anaua Healthy Parents Healthy Babies

anaua Healthy Parents Healthy Babies
Healthy Parents
Healthy Babies
Report by the
National Council of Welfare
Summer 1997
anaua
liii
HEALTHY PARENTS HEALTHY BABIES
Report
National
Council
Summer
by the
of Welfare
1997
Copies of
this
National
publication
613
K1A
Parents
Cat
No
0J9
957-2963
957-0680
disponible
Minister
from
1010 Somerset Street West
FAX 613
Egalement
obtained
Council of Welfare
2nd Floor
Ottawa
may be
en francais sous
en sante
of Public
H68-42/1997E
ISBN 0-662-25790-1
le titre
bØbØs en Sante
Works
and Government
Services
Canada
1997
TABLE OF CONTENTS
INTRODUCTION
PRENATAL CARE
II
THE
FIRST
YEAR OF
LIFE
19
CONCLUSION
33
FOOTNOTES
37
INTRODUCTION
the
at
getting
root
with problems
the
the
in
Experts
causes
The Canadian
which
economic
types
them
put
of
should
vocal
be trying
to
recent
in
Rather than
families
facing
them
prevent
childhood
and
to
by governments
Our
sister
about
years
deal
to
waiting
from arising
in
We
continuing
to
need
rely
to
Canada
children
has
begun
about
dramatic
healthy
the criminal
factors
underlying
Crime
development
in
in
justice
in
the
is
social
difference
to
Human
families
Resources
diverse
as
as part of
as
larger
life
Council
targeted
and strong
to
promoting
is
the welfare
communities
people
young
of young
rather
We
says the Council
system
children
broad
or have described
children
Prevention
that
and the
children
characteristics
young
start
children
lead
that
measure
to
problems
National
social
through
begin investing
the
written
can make
that
the best possible
the
upon and spend on
addressing
have
articles
scholarly
their
Survey of Children and Youth sponsored by
group
advisory
and
of parents
researchers
mothers and behavioral
strategy of crime prevention
children
other
numerous
published
and well-being
interventions
Statistics
give
has
sometimes called the determinants of health
Longitudinal
Canada
Research
the health
Many
forces
care for expectant
prenatal
begin
we
argue
to
risk
at
early
National
Development
to
of problems
for Advanced
contribute
or demographic
The
effort
they
Institute
on the factors which
specific
fact
become more
have
welfare
instance
first
factors
child
of the host
the
after
of
field
than
need
and adults toward
criminality
The same
Forum on Health
term investment
as
natural
The
issues
facing
This
life
The
the report
resource
representing
children
first
part
at
Parents
Healthy
and parents
at
examines concerns
of the
report
needs
future
the
the
children
Canada
Council of Welfare
National
report
says
in
through
directed
Spending
of Healthy
publication
came
orientation
is
Babies
different
discusses
and
to
their
published
should
parents
invest in
its
of
report
children
the
be viewed
and
to
National
long
as
view children
of the country
proud
before
recently
to
add
its
the first of several
stages
to
support
all
these
reports that
efforts
will
with
focus
the
on key
of life
and during
pregnancy
low birth weight
and during
the first year
and the many problems
of
associated
-2-
with
The second
it
affecting
The emphasis
at
these
The
of
healthy
the
report
is
on
or other countries
in their
families facing
issues
throughout
in Canada
stages
with
National
normal
would
lives
of the
many
care
described
in
poverty
can
all
its
As one
forward
the
school
of
substantial
that
proved
more
Obviously
whole
as
prevention
by one program
directly
for society
or
form of
the
in
work force and
productive
assist
to
of problems
these kinds
policy
families helped
be
families
facing
developed
to
behaviour
preventing
social
savings
drop-outs
have
were
programs
or dysfunctional
Canadian
in
thousands
mean
also
of these
1994
came
to
most important
Many
hierarchy
equitable
on
the
less
family
us that
to
must extend
prevention
as
damage caused by poverty
society
but
well
the programs
beyond
are linked
to
poverty
they do not eliminate
Specific
the need to
fight
outcomes
more
forms
put
found
place
it Virtually
all
the other risk
among
disproportionately
having an
to
isolated
or impaired
and lacking
live
poor
access
to
the
factors that
make
bad
children
mother
being
services
that
rotten
health
abused
would
in
and
infancy
or neglected
not
the
against
protect
conditions.3
discussion
paper
endorsed
similar conclusion
determinant
show
studies
paper said
distribution
health
clear
So many of our problems
malnutrition
decent
having
is
it
the
limit
expert
also
are
childhood
spend
time
in this report
interventions
Health
would
costs fewer
At the same
effects
issues
and crime
violence
likely
of
all
firmly believes
step
lower health
not
Council of Welfare
major
Prevention
but
which
the most serious problems
addressing
of poor health
be
another
and related
development
interventions
risks
from arising would
the
in
Many
lives
than
higher
improve
child
and children
parents
successful
deals
part
of
care.4
it
described
and
provincial
income
and
territorial
social
Ministers
as
the
income
and
status
of
single
health
that
As
of wealth
when
by federal
health
status
well
societies
have
the
improves
healthiest
which
at
are
each
step up
reasonably
populations
the
prosperous
regardless
of the
social
and have
amount
an
they
-3-
PRENATAL CARE
The
low
are
wide-ranging
of children
lives
Low
birth
research
gestational
The
day
And
according
to
Low
the
Low
behavioral
for
leading
for each
of
can
therapy
of disabled
is
cause
problems many
of which
Demographic
status
has
baby
the
with
level
improve
babies
of two
age
born
are
for their
low
by
birth
and childhood
in infancy
be $500
to
at
pounds
are small
they
been estimated
$1000
to
$200000
be
could
creating
teaching
need additional
each
associated
her
or
grams
says that
of illness
to
range of
birth can
can be explained
help
of an array of demographic
interact
2500
disabilities
equipment
often
characteristics
socio-economic
cause
wide
but
future
Health
deaths
word
of the
an equally
of
prevention
and Youth.6
long-term
children
the result
baby
weight
specialized
than
less
infant
underlying
low
the
into
the
is
sense
strict
preterm birth or because
75 percent
life
begin well before
of Child
Institute
reasons
the
of
requires
that
years
weigh
Council on Children
weight
birth weight
who
low birth weight
of caring
speech
Families
also
is
Canadian
birth
physiotherapy
services
for one of two
of caring
the cost
many
by the Canadian
birth weight
cost
interventions
babies
to
Approximately
age.5
Low
weight
refers
review
with low birth weight
done
stage
in
low birth weight
families for
their
birth weight
medical condition
is
Preventing
Properly
and
the prenatal
concern during
birth weight
and strategies
programs
the
greatest health
Low
birth weight
causes
its
single
and
specialists
in
needs
multiple
order
to
other
costly
cope
medical conditions
factors
for
and
other.7
with
of education
birth weight
age
at
include
conception
the
mothers
marital
status
and race
Premature labour
weight
heads the
Other conditions
by pregnancy
list
of medical
include
and infection
febrile
complications
illnesses
associated
high blood
with low birth
pressure
induced
-4-
Finally there
smoking
Of
Poverty
potent
of
study
differences
all
were
shown
measures
of behavioral
alcohol
nutrition
contribute
that
born
babies
weight
The outcomes
host
the forces
and babies
neighbourhoods
of the
stress
the
birth
in
are
and
born
in
1986
in
infant
the
in
to
access
low
birth
Canadas
mortality
poorest
much worse
to
variables
prenatal
weight
25
between
and
care
social
is
poverty
largest
such
birth weight
affecting
born
babies
support
one of the most
found
cities
as
in
significant
the
richest
neighbourhoods.8
for babies
born
in
the poorest
neighbourhoods
under
all
in Table
TABLE
INCOME
UNFAVOURABLE BIRTH OUTCOMES BY NEIGHBOURHOOD
Ratio
Richest
Neighbourhoods
Neighbourhoods
2500
grams
6.9%
4.9%
1.41
Birth weight
under
1500
grams
1.16%
0.82%
1.41
7.4%
5.7%
1.32
12.1%
8.0%
1.52
9.9%
6.0%
1.66
than
births
37 weeks
Small for gestational
Deaths
in
The
times
higher
appeared
birth
in
to
Richest
under
less
of
Poorest
Birth weight
Premature
at
Poorest
1986
first
rate
of
year
of low
than
the
age
the
results
life
was
birth weight
births
of
percent
rate
for very
4.9
low
birth
in
6.9
percent
in
the
richest
neighbourhoods
weight
babies
the poorest
babies
weighing
neighbourhoods
The same
less
than
1500
1.41
pattern
grams
-5-
The
in
percent
were
the
small
pregnancy
eight
of
rate
Even more
richest
for their
and
percent
gestational
birth
weight
the
richest
in
1.66
or
12.1
was
the
in
than
higher
the
takes
that
year
infant
the percentage
account
of
life
death
the
9.9
of
six
who
term of the
and only
neighbourhoods
was
rate
of babies
both
of
the poorest
in
percent
first
in
and 5.7
neighbourhoods
poorest
the difference
measure
rate
the
in
percent
was
revealing
of deaths
times
7.4
age
The
Finally the percentage
neighbourhoods
was
births
premature
percent
in
the poorest
percent
in
the
richest
neighbourhoods
Based on
children
Huge
in
rate
mortality
consequences
Poverty
Welfares
headed
often
in
poor
housing
but
it
as
is
is
hand
1995 reported
was
with
with
to
cause
restriction
found
in
said.9
study
were
also
its
children
The
demonstrates
than
the
infant
of higher
persistence
the
life-and-death
single
The
poverty
rate
under
children
adds
poorly
of
parenthood
The
National
Council
of
57.2
percent
18
of
for families
For single-parent
mothers
83 percent.1
poor education
suspected
to
Development
clearly
an overall
an astounding
belong
intrauterine growth
most commonly
in
the
disability
Canada 10
mothers under 65 with
rate
combined
Undernourishment
known
Profile
the poverty
in
of death
poor and rich neighbourhoods
commitment
societys
neighbourhoods
poor
hand
in
greater risk
and adolescence
childhood
rates
at
problems of poor
the health
that
appears
these children
Council on Social
inequality
goes
by single-parent
Poverty
live
of income
Poverty
25
under
in
rates
of
it
and 1991
for 1971
no starker measure
says the Canadian
mortality
place
infant mortality
studies done
companion
is
the
to
Canada
infancy
throughout
gaps between
There
infant
problems
for
available
birth and continue
begin before
and other health
found
data currently
to
the
likelihood
functioning
poor
fetal
condition
underdeveloped
family
growth
is
that
during
