Children with low birth weights who receive early intervention and educational services are likely to have higher reading and math scores and better behavior in school than similar children who do not receive such services, a new study shows.
The research, led by Jeanne Brooks-Gunn, a child-development professor at Teachers College, Columbia University, is an 18-year follow-up of the Infant Health and Development Program, a randomized study that was conducted in eight U.S. cities. Her article on the findings appears in the March issue of the journal Pediatrics.
“This study shows that providing preschool to low-birth-weight infants is a smart use of public resources, and in the long term, there are thousands of children who would reap the benefits,” Ms. Brooks-Gunn said.
The study began in 1985 with a group of 985 low-birth-weight, prematurely born infants. Low-birth-weight children, especially those weighing 3 to 4 pounds or less, have been found to have a higher risk of academic and behavior problems than children who are born in the normal weight range of over 5½ pounds.
Differences by Weight
The research sample was divided into two groups: one that received the intervention services and another one that did not. The eight sites in the study were Little Rock, Ark.; Boston; the Bronx, in New York City; Philadelphia; Dallas; Miami; Seattle; and New Haven, Conn.
The Robert Wood Johnson Foundation, a Princeton, N.J.-based organization that focuses on improving health care, launched the demonstration project along with the investigators, who included Dr. Marie C. McCormick of Harvard University’s school of public health.
During their first year of life, the children in the experimental group received home visits each week. The visits were cut back to every other week during the second and third years. Between the ages of 1 and 3, the children also participated in daily, center-based early-childhood education. Support groups were also available to the parents.
The children in both groups received regular medical care, and parents received referrals to community services if needed.
Before the 18-year point, at which 636 members of the original groups participated, follow-ups on the children had been conducted at ages 3, 5, and 8.
For the latest study, Ms. Brooks-Gunn and Dr. McCormick looked at the results for both lighter and heavier premature infants.
In those children under 2,001 grams at birth, which is about 4.4 pounds, the benefits of the early intervention began to fade around age 5. But among the group of children who were heavier at birth, the benefits were sustained. At age 18, those with higher weights who had received the services were still scoring higher on achievement tests than those who had not received the services.
Ms. Brooks-Gunn has worked with other researchers to collect data showing that the more days the toddlers attended the center-based part of the program, the greater the benefit—findings that are not in the Pediatrics article.
“Higher levels of participation in an early intervention for at-risk children can result in larger and longer-lasting effects than can lower levels of participation,” the researchers wrote in a 2003 article appearing in the journal Developmental Psychology.
The researchers say more research is needed on why the positive effects did not last longer for children in the low-weight range.
In a recent interview, Ms. Brooks-Gunn said she suspects that the benefits for the smaller babies might have lasted longer if they had been given the opportunity to enroll in Head Start or another preschool class for another two years before kindergarten.
“It’s not a question of whether they needed different services, just more,” she said.
Beyond a Single Site
Overall, the researchers conclude that the findings are promising.
Ms. Brooks-Gunn, who also teaches at Princeton University, added that the project has implications for education as a whole since the heavier premature babies—those in the 5-pound range—are considered as healthy as normal, full-term babies and usually don’t require any special services.
“[The findings] show that we can implement a high-quality curriculum in multiple sites at once,” she said. Until now, she added, the field of early-childhood education has relied on the positive results of small demonstration projects in single sites.
James J. Heckman, a Nobel Prize-winning economist from the University of Chicago who has become a supporter of early-childhood education as an economic-development strategy, called the work an important study “that adds to the growing body of evidence that early interventions matter.”
