Home-Based Early Intervention and the Influence of Family Resources on Cognitive Development

Pediatrics. 2016 Apr;137(4):e20153766. doi: 10.1542/peds.2015-3766. Epub 2016 Mar 14.


Objective: To investigate whether early developmental intervention (EDI) can positively affect the trajectories of cognitive development among children from low-resource families.

Methods: Longitudinal analyses were conducted of data from 293 children in the Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial, a randomized controlled trial of a home-based EDI program, to examine trajectories of Bayley Scales of Infant Development-Second Edition Mental Development Index (MDI) scores from 12 to 36 months of age among young children from high- and low-resource families in 3 low- to middle-resource countries.

Results: A 3-way interaction among family resources, intervention group, and age was statistically significant after controlling for maternal, child, and birth characteristics (Wald χ(2)(1) = 9.41, P = .002). Among children of families with high resources, both the intervention and control groups had significant increases in MDI scores over time (P < .001 and P = .002, respectively), and 36-month MDI scores for these 2 groups did not differ significantly (P = .602). However, in families with low resources, the EDI group displayed greater improvement, resulting in significantly higher 36-month MDI scores than the control group (P < .001). In addition, the 36-month MDI scores for children in families with low resources receiving EDI did not differ significantly from children from high-resource families in either the EDI (P = .509) or control (P = .882) groups.

Conclusions: A home-based EDI during the first 3 years of life can substantially decrease the developmental gap between children from families with lower versus higher resources, even among children in low- to middle-resource countries.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child Development*
  • Child, Preschool
  • Cognition*
  • Early Intervention, Educational / methods*
  • Female
  • Home Care Services*
  • Humans
  • Infant
  • Intelligence
  • Longitudinal Studies
  • Male
  • Socioeconomic Factors
  • Young Adult