, over 350,000 children ages birth to 3 years with disabilities or developmental delays are provided federal- and state-funded early intervention services, and over 145,000 young children and families are provided services through the Federal Home Visiting Program. Both programs also have the goal of supporting healthy early childhood development.
  2. S. 1086, 113 Cong., 2d sess. Available from: https://www.congress.gov/113/bills/s1086/BILLS113s1086enr.pdf



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Suggested Citation

Meek, S. E., and W. S. Gilliam. 2016. Expulsion and Suspension in Early Education as Matters of Social Justice and Health Equity. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. https://doi.org/10.31478/201610e

Author Information

Shantel E. Meek, PhD, is Policy Advisor for Early Childhood Development, Administration for Children and Families, Department of Health and Human Services. Walter S. Gilliam, PhD, is Associate Professor in the Child Study Center and of Psychology; Director, Yale-China Program on Child Development; Associate Professor of Psychology; Director, The Edward Zigler Center in Child Development and Social Policy.


The views expressed in this Perspective are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (The Academies). The Perspective is intended to help inform and stimulate discussion. It has not been subjected to the review procedures of, nor is it a report of, the NAM or the Academies. Copyright by the National Academy of Sciences. All rights reserved.

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