Early Head Start—Home-based option Meets HHS Criteria

Model effectiveness research report last updated: 2024

Effects shown in research

Child development and school readiness

Findings rated high

Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
CBCL Aggressive behavior
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = -0.09 Not statistically significant, p ≥ 0.05
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Negative value favors the intervention.
FACES positive approaches to learning
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.18 Statistically significant, p < 0.01
FACES Social Behavior Problems
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = -0.13 Statistically significant, p < 0.05
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Negative value favors the intervention.
Child has an individualized education plan
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = -0.02 Not statistically significant, p ≥ 0.05
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Negative value favors the intervention.
Engagement during play
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.04 Not statistically significant, p ≥ 0.05
English receptive vocabulary (PPVT)
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.05 Not statistically significant, p ≥ 0.05
Leiter attention sustained
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.09 Not statistically significant, p ≥ 0.05
Negativity toward parent during play
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = -0.01 Not statistically significant, p ≥ 0.05
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Negative value favors the intervention.
Observed attention
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.07 Not statistically significant, p ≥ 0.05
Observed Leiter emotion regulation
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.02 Not statistically significant, p ≥ 0.05
Speech problems
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = -0.10 Not statistically significant, p ≥ 0.05
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Negative value favors the intervention.
Woodcock Johnson Applied Problems
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.08 Not statistically significant, p ≥ 0.05
Woodcock Johnson Letter-Word identification (English)
FavorableUnfavorable or ambiguousNo Effect
Age 5 Home-based program approach Not reported Not reported Not reported Study reported = 0.03 Not statistically significant, p ≥ 0.05
Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Brief Infant Toddler Social and Emotional Assessment (BITSEA), Total competence score

FavorableUnfavorable or ambiguousNo Effect

15-month follow-up

EHS-HBO vs. Resource referral RCT (MIHOPE); 2012-2014, full sample

468 children Not reported Not reported Difference = 0.30 Not available

Not statistically significant, p ≥ 0.05

The statistical significance after the author's adjustment for multiple comparisons is reported.

Received any early intervention services (%)

FavorableUnfavorable or ambiguousNo Effect

15-month follow-up

EHS-HBO vs. Resource referral RCT (MIHOPE); 2012-2014, full sample

463 mothers Not reported Not reported Difference = 0.01 Study reported = 0.06

Not statistically significant, p ≥ 0.05

The statistical significance after the author's adjustment for multiple comparisons is reported.

Use of nonparental child care

FavorableUnfavorable or ambiguousNo Effect

15-month follow-up

EHS-HBO vs. Resource referral RCT (MIHOPE); 2012-2014, full sample

455 children Not reported Not reported Difference = 0.07 Study reported = 0.18

Not statistically significant, p ≥ 0.05

The statistical significance after the author's adjustment for multiple comparisons is reported.

Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (fixed effect random slope analysis)

FavorableUnfavorable or ambiguousNo Effect

15 months old

EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample

470 children Not reported Not reported Not reported Study reported = -0.01

Not statistically significant, p= 0.88

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Negative effect is favorable to the intervention.

Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (restricted maximum likelihood analysis)

FavorableUnfavorable or ambiguousNo Effect

15 months old

EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample

470 children Not reported Not reported Not reported Study reported = -0.01

Not statistically significant, p= 0.92

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Negative effect is favorable to the intervention.

Brief Infant Toddler Social and Emotional Assessment (BITSEA), total problem score (split-sample analysis)

FavorableUnfavorable or ambiguousNo Effect

15 months old

EHS-HBO vs. Resource referral RCT (MIHOPE), 2012-2014, United States, full sample

470 children Not reported Not reported Difference = -0.10 Study reported = -0.10

Not statistically significant, p= 0.27

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Negative effect is favorable to the intervention.

Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
Child aggression (24 months)
FavorableUnfavorable or ambiguousNo Effect
24 months one site from larger EHS evaluation Not reported Not reported coeff = 0.06 Not available Not statistically significant, p ≥ 0.05
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Higher score equals unfavorable; Note that this outcome controls for physical punishment at 24 months
Child aggression (36 months)
FavorableUnfavorable or ambiguousNo Effect
36 months one site from larger EHS evaluation Not reported Not reported coeff = 0.07 Not available Not statistically significant, p ≥ 0.05
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Higher score equals unfavorable; Note that this outcome measures the incremental impact between 24 months and 36 months and also controls for aggression at 24 months)
Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
FACES aggression
FavorableUnfavorable or ambiguousNo Effect
Kindergarten entry EHS-HBO impact study 928 children Adjusted mean = 2.60 Adjusted mean = 2.70 Mean difference = -0.10 Study reported = -0.07 Not statistically significant, p ≥ 0.05
Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
CBCL – Aggression
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 966 children Adjusted mean = 10.40 Adjusted mean = 10.50 Mean difference = -0.10 Study reported = -0.01 Not statistically significant, p ≥ 0.05
Average MacArthur CDI – Sentence Complexity
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 966 children Adjusted mean = 8.50 Adjusted mean = 7.80 Mean difference = 0.70 Study reported = 0.08 Not statistically significant, p ≥ 0.05
MacArthur CDI – Vocabulary Production
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 966 children Adjusted mean = 56.40 Adjusted mean = 53.50 Mean difference = 2.90 Study reported = 0.13 Not statistically significant, p ≥ 0.05
Percentage MacArthur CDI combining words
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 966 children Adjusted mean = 77.30 Adjusted mean = 75.60 Mean difference = 1.70 Study reported = 0.04 Not statistically significant, p ≥ 0.05
Percentage with sentence complexity <2
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 966 children Adjusted mean = 28.30 Adjusted mean = 30.20 Mean difference = -1.90 Study reported = -0.04 Not statistically significant, p ≥ 0.05
Percentage with vocabulary production <25
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 966 children Adjusted mean = 11.30 Adjusted mean = 11.20 Mean difference = 0.10 Study reported = 0.01 Not statistically significant, p ≥ 0.05