and
woman
be
countries
smoke
undernourished
pregnancy
not well understood
will
condition
by professionals
-6-
Poverty
family
Also
and the greater
planning
including
the
disrupt
is
health
fall
may
delicate
bodys
care
be too
cracks
the
through
or
providers
showed
weight
the
rate
that
teenage
parenthood
reasons
weight
to
with
among
stress
can
12
fmding
medical
the
birth weight
excessive
difficulty
approaching
low
pregnancy
They may
system
of
providers
transportation
services
or
care
from 8.2
One
to
percent
result
of the
from
5.3
The medical
component
identification
weighed
of
to
linked
is
twice
Over
ten-year
to
have
by 21
low birth
the
period
fell
One
birth weight
to
as likely
group and
educated
low
percent
birth
among
1983
to
In
were
of poverty
babies
at
social
program
risks
programs
that
the
risk
and
that
in
to
more
prevent
reduced the
some groups
program
women
situations
poor education
and
and
for psychosocial
reasons
1971
of the
identifiable
in
low birth weight
in
most successful
biological
patient education
women
education
most effective
of education
levels
were
Quebec
the poorly
percent
The program was
with low
in
for biological
less
in
which often occur
to
are thought
and
and
education.3
pregnancies
in France
program
4.4 percent
Women
may have
proxy for poverty
university
by nine percent
Labour
Preterm
national
birth weight
support poor
during
with
preterm labour
of co-ordination
mothers
educated
mothers
increased
Even
economic
lack
to
well-known
is
group with post-secondary
single
Women
care
of social
support
associated
influence
and provoke
balance
health
Poor family
strongly
may
anxiety
may be uncomfortable
due
poorly
than
baby
weight
to
is
lack
isolation
widely dispersed
Poor education
study
assault
spousal
to
of illness
likelihood
internal
barrier
is
and anxiety due
stress
maternal
that
speculation
Poverty
to
and
violence
family
there
with
associated
is
the
rates
preventing
preterm labour
countrys
birth
as 3.7
percent
low birth weight
babies
were
very
of low
rate
as low
was
greatest beneficiaries.4
consisted
of the following
for preterm
lifestyle
taught
labour
using
strategies
scoring
system
that
factors
self-management techniques
and the subtle symptoms of labour
and sensitized
-7-
the
of
education
of
risks
the
and
preterm labour
how
to
these risks
manage
and regular prenatal care
early
about
professionals
in
starting
the first trimester for at least ten
weeks
and
The
social
examinations
cervical
regular
detect
signs of preterm labour
involved
component
national
to
that
policies
encouraged
from
leave
maternity
the
week
34th
of
pregnancy
women
protecting
continuous
require
hours of work
home
Smoking
independent of other
low
birth weight
survey
that
cigarette
countries
is
direct and causal
of
the
medical
by
in
is
more
age
as
40
than
labour
needed
that
the
promote
to
of
effect
lifestyle
changes
on birth weight
smoking
the relationship
that
accepted
in
French and English
biggest
risk
pre-pregnancy
estimated
from
for low
were
weight
among low-income
study
factor
between
smoking
that
incomes of more than
one
year
in
1970
is
and
1984 suggested
three
smokes
in
developed
and third.6
including
$40000
to
birth weight
second
Canadians
incomes under $20000
with
more
commuting
that
15
the
far
One Canadian
living in households
is
it
literature
prevalent
households with
services
and
from jobs
media and
documented
well
factors
was
the
social
Poor nutrition and low
of child-bearing
women
risk
smoking
Smoking
age living
been
has
It
90 minutes
and hard physical
through
and
nursing
than
and exertion
strain
physical
more
standing
week
education
public
from excessive
low-income
women
compared
women
of child-bearing
to
one
in
four
-8-
1995
Smoke
Fetal
blood
the
to
low
between
the
growth
150
200
grams
Other
smaller
lower uterine
the
associated
members
also has
continue
enormous
The
hand smoke are
3.3
Up
to
children
who
1.5
two
is
to
the
live
is
causal
effusion
for life
behaviours
serious problem
risk
that
atopy
children
increased
if
to
modify
to
people
exposed
among
and
will
when
the
pregnancy
are
The
risk of
spontaneous abortion
premature
is
1.4
their
or
of the placenta
of
separation
four
times
infant
than
greater
second
to
20 cigarettes
than
it
for respiratory
is
for
illness
smoke
second-hand
to
of asthma
cough
illness
respiratory
are exposed
of hospitalization
exposed
is
smoke more
to
and other family
parents
who
old
caretakers
and severity
sudden
related
for non-smokers.2
of infants
second-hand
suffer from
the
smoked
cigarettes
implantation
total
months
risk
children
allergies
include
or
infants
their
to
reduces
membranes
of
three
The
of
mothers
than
abnormal
of illness
risk
circulation
attacks
and there
smoke
Second-hand
and wheeze
phlegm
death
smoke
syndrome
reduced lung
and
middle ear
ear
about the
enough
the
with the frequency
evidence
try
of illness
times greater
partial
on
the
smoke
throughout
non-smoking
of hospitalization
Infants up to
for children
fluid in the middle
The
reach
greater
is
the
months
effects
smoke-free environments
in
relationship
also increases
function
age of 18
times
Asthma
times the risk
more
the
smoking
rupture
cause
leading
to
previa
placenta
adverse
and pneumonia
day
placenta
abruptio
such as bronchitis
at
maternal
and premature
smoke
to
with
1.5
impairs
to
fetus.19
born
those
of smoking
be significantly
to
women who smoke
to
1.3 to
is
function
segment
normally implanted placenta
Smoking
than
been shown
and Second-Hand
risk
tobacco
in
are dose related
born
Babies
the
which
nicotine
has
of the
on birth weight
Smoke
describes
monoxide
smoke
restriction
women who smoke
problems
fetal
Tobacco
of
to
Carbon
passive
on average
diminished lung
miscarriage
in
growth
restriction.20
birth for
premature
Even
of smoking
greater
to
and placenta
uterus
through
effects
Effects
by exposure
restricted
the fetus
birth weight
The
can be
the
to
The
publication
and Postpartum Periods graphically
growth
of oxygen
supply
Canada
the Prenatal
in
fetus.8
Health
they
damage caused by smoking
However
are
of
intervention
limited
makes
programs
effectiveness
it
have
Given
one
of the
limitations
the
most obvious
they
powerfully
do not
addictive
-.9-
of nicotine
qualities
most effective
the
Health
recent
Canada
and postpartum
recommended
smoking
the
to
provide
recommended
are
reduction
that
current
that
can be tailored
meet
to
and
family-centred
linked
with
women
The
be modified.23
strategies
In large population
of options
at
targeted
programs
women smoke
why
reasons
underlying
variety
that
programs
of tobacco
survey
period
addressing
enough
flexible
those
are
an
womans needs
individual
prenatal
interventions
local
and
report
be
non
be
there should
doctors
the
should
Programs
centres
in
anti-smoking
groups
Other recommendations
may
not
attend
It
or drug
is
use
if
half the
months
other
of giving
to
the
risk
in
and up
to
to
need
attract
more
women who
pregnant
sensitive
smoke-free
at
likely
encourage
own
to
are
still
pregnant
in
in
public
women
get young
in
women
mothers
to
their
roles
such
places
as
started
women
smoking
drinking
behaviours.24
that
more
smoking again within
three
smoking noted
smoking again
rather than
to
beyond
well
their
the
stop
started
pregnancy
of the
extends
changing
engaged
on the short-term
focus
to
succeed
to
during
70 percent
of smoking
problem
friends
or
would be
of their
Women
factors
are less
quit on their
possibility
health
pregnancy
pregnancies
of programs
the
that
members
suggested
Nutrition
other
women
family
birth
One
of quitting
during
to
be
to
and promoting
relapse
remember
that
women who
researchers
dangers
to
important
One review
to
methods
outreach
counsellors
training
on postpartum
Studies have shown
The
using
halls
bingo
than
classes
prenatal
research
conducting
include
link the
the
within
long-term
dangers
year
benefits
of smoking
with
babies
risk
for nutritional
They may weigh
too
They may be heavy
They may be under 20
little
deficiency
or too
smokers
years
old
or
during
much
pregnancy
often
are subject
They may have low weight
drinkers
They may be
They
may have
vegetarians
Or
gain
had multiple
they
may
live
poverty.26
Two
Diet
well-known
Dispensary
and long-running
in operation
since
nutritional
1963
and
the
supplementation
Special
programs are the Montreal
Supplementary
Food Program
for
10
Women
The Montreal
because
baby
of
Diet
Women
are also referred
In
care
the
Montreal
in
outcomes
The
overall
hands-on role of the
The
cost
an urban
litre
visits
in
States
operation
psychiatric
or
history
and
and home
and
health
nutritional
counselling
visits
as
required
housing and health
support
of 5.6 percent
rate
rate
comparable
the
first
low
birth weight
or under
had
was
birth weight
was highest
The
stress
child
authors
50 percent
of the
study
for
and rehabilitation on pregnancy
but without
previously
the case
in
One
evaluated
well
lower than
of mothers
study
any prenatal
in
the previous
who had been
noted
the
classified
importance
of the
in 1990 was
milk every
day
estimated
woman
for 22
in
at
woman
served
rural
$357 for each pregnant
vitamin
weeks
The
setting
included
figures
and mineral
tablets
the
cost
every day
and
dietician.29
low-income
1990
of
rate
been
has
nutrition assessment
women who
and $383 for each
of whole
evaluation
during
low birth weight
dietician.28
Using these two
cost
United
delivering
for social
resources
program
of individual
of the program
setting
with
in
Dispensary
the effects
either as undernourished
year
of
risk
milk and eggs
low birth weight
reported
Diet
The average
pregnancy
17000
of
community
group of low-income
intervention
the
the
surrounding population.27
example measured
of one
at
depression
supplements
other
to
the dispensary
1987
The
six
in
one-on-one dietary assessment
include
and food
women
targets
violence
family
Services
of vitamins
provision
Dispensary
poverty
nutritional problems
in
WIC
as
1974
since
to
commonly known
and Children
Infants
If
pregnant
the
described
year
of institutional
of
the study
averages
women
program
the
Quebec
would
amount
that
would
of low
rate
conservative
as
life
cut
in
estimated
and non-institutional care
about
fir
have
of providing
been
birth weight
assumption
to
the cost
$5.2
the
in
babies
savings
million
