The Brookline Early Education Project (BEEP): A Comprehensive Birth-to-Kindergarten Program for Children and Their Parents

Investigators: Donald E. Pierson, PhD, Robert I. Sperber, Martha B. Bronson, EdD & Mary-Jane Yurchak, EdD

The Brookline Early Education Project (BEEP) is a comprehensive birth-to-kindergarten program that combines child education and health monitoring services with parent education and support. BEEP utilizes a family-oriented approach designed to reduce learning and adjustment difficulties in school. BEEP consists of three components: 1) Parent Education and Support Program, 2) Child Education Program, and 3) Health and Development Monitoring. The Parent Education and Support Program provides home visits to families, parent discussion groups, a book and toy lending library, and social events. The Child Education Program consists of weekly playgroup sessions and daily prekindergarten classes. Finally, the Health and Development Monitoring program provides nine health and developmental screening exams for children beginning from two weeks of age through age 5. Evaluations of the BEEP program demonstrated higher school functioning in kindergarten and the second grade compared to age-matched peers. At early adulthood, benefits for BEEP participants compared to peers included higher educational attainment, higher income, and more positive health indicators. Click here to view more detailed information on this program.

Expressive Language Delay (ELD) Treatment Program: An Early Intervention for Children with Early Expressive Language Delay

Investigators: Grover J. Whitehurst, PhD & Janet E. Fischel PhD

Specific expressive language delay (ELD) is an early childhood condition characterized by a substantial delay in the child's development of expressive language relative to their receptive language skills and non-verbal intelligence. Young children with ELD are only able to produce a few single words, at an age at which most children are able to produce hundreds of words and a variety of syntactic combinations. The Expressive Language Delay (ELD) Treatment Program is a home- and clinic-based intervention that trains parents of young children diagnosed with ELD, with skills to improve their child's expressive language abilities. The ELD Treatment Program consists of seven 30-minute training sessions, in which parents receive training on seven language therapy skills. Parents are asked to practice each of these skills at-home with their child during the two-week intervals between training sessions. Parent training sessions were conducted on a one-on-one basis at an outpatient pediatric clinic and took place every other week during a three and a half month period. The evaluation of the ELD Treatment Program demonstrated short-term success in helping to improve the expressive vocabulary skills of children diagnosed with ELD. Click here to view more detailed information on this program.

Infant Stimulation and Physical Therapy: An Early Intervention Program for Children with Spastic Diplegia

Investigators: Frederick B. Palmer, MD, Bruce K. Shapiro, MD, & Marilee C. Allen, MD

The Infant Stimulation and Physical Therapy program was developed to address both cognitive and motor developmental areas for children with mild to severe spastic diplegia, a form of cerebral palsy. This program is an early intervention program that lasts a full year and incorporates both an infant stimulation curriculum for the first six months, followed by neurodevelopmental physical therapy for the remaining six months. The Infant Stimulation and Physical Therapy program is both center and home-based. Parents (or primary caregivers) meet bi-weekly for one-hour sessions at a clinic for twelve months where they receive training in the daily home implementation of the program. During the first six months of the program, parents or primary caregivers meet with a child development therapist and receive infant stimulation training structured around checklists and specific behavioral objectives. During the second six months of the program, parents or primary caregivers meet with a physical therapist and receive physical therapy training that are also structured around checklists and specific behavioral objectives. Click here to view more detailed information on this program.

The Abecedarian Approach

Investigators: Craig T. Ramey, Joseph J. Sparling, & Sharon L. Ramey

The Abecedarian Approach is a combination of teaching and learning enrichment strategies for use in early childhood education settings that is comprised of four key elements: 1) learning games, 2) conversational reading, 3) language priority, and 4) enriched care giving. These strategies were developed for and validated in a longitudinal research study known as the Abecedarian Project. By using the Abecedarian Approach, early childhood professionals can enhance their abilities to provide stable and stimulating interactions with children by engaging them in many rich and varied adult-child interaction activities on a daily basis. The ultimate goal of this educational approach is to facilitate positive child outcomes in areas such as cognitive, social-emotional, communication, and school readiness skills. The evaluation results of the Abecedarian Project demonstrate that early education for at-risk children within a safe, responsive, and stimulating environment can produce positive and long-lasting effects on the course of development. The Abecedarian Project is the only early childhood education program that has demonstrated statistically significant cognitive benefits into young adulthood. The four key elements of the Abecedarian Approach constitute a powerful tool for early childhood professionals to improve the competence and quality of life, particularly for children from low resource environments.

