Home visits designed to help parents work with young children on cognitive skills can give kids from low-income families a leg up in brain development, a study suggests.
Researchers examined the impact of home visits at age 3 for children in India, Pakistan, and Zambia who were either from low-income families or households with slightly more resources.
When parents received home visits to teach them age-appropriate activities to do with their babies and toddlers to encourage healthy development, the children from low-income families experienced much more dramatic gains than their peers from households with more resources, the study found.
It’s possible this happened because the parents with more resources had more access to things like toys, books, crayons, and paper and spent more time talking to their children, said lead study author Carla Bann of RTI International Research in Triangle Park, North Carolina.
“The lower resource parents were encouraged to interact with their children and provided examples of what this interaction might look like, and given suggestions on how to turn common objects into toys and other play objects that could take the place of toys the higher resource families might have had available to them,” Bann said by email.
“Without this encouragement, they may have spent less time focusing on their children, Bann added.
More than 200 million children under age 5 worldwide don’t reach their developmental potential because of poverty, malnutrition, poor health and non-stimulating home environments where adults don’t spend enough time speaking, reading or playing with them, Bann and colleagues note in the journal Pediatrics.
To see how home visits might help even the odds for some of the world’s most deprived children, researchers compared developmental outcomes in two groups: 146 children whose parents received home visits with coaching on how to help kids build needed skills, and a control group of 147 kids whose parents also received home visits but didn’t get the coaching on how to improve child development.
On average, mothers in the study were around 25 years old, and slightly more than half of them had no formal education.
Families with low resources were more likely to be from Zambia, have no formal education, be married, have lacked prenatal care, and delivered babies at home with a traditional birth attendant.
In families with more resources, children experienced significant improvements in cognitive development over the course of the study, regardless of what type of intervention parents received during home visits.
When families had fewer resources, however, coaching during home visits was associated with much bigger gains in cognitive skills than kids experienced when parents lacked this assistance.
The study only assessed children until age three, when developmental assessments might not predict long-term outcomes, the authors note.
Larger benefits from the home visits might also be noticed by the time children reached school age, the researchers point out. In many parts of the world, family resources are a major predictor of school enrollment and academic achievement.
In the U.S. and other developed nations, many low-income families still have more resources than the parents who participated in the study, said Dr. Benard Dreyer, president of the American Academy of Pediatrics and author of an accompanying editorial.
For any family experiencing stress and struggling to make ends meet, however, home visits that teach parents how to interact with children may help improve child development, said Dreyer, also a researcher at New York University School of Medicine.
“When you are focused on putting food on the table or figuring out how to keep the heat on or being hounded by your landlord, families are not likely to have the bandwidth to say I am going to play with my child today,” Dreyer said in a phone interview.
Home visits may succeed because they help reduce stress, teach parents how to do activities with their kids, and provide materials to do these activities, Dreyer added. The visits parents received were brief, intermittent and focused on simple activities, he noted. “That alone made a difference,” Dreyer said.