the first year
the
services
order
to
of $6.1
million
by 50 percent
on caring
However
the
of life would
some
which
for the
babies
savings
on the
amount
to
about
$45 million
The
country
in
success
assisting
of
the
Montreal
high-risk
Diet
mothers
Dispensary
was
and other
recognized
by
the
initiatives
federal
scattered
government
across
the
with
the
11
creation
of
Canada
the
for community-based
resources
for families with
years
for
federal
It
also
Canada
the
Prenatal
in poverty
living
and
Aboriginal
be building
Dispensary
The
eggs
cereal
administered
the
in
by the
to
states
such
Target
Futures
programs
funding over
in
called
initiative
collective
social
or
counselling
as
kitchens
groups for the program
women who
use
drugs
States
by outside
the
or
supports
community
women
include
off-reserve
alcohol
Prenatal
The
and delivered
program
Some
locally
the
fact
it
appears
Montreal
Nutrition
Diet
Program
food supplements dairy products
provides
food vouchers or home
services
but
researchers
In
programs
by the Canada
assisted
through
health
nutrition
earlier
the United
formula
referral
related
nutritional
not yet been evaluated
of
successes
program
and baby
and
counselling
delivery individual
funded by the federal
is
states
also provide
funds
juice
nutritional
government
to
supplement
from Washington.3
funds
Over
of
on
WIC
provides
and refugees
one of the groups being
is
Brighter
$100 million
and
Program
women
other
pregnant
whole has
as
an additional
supplements
exchanges
teens
women
Inuit
Nutrition
with
or toy
pregnant
The program
to
through
The program
for Children
activities
include
food-buying clubs
gardens
1994
July
delivered
are
announced
the form of food
take
may
might
in
Program
that
projects
budget speech
Community Action Program
Help
Nutrition
children
The 1997
three
Prenatal
9000
children
the years
clinics
WIC
serving
grew
more
from
than
six
for benefits under the
are eligible
handful
of locally
million
people
run programs
Another
programs
guidelines
the United
States
national
to
three
million
but do not
receive
network
women
and
any because
of limited funding
Five leading
and
its
Budget
impact
in
evaluations
Disease
that
1991
business
conducted
Control
made
they
for
executives
an
special pitch
increase
for the
and National
in
in
U.S
Bureau
federal
to
the
House
financial
Department
of
of Economic
were
of Representives
support.3
Agriculture
Research
so impressed with the program
They
Committee
told
lawmakers
and studies by the
showed
the
on the
following
Centers
results
that
for
12
the
in
Participants
had
program
reduced
low
of
risk
and
birth weight
infant
mortality
Children
memory
in the
The program
the
The
up
to
$3
ensure
executives
medical
in
triple-A rated
that
it
Like
Investments
to
by the
WIC
one
is
and the
of very
rate
1990
expenditures
for the babies
The
future
U.S
but
dollar
of
most
the
seek
to
anemia which
affects
in
WIC
reliable
adequate
care
prenatal
is
the
under
health-care
the
ways
and
care
prenatal
disease
against
invested
added
They
Alcohol
However
pregnancy
devastating
is
effects
mother
and
leading
cause
camiot
not
WIC
saves
of
equivalent
invest
can
government
during
program
to
survive
known
if
their
was
first
of mental retardation
eliminated
in
Canada
the
from
is
of
life
the
during
its
The
early
amounts
fetus
the
in
the
system
babies
that
25
by
cost of the program
was
million in health-related
alone.33
of
level
Federal
concluded
and
birth weight
stages
of reform in 1996
large
Alcohol reaches
efficiently
year
safe
is
in
low
of
rate
Intervention
studies
money saved $853
that
the fmal round
consumed
alcohol
other
by 44 percent
uncertain
there
Early
entitled
17
reduced the
estimated but
helped
on the fetus
be
WIC
Office
reviewed
Savings
low birth weight babies
WIC
managed
It
General Accounting
through
the agency
of the
it
U.S
women
pregnant
in
the
costs
digit
program
childhood
in
likely
are immunized
every
Can Produce
$296 million
in
that
the
and
vocabulary
learn
to
much more
children
their
also noted
investment
are
major drop
to
ability
the program
or hospital
1992 study
percent
span and
outside
better
32
resources
benefits
in
children
comparable
had
childhood
early
been linked
has
attention
Women
to
than
scores
in
program
alcohol
reform
of welfare
more
or less
intact
consumption
during
during
pregnancy
can
have
same
concentration
as
in the
Fetal
one possible outcome
alcohol
syndrome
the
13
Symptoms
alcohol
fetal
Full-fledged
include
retarded
severely
FAS
syndrome
one extreme on
is
central
growth
nervous
continuum
of
symptoms
and
system abnormalities
facial
anomalies
Foetal
alcohol
behavioral
effects
are
speech
often
the
of
children
wide array
have
difficulty
sleeping
and
often
disabilities
learning
maturation
are
dental
impediments
found
problems
vision
problems
among FAS
occurs
problems
and are
dyslexic
and
genital-
bifida
hip
children
with
children
in
and
of physical
common than in normal babies
An increased incidence
of spina
skeletal
of other health
host
FAS
severe
occur
and delayed
dislocation
Among
have
suffer from
may
problems are more
heart
problems
urinary
One-fifth
..
Many
hyperactive
Congenital
children
syndrome
fetal
alcohol
and
difficulties
hearing
syndrome
erratic
behaviour
Fetal alcohol
to
diagnose
milieu
problems
Incorrect
There
government
estimates
the
than
and
alcohol
general
and
inability
can
effects
alcohol
fetal
be neurological
to
recognize
programs
the
for
issued
in
during
All these
efforts
that
In
women
to
Prenatal
1994
catered
at
to
risk
result
the
syndrome
alcohol
and are
syndrome
is
expressed
to
function
in
child
as
difficult
hyperactivity
normally in
being
in
Aboriginal
October
their
1996
certain
social
misclassified
as
years
of
much
complex
social
surveyed
high-risk
and
programs
also
economic
242 prenatal
clients
higher
the first line of defence
federal
for every
Very
at
health
adolescents
is
should
their
high
sensitive
for pregnant
promotion
singles
prevention
be directed
partners
and emotional
wide array of prenatal programs
Canada
one and two
be family-centred and culturally
often have
needs
that
is
The
effects
communities.36
City
said preventive
child-bearing
should
between
at
communities
and Inner
they
or fetal alcohol
syndrome
and other groups agree
Care
Health
of fetal
incidence
some
and
before
Access
Canada
incidence
Aboriginal
joint statement
women
data on fetal alcohol
However
have been reported
community
in
of fetal
diagnosis
Health care
at
disabilities
learning
no national
is
thousand births
In
tends
severe
disruptive
socially
rates
are less
The damage
correctly
behavioral
FAE
effects
and
and
the
should
needs.37
women
programs
low-income
exist
All
women
14
welfare
multicultural
women
and
recipients
populations
homes community
centres
The programs
were
operated
churches
schools
providing
information
during
community
services
training specific
to
were
their
Vancouvers
multicultural
or
baby
women
during
and
American
are
that
agencies
by health
care
Evaluation
Babies
occur
that
risk
to
cover
programs
While
programs
most were
travel
and
social
the
large
take
to
required
widely
an example
of
of having
low birth weight
The program
drug misuse
or
at
is
and funds
postnatal
professionals
program
women
for
care
support
practices varied
Possible
program
child
provided
and family
programs
programs
as
off-reserve
backgrounds
program
clerk
counselling
backgrounds
program
and family changes
emotional
began
in
community-based
1976
and
baby
384
served
1992
Part of the success
cultural
the physical
other
provided
by alcohol
interpreters and
lifestyle
included
and delivery
supplementation
child
outreach
Staff consists of
three
private
centres 38
objectives
nutritional
to
Healthiest
prenatal
affected
linked
healthy
of services
majority
hospitals
pregnancy
were
Programs
of
needs
and quality of life and
health
cope with
Some programs provided
costs
on labour
mothers
women
helping
The
units
the
birth outcomes
maximizing positive
the
health
public
and friendship
addressed
and support
development
skill
of
out
and innovative
holistic
Many
skills
literacy
Programs
providing
improving
low
with
co-ordinator
Counsellors
of the program
the
women
Aboriginal
About
in
visit
is
Breastfeeding
dietician two dieticians
is
the
discussed
due
to
women
at
and promoted
the lay counsellors
program
women
40 percent
pregnant
About
rest
English
to
lay counsellors
provide
nutrition
by the program
who come from
one quarter
and many of the
do not speak
home
four
of
the
the same
women
come from Asian
or
in
the
Latin
15
About
unstable
85 percent
family
of
women
the
have
Many
situations
overall
are
than
less
one-on-one
and
nutritional
free dental
of 5.7
rate
Positive
45.5 percent
cut
At
six
used
first
none
for the
percent
the
Drug
to
know
if
every
and prenatal vitamins
for needs
such
or nursing
support
and
skills
low birth weight
reported
two
weeks
with
one
approved
if
doctor
by
were
housing
clothing
immigration
and
of 5.5 percent
rate
recorded
was
There
smoked
of the
women
comparable
to
the low birth
whole
as
who
of clients
as
training
of Vancouver
City
changes
one-third
48 percent
better
nutrition
quit smoking
among
altogether
and
down
at
121
pregnant
assessment
women
18
and drugs
Of
The
other
term
problems
experienced
abuse
meetings for support
both alcohol
consuming
agencies
substance
Prior to becoming
drugs
other
to
behavioral
Of
participants
in
care
difficulties
weight
counselling
lifestyle
milk and orange juice supplements
The program
are
follow-up
postpartum
group
married or
not
education.4
school
high
are
include
Program components
referrals
Many
poor
users were
self-reported
to
were
the
18
seven
current
using
had used alcohol
users
alcohol
had binge
of alcohol
11
and 65 had used
14
were
drug users
drank small amounts
problems
drinking
illegal
five
and
and were
quit
and
two
term
hardest
to
track
information
because
on drug use
it
was
was
difficult
accurate
to
maintain
contact
and
difficult
16
In
United
the
medical
comprehensive
divided
two
into
experimental
provided
home
The
only
to
in 1987
than
low
prevent
prenatal
babies
of the
The
due
to
resources
of
study
may
in
relationship
between
with successful
and support
workers
the
standard
the
in the
nutritionist
standard
than
were
study
