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Many women experience depressive symptoms after birth, and rates among African Americans are as high as 40 percent. Spirituality and religiosity are valued in African American communities, but their relevance to new mothers has not been empirically tested. We examined effects of religiosity and spirituality on trajectories of depressive symptoms during the year following childbirth. Data were collected by the Eunice Kennedy Shriver NICHD Community and Child Health Network (CCHN) focused on maternal-child health disparities. The sample consisted of 702 low SES African American predominantly Christian women. Participants were interviewed in their homes throughout the year following a birth. Spirituality and religiosity each independently predicted changes in depressive symptoms with low levels predicting increases over time. Effects of religiosity were mediated by a woman's spirituality. Religiosity and spirituality functioned as significant, interrelated protective factors in this study which provides novel insight about lower income African American women following birth.

The Abecedarian Approach is an early intervention and contains a broad-spectrum adult/child curriculum. The Approach has been studied in three longitudinal randomized controlled trials in the USA, starting in 1972 and continuing today. Recent research studies in multiple countries have examined the Abecedarian Approach during the first three years of life. The collective findings from these studies lead to the conclusion that human development is malleable, especially in the years before school entry, and that high-quality early intervention exerts positive, early, and long-lasting influences on human development, including social development and mental health.

Does early exposure to cognitive and linguistic stimulation impact brain structure? Or do genetic predispositions account for the co-occurrence of certain neuroanatomical phenotypes and a tendency to engage children in cognitively stimulating activities? Low socioeconomic status infants were randomized to either 5 years of cognitively and linguistically stimulating center-based care or a comparison condition. The intervention resulted in large and statistically significant changes in brain structure measured in midlife, particularly for male individuals. These findings are the first to extend the large literature on cognitive enrichment effects on animal brains to humans, and to demonstrate the effects of uniquely human features such as linguistic stimulation., (© 2021 Massachusetts Institute of Technology. Published under a Creative Commons Attribution 4.0 International (CC BY 4.0) license.)

Objectives: Dramatic increases in opioid and drug overdose mortality have occurred in the United States (US) over the past two decades. To address this national public health crisis and identify gaps in the literature, we analyzed recent empirical trends in US drug overdose mortality by key social determinants and conducted a selective review of the recent literature on the magnitude of the opioid crisis facing different racial/ethnic, socioeconomic, and rural-urban segments of the US population., Methods: We used the 1999-2017 mortality data from the US National Vital Statistics System to analyze trends in drug overdose mortality by race/ethnicity, age, and geographic area. Log-linear regression was used to model mortality trends. Using various key words and their combinations, we searched PubMed and Google Scholar for select peer-reviewed journal articles and government reports published on the opioid epidemic between 2010 and 2018., Results: Our original analysis and review indicate marked increases in drug overdose mortality overall and by race/ethnicity and geographic regions, with adolescents and young adults experiencing steep increases in mortality between 1999 and 2017. Our selective search yielded 405 articles, of which 39 publications were selected for detailed review. Suicide mortality from drug overdose among teens aged 12-19 increased consistently between 2009 and 2017, particularly among teen girls. The rise of efficient global supply chains has increased opioid prescription use and undoubtedly contributed to the opioid epidemic. Many other important contributing factors to the epidemic include lack of education and economic opportunities, poor working conditions, and low social capital in disadvantaged communities., Conclusions and Global Health Implications: Our analysis and review indicate substantial disparities in drug overdoses and related mortality, pain management, and treatment outcomes according to social determinants. Increases in drug overdoses and resultant mortality are not only unique to the US, but have also been observed in other industrialized countries. Healthcare systems, community leaders, and policymakers addressing the opioid epidemic should focus on upstream structural factors including education, economic opportunity, social cohesion, racial/ethnic disadvantage, geographic isolation, and life satisfaction., Competing Interests: Conflicts of Interest: The authors declare that there are no conflicts of interest., (Copyright: © 2019 Singh et al.)

In the section "Ages 39-45 Outcomes," an error was made by providing details from my ongoing collaborative research with colleagues on neuroanatomical effects (Farah et al 2017) and social decision-making (Luo et al 2017).

