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Benefits of Early Intervention Persist into Adulthood

April 29, 2014

Benefits of Early Intervention Persist into Adulthood

  1. Martin T. Stein, MD

Children randomized to early intervention had significantly lower prevalence of cardiovascular and metabolic risk factors in their 30s.

  1. Martin T. Stein, MD

In the Carolina Abecedarian Project (ABC), 111 children born between 1972 and 1977 and living in poverty in North Carolina were randomized to an intervention that emphasized language development, emotional regulation, and cognitive skills with supervised play for 8 hours daily, two meals and a snack, and access to primary care from birth through age 5 years. Children in the control group received adequate nutrition but no programs to enhance cognitive or social development. Previous reports documented significant improvements in cognitive and social development by age 3 years in the intervention group (Am J Ment Defic 1984 Mar; 88:515), and a long-term follow-up study found that children in the intervention group were four times more likely to graduate from college than controls (Dev Psychol 2001 Mar; 37:231).

A new report provides data on the adult health status of the ABC study participants. In their mid-30s, those randomized to the early intervention had significantly lower prevalence of risk factors for cardiovascular and metabolic diseases. The evidence was strongest for men: One in four men in the control group was affected by metabolic syndrome versus no men in the treatment group. Men in the intervention group had lower mean systolic blood pressure (126 vs. 143 mm Hg) and borderline but not statistically significantly higher levels of high-density lipoprotein cholesterol. The authors estimate that half the effect of the intervention on hypertension and obesity in adults is mediated by body-mass index of the children at age 1 year.

Comment

James Heckman, a professor of economics who led the data analysis, recently stated: “This [study] tells us that adversity matters and it does affect adult health. But it also shows us that we can do something about it, that poverty is not just a hopeless condition” (New York Times, Mar 27, 2014). Together with other studies, the data indicate that young children who live in low-income, vulnerable families can improve in measures of educational achievement and health status from such early intervention programs. The Head Start program is a modified form of the Abecedarian Project.

  • Disclosures for Martin T. Stein, MD at time of publication Consultant / advisory board BioBehavioral Diagnostics Grant / research support Eli-Lilly Editorial boards Journal of Developmental and Behavioral Pediatrics

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