The efficacy of early intervention for low birth weight infants: What works, how, and for whom?

Research has demonstrated that low birth weight (LBW) infants are at risk for less optimal development, and intervention programs have been initiated to ameliorate their risks. Although existing research has demonstrated that early intervention is beneficial for LBW children, it has not addressed such specific issues as variations in individual experiences of intervention, relationships between the intervention experience and program effects, impact of specific intervention components, or potential differential effects of intervention on children from different backgrounds. The purpose of this study was to investigate these issues, using the data from the Infant Health and Development Program (IHDP). The IHDP is a randomized trial of an early intervention (including 295 intervention children and 608 control children) that provided LBW infants and their parents with home visits from the infant's hospital discharge to 36-months corrected age, and a center-based educational curriculum and parent group meetings in the second and third years. The results show that the IHDP was beneficial for LBW children, especially for those who lived in poverty and those who were relatively heavier in birth weight. The findings also indicate that the success of intervention depended more on parental interest in the home visit activities and child mastery of intervention activities than on occurrence of contacts or number of activities. Further analyses show that high levels of active involvement from both the parent and the child produced more cognitive and receptive language development in children than high parental involvement alone, high child involvement alone, or low parental and child involvement. Moreover, without the IHDP, control children evidenced developmental and language delays by age 3. The results also suggest that although a center-based child educational curriculum is important for LBW children's development, parent support group meetings are differentially helpful for poor parents and children, whereas the home visit parent-education program was more useful to children who were relatively lower in birth weight. The findings of this study support the position that the extent to which the parents and children actively respond to and experience the intervention determines the impact of intervention. This study not only confirms the ameliorative function of early intervention for LBW children, but strengthens the need for identifying children who are at elevated risk and for varying intervention procedures to match individual characteristics and needs so that all children and families can have the best chance of reaching their full developmental potential.Ed.D.EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/105645/1/9208478.pdfDescription of 9208478.pdf : Restricted to UM users only