EM participated in the design of the study and data collection instruments and managed the data collection. J Intell Disab Res. Nutritional supplementation, psychosocial stimulation and mental development of stunted children: Early intervention in low-birth-weight premature infants. Child health and demographic characteristics were summarized separately for those randomized to receive EDI and included in the treatment dose analysis and those who were excluded from this analysis, and differences in mean values for continuous variables were tested using t-tests and categorical measures were tested using chi-square and Fisher exact tests. Location, sociodemographic, and child health variables were associated with treatment dose.

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As in previous studies, the number of home visits completed over the course of the EDI was measured.

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In the absence of established criteria for adequate treatment dose for EDI and to determine where the effectiveness of the intervention may plateau, both treatment dose indicators were divided into quintiles. Whereas the identical program was bmd, for example in terms of the same basic structure and developmental activities, the social process transpiring in the home visits would naturally vary as a function of the specific people engaged and their local culture.

We examined two indicators of dose of EDI. A Home Living Standard Index was calculated based on seven indicators e. Infants with birth asphyxia resuscitated and infants without birth asphyxia or other perinatal complications non-resuscitatedborn from January through June in rural communities in three sites in India, Pakistan and Zambia, were matched for country and chronological time and randomly selected from those enrolled in epark First Breath Trial [ 34 ].


We employed backward elimination with an alpha of 0. One strength of home visiting EDI is that in this manner it can be both programmatically structured yet culturally flexible. Pediatr Clin North Am.

J Child Psychol Psychiat. WC, as principal investigator, conceptualized and designed the overall study. A step-down test comparing mean MDI for those with home visit dose below the 40th percentile quintiles 1 and 2 to bjc with home visit dose above the 40th percentile quintiles 3—5provided estimates of Intervention procedures Investigators at each research site selected EDI parent trainers who were trained in an b,c 5-day workshop, which was led by the same experts at each research site.

None of the interaction terms were retained in the final model.

World Health Organization; Our research has added to this literature by showing that the same program can do so across quite different cultures, represented here by India, Pakistan, and Zambia [ 32 ]. Programs of early developmental intervention EDI implemented in the first years of life in children born with, or at risk for, neurodevelopmental disability have been shown to improve cognitive developmental outcomes and consequently, their quality of life.

Treatment dose indicators Two indicators of treatment dose were calculated.

A purpose-designed race machine, every element of its structure is crafted to optimize speed, save seconds, and keep riders ahead of the pack. Infant health and development program for low birth weight, premature infants: Cards depicting the activities were then left with the parent, who was encouraged to apply the activities in daily life with the child until the next home visit.

Program intensity, or dosage, typically is measured by the quantity and quality the intervention actually achieved when implemented [ 2122 ], although it ideally should be determined based on the needs of the population at hand [ 23 ]. A randomized controlled trial of a home-visiting intervention on cognition and behavior in term low birth weight infants. Only a few studies had previously examined whether dose of EDI during the first three years of life is associated with developmental outcomes.


Am J Ment Retard.

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Mother or family directly refusing the home visit at the scheduled time was rare 2. Despite its logical importance to the success of home visiting EDI, we are not aware that parent program implementation dose has been examined in EDI.

Average home visits dose was Groups of children at risk for receiving lower treatment dose may require special attention to ensure adequate effect.

Family resources, personal well-being, and early intervention. Conclusions The body of research in which the current study is embedded quite consistently establishes that within an effective EDI, a higher dose is generally associated with better developmental outcomes.

Previous research has indicated higher treatment dose among families participating in EDI who have better financial and social resources [ 2027 — 30 ]. This article has been cited by other articles in PMC. Mothers reported engaging the child in the assigned activities on an average of These activities cover a spectrum of abilities across the cognitive, social and self-help, gross and fine motor, and language domains.