The women
the
only
babies
in the
medical
medical
control
care
care
group
but
received
risk
After
pregnancy and the degree
in the
study
were
mothers
in
who
is
not
Winnipeg
received
less
care.42
adequate
factor
women
pregnant
between
alone
care
other factors such as smoking
of prenatal care
89 grams
were
factored
on average
lighter
than
the
study
the unexplained
that
middle-income
Social
support
family
or
wealthy
may be more
more
with which
birth weight
received
some 12000
outcomes
medical
that
suggestion
difference
in
average birth weights
was
poverty
be exposed
social
the
pregnancy
Support
of
women
in
in
major
as
during
speculated
to
to
available
study
women
related
deficits
Social
emerged
the
is
and those who
care
of the poorest
researchers
occupations
One
birth weight
poverty
Compared
nutritional
to
of providing
weight
group
social
addition
in
birth weight
and other research
this
medical
richest
factors
control
group received
higher
birth
Low-income women
nurse-midwives
control
significantly
complications
pregnancy
the
babies
of
psychologist
The
residents
through
Once again
out
and
and 1988 found only subtle differences
ideal
during
group
on
effect
mothers.4
for first-time
Running
care
services
and
visitors
group had
experimental
sufficient
the
the
prenatal
an experimental
received
obstetrical
by
evaluated
study
and psycho-social
groups
group
paraprofessional
one
States
to
frequently
respond
support
and teenage
support
to
to
refers
women
stable
pregnancy
have
by the mother may have
be employed
the demands
to
social
women may
infection
vaginal
and birth weight
outcomes
to
likely
poor
in
in physically
and may
in
general
greater
demanding
have fewer
of pregnancy.43
relevant
Canada
outcome
support
influenced
experience
the
and meaningful
found
Many
component
results.45
relationships
statistically
intervention
significant
programs
and the extra contact
17
One example of
women
The
through
semi-rural
worst Standard
conditions
an intervention
is
comprehensive
was
setting
this
also had
the
states
York
Area
Statistical
Metropolitan
It
New
of
highest
birth outcomes
improve
home
and postpartum
State
was
that
United
the
in
to
sought
of prenatal
program
region
that
States
and confinned
reported
the
terms
in
by nurses
visits
at
regarded
of
for poor
time
economic
its
abuse
of child
cases
the
as
and
neglect
In the
no
services
special
developmental
prenatal
of nine
home
fourth
years
visits
program
were
under
19
who
The
babies
the
to
and
reduction
in
main
three
above
The
also tested
the
to
services
home
received
received
third
for
free
until
for
transportation
an average
by the second
their
and
sensory
received
group
received
visits
group received
control
screened
were
The second group
addition
babies
children
group
two
were
group
smokers
Numerous
other
community
services
Women
Infants
The
Smokers
number
the
mothers
the
pregnancies
The
positive
home
visits
Their
children
until
chief
and were
Women
services
The
focus
who took
was
their
augment
part in the
mothers
first-time
helped
beneficiaries
more
in
on average than
women
were
reduction
under 17
births
preterm
the
years
due
to
continued
were
likely
WIC
to
attend
childbirth
program and reported
And
they
interested
in
their
were
room
least
visits
greater improvements
In the
to
in talking
partners
year
in their
themselves
about
who had
abuse and neglect
first
use
pregnancies
Mothers
child
likely
They made more
classes
more open
were
the birth of
after
two
The women became more aware
from the program
Men became more
emergency
of the
program
75 percent
flowed
infections
children
395 grams heavier
were
smoked
and Children
had fewer
community
mothers
parents help
or disadvantaged
showed
advantages
results
their
being
of cigarettes
They had fewer kidney
their
educate
to
and poor
single
of
to
unmarried
either adolescents
were
were
activities
and link parents
systems
in the control
of age
and
in
babies
their
The
groups
old
support
diets
were
four
into
but
two
infants
pregnancy
in addition
group
informal
of the
their
during
divided
one and
ages
and
care
The nurses
of
at
were
pregnancy
during
problems
regular
The
women
intervention
of life
received
their
children
the
children
had fewer
18
the
visits
to
were
fewer
of
cases
The
room
emergency
authors
accidents
workers
likelihood
substantially
who made home
care
required
helped said
Social
review
of
psychological
and
less
healthier
likely
in
support
to
long-range
of
following
companion
with them
worry-free
labour.49
during
was
the
less
there
were
labour
about
to
be
The
less
level
Overall
intervention
was
giving
satisfied
who
to
birth
with
by child
are in
all
both mothers
of neonatal
They
were
care
of the
cent
nervous
also
and
to
the
women
to.48
according
enhanced
unhappy
between
However
listened
being
received
feel
their
80 per
and babies
illness
same
the
midwives
research
and childbirth
of pregnancy
likely
in
four
group was
control
would be offset by
community
the
to
involved
resulted
birth
visits
suffering.47
that
day
Women
studies
feelings
human
intensive
experience
pregnancy
in
and
quality of the
different
have negative
year
visits and intervention
financial savings
24 hours
call
babies
important
during
second
In the
home
of
room
women
disadvantaged
on
of the cost
the reduction
the weeks
can enhance
number
infections
emergency
getting special support
the most
support
is
as
and were
by the supported
that
The
of socially
study
of mothers
the children
major portion
hospitalizations
greater
visits
being significantly
that
They added
protection
tract
respiratory
or poisonings
concluded
fewer foster care placements
different
for upper
social
to
and
and worried
more
likely
to
report
that
they
have
had
19
THE FIRST YEAR OF LWE
II
addition
the
to
the
parents
are born
babies
This
while
host
the
to
of
and ways
of promoting
Canada
has
of early childhood
Program
in
directed
the
not
better
health
taken
for Children several
to
the
of very
areas
general
of
what
explore
to
after
expect
their
from family or friends
child
and
children
young
the special problems
parents
low birth weight
The end
and infants
their
and parenting
development
resulting from
problems
group of parents
facing
of
the
teenage
chapter
mothers
families
first steps
described
ago
years
on behalf
safely
learners.50
know
they
readily available
parenthood
in
are better
met
secure
require
to
opportunity
In
infancy
during
infants
shelter
and the
so that
well
overcoming
at
broader
interventions
The program
the
actual
The
National
as one of
from birth
to
18
its
in this
An
as poverty
managed by
jointly
to
address
establish
to
chapter
increase
in
framework
national
with
the start of the
funding
for the
kinds
Community Action
was announced
for the program
the federal
the developmental
provincial
needs
and
of children
territorial
are delivered
risk
at
governments
by
51
Forum on Health
women
should
risk
are at
it
be directed
said
to
Particular
programs
women
pregnant
attention
that
should
include
home
and children
be given
to
the
and children.52
of the issues raised
poor nutrition
singled out community-based
Programs
priorities
months who
needs of Aboriginal
Many
is
services
community groups
visits
is
and
clothing
needs
development
1997 budget speech
in the
but
issues
for
already
as
on interventions
specific
are
it
if
help
on issues such as adjustment
touches
these
how
child
healthy
interaction
social
who have
get
to
food
need special help
suitable
are
of
may
programs
others
needs
Babies
focuses
chapter
and covers
Some of
and
vital
is
and stimulating
world around them
New
stress
fundamental
extensive
attachments
undue
without
Stability
and
in
the first chapter
stress
do not
reappear
disappear
in
this
automatically
chapter
once
Risk factors such
new baby
arrives
20
and the need for
it
is
the
in
be
is
supports
of very
even greater for parents
probably
children
young
than
period
prenatal
mention
Special
to
social
determinant
be made
should
of
the
of the impact
home
of the
quality
of poverty
on families
which
environment
is
Poverty
is
linked
strongly
known
to
child
development
1991 Quebec report
an
as
poverty
absolute
Parents
have
isolated
vulnerable
of
to
with
strict
frustration
in
Some
of
Study
their
of
the
most
An
Youth
poverty
depth
those
The
to
who
were
results
use
the
to
The
as
the
who
incomes
New
to
promoting
means
of
this
in
come
home
that
are
damage
U.S
their
child
that
born
was
Poor
less
affectionate
elements
nutrition
the
into
in
child
variables
poverty
family
and
on
had
income
pattern of spending
children
development
child
Longitudinal
poor
child-centred
Meeting
about
more
relationships
household
found
for their
crucial
are
more
and are more
National
maternal
chronically
Points
They
and
available
the
of
have
of children
behaviour.53
their
on the early
Starting
threaten
most from improvements
life
parental knowledge
preventing
less
reduce
are sick
events
says
to
and are more suspicious
frequently
isolation
and whether
improve
stressful
environment
parents
efforts
the well-being
the report
from
families were
information
York
in
described
of arbitrary decisions
contribution
and environmental influences
New
and
attentive
benefitted
also suggest
improve
more
and
has
of poverty
born poor or whose
Corporation of
children
of
to
the mercy
less
relative
quality
children
of the study
Children recommends
in
at
despondency
the
duration
any additional
both genetics
of
enfants
difficulties
depression
research
ses
negative
and more authoritarian
analysis
Brain Development
Carnegie
experience
important
of poverty
significant impact.54
that
fmancial
their
This
judgement
characteristics
and tend
They
services
poverty
were
more
clout see themselves
social
social
through
children they become more distant
their
more
less
and
society
about
constantly
de
fou
QuØbec
any broad campaign
in
necessity
of poor families live
and worry
often
Un
entitled
the
in
of
confirms
human growth
Needs
development
in
the brain
infancy
of
The
Our Youngest
and also investing
for
example
can
-21-
with
interfere
seriously
brain
and
development
lead
to
and
disabilities
learning
mental
retardation.55
Recent
children
research
retarded
the development
Connections
develop
stimulation
about
who
Babies
in
Fewer
development
