40 Years After ‘A Nation at Risk,’ Assessing the Impact of Whole-Child Reforms on America’s Schools

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The 74 is partnering with Stanford University’s Hoover Institution to commemorate the 40th anniversary of the ‘A Nation At Risk’ report. Hoover’s A Nation At Risk +40 research initiative spotlights insights and analysis from experts, educators and policymakers as to what evidence shows about the broader impact of 40 years of education reform and how America’s school system has (and hasn’t) changed since the groundbreaking 1983 report. Below is an abridged executive summary of the report’s chapter on 40 years of whole child school reforms. (See our full series)

Whole-child education models are those that expand the ambit of schools beyond a traditional academic focus. While a range of whole-child models have been explored since at least the Progressive Era, use of these models has expanded greatly over the past twenty years.

Because nearly all children in the United States attend public schools, it can be a tempting place to provide near-universal access to programs and resources. However, for various reasons, some families and educators are wary of a more expansive role for schools in children’s lives beyond academic training. In the Hoover Institution’s report “A Nation At Risk +40,” I review several examples of whole-child reforms that have become popular over the past few decades: community schools, school based health centers, wraparound service models, and social emotional learning curricula. 

While some models have proven effective at shifting child outcomes in certain settings, none have yet been proven — at large scale, using high-quality causal research methods — to be a silver bullet that can overcome the challenges many children face today in terms of improving academic outcomes. Though they may have other positive impacts on their own, without related investment in academic reforms, they are unlikely to be the panacea for the low academic performance that plagues children in the United States. Thus, at the end of my brief, I close with recommendations for policymakers to think carefully about implementation of these models in their own contexts.

• Whole-child education models are becoming better known in the United States

• Their adoption in some public schools provides an opportunity to see which models contribute to academic success.

• However, they are a part of the topic of child welfare, not the entire picture.

In the past couple of decades, there has been a renewed interest in the idea that schools should expand their ambit to address a wider range of student needs around health and well-being. Often this is described as a focus on development of the “whole child” rather than just the academic aspects of child development.

Of course, promotion of a wider ambit for schools beyond the academic sphere is at least a century old, as is the debate about whether it is optimal. The intellectual leaders of the Progressive Era, in the nineteenth century, sought to bring a broader focus to education systems than the traditional academic one. This included various ways of engaging the whole child, some of which are similar to the models covered here, particularly the social and emotional learning curricula and community school models that have skyrocketed in popularity in the past several years.

Similarly, the roots of whole-child reforms that are focused on improving children’s physical health are deeply embedded in US education history. As early as 1850, states began requiring immunizations and sometimes hosted immunization clinics in schools, where there was easy direct access to children. Also, the beginning of what we now know as the standard school nurse model began in 1902 as a pilot program aiming to insert healthcare into schools in order to improve chronic absenteeism by managing easily treatable illnesses and focusing on prevention. Each of these foreshadowed the more recent creation and rapid expansion of school-based health centers, which insert healthcare providers directly into schools with the goal of improving academic and overall well-being.

Recent decades have seen a renewal in the popularity of whole-child models. To some extent, this renewed interest is partly a backlash to what many perceived as the laser focus of the No Child Left Behind era on student test score performance. The difficult periods of the Great Recession and the COVID-19 pandemic also contributed to this shifted focus. The recent version of this movement has also been helped by increased emphasis on the complex relationships between education, health, housing, and other social dimensions across a range of academic disciplines and policy spheres.

This whole-child movement in schools has taken many forms, some of which I describe in more detail below. Across all its forms, the theory of change driving whole-child reform has two main parts. First, many students struggle academically because their basic needs are not met. Second, supporting these basic needs directly by bringing healthcare and/or social service resources into the school itself will overcome the access barriers that some children face, particularly poor children, thereby increasing their ability to thrive academically and socially.

To some extent, this theory of change pervades the entire US education system. Almost all districts in the country provide some form of nonacademic care to students through the school nurse, school counselors, or expanded offerings like universal vision screening programs. And many provide extracurricular activities or partner with community organizations in a variety of ways. What differentiates the whole-child models of reform here from the standard public school environment is the broader range of services provided and the depth of engagement between the school and community partners.

Intuitively, the first part of this theory of change makes some sense. How can a child learn if they suffer from an ongoing undiagnosed disease or disorder that prevents them from attending school regularly, concentrating in class, or participating fully in the community around them? How can a child learn if they feel isolated in a community, are surrounded by violence, and lack strong support inside and outside of school?

There is little direct causal evidence to support this theory of change, and there are plenty of anecdotes about children thriving despite incredibly challenging experiences during childhood. Yet a majority of parents would agree that children thrive most when their basic needs are met. However, as with all aspects of childrearing, there is debate about which “needs” require fulfillment for children to thrive. Furthermore, there is debate about whether schools are the best provider of health and social services to support children.

For decades, people have debated whether schools are the most effective places to solve the deep-rooted societal problems, like poverty, that leave many children with their basic needs unmet. Some people see schools as the great equalizer, holding them uniquely responsible for the achievement and well-being of all students, regardless of their backgrounds or the social forces determining those backgrounds. Others argue that systemic poverty, isolation, violence, poor health, and other ills have such a strong role that schools cannot be responsible for overcoming them.

Because nearly all children in the United States attend public schools, it can be a useful place to provide nearly universal access to programs and resources. However, for various reasons, some families are wary of a more expansive role for schools in children’s lives beyond academic training. Some have concerns about the differences between their own values and beliefs and those promoted in the school environment, as is the case with the recent backlash among social emotional learning programs. Others have concerns about whether school employees have the bandwidth and expertise to provide an expansive range of high-quality care; instead, they suggest that a focus on academic knowledge would allow school employees, like teachers, to be more impactful. Still others distrust the push for schools to focus on issues beyond academics because of concerns about greater intrusion into the private lives of families.

In “A Nation At Risk +40,” I review several examples of whole-child reforms that have become popular over the past few decades. After describing the general framework of each, I explore research into each model’s effectiveness. Most have been described as effective by the literature, but this assertion is generally based on research that is largely theoretical, comprises mixed methods, or is conducted either at a small scale or without the types of carefully constructed comparison groups that are essential for determining causal impacts. I focus on summarizing the subset of this literature that meets the Tier 1 or Tier 2 standard of the US Department of Education for strong or moderate evidence of effectiveness from either an experimental or a quasiexperimental design study (What Works Clearinghouse 2020).

Further, since many areas of research have shown patterns of effective programs in small studies that have limited effectiveness when taken to scale, I place particular emphasis on the relatively few studies that have analyzed the effectiveness of programs with large numbers of students across multiple school settings. 

While some have proven effective at shifting child outcomes in certain settings, none have yet been proven at scale, using high-quality causal research methods, to be a silver bullet that can overcome the challenges many children face today. Importantly, when looked at in total and given the scale of the existing research, the lack of conclusive evidence of a clear positive causal effect of these reforms on children’s academic achievement casts doubt on the theory underlying these reforms. Though they may have other positive impacts, on their own and without attention to academic reforms they are unlikely to be the panacea for low academic performance that plagues children in the United States. 

Thus, at “A Nation At Risk +40,” I close with recommendations for policymakers to think carefully about implementation of these models in their own contexts. Read the full chapter. 

Maria D. Fitzpatrick is a professor of economics and public policy in the Brooks School of Public Policy at Cornell University. She is co-director of the National Data Archive on Child Abuse and Neglect, research associate at the National Bureau of Economic Research, and an affiliate in the CESifo Research Network. Her research focuses on child and family policy, particularly education. 

See the full Hoover Institution initiative: A Nation At Risk +40.

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