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Home-Based Early Intervention and the Influence of Family Resources on Cognitive Development.

  • Author(s): Bann, Carla M;
  • Wallander, Jan L;
  • Do, Barbara;
  • Thorsten, Vanessa;
  • Pasha, Omrana;
  • Biasini, Fred J;
  • Bellad, Roopa;
  • Goudar, Shivaprasad;
  • Chomba, Elwyn;
  • McClure, Elizabeth;
  • Carlo, Waldemar A
  • et al.
Abstract

To investigate whether early developmental intervention (EDI) can positively affect the trajectories of cognitive development among children from low-resource families. Longitudinal analyses were conducted of data from 293 children in the Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial, a randomized controlled trial of a home-based EDI program, to examine trajectories of Bayley Scales of Infant Development-Second Edition Mental Development Index (MDI) scores from 12 to 36 months of age among young children from high- and low-resource families in 3 low- to middle-resource countries. A 3-way interaction among family resources, intervention group, and age was statistically significant after controlling for maternal, child, and birth characteristics (Wald χ(2)(1) = 9.41, P = .002). Among children of families with high resources, both the intervention and control groups had significant increases in MDI scores over time (P < .001 and P = .002, respectively), and 36-month MDI scores for these 2 groups did not differ significantly (P = .602). However, in families with low resources, the EDI group displayed greater improvement, resulting in significantly higher 36-month MDI scores than the control group (P < .001). In addition, the 36-month MDI scores for children in families with low resources receiving EDI did not differ significantly from children from high-resource families in either the EDI (P = .509) or control (P = .882) groups. A home-based EDI during the first 3 years of life can substantially decrease the developmental gap between children from families with lower versus higher resources, even among children in low- to middle-resource countries.

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