3.3.2. Early Interventions

In addition to preschool evaluations, the EDI has also been used to explore the impacts of early child development programs. One such program is the *Primeira Infância Melhor* (Better Early Childhood), a home-visiting program held in Rio Grande do Sul State, Brazil, involving regularly scheduled visits to pregnant women in their home, which continue after the child is born. The goal of this program was to help women promote their child's health and holistic development. The EDI was used to assess the efficacy of this program. The results showed that the earlier a child exited the program, the more vulnerable they were in all five developmental domains of the EDI [19], suggesting the program was effective at improving children's developmental health; however, a multivariate analysis found no overall difference among the study groups in terms of EDI outcomes. Many other countries have attempted to use early at-home interventions to improve developmental outcomes for marginalized communities before entering preschool [18,72]. A study by Enns et al. [18] focused specifically on the Families First Home Visiting (FFHV) program available to indigenous populations in Manitoba. An analysis of data for over 4000 families showed no significant difference in a child's likelihood of being vulnerable in one or more domains of the EDI in comparison to non-participants. Another study of early intervention was conducted in Australia and explored the efficacy of a nurse home visiting (NHV) program, in which mothers from disadvantaged populations received home visits by a registered nurse during the immediate postnatal period. The children enrolled in this program were followed up at age five and did not show any improvement in EDI scores in comparison to children who were not involved in the NHV program [72].