the brain appear
most of the
spend
of the brain
than
15
to
first
is
into
insights
the
way
develop normally only with proper external
of
year
life
of the babies
percent
new
providing
in
lying
one study
in
cribs
their
often
suffer
walk by the age
could
of three
It
is
now
recognized
and other stimuli
crucial
stimuli for children
and behavioral
cognitive
the
Having
Too much
cause
develop
to
stimulation
child
problems
to
live
during
handicaps
such
as
Thus
the
in later
of inputs
exposure
of the childs
stimulated
factors
sensitive
on high alert and
remainder
for the
fully
right balance
must be
children
that
it
our
environment
social
of
periods
neural
the
brain
severe
may
key
is
also cause
the
during
risk
stress
for
infancy
cognitive
behavioral
FOR LEARNING
Motor Development
Prenatal
Emotional
Birth to
years
Birth to
years
Birth to
years
Social
Attachment
Vocabulary
Second
Language
and auditory
impair
could
these
lead
to
to
Birth to
MathlLogic
year
Music
years
years
years
months
to
to
to
10 years
years
10
years
stage
of life
many poor children may
life.57
WINDOWS OF OPPORTUNITY
Vision
that
development
TABLE
Control
tactile
life.56
to
to
in
visual
through
and emotional
22
The
brain
and childhood
that
as outlined
form words
language
rapid
in
are
certain
Table
wired
in
kinds
on the previous
the
first
learn
to
capacity
year
different
at
The development
page
of infancy
stages
of language
and the months
children
hear
follow
that
are
the
more
programs
for
infants
age
an
time
two
by
is
the sounds
Circuits in the brain representing
of life
The more words
development
of information
of
their
will grow.58
vocabulary
Parent-Infant
are
parents
receive
to
of the infants
example
important
primed
is
known
development
Stimulation
stimulation
as
and
to
attempt
Many
Programs
programs
make
sure
that
of
the
special
These programs build on our knowledge
infants
stimulation
the
get
need
and
of child
to
develop
are at risk
because
they
properly
Some
they
were
of the children
or
premature
preschool
years
low
birth weight
and help prepare
Stimulation
programs
Activities
take
learning
centre
There
the
The
is
them
place
at
voluntary
Programs
care
Aimed
low birth weight
consciously
at
Low
babies
in
the process
the
staff
focus
is
risk
of the children
in their
school
at
an outside
is
actively
reinforced
promoted
twice
and
Despite
for developmental
also go to
one parent
least
on both cognitive
children
development
are
community
Babies
the
least
of child
frequent
start
work with both
features
or not
of at
programs
development
once they
whether
involvement
Birth Weight
are at
Well-designed
the following
home
role models from
Contact with program
Programs
for success
and others
environments
babies
typically have
role of the parent
Positive
home
and social-emotional
the cognitive
They improve
groups
are from poor
monthly
social
and emotional factors.6
technological
delay
at
later
advances
ages.6
in
health
The problems
-23-
low
disadvantaged
born into
infants
skills
low
for
compounded
are
birth
birth weight
less
birth weight
they
are
more
infants
does
infant
in
living
not
well
as
develop
In
poverty.62
the
fact
similar low
as
socially
birth weight
environments.63
stressful
Low
weight
babies
fretful
smile
they
for caregivers
problems
pose
and
less
have
they
may
they
more
have
fewer
social
coping
difficulty
with
distress
The
Health
Infant
985
involved
low
birth weight
different population
neonatal
of
Programs
to
At
games and
12
in
the
of behavioral
problems
who
three
This
less
weighed
Parents
found
to
reported
locations
were
discharged
with
managing
two
or
follow-up
but
from
development
with
one teacher
was
problems
self-identified
centre
goals
teacher-child
to
every
four
that
provided
than
children
lower average
number
and safety concerns
higher
significantly
There was
the
infants
Emotional
development
to
their
by group meetings for parents
have
with
information
developmental
use
to
and health
2000 grams
the infants
and
in
help
one
aged
The program
old
health
child
complemented
only pediatric
than
got
of pediatric
centre
diverse
geographically
development
attended
children
was
were
received
were
social
on child-rearing
program
who
group
as well
the infants
every
three
and
of
assess the effects
development
for parents
designed
linguistic
and information
support
for infants
to
to
in
36 months
form
the
in
were
activities
child
to
sites
eight
were
they
support
of age
at
visits
to
attempted
The program began when
until
cognitive
months
aged two
control
infants
part of the program
Infants
in
family
of one teacher
children
social
was
emphasize
an important
ratios
and ran
Program
and
visits
characteristics
nursery
There
were
by home
supplemented
follow-up
the
and Development
IQ
significantly
small increase
there were
scores
in reported
no differences
minor
in
illnesses
serious health
conditions
group
Mothers
who
mothers
on
children
involved
scored
in their
took
the
well
part in
quality
of
on persistence
activities
67
related study
the
assistance
were
they
and enthusiasm
found
to
have higher
demonstrated
They
were
also
with
ratings than
control
infants
Their
their
more competent and more
24
tried
results
overcome
the cold
to
often disturbed
and was
to
designed
The
them
in
rocicing
intended
in
Instructors
babies
getting
the
nurses
Weight
games
to
to
The
babies
months and
during
gain
released
targeted
premature
babies
by providing
are
infants
disadvantaged
socially
development
them
located
about ten
instructed
to
tactile
visual
from
inches
talk
the
to
their
babies
All of
these
to
done
Feedings were
feedings
during
for burping
see
to
were
activities
who
the babies
received
only
social
workers
from hospital
and demonstration
instruction
next steps
behavioral
was
period
their
of
reaching
standard
better
pediatric
child
ready
to
brightly
and
handling
made weekly
were
infants
to
significantly
stimulating
at
gazing
also responded
They
the nursery
during
infants
three-pound
feedings
hand-eye coordination
their
the
in
mothers
mothering
In
hospitalized
mothers
in
were
were
satisfactory
intervention
neonatal
taught
to
group
almost
for low
intensive
appreciate
low
care
at
for the
care
home
visits
care
Mothers
take
and given
grasping vocalizing
birth
weight
infants
the
babies
sitting
up and
more
likely
to
babies
into
beginning
the
home
unique behavioral
One reason
report
at
12
group
for this
dissatisfaction
in
symptoms.69
while
over
levels
in the control
on the mother
and more psychological
and extending
their
than
focus
are
attitudes
near-normal development
better
babies
backgrounds
child-rearing
for
were
ten points
birth weight
of lower educational
less
one
intervention
IQ scores
Other interventions
that
where
that
themselves
feeding
is
care
birds
upright
faces
were
promote
held
astonished
than
assess what
to
play
nursery
Nurses were
were
treatment
babies
coloured
and play with
were
hospital
the
at
special
the
helped
low birth weight babies
orientation
mothers and provided
the
very
intervention
nursery
hospital
rock them
to
distressed
After
were
and
birds
when
to
the
in
visual
promote
voices
with
and motor
sensory
chair and the babies
to
The
had mobiles of brightly
up often and
coloured
their
improve
were
they
pick
associated
necessary
with
intervention
stimulation.68
infants
while
another
in
environment
when
only
and kinesthetic
cribs
occurred
Impressive
the
infants
three-month
characteristics
were
period
They were
25
sensitized
readiness
infants
the
to
cues
And
for interaction
The program
were
they
and
babies
weight
cues.7
the first group reported
between
babies
on cognitive
scores
birth weight
more
of their babies
low birth weight
babies
control
significantly
perceptions
resulted
that
in
experimental
in significant group
caught up
the normal
to
birth
babies
attachment
vital
is
the world
been linked
the
babys
later
and
varied
is
opportunities
and
with
holistic
Development
they
the
understands
entered
city
broad
in
the
the
which
quality attachment
..
on
family
United
length
Table
in
Or
aggression
from
base
level
of understanding
with
started
program
shown
as
High
to
caregiver
to
has
of an infant and can
she
must be able
to
intrusive.72
being
Centres
as
caregiver
distressed.7
level
intervention
the
their
the developmental
childs
the
can lead
attachment
or
competence
linguistic
and play without
of
example
when
above
just
use
infants
of comfort when
knows and
exploration
received
instruction
of children through
discussions
management
Secure
attachment
Mother-child
Insecure
development
source
that
Babies
Weight
the
of
support
States
the
in
program
next
page
services
1970s
the
the
is
The
and the type
All
the
of
children
36 months.73
at
Mothers
development
child
ages
as
of Parent-Child
graduated
or group
at
caregiver
age of the babies
program
healthy
stimulation
good
program
to
Birth
long-term cognitive
to
skilled
provide
Normal
for
withdrawal
explore
guide
in
difference
the low
to
or
distress
29 low birth weight babies
growing
control
overload
respond appropriately
and more favourable
mothering
36 and 48 months when
at
Programs
social
also
was
and low birth weight
differences
with
satisfaction
Mothers
stimulus
signalled
25 low birth weight babies
involved
There
temperaments
that
to
taught
group and 28 normal birth weight babies
self-confidence
those
particularly
the
They were
nutrition and health
on
the
programs nursery
encouraged
community
to
intellectual
and
physical
programs with
their
children
emotional
social
laboratory
develop as individuals
resources
government
by learning
and continuing
about home
education
26
TABLE
CENTRES
PARENT-CHILD DEVELOPMENT
Location
1-33
months
12
Houston
family
social
services
varied
educational
provided
supports
months
included
home
and
small
and centre-based
centre-based
transportation
some meals
daily stipend
and often from the same
backgrounds
centre-based
34 months
for siblings
program
Program Type
Length
24 months
months
Orleans
The
Program
Entry
3-5 months
Birmingham
New
of
Age
ethnic
and
family
health
and
members came from
Staff
cultural
as the
backgrounds
mothers
number
child
higher
outcomes
scores
and scoring
of different variables
However
at
of active
teaching
demonstrated
the
activities
to
measure
maternal
and
attained significantly
