BOX 3-1
Infant Health and Development Program

The Infant Health and Development Program (IHDP) was designed to provide early intervention services to low-birthweight, premature babies with no severe impairments or illnesses. As both a demonstration program and a research project, the program targeted this population of infants because they are at higher risk of health and developmental problems than normal-weight infants.

IDHP was a large, randomized, multisite trial devised to test the effectiveness of child- and family-oriented intervention strategies to improve the health, behavioral, and intellectual outcomes for these at-risk children. The project included 985 infants who were enrolled from October 1984 through August 1985. Infants randomly assigned to the intervention group received services from the time they left the hospital until each child reached the age of 3. Children in both the intervention and follow-up only groups were assessed through age 8.

Multiple services were rendered to each child in the intervention group in the form of home visits, enrollment in a child development center (beginning at age 1) and health care. Specially trained home visitors regularly assigned to the same family facilitated good hygiene and health care. To ensure adequate health care, children received services at university-based clinics or from private providers. Home visitors also enhanced parenting skills and provided a home education program.

Beginning at age 1, children attended a high-quality child development center 5 days a week, year round. Activities at the centers were geared to promoting the childrens’ intellectual and social skill development.

Children in both the intervention and follow-up groups were assessed at the ages of 3, 5, and 8. At age 3, children in the intervention group showed higher IQ scores than children in the follow-up group, fewer behavioral problems, and little difference in overall health. The heavier low-birthweight children had cognitive test scores that were 13 points higher on average than the control group. The lighter low-birthweight group scored 6.6 points higher. At age 5, differences between the two groups diminished with only the heavier low-birthweight children showing a sustained IQ gain of 3.7 points. As at age 5, there were few differences between the two groups at age 8, except the heavier low-birthweight children scored 4 points higher than the heavier low-birthweight children from the follow-up group (Ramey et al., 1992).

for American Indians/Alaskan Natives than for whites (McLoyd and Lozoff, 2001).

While the reported number of women who drink during pregnancy has declined since the mid-1980s (Serdula et al., 1991), the overall change was driven by a decrease in light drinking (Hankin et al., 1993). In 1995 the Centers for Disease Control and Prevention (CDC) found the incidence of drinking at a level that put the fetus at risk for neurobiological damage was at 4.5 percent (Ebrahim et al., 1998). No data are available on differences by race/ethnicity over time.

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