Early Relational Health Among Children Born Preterm and With Functional Impairments Enrolled in Early Head Start

Early head start (EHS) supports early relational health (ERH) among low-income parent-child dyads through center-based and home-visiting services. Children born preterm and/or with functional impairments may benefit from these services due to unique developmental needs. We aimed to 1) describe child, family, and program characteristics among children born preterm or with functional impairment enrolled in EHS; 2) investigate associations between prematurity and functional impairment and ERH outcomes; 3) explore whether EHS programming modifies these associations.

We used data from the 2018 EHS Family and Child Experiences Study. We calculated descriptive characteristics of children stratified by prematurity and functional impairment. We used regression to study associations between these conditions and ERH while accounting for child and family characteristics and investigated interactions between these conditions and EHS program characteristics.

Our sample included 2084 children (10% preterm, 9% with ≥1 functional impairment). Compared to full-term children, preterm children had lower social-emotional competence (B -1.07, SE 0.40). Compared to those without, children with ≥1 functional impairment had lower parent-child relationship closeness (B -1.79, SE 0.69) and child social-emotional competence (B -1.81, SE 0.52), and higher parent-child relationship conflict (B 1.76, SE 0.65) and child social-emotional problem behaviors (B 2.31, SE 0.93). Communication/language skills were lower among preterm children receiving center-based compared to home-based EHS services (B -3.65, SE 1.76).

Medical/developmental conditions affect ERH among low-income dyads. Future studies should examine whether community-based services like EHS adequately support ERH among this population.