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The effects of early education intervention on maternal employment, public assistance, and health insurance: the infant health and development program.

OBJECTIVES: The purpose of this study was to test whether early education intervention influences maternal employment, education, fertility, and receipt of public assistance and health insurance. METHODS: The Infant Health and Development Program is a randomized trial of the efficacy of early education on the outcomes of 985 low-birthweight, premature children. Families in eight sites received either pediatric follow-up and referral (follow-up only group) or pediatric services plus early intervention services (intervention group) for the first 3 years of the child's life. RESULTS: Mothers in the intervention group were employed more months and returned to the work force earlier than those in the follow-up only group. Fertility and education were not associated with treatment. Mothers who had some college education received more months of public assistance in the intervention group compared with the follow-up only group. Mothers who were employed received more public assistance and public health insurance in the intervention group compared with the follow-up only group, when maternal employment was controlled. CONCLUSIONS: Findings are discussed in terms of the recent emphasis on two-generational programs directed to providing health, welfare, and child care services to young children and their families.

Adult↗

Early educational intervention for very low birth weight infants: results from the Infant Health and Development Program.

OBJECTIVE: To examine the effect of early educational intervention after discharge from the hospital on the health and developmental status of very low birth weight (< or = 1500 gm) infants. DESIGN: Randomized, controlled trial, with post hoc analysis. SETTING: Eight sites, heterogeneous for sociodemographic and health care use. PARTICIPANTS: Infants (N = 280) born weighing < or = 1500 gm and selected for the Infant Health and Development Program. Eligibility was limited primarily by geographic distance from the day care center. One third were randomly assigned to the intervention (INT) group and two thirds to follow-up only. INTERVENTIONS: All children received intensive pediatric and developmental surveillance. The INT group received home visits and center-based educational interventions until 36 months of age (corrected for gestational age when final assessments were completed). OUTCOMES: Cognitive development (Stanford-Binet Intelligence Scale), behavioral competence (Achebach Child Behavior Checklist), and health status (indexes summarizing reported morbidity, the Functional Status II (R) Scale, and General Health Ratings Index). RESULTS: Cognitive development scores were 7.2 points higher (p = 0.002) in the INT group, after adjustment for baseline differences in site, sociodemographic characteristics, and neonatal morbidity, and were 9.4 points higher (p < 0.0003) when the 29 children with significant cerebral palsy were removed. No differences in behavior, serious morbidity, functional status, or health rating were found overall. The infants in the INT group who weighted < or = 1000 gm at birth had significantly lower behavior problem scores but no differences on other outcomes. All children in the INT group had slightly higher rates of less serious morbidity. CONCLUSION: The advantage conferred by being in the INT group, as previously reported for heavier infants, extends to very low birth weight children, supporting the use of early intervention in this group.

Cerebral Palsy↗

The effects of the problem-based Alcohol Early-Intervention Education Package on the knowledge and attitudes of students of nursing.

The profession of nursing is seeking to establish its unique professional identity by developing discipline-focused research and clinical practice supported by university education. However, according to refereed literature, educating undergraduate nurses in alcohol-related problems is lacking. The literature reveals that nurses in general lack the necessary knowledge, attitudes, and skills to work with problem drinkers. Alcohol early intervention is advocated as a strategy compatible with contemporary nursing practice. This paper reports a study that commenced with the development of a problem-based, five-week Alcohol Early Intervention Education Package (AEIEP). This package became an intervention around which the knowledge and attitudes of a sample of 212 students of nursing were evaluated. A comprehensive instrument was developed to measure the respondent's knowledge and attitude regarding alcohol-related problems in general and specifically in early intervention. The effects of the education intervention on the different strata of students, were examined in a quasi-experimental, pre-post test design. The findings demonstrated it had a significant effect on the knowledge and attitudes of students enrolled in an integrated bachelor of nursing curriculum.

Adult↗

The development of cognitive and academic abilities: growth curves from an early childhood educational experiment.

In the Abecedarian Project, a prospective randomized trial, the effects of early educational intervention on patterns of cognitive and academic development among poor, minority children were examined. Participants in the follow-up were 104 of the original 111 participants in the study (98% African American). Early treatment was full-time, high-quality, educational child care from infancy to age 5. Cognitive test scores collected between the ages of 3 and 21 years and academic test scores from 8 to 21 years were analyzed. Treated children, on average, attained higher scores on both cognitive and academic tests, with moderate to large treatment effect sizes observed through age 21. Preschool cognitive gains accounted for a substantial portion of treatment differences in the development of reading and math skills. Intensive early childhood education can have long-lasting effects on cognitive and academic development.

Adolescent↗

Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: A 15-year follow-up of low-income children in public schools.

