Child Development
Conditions
Keywords
child, preschool, intelligence, environment, home visiting
Brief summary
The purpose of the MOM Program Continuation is to promote child development by helping families become more competent in accessing and using available health, developmental and educational resources. The program focuses are childhood immunizations, Early Intervention services, lead screening, Early Head Start and Head Start enrollment. The Intervention consists of frequent phone calls and home visits to encourage mothers to have their babies immunized on schedule and to participate in needed developmental and educational services. The program seeks to fill the gap between children's need for services and mothers' ability to assure their children's participation in those services.
Detailed description
The MOM Program Continuation builds on the work of The MOM Program, a 3 year randomized intervention. The premise of the MOM Program was that professional support through home visits and frequent phone contacts would improve children's cognitive and behavioral development, ultimately improving their early educational success. The children were enrolled in the MOM Program at birth. The MOM Program Continuation provides continued intervention for the children and mothers of the original cohort to assure that the children are prepared for kindergarten entry at 5 years of age and to evaluate the children's cognitive and behavioral outcomes at age 5 years. The program will also create a longitudinal database to study the linkages between maternal cognitive ability and child cognitive, educational, and behavioral outcomes through entry into school.
Interventions
BEHAVIORALHome visiting professional support model
Home visits and telephone calls keyed to well child visits.
OTHERControl
The control group received an information booklet on child/family services upon enrollment and transportation for the follow-up evaluations. They were called every 4 months to maintain contact information
Sponsors
William Penn Foundation
Claneil Foundation, Inc.
Robert Wood Johnson Foundation
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
4 Years to 5 Years
Healthy volunteers
Yes
Inclusion criteria
Previous enrollment in The MOM Program; child age of 5 years (plus or minus 3 months); willingness to come to office for follow-up assessment visit; parental consent and child assent.
Exclusion criteria
None.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III) | 5 years of age (plus or minus 1 month) | Cognitive ability was assessed through the Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III). The WPPSI-III has been developed and standardized for children ages 2 years, 6 months through 7 years, 3 months of age. The WPPSI-III yields a Verbal Score, a Performance Score, a General Language Score, and a Full Scale Score. These scores have a mean of 100 and a standard deviation of 15. The range of possible values is 50 (worst value) to 150 (best value). |
| Child Behavior Checklist Internalizing Scale at 5 Years of Age, Percentage of Participants | at child age of 5 years (plus or minus 1 month) | Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal). |
| Child Behavior Checklist Externalizing Scale, Percentage of Abnormality in Participants | at child age of 5 years (plus or minus 1 month) | Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal). |
| Child Behavior Checklist Aggressive Subscale, Percentage of Abnormality in Participants | at child age of 5 years (plus or minus 1 month) | Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal). |
| Child Behavior Checklist Attention Subscale, Percentage of Abnormality in Participants | child age 5 years (plus or minus 1 month) | Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal). |
Countries
United States
Participant flow
Recruitment details
Participants were recruited from the Hospital of the University of Pennsylvania after giving birth to a healthy singleton newborn infant, if they lived in pre-identified ZIP Code areas of Philadelphia. Participants were recruited from July 6, 2001 through January 7, 2002. 302 mothers were enrolled and 254 completed the 5-year follow-up visit.
Pre-assignment details
Randomization occurred at enrollment. At the time of follow-up, participants continued to remain in the originally assigned group of either control or intervention.
Participants by arm
| Arm | Count |
|---|---|
| Home Visiting Intervention The intervention group received home visits and follow up calls keyed to well child visits following American Academy of Pediatric guidelines. Follow-up and reminder calls were made to track health care visits completed and referrals made. | 152 |
| Control The control group received an information booklet on child/family services upon enrollment and transportation for the follow-up evaluations. They were called every 4 months to maintain contact information. | 150 |
| Total | 302 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 21 | 21 |
| Overall Study | Withdrawal by Subject | 3 | 3 |
Baseline characteristics
| Characteristic | Home Visiting Intervention | Control | Total |
|---|---|---|---|
| Age, Customized 4-5 years | 152 participants | 150 participants | 302 participants |
| Region of Enrollment United States | 152 participants | 150 participants | 302 participants |
| Sex: Female, Male Female | 81 Participants | 82 Participants | 163 Participants |
| Sex: Female, Male Male | 71 Participants | 68 Participants | 139 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 152 | 0 / 150 |
| serious Total, serious adverse events | 0 / 152 | 0 / 150 |
Outcome results
Primary
Child Behavior Checklist Aggressive Subscale, Percentage of Abnormality in Participants
Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal).
