This article reports on the fourth phase follow-up of participants in the Infant Health and Development Program, a randomized, controlled trial of an educational intervention for low birth weight, preterm infants, which began in 1984. The intervention included weekly home visits during the infant's first year and biweekly visits during the second and third years. In addition, from 12 months the infants participated in daily, center-based education and parents joined a bimonthly support group. Within two birth weight groups (heavier low birth weight: 2001 to 2500 grams and lighter low birth weight: 2000 or fewer grams), infants were randomly assigned to an intervention group or to a follow-up only group. Infants were assessed at three, five and eight years of age. In the fourth phase, 636 (64.6 percent) of the original 985 participants were assessed at age 18 on academic achievement, behavior, cognitive development and physical health.

Key Findings:

• Among the heavier low birth weight group, those receiving the intervention demonstrated higher achievement on the Woodcock-Johnson Tests of Achievement in math and the Peabody Picture Vocabulary Test and fewer risky behaviors on the Youth Risk Behavior Surveillance System.
• Consistent with results at eight years of age, the lighter birth weight group did not exhibit significant differences between the intervention and follow-up only groups, with one exception. Achievement on the Woodcock-Johnson Tests in reading was higher for the follow-up only group than for the intervention group.

The authors conclude that the results support preschool education for developmentally at risk children, yet note that the absence of effects for the lighter low birth weight group raises questions about biological and educational factors that influence sustained effects of early education.