Prenatal and Postnatal Preventive Interventions Based on Risk Factors

Research from a wide array of disciplines indicates that specific factors in a child’s life are associated with an increased likelihood of delinquency and other poor outcomes. These correlates, collectively known as risk factors, operate in the multiple domains in which the child interacts including his family, schools, peers, and community. These factors have been found to operate not simply in an additive manner but instead cumulatively and interactively, thereby producing higher likelihood, severity, and frequency of negative life outcomes with the increasing numbers of risk factors the child faces. Additionally, research finds that the children from these disadvantaged households demonstrate a high and stable trajectory of disruptive and disturbing behaviors that continue and even escalate into adolescence. As many of these risk factors can be identified prenatally or early in the child’s first few years of life, there is the opportunity to intervene preventively. Prevention programs seek to compensate or correct for factors placing the child’s developmental course at risk by targeting the child, their caregivers, and/or their communities. This entry provides an overview of three preventive programs implemented during pregnancy, infancy, or early childhood that have been rigorously tested and found effective in lessening the likelihood of these poor outcomes for children deemed to be at high risk. Included are home visitation programs, parent training programs, and early enriched educational programs. Research from a wide array of disciplines shows surprising similarity in their findings regarding childhood variables associated with a higher likelihood of negative life outcomes. These variables are collectively known as risk factors and have been found to exist in the multiple domains in which a child interacts including his family, peers, school, and community. Current research has found that many different disorders share the same risk factors. That is, predictors of any one specific negative outcome, such as delinquency, are associated with a wide array of problematic outcomes such as disruptive and defiant behavior, poor school adjustment, academic failure, drug use and alcohol abuse, mental illness, risky sexual behaviors, and suicide, among others. Importantly, these risk factors appear to operate similarly across different racial and cultural groups. Therefore, carefully and well-designed preventive programs have the potential to affect multiple health and behavioral problems simultaneously thereby proving highly cost-effective. Many of these risk factors can be identified prenatally or early in the child’s first few years of life. Longitudinal research has found several factors associated with maternal characteristics and behavior during pregnancy that are related to an increased likelihood of early childhood disruptive behaviors. These include mother’s socioeconomic status, young age at first birth, low educational status, and smoking while pregnant. In the months and years following the child’s birth, the parent’s inability to effectively socialize has been found to be a powerful predictor of a child’s long-term poor outcomes. While research indicates that all young children engage in disruptive and physically aggressive behaviors, most children learn to control these impulses by the time they enter school. However, studies have found that a small percentage continue to demonstrate a high and stable trajectory of disruptive and disturbing behaviors that continue well into adolescence. Data from a large longitudinal study conducted in America (Campbell et al. 2006) found that Prenatal and Postnatal Preventive Interventions Based on Risk Factors 3895 P