Mental Health Moderators of Early Head Start on Parenting and Child Development: Maternal Depression and Relationship Attitudes

Objective. Interventions designed to help parents and infants living in poverty could show greatest positive impacts on those participants who have multiple risks. In this study, we examine 2 maternal mental health risks (depression and insecure attitudes toward relationships) that were assessed prior to random assignment as potential moderators of 2 Early Head Start (EHS) programs impacts on parent-child interaction and child development. Design. 309 women were randomly assigned to either EHS program services plus developmental screenings (n = 158) or community services as usual plus developmental screenings (n = 151) following an enrollment interview; 272 provided data at 1 or more follow-up assessment visits. Results. Impacts of EHS on dimensions of parent-child interaction repeatedly observed between 14 and 36 months of child age were concentrated among depressed women (for maternal hostility) and among mothers who were depressed and had insecure relationship attitudes (for maternal sensitivity and child involvement of parent in play). Positive impacts on child language were concentrated among children of depressed mothers. Impacts on cognitive development assessed at 14, 24, and 36 months were not significant. Maternal depression at 36 months was not related to treatment condition as a main effect or moderated by depression and relationship attitudes. Conclusions. Parenting science continues to evolve models for identifying what works best for whom and under what circumstances. In this effort, programs are urged to identify mental health risks early in their alliance with families to support comprehensive service delivery.