The Miami site of the Infant Health and Development Program, an early intervention for infants born low birth weight (LBW) and preterm, was investigated. Analyses unique to this sample were required because it was the only site that selected a normal birth weight (NBW) comparison group and had the lowest sociodemographic characteristics. Epidemiological methods determined the effects of LBW and early intervention on school outcomes. Children born LBW who did not receive intervention had an increased risk of scoring below the 10th percentile on achievement tests and were placed in special education three times more often than their peers born NBW. The school outcomes of children born LBW who received intervention were consistently better than those who did not, but were worse than children born NBW; however, differences did not reach statistical significance. Children born LBW who did not receive intervention are at significant risk for poor school outcomes compared with their peers born NBW.
The causes of negative child outcomes need to be reconceptualized in terms of the effects of multiple risks. This paper reviews the extent of the problems associated with adverse development in children from deprived backgrounds using two parallel lines of research: epidemiological evidence and early intervention. Epidemiological studies suggest that multiple risk factors interact, magnifying the chances of non-optimal development for atrisk populations. Furthermore, evidence from intervention studies suggests that full-service intervention models are the most effective format for reducing poor developmental outcomes for at-risk children.
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