A CRITICAL ANALYSIS OF THE INFANT HEALTH AND DEVELOPMENT PROGRAM

The largest study designed to ameliorate adverse effects of premature low birth weight (LEW) and to prevent mental retardation is the Infant Health and Development Program (IHDP). This was a randomized, multisi te intervention: home visits for 3 years, parents meetings, and intens ive preschool education for 2 years. IHDP reported results alleging th e program significantly influenced intelligence and prevented mental r etardation. We conducted an independent analysis of the original compu terized database (at 3 years). Five-year follow-up data were obtained from the journal publication and from data on file with the National A uxiliary Publication Service. Our intent was to determine the magnitud e, durability and clinical significance of purported intervention effe cts and how these are mediated. Methods used were primarily multivaria te correlational analyses and examination of the logic underlying the conclusions. Results suggest alternative interpretations of claims reg arding IHDP. Effects are explained by confounding variables, questiona ble analytical procedures, distorted interpretations, and data inconsi stencies. Effect sizes and specificity of effect reported by IHDP do n ot survive scrutiny either in the original database or at 5 years. Giv en the vastly complex nature of premature LEW, IHDP was poorly conceiv ed, failing to produce meaningful and enduring effects on IQ. Policy c onclusions for interventions with LEW infants stemming from IHDP are m isleading.