Childlull and Youth Services Review. Vol. 17, Nos. l/2. pp. 151-276.

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The Learning, Physical, and Emotional

Environment of the Home in the Context of
Poverty: The Infant Health and
Development Program

Jeanne Brooks-Gunn
Pamela Kato Klebanov
Fong-ruey Liaw
Columbia University

The impact of individual environmental and biological risks and the number of
risks on the home environment of 3-year-olds is examined in a sample of low
birth weight, premature infants enrolled in the Infant Health and Development
Program (IHDP). The 1HDP is a large clinical trial designed to test the efficacy
of early intervention services. The effects of 13 risk factors upon the HOME
are examined separately for poor and non-poor families. Compared to non-
poor families, poor families experienced more multiple risk factors and had
lower HOME scores. The number of risk factors was associated with less stim-
ulating home environments, in both poor and non-poor families. Early

Acknowledgments: This paper is based on the data from the Infant Health and Development
Program and was presented at the meeting of the Society of Research in Child Dcvclopment.
New Orleans, March 25, 1993. The Infant Health and Dcvelopmcnt Program was funded by
the Robert Wood Johnson Foundation. Additional support was provided from the Pew Char-
itable Trusts; the Bureau of Maternal and Child and Resources Dcvelopmcnt. HRSA. PHS,
DHHS; the National Institute of Child Health and Human Development. The writing of this
paper was supported in part by grants from the March of Dimes Foundation. the National
Institute of Child Health and Human Development, and the Pew Charitable Trusts. The con-
tinuation of the Infant Health and Development Program was supported by grants from the
sources listed earlier to the Longitudinal Study Office (Einstein Medical School and Colum-
bia University) and the Data Coordinating Center (Johns Hopkins University). We wish to
thank Ruth Gross, Donna Spiker. Helena Kraemer, Sam Shapiro, Craig Ramey. Donna Bry-
ant, Cecelia McCarton, James Tonascia. and Pat Belt. as well as the National Study Office of
the Infant Health and Development Program of Stanford University for assistance in data
preparation and coordination. and Educational Testing Scrvicc for its support of the research.
Reprint requests should bc sent to Dr. Jeanne Brooks-Gunn, Virginia and Leonard Marx
Professor of Child Dcvclopmcnt. Ccntcr fat- Young Children and Families. Tcachcrs Collcgc.
Columbia University, New York, NY l(H)27 USA.

251
252 Brooks-Gunn, Klebanov, and Liaw

intervention services were associated with higher learning scores but not higher
physical or emotional environment scores. In terms of learning experiences,
non-poor mothers who experienced the greatest number of risks benefitted
more from the treatment than mothers with fewer risk factors. The pathways
through which poverty influences learning experiences and intervention strat-
egies to improve the home environments of young children are proposed.

Many dimensions of parenting have been identified as central to the parent-

child relationship and to children’s well-being. Dimensions identified from
most studies of young children and their families include the provision of
developmentally appropriate, stimulating learning environments, warmth,
and the physical environment (Barnard & Kelly, 1990; Beckwith, 1990;
Bornstein, in press; Maccoby & Martin, 1983). The provision of learning
experiences and maternal warmth have been studied via observation of the
home, interview of the mother, and observation of the mother and child in
interaction. Perhaps the most commonly used measure for assessing all three
dimensions is the Home Observation of Measurement of the Environment
(HOME) (Caldwell & Bradley, 1984). The HOME assesses the learning
materials in the home, the experiences offered by the mother, and the amount
of warmth expressed toward the child (Bradley et al., 1989; Gottfried, 1984;
Wachs & Gruen, 1982). The HOME is highly related to a variety of child out-
comes, often being a more potent predictor of cognitive and school academic
readiness scores than maternal education (in regressions entering both vari-
ables) (Bradley et al., 1989). Typically, outcome studies use the total HOME
score, although conceptually, the provision of learning experiences, warmth,
and the physical environment are quite distinct.
Less work has focused on the antecedents of home environment measures
than on their influences upon the child. However, understanding the path-
ways linked to the provision of learning experiences, warmth, and physical
environment is important, not only for building conceptual frameworks
including family process and outcome, but for developing family-focused
interventions or improving programs offered to mothers entering the work
force. Children’s development may be enhanced by a change (or improve-
ment) in the ways in which mothers provide learning experiences or in
maternal warmth (Bradley et al, 1994; Chase-Lansdale & Brooks-Gunn, in
press). Additionally, augmenting maternal parenting skills may also influ-
ence the mother by increasing her self-esteem and enjoyment of parenting,
as well as by lessening family conflicts.
This research article has two aims-a) to examine the antecedents of the
provision of learning experiences, warmth, and physical environment in the
context of poverty and multiple risk factors, and b) to examine the effects of
early intervention upon the home environment, again, in the context of pov-
erty and multiple risk factors. The sample consists of low birth weight
(LBW), premature infants who were enrolled in the Infant Health and Devel-
Poverty and the Home Environment 253