Findings rated moderate

Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Bayley BRS: Orientation/Engagement
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 3.90 Adjusted mean = 3.80 Mean difference = 0.00 Study reported = 3.40 Not statistically significant, p ≥ 0.05
Bayley Behavioral Rating Scale(BRS): Emotional regulation
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 4.00 Adjusted mean = 4.00 Mean difference = 0.00 Study reported = 2.10 Not statistically significant, p ≥ 0.05
Bayley Mental DevelopmentIndex(MDI)Standard Score
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 746 children Adjusted mean = 94.10 Adjusted mean = 92.80 Mean difference = 1.20 Study reported = 9.50 Not statistically significant, p ≥ 0.05
Child behavior checklist - aggressive behavior
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 746 children Adjusted mean = 11.20 Adjusted mean = 11.70 Mean difference = -0.50 Study reported = -7.80 Not statistically significant, p ≥ 0.05
Engagement of parent during parent-child puzzle challenge task
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 5.10 Adjusted mean = 5.00 Mean difference = 0.10 Study reported = 5.60 Not statistically significant, p ≥ 0.05
Engagement of parent during parent-child semistructured play
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 4.80 Adjusted mean = 4.60 Mean difference = 0.20 Study reported = 19.20 Statistically significant,
p < 0.05
Frustration during parent-child puzzle challenge task
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 2.70 Adjusted mean = 2.60 Mean difference = 0.10 Study reported = 5.90 Not statistically significant, p ≥ 0.05
Negativity toward parent during parent-child semistructured play
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 1.30 Adjusted mean = 1.30 Mean difference = 0.00 Study reported = -6.60 Not statistically significant, p ≥ 0.05
Peabody Picture Vocabulary Test (PPVT)-III Standard Score
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 746 children Adjusted mean = 84.60 Adjusted mean = 83.10 Mean difference = 1.50 Study reported = 9.10 Not statistically significant, p ≥ 0.05
Percentage with PPVT-III<85
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 746 children % = 45.60 % = 48.60 = -3.00 Study reported = -6.10 Not statistically significant, p ≥ 0.05
Percentage with MDI <85
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 746 children % = 20.50 % = 22.00 = -1.40 Study reported = -3.10 Not statistically significant, p ≥ 0.05
Persistence during parent-child puzzle challenge task
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 4.70 Adjusted mean = 4.60 Mean difference = 0.10 Study reported = 12.00 Not statistically significant, p ≥ 0.05
Sustained attention with objects during parent-child semistructured play
FavorableUnfavorable or ambiguousNo Effect
Age 3 EHS-HBO impact study 744 children Adjusted mean = 5.00 Adjusted mean = 4.90 Mean difference = 0.10 Study reported = 10.60 Not statistically significant, p ≥ 0.05
Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
BSID MDI
FavorableUnfavorable or ambiguousNo Effect
24 months EHS-HBO impact study (Utah) 161 children Not reported Not reported Not reported Not available Not statistically significant, p ≥ 0.05
BSID MDI
FavorableUnfavorable or ambiguousNo Effect
36 months EHS-HBO impact study (Utah) 161 children Not reported Not reported &beta; = 0.19 Not available Statistically significant,
p < 0.05
Attachment security
FavorableUnfavorable or ambiguousNo Effect
18 months EHS-HBO impact study (Utah) 161 children Not reported Not reported &beta; = 0.17 Not available Statistically significant,
p < 0.05
Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes

ADD/ADHD diagnosis

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

744 children Adjusted proportion = 0.13 Adjusted proportion = 0.18 Difference = -0.05 Study reported = -0.13

Not statistically significant, p ≥ 0.05

Child Behavior Checklist (CBCL): Aggressive behavior

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 5.90 Adjusted mean = 6.50 Mean difference = -0.60 Study reported = -0.11

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Anxious/depressed

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 3.20 Adjusted mean = 3.70 Mean difference = -0.50 Study reported = -0.14

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Attention problems

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 4.20 Adjusted mean = 4.60 Mean difference = 0.00 Study reported = -0.11

