Parenting Program Raises IQ of Children Living in Poverty

Caroline Helwick

November 28, 2014

NEW ORLEANS — A program for mothers living in poverty resulted in significant improvements in their children's IQ and other cognitive outcomes 5 years after the intervention, new research shows.

"We found a 5-point difference in IQ at age 3 that was sustained through the third grade. This is pretty huge, especially when you think about the long-term needs of individuals with lower levels of IQ," said lead investigator Lara Robinson, PhD, from the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

More than 16 million American children live in poverty. These children are 1.3-times more likely to have learning disabilities and developmental delays than their more advantaged peers and to exhibit more neurocognitive disparities, Dr Robinson explained.

The prevailing models of early intervention focus on high-quality preschools, behavioral parent training, and home visits.

We need a public health approach to improve outcomes for children in poverty by promoting positive parenting practices.

"We have concluded that we need a public health approach to improve outcomes for children in poverty by promoting positive parenting practices," Dr Robinson said here at the American Public Health Association 142nd Annual Meeting.

The Legacy for Children program, which addresses the developmental disparities associated with poverty, was developed by the CDC to promote maternal self-efficacy, a sense of community, and high-quality parent–child relationships. The curriculum is focused on parenting during early childhood, is delivered in a group-based format with strategies to ensure participation, and the content is reinforced on an individual level.

The investigators tested the intervention in a set of randomized controlled trials. In the Los Angeles study, 233 pregnant mothers and mothers of children up to 3 years of age were randomly assigned to the intervention or comparison group. In the Miami study, 246 mothers of children from 6 weeks to 5 years of age were randomly assigned to the intervention or comparison group. In each study, members of the comparison group did not receive the intervention, but the assessments were the same as in the intervention group.

All parents had an income 200% below the poverty level, and half had a mean annual income below $20,000.

The researchers evaluated the impact of interventions on parenting and maternal wellbeing, child development — cognitive, language, and socioemotional — and health.

The children were assessed when they were aged 3 or 5 years and in third grade. IQ was measured with the Kaufman Assessment Battery for Children, second edition, and word identification, spelling, reading comprehension, and the ability to solve math problems and do calculations were measured with the Woodcock–Johnson III Tests of Achievement.

When children in the Los Angeles group were 3 years of age, more of the intervention than comparison group had an IQ in the average or above average range (50% vs 30%). Five years after the intervention, children in the third grade had significantly higher IQs than children in the comparison group.

In fact, children in the intervention group scored significantly higher than those in the comparison group on many of the parameters.

Because this was an intent-to-treat analysis, children were included in the analysis even if their mothers in the intervention group attended no sessions. "These are conservative numbers," Dr Robinson said.

In the Miami study, cognitive differences were not significantly different between the intervention and comparison groups, she reported, which could be explained by differences in demographic characteristics or timing of the intervention. However, the lack of benefit of the intervention is not yet understood, she explained.

Still, Dr Robinson and colleagues conclude that "shifting the developmental trajectory of early cognitive development has immediate and long-term implications for child health, educational achievement, and wellbeing."

"We know that the disparities related to poverty are huge. They emerge early and widen over time," Dr Robinson said. "There is real importance in shifting IQ and impacting cognitive outcomes."

The peer-to-peer networks have resulted in continued friendships among participants, she added. The researchers are currently involved in bringing their model to other communities.

There is a need to implement interventions that are not only developmentally appropriate, but are also sensitive to the "major cultural angle" of the communities they serve, said Susan Cheng, PhD, from Benedictine University in Chicago, Illinois, who is involved in improving child health in the Native American population in California.

"This is part of relationship building and trust," she told Medscape Medical News. "We need to learn how to get community buy-in so that mothers trust the ones providing the good information without feeling that they are being judged," she explained.

Cognitive Outcomes in the Los Angeles Study


Intervention Group

Comparison Group

P Value

Age 3 IQ




Age 5 spelling




Third grade      




Word identification




Reading comprehension




Solving math problems





Dr Robinson and Dr Cheng have reported no relevant financial relationships.

American Public Health Association (APHA) 142nd Annual Meeting: Abstract 304166. Presented November 18, 2014.


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