Healthy Steps for Young Children

About the program

Healthy Steps for Young Children is a universal, practice-based intervention that enhances the delivery of behavioural and developmental services and relies on partnerships between developmental specialists and families.

Who does it work for?

The intervention is a universal program designed for children aged from newborn to 3 years old. In a 2007 study of Healthy Steps for Young Children by Minkovitz and colleagues, the study cohort was 65% White, 21% Black, with 4.5% described as ‘Asian/Native American’. The study excluded families with babies who were too ill to join the program at 4 weeks, mothers did not speak English or Spanish, families intending to move away within 6 months, and families  planning to place the baby for adoption or foster care. In the sample, 25% of families were classified as low income; 36% as middle income; and 39% as high income.

This review did not identify any evidence that the program has been evaluated in Australia or with First Nations communities.

What outcomes does it contribute to?

Positive outcomes:

Positive parenting: A smaller percentage of families in the intervention group used severe discipline (e.g. striking their child) (10.1%), compared with families in the control group (14.1%). A greater proportion of families in the intervention group negotiated with their child (59.8%) compared with families in the control group (56.3%). A greater proportion of families in the intervention group tended to ignore misbehaviours (10.3%) compared with families in the control group (8.5%) (Minkovitz et al. 2007).

No effect:

None.

Negative outcomes:

None.

Is the program effective?

Overall, the program had a positive effect on client outcomes.

How strong is the evidence?

Promising research evidence:

At least one high-quality RCT/QED study reports statistically significant positive effects for at least one outcome, AND

• Fewer RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects

How is it implemented?

The core program components include contact with developmental specialists and seven services:

• Enhanced well-childcare
• Up to six home visits in the first 3 years
• A telephone line for non-emergency developmental concerns
• Developmental assessments
• Written materials
• Parent groups
• Linkages to community resources

How much does it cost?

Information not available

Where does the evidence come from?

These findings are from a national evaluation in the USA (Minkovitz, et al. 2007). This study was a prospective randomised controlled trial, with six randomised sites and nine quasi-experimental sites. The study included a follow-up of the children at age 61 to 66 months, finding modest, sustained, positive effects of the program. There were 5,565 families enrolled in the study, including 3,165 families who provided interview data when the child was 5.5 years old.

Further resources

• https://www.healthysteps.org/
• Minkovitz, C. S., et al. (2007). “Healthy Steps for Young Children: sustained results at 5.5 years.” Pediatrics 120(3): e658-668.