Program

Jan 16, 2013

OVERVIEW

This intervention uses nurse specialists to visit mothers
in their homes from the child’s birth until he or she turns 36 months of age.
All children were exposed to drugs in utero. The nurses support the mothers and
monitor the child’s health. The program was found to have no impacts on child
behavior problems or parent stress when the children were two and three years of
age, but children in the treatment group were less withdrawn than children in
the control groups receiving standard care.

DESCRIPTION OF PROGRAM

Target population: Children with in utero drug
exposure

Between birth and 18 months, children receive 16 home
visits, and there are more frequent visits during the first six months of age.
Then, with every six months children are examined until age 36 months. Two
pediatric nurse specialists visit the mother’s home. The pediatric nurse
specialists are supervised by pediatric nurse practitioners who are available to
them 24 hours a day.

The pediatric nurse specialists support the mothers
emotionally, model positive parent-child interactions, monitor the infant’s
health, provide parenting information, and teach the mother specific skills to
increase the quality of the mother-child interaction. The materials for the
mother are based on the

Hawaii Early Learning Profile
and the

Carolina preschool curriculum.

EVALUATIONS OF PROGRAM

Butz, A. M., Pulsifer, M.,
Marano, N., Belcher, H., Lears, M. K., & Royall, R. (2001). Effectiveness of a
home intervention for perceived child behavioral problems and parenting stress
in children with in utero drug exposure. Archives of Pediatrics and
Adolescent Medicine, 155
, 1029-1037.

Evaluated population: Mothers were between 19 and 40
years old. Ninety-six percent of the children in the sample were 96 percent
African American. On average, mothers had 11 years of education, 98 percent were
single, and 68 percent of the mothers had custody of their children.

Approach: During pregnancy, mothers were assessed on
self-reports of addiction severity, drug use, and drug use during pregnancy.
Toxicology screens were used to detect drug use by the mother during pregnancy.
Nursing staff collected specimens during labor from the mother and from the baby
within 24 hours of birth. All child measures were taken every six months from
birth to three years of age. Child behavior problems and parental stress were
reported in this study. Parental stress was measured at child’s age two years
and age four years, and is reported here as well.

Results: Impacts were not found for the child
behavior problems measure. Specifically, no impacts were found for the
internalizing and externalizing parts of the measure, as well as the
anxiety-depression, sleep, somatization, aggression, and destruction subscales.
However, in the subgroup of children who had clinically significant
emotional/behavioral problems, significant impacts were found for externalizing,
internalizing, and anxiety-depression. For the clinical problem group, no
significant impacts were found for number of hospital visits (low number versus
high number) or for continued maternal alcohol and other drug use.

The subgroup of parents who scored at the 90th
percentile or higher or at a standard score of 119 or higher on the parenting
stress measure had no significant impacts. Parents with high parenting stress in
the control group did not significantly differ from the treatment group on the
number of hospital visits, continued maternal alcohol and other drug use, or
parenting stress subscales.

The withdrawn subscale was significant, with the control
group being significantly more withdrawn than the treatment group. No
significant impacts were found for parenting stress (consisting of parent-child
dysfunctional interaction, parental distress, and difficult child subscales).

SOURCES FOR MORE INFORMATION

References:

Butz, A. M., Pulsifer, M.,
Marano, N., Belcher, H., Lears, M. K., & Royall, R. (2001). Effectiveness of a
home intervention for perceived child behavioral problems and parenting stress
in children with in utero drug exposure. Archives of Pediatrics and
Adolescent Medicine, 155
, 1029-1037.

KEYWORDS: Infants (0-12 months), Toddlers (12-36
months), Home-based, Home Visitation, Parent/Family Component, Parent
Training/Education, White or Caucasian, Black or African American,
Aggression, Bullying, Depression/Mood Disorders, Anxiety
Disorders/Symptoms, Tobacco Use, Alcohol Use, Marijuana/Illicit/Prescription
Drugs, Other Substance Use.

Last Updated on 3/24/10