Relationship-based intervention for children who were prenatally alcohol exposed in South Africa.
Wendy O Kalberg, Anna-Susan Marais, Marlene M De Vries and 8 others
PMID 36963311WHAT IT FOUND
Home visits improved the caregiving environment for all children, especially in how parents responded to them.
Child development scores only improved for those who started with the lowest abilities. There was no control group, so these gains cannot be proven to be caused by the intervention.
Key findings
01The home environment score improved significantly for both groups after the intervention, with the largest gains seen in caregiver responsivity.
02Children who had the lowest developmental scores at the start of the study showed significant improvement over time, while those with the highest scores regressed towards the mean.
03There was no significant difference in home environment improvements between children with heavy prenatal alcohol exposure and those with no or light exposure.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
There was no control group, so it is impossible to know if the improvements were due to the intervention or natural development. The study was very small, with only 38 participants. The ASQ was not normed for this specific population and was translated in real-time, which may affect the accuracy of the child development scores. The same assessor often did both the pre- and post-test HOME assessments, which could introduce bias, although the authors state statistical checks did not detect this. The results may only apply to low-income populations in South Africa with very limited learning materials at home.
Declared interests
The authors declared no competing interests. The study was funded by grants from the National Institute on Alcohol Abuse and Alcoholism.
The easy way to misread this
Do not conclude that this intervention improves child development outcomes. The study had no control group, and the improvements in home environment scores could have occurred without the intervention. The child development gains were only seen in the lowest-performing children, which is likely due to regression to the mean rather than a treatment effect.