such as
participation
behaviour
were used
months program mothers
three sites at 36
of behaviour
on measures
level
all
systems
with
degree
the
to
or
focused
to
which
child
which
on
mother
labelled
gave
information
task
stimulation
facilitation
the
degree
mother
provided
permission and
affection
holding
kissing
comforting and praising
help
or
materials
or
gave
27
At
However
Another
and lasted
demonstrated
well
to
on videotaped
the
were
more
longer
the
were
significant
that
suggests
scores
test
intelligence
developmental
early
entry
these
into
to
felt
early
better
intervention
was
provided
to
levels
mid-
at
took
part in
mother
the
model
health
low
began
of subjects
percent
mental
part of
95 mothers with
where
in
nurse
support depression
social
to
the
mother was
social
measured
at
skills
and
and 30
13
ended
better
with
behaviour
the mental health
their
when
separated
have securely
group where
The
babies
and competence
to
likely
in
in
the
were
conclusions
of
presence
were
they
the
based
mother
and then reunited with the mother
attached
infants
if
were
they
in the
group
study
home
visitor
more
was
only partially
would
programs
successful
because
be effective
for
low percentage
only
attached
program
intervention
intellectual
whether uniform
questioned
the program
or consistent
the
information
attachment
the childs behaviour
ranked as securely
on the
Forty-four
stress
relationships
of child
The
stress
life
to
targeted
relationships.74
with respect
secure
of the
longitudinal
effect
family
intervention
and resource
They
positive
where
women
IQ mothers were more
families
that
superior
showed
This
was
that
or high
problems
of the childs
security
have
authors
found
children
later
intervention
with the most problems fared
The
of children
other
assessed
observing
Higher
all
The
assessments
included
year
had
children
Orleans
given
model
of handling
after
Mothers
likely
the
all
the childs first birthday
resource
were
The
intelligence
information
and
ways
Mothers
This
tests
nursing
until
way
straight-forward
more
in
was
study
information
months
them
low support multiple
of education
pregnancy
sites
be important
may
programs
three
all
Birmingham and New
the
only
and maintained
gains
an
at
graduation
abilities
consistent the
in
Florida
the
during
of low
involving
first
income
better.75
three
children
258 mothers and
years
of
the
life
their
had
earlier
the
babies
long-term
better
the
28
from within
Parents
their
The
infants
provide
wide range
materials
within
child
surrounded
raise
whether
teaching
became
from the
to
Children
or
the
to
children
first
who
year
in
only
IQ scores
placed
in
lessening
among
the
be
divided
three
of the
the
of
classes
interventions
healthy
when
was
each
trained
and being able
Parental
structured
staff
the
Parent
latter
how
in
other
and
control
principle
well
fairly
home
internal
useful
guiding
would be
the child
of
sense
and professional
all
were
they
drawn
best
tests
confirmed
in
math
in
any two consecutive
three years
were
in
which
children
to
at
primary
All results
this
turn could
superior
age five
found
school
and reading
such as
were
years
and were
to
appears
mean
cost
that
less
raise
savings
had
they
likely
to
be
the likelihood
to
society
by
education.76
also appear to
full-term infants
them
were
on intelligence
intervention
benefit
eight-month Canadian
and tested
either
achievement
An
to explore
activity
differences
children
disadvantaged
An
healthy
their
was
roles
which
in
activity
and nursing
best results
The
levels
higher
why an
Paraprofessional
in
stimulate
to
and language of the
and improve
Staff
psychology
infants
need for remedial
at risk
groups
child
how
for infants
opportunities
an environment
appropriately
important
group
special education
Early
to
their
achieved
testing
higher
of success
also
parents
context
example knowing
responding
other
the discussions
into
had been in the program
control
Further
interaction
friends of the family
engage
especially
of the parents
for
of education
fields
mothers
self-esteem
teach
to
to
of experience
by and introduced
were
selected
were
program
verbal
an infant was
techniques
educators
teach
the
were
language by providing
involvement
Parental
judge
of the
objectives
enhance
to
the community
aged two
for mental
parents
parent
to
15
and children
education
months
and psychological
from
who
and infant
are not
stimulation
middle-class
development.77
considered
program
backgrounds
into
29
The
first
22 structured
group received
from an interdisciplinary
children
homework
received
on
child
The second group had 22
with no workshops
was
on
measuring
tests
The
data
structured
teachers
competent
for their
Children became more active
data
further
children
suggest
and
adults
from
interviews
developmental
enhanced
Other Types
major challenge
before
and
lifeskills
family
in
Vancouver
after
and
started
they
which
support
an outreach
have yet
study
to
more
less
data
only
testing
best
this
indicate
of
intervention
The
clinical
with other
Clinical
anxiety
increased
and
agents
interactions
social
separation
understanding
of
knowledge
interactions
parent-child
over childrearing.78
anxiety
for Infants and Parents
and new parents
The
transition
to
often need outside
parenthood represents
help
with the
in coping
baby
many programs
groups
and
One Quebec
things
the
change
of
result
as
seek
self-report
and lessened
offers
the birth of their
support
education
organizers
of
to
effective
exhibit
children
better
for most families
One example
Program
appeared
of Programs
sessions
who performed
groups
imitators and manipulators
explorers
these
come from having
that
changes
children
young
and
processes
more
became
that
parents
enjoyment
lecture topics
structured
group received
the first and third
settings
own
their
group had 11
third
control
evenings
mothers
that
The
children
their
held
Members chose
sessions
with
difficulty
training and
growth
developmental
suggest
were
evenings
workshops
or
and only three parent
in
experiencing
training with their
classroom
by formal
augmented
Mothers
unstructured
assignments
the children
was
and parent
consultations
and had no homework
This
issues
development
individual
It
staff
of hands-on interactive
sessions
wide
community
program
said having
learn about
weekly
help
baby
parenting
in
younger
and
area
certain
programs
it
fathers
said fathers
new
in
to
young
more
Parenting
both
parents
on-site parenting
outreach
group
learn
make
ACCESS
include
classes
parenting
to
the
is
services
and cooking
drop-in
is
this
support
post-natal
outings
to
of
range
The
children
and
operating
programs
Earlier
about
parents
year
parenting
aware
particular have
this
of
of
lot
all
to
the
learn
30
about
close
getting
would
that
program
to
intervention
Trained
three months
couples
help
Over time
involvement
months
more
were
they
Intervention
also
study
United
States
control
products
was
involvement
in the
from middle-class
higher
in
could
of day
care
time
than
spent
their
were
more
being
no separations
during
may
with
At
18
satisfied
and
have
been
or divorces
in the
status
the
home
received
and
couples
socio-economic
visits
another
training
less
non-intervention
there were
as
roles
satisfied
There
and home
couples
together
new
less
be doing
group reported
mothers of low
teenage
intervention
relationships
couples
and parent
component
they
whose
skills
day also took part
through
trainees
were
in
full
WIC
the
able to
infants
the day
tests
before
than
see
the
after
the parenting
attended
care
and
the
and home
babies
in
in
program
The mothers were employed
aide
the babies
mental and motor
fathers
they
more
sexual
day care for the
teacher
backgrounds
At 12 months
intervention
parental
promote
and non-intervention
with
satisfaction
to
relationship.80
The
and
to
adjustment
first
of
year
and
visits
only.81
attended
program
to
self-confidence
labour
thought
the
from pregnancy
couples
conflicts
more
babies
their
merits
consultations
as part-time
of their
make
assess their
fathers in the control
in
born
care
day
they
for intervention
nutrition
and pediatric
centre
changes
infants
testing
who
infants
There
program
care
received
months
the
national
children.79
their
Both intervention
household
of
baby
care
the relative
group received
The
shared
negative
compared
six
while
satisfied
of normal
One group
life
At
them
and
mothers reported
of the
care
in marital stability
improvements
division
labour
couples
fewer
reported
the
with
parental
fmdings
tensions
heightened
to
96 couples
help
worked
and help
interesting
intervention
in the
to
recommended
study
attachment
their
support enhance
of
over
of household
division
their
experienced
and
attempted
change
The
possible
professionals
cope with
number
had
more concern
couples
health
as
of fathers
program
provide
couples
study
initially
expressed
the
to
postpartum
involvement
The
mental
soon
as
the role
promote
preventive
parenthood
children
their
at
an infant stimulation
access
to
minimum wage
hours
school
skills
As
of teachers
free
dairy
in the
part
of
day
their
and mothers
nursery.82
visit
groups were
the control
group
bigger
Babies
and scored
in
the
day
31
care
centre
Mothers
skills
most
scored
to
likely
The
education
much
more
health
with
in the
interest
decline
in family
in
Child
visitors
families and parent
visit
group in mental and motor
and were
visited
behaviours
the newborn
The program
raised
Start
initiatives
designed
low-income
among young
in
to
in
in
families
of
nutrition
cases
in
design
to
be the
the families
behaviours
immunization
and
programs
support
abuse and neglect
States
were
series
outcomes
pregnancy
The
all
healthy
of child
United
the
improve
families
1930
improvements
and confirmed
suspected
interventions
of
and
outreach
asked
visitors
awareness
parental
enrolment
increased
planning
babies
effective
an
Home
83
and resulted
for services
was
program
of each
of
and infant
initiative
varied
served.M
community
Home
Visitor
healthy
Survival/Fair
community-based
home
have an early repeat pregnancy
to
likely
Home
number of
the
the
in
work
demand
the
babies
least
promote
region
and development
the
to
designed
Finally the
structured
or
Start
Healthy
increased
substantial
school
to
than
were
good grandmothers
of
