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Home-based child development interventions for pre-school children from socially-disadvantaged families

Additional Info

  • Authors: Sarah Miller, Lisa K. Maguire, Geraldine Macdonald
  • Published date: 2012-01-03
  • Coordinating group(s): Social Welfare
  • Type of document: Protocol, Review, Plain language summary
  • Volume: 8
  • Issue nr: 1
  • Category Image: Category Image
  • PLS Title: Home-based interventions do not improve child development outcomes for preschool children from socially disadvantaged families
  • PLS Description: This review examines the effectiveness of home-based interventions aimed primarily at improving developmental outcomes for preschool children from socially disadvantaged families.
  • Title: Home-based child development interventions for pre-school children from socially-disadvantaged families
  • Spanish PLS: Las intervenciones domiciliarias no mejoran los resultados del desarrollo infantil para niños en edad preescolar provenientes de familias socialmente desfavorecidas
  • Spanish PLS Description: Los niños pequeños provenientes de entornos familiares desfavorecidos son más susceptibles a tener problemas de desarrollo y salud deficiente. El objetivo de las intervenciones domiciliarias es ayudar a los padres a proporcionar un ambiente familiar de mejor calidad para sus hijos con el fin de prevenir o mitigar estos resultados adversos. Esta revisión examina la efectividad de las intervenciones domiciliarias orientadas principalmente a mejorar los resultados del desarrollo de niños en etapa preescolar que pertenecen a familias socialmente desfavorecidas.
  • Norwegian PLS: Hjemmebaserte tiltak bedrer ikke utviklingsutfall for førskolebarn fra sosialt svakerestilte familier
  • Norwegian PLS Description: Små barn fra sosialt svakerestilte familier har større sannsynlighet enn andre barn for å få problemer med utvikling og dårlig helse. Formålet med hjemmebaserte tiltak er å hjelpe foreldrene med å skape et godt hjemmemiljø for barna for å forhindre eller begrense disse negative utfallene. Denne oversikten undersøker hvor effektivt hjemmebaserte tiltak er når det gjelder å bedre utfall knyttet til utvikling for førskolebarn fra svakerestilte familier.
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About this systematic review

This Campbell systematic review assesses the effectiveness of home-based child development interventions in improving children’s developmental outcomes. The review summarises findings from seven studies. Two of the studies were undertaken in the US, one in Canada, one in Jamaica, one in Ireland, one in an unreported location and one in Bermuda.

What are the main results?

The nature of the evidence makes it difficult to assess the impact on child cognitive development. Evidence synthesis of four of the seven studies finds no effect. But evidence from the other three studies cannot be combined, so the overall finding is inconclusive. Adverse outcomes for parents (for example, disempowerment) were not reported in any of the seven studies, so no conclusion can be reached.

The evidence did not allow conclusions to be reached for secondary outcomes such as child physical development and parenting behaviour.

Background

Social disadvantage can have a significant impact on early child development, health and wellbeing. What happens during this critical period is important for all aspects of development. Caregiving competence and the quality of the environment play an important role in supporting development in young children and parents have an important role to play in optimising child development and mitigating the negative effects of social disadvantage. Home-based child development programmes aim to optimise children's developmental outcomes through educating, training and supporting parents in their own home to provide a more nurturing and stimulating environment for their child.

Objectives

To determine the effects of home-based programmes aimed specifically at improving developmental outcomes for preschool children from socially disadvantaged families.

Search strategy

We searched the following databases between 7 October and 12 October 2010: Cochrane Central Register of Controlled Trials (CENTRAL) (2010, Issue 4), MEDLINE (1950 to week 4, September 2010), EMBASE (1980 to Week 39, 2010), CINAHL (1937 to current), PsycINFO (1887 to current), ERIC (1966 to current), ASSIA (1987 to current), Sociological Abstracts (1952 to current), Social Science Citation Index (1970 to current). We also searched reference lists of articles.

Selection criteria

Randomised controlled trials comparing home-based preschool child development interventions with a 'standard care' control. Participants were parents with children up to the age of school entry who were socially disadvantaged in respect of poverty, lone parenthood or ethnic minority status. Data collection and analysis Two authors independently selected studies, assessed the trials' risk of bias and extracted data.

Results

We included seven studies, which involved 723 participants. We assessed four of the seven studies as being at high risk of bias and three had an unclear risk of bias; the quality of the evidence was difficult to assess as there was often insufficient detail reported to enable any conclusions to be drawn about the methodological rigour of the studies. Four trials involving 285 participants measured cognitive development and we synthesised these data in a meta-analysis. Compared to the control group, there was no statistically significant impact of the intervention on cognitive development (standardised mean difference (SMD) 0.30; 95% confidence interval -0.18 to 0.78). Only three studies reported socioemotional outcomes and there was insufficient data to combine into a meta-analysis. No study reported on adverse effects.

Authors’ conclusions

This review does not provide evidence of the effectiveness of home-based interventions that are specifically targeted at improving developmental outcomes for preschool children from socially disadvantaged families. Future studies should endeavour to better document and report their methodological processes.

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