MTB clinicians have served nearly 150 economically disadvantaged and ethnic minority families in New Haven since 2002, while over 250 families have been enrolled in MTB research projects. The intervention has been tested in two federally supported randomized controlled trials (RCTs) in New Haven.
When compared with control families, health outcomes include significantly lower rates of obesity and significantly higher rates of normal weight in MTB toddlers, significantly higher rates of on-time pediatric immunization, lower rates of rapid subsequent childbearing, and lower rates of child protection referrals in intervention families.
Socioemotional outcomes include significantly higher rates of secure attachment and lower rates of disorganized attachment in intervention children. Mothers in the intervention group were also significantly more likely to parent in a reflective rather than reactive way. At 1-3 year follow-up, MTB preschoolers were found to have significantly lower rates of maternally reported externalizing disorders (acting out behaviors).
In a longer term follow-up study, data from MTB families with 4-9 year-old children are currently being analyzed and findings look promising. Positive mother-child interactions, maternal reflectiveness, secure infant attachment, and lower rates of child behavior disorders all contribute to non-cognitive, socio-emotional development, a key ingredient in school success as well as future wellness.
MTB is distinct from other home visiting programs in several ways, including:
- the interdisciplinary model and provision of continuous in-home mental health services
- program intensity and providers’ level of training
- a flexible curriculum, matched to families’ needs
- the intergenerational focus on relationships and the development of attachment
- emphasis on maternal and child health promotion
- a focus on prevention and the development of resources and protective factors to limit the long-term impact of adverse childhood experiences and toxic stress on current and later health and mental health
These distinctions equate to the unique ability to support families who are struggling with serious mental health challenges and complex trauma. By strengthening early parent-child relationships, MTB home visitors aim to mitigate the disabling effects of toxic stress and promote positive health, mental health, development, life course, and attachment outcomes in babies, mothers, and their families.