turn
in
return
Kansas
with newborns
That
of day care babies
strategy
equivalent
better
significantly
were
drawn from
the
and were
community
target
trained
to
work
with
groups to
promote
simple
and home
care practices
good
and infant nutrition
maternal
hygiene
safety
encourage
augment
health
knowledge
of medical
care
childrearing
and
utilization
appropriate
and
skills
in
to
strengthen
the parent-infant
relationship
help
strengthen
on childrearing
impinge
dealing
help
parental
with
crises
participating
supports
skills
in
managing
coping
with
budgets
other
aspects
mobilizing
of family
informal
life
that
supports and
and
families
gain
access
to
services
and
formal
institutional
32
The
resources
educators
families
in
the
highly
community
advocates
environments
were
better
and
social
receptive
They
were
supports
neighbourhood
to
the
able
to
The
conditions
interventions
activate
results
Organizers
and nurture
of the programs
and the promotion
found
people
included
of healthy
child
to
untapped
be mentors
better
family
development
33
CONCLUSION
The
cycle
They
can
babies
lead
to
reviewed
in
of healthy
child
protection
governments
in life
start
possible
larger goal
of
prepared
take
to
The
host
fighting
governments
programs an end
continuity
An
ultimately
of
to
stress
and
to
act can
considered
and
timely
outcomes
better
health
neglect
to
depends
carefully
improved
more
levels
can
interventions
that
foster
good
Canada
birth
self-confident
lower the
care placements
for the
types
poverty
would
failure
parents
incidence
and
greater
of
child
abuse
and emergency
hospitalization
facing
undoubtedly
It
and
room
remains
families
of cash
believes
fmance
changes
be
that
downloading
however
seen
rhetoric
that
there
until
programs by outside
social
to
their
to
assume
about
will
it
are
new
children
be
this
whether
difficult
major changes
into
to
would
there
report
best
or for the
governments
are
reality
deal adequately
in
be
the
with
orientation
of
initiatives
are needed
social
in
the
children
giving
described
of special interventions
of translating
that
agree
person might therefore
policy
public
governments
successful
end
and
of mothers
development
most important
of government
scrutiny
in
and an infusion
the
that
prove
report
Council of Welfare
problems
Among
indifference
life
services
up the task
National
of
is
support
political
when
the
in
periods
and well-being
the health
in
benefits for families
reduced
also evidence
is
and child
All
investment
this
and minimize the need for
neglect
the most critical
are arguably
life
are also times
They
skills
parenting
There
the
modest
have many positive
understanding
of
stages
problems
studies
interventions
broad
when
lifetime
last
The
care
times
are
lifelong
stronger
and infancy
prenatal
are an end to
arbitrary cuts
problems on others thorough
experts and
in social
and timely
commitment by governments
to
the
programs
arbitrary cuts in social
on the willingness
programs
The
of governments
to
well-being
support
of children
people
who
and
their
parents
are unable to
fend
34
themselves
for
employment
in
this
This
includes
social
such
programs
and public pension programs as well as the special interventions
insurance
welfare
as
described
report
The
of
reality
recent
The most extreme example
Ontario
government
the
among
serious
rates
assessment of whether
government
An
which
end
put
such
of the past decade
of social
to
programs
The
similar tactics
on voluntary
result
non-profit
policy
to
Successive
decline
was
sharp
and
charitable
houses
Many
of government
levels
in
were
children
taken
without
food
or
clothing
of the
popularity
continuing
any
effect
into
fmancial
their
put
the
imposed by the
young
adequate
and
widespread
percent
and was
allow
was
sobering
problems
social
would
been
with
arbitrary
totally
rates
Just as
of 21.6
rates
for families
rates
was
have
programs
welfare
in
welfare
mindless
trying
lower
decision
rolls
downloading
to
social
Welfare
new
the
on the welfare
for children
shelter
The
cut
were
that
in
the cut
is
1995
October
in
cuts
that
is
years
severe
much
broad-based
for
support
federal
in
order
for social
support
and
organizations
local
cost
tried
governments
programs
growing
an increase
ultimately
spent
the
by downloading
and
provincial
have
governments
in
burden
human
misery
The withdrawal of
time
first
in decades
in
player
some of
disappeared
set
out
Canada
Thorough
rights
by
of citizens
tax
difficult
results
Canada
too
late
dollars
in
the
in every
in the
in
and
federal
are properly
have
and
policy
except
social
for these
funding
disinterested
observer
standards
regarding
such as
For the
programs
rather than
National
programs
for the
evaluations
independent
democracy
is
those
to
have
unless
interference
evaluated
reliable
programs
democracy
without
any impact
was
in programs
an active
standards
medicare
all
but
that
are
Act
Health
parliamentary
in federal
most important
area of social
whether
cuts
government
countrys
timely
are published
to
the
from direct involvement
government
and housing accompanied
welfare
medicare
the federal
fulfilling
their
programs
that
One of
about the programs
intended
programs are evaluated
evaluations
policy
social
information
by governments
and the few
on public
are
of
few
experts
social
basic
supported
purposes
by outside
Relatively
the
That
is
and the
programs
in
have been done are often published
35
Almost
and they
crafted
the programs
all
are the
are
commitment
This
governments
clear
interpreted
Social
purely
This
designed
We
have
to
have the means
means
The
help
we
lack
The problems
that
responsibility
the
primary
interest
to
persistent
is
not
provides
to
work
the
surrounds
additional
be
for
money
for families with
all
lies
all
of
as
of
doing enough
well
children
as
level
to
What
supportive
is
it
carefully
nation
as
We
that
in
and action
it
programs
that
is
clear
is
the
that
must be done
broad
is
that
environments
healthy
Something
Canada
Whatever
of poverty
needed
collective
our collective
in
is
strategy
that
have been proven
also
go with
yet the
firmly believe
poverty
provide
children
that
problems
taking
we
Child
attention
shown
our society
resisted
with parents
and the actual
money
to
While
children
Canadas
new
have
we
children
requires immediate
the causes
question
of
are not
for
in government
way85
this
by
or ideology
politics
hand
up the challenge
that
Canadian
at
programs
need special help
social
been
sight
our well-being
to
and the
in
change
has
researchers
work
the
suggests
of
another
is
by
has
traditionally
reshapes
were motivated
that
poverty
poverty
society are not
development
simply
to
changes
have
anything
new government
once there
and child
well-being
problem which
Canadian
well-
that
program
Canada
for families which
get on with
to
Once
almost
work and do add
against
for children
responsibility
ensure
we
It
will
exist
still
that
as
the
for the health
rhetoric
for child
indeed
special interventions
of inequality
they
experts
programs
from senseless
in
change
other
by
reports
be immune
to
that
Forum on Health summed
National
fact
other
major inroads
is
time
be undone
to
families do
mount
to
for successful
governments
Any changes
certain
many
make
to
What
poverty
like
report
confidence
us
give
programs
social
mandate
every
reasons
are almost
programs
the
victim
or ideological
in the first instance
they
easier
it
should
it
because
difficult
the polls as
the
is
progress
political
at
victory
make
of successful
be effective
to
be
will
However
nile
by outside
Canada
and shown
evaluated
properly
have been evaluated
report
and they
the continuity
to
in this
the
worthwhile
parts of
other
in
replicated
rather than
exceptions
interventions
described
36
The Canadian
in
recent
publication
Canadas
children
backs
the
of poor
Council on Social
future
report
Child
entitled
Poverty
our security
concluded
and unhealthy
It
is
children.86
offered
Development
What
not
but
blunter
assessment
Are the Consequences
and quality of
simpiy
similar
life
possible
depend
to
upon
develop
the
well-being
healthy
society
of
our
on the
37
FOOTNOTES
Crime
National
Prevention
Lisbeth
1989
Preventing
Crime
Health
Action
Our Reach
II
43
the
Breaking
Volume
on the Legacy
Building
Ottawa 1997
Cycle
of
Disadvantage
Toronto
xxii-xxiii
Health
Health
the
in
Investing
of Canadians
Ottawa
Health
1994
Canada
Prevention
Low
of
of
Canadas
Birth
Children
Commons
the
Status
of
in
Investing
Standing
Low
of
Birth
on infant birth
effect
Wilkins
in
and Welfare
the primary
is
source
for
Social
on Poverty
Affairs Seniors
of
and
16
16
Canada
in
Christensen Kathryn
of
trial
weight
comprehensive
Pediatrics
1986
Urban Canada
also
Joseph
Sherrof
Mary
pre-natal
care
1992
Sherman and P.A.F
Gregory
by Income
Mortality
work
This
on Health
Weight
Myra
Randomized
Stern
women
Canada
our Future Report of the Sub-Committee
Committee
Altemeier
David
in
Women Ottawa 1991
The Prevention
William
Weight
section
this
the
Russell
pp
for Population
Strategies
rest
Within
Schorr
Anchor Books
the
Canada
Reports and Issues Papers
Synthesis
in
Investing
29
Forum on Health
National
Money Well Spent
Council
Ottawa September 1996
Health
Reports
Dietrich
for
and
low-income
128
Birth
Best
McLaughlin
Outcomes
1991
and
Infant
15
jjd.p.8
10
Canadian
Council on Social
Development
Child
Poverty
What
Are the Consequences
Ottawa 1996
11
National
12
Prevention
Council of Welfare
and Social
of
Low
Justice
13
The Prevention
14
Ibid
28
15
Ibid.p
19
of
Birth
Yours
Low
Poverty
Weight
in
Profile
Canada
1995
Premiers Council on Health
Mine and Ours Toronto
Birth
Weight
in
Canada
1994
21
36
Well-Being
38
16
M.S
Hotz
Stephen
Women Ottawa
Health
Canada The
Effects
and Postpartum
Periods
19
The Prevention
of
20
Ibid
21
The
This
Health
Canada
of the
Birth Weight
Smoke
of Tobacco
Effects
Periods
22
Low
source
in
and
Smoking
16
Smoke
Ottawa
in the
Prenatal
1995
19
Smoke
for the
the
meta
663 721
Allston
Julie
1996
Literature
and Second-Hand
Interventions
Smoking
Canada
Canada
in
also the
is
report
and
Smoke and Second-Hand
of Tobacco
Summary
1987 pp
Simms-Jones
Health
and
methodological assessment
Organization
Nicki
Nancy Edwards
High Risk Pregnant
18
of low birth weight
World Health
Bulletin of the
analysis
17
Determinants
