Family home visiting outcomes for mothers with and without intellectual disabilities.
Public-health nurse home visits lift family outcomes, but moms with ID gain more when you bolt on behavioral skills training and prenatal teaching.
01Research in Context
What this study did
Leung et al. (2011) sent public-health nurses to visit families at home. Some moms had intellectual disabilities. Some did not. The team tracked 21 family-life measures before and after the visits.
The design was quasi-experimental. No random assignment. Just real-world service data.
What they found
Both groups got better. Moms without ID, however, gained more across the board. The visits still helped moms with ID, just not as much.
The study calls the result “positive” for both, but notes a clear gap.
How this fits with other research
Llewellyn et al. (2003) ran a tight 10-week RCT that taught safety skills to parents with ID. Everyone improved and kept the gains for three months. Their stricter design shows stronger, lasting change than the 2011 nurse visits.
Feldman et al. (2025) went further. They used behavioral skills training before the baby arrived. Both parents learned newborn care with a doll, then kept their real babies at home past one year. Their focused, prenatal approach outperforms the broad post-birth visits seen in K et al.
Pettingell et al. (2022) surveyed the nurses themselves. Visitors said they lack training and site support when working with parents who have ID. That explains the smaller gains K et al. saw: without targeted skills, friendly home visits are only half the solution.
Why it matters
If you contract with public-health nurse programs, ask for the curriculum. Make sure staff get hands-on training in behavioral skills and ID-specific supports. Add prenatal BST when possible. A general wellness visit helps, but adding clear, step-by-step teaching closes the outcome gap K et al. found.
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02At a glance
03Original abstract
BACKGROUND: The purpose of this study was to evaluate outcomes of public health nurse home visiting for mothers with intellectual disabilities (ID) and a comparison group. METHODS: The study was a secondary analysis of existing de-identified family home visiting data. It used a two-group comparative, 1:3 match design. Sixty-eight clients were in the study (n = 17 for mothers with ID and n = 51 for mothers without ID). Client characteristics and problem prevalence were compared using standard descriptive and inferential statistics. Mixed model methods were used for the analysis of outcomes, accounting for baseline scores, time of services and matched cases. RESULTS: Mothers with and without ID showed statistically significant improvement following family home visiting services. For both groups, discharge scores were consistently higher than the corresponding admission scores, with a mean increase of 0.37 (range = 0.05-0.90). Mothers without ID attained higher outcomes than mothers with ID. Seven of 21 outcomes significantly improved for mothers with ID, and 10 of 21 for the comparison group. The percentage of mothers with ID attaining the benchmark of 4 ranged from 13.3% to 90.4% and for the comparison group ranged from 30% to 95.7%. Public health nurses addressed 15 environmental, psychosocial, physiological and behavioural problems for both groups. CONCLUSION: Family home visiting appears to be effective in assisting parents with ID to have improved outcomes in many domains. These results provide an opportunity for service providers, home visiting nurses and public health agencies to understand the unique needs of mothers with ID.
Journal of intellectual disability research : JIDR, 2011 · doi:10.1111/j.1365-2788.2011.01402.x