Preschool

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In a Nutshell

  • Kids who got extra social and emotional skill-building in Head Start preschool reported better mental health, stronger relationships, and greater life satisfaction at ages 21 to 22 compared to kids in standard Head Start classrooms.
  • Children who faced more hardship and instability early in life generally had worse outcomes as young adults, but for two measures (how empathetic and how outgoing they became) the preschool program’s benefits were actually stronger for kids who had faced the most early adversity.
  • The positive effects showed up almost two decades after the program ended, suggesting that early emotional skill-building can have a lasting ripple effect rather than fading out like some preschool academic gains do.

A simple preschool lesson in managing emotions still showed up in young adults nearly 20 years later. Back in 2003, a group of four-year-olds in Head Start classrooms learned a calming exercise called “doing turtle”: stop, take a deep breath, and name the problem and the feeling. Nearly two decades later, those kids are faring better than classmates who got standard Head Start, reporting fewer conduct problems, less depression, less loneliness, more empathy, stronger emotional support, more healthy days, and greater life satisfaction. That is seven out of eleven measures of well-being, according to a new study that followed 356 low-income children into their early twenties.

Researchers followed the group from preschool to ages 21 and 22, comparing kids who attended Head Start classrooms with an extra program teaching emotional skills and language to those in standard classrooms. Unlike early academic gains that often fade within a few years, the social and emotional benefits continued to show up nearly two decades later, surfacing right as loneliness and emotional distress have become alarmingly common among young people nationwide.

Researchers from Penn State’s Department of Psychology and its prevention research center conducted the study and published it in American Psychologist. The timing is notable: a recent American Psychological Association survey found more than half of respondents reported heightened social isolation, depression, anxiety, and a lack of emotional support. This research points to a possible answer that starts decades earlier, in a four-year-old’s classroom.

How the Head Start Program Study Tracked Kids Into Adulthood

Back in 2003 and 2004, researchers invited families with kids attending 44 Head Start classrooms across three Pennsylvania counties to join a long-term study. Researchers randomly split the classrooms into two groups. Some kept doing Head Start as usual. Others added an enrichment program called REDI, which layered in a curriculum called Preschool PATHS along with a daily interactive reading program.

The PATHS lessons used stories, puppet shows, and role-play to teach four-year-olds how to manage their emotions, solve problems with other kids, and be kind. Teachers reinforced the lessons all day with posters and reminders, and received coaching to help them deliver the material effectively. Parents received handouts and videos so they could echo the same ideas at home. The reading program added new vocabulary and comprehension practice through books tied to those same emotional themes.

Participants were about 54% female and included Black, Latinx, and White children; they came from low-income families, with household income around $15,000 a year at the time. Researchers checked in on the kids before and after their Head Start year, then followed up throughout childhood and adolescence. For this study, the main follow-up occurred in early adulthood through phone interviews when participants were 18 to 19 and again at 21 to 22. Out of the original 356 children, researchers collected follow-up data from 263 people, or 74%, when they were 21 to 22 years old, a solid number for a study spanning nearly two decades.

What the Interviews Measured

During those long phone calls, young adults answered detailed questions covering eleven measures grouped into three categories: mental health (things like conduct problems and depression), social life (loneliness, empathy, how outgoing someone is, and whether they had people to lean on emotionally), and overall quality of life (healthy days per month, life satisfaction, and feelings of security and belonging).

Researchers also tracked hardship from early childhood, meaning stressful situations like witnessing violence, frequent harsh punishment, family instability, or a parent struggling with depression. Parents reported these when children first enrolled.

Infographic showing how enriched preschool social and emotional lessons were linked to seven improvements in mental health and well-being nearly 20 years later.
Infographic by StudyFinds

What the Head Start Study Found

Of the eleven well-being measures, the group that received the enriched preschool program scored clearly better on seven of them as young adults. That included fewer conduct problems, fewer symptoms of depression, less loneliness, more empathy, stronger emotional support systems, more healthy days per month, and greater overall life satisfaction.

When researchers grouped all eleven measures together to build an overall well-being snapshot, they found three general patterns among participants: a higher well-being group, a moderate one, and a lower one. Young adults who completed the enriched preschool program were more likely to fall into the higher group than the lower one, compared with peers from standard Head Start classrooms.