Time frame: at child age of 5 years (plus or minus 1 month)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Home Visiting Intervention | Child Behavior Checklist Aggressive Subscale, Percentage of Abnormality in Participants | 4 Percentage of participants |
| Control | Child Behavior Checklist Aggressive Subscale, Percentage of Abnormality in Participants | 12 Percentage of participants |
p-value: <0.05Chi-squared
Primary
Child Behavior Checklist Attention Subscale, Percentage of Abnormality in Participants
Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal).
Time frame: child age 5 years (plus or minus 1 month)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Home Visiting Intervention | Child Behavior Checklist Attention Subscale, Percentage of Abnormality in Participants | 7 Percentage of participants |
| Control | Child Behavior Checklist Attention Subscale, Percentage of Abnormality in Participants | 8 Percentage of participants |
p-value: 0.64Chi-squared
Primary
Child Behavior Checklist Externalizing Scale, Percentage of Abnormality in Participants
Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal).
Time frame: at child age of 5 years (plus or minus 1 month)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Home Visiting Intervention | Child Behavior Checklist Externalizing Scale, Percentage of Abnormality in Participants | 3 percentage of participants |
| Control | Child Behavior Checklist Externalizing Scale, Percentage of Abnormality in Participants | 12 percentage of participants |
p-value: <0.01Chi-squared
Primary
Child Behavior Checklist Internalizing Scale at 5 Years of Age, Percentage of Participants
Caregivers completed The Child Behavior Checklist (CBCL) Preschool form from The Achenbach System of Empirically Based Assessment (ASEBA). The CBCL is standardized for children ages 1.5 to 5 years and measures child internalizing and externalizing behaviors and total problems. Respondents are asked to rate 99 problem items as 0 for not true of the child, 1 for somewhat or sometimes true of the child, and 2 for very true or often true of the child based on the past two months. The range of possible values is 0-100. Percentage of Participants with Abnormal Behavior is calculated by: % abnormal = # of Abnormal / (# of Normal + # of abnormal).
Time frame: at child age of 5 years (plus or minus 1 month)
Population: Number of mothers/caregivers evaluated at 60 month visit.
| Arm | Measure | Value (NUMBER) | Dispersion |
|---|---|---|---|
| Home Visiting Intervention | Child Behavior Checklist Internalizing Scale at 5 Years of Age, Percentage of Participants | 8 percentage of participants | 8.9 |
| Control | Child Behavior Checklist Internalizing Scale at 5 Years of Age, Percentage of Participants | 11 percentage of participants | 11.2 |
p-value: 0.72Chi-squared
Primary
Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III)
Cognitive ability was assessed through the Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III). The WPPSI-III has been developed and standardized for children ages 2 years, 6 months through 7 years, 3 months of age. The WPPSI-III yields a Verbal Score, a Performance Score, a General Language Score, and a Full Scale Score. These scores have a mean of 100 and a standard deviation of 15. The range of possible values is 50 (worst value) to 150 (best value).
Time frame: 5 years of age (plus or minus 1 month)
Population: Number of children evaluated at 60 month visit.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Home Visiting Intervention | Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III) | 86.5 Scores on a scale | Standard Deviation 12.6 |
| Control | Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III) | 87.4 Scores on a scale | Standard Deviation 12.2 |
Comparison: We compared scores for verbal, performance, and full scale Intelligence Quotient (IQ).p-value: 0.5995% CI: [0.31, 2.13]t-test, 2 sided