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Guide
to Effective Programs
for Children and Youth |
TRANSACTIONAL MODEL OF EARLY HOME INTERVENTION
OVERVIEW
The Transactional Model of Early Home Intervention is designed for mothers who give birth to low birth-weight infants. The program focuses on improving child development, which is often slower for low birth-weight infants, by improving mother-child interaction and parent responsiveness through the first year of life. A randomized, experimental evaluation of the intervention found that it was effective in improving the home environment of the child and some aspects of the child’s cognitive development. Up to 16 months, the parent-child interaction, or Transactional, program had a larger impact. In the second year of life, the parent-child interaction program enhanced children’s security, while the developmental program enhanced children’s social competence, relative to a no-treatment control group. The intervention had limited or no impacts on child temperament, parent interactive behaviors, and child interactive behaviors.
Early Home Intervention is different from many infant home-visiting programs in that it focuses on improving the quality of interactions between the mother and child instead of the child’s health or developmental progress. The program seeks to teach parents observational skills so that they can better understand their child’s body language and better respond to it. It is thought that the program improves a child’s development by improving parental responsiveness to the child’s needs. The intervention lasts for one full year. Families in the program are visited by an infant-parent therapist for 1-2 hours each week for four months of the program, every other week for the next five months, and then monthly for the last three months for a total of approximately 28 visits. In each visit, the infant-parent therapist helps the parent learn to recognize the child’s specific body cues and appropriately react to them. The therapist also works with the parent to develop a plan for different interaction situations.
Barrera, M. E., Rosenbaum, P. L., & Cunningham, C. E. (1986). Early home intervention with low-birth-weight infants and their parents. Child Development, 57, 20-33.
Approach: To be eligible for the study, pre-term infants had to have a birth-weight less than 2,000 grams, gestational age less than 37 weeks, a good prognosis for survival, released from hospital 2 weeks before the study, and had to be living in the area. The full-term infants had to meet similar criteria except for birth-weight and gestational age which had to be in the normal range. The full-term infants were all assigned to a no treatment comparison group for comparison. It should be noted that this is not intended to be a comparison for program effectiveness but as a benchmark for the pre-term infant’s development. Pre-term infants were matched on sex, birth weight, socioeconomic status, and pre- and post-term complications. After matching, pre-term infants were randomly assigned to one of three conditions: a no-treatment control condition, the Transactional Model parent-infant intervention, and a comparison developmental programming intervention. The Transactional intervention consisted of a series of home visits which were designed to improve parent-infant interaction. The developmental programming intervention consisted of the same number of home visits but with a focus on improving the child’s developmental functioning which was done through activities designed to stimulate the child. The infants were assessed at 4, 8, 12, and 16 months on measures of infant development, home environment, and parent-child interactions.
Results: At pre-test, the pre-term groups of parents and infants did not differ significantly on any demographic or birth variables. As expected, the pre-term group did differ significantly from the full-term group on many variables including birth-weight, gestational age, and pre- and post-natal complications.
At 4 months, children in the pre-term conditions had lower scores on mental skills, motor skills, development, and home environment. By 16 months, children in both intervention conditions had caught up to the developmental levels of full-term control children, meaning that there were not significant differences in developmental scores. By 12 and 16 months, children in both intervention conditions had also caught up with full-term comparison children in terms of motor development. At 8 and 12 months, children in both intervention conditions had achieved similar home environment. At 16 months, children in the full-term comparison group and children in the pre-term Transactional Model intervention group had higher home environment scores than those in the pre-term control group and pre-term developmental programming intervention. Infants in the full-term comparison and pre-term intervention conditions engaged in independent verbal play more often than those in the pre-term control group. Parents in the pre-term intervention conditions were less likely to become unresponsive to infants when compared with those in the pre-term control condition.
The program had no impacts on children’s temperament and the only differences observed were changes over time across all 4 groups. Similarly, the program had no impacts on infant interactive behaviors or mother interactive behaviors.
Barrera, M. E., Doucet, D. A., & Kitching, K. J. (1990). Early home intervention and socio-emotional development of preterm infants. Infant Mental Health Journal, 11(2), 142-157.
Evaluated population: 59 parents of infants who were born pre-term and 24 mothers of infants who were born at full-term. Approximately 55 percent of the pre-term sample were males. The average birth-weight of the pre-term infants was approximately 1677 grams; normal birth-weight is considered to be between 2,500 and 4,000 grams. Most mothers were married, around 94 percent and the average age of mothers was around 27 years.
Approach: This study reports additional results of data collection from the previously mentioned study. The purpose of this study was to assess infant security and social competence after the conclusion of the program. Infant security was measured using the Flint Infant Security Scale and social competence was measured using the Vineland Social Maturity Scale.
Results: The Transaction intervention program had no impacts on social competence at any of the follow-up periods, 4, 8, 12, and 16 months. At the 16-month follow-up, children in the developmental intervention group had higher social competence scores than children in the pre-term control group. In terms of infant security, children in the Transaction intervention were more secure than those in both the pre-term control group and those in the developmental intervention. At 16 months, children in the developmental intervention were as socially competent as children in the comparison group.
Barrera, M. E., Doucet, D. A., & Kitching, K. J. (1990). Early home intervention and socio-emotional development of preterm infants. Infant Mental Health Journal, 11(2), 142-157.
Barrera, M. E., Rosenbaum, P. L., & Cunningham, C. E. (1986). Early home intervention with low-birth-weight infants and their parents. Child Development, 57, 20-33.
Program categorized in this guide according to the following:
Evaluated participant ages: birth to 1 year / Program age ranges in the Guide: early childhood
Program components: home visiting; parent or family component
Measured outcomes: social and emotional health and development
Program information last updated 12/5/07
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© Child Trends 2004 |