PEDIATRICS Vol. 89 No. 3 March 1992, pp. 454-465
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Infant Health and Development Program for Low Birth Weight, Premature Infants: Program Elements, Family Participation, and Child Intelligence

Craig T. Ramey PhD1, Donna M. Bryant PhD2, Barbara H. Wasik PhD2, Joseph J. Sparling PhD2, Kaye H. Fendt MSPH2, and Lisa M. La Vange PhD2

1 From the Civitan International Research Center and Sporks Center for Developmental and Learning Disorders, University of Alabama at Birmingham
2 From the Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill

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 le70), 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.

Key Words: low birth weight • prematurity • intervention • intelligence quotient • family • systems theory • treatment • prevention

Submitted on September 17, 1990
Accepted on January 29, 1991




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