This paper places the Abecedarian Approach in theoretical and historical context and reviews the results from three randomized controlled trials that have tested an experimental protocol designed to prevent cognitive disabilities and their social consequences. Results affirm that cognitive disabilities can be prevented in early childhood and subsequent academic achievement enhanced via a multipronged comprehensive approach that contains individualized and responsive early childhood education starting in early infancy, coupled with pediatric health care, good nutrition, and family-oriented social services. Additional important findings reveal that the most vulnerable children benefited the most and that cognitive gains were not at the expense of children's socioemotional development or relationship to family. In general, mothers derived benefits in education and employment and teenage mothers especially benefited from their children participating in the early education treatment group. On the whole, the overall pattern of results supports a multidisciplinary, individualized, and long-term longitudinal perspective on human development and prevention science. Recent structural and functional brain imaging in the fifth decade of life shows persistent effects of intensive early educational treatment. Independent recent cost-benefit analysis in adulthood reveals a 7.3:1 return on investment with a 13.7% average annual rate of return. The paper concludes with a discussion of implications of the Abecedarian Approach to today's high-risk population in the USA.

Objectives: This study describes key population health concepts and examines major empirical trends in US health and healthcare inequalities from 1935 to 2016 according to important social determinants such as race/ethnicity, education, income, poverty, area deprivation, unemployment, housing, rural-urban residence, and geographic location., Methods: Long-term trend data from the National Vital Statistics System, National Health Interview Survey, National Survey of Children's Health, American Community Survey, and Behavioral Risk Factor Surveillance System were used to examine racial/ethnic, socioeconomic, rural-urban, and geographic inequalities in health and health care. Life tables, age-adjusted rates, prevalence, and risk ratios were used to examine health differentials, which were tested for statistical significance at the 0.05 level., Results: Life expectancy of Americans increased from 69.7 years in 1950 to 78.8 years in 2015. However, despite the overall improvement, substantial gender and racial/ethnic disparities remained. In 2015, life expectancy was highest for Asian/Pacific Islanders (87.7 years) and lowest for African-Americans (75.7 years). Life expectancy was lower in rural areas and varied from 74.5 years for men in rural areas to 82.4 years for women in large metro areas, with rural-urban disparities increasing during the 1990-2014 time period. Infant mortality rates declined dramatically during the past eight decades. However, racial disparities widened over time; in 2015, black infants had 2.3 times higher mortality than white infants (11.4 vs. 4.9 per 1,000 live births). Infant and child mortality was markedly higher in rural areas and poor communities. Black infants and children in poor, rural communities had nearly three times higher mortality rate compared to those in affluent, rural areas. Racial/ethnic, socioeconomic, and geographic disparities were particularly marked in mortality and/or morbidity from cardiovascular disease, cancer, diabetes, COPD, HIV/AIDS, homicide, psychological distress, hypertension, smoking, obesity, and access to quality health care., Conclusions and Global Health Implications: Despite the overall health improvement, significant social disparities remain in a number of health indicators, most notably in life expectancy and infant mortality. Marked disparities in various health outcomes indicate the underlying significance of social determinants in disease prevention and health promotion and necessitate systematic and continued monitoring of health inequalities according to social factors. A multi-sectoral approach is needed to tackle persistent and widening health inequalities among Americans., Competing Interests: Conflicts of Interest: The authors declare that they have no conflicts of interest. Financial Disclosure: None to report. Ethics Approval: All analyses were conducted using public-use data and were thus exempt from the institutional review board (IRB) approval.

