Can one and a half hours’ home based intervention in addition to a center based program give sustained benefits to young children with developmental problems? Follow-up, one year post-intervention.

Can one and a half hours’ home based intervention in addition to a center based program give sustained benefits to young children with developmental problems? Follow-up, one year post-intervention.
JE WALSTABBSC 1, 2, 3, AL RICKARDSPHD 1, 3, 2 DS REDDIHOUGHMD3, 2, 1, RA WRIGHT-ROSSIBED 1, 3,
J SIMPSON BSPED1, 3
1 Developmental Disabilities Research, Murdoch Children’s Research Institute, Parkville, VIC;
2 Paediatrics, University of Melbourne, Parkville, VIC;
3Developmental Medicine, Royal Children’s Hospital, Parkville, VIC, Australia

Background/objectives: There is debate about the type and intervention that is most helpful for children with developmental problems. We aimed to examine a low intensity home-based program provided over 12 months in addition to a center based program resulted in sustained improvement in development and behavior 12 month after the intervention ceased. The characteristics of children and families who benefitted most from the intervention were also studied.
Design: Randomized control trial.
Participants and Setting: Fifty-nine children, aged 3-5 year, with developmental delay and/or autism spectrum disorders attending two early childhood intervention centers in Melbourne. Children with physical disabilities were excluded. Children were paired according to developmental quotient and blindly assigned to the intervention (EI) or the control group (C).
Materials/Methods: The intervention: half of the subjects received an additional home-based program consisting of 40 weekly visits, individually tailored to the child’s needs .Primary outcome measures: Bayley scales of infant development and Wechsler preschool and primary scale of intelligence revised (WPPSI-R), preschool behavior checklist, Bayley behavior rating scale and behavior screening questionnaire. Secondary outcome measures: family stress, support and empowerment. All tests were administered pre-intervention, following the intervention and 12 months later. Statistical test used included repeated measures analysis comparison of means (t-tests) and Chi-square test for reliable change indices.
Result: Fifty-Four completed the assessments 12 months after conclusion of the intervention. Compared to control group, improvement in cognitive development in the children who received the extra intervention was sustained one year later (p=0.007) (mean IQ (SEM) EI: 67.0 (3.6), C58.7 (4.4)) whilst significant behavioral differences post intervention were not (mean PBCL (sem) EI: 9.7(1.1), C: 10.5 (1.4)).Analyses of the data by the reliable change index (RC) indicated improvement of clinical significance occurred in non-verbal areas. In contrast to the control group who deteriorated, language skills in the intervention group remained stable. Children from families stress levels sustained greater improvements.
Conclusions/Significance: Improvements following the provision of a home base program to preschool children with developmental disabilities were sustained one year later. Children from highly stressed families benefitted most. The study has highlighted the importance of involving families benefitted most. The study has highlighted the importance of involving families in early childhood intervention programs.

 
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