Many studies have documented the effectiveness of developmental programmes for preterm children after discharge from NICU's. Such programmes demand sophisticated organisation and are costly. We have compared the effect of a developmental intervention (Portage) with that of providing non-directive parental support (`Parent Adviser') in a geographically defined cohort of 309 children <33 weeks gestation, bom 1990-93.

Families were randomly assigned to receive home visiting for up to 2 years by a Nurse, trained in one of the two interventions, or to a control group. The children were independently assessed using the Griffiths Scales at 12 and 24 months of age, together with 88 term children. Visiting frequency, duration and age at last visit did not differ between the two intervened groups. Analysis was performed on an `intention to treat basis'.

Results of DQ testing excluding those with severe disability are shown below. No differences between preterm groups were seen at 12 months, even after allowing for social factors. At 24 months, the Portage group performed significantly better than controls and results for the Parent Adviser group fell between these two, but differences were not significant even after allowing for the effect of the most powerful social variable - mother's education beyond 16y(*). Table

Table 1
Full size table

We conclude that developmental intervention appears effective within the UK health system and to offer a small advantage over less structured interventions.