Bottom Line: A program of home visits designed to help families enhance school readiness for their preschool children had by the third grade improved academic performance, eased the social-emotional adjustment to school, and reduced problems at home for the children.
Why The Research Is Interesting: Little research with long follow-up exists on home-visiting programs that are designed for older preschool children (4-5 years old) and emphasize the parenting practices needed to support school readiness skills in children.
Who and When: 200 4-year-old children from low-income families recruited for this randomized clinical trial in 2008-2009 and followed up in 2013-2014
What (Study Interventions and Outcomes): 95 families chosen to receive 10 home visits during preschool, six visits in kindergarten, parent coaching and home-learning materials as part of the Research-Based and Developmentally Informed-Parent home visiting program (intervention); 105 families served as a comparison group and received math home-learning games in the mail (control); assessment of academic performance, social-emotional adjustment and problems at home by the end of third grade (outcomes)
How (Study Design): This was a randomized clinical trial (RCT). RCTs allow for the strongest inferences to be made about the true effect of an intervention. However, not all RCT results can be replicated in real-world settings because patient characteristics or other variables may differ from those that were studied in the RCT.
Authors: Karen L. Bierman, Ph.D., Pennsylvania State University, University Park, and coauthors
Results: In this randomized clinical trial that included 200 families (n = 200 children), preschool home visiting promoted gains in child academic performance, social-emotional adjustment, and reduced home problems in third grade. Intervention-related improvements in these 3 domains mediated significant reductions in child need for educational and mental health services.
Study Limitations: Some parents invited to participate in the study declined to do so, likely contributing to a final group of motivated study participants.
Study Conclusions: The results of this study appear to support the value of preschool home visiting programs as a strategy to help close the gap in school readiness and child well-being associated with poverty.
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Related material: An author podcast will be posted on this page.
To Learn More: The full study is available on the For The Media website.
(doi:10.1001/jamapediatrics.2018.1029)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
JAMA Pediatrics