A randomized controlled trial of a home-visiting intervention on cognition and behavior in term low birth weight infants

Objectives: To determine whether early psychosocial intervention with low birth weight term (LBW-T) infants improved cognition and behavior and to compare LBW-T with normal birth weight (NBW) infants. Study design: A randomized controlled trial was carried out in Kingston, Jamaica, with 140 LBW-T infants (weight < 2500 g). The intervention comprised weekly home visits by paraprofessionals for the first 8 weeks of life aimed at improving maternal-child interaction. LBW-T and 94 matched NBW (weight 2500 to 4000 g) infants were recruited from the main maternity hospital. Main outcome measures were problem solving (2 means-end tests: cover and support) and 4 behavior ratings at 7 months. Analyses used were the t test for intervention effects and multiple regression to compare LBW and NBW infants. Results: LBW-T intervened infants had higher scores than LBW-T control infants on the cover test (P < .05) and were more cooperative (P < .01) and happy (P < .05). LBW-T control infants had poorer scores on both the cover (P < .001) and support tests (P < .01), vocalized less (P < .02), and were less cooperative (P < .001), happy (P < .02), and active (P < .02) than NBW infants. LBW-T intervened infants bad lower scores than NBW infants only on the support test (P < .05). Conclusions: Early low-cost intervention can improve cognition and behavior of LBW-T infants in developing countries.