Behavioral development of preschoolers who spent their first one to eighteen months in a prison nursery program with a supportive nursing intervention

Background: The study aim was to compare preschool behavioral development in children who lived with their mother in a prison nursery and received a developmentally supportive nursing intervention to children who were separated from their mother because of incarceration. Methods: This secondary analysis included 47 preschool children who lived during infancy with their mother in a prison nursery and a subsample of 60 children from a large national dataset who were separated from their mother due to her incarceration. The primary outcome was caregiver reported behavior problems on the Child Behavior Checklist. Separate ANCOVA models predicted Anxious-Depressed, Withdrawn, Aggressive, and Attention-Deficit/Hyperactivity scores, while controlling for child gender, a cumulative ecological risk score, and the differential propensity to have received the nursery given baseline demographic heterogeneity. Results: Being separated was associated with scoring 1.24 points higher (95% CI .11-2.37, p = .03) for Anxious-Depressed behavior problems, a similar difference to that seen between clinical and nonclinical normative preschool samples. Gender and cumulative risk, but not prison co-residence, significantly predicted the variance in Withdrawn scores. No significant differences were found between the groups for Externalizing behavior problems. Conclusions: Findings suggest that prison co-residence with supportive nursing intervention confers resilience to anxious-depressed behavior problems in children who experience early maternal incarceration, even in the presence of high levels of ecological risk. Co-residence programs that provide nursing intervention to support the parent-child relationship should be promoted as a best practice for incarcerated childbearing women.