Play and Learning Strategies (PALS) I & II: A Responsive Parenting Program for Parents of Infants and Toddlers

Investigators: Susan H. Landry, PhD & Karen E. Smith, PhD

The Play and Learning Strategies (PALS) program is a home visiting intervention for parents of infants and toddlers that target aspects of a responsive parenting style shown to enhance children's cognitive and social development. The goal of the PALS program is to teach parents responsive parenting skills to support their child's social-emotional, cognitive, and language development. The parent learns specific behaviors that help her tune into her child, respond in a sensitive and contingent manner, provide appropriate cognitive and language stimulation, and manage behavior and discipline in a positive, developmentally appropriate manner. The PALS program consists of two separate curricula: the PALS I Infant curriculum and the PALS II Toddler curriculum. Family coaches deliver the intervention by visiting families on a weekly basis over the course of three months. Each session includes a discussion of the parent's practice during the preceding week; introduction of the new topic; viewing of educational videos demonstrating the skill; guided, videotaped practice using the skill with her own child; review of the videotaped practice; and planning for practice during the upcoming week. Click here to view more detailed information on this program.

Medical Outcome Study, 1986-1992

Investigators: Alvin R. Tarlov John E. Ware, Jr. Kenneth B. Wells Anita L. Stewart Cathy D. Sherbourne Ron D. Hays William H. Rogers Sheldon Greenfield Sandra H. Berry

The Medical Outcomes Study (MOS) is a large-scale multi-year survey of patients with prevalent and treatable chronic health conditions, particularly hypertension, heart disease, diabetes, and major depression. The MOS, which began in 1986, includes both cross-sectional and longitudinal components. The cross-sectional component describes the impact of chronic diseases on patient well-being as well as the medical care that patients received. The longitudinal component illustrates changes in health conditions over time and explains outcomes in terms of systems of care, provider specialty, styles of practice, and other factors that influence utilization of health care resources. The investigators employed a variety of assessment instruments, such as self-administered questionnaires for patients and clinicians, face-to-face interviews, telephone interviews, clinical reports, and health examinations. Furthermore, the SF-36 health survey was administered longitudinally, with a sample of 3,588 cases, in order to measure important health and functioning domains. The study samples were drawn from patients receiving health care from 523 solo or group practices in Boston, Chicago, and Los Angeles. The objectives of the study were assessment and evaluation of health status--defined in the MOS as the combination of: (1) clinical status, (2) functioning, and (3) well-being. In particular, the MOS investigated four prevalent and treatable chronic health conditions--three medical conditions of hypertension, heart disease, and diabetes as well as one psychological condition of major depression or dysthymia. The MOS examined these health conditions and their outcomes longitudinally in terms of health care, provider specialty, style of practice, and other factors that influenced utilization of health care resources. Among these, the study focused on the comparisons of (1) systems of care--HMOs, large multispecialty groups, and solo and small groups; (2) payment types--parepaid vs. fee-for-service; and (3) clinician specialty--specialist vs. generalist care. This large-scale multi-year study marked several methodological advances. First, the MOS measured the three parameters of health status in parallel, initially and longitudinally. Second, the MOS focused on patients' own personal evaluation of their functional status and well-being--an attempt to meet the recent needs of patient-based assessments of medical outcomes. Consequently, the MOS was the first large-scale study in which patients with different medical and psychiatric conditions completed the same self-administered questionnaires. Finally, the MOS is also distinctive in that it used both standardized patient surveys and clinical evaluations as measures of health status. With its large samples drawn from three urban cities in the U.S., the MOS increased standardization of general health surveys across studies and populations.

National Maternal and Infant Follow-up Health Survey, 1991

Investigators: National Center for Health Statistics

The 1991 Longitudinal Follow-up to the 1988 National Maternal and Infant Health Survey (NMIHS) was conducted by the National Center for Health Statistics. The 1991 Follow-up study examines such factors as child health status and development, the effects of low birth weight, use of federal programs, child safety, child injury, child care, pediatric care, maternal health, sociodemographic characteristics, acute and chronic illness, and health insurance. The 1988 study examined factors relating to poor pregnancy outcome, such as adequacy of prenatal care, inadequate or excessive weight gain during pregnancy, maternal health behaviors such as smoking, drinking and drug use, and pregnancy and delivery complications. The 1988 National Maternal and Infant Health Survey (NMIHS) is archived as RADIUS dataset #18-20. This dataset includes data for the 1991 Follow-up Live Birth Survey and the 1991 Follow-up Medical Provider Survey. The 1991 Follow-up Live Birth Survey includes 722 variables and 8,285 cases. The 1991 Follow-up Medical Provider Survey includes 217 variables and 99,117 medical provider contacts. Because the Provider file contains hierarchical data, the Live Birth and Provider files were not merged to create a single dataset. Live Birth and Provider files have been archived as separate datasets, RADIUS datasets #01 and #02, respectively.

