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First 1,000 days: enough for mothers but not for children? Long‐term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow‐up of a randomised controlled trial.

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Title: First 1,000 days: enough for mothers but not for children? Long‐term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow‐up of a randomised controlled trial.
Authors: Tomlinson, Mark, Skeen, Sarah, Melendez‐Torres, G. J., Hunt, Xanthe, Desmond, Chris, Morgan, Barak, Murray, Lynne, Cooper, Peter J, Rathod, Sujit D., Marlow, Marguerite, Fearon, Pasco
Source: Journal of Child Psychology & Psychiatry. Mar2022, Vol. 63 Issue 3, p261-272. 12p. 4 Charts.
Subjects: Attitudes of mothers, Affect (Psychology), Confidence intervals, Psychology of mothers, Child development, Mother-infant relationship, Medical care costs, Mental health, Treatment effectiveness, Parent-infant relationships, Socioeconomic factors, Mental depression, Questionnaires, Cognitive testing, Early medical intervention, Long-term health care
Abstract: Background: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low‐ and middle‐income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother–infant relationship. The aim of this study was to examine the long‐term impact of an early intervention to improve the mother–infant relationship quality on child cognitive outcomes at 13 years of age. We also estimated the current costs to replicate the intervention. Method: We re‐recruited 333 children from an early childhood maternal–infant attachment intervention, 'Thula Sana', when the children were 13 years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ‐9) and the Self‐Reporting Questionnaire (SRQ‐20) to assess maternal mental health. Results: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ‐9, ES = −0.17 [CI: −1.95, 0.05] and SRQ‐20, ES = −0.30 [CI: −2.41, −0.19]), but not anxiety. The annual cost per mother–child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). Conclusion: In a socio‐economically deprived peri‐urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13 years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long‐term child outcomes, the improvements in maternal mood are important. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: First 1,000 days: enough for mothers but not for children? Long‐term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow‐up of a randomised controlled trial.
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  Data: <searchLink fieldCode="AR" term="%22Tomlinson%2C+Mark%22">Tomlinson, Mark</searchLink><br /><searchLink fieldCode="AR" term="%22Skeen%2C+Sarah%22">Skeen, Sarah</searchLink><br /><searchLink fieldCode="AR" term="%22Melendez‐Torres%2C+G%2E+J%2E%22">Melendez‐Torres, G. J.</searchLink><br /><searchLink fieldCode="AR" term="%22Hunt%2C+Xanthe%22">Hunt, Xanthe</searchLink><br /><searchLink fieldCode="AR" term="%22Desmond%2C+Chris%22">Desmond, Chris</searchLink><br /><searchLink fieldCode="AR" term="%22Morgan%2C+Barak%22">Morgan, Barak</searchLink><br /><searchLink fieldCode="AR" term="%22Murray%2C+Lynne%22">Murray, Lynne</searchLink><br /><searchLink fieldCode="AR" term="%22Cooper%2C+Peter+J%22">Cooper, Peter J</searchLink><br /><searchLink fieldCode="AR" term="%22Rathod%2C+Sujit+D%2E%22">Rathod, Sujit D.</searchLink><br /><searchLink fieldCode="AR" term="%22Marlow%2C+Marguerite%22">Marlow, Marguerite</searchLink><br /><searchLink fieldCode="AR" term="%22Fearon%2C+Pasco%22">Fearon, Pasco</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Child+Psychology+%26+Psychiatry%22">Journal of Child Psychology & Psychiatry</searchLink>. Mar2022, Vol. 63 Issue 3, p261-272. 12p. 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Attitudes+of+mothers%22">Attitudes of mothers</searchLink><br /><searchLink fieldCode="DE" term="%22Affect+%28Psychology%29%22">Affect (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+of+mothers%22">Psychology of mothers</searchLink><br /><searchLink fieldCode="DE" term="%22Child+development%22">Child development</searchLink><br /><searchLink fieldCode="DE" term="%22Mother-infant+relationship%22">Mother-infant relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+costs%22">Medical care costs</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Parent-infant+relationships%22">Parent-infant relationships</searchLink><br /><searchLink fieldCode="DE" term="%22Socioeconomic+factors%22">Socioeconomic factors</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+testing%22">Cognitive testing</searchLink><br /><searchLink fieldCode="DE" term="%22Early+medical+intervention%22">Early medical intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Long-term+health+care%22">Long-term health care</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low‐ and middle‐income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother–infant relationship. The aim of this study was to examine the long‐term impact of an early intervention to improve the mother–infant relationship quality on child cognitive outcomes at 13 years of age. We also estimated the current costs to replicate the intervention. Method: We re‐recruited 333 children from an early childhood maternal–infant attachment intervention, 'Thula Sana', when the children were 13 years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ‐9) and the Self‐Reporting Questionnaire (SRQ‐20) to assess maternal mental health. Results: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ‐9, ES = −0.17 [CI: −1.95, 0.05] and SRQ‐20, ES = −0.30 [CI: −2.41, −0.19]), but not anxiety. The annual cost per mother–child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). Conclusion: In a socio‐economically deprived peri‐urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13 years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long‐term child outcomes, the improvements in maternal mood are important. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/jcpp.13482
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      – Code: eng
        Text: English
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        PageCount: 12
        StartPage: 261
    Subjects:
      – SubjectFull: Attitudes of mothers
        Type: general
      – SubjectFull: Affect (Psychology)
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Psychology of mothers
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      – SubjectFull: Child development
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      – SubjectFull: Mother-infant relationship
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      – SubjectFull: Medical care costs
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      – SubjectFull: Mental health
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Parent-infant relationships
        Type: general
      – SubjectFull: Socioeconomic factors
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      – SubjectFull: Mental depression
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      – SubjectFull: Questionnaires
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      – SubjectFull: Cognitive testing
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      – SubjectFull: Early medical intervention
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      – SubjectFull: Long-term health care
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      – TitleFull: First 1,000 days: enough for mothers but not for children? Long‐term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow‐up of a randomised controlled trial.
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              Text: Mar2022
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