McCormick Marie C, Brooks-Gunn Jeanne, Buka Stephen L, Goldman Julie, Yu Jennifer, Salganik Mikhail, Scott David T, Bennett Forrest C, Kay Libby L, Bernbaum Judy C, Bauer Charles R, Martin Camilia, Woods Elizabeth R, Martin Anne, Casey Patrick H
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA.
Pediatrics. 2006 Mar;117(3):771-80. doi: 10.1542/peds.2005-1316.
To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age.
This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001-2499 g) and lighter low birth weight (LLBW; < or = 2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status.
We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (-0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2).
The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention.
为评估学前教育项目中所观察到的认知和行为发展改善情况是否会持续存在，我们将一项此类项目的多地点随机试验中3岁前儿童（干预组）与仅在18个月时进行随访的儿童（仅随访组）进行了比较。
这是对婴儿健康与发展项目在8个社会人口统计学特征各异的地点进行的前瞻性随访。最初，985名儿童在两个出生体重分层中被随机分为干预组（n = 377）或仅随访组（n = 608）：较重的低出生体重儿（HLBW；2001 - 2499克）和较轻的低出生体重儿（LLBW；≤2000克）。主要结局指标包括皮博迪图片词汇测验（PPVT - III）、伍德库克 - 约翰逊成就测验的阅读和数学分量表、青少年关于总行为问题指数的自我报告以及青少年风险行为监测系统（YRBSS）中的高风险行为。次要结局包括韦氏全量表智商、照顾者关于总行为问题指数的报告以及照顾者和青少年使用医学结局研究指标自我报告的身体健康状况。评估者对研究状态不知情。
我们在18岁时评估了636名青少年（占985名的64.6%，其中72%在之前的评估中未死亡或拒绝参与）。在对队列损耗进行调整后，HLBW青少年中，干预组在伍德库克 - 约翰逊成就测验的数学部分（5.1分）、YRBSS（ - 0.7分）和PPVT - III（3.8分）方面表现出更优。在LLBW青少年中，仅随访组在伍德库克 - 约翰逊成就测验的阅读部分得分高于干预组（4.2分）。
HLBW干预组的研究结果支持学前教育能为处于发育风险的不同儿童群体带来长期改变。LLBW组缺乏明显益处引发了关于促进或抑制早期教育干预持续效果的生物学和教育因素的疑问。