opment Program (IHDP). The IHDP is a large multisite clinical trial testing
the effect of family and child early intervention services in the first three
years of life in reducing developmental delays (Infant Health & Develop-
ment Program, 1990). Low birth weight children are more likely than normal
birth weight children to experience a variety of cognitive, neurological, lan-
guage, and emotional delays as well as decrements in school functioning
(Dunn, 1986; Institute of Medicine, 1985; Landry, Chapieski, Richardson,
Palmer, & Hall, 1990; McCormick, 1989; McCormick, Brooks-&inn,
Workman-Daniels, Turner, & Peckham, 1992). Mothers of LBW children
are at greater risk for less optimal parenting, in large part due to the charac-
teristics of their children (difficulty regulating distress, less task persistence,
more distracted, more labile) (Beckwith & Cohen, 1984; Cmic, Greenberg,
Ragozin, Robinson, & Basham, 1983; Field, 1989).
Perhaps most troubling from the perspective of eventual child outcomes,
mothers of LBW children are more likely to be socially and economically
disadvantaged than mothers of normal birth weight children-poverty-level
incomes, less than high school education, low levels of literacy, residence in
poor neighborhoods, less access to health care, minority status (Institute of
Medicine, 1985; Kleinman & Kessel, 1987). These factors not only contrib-
ute to the birth of a LBW baby, but have negative impacts throughout the
child’s life course. Children with a biological risk factor in the face of pov-
erty (or its co-variates) have been considered to be at double jeopardy
(Brooks-Gunn, Klebanov, Liaw, & Duncan, 1994; Escalona, 1982; Parker,
Greer, & Zuckerman, 1988). Many, but not all, LBW children fit this
description.
Two research traditions are relevant to our first aim, an examination of
the antecedents of parenting behavior in the context of poverty. Previous lit-
erature suggests that poverty is associated with inadequate parenting (e.g.,
harshness, lability or inconsistency, family conflict, family violence). Much
of our knowledge about parenting outcomes is derived from observational
studies of unemployed parents (Conger et al., 1992; Elder, 1974) and single
parents (Barnard et al., 1988; Chase-Lansdale, Brooks-Gunn & Zamsky,
1994; Hetherington & Clingempeel, 1992; McLoyd, 1990). Studies in this
tradition have not focused on provision of learning experiences and physical
environment. Their measures of warmth are derived from complex interac-
tion coding schemes or interviews, not on relatively straightforward
observations. Another literature uses as its frame the notion of cumulative
risks. This research focuses on children, not parents. Generally, as the num-
ber of risk factors increases, child outcomes become poorer. Perhaps the best
exemplar is the work of Sameroff and his colleagues (Sameroff, Seifer,
Baldwin, & Baldwin, 1993; Sameroff, Seifer, Barocas, Zax, & Greenspan,
1987) who have reported on child IQ at ages 4 and 13, and found a steep drop
in IQ as a function of the accumulation of risk factors in families.
254 Brooks-Gunn, Klebanov, and Liaw

This article brings together these two research traditions in looking at the
effects of 13 risk factors, both biological and environmental, upon parents’
provision of learning experiences, warmth and physical environment to their
3-year-olds and in looking at these effects separately for families who are
poor and who are not poor. Most developmental studies do not include pov-
erty in their regression analyses (developmental studies often do not include
family income measures, or include inadequate economic information to cal-
culate income-to-needs ratios, a shortcoming not found in sociological or
economic studies [Brooks-Gunn, Phelps, & Elder, 199 1; Brooks-Gunn,
McCarton et al. in press; Duncan, Brooks-Gunn, & Klebanov, 19941). That
is, other studies may over-estimate the effects of other risk factors because
of their association with poverty (the same could be said about studies only
looking at poverty and the home environment, although such studies are rare
in the developmental literature). We expect that growing up in a poor house-
hold influences parents’ behavior quite negatively, following other research
(Chase-Lansdale & Brooks-Gunn, in press; Huston, 1991; McLoyd, Garcia-
Coll, & Huston, 1994; see for a brief review, Danziger & Stem, 1990).’
However, it is less clear what the role of other familial factors are, or whether
or not these factors operate differently in families who are poor and those
who are not. The contributions of other risk factors to the expected effect of
poverty are explored here, going beyond the social and demographic factors
often examined in macro-oriented data sets (and included here as well-sin-
gle parenthood, unemployment of head of household, low maternal
education, high child to adult ratio). Maternal depression, low social support,
and stressful life events have been associated with poverty in previous work
(Belle, 1990; Parker et al., 1988). Maternal beliefs about childrearing also
probably influence parental behavior. Maternal knowledge of the develop-
mental abilities of infants is associated with the mother’s structuring of a
stimulating physical and learning environment (Luster & Dubow, 1990;
Snyder, Eyres, & Barnard, 1979; Stevens, 1984). Not only may these indi-
vidual risk factors influence parenting behavior, but the effect of experienc-
ing multiple risk factors may have a particularly devastating effect, a premise
that is tested here.
The second aim of the study is to see whether or not the early intervention
services provided by the IHDP influenced the home environment, and
whether or not it did so differently as a function of poverty status and multi-
ple risk factors. Overall effects for the total sample are reported in Bradley,
Casey, Barrett, Whiteside, Mundfrom, and Caldwell (in press). While other
interventions have examined parental outcomes in LBW, disadvantaged, or
families with many risk factors (often termed multi-problem families; Bar-

1. Issuesof persistenceand timing of poverty are not examined in this article. given the focus
on cumulative risks other than poverty: see Duncan. Brooks-Gunn& Klchanov (1994) for a
discussionof persistenceeffecls on child outcomes in this sample.
Poverty and the Home Environment 255

nard et al., 1988; Rauh, Achenbach, Nurcombe, Howell, & Teti, 1988; See
also review by Benasich, Brooks-Gunn, & Clewell, 1992), to our knowledge
no previous study has looked at effects vis-a-vis the number of risk factors
or in poor and non-poor samples separately. Few interventions have had
enough families for subgroup analyses and few early childhood interven-
tions include not poor families.

