Early Intervention: You *Might* Get What You Pay For

Reviews a good RCT (Dodge et al, Am J Psychiatry) on a 10-year, ~$60k/kid early-intervention program for at-risk youth, framed against the genetics-vs-psychiatry divide over whether childhood experience shapes outcomes. Modest real effects (odds ratios ~0.6-0.7 for psychiatric disorders, drug/alcohol abuse, violent crime) but NO effect on graduation, employment, or incarceration, with some awkward nonsignificant signals (raised death/incarceration; the DV reduction mediated entirely by fewer relationships). Sharp cost-effectiveness coda: going from ~$200k to ~$260k/child for modest gains is scientifically interesting but, as policy, 'nothing to write home about' -- and any too-cheap 'it worked for $1,000' program should make us suspicious.

Quality 67 · Strong. Strong (67). A clear, fair, numerate study-review with genuinely sharp cost-effectiveness reasoning (the $1,000-program skepticism; the $200k->$260k framing) and honest engagement with the study's weak points. Capped below Excellent by its scope as a single-study review.

Claude’s paradigm shift 45 · Moderate. Moderate (45). A study review; the mildly fresh elements are the genetics-vs-psychiatry framing and the cost-effectiveness lens, not a new idea.

Real-world impact 2 · Minor. 2 -- minor/within-blog. Bears on early-intervention policy, but a single study-review with within-discourse reach.