We propose that executive dysfunction is an important component relating to the socio-economic status gradient of select health behaviors. We review and find evidence supporting an SES gradient associated with (1) negative health behaviors (e.g., obesity, excessive use of alcohol, tobacco and other substances), and (2) executive dysfunction. Moreover, the evidence supports that stress and insufficient cognitive resources contribute to executive dysfunction and that executive dysfunction is evident among individuals who smoke cigarettes, are obese, abuse alcohol, and use illicit drugs. Collectively these data support the dual system model of cognitive control, referred to here as the Competing Neurobehavioral Decision Systems hypothesis. The implications of these relationships for intervention and social justice considerations are discussed., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Adult (age 30) educational, economic, and social-emotional adjustment outcomes were investigated for participants in the Abecedarian Project, a randomized controlled trial of early childhood education for children from low-income families. Of the original 111 infants enrolled (98% African American), 101 took part in the age 30 follow-up. Primary indicators of educational level, economic status, and social adjustment were examined as a function of early childhood treatment. Treated individuals attained significantly more years of education, but income-to-needs ratios and criminal involvement did not vary significantly as a function of early treatment. A number of other indicators were described for each domain. Overall, the findings provide strong evidence for educational benefits, mixed evidence for economic benefits, and little evidence for treatment-related social adjustment outcomes. Implications for public policy are discussed.

The extent to which early educational intervention, early cumulative risk, and the early home environment were associated with young adult outcomes was investigated in a sample of 139 young adults (age 21) from high-risk families enrolled in randomized trials of early intervention. Positive effects of treatment were found for education attainment, attending college, and skilled employment; negative effects of risk were found for education attainment, graduating high school, being employed, and avoiding teen parenthood. The home mediated the effects of risk for graduating high school, but not being employed for teen parenthood. Evidence for moderated mediation was found for educational attainment; the home mediated the association between risk and educational attainment for the control group, but not the treated group.

The number of immigrants in the United States is at an all time high, yet psychologists have largely ignored the domain of immigrant health. This article considers 1 aspect of immigrant health, risk for pediatric injury. A sample of over 5,000 5-year-old children from impoverished families was studied; approximately 13% had immigrant mothers. Children of immigrants had a significantly lower rate of injury in the prior year. This was particularly true of non-White children of immigrants. Three possible mediators for this finding--assistance with parenting, parenting style, and health care accessibility--were considered, but none explained the difference. The need for further research on the topic and implications of results for injury prevention are discussed., ((c) 2005 APA, all rights reserved)

Objectives: Two factors were considered as predictors of children's risk for unintentional injury: (a) children's temperamentally difficult behavior patterns and (b) parenting. Along with hypotheses to replicate previous univariate effects, it was hypothesized that active, involved parents with sufficient time resources might reduce injury risk among temperamentally at-risk children., Methods: Study 1 used a retrospective design with a diverse sample of over 10,000 5-year-olds. Study 2 replicated Study 1 using a prospective design and behavioral data from a sample of over 1,000 children followed from 6 to 36 months of age., Results: In Study 1, male gender, child hyperactivity, and family poverty predicted injury in a univariate manner. In Study 2, male gender and lack of positive parenting predicted injury in a univariate manner. Interaction effects also emerged: in Study 1 the interaction between child hyperactivity and parental time resources protected children from injury, and in Study 2 the interaction between child's difficult temperament and positive parenting protected children from injury., Conclusions: Children at increased risk for injury, i.e., those with hyperactive and difficult behavior patterns, might be protected in the environment of positive parenting. Theoretically, results suggest that researchers should consider Temperament x Environment interactions along with univariate predictors of outcome behavior. From an applied perspective, results have implications for the design of injury prevention campaigns: Parents who spend positive time with temperamentally difficult children might protect them from injury.

In the Abecedarian Project, a prospective randomized trial, the effects of early educational intervention on patterns of cognitive and academic development among poor, minority children were examined. Participants in the follow-up were 104 of the original 111 participants in the study (98% African American). Early treatment was full-time, high-quality, educational child care from infancy to age 5. Cognitive test scores collected between the ages of 3 and 21 years and academic test scores from 8 to 21 years were analyzed. Treated children, on average, attained higher scores on both cognitive and academic tests, with moderate to large treatment effect sizes observed through age 21. Preschool cognitive gains accounted for a substantial portion of treatment differences in the development of reading and math skills. Intensive early childhood education can have long-lasting effects on cognitive and academic development.