CONTEXT: Most studies of the long-term effects of early childhood educational interventions are of demonstration programs rather than large-scale public programs. Previous studies of one of the oldest federally funded preschool programs have reported positive effects on school performance, but effects on educational attainment and crime are unknown. OBJECTIVE: To determine the long-term effectiveness of a federal center-based preschool and school-based intervention program for urban low-income children. DESIGN, SETTING, AND PARTICIPANTS: Fifteen-year follow-up of a nonrandomized, matched-group cohort of 1539 low-income, mostly black children born in 1980 and enrolled in alternative early childhood programs in 25 sites in Chicago, Ill. INTERVENTIONS: The Chicago Child-Parent Center (CPC) Program (n = 989 children) provides comprehensive education, family, and health services and includes half-day preschool at ages 3 to 4 years, half- or full-day kindergarten, and school-age services in linked elementary schools at ages 6 to 9 years. The comparison group (n = 550) consisted of children who participated in alternative early childhood programs (full-day kindergarten): 374 in the preschool comparison group from 5 randomly selected schools plus 2 others that provided full-day kindergarten and additional instructional resources and 176 who attended full-day kindergartens in 6 CPCs without preschool participation. MAIN OUTCOME MEASURES: Rates of high school completion and school dropout by age 20 years, juvenile arrests for violent and nonviolent offenses, and grade retention and special education placement by age 18 years. RESULTS: Relative to the preschool comparison group and adjusted for several covariates, children who participated in the preschool intervention for 1 or 2 years had a higher rate of high school completion (49.7 % vs 38.5%; P =.01); more years of completed education (10.6 vs 10.2; P =.03); and lower rates of juvenile arrest (16.9% vs 25.1%; P =.003), violent arrests (9.0% vs 15.3%; P =.002), and school dropout (46.7% vs 55.0%; P =.047). Both preschool and school-age participation were significantly associated with lower rates of grade retention and special education services. The effects of preschool participation on educational attainment were greater for boys than girls, especially in reducing school dropout rates (P =.03). Relative to less extensive participation, children with extended program participation from preschool through second or third grade also experienced lower rates of grade retention (21.9% vs 32.3%; P =.001) and special education (13.5% vs 20.7%; P =.004). CONCLUSIONS: Participation in an established early childhood intervention for low-income children was associated with better educational and social outcomes up to age 20 years. These findings are among the strongest evidence that established programs administered through public schools can promote children's long-term success.

Adolescent↗

The Home Instruction Program for Preschool Youngsters (HIPPY).

The Home Instruction Program for Preschool Youngsters (HIPPY) is a two-year home-based early education intervention program designed to help parents with limited formal education prepare their four- and five-year-old children for school. This article begins with a brief overview of the HIPPY program and then presents the findings from a series of interconnected research studies, including a two-site, two-cohort evaluation in New York and Arkansas, a one-site case study, and a three-site qualitative study. With respect to program effectiveness, results varied across the New York and Arkansas sites and across participating cohorts at each site. For Cohort I, children who had been enrolled in HIPPY scored higher than children in the control/comparison groups on measures of cognitive skills (New York), classroom adaptation (New York and Arkansas), and standardized reading (New York); and more children were promoted to first grade (Arkansas). For Cohort II, comparison group children outperformed HIPPY children on school readiness and standardized achievement at posttest (Arkansas). Analyses to account for the differing results between cohorts were inconclusive. Qualitative analyses revealed considerable variation in parent involvement in HIPPY. Program staff identified four patterns of attrition from HIPPY: (1) early attrition within the first month after enrollment, (2) attrition between the program's first and second years, (3) attrition due to changes in the life circumstances of participating families, and (4) attrition due to turnover among the home visitors. Families were more likely to participate in in-home than out-of-home aspects of the program (for example, group meetings), but different family characteristics were associated with participation in the in- and out-of-home aspects of the program. The authors conclude with recommendations for future practice and research.

Child, Preschool↗

The pediatrician's role in development and implementation of an Individual Education Plan (IEP) and/or an Individual Family Service Plan (IFSP). American Academy of Pediatrics. Committee on Children with Disabilities.

The Individual Education Plan and Individual Family Service Plan are legally mandated documents developed by a multidisciplinary team assessment that specifies goals and services for each child eligible for special educational services or early intervention services. Pediatricians need to be knowledgeable of federal, state, and local requirements; establish linkages with early intervention, educational professionals, and parent support groups; and collaborate with the team working with individual children.

Adolescent↗

Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management.