Method

Design

Infants who weighed 2500 grams or less at birth and were 37 weeks or
less gestational age were screened for eligibility if they were 40 weeks post-
conceptional age during a 9-month period in 1985, and if they were born in
one of 8 participating medical institutions (Arkansas, Einstein, Harvard,
Miami, Pennsylvania, Texas at Dallas, Washington, and Yale). The primary
analysis group consisted of 985 infants who consented to participate and
joined the study (21% of the families who met the enrollment criteria refused
consent). Infants were randomized into two groups-a follow-up only group
(FUO) and an intervention group (INT).2
The sample was stratified by clinical site and into two birth weight
groups-heavier low birth weight preterm infants (2001 to 2500 grams) and
lighter low birth weight preterm infants (2000 grams or less). Twice as many
lighter than heavier low birth weight infants were randomized (given the
focus on biological risk). More infants were randomized to the follow-up
only group than the intervention group, due to the high cost of the interven-
tion. Other characteristics included in the randomization procedure were
gender, maternal education, maternal ethnicity, primary language in the
home, and infant participation in another study (see Kraemer & Fendt,
1990). The two groups did not differ on any of these characteristics (see
Table 1 in Brooks-Gunn, Klebanov, et al., 1993). The target sample for each
site was estimated at 135 infants (actual range was 100 at Miami to 138 at
Einstein and Harvard; see Table 1 in Infant Health & Development Program,
1990).
Attrition over the three years of the study was low (7%). The two arms of
the trial did not differ on any of the variables measured prior to randomiza-
tion at the 3-year follow-up. Results of the IHDP have been previously

2. Specific information concerning enrollment criteria, home visitation, and the assessment
schedule of the IHDP study have been reported in detail elsewhere (Brooks-Gunn, Klebanov,
Liaw, & Spiker, 1993; Infant Health & Dcvelopmcnt Program, 1990; Ramey et al., 1992;
Spiker, Ferguson, & Brooks-Gunn. 1993).
256 Brooks-Gunn, Klebanov, and Liaw

reported for three primary outcomes when the children were 24 and 36
months of age corrected for prematurity; significant treatment effects were
reported for enhanced cognitive scores and reduced behavior problem scores
(Brooks-Gunn, Klebanov, et al., 1993; See also Brooks-Gunn, McCarton,
Casey, McCormick, et al., 1994; Infant Health and Development Program,
1990; Liaw & Brooks-Gunn, 1993).

Program

The intervention program began when the infant was released from the
neonatal nursery. It continued until the child was 36 months of age corrected
for prematurity (Constantine et al., 1987). Children in both the follow-up
only and the intervention group received the same pediatric follow-up ser-
vices, which included medical, developmental, and social assessments, and
referral for pediatric care and other services when indicated. The interven-
tion group families received home visits over the first 3 years of the child’s
life, a center-based educational program in the 2nd and 3rd years, and parent
group meetings during the 2nd and 3rd years. Home visits occurred weekly
during the first year and twice a month during the second two years. The con-
tent of the home visits included information on child health and development
(instruction in the use of age-appropriate games and activities in emotional,
social, cognitive, and linguistic domains [Sparling & Lewis, 1985; Sparling
et al., 19911). It also included family support in the management of self-iden-
tified problems (Wasik, 1984). The child development centers were open to
the children 5 days a week; children were expected to attend at least 4 hours
a day. Teacher-child ratios were 1:3 for children in the 2nd year of life and
1:4 in the 3rd year of life. The center-based schooling used basically the
same child curriculum as implemented in the home (Ramey et al., 1992;
Sparling et al., 1991). Parent support groups met about 6 times a year during
the 2nd 2 years.

Procedure

Children in both groups received pediatric surveillance through clinic

visits at 40 weeks conceptional age (birth) and at 4, 8, 12, 18, 24,30, and 36
months corrected age. Over 90% of the assessments occurred within plus or
minus 2 weeks (as specified by protocol). Home visits occurred at 12 and 36
months of age to obtain information on the home environment. The inter-
viewers and testers were unaware of the infant’s group status for collection
of child cognitive and behavioral outcome and home environment data.
Clinic staff also conducted family interviews at each visit (clinic staff were
aware of group status).
Poverty and the Home Environment 257

Sample

Data were used from the initial status variables collected at the time of
randomization, from the 12 month-assessment, the 18-month assessment,
and the 36-month assessment. Complete data for these analyses were avail-
able on 704 children (72% of the primary analysis group). The loss is due to
the fact that not all families completed each assessment (in fact, the high
retention rate at 36 months is due in part to the decision to send psychologists
out to assess families who had moved out of the 8 catchment areas; this
costly procedure could not be used at intermediate points in the trial). Com-
paring the families for whom we had complete data across the multiple
assessment points with those for them we did not revealed no differences in
child initial status variables (gender, neonatal health, birth weight) or treat-
ment group. However, the mothers included in these analyses were more
likely to be white (39% vs. 31%), in their twenties or thirties (9% vs. 15%
being a teenager at the time of the birth), and better educated (65% vs. 48%
having at least a high school degree). Such differences in maternal charac-
teristics may affect our findings for both risk factors and outcomes. The
average number of risk factors reported may be lower and the average level
of the home environment may be higher for the analysis sample than for the
full sample. We do not know how such differences may affect the strength
of the associations between risks and outcomes. However, the within group
analyses for poor and not poor subgroups are probably not affected, given
that these two subgroups (poor and not poor) did not differ for families with
and without complete data.
The FUO group constituted the sample for all analyses (N = 423). The
only exception was for analyses that examined the effect of treatment on the
three aspects of the home environment because of our interest in isolating the
effects of risk and poverty from the receipt of intervention services.

Measures

Poveqr. Families were classified as poor or not poor using the 1986 U.S.
poverty thresholds, based on family income and size at the 12-month assess-
ment. Poverty was defined as an income-to-needs ratio of 150% or less. The
number of families classified as poor was 397 (230 of the FUO and 167 of
the INT group); 307 were designated as not poor (193 in the FUO and 114
in the INT group).
Risk characteristics. These analyses include 13 risk factors representing
biological, social and economic, family structural, and maternal characteris-
tics. The majority of risk factors are similar to those examined by Sameroff
et al. (1987, 1993). Risk factors were constructed based on the first time that
258 Brooks-Gunn, Klebanov, and Liaw

