Early intervention in low birth weight premature infants: Results at 18 years of age for the infant health and development program

被引:265
|
作者
McCormick, MC
Brooks-Gunn, J
Buka, SL
Goldman, J
Yu, J
Salganik, M
Scott, DT
Bennett, FC
Kay, LL
Bernbaum, JC
Bauer, CR
Martin, C
Woods, ER
Martin, A
Casey, PH
机构
[1] Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, Boston, MA 02115 USA
[2] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA
[3] Columbia Univ, Teachers Coll, Natl Ctr Children & Families, New York, NY 10027 USA
[4] Columbia Univ, Coll Phys & Surg, New York, NY 10027 USA
[5] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
[6] Univ Washington, Dept Pediat, Seattle, WA 98195 USA
[7] Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75230 USA
[8] Univ Penn, Sch Med, Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA
[9] Univ Miami, Sch Med, Dept Pediat, Miami, FL 33152 USA
[10] Beth Israel Deaconess Med Ctr, Dept Neonatol, Boston, MA 02215 USA
[11] Childrens Hosp, Boston, MA 02115 USA
[12] Univ Arkansas Med Sci, Dept Pediat, Little Rock, AR 72205 USA
关键词
early intervention; long-term results; low birth weight; randomized controlled trial;
D O I
10.1542/peds.2005-1316
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE. To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age. METHODS. This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001-2499 g) and lighter low birth weight (LLBW; <= 2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status. RESULTS. We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (-0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2). CONCLUSIONS. The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention.
引用
收藏
页码:771 / 780
页数:10
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