This paper presents a conceptual framework that has guided three randomized, controlled early intervention trials designed to improve cognitive development and social competence in high-risk young children from birth to 3 years of age. Two of the projects (Abecedarian and CARE) enrolled infants from economically and socially low-resource families and the other project (IHDP) was an eight-site randomized controlled trial with 985 low birth-weight and premature infants and their families. IHDP families varied widely in their economic and social resources. Results consistently indicated positive effects of the intervention on child IQ during the first 3 years of life. Children from the lowest resource families consistently benefited the most from the early intervention.

For 4 decades, vigorous efforts have been based on the premise that early intervention for children of poverty and, more recently, for children with developmental disabilities can yield significant improvements in cognitive, academic, and social outcomes. The history of these efforts is briefly summarized and a conceptual framework presented to understand the design, research, and policy relevance of these early interventions. This framework, biosocial developmental contextualism, derives from social ecology, developmental systems theory, developmental epidemiology, and developmental neurobiology. This integrative perspective predicts that fragmented, weak efforts in early intervention are not likely to succeed, whereas intensive, high-quality, ecologically pervasive interventions can and do. Relevant evidence is summarized in 6 principles about efficacy of early intervention. The public policy challenge in early intervention is to contain costs by more precisely targeting early interventions to those who most need and benefit from these interventions. The empirical evidence on biobehavioral effects of early experience and early intervention has direct relevance to federal and state policy development and resource allocation.

This longitudinal study of 161 African American children from low-income families examined multiple influences, including early childhood interventions and characteristics of the child and family, on longitudinal patterns of children's cognitive performance measured between 6 months and 8 years of age. Results indicate that more optimal patterns of cognitive development were associated with intensive early educational child care, responsive stimulating care at home, and higher maternal IQ. In accordance with a general systems model, analyses also suggested that child care experiences were related to better cognitive performance in part through enhancing the infant's responsiveness to his or her environment. Maternal IQ had both a direct effect on cognitive performance during early childhood and, also, an indirect effect through its influence on the family environment.

The Infant Health and Development Program was an eight-site randomized controlled trial of comprehensive early intervention for low birthweight, premature infants during the first 3 years of life in which intellectual development was an outcome of major importance. At 24 and 36 months, but not at 12 months, higher Mental Development Index and IQ were associated with higher levels of participation in the intervention. In a longitudinal analysis of these data, we found that the intellectual development of children in the intervention group was associated with each of the three intervention modalities (the number of home visits received, days attended at child centers, and the number of parent meetings attended) but not with children's background characteristics (i.e., maternal education, birthweight). We suggest that these findings represent a dose-response relation between intervention and outcome.

Recent findings from three separate studies support and extend a large and growing body of early-intervention research literature spanning 30 years. The literature is consistent in demonstrating positive developmental outcomes as a result of intensive early intervention for children of low-income and undereducated families. New analyses confirm that maternal intelligence is a key factor in children's intellectual development, especially when these children are not provided with intensive early intervention. Fortunately, children whose mothers have low IQs respond positively to intensive, high-quality early intervention, which leads to a dramatic reduction in their rates of mental retardation during the intervention program. Unresolved issues include how best routinely to identify children and families who will benefit from such programs, how early to begin programs and for how long to continue them to produce desirable developmental outcomes, and whether sufficient public and political will exists to scale-up early intervention efforts to match the magnitude of the problem in our society.

Follow-up data, obtained 4-7 years after intervention ended, are presented for the Carolina Abecedarian Project, an experimental study of early childhood educational intervention for children from poverty families. Subjects were randomly assigned to 1 of 4 intervention conditions: educational treatment from infancy through 3 years in public school (up to age 8); preschool treatment only (infancy to age 5); primary school treatment only (age 5-8 years), or an untreated control group. Positive effects of preschool treatment on intellectual development and academic achievement were maintained through age 12. School-age treatment alone was less effective. Results generally supported an intensity hypothesis in that scores on cognitive and academic achievement measures increased as duration of treatment increased.