they were assessed in the IHDP (See also Liaw & Brooks-Gunn, in press, for
a description of these risk factors). The presence of a risk was coded 1; the
absence of a risk was coded 0. The risk factors are: (a) Having a child who
weighed 1500 grams or less was a risk factor. (b) A neonatal health index
(NHI) was derived, based on the length of stay in the newborn nursery which
is adjusted for birth weight (since lighter infants tend to stay in the nursery
longer). Standardized to a mean of 100 and a S.D. of 16, higher scores are
indicative of better health (Scott, Bauer, Kraemer, & Tyson, 1989). A score
less the 25th percentile for this sample (NH1 < 92) was designated as high
risk. (c) Unemployment of the household head at the time of the family inter-
view was designated a risk factor. (d) Mothers having less than a high school
education was defined as a risk. (e) Mothers having a verbal comprehension
score on the Peabody Picture Vocabulary Test-Revised (PPVT-R) (Dunn &
Dunn, 1981) lower than the 25th percentile for this sample (score less than
66; mean of the PPVT-R is 100 with aS.D. of 16). (f) Having a high maternal
depression score on the General Health Questionnaire (GHQ), a 12-item 4-
point Likert scale (Goldberg, 1978); high is defined as the 25th percentile
(score of more than 13). (g) Having a stressful life events score of more than
3, from a scale including 18 events, including illness, death, change in
school, work or residence, and need for services. (h) A low social support
network score, based on mothers’ responses to 6 vignettes asking to whom
they would turn for emotional, child care, and monetary support (Cohen &
Lazarus, 1977; McCormick et al., 1987); overall scores for the vignettes
range from 0 to 12 with risk defined as a score of less than 7. (i) Being a teen-
ager at the time of the child’s birth was a risk factor. (j) Father absence at the
time of the family interview was also considered a risk factor. (k) Having a
child-to-adult ratio in the household of greater than 2, a measure of family
density, was defined as high risk. (1) Having a simplistic, categorical view of
child development, based on the Concepts of Development Questionnaire
(CODQ; Sameroff & Feil, 1985). Using a 20-item scale with a range for 1.00
to 4.00; a score lower than the 25th percentile designated risk (score of less
than 1.65). (m) Being from an ethnic minority (in this sample Black or His-
panic, accounted for 52% and 9% of the sample respectively) (Liaw &
Brooks-&inn, 1994, p. 363-364).3 The prevalence of risk factors in poor and
non-poor families by ethnic background are presented in Table 1.
&variates. We included clinical sites and the child’s gender as covariates
in all our analyses. Child’s gender was dummy-coded (female = l), and the
8 clinical sites were coded into 7 dummy variables, with the eighth site omit-
ted as the control group.
Outcomes. Three aspects of the home environment were measured by the
preschool version (ages 3-6) of the Home Observation for Measurement of
the Environment (HOME) (Caldwell & Bradley, 1984) at 36 months cor-
rected age. The HOME is a 55 item semi-structured observation interview
Poverty and the Home Environment 259

that assesses the child’s level of stimulation in the home environment. Three
subscales were used here: provision of learning stimulation, which is a com-
posite of the learning, academic, and language stimulation and variety in
experience subscales (e.g., child has toys which teach color, size, shape,
child is encouraged to learn the alphabet and numbers); mean = 22; S.D. = 6;
range 6-32; alpha reliability = .87 for 32 items; physical environment (out-
side play environment appears safe, interior of apartment not dark or
perceptually monotonous); mean = 5; S.D. = 2; range O-7; alpha = .74 for 7
items; and emotional atmosphere/parental warmth (parent caresses, kisses,
or cuddles child during visit); mean = 5; S.D. = 2; range O-7; alpha = .64 for
7 items. Reliability coefficients are based only on the follow-up subjects.
The three subscales are moderately correlated (all correlations significant at
p c .Ol). Correlations between home learning and physical environment and
warmth are .47 and .48, respectively; correlations between home physical
environment and warmth are .25. The interview and observation of the
HOME was conducted by staff trained by one of the developers of the
HOME (Bradley) as well as by the deputy director of the IHDP (Spiker) (See
Bradley et al., 1994, in press).

Results

Poverty ad Risk Factors

Poor families were more likely to have multiple risk factors, compared to
families who were not poor (analyses are for FUO group only; 5 vs. 2, t =
12.97,~ < .OOl). Significant differences were found for all risk factors except
having a very low birth weight child and having a child with poor neonatal
health.4 For example, while only 2% of poor families had no risk factors and

3. Minority status could have been designated a risk factor or a co-variate. In either ca.se.
minority status must be considered since it is associated with lower home scores. the outcome
measureof interest in this study (Bradley et al., 1989). This association is probably due in part
to the fact that ethnic minority families are more likely to be poor and more likely to be per-
sistently poor (Duncan, et al., 1994: Huston. 1991). Additionally, and important given our
interest in cumulative risk in the context of poverty, poor minority families are also more
likely to have more other risk characteristics than are poor white families. speaking to the
former’s more disadvantaged status, over and above income disadvantage (Table 1). If the
sample size had been larger, we would have developed separate poverty by risk analyses for
the ethnic groups separately. Instead. we included ethnicity as a risk factor to reflect the more
disadvantaged status of ethnic minority families. Minority status was also included as a risk
factor in the analyses of Sameroff and colleagues (1987, 1993).
4. Differences between poor and not poor groups continued to be significant after adjusting
for minority status differences in the poor and not poor groups (set Liaw & Brooks-Gunn,
1994).
260 Brooks-Gunn, Klebanov, and Liaw

Table 1
The Prevalence (%) of Risk Factors in Poor and
Non-poor Families, Follow-Up Group

Nonpoor Families Poor Families

Black Hispanic White Total Black Hispanic White Total
n=58 n=12 n=123 n=l93 n=158 n=26 n =46 n=230
Biological risks:
Very low birth weight 24.1 8.3 21.1 21.2 29.7 30.8 21.7 28.3
Poor neonatal health 12.1+ 25.0 37.4 29.0 17.7* 23.1 37.0 22.2

Socio-economic risks:
Unemployment 20.7* 8.3 8.1 11.9 52.5$ 53.8 19.6 46.1*

Maternal characteristic risks:

Low maternal education 22.4* 25.0 9.8 14.5 47.5 65.4 39.1 47.8*
Low maternal PPVT-R 25.9j 8.3 0.8 8.8 39.9$ 38.5 10.9 33.9
High depression 13.8 16.7 17.9 16.6 25.3 26.9 37.0 27.8’
High stressful life events 8.6 8.3 12.2 10.9 19.0 23.1 28.3 21.3”
Low social support 20.7 8.3 9.8 13.0 31.6 42.3 17.4 30.0.

