Controlled Study of Child Health Supervision: Behavioral Results

Abstract

Extensive child health supervision, with emphasis on counseling and anticipatory guidance, was provided for the first three years of life to an experimental series of 47 normal first-born black infants from low-income families living in the environs of Children's Hospital in Washington, D.C. The mothers were unmarried schoolgirls in normal physical and mental health. A control series consisted of 48 similar mother-child dyads from the same area. Data were collected, in part by an outside evaluator, at yearly intervals on both experimental and control series in a form suitable for coding on computer cards. Comparison of differences in behavioral results between the two series showed statistically significant findings in favor of the experimental children, as well as numerous favorable trends during the first six years of life. Positive effects became evident in diet and eating habits, in some developmental problems of growing up (such as toilet training), and in certain abstract qualities including self-confidence. Significant differences were also noted between the experimental and control mothers for various child rearing practices and personality characteristics. No significant difference or trend favored the control series. We believe that a causal relationship existed between the intervention amid at least some of the significant findings.

Effects of parenting education with expectant and new parents: A meta-analysis.

“…This suggestion is supported by the stronger effect of interventions with a postnatal component on cognitive development. In these interventions, parents can receive information about stimulation that would be appropriate for the particular age of the child (e.g., Gutelius, Kirsch, & MacDonald, 1977).…”

Prevention as cumulative protection: Effects of early family support and education on chronic delinquency and its risks.

“…Finally, the Yale Child Welfare Project (Seitz, Rosenbaum, & Apfel, 1985) affected measures of SES, cognitive development, and teacher-rated antisocial behavior in early adolescence. The other interventions reviewed that affected multiple risk factors for delinquency (Gutelius, Kirsch, MacDonald, Brooks, & McErlean, 1977; Olds, Henderson, Chamberlin, & Tatelbaum, 1986; Olds, Henderson, Tatelbaum, & Chamberlin, 1988; see Table 1) did not involve long-term follow-up; these programs may have had preventive effects on delinquency, but, if so, they remain unknown.…”

“…However, the fact that the minimum length of the four prevention programs was 2 years indicates that programs such as Head Start, a 1-year preschool for many of its participants, may not be of sufficient duration to achieve long-term gains in social competence. The interventions affecting multiple predictors of delinquency but not assessing behavior problems or delinquency itself (Gutelius et al, 1977; Lazar & Darlington, 1982; McKey et al, 1985; Olds et al, 1986, 1988; see Table 1) ranged from 1 to 3 years in length. The other interventions, which affected single risk factors, were generally from 9 months to 1 year in duration.…”

Effective interventions for adolescent mothers.

“…One of the most encouraging findings of programs for adolescent mothers is that it is possible to improve their childrearing practices, with very substantial benefits for their children. In an early study that provided both cognitive stimulation to infants and family support to their adolescent mothers, Gutelius and her colleagues (Gutelius et al, 1972, Gutelius, Kirsch, MacDonald, Brooks, & McErlean, 1977) were able to change the quality of parenting that teenagers provided. The 95 subjects were low-income African-American teenagers who delivered healthy firstborn infants, were not retarded, and were judged by a psychiatrist not to show signs of major emotional pathology.…”