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Enough for mothers but not for children? Long‐term outcomes of an early intervention on maternal depressed mood and child cognitive development: follow‐up of a randomised controlled trial

Bibliographic Data

ID21344809
AuthorsMark Tomlinson (0000-0001-5846-3444, Department of Global Health Institute for Life Course Health Research Stellenbosch University Stellenbosch South Africa, corresponding author), Sarah Skeen (0000-0002-7464-2861, Department of Global Health Institute for Life Course Health Research Stellenbosch University Stellenbosch South Africa), G J Melendez-Torres (0000-0002-9823-4790, University of Exeter), G J Melendez‐Torres (Peninsula Technology Assessment Group University of Exeter Medical School Exeter UK), Xanthe Hunt (0000-0001-7531-6665, Department of Global Health Institute for Life Course Health Research Stellenbosch University Stellenbosch South Africa), Cosmas Desmond (0000-0002-3500-0196, University of the Witwatersrand), Chris Desmond (Priceless, School of Public Health Wits University Johannesburg South Africa), Barak Morgan (0000-0002-9380-431X, Global Risk Governance Programme Institute for Safety Governance and Criminology, Law Faculty University of Cape Town Cape Town South Africa), Lynne Murray (0000-0002-1127-4790, School of Psychology and Clinical Language Sciences University of Reading Reading UK), Peter Cooper (0000-0002-8978-3448, School of Psychology and Clinical Language Sciences University of Reading Reading UK), Sachinkumar Rathod (0000-0001-8783-7724, London School of Hygiene & Tropical Medicine), Sujit D Rathod (Department of Population Health London School of Hygiene and Tropical Medicine London UK), Michael Marlow (0000-0002-9181-2447, Department of Global Health Institute for Life Course Health Research Stellenbosch University Stellenbosch South Africa), R M Pasco Fearon (0000-0003-1847-8443, Developmental Neuroscience Unit University College London London UK)
Year2022
Volume63
Issue3
Pages261-272
Publication date2022-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Child Psychology and Psychiatry (JOURNAL)
Journal identifiersISSN: 0021-9630 • E-ISSN: 1469-7610
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jcpp.13482
PMID34227113
OpenAlexW3178626074
LanguageEN
Citations received10
References cited81

BACKGROUND: Child cognitive development is often compromised in contexts of poverty and adversity, and these deficits tend to endure and affect the child across the life course. In the conditions of poverty and violence that characterise many low- and middle-income countries (LMIC), the capacity of parents to provide the kind of care that promotes good child development may be severely compromised, especially where caregivers suffer from depression. One avenue of early intervention focuses on the quality of the early mother-infant relationship. The aim of this study was to examine the long-term impact of an early intervention to improve the mother-infant relationship quality on child cognitive outcomes at 13 years of age. We also estimated the current costs to replicate the intervention. METHOD: We re-recruited 333 children from an early childhood maternal-infant attachment intervention, 'Thula Sana', when the children were 13 years old, to assess whether there were impacts of the intervention on child cognitive outcomes, and maternal mood. We used the Kaufman Assessment Battery to assess the child cognitive development and the Patient Health Questionnaire (PHQ-9) and the Self-Reporting Questionnaire (SRQ-20) to assess maternal mental health. RESULTS: Effect estimates indicated a pattern of null findings for the impact of the intervention on child cognitive development. However, the intervention had an effect on caregiver psychological distress (PHQ-9, ES = -0.17 [CI: -1.95, 0.05] and SRQ-20, ES = -0.30 [CI: -2.41, -0.19]), but not anxiety. The annual cost per mother-child pair to replicate the Thula Sana intervention in 2019 was estimated at ZAR13,365 ($780). CONCLUSION: In a socio-economically deprived peri-urban settlement in South Africa, a home visiting intervention, delivered by community workers to mothers in pregnancy and the first six postpartum months, had no overall effect on child cognitive development at 13 years of age. However, those caregivers who were part of the original intervention showed lasting improvements in depressed mood. Despite the fact that there was no intervention effect on long-term child outcomes, the improvements in maternal mood are important

Child development · Cognition · Cognitive development · Developmental psychology · Intervention (counseling) · Mood · Psychiatry · Randomized controlled trial · Term (time) · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Infant Development and Preterm Care · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Psychology

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