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Externalizing behavior

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 8.20 Adjusted mean = 9.00 Mean difference = 0.00 Study reported = -0.10

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Internalizing behavior

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 6.20 Adjusted mean = 6.80 Mean difference = -0.60 Study reported = -0.11

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Rule-breaking behavior

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 2.30 Adjusted mean = 2.50 Mean difference = -0.20 Study reported = -0.08

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Social problems

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 2.80 Adjusted mean = 3.10 Mean difference = -0.30 Study reported = -0.11

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Somatic complaints

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 1.10 Adjusted mean = 1.20 Mean difference = -0.10 Study reported = -0.07

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Thought problems

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 2.20 Adjusted mean = 2.40 Mean difference = -0.20 Study reported = -0.08

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Child Behavior Checklist (CBCL): Withdrawn/depressed

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted mean = 1.90 Adjusted mean = 1.90 Mean difference = 0.00 Study reported = -0.02

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Chronic absenteeism (%)

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

737 children Adjusted proportion = 0.11 Adjusted proportion = 0.09 Difference = 0.02 Study reported = 0.06

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Early Childhood Longitudinal Studies - Kindergarten Self Description Questionnaire (ECLS-K SDQ): Anger/distractibility

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

709 children Adjusted mean = 2.20 Adjusted mean = 2.10 Mean difference = 0.10 Study reported = 0.04

Not statistically significant, p ≥ 0.05

Early Childhood Longitudinal Studies - Kindergarten Self Description Questionnaire (ECLS-K SDQ): Peer relations

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

707 children Adjusted mean = 3.10 Adjusted mean = 3.20 Mean difference = 0.00 Study reported = -0.09

Not statistically significant, p ≥ 0.05

Early Childhood Longitudinal Studies - Kindergarten Self Description Questionnaire (ECLS-K SDQ): Sad/lonely/anxious

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

709 children Adjusted mean = 2.30 Adjusted mean = 2.30 Mean difference = 0.00 Study reported = 0.00

Not statistically significant, p ≥ 0.05

Individualized Education Plan (IEP)

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted proportion = 0.16 Adjusted proportion = 0.15 Difference = 0.02 Study reported = 0.04

Not statistically significant, p ≥ 0.05

Panel Study of Income Dynamics - Child Development Supplement, Wave 2 (PSID-CDS2): Bullying scale

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

705 children Adjusted mean = 6.80 Adjusted mean = 7.00 Mean difference = -0.20 Study reported = -0.06

Not statistically significant, p ≥ 0.05

Retention (%)

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

747 children Adjusted proportion = 0.13 Adjusted proportion = 0.12 Difference = 0.01 Study reported = 0.04

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Self-reported delinquent behavior

FavorableUnfavorable or ambiguousNo Effect

Grade 5

EHS-HBO vs. comparison, 1996-1998, full sample

706 children Adjusted mean = 1.60 Adjusted mean = 1.60 Mean difference = 0.00 Study reported = 0.00

Not statistically significant, p ≥ 0.05

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Negative effect is favorable to the intervention.

Early Head Start Home-based option
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
BSID Mental Development Index (MDI)standard score
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 814 children Adjusted mean = 91.60 Adjusted mean = 90.50 Mean difference = 1.10 Study reported = 0.08 Not statistically significant, p ≥ 0.05
Bayley BRS – Emotional Regulation
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 814 children Adjusted mean = 3.60 Adjusted mean = 3.60 Mean difference = 0.00 Study reported = 0.07 Not statistically significant, p ≥ 0.05
Bayley BRS – Orientation/Engagement
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 814 children Adjusted mean = 3.60 Adjusted mean = 3.60 Mean difference = 0.00 Study reported = 0.01 Not statistically significant, p ≥ 0.05
Parent-Child Structured Play: Child Engagement
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 794 children Adjusted mean = 4.30 Adjusted mean = 4.30 Mean difference = 0.00 Study reported = 0.02 Not statistically significant, p ≥ 0.05
Parent-Child Structured Play: Child Negativity Toward Parent
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 794 children Adjusted mean = 1.70 Adjusted mean = 1.70 Mean difference = 0.00 Study reported = -0.02 Not statistically significant, p ≥ 0.05
Parent-Child Structured Play: Child Sustained Attention with Objects
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 794 children Adjusted mean = 5.10 Adjusted mean = 5.00 Mean difference = 0.10 Study reported = 0.05 Not statistically significant, p ≥ 0.05
Percentage with MDI < 100
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 814 children Adjusted mean = 73.00 Adjusted mean = 71.90 Mean difference = 1.10 Study reported = 0.03 Not statistically significant, p ≥ 0.05
Percentage with MDI < 85
FavorableUnfavorable or ambiguousNo Effect
Age 2 EHS-HBO impact study 814 children Adjusted mean = 31.50 Adjusted mean = 32.50 Mean difference = -1.00 Study reported = -0.02 Not statistically significant, p ≥ 0.05
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