Family structural risks:

Teenage motherhood 10.3* 0.0 1.6 4.1 12.7 3.8 10.9 11.3O
Father absence 46.65 16.7 5.7 18.7 74.1$ 53.8 39.1 64.8.
High family density 12.1 8.3 4.9 7.3 27.8 23.1 19.6 25.70

Parenting risks:
Categorical child-
rearing views 24.13 8.3 2.4 9.3 34.8+ 26.9 10.9 29.1,

* indicates that ethnic group differences were significant, p < .05.

+ indicates that ethnic group differences were significant, p < .Ol.
$ indicates that ethnic group differences were significant, p < .OOl.
’ indicates that poor vs. non-poor group differences were significant, p < .Ol.
l indicates that poor vs. non-poor group differences were significant, p < .oOl.

35% had experienced 6 or more risk factors, for non-poor families, 19%
experienced no risks at all and only 5% experienced 6 or more risk factors
(See Liaw & Brooks-Gunn, 1994, p. 364-365, for the complete frequency of
risk factors by poverty).
The frequency of risk factors by poverty status and ethnicity was also
examined (see Table 1). Greater ethnic differences were seen for non-poor
families than for poor families. For non-poor families, ethnic differences
were present for seven risk factors: neonatal health, unemployment, mater-
nal education, verbal ability, teenage parenting, father absence, and child-
rearing views. For poor families, ethnic differences were seen on five of
these risk factors, with no differences on maternal education and teenage
parenting.
Poverty and the Home Environment 261

The ESfect of Risk Factors on the Home Environment

Home learning environment. The associations between individual risk

factors and the home environment were examined in hierarchical regressions
(FUO group only). These associations were examined after controlling for
the covariates (gender, site) in the 1st step, and poverty in the 2nd step. Addi-
tionally, the interaction of risk factors by poverty on home learning was
examined via a series of regressions where each individual interaction term
was entered one by one (hence, 13 regressions; p set at .Ol to adjust for mul-
tiple analyses; see Cohen & Cohen, 1983).
Table 2 presents the regression for the provision of learning experiences.
The total R squared for the entire model was .47, p < .OOl. Family poverty
was a strong and significant predictor (Standardized Estimates or SEs in
parentheses; -.16). However, even controlling for poverty status, 4 factors
were associated with home learning scores at 36 months of age-non-minor-
ity status (-.22), more maternal education (.16), higher maternal PPVT-R
scores (. 17), and more perspectivistic view of child-rearing (. 13).
Using the multiple-risk score (range: 0 to 12), families in the FUO group
only were put into six groups (given the small numbers in some of the
groups)-those with none or 1 risk, those with 2 risks, and those with 3,4,
5, and 6 or more risks. Hierarchical multiple regressions were used; covari-
ates, the multiple risk score, and poverty status were entered first.5 Then the
interaction term of poverty by multiple risk score was entered to see if the
number of risks had differential effects for the poor and non-poor families.
Significant main effects of multiple risk were seen (t = -7.07, p <.OOOl); as
risks increased, the home learning environment became less stimulating.6 A

5. The same regression analysis based on a cumulative risk score computed from different
cut-offs of risk for three of the risk factors was conducted because of the possibility that dctin-
ing some of the risks relative to the sample rather than relative to the population may produce
discrepant results. Low maternal PPVT-R was defined as less than one standard deviation
below the mean (i.e., a score of less than 84) rather than as a score lower than the 25th per-
centile for the sample). High maternal depression was defined based on an cut-off score of9
or higher (extrapolated from Goldberg. 1978) rather than as the 25th perccntilc. Finally. pool
neonatal health was defined as scoring less than one smndard deviation below the mean (i.e.,
a score of less than 84) rather than as a score less than the 25th percentile. The results for the
effects of this cumulative risk index on the three home environment outcomes were virtually
identical to the results using the original index. This heing the case, the original index of
cumulative risk was used in all the analyses to remain comparahlc with the analyses con-
ducted by Sameroff et al. (1987. 1993).
6. Additional regression analyses also tested the possibility that the effect of risks was non-
linear. These analyses controlled for the effect of risk and the effect of risk squared (i.e., a qua-
dratic risk term). The results reveal a nonsignificant effect of risk squared for all three home
environment outcomes.
262 Brooks-Gunn, Klebanov, and Liaw

Table 2
Standardized Regression Coefficients of Risk Factors Predicting
36 Month Home Outcomes (Follow-Up Only Children)

Predictor Learning Physical

Environment Environment Warmth
(N = 386) (N = 386) (N = 3X6)
Covariates:
Site
Female .05 .OiI .07
Poverty -.16+ -.38$ -.27$
R2 ,293 .22$ .lO$
Risk factors:
Birth weight -.02 -.OO -.04
Neonatal health index .Ol -.04 .03
Minority -.22$ -.15* -.15*
Unemployment .03 .04 -.04
Maternal education .16X+ .13* .04
Maternal PPVT-R .17+ .15* .I4
Maternal depression -.04 -.05 -.Ol
Stressful life events .02 -.04 -.05
Social Support .07 -.08 .07
Maternal age < 18 years .Ol .03 -.13*
Father absence -.02 .01 -.02
Father density -.06 -.15+ .09
Perspectivistic view of child-rearing .13* .02 .Ol
(R2 change due to risk factors) (. l7i) (.I()$) (.08$)
Total R’ .47f .32$ .IS$
Significant novertv x individual risk interaction”:
Poverty x Maternal PPVT-R N. S. N. S. .48*

aEach of the 13 risk x poverty interaction was entered individually in the second step of regres-
sions; only the significant interactions arc presented.
*p<.05.+p<.01.J:p<.001.

