Mar 16, 2007


Project CARE is a longitudinal, early childhood
intervention study of the Frank Porter Graham Child Development Center at the
University of North Carolina. Project CARE included a combination of
educational daycare, provided by the Child Development Center, as well as a
home-based, family education component. Families were selected to participate
in the program if they had infants who were considered to be at risk for delayed
development. The families were randomly assigned to one of three groups: Child
Development Center Plus Family Education, Family Education only, or a Control
group. Project CARE revealed that, although quality daycare had a positive
impact on children’s cognitive development, the family education component
did not. An evaluation of Project CARE revealed that the combination of the
Child Development Center and a family education component significantly
increased children’s cognitive development when compared to either family
education alone or to the control group.


Target population: Families
with newborn infants considered to be at an elevated risk for developmental
delays due to the disadvantaged educational and social circumstances of the
parents were the focus.

Project CARE consisted of two major interventions. One component included an
educational daycare program provided by the Child Development Center. Home
visitors provided the other component of Project CARE which involved family
education. The entire intervention was intended to last throughout the preschool
The educational daycare component was organized according to a systematic
developmental curriculum and emphasized intellectual and social development. The
daycare center maintained low child/teacher ratios and employed staff with an
average of seven years experience in early childcare.
The family education component was intended to help parents foster both the
cognitive and social development of their child. Home visitors provided families
with various supports, information, advice and referrals. They emphasized
problem-solving methods as well as components of the same basic child curriculum
used by the daycare center. Home visitors were traditionally teachers, social
workers and nurses.


Wasik, B., Ramey, C., Bryant, D., & Sparling, J. (1990). A
longitudinal study of two early intervention strategies: Project CARE. Child
Development, 61,

Of the 65 families that were ultimately selected to
participate in Project CARE, only one elected not to participate. All families
had been identified because at birth, their infant was considered to be at-risk
for developmental delays. The average age of the parents was 22 for women and
25 for men. On average, parents had completed 10.5-11.4 years of education.

Approach: Over a period of 18 months, a home visitor at one local hospital reviewed
all births and then selected families based on conditions of the target population.
Families underwent a basic screening process, which consisted of an interview
and a psychological assessment. Once families were considered eligible and
accepted the conditions of the study, they were randomly assigned to one of
three conditions. The first group, Child Development Center Plus Family
Education, consisted of 16 families and received both educational daycare and
the family education component. The second group, Family Education, included 25
families that received only the family education component. The control group
received neither treatment and consisted of 23 families. Although the control
group did not receive any systematic education or daycare from Project CARE,
families in both the control group and the family education group received free
iron-fortified formula as well as a monthly supply of diapers. Many of them
also chose to send their children to other community daycares. Social workers
were available for all groups.

intervention began one month after birth with home visits. Only two families
entered the program late. At six months, one family in the combined group moved
away and one infant in the family education group had died. These developments
brought the total sample size to 62 families. The control group did not lose any
families. The overall retention rate of Project CARE at 54 months was 91

the combined group and the family education group were assigned to receive
weekly home visits during the first 3 years of the program. Home visits during
the fourth and fifth years depended on parents’ preferences.

visits were not completed as often as the intended weekly amount. On average,
the family education group reported 2.5 visits per month and the combined Child
Development Center Plus Family Education group reported 2.7 visits per month.
During the 4th and 5th years when visits were arranged
according to parents’ needs, the average frequency of visits for the
parent education group and the combined group was 1.4 per month and 1.1 per
month, respectively. Overall, 92 percent of the home visits were conducted with
the mother. 60 percent of the visits lasted 30-60 minutes, however 20 percent
lasted over an hour. Parents in both the family education and combined groups
had the option of attending monthly parents’ information/support meetings
as well.

evaluation assessed the cognitive development of the infant, the home
environment, and childrearing attitudes of the parents. Evaluators used a
variety of standardized tests, such as the Stanford-Binet Test of Intelligence,
to assess cognitive development. All tests were administered in the same child
development laboratory by research assistants not affiliated with Project CARE.
To assess the home environment, evaluators used the infant/toddler and
preschool versions of the Home Observation for Measurement of the Environment
(HOME). Childrearing attitudes were assessed using maternal report.

Results: In general, the largest impacts in cognitive development were reported for
the Child Development Center Plus Family Education group. The family education
component, whether combined with the educational daycare or alone, did not
appear to have a significant impact on any of the measured outcomes.
Intellectual performance, measured through standardized intelligence tests,
became significant after twelve months. At the 12, 18, 24 and 36 month tests,
the combined group differed significantly from the other two groups on
cognitive development outcomes. At the 30 and 42 month tests, however, the
combined group differed significantly from the family education group but not
from the control group. It is important to note that after the 24th
month test, there was a general increase in scores for both the family
education and control groups. Evaluators believe that this may be due to
attendance in other daycare programs. The HOME inventory and an assessment of
childrearing attitudes found no significant differences in outcomes between the



B., Ramey, C., Bryant, D., & Sparling, J. (1990). A longitudinal study of
two early intervention strategies: Project CARE. Child Development, 61,1682-1696.


KEYWORDS: Infants, Toddlers, Preschool, Black/African American, Hispanic/Latino, Child Care, Clinic/Provider-Based, Home Visitation, Parent or Family Component, Parent Training/Education, Other Social and Emotional Health.

information last updated 3/16/07