Abstract
BackgroundThree to seven percent of pre-schoolers have developmental problems or child psychiatric disorders. Randomized controlled trials (RCTs) indicate that interventions in early childhood education and care (ECEC) improve long-term outcomes of children from disadvantaged backgrounds. It is unknown if such effects generalize beyond the well-structured context of RCTs and to children who may not have a disadvantaged background but have developmental problems or psychiatric disorders.MethodsWe used data from the population-based Norwegian Mother, Father and Child Cohort Study, recruiting pregnant women from 1999 to 2009, with child follow-up from ages 6, 18, and 36 months to ages 5, 7, and 8 years. This sub-study included 2499 children with developmental problems or psychiatric disorders at age five. We investigated the effects of special educational assistance at age five on mother-reported internalizing, externalizing, and communication problems at age eight. We analysed bias due to treatment by indication with directed acyclic graphs, adjusted for treatment predictors to reduce bias, and estimated effects in different patient groups and outcome domains with a hierarchical Bayesian model.ResultsIn the adjusted analysis, pre-schoolers who received special educational assistance had on average by 0.1 (0.04–0.16) standardised mean deviation fewer psycho-social difficulties in elementary school.ConclusionIn a sample of children from mostly higher socioeconomic backgrounds we estimate a positive effects of special educational assistance during the transition from preschool to the school years. It may therefore be considered as an intervention for pre-schoolers with developmental or behaviour problems. More research with improved measurements of treatment and outcomes is needed to solidify the findings and identify success factors for the implementation of special educational assistance in ECEC.
Highlights
Between three and seven percent of pre-schoolers have developmental problems or child psychiatric disorders [1, 2], which are an important risk factor for mentalBiele et al Child and Adolescent Psychiatry and Mental Health (2022) 16:14 disorders in adulthood [3]
Interventions in early childhood education and care (ECEC) can be especially effective because, in contrast to parental training programs, their implementation relies less on parents’ abilities or motivation, and on average 93% of three to five year old children in Organisation for Economic Co-operation and Development (OECD) countries are enrolled in ECEC [10, more than 95% or 5 year old children in Norway are in ECEC]
This study focuses on children with one or more of the following developmental or behavioural problems: Attention deficit hyperactivity disorder, language development, oppositional defiant or conduct disorder, autism spectrum disorder and learning disabilities
Summary
Between three and seven percent of pre-schoolers have developmental problems or child psychiatric disorders [1, 2], which are an important risk factor for mentalBiele et al Child and Adolescent Psychiatry and Mental Health (2022) 16:14 disorders in adulthood [3]. Randomized controlled trials (RCTs) reported clear effects of early interventions in ECEC for a horizon of up to 9 months, for instance for language problems [11], children with ADHD or autism [12], and for teacher classroom management programs [13]. Randomized controlled trials (RCTs) indicate that interventions in early childhood education and care (ECEC) improve long-term outcomes of children from disadvantaged backgrounds. It is unknown if such effects generalize beyond the well-structured context of RCTs and to children who may not have a disadvantaged background but have developmental problems or psychiatric disorders
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