Recent positive findings from three early educational intervention programs designed to prevent mental retardation as well as to improve school readiness and educational progress were summarized. Evidence was presented to show that without early intervention, children of low-IQ mothers are particularly at-risk for poor intellectual outcomes and that such children respond very favorably to intensive, systematic early intervention. In addition, new findings indicate a strong relation between the intensity of the early educational intervention and the amount of benefits realized by individual children. Further, there is new evidence that the benefits of continuous educational intervention over the first 5 years of life last at least until early adolescence. We identified six essential types of experiences that we think account for the positive outcomes and that need to be systematically included to the maximum feasible level in future early intervention programs.

Recently developed methods for power analysis expand the options available for study design. We demonstrate how easily the methods can be applied by (1) reviewing their formulation and (2) describing their application in the preparation of a particular grant proposal. The focus is a complex but ubiquitous setting: repeated measures in a longitudinal study. Describing the development of the research proposal allows demonstrating the steps needed to conduct an effective power analysis. Discussion of the example also highlights issues that typically must be considered in designing a study. First, we discuss the motivation for using detailed power calculations, focusing on multivariate methods in particular. Second, we survey available methods for the general linear multivariate model (GLMM) with Gaussian errors and recommend those based on F approximations. The treatment includes coverage of the multivariate and univariate approaches to repeated measures, MANOVA, ANOVA, multivariate regression, and univariate regression. Third, we describe the design of the power analysis for the example, a longitudinal study of a child's intellectual performance as a function of mother's estimated verbal intelligence. Fourth, we present the results of the power calculations. Fifth, we evaluate the tradeoffs in using reduced designs and tests to simplify power calculations. Finally, we discuss the benefits and costs of power analysis in the practice of statistics. We make three recommendations: Align the design and hypothesis of the power analysis with the planned data analysis, as best as practical.Embed any power analysis in a defensible sensitivity analysis.Have the extent of the power analysis reflect the ethical, scientific, and monetary costs. We conclude that power analysis catalyzes the interaction of statisticians and subject matter specialists. Using the recent advances for power analysis in linear models can further invigorate the interaction.

The Infant Health and Development Program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. The 377 intervention families received for the first 3 years of life: (1) pediatric follow-up, (2) home visits, (3) parent support groups, and (4) a systematic educational program provided in specialized child development centers. The control group (n = 608) received the same pediatric follow-up and referral services only. This paper describes the delivery of the intervention and its outcomes. A Family Participation Index that was the sum of participation frequencies in each of the program modalities unique to the intervention revealed that program implementation was not different across the eight sites. Index scores did not vary systematically with mother's ethnicity, age, or education or with child's birth weight, gender, or neonatal health status; but they were positively related to children's IQ scores at age 3. Only 1.9% of children of families in the highest tercile of participation scored in the mentally retarded range (IQ less than or equal to 70), whereas 3.5% and 13% of children in the middle and lowest participation terciles, respectively, scored in the retarded range. Similar findings were obtained for borderline intellectual functioning. These findings are consistent with previous research linking intensity of intervention services with degree of positive cognitive outcomes for high-risk infants. The determinants of variations in individual family participation remain unknown.

The need for a coordinated national policy on family support in the home is discussed. First, the history of home visiting programs is reviewed. Then, recommendations for practice, training, and research in family support programs are presented. A discussion of the impact of new federal initiatives on family support programs and research demonstration efforts follows.

65 families with children at risk for cognitive difficulties were randomly assigned at the time of the child's birth to 1 of 3 groups, 2 intervention and 1 control. For the most intensive intervention group, family education was combined with a center-based educational day-care program; the less intensive intervention group received the home-based family education program only. To assess the cognitive performance of children, The Bayley Scales of Infant Development were administered at 6, 12, and 18 months; the Stanford-Binet Intelligence Test at 24, 36, and 48 months; and the McCarthy Scales of Children's Abilities at 30, 42, and 54 months. On each test after the 6-month assessment, scores of children in the educational day-care plus family support group were greater than those in the other 2 groups. No cognitive intervention effects were obtained for the family education group. Group effects were not obtained for measures of either the quality of the home environment or parent attention.