main effect of poverty indicated that across all risk groups, generally, poor
families had less stimulating home learning environments (t = -4.56, p <
.OOOl). The interaction term was not significant (t = 1.38, p > .OS). Figure 1a
presents these findings, using HOME-learning scores adjusted for site and
gender.
Home physical environment. Table 2 also presents the regression for the
physical environment of the home. The total R squared for the entire model
was .32, p < .OOl. Family poverty was a strong and significant predictor (SE
= -.38). In addition, four risk factors were associated with physical environ-
ment scores even controlling for poverty status (SEs in parentheses)-
minority status (-.15), maternal education (. 13), maternal PPVT-R (.15), and
family density (-.15). Mothers who were not ethnic minorities, who had
Poverty and the Home Environment 263

3-I 2 3 1 5 6*

Number of Risks

Figure la.
Adjusted HOME-Learning Scores by Risk Groups
and Poverty Status (Follow-Up Only Group)’

2a1
- Abow Povwly
- 1” Pow*

Number of Risks

Figure lb.
Adjusted HOME-Physical Environment Scores by
Risk Groups and Poverty Status (Follow-Up Only Group)’

‘Means presented are adjusted for the effects of site and gender.
264 Brooks-Gunn, Klebanov, and Liaw

Number of Rusks

Figure lc. Adjusted HOME-Warmth Scores by Risk Groups and Poverty

Status (Follow-Up Only Group)l

’ Means presented are adjusted for the effects of site and gender.

In addition, significant main effects were found for the effects of cumu-
lative risk (t = -4.38, p < .OOOl) and for poverty status (t = -4.86, p c .OOOl).
Greater risks and poverty were both associated with a worse physical envi-
ronment. The interaction between risks and poverty, however, was
nonsignificant (t = 1.07, p < .28). Figure lb presents these findings, using
home physical environment scores adjusted for site and gender.
Home warmth. As presented in Table 2, the total R squared for the model
is .18,p c .OOl. As found for the other home outcomes, poverty was a strong
and significant predictor (SE = -.27). After controlling for the effects of pov-
erty, only two of the risk factors were associated with home warmth (SEs in
parentheses)-minority status (-. 15) and teenage parenting (--13). Mothers
Poverty and the Home Environment 265

who were ethnic minorities and who were teenage parents exhibited less
warmth. There also was a significant interaction between poverty and mater-
nal PPVT-R scores (.48). The effect of maternal PPVT-R on enhancing
maternal warmth and responsivity was greater for poor children than for
non-poor children.
There were significant main effects for the effect of risks on the warmth
and responsiveness of the mother (t = -4.03, p < .OOOl) and for poverty (t =
-2.62, p c .Ol). Greater risks and poverty were associated with less maternal
warmth (See Figure lc). The interaction between risk and poverty was non-
significant (t < 1, p < .38).

The Effects of Risk in the Context of Early Intervention

Home learning environment. These analyses include the FUO and INT
groups, comparing them by means of hierarchical multiple regressions.
Here, covariates of site and gender were entered, then the multiple-risk score
and intervention group, and finally an interaction term for multiple-risk by
treatment (IHDP, 1990). Two sets of regressions were run-one for poor
families and one for families who were not poor.
In the families who were poor, significant effects of treatment (t = 3.48,
p < .OOl) were seen. Additionally, as multiple-risks increased, HOME-leam-
ing scores decreased (t = -5.78, p c.001). No interaction was seen (t < l),
suggesting that the intervention had similar effects across multiple-risk
groups. In the families who were not poor, significant effects of treatment (t
= 2.80, p < .Ol) were also seen. Also, multiple-risks had adverse effects on
HOME-learning scores (r = -5.79,~ < .OOl). A significant treatment by mul-
tiple-risk interaction was found (t = 2.3 1, p < .OS). The treatment effect for
mothers on non-poor households was more pronounced in the families who
had five or six risk factors than those with none to one or two risk factors.
Figure 2 presents these findings adjusted for site and gender.
Home physical environment. In the families who were poor, there was no
effect of treatment (t < -1) or a treatment by risk interaction (t < 1). There
was, however, an effect of risk, with greater risks associated with worse
physical environment scores (t = -3.42, p < X01). Similar results were found
in the families who were not poor. There was no effect of treatment (t < -1)
or treatment by risk interaction (t = 1.10, p >.27), although there was an
effect of risk (t = -4.45, p < .OOOl).
Home warmth. In the families who were poor, there was no effect of treat-
ment (t < 1) or treatment by risk interaction (t < 1). There was an effect of
risk (t = -3.71,~ < .OOl), with greater risks associated with less warmth. In
families who were not poor, there was no effect of treatment (t < 1) or treat-
ment by risk interaction (t = 1.09, p > .28). Greater risks were marginally
associated with less warm home environments (t = - 1.85, p < .07).
266 Brooks-Gum, Klebanov, and Liaw

6
0-l L 4 5 6+

Number of Risks

Figure 2.
Adjusted HOME-Learning Scores by Treatment and Risk Groups’

‘Means presented are adjusted for the effects of site and gender.

