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Part II:
Status of Research-Based Programs
Early Childhood Programs
II. The Infant Health and Development Program
The Infant Health and Development Program (IHDP) was a multifaceted intervention designed for low birth weight infants and their families in eight cities: Little Rock, the Bronx (New York), Boston, Miami, Philadelphia, Dallas, Seattle, and New Haven. It was a randomized clinical trial involving 985 infants and their families that tested the efficacy of a program consisting of high-quality pediatric follow-up and in-home family education and support services for the first 3 years of life, and an educational day care center (at least 4 hours per day, 5 days per week) from ages 1 to 3. Several studies have shown the positive impact of IHDP on children's health and development, compared to children who received only pediatric follow,,kk-up, through the first 3 years of life.
One study from this program (Bradley et al., 1994) focused on a subsample from the larger IHDP--specifically, 410 children with the risk factors of prematurity (< 37 weeks gestational age), low birth weight (< 2,500 g), and poverty. They investigated whether resilience in early childhood was greater for those subjects who received the IHDP intervention than for the control group who received only pediatric follow-up. They defined resilience in terms of a multi-dimensional outcome: freedom from major developmental problem in cognitive competence, behavioral competence, health status, and growth status. They also examined relative protection, that is, whether an accumulation of protective caregiving experiences in the home increased the likelihood that children would show early resilience. Moving beyond simply delineating protective mechanisms, they focused "on specific aspects of caregiving and the caregiving context that may serve as protective mechanisms because the family environment most directly impinges on children through such aspects of caregiving" (p.426). These are low density in the home, a safe area in which to play, responsivity of the parent, acceptance of the child, variety of experiences for the child, and the availability of enriching learning materials.
Key findings from this study were that, by the age of 3, 39% of the IHDP children were functioning in the normal range for cognitive, social/adaptive, health, and growth parameters, compared to only 11% of the control group. Moreover, the resilient IHDP children were receiving more responsive, accepting, stimulating, organized care in their own homes, and these homes were safer and less crowded. Children having three or more protective factors and participating in the IHDP intervention more often showed early signs of resilience.
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