Potential of 'stacking' early childhood interventions to reduce inequities in learning outcomes

J Epidemiol Community Health. 2019 Dec;73(12):1078-1086. doi: 10.1136/jech-2019-212282. Epub 2019 Oct 5.

Abstract

Background: Early childhood interventions are critical for reducing child health and development inequities. While most research focuses on the efficacy of single interventions, combining multiple evidence-based strategies over the early years of a child's life may yield greater impact. This study examined the association between exposure to a combination of five evidence-based services from 0 to 5 years on children's reading at 8-9 years.

Methods: Data from the nationally representative birth cohort (n=5107) of the Longitudinal Study of Australian Children were utilised. Risk and exposure measures across five services from 0 to 5 years were assessed: antenatal care, nurse home-visiting, early childhood education and care, parenting programme and the early years of school. Children's reading at 8-9 years was measured using a standardised direct assessment. Linear regression analyses examined the cumulative effect of five services on reading. Interaction terms were examined to determine if the relationship differed as a function of level of disadvantage.

Results: A cumulative benefit effect of participation in more services and a cumulative risk effect when exposed to more risks was found. Each additional service that the child attended was associated with an increase in reading scores (b=9.16, 95% CI=5.58 to 12.75). Conversely, each additional risk that the child was exposed to was associated with a decrease in reading skills (b=-14.03, 95% CI=-16.61 to -11.44). Effects were similar for disadvantaged and non-disadvantaged children.

Conclusion: This study supports the potential value of 'stacking' early interventions across the early years of a child's life to maximise impacts on child outcomes.

Keywords: child development; child inequities; cumulative benefit; cumulative risk; early childhood interventions; socioeconomic disadvantage.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Academic Performance*
  • Australia
  • Child
  • Child Development / physiology*
  • Child, Preschool
  • Early Intervention, Educational / methods*
  • Environment
  • Family / psychology*
  • Female
  • House Calls
  • Humans
  • Learning*
  • Male
  • Parenting
  • Pregnancy
  • Prenatal Care
  • Reading*
  • Social Behavior
  • Socioeconomic Factors