As expected, kids who faced more early hardship generally had a tougher time as young adults, showing up as higher rates of conduct problems, hyperactivity, depression, and lower life satisfaction. But one pattern stood out: for two specific outcomes, empathy and sociability, the preschool program’s benefits were actually stronger among kids who had experienced more early hardship, not weaker. In other words, the kids who needed the most support seemed to benefit the most, at least in those two areas. For the other nine measures, researchers found no clear evidence that early hardship changed how children responded to the program, suggesting its benefits weren’t limited to kids with less difficult childhoods.

Researchers described the size of these effects as “small-to-moderate,” which they considered worth noting given the time between the preschool program and the young adult check-in and the comparison against standard Head Start rather than no preschool at all.

Why This Matters Beyond the Classroom

Earlier findings from this same group of children showed that language and literacy gains from the program faded by early elementary school, a pattern seen in a lot of preschool research. But the emotional and social skills stuck around, showing up as fewer behavior problems and less emotional distress all the way through high school. This new study carries that story into early adulthood: kids taught to manage their emotions and get along with others seem to reap benefits that outlast academic head starts.

The researchers described a chain reaction: early gains in managing emotions help kids build better relationships with peers and teachers through elementary and high school, and those relationships carry forward into healthier adult functioning. It’s less about one skill learned in preschool than about how that early skill opens doors to better experiences for years afterward.

The study has real limits. It relied on young adults reporting on their own mental health and relationships, which can be shaped by memory or a desire to look good. The sample came from three Pennsylvania counties, so the results might not hold up elsewhere. Researchers measured early hardship only once, at the start of the study, so they couldn’t account for difficult experiences later in childhood.

Still, the bottom line is hard to ignore. A relatively modest addition to existing Head Start classrooms, teaching four-year-olds how to name their feelings, calm themselves down, and solve problems with others, appears to have left something behind that lasted into adulthood. At a time when loneliness and emotional distress are rising among young adults nationwide, this study argues that part of the fix might begin years earlier than expected, in a preschool classroom, with a puppet show about taking a deep breath.

Disclaimer: This article summarizes peer-reviewed research and is provided for general informational purposes only. It is not medical, psychological, or professional advice. The reported effects were small to moderate and come from a single randomized trial conducted in three Pennsylvania counties, so the results may not apply to every child or setting. Readers seeking guidance for a specific child should consult a qualified professional, and anyone wanting full details should refer to the original study.


Paper Notes

Limitations

The study authors noted several caveats. Young adult outcomes were based entirely on self-reported answers during phone interviews, which can be affected by memory issues or a tendency to present oneself in a favorable light. Although the study retained a large percentage of its original participants, attrition was not evenly distributed across groups: retained participants were more likely to be female and more likely to come from the standard Head Start group than the enriched group, raising the possibility of small biases despite statistical corrections. Measures of early childhood adversity were collected only once, through parent report at the start of the study, so experiences occurring later in childhood were not captured. The cutoff point used to classify children as having experienced “higher” adversity followed methods used in prior research but can vary across studies. Finally, the study was conducted in three Pennsylvania counties, and results may not fully generalize to other regions or cultural contexts.

Funding and Disclosures

The National Institutes of Health, National Institute of Child Health and Human Development, supported the project under Grant HD046064. The authors stated they had no conflicts of interest to declare. The views expressed in the paper are those of the authors and do not necessarily represent the views of the funding agencies.

Publication Details

Paper Title: “Promoting Resilience With Social–Emotional Learning: Young Adult Follow-Up of a Preschool Randomized-Controlled Trial”

Authors: Karen L. Bierman, Brenda S. Heinrichs, and Janet A. Welsh of the Department of Psychology at The Pennsylvania State University, along with Damon E. Jones and D. Max Crowley of the Edna Bennett Pierce Prevention Research Center at The Pennsylvania State University.

Journal: American Psychologist, September 17, 2026

DOI: 10.1037/amp0001765

The study was preregistered in the Registry of Efficacy and Effectiveness Studies under No. 16840.

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