Carla M Bann1, Jan L Wallander2, Barbara Do3, Vanessa Thorsten3, Omrana Pasha4, Fred J Biasini5, Roopa Bellad6, Shivaprasad Goudar7, Elwyn Chomba8, Elizabeth McClure3, Waldemar A Carlo9. 1. Division of Statistical and Data Sciences, and cmb@rti.org. 2. Psychological Sciences and Health Sciences Research Institute, University of California, Merced, California; 3. Biostatistics and Epidemiology, RTI International, Research Triangle Park, North Carolina; 4. Departments of Community Health Sciences and Family Medicine, Aga Khan University Medical College, Karachi, Pakistan; 5. Sparks Clinics and Department of Psychology, and. 6. Department of Pediatrics, and. 7. Department of Medical Education, KLE Jawaharlal Nehru Medical College, Belgaum, India; and. 8. Department of Pediatrics, University of Zambia, Lusaka, Zambia. 9. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama;
Abstract
OBJECTIVE: To investigate whether early developmental intervention (EDI) can positively affect the trajectories of cognitive development among children from low-resource families. METHODS: Longitudinal analyses were conducted of data from 293 children in the Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial, a randomized controlled trial of a home-based EDI program, to examine trajectories of Bayley Scales of Infant Development-Second Edition Mental Development Index (MDI) scoresfrom 12 to 36 months of age among young children from high- and low-resource families in 3 low- to middle-resource countries. RESULTS: A 3-way interaction among family resources, intervention group, and age was statistically significant after controlling for maternal, child, and birth characteristics (Wald χ(2)(1) = 9.41, P = .002). Among children of families with high resources, both the intervention and control groups had significant increases in MDI scores over time (P < .001 and P = .002, respectively), and 36-month MDI scores for these 2 groups did not differ significantly (P = .602). However, in families with low resources, the EDI group displayed greater improvement, resulting in significantly higher 36-month MDI scores than the control group (P < .001). In addition, the 36-month MDI scores for children in families with low resources receiving EDI did not differ significantly from children from high-resource families in either the EDI (P = .509) or control (P = .882) groups. CONCLUSIONS: A home-based EDI during the first 3 years of life can substantially decrease the developmental gap between children from families with lower versus higher resources, even among children in low- to middle-resource countries.
RCT Entities:
OBJECTIVE: To investigate whether early developmental intervention (EDI) can positively affect the trajectories of cognitive development among children from low-resource families. METHODS: Longitudinal analyses were conducted of data from 293 children in the Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial, a randomized controlled trial of a home-based EDI program, to examine trajectories of Bayley Scales of Infant Development-Second Edition Mental Development Index (MDI) scores from 12 to 36 months of age among young children from high- and low-resource families in 3 low- to middle-resource countries. RESULTS: A 3-way interaction among family resources, intervention group, and age was statistically significant after controlling for maternal, child, and birth characteristics (Wald χ(2)(1) = 9.41, P = .002). Among children of families with high resources, both the intervention and control groups had significant increases in MDI scores over time (P < .001 and P = .002, respectively), and 36-month MDI scores for these 2 groups did not differ significantly (P = .602). However, in families with low resources, the EDI group displayed greater improvement, resulting in significantly higher 36-month MDI scores than the control group (P < .001). In addition, the 36-month MDI scores for children in families with low resources receiving EDI did not differ significantly from children from high-resource families in either the EDI (P = .509) or control (P = .882) groups. CONCLUSIONS: A home-based EDI during the first 3 years of life can substantially decrease the developmental gap between children from families with lower versus higher resources, even among children in low- to middle-resource countries.
Authors: Peter C Rockers; Arianna Zanolini; Bowen Banda; Mwaba Moono Chipili; Robert C Hughes; Davidson H Hamer; Günther Fink Journal: PLoS Med Date: 2018-04-24 Impact factor: 11.069