This proposal examines 4 issues central to the early development of low birth weight (LBW) infants: (1) Do intervention programs benefit mothers as well as children and if so, how? (2) How do maternal characteristics and environmental variables, over and above socio-demographic factors, influence child outcomes? (3) How do maternal characteristics mediate the association between neonatal health status (LBW, neonatal illness) and child outcomes at ages 2, 3, 5, and 6 1/2? Are certain maternal characteristics more important for LBW children who are lighter or sicker at birth? Do maternal characteristics become more important to children as they grow older (i.e., ages 2 to 6 l/1)? (4) Do maternal characteristics play a greater role for Follow-up children (FU) than for Intervention children (INT)? We propose to examine these questions using extant data from a multi-center, randomized, controlled trial of early intervention designed to reduce the incidence of health/developmental problems among LBW premature infants (N=985). We examine the efficacy of the intervention in altering maternal beliefs about childrearing, emotional functioning, and social support using multiple regression with prerandomization and infant status variables as covariates. Next, the direct and indirect effects of maternal characteristics upon child outcomes at ages 2, 3, 5, and 6 1/2 are examined, also considering the home environment, maternal IQ and employment, using structural equation modelling for the FU and INT group separately. We explore whether certain maternal characteristics are more important for children lighter or sicker at birth via hierarchical regressions that examine the interactive effects of LBW (< 2000 & > 2000 g) and neonatal illness with maternal characteristics; and via structural equation modelling that tests the strength of the direct and indirect effects of child health status on maternal characteristics and child outcomes. Assessment of child cognitive, behavioral, and social competence at ages 5 and 6 1/2 allow a comparison of correlates of cognitive and behavioral competence at ages 2, 3, 5, and 6 1/2. Finally, we compare the strength of associations between child outcomes and maternal characteristics, separately for the FU and INT groups, to determine if maternal characteristics are more important for children who did not receive the enriched intervention.
