Potential of ‘stacking’ early childhood interventions to reduce inequities in learning outcomes

• Published in: Journal of epidemiology and community health (1979) 2019-12, Vol.73 (12), p.1078-1086
• Main Authors: Molloy, Carly, O'Connor, Meredith, Guo, Shuaijun, Lin, Colleen, Harrop, Christopher, Perini, Nicholas, Goldfeld, Sharon
• Format: Article
• Language: English
• Subjects: Academic Performance; Australia; Child; Child care; Child development; Child Development - physiology; Child, Preschool; Children; Children & youth; Curricula; Early childhood education; Early Intervention, Educational - methods; Environment; Evidence-based public health policy and practice; Families & family life; Family - psychology; Female; House Calls; Humans; Learning; Literacy; Longitudinal studies; Male; Mental health; Parenting; Pregnancy; Prenatal Care; Preschool education; Reading; Social Behavior; Socioeconomic Factors; Stacking
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2019-212282

BackgroundEarly childhood interventions are critical for reducing child health and development inequities. While most research focuses on the efficacy of single interventions, combining multiple evidence-based strategies over the early years of a child’s life may yield greater impact. This study examined the association between exposure to a combination of five evidence-based services from 0 to 5 years on children’s reading at 8–9 years.MethodsData from the nationally representative birth cohort (n=5107) of the Longitudinal Study of Australian Children were utilised. Risk and exposure measures across five services from 0 to 5 years were assessed: antenatal care, nurse home-visiting, early childhood education and care, parenting programme and the early years of school. Children’s reading at 8–9 years was measured using a standardised direct assessment. Linear regression analyses examined the cumulative effect of five services on reading. Interaction terms were examined to determine if the relationship differed as a function of level of disadvantage.ResultsA cumulative benefit effect of participation in more services and a cumulative risk effect when exposed to more risks was found. Each additional service that the child attended was associated with an increase in reading scores (b=9.16, 95% CI=5.58 to 12.75). Conversely, each additional risk that the child was exposed to was associated with a decrease in reading skills (b=−14.03, 95% CI=−16.61 to −11.44). Effects were similar for disadvantaged and non-disadvantaged children.ConclusionThis study supports the potential value of ‘stacking’ early interventions across the early years of a child’s life to maximise impacts on child outcomes.