Kramer
in
next
three
paragraphs
and Postpartum
Prenatal
and Postpartum
the Prenatal
Ottawa
Periods
1995
23
Health
Tobacco
Canada
Reduction
Priority Families Results
24
Louise
Determinants
Health
of Healthy
Smoking
26
The Prevention
27
Agnes
of
Low
Health
Moxley
Paul
Journal
of
in
for
High
Papers
Premiers
on
the
Council on
22
22 see footnote
17
20
Denise Mikolainis
Pencharz
Program on
Intervention
the American
Working
Toronto
Development
Canada
of the Higgins Nutrition
analysis
Status
Women pp 20
in
Programs
Postpartum
Ottawa 1995
Survey
1993
Justice
Birthweight
John
Higgins
on
and Youth
Child
and High Risk Pregnant
Dubois Impact
mother
Paper
and Social
Well-Being
25
of Cross-Canada
Working
Hanvey
and
Prenatal
in
Dietetic
Association
and
birth weight
Sheila
within-
1989 pp
1097
1101
28
Ibid
29
Marie-Paule
Duquette
daide
femmes
30
aux
Dispensary
1991
The WIC
Project
Janine
Desrosiers
de
enceintes
of the
Choquette
milieux
Center on Budget
and
Sheila
defavorisØs
and Policy
Dubois
Montreal
Priorities
Programme
Montreal
Diet
Washington
April
the
House
1994
31
Corporate
Committee
Support
For
on the Budget
The
WIC Program
March
1991
Testimony
presented
to
39
32
Ibid
33
The WIC
34
Foetal
Alcohol
35
1992
come from
36
j_d
37
Canadian
39
Vancouver
40
Prenatal
41
McLaughlin
42
Cam Mustard
Health
Affairs
Seniors
Low
of
of
Commons
the
and the
Birth Weight
Standing
Women
of
20
Canada
in
and the following
quotation
Status
two paragraphs
also
in
Promotion
Canada
Joint
Report
Healthiest
Report
of
Prevention
Fetal Alcohol
Statement
Ottawa
Babies
Syndrome
and
1996
October
Supply and Services
Possible
FAS
Program
Canada
1994
1992
26-3
pp
128 see footnote
The
Utilization
1987-88
Care and Relationship
of Prenatal
Winnipeg
Manitoba
Centre
Phillips
Social
to
for Health
Outcome
Birthweight
Policy
and Education
ui-v
IbLd.p.45
Turner
The
Grindstaff
Olds
of
Low
care
and Social
Birth Weight
Henderson
Pediatrics
and
of Health
Journal
Prevention
prenatal
and outcomes
1986 pp
and
of pregnancy
17-18
This
1990
Chamberlin
randomized
section
is
outcome
in
teenage
50
31
Canada
in
Tatelbaum
Behaviour
and
support
all
trial
from
Improving the
of nurse home
this
delivery
of
visitation
source
Ibid
Oakley
Journal
49
FAE
Department
et
pregnancy
48
al
et
Health Promotion
Health
Winnipeg
44
47
pp 2-3 The
Society
Effects
Prenatal
1993 pp
46
Report
source
Paediatric
Canada
45
Tragedy
Social
Prevention
Priorities
pp 4-5
38
43
The
also
this
Fetal Alcohol
in
and Policy
Preventable
and Welfare
Alcohol Syndrome
Foetal
Center on Budget
Syndrome
on Health
Committee
Ottawa
of the
Project
Elboume
Grant
Rajan and
of Obstetrics
and Gynaecology
Oaldey
and
Social
support
1990
Chalmers
pp
Social
and pregnancy
160
outcome
British
157
and psychological
support
during
40
50
Dame
in
Working
also Carnegie
Our Youngest
51
information
Un QuØbec
of Health
54
de
fou
ses
and Social
and
the Needs
56
Daniel
Keating
and
Fraser
Development
Toronto
57
Starting
58
Sharon
Begley
Ramey
and
Meeting
Justice
Needs
the
of
New York 1994 pp 6-7
for Children
was
supplied
Final
of the
Report
Forum on
National
Development
Our Youngest
of
Ministry
children
652
1994
April
and the
pp 331-45
Children
Economic
Social
for Advanced
Institute
of young
experiences
Poverty
Child
Mustard
Canadian
Quebec
Force on Children
and
Factors
Research
1993
19
1996
Human
Points
Your
Advanced
The
Child
Canadian
Research
Health
Institute
Health
premature
Association
of
February
through
intelligence
of
1995
Successful
pp
early
57 C.T
experience
Perspective
for Advanced
Howell
early
intervention
Minimizing
program
Child
and
Outcomes
Toronto
Population Health
Canadian
for
Institute
3035
Child
Successful
Enhancing
randomized
adverse
of
trial
of
Development
outcome
the
Journal
V.A Rauh T.M
effects
Interventions
Toronto
1994
Research
also
and Long-Term Outcomes
Development
Summary
Program
multisite
1990
C.T
Interventions
14-16
Wiens
and Development
infants
and Long-Term
Development
and Summary
Hertzman and Michele
Population
Newsweek
brain
modification
1981
Hertzman
Perspective
childs
Haskins
Intelligence
Infant
Points
Youth
and
Social
and
67
Ferron
home environments
their
Meeting
61
and
Well-Being
Starting
children
in
Child
Healthy
Corporation of
The
1991
Services
Points
Clyde
York
Carnegie
Volume
Starting
60
of
on the Community Action Program
55
Clyde
New
enfants Report of the Task
Ngandu
Garrett
quality of
59
University
24
Health
53
New
Determinants
the
and well-being
of health
Council on Health
York
Forum on Health
National
Oxford
Toronto
Canada
by Health
52
Premiers
Corporation of
Children
Background
determinants
on
Papers
Toronto
Development
1993
and Childbirth
Pregnancy
Developmental
Keating
youth
in
222
1989
Press
Care
in Effective
pregnancy
of
of low
the
Achenbach
low birthweight four-year
1988
birthweight
American
544
Medical
Nurcombe and
results
of
an
41
62
intervention
Journal
63
Canadian
June
65
66
Ramey
premature
infants
Pediatrics
1992
68
McCarton
for
very
Program
al
1993
70
Rauh
71
C.L Booth
S.J
intervention
in
Guilford
Education
Mental
Booth
73
S.E
et
Booth
1992
J.B
Development
et
al
and
birth
child
weight
intelligence
Fall
from
the
Early
educational
Infant
Health
1234 pp
1993
and
527-533
64
of
effects
early
on
stimulation
low
pp 97-98
62
and
also I.J
Programs
C.E
Birth
in
The
mothers
1987
Preschool
on
the
in
Jester
preventive
Preventing
New
Adolescence
in
Mitchell
effects
role of
trajectory
through
Gordon and R.E
Barnard
The
Morisset
developmental
from
Booth
also
October
The
maladaptive
pp 27-29
The
Action Boston
and
Parent
Allyn
Successful
Spieker
mother-infant
York
Florida
relationship
289
26
Blumenthal
and
D.L
Johnson
Wallace
Centres
1982
1987
for low
Brooks-Gunn
results
1973
Barnard
Interventions
multi-problem
Malone
Development
Child Development
61
K.E
and Toddler
Journal
Andrews
Lasater
Child
1992
with
al
weight
and
infants
Williams
deflecting
99
Health
behaviour
interactive
infants
participation
758 see footnote
M.L
Spieker
Infant
intervention
Tonascia
324 see footnote
1977
Bacon
family
of Pediatrics
546 see footnote
Press
1994
11-12
maternal
Program
Development
Child Development
Behaviour
Antisocial
72
al
et
al
et
pp 754
infants
Nurcombe
birth
Journal
and
Scarr-Salapatek
69
Prevention
Prematurity
455
low
et
Enhancing
319
April
weight premature
and
elements
program
intervention
birthweight
74
Health
Infant
M.C McCormick
Spiker
birth
Meeting
results
755
al The
et
low
and
An
Brennan
preliminary
1984
Weight
Workshop
Brooks-Gunn
in
competence
1993
Birth
and
infants
Psychiatry
Low
Child Health
Ruoff
Teti
birthweight
of Child
Academy
Ferguson and
social
Development
67
of
low
of
Action Plan Coalition
the
Spiker
and child
mothers
for
American
Institute
V.A Rauh D.M
Howell
program
of the
Developing
64
D.C
Nurcombe
Serial
293
Monographs
No
198
The
of
A.J
skills
the
of
Kuhn
C.J
mothering
Society
for
Ferguson
study
Research
of
in
T.M
Parent
Child
42
75
76
Gordon and
and
Jester
Lawrence
Eribaum
and
Health
78
Ibid
13
79
Un OuØbec
80
Cowan
Research
Co
Preventive
and
The
of
effects
program
intervention
and Infants
in
bent..
is
New
Jersey
an interdisciplinary
infant
upon
for couples
the Postnatal
Document
Source
Wiens
Outside
Programs
infant
development
Infant
becoming
Period
New
parents
in
Jersey Ablex
Canada
of
of Longitudinal
Toronto
Canadian
Research
and
for
Institute
10
Infants born
Early
twig
Toddler
pp 225 233
1994
Research
risk
at
Childhood
Early
Compensatory
Development
Burlington
Experiences in Facilitating
of Vermont Press
University
337
1982
Barquest and
Halpern
85
National
86
Child Poverty
The
Start
What
Are
Volume
the
home
visitors
and Guidance
family support
Infant
initiative
Forum on Health
of lay
Personnel
Lamer Lay
and
Survival/Fair
Use
Martin
newborn
families with
84
1987
Intervention
Field
Infant
83
Cowan
the
and
pp 77 89-90
on Support for Parents
Advanced
T.M
1984
enfants
ses
As
Infant
129
intervention
Spring
Education
Parent
Studies
Wasser-Kastner
Clyde Hertzman and Michele
Specific
82
de
fou
and
Publishing
81
Journal
Gordon
1983
education
stimulation-parent
Mental
The
for Longitudinal
Associates
Derevensky
71
113-116 see footnote
Guinagh
Barry
Consortium
Program
77
pp
Jester
Mental
II
during
pregnancy
Health Journal
10
Consequences
primary prevention
Journal
27
1984
and infancy
Summer
for
strategy
560
the
1987
Child
132
MEMBERS
OF THE NATIONAL COUNCIL OF WELFARE
Mr
Bruce Hardy
Mr
Armand
Ms
Helen Margaret
Mr
Charles
Ms
Dana Howe
Windsor
Mr
Jonathan Murphy
Edmonton
Alberta
Mr
David
Winnipeg
Manitoba
Ms
Lorraine
Ms
Claudette
Mr
Calvin
Acting
Chairperson
Surrey
Brun Vice-Chairperson
British Columbia
Shediac
Finucane
New
Regina Saskatchewan
Hamilton
Forsyth
Northcott
Fort
Tordiff
Ontario
Ontario
Smith Northwest
St-Bruno
Toupin
White
Flat
Director
Consultant
Steve
Brenda
Researcher
Liaison
Bay
Quebec
Newfoundland
Kerstetter
Beauchamp
Gilles SØguin
Officer Carole
Publications
Bnrnswick
Officer
Lanthier
Bayram
Anna Kyle
Territories
NATIONAL COUNCIL OF WELFARE
The
Act
Organization
It
to
advises
Council
National
the
1969
Minister
low-income
citizens
as
Human
of
public
of
as
representatives
Council
the
body
by
the
to
Government
the
government
federal
on matters
Development
has
poverty
programs
welfare
income
included
in voluntary
social
reform
system
and serve
citizens
past
and present
as well
people
or charitable
in
policy
of concern
medicare
poverty
taxation
labour
peut
toutes
Œtre
se
procurer
des
les
publications
en
social
bien-Œtre
Ottawa
sadressant
social 2e
K1A
du Conseil
with
social
0J9
en francais
national
au Conseil
The
recipients
as educators
wide
income
and poverty
market issues
exemplaires
personal
agencies
social
de
du bien
national
du
Øtage 1010 rue Somerset ouest
range
of
security
statistics
services
aid
On
their
welfare
including
lines
and appointed
organizations
deal
Canada
in
or
organizations
Council of Welfare
National
and
from across Canada
of
and other low-income
by the
on
retirement
Resources
All are private
and people involved
Reports
issues
than
rather
housing tenants
workers
established
advisory
members drawn
consists of
by the Governor-in-Council
membership
was
Canadians
The Council
capacities
Welfare
of
and
the
legal
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