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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 .
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Intervention_Educational
Early educational intervention
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Intervention_Educational
Infant Health and Development Program .
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Intervention_Educational
early educational intervention
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Intervention_Control
follow-up only
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Intervention_Educational
.
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Intervention_Educational
intensive pediatric and developmental surveillance .
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Intervention_Educational
received home visits and center-based educational interventions
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Outcome_Mental
Cognitive development ( Stanford-Binet Intelligence Scale )
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Outcome_Mental
behavioral competence ( Achebach Child Behavior Checklist )
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Outcome_Physical
health status ( indexes summarizing reported morbidity , the Functional Status II ( R ) Scale , and General Health Ratings Index )
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Outcome_Physical
Cognitive development scores
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Outcome_Physical
neonatal morbidity
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Outcome_Physical
behavior , serious morbidity , functional status , or health rating
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Outcome_Physical
lower behavior problem scores
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Outcome_Physical
rates of less serious morbidity .
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Participant_Condition
very low birth weight infants :
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Participant_Condition
very low birth weight ( < or = 1500 gm ) infants .