Program

Mar 28, 2002


OVERVIEW

The Infant Health and Development Program (IHDP) is designed to reduce the developmental and health problems of low birthweight premature infants. Between birth of a premature child and the age of three, program families received service such as home visits, enrollment at a child development center, and parent group meetings in additional to service referrals and developmental assessments. At the end of the program, an experimental evaluation showed that IHDP had positively impacted cognitive and motor skills in participants, particularly those from the most at-risk families and those who had been born at the “heavier” side of the low birthweight range. Furthermore, positive IHDP impacts for heavier low birthweight infants, but not lighter low birthweight infants, were particularly long lasting.

DESCRIPTION OF PROGRAM

Target population:
Families with infants that were born prematurely (born after 37 or fewer weeks gestation) and at low birthweight (2500 grams or less)

The Infant Health and Development Program (IHDP), initiated in 1985, has served low birthweight, premature infants upon their discharge from the hospital; services continued until the age of 3. Infants and their families received medical, developmental and social assessments, and referrals for services such as health care, as well as more comprehensive services such as home visits, enrollment in a child development center and parent group meetings. During home visits, parents were provided with information on their child’s health and development. They were also taught a series of games and activities to use to promote their child’s cognitive, language and social development, and they were helped to manage self-identified problems. Beginning at age 12 months, children attended child development centers for five days per week. The curriculum was designed to match the activities that parents were taught to carry out with their children during home visits. The last component was parent groups, which began meeting when infants were 12 months old. Parents met every two months and were provided with information on such topics as health, safety, and raising (for more information, see Research Forum web site, below.)

· Length: Three years.
· Intensity: Home visits occurred weekly during the first year and biweekly for the next two years. Attendance at the child development center began at age 12 months and lasted until age 36 months; the children attended the center for five days per week. Parent groups met every two months beginning when children were 12 months old.
· Service Delivery Mode: Home visits, child attendance at a child development center and parent group meetings.

EVALUATION(S) OF PROGRAM


Evaluated population:
985 infants and their families. 362 infants were “heavier” (born weighing greater than 2000 grams), 623 were “lighter” (born weighing less than 2000 grams).

The Infant Health and Development Program (IHDP) has been implemented and evaluated in eight cities (Little Rock, Ark.; Bronx, N.Y.; Cambridge, Mass.; Miami, Fla.; Philadelphia, Pa.; Dallas, Texas; Seattle, Wash.; and New Haven, Conn.). Infants were randomly assigned to either the intervention group or the follow-up group. Infants and families in both groups received medical, developmental and social assessments, as well as referrals for services such as health care. Infants and families in the IHDP program received services such as home visits, enrollment in a child development center and parent group meetings, as well.

At age 36 months, investigators found that children in the intervention group had higher scores than children in the follow-up group on tests of receptive language, cognitive development, and visual-motor and spatial skills (Brooks-Gunn, Liaw & Klebanov, 1992; McCormick, McCarton, Tonascia & Brooks-Gunn, 1993). In addition, the effects were the strongest for families with the greatest risk (i.e., children whose parents had a high school education or less and who were of ethnic minority status; Brooks-Gunn, Gross, Kraemer, Spiker & Shapiro, 1992). It is important to note, however, that investigators independent of the IHDP team (Baumeister & Bacharach, 1996) found that the intervention was effective for “heavier” infants (> 2000 grams), but not for “lighter” infants (< 2000 grams).

Thus far, the IHDP children have been studied and reported on through age 8. McCarton et al. (1997) found that there were no overall significant differences between the intervention and follow-up groups. However, the subsample of children in the intervention group who were “heavier” at birth had higher scores on several cognitive tests (e.g., receptive vocabulary, math, overall IQ) than the subsample of “heavier” children in the follow-up group. The difference between the two groups was smaller than that seen at age 3, so the effects of IHDP had faded a bit over time. As for the “lighter” subsample of the intervention group, in comparison to the “lighter” subsample of the follow-up group, all of the earlier positive effects had disappeared by age 8.

SOURCES FOR MORE INFORMATION

References:

Baumeister, A. A. & Bacharach, V. R. (1996). A critical analysis of the Infant Health and Development Program. Intelligence, 23, 79-104.

Brooks-Gunn, J., Gross, R.T., Kraemer, H.C., Spiker, D. & Shapiro, S. (1992). Enhancing the cognitive outcomes of low birth weight, premature infants: For whom is the intervention most effective? Pediatrics, 89, 1209-1215.

Brooks-Gunn, J., Liaw, F. & Klebanov, P.K. (1992). Effects of early intervention on cognitive function of low birth weight preterm infants. Journal of Pediatrics, 120, 350-359.

McCarton, C. M., Brooks-Gunn, J., Wallace, I. F., Bauer, C. R., Bennett, F. C., Bernbaum, J. C., Broyles, R. S., Casey, P. H., McCormick, M. C., Scott, D. T., Tyson, J., Tonascia, J. and Meinert, C. L. (1997). Results at age 8 years of early intervention for low-birth-weight premature infants. Journal of the American Medical Association, 277, 126-132.

McCormick, M. C., McCarton, C., Tonascia, J. & Brooks-Gunn, J. (1993). Early educational intervention for very low birth weight infants: Results from the Infant Health and Development Program. Journal of Pediatrics, 123, 527-533.

Web Sites: www.tc.columbia.edu/centers/ccf/earlychild.htm (Center for Children and Families, Teachers College, Columbia University); link for PDF of report
(Research Forum web site-provides a good, detailed overview)

KEYWORDS:  Infants, Toddlers, Children, High-Risk, Child Care, Attendance, Community-Based, Health Status/Conditions, Home Visitation, Home-Based, Community-Based, Home Visitation, Parent Training/Education, Parent/Family Component, Reading/Literacy, Early Childhood Education, Health Status/Conditions, Mathematics, Other Education

Program information last updated 3/28/02.

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