Effectiveness of a Home Intervention for Perceived Child Behavioral Problems and Parenting Stress in Children With In Utero Drug Exposure | Child Development | JAMA Pediatrics | JAMA Network
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Article
September 2001

Effectiveness of a Home Intervention for Perceived Child Behavioral Problems and Parenting Stress in Children With In Utero Drug Exposure

Author Affiliations

From the Departments of Pediatrics (Drs Butz and Belcher) and Psychiatry (Dr Pulsifer), The Johns Hopkins University School of Medicine, Institutional Research Department, Loyola College, Baltimore (Ms Marano), The Kennedy Krieger Institute, Baltimore (Dr Belcher), and the Schools of Nursing (Ms Lears) and Public Health (Dr Royall), The Johns Hopkins University, Baltimore, Md.

Arch Pediatr Adolesc Med. 2001;155(9):1029-1037. doi:10.1001/archpedi.155.9.1029
Abstract

Objective  To determine if a home-based nurse intervention (INT), focusing on parenting education/skills and caregiver emotional support, reduces child behavioral problems and parenting stress in caregivers of in utero drug-exposed children.

Design  Randomized clinical trial of a home-based INT.

Settings  Two urban hospital newborn nurseries; homes of infants (the term infant is used interchangeably in this study with the term child to denote those from birth to the age of 36 months); and a research clinic in Baltimore, Md.

Participants  In utero drug-exposed children and their caregivers (N = 100) were examined when the child was between the ages of 2 and 3 years. Two groups were studied: standard care (SC) (n = 51) and INT (n = 49).

Intervention  A home nurse INT consisting of 16 home visits from birth to the age of 18 months to provide caregivers with emotional support and parenting education and to provide health monitoring for the infant.

Main Outcome Measures  Scores on the Child Behavior Checklist and the Parenting Stress Index.

Results  Significantly more drug-exposed children in the SC group earned t scores indicative of significant emotional or behavioral problems than did children in the INT group on the Child Behavior Checklist Total (16 [31%] vs 7 [14%]; P = .04), Externalizing (19 [37%] vs 8 [16%]; P = .02), and Internalizing (14 [27%] vs 6 [12%]; P = .05) scales and on the anxiety-depression subscale (16 [31%] vs 5 [10%]; P = .009). There was a trend (P = .06) in more caregivers of children in the SC group reporting higher parenting distress than caregivers of children in the INT group.

Conclusions  In utero drug-exposed children receiving a home-based nurse INT had significantly fewer behavioral problems than did in utero drug-exposed children receiving SC (P = .04). Furthermore, those caregivers receiving the home-based INT reported a trend toward lower total parenting distress compared with caregivers of children who received SC with no home visits.

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