We estimated the effects of an experimental educational day care program on the intellectual development of preschoolers from 86 high-risk families in a randomly allocated longitudinal study. At six through 54 months of age, the IQs of experimental program children ranged from 7.9 to 20.1 points higher than those of control children when maternal mental retardation and home environment effects were controlled; at every age, a greater proportion of the experimental program children had normal range IQs (greater than 84). In 13 children with retarded mothers, none of six experimental program children, but six of seven control children, had IQ scores below normal.

When the concept of intervention is applied to human development, the goal is usually to enhance functioning or to prevent some unwanted condition. During the past 20 years, the United States has committed itself to an early intervention position for young children who are socio-economically, educationally, or physically disadvantaged. This article summarizes the knowledge base concerning early educational interventions and to recommend actions concerning public policy and associated research.

Mother-infant dyads (N = 27) were seen as part of a longitudinal study of lower-socioeconomic-status infants at high but varying risk for mild mental retardation. A 20-min unstructured interaction session was videotaped in a laboratory setting when the infants were 6 months old. Transcriptions were made of mothers' speech to their infants. Measures of maternal language included sentence form, amount of speech, and syntactic complexity. It was found that the proportion of imperatives, but not the amount of maternal speech, was positively correlated with a composite measure of risk status (High Risk Index) and negatively correlated with maternal education and WAIS IQ. Similar to previous findings for maternal speech to older infants, syntactic complexity was not significantly related to social risk indices. In terms of descriptive aspects of the data, there was a high degree of variability on the language measures-indicative of wide individual differences in maternal language style.

Longitudinal mental test scores for 54 educationally treated disadvantaged preschool children at high-risk for nonbiologically based mild mental retardation and 53 control children were compared. The educationally treated children were in a child-centered prevention-oriented intervention program delivered in a daycare setting from infancy to age 5. Language, cognitive, perceptual-motor, and social development were stressed. Children were examined with age-appropriate tests of development at 6, 12, 18, 24, 30, 42, 48, and 54 months of age. Beginning at 18 months, and on every test occasion thereafter, educationally treated children significantly outscored control group children on mental tests; treated children consistently scored at the national average whereas control children's scores declined from the average level at 12 months to below average at 18 months and thereafter. Implications of the results for early intervention were discussed.

This review examines eighteen exemplary prevention-oriented early intervention programs designed for high-risk and normal infants. The target populations, the form of the program delivery, and the content of the curriculum are described. Issues in the design and methodology of such programs are discussed. The review also summarizes continuing and delayed effects of early intervention programs with an emphasis on those projects that had a follow-up evaluation phase. Finally, three theoretical perspectives are presented. These perspectives have important implications for infant program planning and evaluation from which recommendations are made for future programs designed for high-risk infants.

In previous works, information contained on standard U.S. birth certificates was linked to intelligence, academic achievement, and social adjustment in first grade for a statewide random sample. The present screening effort was concentrated on a sample that was already considered to be at high but still variable levels of risk. The families of the 52 black subjects were characterized by low levels of formal education, a fairly low level of maternal intelligence, and very low incomes. By focusing on a group at relatively high risk, we hoped to increase the precision and economy of early identification by using more process-oriented information about the children's early development and environment. As the children attained 6 months of age, characteristics of the mother, the child, and the home were assessed. At 2 years of age, the children were given a Stanford-Binet and divided into a nonretarded group (IQ greater than 85, n = 27) and a high-risk group (IQ less than 85, n = 25). We used a step-wise discriminant analysis to derive a predictor set consisting of mother's democratic attitudes, child's temperament, and the amount of time the child spent outside the home that allowed for the correct prediction of 75 percent of the children, with an overall miss rate of 20 percent and a false positive rate of 29.6 percent.

Infants at-risk for mental retardation were divided into a group that received early day-care intervention and a matched control group that did not. The purpose of the intervention was to prevent sociocultural retardation. Children were tested at 7 and 18 months on a simple two-choice visual-discrimination task and on the Bayley Scales of Infant Development to assess the impact of the intervention program on their development. Analyses revealed that the experimental group's performance was reliably superior to that of the control group on both measures and that experimental subjects scoring high on the Bayley Scales reached criterion on the discrimination task on fewer trials than low Bayley scorers. The relationship was particularly strong at 18 months.

