Adult outcomes as a function of an early childhood educational program: an Abecedarian Project follow-up.

Adult (age 30) educational, economic, and social-emotional adjustment outcomes were investigated for participants in the Abecedarian Project, a randomized controlled trial of early childhood education for children from low-income families. Of the original 111 infants enrolled (98% African American), 101 took part in the age 30 follow-up. Primary indicators of educational level, economic status, and social adjustment were examined as a function of early childhood treatment. Treated individuals attained significantly more years of education, but income-to-needs ratios and criminal involvement did not vary significantly as a function of early treatment. A number of other indicators were described for each domain. Overall, the findings provide strong evidence for educational benefits, mixed evidence for economic benefits, and little evidence for treatment-related social adjustment outcomes. Implications for public policy are discussed.

Do Gender Differences Exist in the Academic Identification of African-American Elementary-School Aged Children?

The disidentification hypothesis predicts that African-American boys achieve less in school than African-American girls do because boys have less personal investment in doing well academically (i.e., they are disidentified). When do such gender differences emerge? Using self-perception and achievement data from longitudinal studies of children (N = 113) at high-risk for academic problems because they come from low-income families, the authors examined whether elementary school-aged and early adolescent African-American boys are more prone to low achievement and disidentification than African-American girls. Multiple regression analyses indicated no gender differences in reading or mathematics achievement between boys and girls at age 8 or at age 12. At 12, African-American boys' self-esteem was predicted by academic performance in ways similar to that of African-American girls. Thus, no gender differences emerged in elementary school achievement and no gender-specific disengagement patterns were confirmed among at-risk African-American students.

Early educational intervention, early cumulative risk, and the early home environment as predictors of young adult outcomes within a high-risk sample.

The extent to which early educational intervention, early cumulative risk, and the early home environment were associated with young adult outcomes was investigated in a sample of 139 young adults (age 21) from high-risk families enrolled in randomized trials of early intervention. Positive effects of treatment were found for education attainment, attending college, and skilled employment; negative effects of risk were found for education attainment, graduating high school, being employed, and avoiding teen parenthood. The home mediated the effects of risk for graduating high school, but not being employed for teen parenthood. Evidence for moderated mediation was found for educational attainment; the home mediated the association between risk and educational attainment for the control group, but not the treated group.

Differential recall of consent information and parental decisions about enrolling children in research studies.

In the present simulation research, the authors examined the relations between the type of information that low-income parents (N = 116) recalled from informed-consent materials and their hypothetical decision to enroll a child in a clinical study. The authors gave parents or guardians of Head Start children information about a medical protocol involving high risk and significant potential benefit to child participants. Differential recall of the various categories of information (procedures, benefits, risks and costs, rights, and other) showed that relative to all consent information conveyed to them, participants recalled most about procedures and least about their child's rights as a study participant. Relative to their own recall, they also recounted most about procedures, slightly more about benefits than risks, and least about research rights. The pattern of recall differed among those who agreed to enroll and those who declined. The ratio of recalled risks to benefits predicted enrollment decisions.

Depressive symptoms in young adults: the influences of the early home environment and early educational child care.

The relationship between depressive symptoms in young adults, the quality of the early home environment, and early educational child care was investigated in young adults randomly assigned to receive early childhood intervention in the Abecedarian study. Of the original 111 infants enrolled (98% African American), 104 participated in an age-21 follow-up. Those who had early treatment reported fewer depressive symptoms. The protective effects of the early childhood program were further supported by a significant home environment by treatment interaction. Negative effects of lower quality home environments on young adult depressive symptoms were almost entirely offset by preschool treatment, whereas depressive symptoms increased as the quality of the early home environment decreased for those in the control group.

Reduction of opioid-withdrawal symptoms with quetiapine.

OBJECTIVE: To determine the utility of quetiapine in a population undergoing ambulatory detoxification from opioids. METHOD: Medications utilized in our outpatient clinic for opioid withdrawal were evaluated for quality-assurance purposes. The treatment regimen generally included clonidine, hydroxyzine, trazodone, diphenoxylate/atropine, and sometimes chlordiazepoxide. Patients were also initially given eight 25-mg tablets of quetiapine and instructed to take 1 or 2 tablets every 4 hours as needed for symptoms of withdrawal or craving (with a maximum daily dose of 200 mg). Data were based on patient evaluations from June 2003 to June 2004. RESULTS: 41% of all patients (N = 213) successfully completed the detoxification phase of the program (i.e., completed at least 5 days of abstinence). A medication questionnaire was instituted for quality-assurance purposes after some apparent initial success with quetiapine. A retrospective analysis of these data revealed that, of the 107 patients evaluated for medication response, 79 reported that quetiapine helped reduce craving for opioids, 52 reported that quetiapine helped reduce their anxiety, 24 reported a reduction in somatic pain, 22 reported that quetiapine helped alleviate insomnia, and 14 reported an improved appetite. Four individuals did not feel quetiapine had any benefit, and another 7 were unable to tolerate quetiapine because of side effects. The quetiapine dose used ranged from 25 to 600 mg/day (mean +/- SD dose = 206 +/- 122 mg/day). CONCLUSIONS: Quetiapine use during opioid cessation was found to help abate symptoms of opioid withdrawal in our patient population and was generally well tolerated.

The effect of format modifications and reading comprehension on recall of informed consent information by low-income parents: a comparison of print, video, and computer-based presentations.

A randomized trial comparing the amount of knowledge orally recalled from four different presentations of the same consent information was conducted in a non-clinic sample of 233 low-income parents who displayed a range of reading comprehension skill. The study simulated recruitment of children into one of two actual studies underway at another location: one involved high risk to participants, the other did not. Use of a non-clinic sample controlled for prior knowledge of the conditions, and avoiding discussion of the information further assured that differences in recalled information could be attributed more confidently to the format itself. The formats included the original written forms, enhanced print (simpler language, topic headings, pictures), narrated videotapes, and self-paced PowerPoint presentations via laptop computer with bulleted print information, pictures, and narration. No format-related differences in recalled information were found in the full sample but for the 124 individuals with reading comprehension scores at or below the 8th grade level, the enhanced print version tended to be more effective than either the original form or the video. Across all formats, more information was recalled about the low-risk study. The findings emphasize the necessity for clinicians and researchers to verify understanding of consent information, especially when there is risk of reduced literacy skill. Reliance on video to convey information in preference to well-done print media appeared questionable.

Early Intervention and Mediating Processes in Cognitive Performance of Children of Low-Income African American Families.

This longitudinal study of 161 African American children from low-income families examined multiple influences, including early childhood interventions and characteristics of the child and family, on longitudinal patterns of children's cognitive performance measured between 6 months and 8 years of age. Results indicate that more optimal patterns of cognitive development were associated with intensive early educational child care, responsive stimulating care at home, and higher maternal IQ. In accordance with a general systems model, analyses also suggested that child care experiences were related to better cognitive performance in part through enhancing the infant's responsiveness to his or her environment. Maternal IQ had both a direct effect on cognitive performance during early childhood and, also, an indirect effect through its influence on the family environment.