Home Environment and Developmental Outcome of African American and White Infants with Very Low Birthweight

The independent and additive contribution of psychosocial and biological risk factors to developmental outcome of very low birthweight infants (< 1,500 g) were examined through 24 months corrected age as a function of race. Psychosocial risk was assessed in terms of the quality and quantity of stimulation and support offered in the infant's home environment as reflected in the Home Observation of Environment (HOME) Inventory. Biological risk was assessed through the Neurobiological Risk Score (NBRS) that reflects processes potentially deleterious to the developing brain during the neonatal period. The NBRS accounted for significant portions of variance in Bayley Mental Developmental Index (MDI) within the African American and White subgroups at 15 months corrected age but only within the White subgroup at 24 months corrected age. At 24 months the HOME accounted for a significant increment (13%) in cognitive functioning (MDI) over and above that accounted for by biomedical risk (23%) but only within the subgroup of White infants. The findings are discussed in terms of the need to develop measures that reflect dimensions of the home environment of African American children that are associated with subsequent developmental outcome.