This report presents continuing longitudinal data of a natural experiment in which fetally malnourished infants and their controls were randomly assigned to 2 environments differing in intellectually supportive characteristics. Whereas a previous report of these infants from 3 to 24 months of age provided evidence supporting the bidirectionality of effects of infant and environmental attributes, this study shows the continuation of the detrimental effects through 36 months of age on intellectual, behavioral, and social-interactional development in a nonsupportive caregiving environment, and the continued amelioration of those effects in a supportive caregiving environment. Further, analyses of maternal variables showed that the mothers of fetally malnourished infants may have had life histories of increased risk when compared to mothers of control infants. The results are discussed in terms of the convergence of dynamic intergenerational, prenatal, and postnatal influences on development.

Information from birth certificates (including race, birth order and weight, and maternal age and education) was used to develop a set of classification equations to predict the educational status of first-grade children. The equations were developed with one-half of the sample and then applied to the other half in a replication test. The equations accurately identified approximately 80 percent of the children who scored 1 standard deviation or more below the mean on both a measure of intellectual competence and a measure of adaptive behavior. The usefulness of birth certificates as a first-line screening method was discussed.

The social interactions of 60 mother-infant pairs were observed for 25 min in a seminaturalistic setting when the infants were 6 months old and again at 20 months. 46 of the infants were termed at high risk for later school failure due to the socioeconomic situations of their families. Half of these high-risk infants had been randomly assigned to an early intervention program. The remaining group of 14 infants was a sample drawn from the general population. Principal components analyses of the 10 behaviors scored during the session yielded a first component at both 6 and 20 months which represented "dyadic involvement." Comparing the 3 groups of dyads on the proportion within each who scored positively on the dyadic-involvement component, it was evident that the groups did not differ at 6 months but did differ at 20 months. The changes in level of interaction across time were compared with changes in scores on developmental tests. Results indicated that higher dyadic involvement at 20 months was associated with higher intellectual performance.

Infant-intervention programs that evaluate their effectiveness by repeatedly testing infants with standardized tests may confound intervention effects with repeated-testing effects. Further, maternal participation in testing may increase infants' test scores, either directly by giving infants practice with test-like items at home between test administrations or indirectly by helping infants adapt to the test setting. Thirty-five infants were tested at 3-month intervals between 4 and 28 months of age with the Bayley Scales of Infant Development and at 31 months of age with the Stanford-Binet; 25 infants were tested with the Bayley at 4 months and the Stanford-Binet at 31 months. Mothers of some infants in each group participated in the testing process. Between-subjects analysis on the Stanford-Binet revealed no effects for repeated testing or maternal participation. Within-subjects analyses for repeatedly tested groups demonstrated that maternal presence during testing, but not repeated testing, was associated with significantly higher Bayley scores. It was concluded that maternal presence is a potent influence on Bayley performance, that repeated experience with the Bayley biased neither performance on another standardized test of development nor subsequent Bayley performance, and that infant intervention programs are not likely to confound their evaluation designs by testing infants repeatedly.

The predictive efficiency of Caldwell's Home Observation for Measurement of the Environment (HOME) with a sample of infants from low-income families at-risk for developmental retardation was assessed. The home environments of 51 infants were assessed with the HOME at 6 and 18 months. Multiple discriminant functions composed of the six HOME subscale scores predicted whether the child would be low IQ (below 75), low average (75 to 89), or average to superior (90 and above) at age 3. At both 6 and 18 months, the discriminant function of the HOME was found to be moderately sensitive in identifying children in the low-IQ group (62% correctly identified); 56% were false positives. Additional research is necessary to differentiate with precision among families at elevated risk levels.

