176

HOME BASED INFANT COGNITIVE STIMULATION FOR AT-RISKFAMILIES BY LAY WORKERS

Barbara Howard, l-I.D. Esther Dienstag, l-LA

Infants born to lower-income mothers are at riskfor later developmental problems, especially poorlanguage skills. A cost effective program to providehome-based infant stimulation training to parents bylay workers was implemented at a pediatric primarycare center. Training for 23 low income single blackmothers was initiated in the hospital in a demonstra­tion of a modified version of the Brazelton NeonatalBehavioral Assessment Scale and was followed by bi­weekly home visits through six months. A controlgroup of 24 mothers received routine medical care only.Questions included acceptability of the home visits tothe families and our ability to train lay workers ininfant s~imulation techniques.

Results indicated that workers were welcomed intothe homes of the intervention groups and strongattachments developed.

Assessments were performed at 1 and 6 months usingthe Home Scale and the Nursing Child Assessment Teach­ing (NCATS) and Feeding (NCAFS) Scales. Significantresults were found at. 1 month on the Home Scale(p<.Ol)in mothers' provision of appropriate .play materialsand maternal involvement with the child. At 6 months,differences were found in observed -infant behavior onthe NCATS Scale. TIle experimental group babies weremore alert and showed more task-directed motor andpostural activity (p<:Ol). They also vocalizedmore (p<.Ol).

It was noted that the outreach workers were better~ble to deal .with concrete tasks of teaching sensori­motor skills and use of toys rather than interactionskills. Experimental group mothers, in turn, learned~hese concrete skills but failed to differ from con­~rol group mothers in other interaction skills.