Our understanding and treatment of children with autism have changed dramatically since Leo Kanner first formally documented the disorder in 1943. With reference to the historical context, this paper reviews recent research addressing 4 major issues: early detection, intervention, education, and psychopharmacological management of children with autism and related (autistic) spectrum disorders (hereafter, "autism"). We conclude from our review of the evidence that, in the absence of additional, more compelling data, the clinical usefulness of existing screening instruments remains questionable. However, the potential importance of such research is underscored by the clear benefits of early behavioural intervention: despite differences in orientation, outcomes for children with autism can be significantly enhanced with early intensive intervention. Although many questions remain (notably, What are the critical therapeutic components? For whom? For what domains of development? For what level of intensity and duration?), interventions shown to be effective are all carefully planned, engineered, monitored, and designed to target specific skill domains. Including children with autism in regular classes within the public school system poses several challenges, the most pressing of which is the large number of school personnel who need to be trained in evidence-based teaching and behavioural management practices. Finally, psychotropic drugs may help to reduce some symptoms, but they are neither curative nor a substitute for other forms of support and intervention.

Adolescent↗

[Early intervention and psycho-educational support: a review of the English language literature].

While research on early-intervention programs remains rare in France, there are numerous scientific publications in the English-language literature. This article attempts to describe the contribution of such programs in terms of children subsequent development and changes in their families. Twenty-six programs incorporating home intervention, care, social support and early-childhood education, have been conducted for more than a year within local and hospital populations selected through various scales of risk. The large majority of the programs have randomized trials. Intervention and early education applied essentially to families from deprived environment, families with premature or low-birth-weight infants, and families exhibiting psychosocial or psychiatric risks. Programs of relatively long-term and addressing to families' needs and well-being, initiated in the prenatal period, resulted in variable degrees of positive influences on children cognitive, behavioural and social development, and on parent-child relationships. The most remarkable results with the most prolonged effects concerned school attendance and school performance. Positive effects were also recorded in specific populations (adolescent mothers, mentally retarded mothers.). Nevertheless the efficacy of such programs remained limited and mainly dependent upon parents' motivation and involvement and concurrent family risk factors. Although evaluation of intervention programs regarding multiple risk factors remains difficult, qualitative analyses complementing the available statistical data appear necessary.

Child↗

Early intervention in low birth weight premature infants: results at 18 years of age for the Infant Health and Development Program.

OBJECTIVE: To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age. METHODS: This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001-2499 g) and lighter low birth weight (LLBW; < or = 2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status. RESULTS: We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (-0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2). CONCLUSIONS: The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention.

Adolescent↗

Early intervention: why, for whom, how, and at what cost?

When the concept of intervention is applied to human development, the goal is usually to enhance functioning or to prevent some unwanted condition. During the past 20 years, the United States has committed itself to an early intervention position for young children who are socio-economically, educationally, or physically disadvantaged. This article summarizes the knowledge base concerning early educational interventions and to recommend actions concerning public policy and associated research.

Child Development↗

Changing early childhood development through educational intervention.

A major issue in child development is the extent to which educational intervention can impact the pattern of growth. The High/Scope Perry Preschool study, which began in 1962, has now reported results through age 27. These findings indicate significantly improved social responsibility and educational performance in adult life by children who participated when compared with the randomly assigned nonparticipating group of children. A benefit-cost study found a return of $7.16 for each dollar invested. However, such outcomes are found only from specific, high-quality operations. The longitudinal High/Scope Curriculum Comparison study found that children who had experienced a highly intensive academic program were significantly less socially responsible at age 23 than were children from programs that encouraged individual choice and initiative. These studies indicate that children at ages 3 and 4 are at a sensitive period in their development toward stable adult-behavior patterns. High-quality early education programs can significantly improve adult adjustment and performance. However, such programs need to involve the child in active experiences and independent decision-making to be effective.

Adolescent↗

A national survey of educational preparation programs for early intervention specialists.

To examine the status of preprofessional education in early intervention, we conducted a nationwide survey of college and university programs offering degrees in education of the deaf. Curriculum content and practicum experiences with infants and toddlers and their families were examined, as well as general comments and recommendations of program directors. Additional information was sought from programs offering specializations at the preschool level to determine whether they had CED affiliation, and if so, whether they were certified in the areas of parent-infant education or early childhood education. The findings are discussed in the context of Public Law 99-457 and the growing emphasis on family centered early intervention.

Adult↗

Early secondary prevention with disadvantaged preschool children.

A body of research data is reviewed pointing to considerable intellectual lag and nonstandard linguistic abilities among the disadvantaged. While "difference" and "deficit" theorists interpret these findings differently, many observers agree that early educational intervention may be a useful approach to such problems. A series of early intervention programs is reviewed for three young disadvantaged groups: infants, toddlers, and preschoolers. Findings from these programs suggest that early intervention helps materially to reduce the intellectual and linguistic problems of the young disadvantaged.

Age Factors↗