Discussion

Poverty clearly has a negative effect on the provision of learning experi-

ences, physical environment, and maternal warmth as seen in the homes of
LBW 3-year-olds.7 That the effect of poverty is seen even in families with
few risk factors (Figure 1) suggests that of the factors measured in this study,

7. Because children in the IHDP were LBW, premature infants assessed at eight medical sites,
a cautionary note is needed about the representativeness of the IHDP sample. It is not known
whether similar results would be found for a national sample of normal birth weight children.
However, the results of another large sample of low and normal birth weight (NBW) children
found that education, ethnicity, and female headship are associated similarly across the birth
weight spectrum (McCormick et al., 1992).
Poverty and the Home Environment 267

poverty is one of the most potent (see also the regression results in Table 2).
At the same time, all of the risk factors measured in this study were them-
selves associated with poverty, with the exception of infant health and
gender. Given that the sample was limited to low birth weight children, the
distribution of infant health outcomes is quite truncated. Indeed, poverty and
its co-factors are associated with the birth of a low birth weight infant (Ber-
endes, Kessell, & Yaffe, 1991; Institute of Medicine, 1985; Kleinman &
Kessel, 1987; Kramer, 1987).
Our findings allow us to speculate on some of the pathways by which
poverty might influence home stimulation, given the results controlling for
poverty status. One likely pathway might be the education and verbal ability
of the parent. Effects of these two factors on the home learning environment
were seen over and above family poverty. Moreover, studies looking at edu-
cation and verbal skills (but not poverty) always report significant associ-
ations with provision of home learning using the HOME or similar measures
(Bradley et al., 1989; Gottfried, 1984; Wachs & Gruen, 1982).
Another set of pathways may involve maternal beliefs about parenting. In
this study, taking a perspectivistic view of childrearing was associated with
provision of stimulating experiences in the home 24 months later (the former
measure being collected when the child was 12 months old and the home
learning measure when the child was 36 months). This finding is consistent
with previous work that has hypothesized links between childrearing beliefs
and parental behavior (Martin & Johnson, 1992; McGillicuddy-Delisi, 1985;
Sameroff & Chandler, 1975; Sigel, 1985), with some evidence supporting
this premise (see Miller, 1988 for a review).
The research literature suggests other pathways through which poverty
may affect the home environment. One of these pathways is the time avail-
able to spend with the child (time being less likely in families with high child
to adult ratios as well as in father absent homes) (Garfinkel & McClanahan,
1986; Lee, Brooks-Gum-i, Schnur, & Liaw, 1990; Zajonc, 1976). Similarly,
the lack of availability of adults, particularly committed, related adults, also
may signal less emotional resources, as well as time resources. However, our
results do not support such a pathway. Net of poverty and the other influ-
ences, father presence and density of children were not associated with home
learning.
Another set of pathways involves maternal depression, stressful life
events, and social support. All three variables are highly inter-related and
often have been often postulated to influence parenting behavior. There is a
plethora of research linking distress, specifically depression, with develop-
mental outcomes of the child (See special section on developmental
psychopathology in children of depressed mothers) (Dodge, 1990). More-
over, some studies have documented an association between psychological
distress and poor or impaired parenting behavior (Belle et al., 1982;
268 Brooks-Gunn, Klebanov, and Liaw

McLoyd, 1990; McLoyd & Wilson, 199 1) and even child abuse (Garbarino,
1976). Our findings, however, do not support such a pathway. The indepen-
dent effects of this triad on the home learning environment were not seen
after controlling for family resources such as income, household structure,
and human capital.
These findings on the irzdividual correlates of home learning scores speak
to the types of interventions that might be mounted. Clearly, interventions
that target maternal education are likely candidates vis-a-vis altering mater-
nal provision of learning experiences. The majority of workfare and JOBS
program evaluations look at maternal education, job skills, employment and,
to a lesser extent, literacy, as outcomes (Chase-Lansdale & Brooks-Gunn, in
press). However, few look at parenting outcomes (see review of programs
for teenage mothers that focus on parenting and child outcomes by Clewell,
Brooks-Gunn, & Benasich, 1989). An exception is Project Redirection, a
program targeting poor teenage mothers. HOME scores improved for moth-
ers enrolled in Project Redirection (Polit, 1989). Current evaluations are
including such outcomes, however, as more “two-generational” approaches
to the problems of poor women and young children are being designed and
implemented (Chase-Lansdale & Brooks-Gunn, in press; Smith, in press;
Wilson, Ellwood, & Brooks-Gunn, in press).
The link of HOME-learning scores with maternal beliefs about childrear-
ing, net of al1 of the other family risk factors, may be interpreted as support
for conducting more parenting components in the context of JOBS and
workfare programs. However, altering parental beliefs is difficult, as
inferred from the early childhood intervention and home visiting programs,
where more effort is placed on childrearing in terms of curriculum develop-
ment and time spent with individual families on parenting issues, than in the
typical JOBS program (see reviews by Benasich et al., 1992; Clewell et al.,
1989; Olds, 1990). Several programs do report success, though, typically in
high risk groups of disadvantaged mothers (those with low education or
teenage mothers).8
The correlates of maternal warmth were fewer, and the entire regression
model not as strong (i.e., 18% of the variance accounted for in the maternal
warmth regression and 47% in the learning environment regression). Of par-
ticular interest is the fact that teenage mothers had lower warmth scores
(even though they had similar learning and physical environment scores).
Teenage mothers have been found to be less warm and responsive than older
mothers in many interaction studies (Osofsky, Hann, & Peebles, 1991;
Ragozin, Basham, Crnic, Greenberg, & Robinson, 1982) but not all studies
(see Brooks-Gunn & Chase-Lansdale, in press). Maternal behavior may be

