Effects of parent training on teenage mother and their infants. Home visiting of varying frequency and child development. Home again: effects of the Mother-Child Home Program on mother and child. Community mothers' programme: randomised controlled trial of non-professional intervention in parenting.
Parent training was provided for 80 low-income, black teenage mothers during their infants' first six months. Half of the mothers were visited biweekly in their homes to be instructed in caregiving and in sensorimotor and interaction exercises, and half were trained as CETA (Comprehensive Employment Training ACT)-paid, teacher's aides in a medical school infant nursery that provided care for their infants and infants of medical faculty. Growth and development during the first two years were superior for the infants whose mothers received training, particularly those who received paid parent training as teacher's aides in the infant nursery. Repeat pregnancy rates were lower and return to work/school rates were higher for the infant nursery mothers, most of whom subsequently pursued nurse's aide training. Two studies were made of home visiting and psychosocial stimulation with deprived urban children in Jamaica. The aim was to determine the relative effectiveness of different frequencies of visiting on the children's developmental levels and the feasibility of integrating the model into government primary health care services. Health paraprofessionals supervised by a nurse from a local health center conducted the intervention. In the first study, 152 children aged 6 to 30 months were assigned to groups visited biweekly, monthly, or not at all by area of residence. The biweekly group showed small but significant increases in scores on the Griffiths Mental Development Scales (developmental quotient) and performance subscale compared with the monthly and control groups, whereas no benefit was shown in the Griffiths scores of the monthly group. In the second study, 58 children aged 16 to 30 months from the same neighborhoods were randomly assigned to weekly visited and control groups. The group visited weekly showed marked improvements in the performance and hearing and speech subscales as well as the developmental quotient scores. The results indicate that as the frequency of visiting increases from none through monthly and biweekly to weekly, the benefits increase as well. 4 successive cohorts of low-income families were randomly assigned either to a home-based intervention program that focused on modeling verbal interaction between mother and child around selected toys and books or to comparison treatments. Large program effects were found on maternal interaction styles in videotaped observations. Small IQ and program-specific effects were found for children in contrast to much larger IQ effects found in earlier research. IQ effects did not appear to have been mediated by changes in maternal behavior. A variation in which toys and books were supplied without home visits was as effective as the full program on IQ but not on maternal behavior. 3 years postprogram , there were no detectable effects in achievement or IQ tests or in first grade teachers' ratings of school adjustment and performance, but IQ and achievement scores were near national norms. Reasons for discrepancies with earlier results are discussed. The results highlight the need for continued experimental evaluation of early intervention programs with safeguards to insure that samples are educationally at risk. To see whether non-professional volunteer community mothers could deliver a child development programme to disadvantaged first time mothers for children aged up to 1 year.
                Randomised controlled trial.
                A regional health authority in Dublin.
                262 first time mothers who were delivered during six months in 1989 and who lived in a deprived area of Dublin; 30 experienced mothers from the same community recruited as community mothers.
                All the first time mothers received standard support from the public health nurse. In addition, those in the intervention group received the services of a community mother, who was scheduled to visit monthly during the first year of the child's life.
                232 (89%) first time mothers completed the study--127 in the intervention group, 105 controls. At the end of the study children in the intervention group were more likely to have received all of their primary immunisations, to be read to, and to be read to daily, played more cognitive games; and were exposed to more nursery rhymes. They were less likely to begin cows' milk before 26 weeks and to receive an inappropriate energy intake and inappropriate amounts of animal protein, non-animal protein, wholefoods, vegetables, fruit, and milk. Mothers in the intervention group also had a better diet than controls. At the end of the study they were less likely to be tired, feel miserable, and want to stay indoors; had more positive feelings; and were less likely to display negative feelings.
                Non-professionals can deliver a health promotion programme on child development effectively. Whether they can do so as effectively as professionals requires further study.
This review does not provide evidence of the effectiveness of home-based interventions that are specifically targeted at improving developmental outcomes for preschool children from socially disadvantaged families. Future studies should endeavour to better document and report their methodological processes.