Home environments of 30 infants at high-risk for developmental retardation were compared with those of 30 infants from the general population (matched for age, sex, and parity) by means of the Home Observation Measurement of the Environment. Fifteen high-risk infants attended a day-care intervention program; 15 did not. The Home Observation for Measurement of the Environment showed significant differences (ps less than .001) between the high-risk groups and the general population, favoring the general population, on all factors (maternal-warmth, absence of restriction and punishment, organization of the environment, appropriate toys, maternal involvement, and opportunities for variety) but none between the two high-risk groups.

The relationship between the occurrence of otitis media with effusion during the first 3 years of life and subsequent verbal and academic performance was examined in 61 socioeconomically disadvantaged children who attended a research day-care program. Study children were participants in a longitudinal study of child development in which the number of episodes of otitis media and duration of each otitis episode were reported prospectively from infancy. The incidence of otitis media was highest during the first 2 years of life. Bilateral otitis media accounted for 66% of the days with otitis media with effusion. Standardized tests of intelligence and academic performance were administered to the children when they were 3 1/2 to 6 years of age. No evidence of associations between measures of early childhood otitis media experience and these measures of verbal or academic functioning was found in this study population.

Longitudinal observations of maternal and infant characteristics were used to investigate the consequences of early day-care intervention for infants at high risk for intellectual retardation due to sociocultural factors. High-risk infants and their mothers were compared on social and intellectual characteristics with a control group not enrolled in an intervention program and with a random sample of mother-child dyads from the general population. Results from group comparisons indicated that mothers of high-risk infants in a day-care intervention group interacted with their infants in ways quite similar to mother of high-risk infants who were not enrolled in the intervention program. Both high-risk groups differed from the general population of mothers on interaction and attitudinal measures. Changes across time on the measures taken were roughly parallel from all three groups. Multiple regression analyses using maternal variables and mother-infant interactional variables to predict 36-month Stanford-Binet scores for the high-risk samples indicated that children's intelligence was predictable from previous maternal behaviors and attitudes, particularly for the control group, and that early day-care intervention apparently had altered the predictiveness of some maternal factors.

The relation of nonoptimal condition at birth to the intellectual development of children reared in 2 different environments was investigated in a 4 1/2-year longitudinal experiment. Subjects were 80 disadvantaged children, half of whom were randomly assigned at birth to a day-care program designed to prevent mild mental retardation and half to an educationally untreated control group. All subjects for this report were full-term and weighed over 2,500 grams at birth; condition at birth was considered nonoptimal if the 1-min Apgar score was less than or equal to 8. Results indicated that nonoptimal perinatal status had significant adverse effects on 4 1/2-year scores on the McCarthy Scales of Children's Abilities in the control group (p less than .01); however, test scores of children with optimal or nonoptimal Apgars did not differ within the group that received educational treatment. The results provide support for a framework stressing initial biological vulnerability and subsequent environmental insufficiency as cumulative risk factors in the development of children from low SES families.

The relationship between the occurrence of otitis media during the first 3 years of life and cognitive, academic, and classroom performance during the third year of elementary school was evaluated in 44 socioeconomically disadvantaged children. The children attended a research day-care program where their otitis media experience and psychoeducational development were documented prospectively from birth. No significant relationship was found between otitis media in early childhood and performance on tests of verbal intelligence or academic achievement in the third year of school. The number of days of otitis media before 3 years of age was significantly correlated with teachers' ratings of children's attentional behavior in the classroom, however. Children with more early otitis media tended to be rated as less task oriented and less able to work independently than children with less otitis media. This was an exploratory study of a small number of children. Further study of the potential association is needed.

The effects of preventive education and birth order on IQ scores of 95 economically disadvantaged children at risk for retarded intellectual development were studied. Experimental first- and later-born children participated from birth in a 5-year programme of systematic educational intervention. An equal number of children served as controls and received no systematic intervention. First-borns prevailed as the brighter children in both the educational treatment group and the control group when Wechsler Preschool and Primary Scale of Intelligence (WPPSI) full scale and verbal IQ scores were compared. Furthermore, mothers of first-borns (70% of whom were only-born at age 5) achieved significantly higher WAIS scores than did mothers of later-born children. Results suggest that later-born disadvantaged children are at greatest risk for developmental retardation.