8. Findings for the physical environment were quite similar with the exception that childrear-
ing views were not associated with poor physical environment while high family density was.
Poverty and the Home Environment 269

mediated by the context in which the young mother lives (i.e., alone, with
partner, or with grandmother figure; Chase-Lansdale et al., 1994; Spieker &
Booth, 1988). Such findings have implications for policy, in that programs
for teenage mothers should target parenting directly (as well as the social
support offered to mothers via the family).
However, perhaps what is most striking are not the results of the individ-
ual analyses, but those from the multiple-risk analyses. The number of risk
factors is associated with what mothers are providing to their 3-year-olds in
the way of a stimulating home environment. Multi-problem families clearly
are less able to offer adequate learning experiences. Services offered to fam-
ilies with many risk factors might be quite different than those targeted to
families with fewer risk factors. It is likely that more individualized, tailored
programs may be necessary for the highest risk groups, as Seitz and her col-
leagues (Seitz, Rosenbaum & Apfel, 1985) have argued persuasively.
Programs may need to be flexible enough to respond to variations in mater-
nal-child interactions, and adapt to changing family compositions, stressful
events, and neighborhood quality of life issues (Halpern, 1986).
Multiple-risk has consequences for families who are not poor as well as
families who are poor. That cumulative risk operates similarly in both
income groups suggests that programs must not ignore multi-problem fami-
lies just because they are not poor. Researchers also need to develop
conceptual models that take into account not only the factors that predict suc-
cessful family outcomes in groups expected to have problems (such as poor
families), but the factors that predict negative outcomes in groups expected
to do well (such as families who are not poor). Such “off diagonal” analyses
are typically not conducted.
The use of the IHDP data set allows for more direct statements about
intervention to be made, given that a comprehensive set of early education
and family services were provided in the context of a clinical trial. While the
effects of the intervention on HOME scores overall have been presented in a

9. Whether similar results would be seen with other aspects of parental behavior is an open
question. To our knowledge, previous studies of mother-child interaction focusing on dimen-
sions such as responsivity, control, hostility, and warmth have not used a multiple-risk
framework analytically (aIthough such a conceptual framework often guides research; Bar-
nard et al, 1988; Field, 1987; Garmezy & Rutter, 1988: Rauh et al, 1988). We believe that the
home environment measures we have examined are important ones in that (i) intervention
programs have targeted them for change (Benasich et al.. 1992: Olds, 1990), and (ii) they are
strongly associated with measures of child well-being, especially cognitive, linguistic, and
preschool school readiness scores (Bradley et al., 1989; Wachs & Gruen. 1982). For example,
in analyses on correlates of 3-year-old intelligence test scores in the IHDP, the home learning
environment score is more predictive of IQ than other aspects of the home environment (phys-
ical environment, and warmth and responsiveness of the mother) and family structural
characteristics (female headship), net of family income, ethnicity, and maternal education
(Brooks-Gunn, Duncan, Klebanov, & Sealand. 1993).
270 Brooks-Gunn, Klebanov, and Liaw

previous article (Bradley et al., 1994, in press), these analyses are unique in
that they examine the HOME in the context of poverty and risk. Perhaps not
surprisingly (given that the curriculum was designed for mothers across a
family income range), the intervention was beneficial to both poor and not
poor families’ provision of learning experiences to their 3-year-olds. Even
though families who were not poor started with higher home learning scores
(inferred from the higher scores of the not poor FUO group compared to the
poor FUO group), the not poor INT group mothers had higher learning
scores than the not poor FUO group mothers. Also expected was that the
intervention seemed to have comparable effects across the multiple-risk
range for poor mothers (inferred from the lack of a treatment by multiple-risk
interaction). More unexpected was the interaction was seen for the families
who were not poor; the mean analyses in Figure 2 suggest that the interven-
tion was most beneficial for mothers with more risk factors. Perhaps this is
in part due to a ceiling effect (i.e., the FUO group mothers who were not poor
and had few risks had very high HOME scores). At the same time, these find-
ings suggest that multi-problem families, whether they be poor or not, are
able to benefit from an intervention that provides information on health,
development, and problem solving.
At the same time, the intervention did not alter the physical environment
or parental warmth scores, for either the poor or non-poor families. It is prob-
ably unrealistic to expect a child-development program to affect the physical
environment of poor families’ homes. Programs focussing on maternal
employment are likely to have an impact if they raise family incomes appre-
ciably or if they move families off welfare. Additionally, moving families
into more affluent neighborhoods may make a difference (see the Gautreau
experiment results; Rosenbaum & Popkins, 1991). In the IHDP sample, the
physical environment of the home was associated with residence in poor
neighborhoods, controlling for ethnicity, maternal education, welfare status,
income, household size, teenage birth, and father absence (Klebanov,
Brooks-Gunn, & Duncan, 1994). The lack of treatment effects for maternal
warmth is more surprising, given that families were seen in their homes for
a three-year period. We had anticipated that effects might be seen for the
poor mothers, who generally had lower warmth scores. Some but not all
early intervention studies report positive effects on parenting (Benasich et
al., 1992). Indeed, altering the family climate or the parent in some way is
the pathway by which early childhood interventions are believed to influence
children over a sustained period of time (Bronfenbrenner, 1979; Woodhead,
1988), although this hypothesis has not been adequately tested (Brooks-
Gunn, in press b). When mothers and children from the IHDP were observed
in the clinic in a structured problem solving task, modest treatment effects in
the mother were seen (Spiker et al., 1993). Perhaps the HOME measure of
warmth is not as sensitive to variation as the interaction sequence measures
Poverty and the Home Environment 271

or perhaps warmth is not the parenting dimension most amenable to inter-

vention.
In brief, maternal behavior is influenced by poverty and, to a lesser
extent, by other risk factors. The number of risk factors present is strongly
associated with parenting, as measured by the HOME. Some of these factors
are amenable to familial or maternal-oriented interventions (childrearing
perspective, maternal education). Others provide additional evidence for the
importance of targeting specific groups of families (teenage mothers, poor
families, less literate mothers). Finally, this study makes an attempt at differ-
entiating multi-problem from low problem families. Multi-problem families,
be they poor or non-poor, are likely to suffer decrements in parenting. Inter-
vention programs need to consider more carefully what it means to serve
multi-problem families, and whether intervention programs should provide
more individualized services for such families.

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