National Maternal and Infant Health Survey, 1988

Investigators: National Center for Health Statistics

The 1988 National Maternal and Infant Health Survey (NMIHS) was conducted by the National Center for Health Statistics (NCHS). This study examines child health status and development, use of federal programs, child safety, child injury, child care, pediatric care, maternal health, socio-demographic characteristics, acute and chronic illness, and health insurance. Furthermore, the 1988 NMIHS examines factors related to poor pregnancy outcomes, such as adequacy of prenatal care, inadequate or excessive weight gain during pregnancy, maternal health behaviors such as smoking, drinking and drug use, and pregnancy and delivery complications. This study is a national sample of live births, fetal deaths, and infant deaths in 1988. Furthermore, this study includes a supplementary sample of Hispanic live births, fetal deaths, and infant deaths in Texas, and a supplementary sample of live births for urban American Indians. These studies assess longitudinal outcomes for mothers and children between 1988 and 1991. The 1988 NMIHS obtains information in the following substantive areas: Weeks pregnant at first prenatal visit, number of visits, access and barriers to care, source of payment for prenatal care, smoking, drinking, drug use, use of Federal programs and WIC participation Length of hospital stay, source of payment for delivery Number of admissions, outpatient visits, Center for Epidemiologic Studies Depression (CES-D) scale Gestational age and birth weight Mother's marital status, height and weight, age, education, race, and occupation-work patterns Household income one year before delivery Infant feeding practices, source of payment for infant care and health insurance, child care, illness and injuries, vaccinations, and hospitalizations.

National Health Interview Survey, Sample Adults, 2002

Investigators: National Center for Health Statistics

The National Health Interview Survey (NHIS) is a multi-purpose health survey conducted annually by the National Center for Health Statistics and is the principal source of information on the health of the civilian, noninstitutionalized, household population of the United States. The main objective of the NHIS is to monitor the health of the United States population through the collection and analysis of data on a broad range of health topics. NHIS data are used widely throughout the Department of Health and Human Services to monitor trends in illness and disability and to track progress toward achieving national health objectives. The data are also used by the public health research community for epidemiologic and policy analysis of such issues as characterizing those with various health problems, determining barriers to accessing and using appropriate health care, and evaluating Federal health programs. For each sample adult, extensive information is collected on health status, conditions, disability, health care services, and behavior. A unique feature of the 2002 NHIS is the Alternative Health/Complementary and Alternative Medicine Supplement, which collected information from sample adults on their use of 17 non-conventional health care practices.

National Health Interview Survey, Sample Adults, 2000

Investigators: National Center for Health Statistics

The National Health Interview Survey (NHIS) is a multi-purpose health survey conducted annually by the National Center for Health Statistics (NCHS) and is the principal source of information on the health of the civilian, noninstitutionalized, household population of the United States. The NHIS has been conducted continuously since its beginning in 1957. The main objective of the NHIS is to monitor the health of the United States population through the collection and analysis of data on a broad range of health topics. A major strength of this survey lies in the ability to display these health characteristics by many demographic and socioeconomic characteristics. NHIS data are used widely throughout the Department of Health and Human Services (DHHS) to monitor trends in illness and disability and to track progress toward achieving national health objectives. The data are also used by the public health research community for epidemiologic and policy analysis of such timely issues as characterizing those with various health problems, determining barriers to accessing and using appropriate health care, and evaluating Federal health programs. The data set archived by Sociometrics contains data from three components or modules of the 2000 NHIS: the family core, the sample adult core, and the cancer control module. The family core component collects information on everyone in the respondent's family, including information on household composition and socio-demographic characteristics, basic indicators of health status, activity limitations, injuries, health insurance coverage, and access to and utilization of health care services. Within each family in the NHIS, one sample adult is randomly selected, and is administered the sample adult core questionnaire. For each sample adult, extensive information is collected on health status, conditions, disability, health care services, and behavior. In addition, sample adults were administered the cancer control module, which focused on cancer risk factors and behaviors and collected information on Hispanic acculturation, diet and nutrition, physical activity, tobacco, cancer screening, genetic testing, and family history.