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Promotion of Positive Parenting and Prevention of Socioemotional Disparities

Weisleder, Adriana; Cates, Carolyn Brockmeyer; Dreyer, Benard P; Berkule Johnson, Samantha; Huberman, Harris S; Seery, Anne M; Canfield, Caitlin F; Mendelsohn, Alan L
OBJECTIVE: The goal of this study was to determine what effects pediatric primary care interventions, focused on promotion of positive parenting through reading aloud and play, have on the socioemotional development of toddlers from low-income, primarily immigrant households. METHODS: This randomized controlled trial included random assignment to 1 of 2 interventions (Video Interaction Project [VIP] or Building Blocks [BB]) or to a control group. Mother-newborn dyads were enrolled postpartum in an urban public hospital. In VIP, dyads met with an interventionist on days of well-child visits; the interventionist facilitated interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interactions. In BB, parents were mailed parenting pamphlets and learning materials. This article analyzes socioemotional outcomes from 14 to 36 months for children in VIP and BB versus control. RESULTS: A total of 463 dyads (69%) contributed data. Children in VIP scored higher than control on imitation/play and attention, and lower on separation distress, hyperactivity, and externalizing problems, with effect sizes approximately 0.25 SD for the sample as a whole and approximately 0.50 SD for families with additional psychosocial risks . Children in BB made greater gains in imitation/play compared with control. CONCLUSIONS: These findings support the efficacy of VIP, a preventive intervention targeting parent-child interactions, for enhancing socioemotional outcomes in low-income toddlers. Given the low cost and potential for scalability of primary care interventions, findings support expansion of pediatric-based parenting programs such as VIP for the primary prevention of socioemotional problems before school entry.
PMCID:4732361
PMID: 26817934
ISSN: 1098-4275
CID: 1929662

Talking to children matters: early language experience strengthens processing and builds vocabulary

Weisleder, Adriana; Fernald, Anne
Infants differ substantially in their rates of language growth, and slow growth predicts later academic difficulties. In this study, we explored how the amount of speech directed to infants in Spanish-speaking families low in socioeconomic status influenced the development of children's skill in real-time language processing and vocabulary learning. All-day recordings of parent-infant interactions at home revealed striking variability among families in how much speech caregivers addressed to their child. Infants who experienced more child-directed speech became more efficient in processing familiar words in real time and had larger expressive vocabularies by the age of 24 months, although speech simply overheard by the child was unrelated to vocabulary outcomes. Mediation analyses showed that the effect of child-directed speech on expressive vocabulary was explained by infants' language-processing efficiency, which suggests that richer language experience strengthens processing skills that facilitate language growth.
PMCID:5510534
PMID: 24022649
ISSN: 1467-9280
CID: 2333112

SES differences in language processing skill and vocabulary are evident at 18 months

Fernald, Anne; Marchman, Virginia A; Weisleder, Adriana
This research revealed both similarities and striking differences in early language proficiency among infants from a broad range of advantaged and disadvantaged families. English-learning infants (n = 48) were followed longitudinally from 18 to 24 months, using real-time measures of spoken language processing. The first goal was to track developmental changes in processing efficiency in relation to vocabulary learning in this diverse sample. The second goal was to examine differences in these crucial aspects of early language development in relation to family socioeconomic status (SES). The most important findings were that significant disparities in vocabulary and language processing efficiency were already evident at 18 months between infants from higher- and lower-SES families, and by 24 months there was a 6-month gap between SES groups in processing skills critical to language development.
PMCID:3582035
PMID: 23432833
ISSN: 1467-7687
CID: 2333122

Mitigating the Effects of Family Poverty on Early Child Development through Parenting Interventions in Primary Care

Cates, Carolyn Brockmeyer; Weisleder, Adriana; Mendelsohn, Alan L
Poverty related disparities in early child development and school readiness are a major public health crisis, the prevention of which has emerged in recent years as a national priority. Interventions targeting parenting and the quality of the early home language environment are at the forefront of efforts to address these disparities. In this article we discuss the innovative use of the pediatric primary care platform as part of a comprehensive public health strategy to prevent adverse child development outcomes through the promotion of parenting. Models of interventions in the pediatric primary care setting are discussed with evidence of effectiveness reviewed. Taken together, a review of this significant body of work shows the tremendous potential to deliver evidence-based preventive interventions to families at risk for poverty related disparities in child development and school readiness at the time of pediatric primary care visits. We also addresss considerations related to scaling and maximizing the effect of pediatric primary care parenting interventions and provide key policy recommendations.
PMCID:5778903
PMID: 27044688
ISSN: 1876-2867
CID: 2065502

Towards a bioecological model of bilingual development [Editorial]

Weisleder, Adriana
At its best, the field of bilingualism is a dynamic discipline informed by diverse perspectives. Carroll's critical review - situated within a linguistics framework - contends that current research on bilingual exposure and language development suffers from a lack of theoretical clarity, and makes little contribution to our understanding of bilingual acquisition. Carroll's push (Carroll) towards greater precision in our thinking about the relation between input and outcomes is an important and welcome challenge. However, it is also critical to keep in mind the social context that motivates much of the current research on bilingual development, and to leave room for studies whose main goal is to provide answers to societally important questions about bilingual children's health and development.
ISI:000390329700012
ISSN: 1469-1841
CID: 2395002

Supporting responsive parenting in real-world implementation: minimal effective dose of the Video Interaction Project

Piccolo, Luciane R; Roby, Erin; Canfield, Caitlin F; Seery, Anne M; Weisleder, Adriana; Cates, Carolyn Brockmeyer; Tutasig, Leonela; Matalon, Maya; Custode, Aida; Rodriguez, Luis; Mendelsohn, Alan L
BACKGROUND:The Video Interaction Project (VIP) is a healthcare-based intervention that provides real-time video-feedback of parent-child play and reading interactions to families with children aged 0 to 36 months. Although evidence from randomized controlled trials demonstrates improved early relational health, including responsive parenting, after three to five VIP visits, the minimal effective dose in real-world implementations is unknown. This study aimed to determine the minimal effective dose of VIP during a real-world implementation for changing responsive parenting behaviors. METHODS:We performed a longitudinal prospective study of 183 dyads at a public hospital pediatric clinic. Responsive parenting behaviors were assessed with an observational checklist utilized as part of standard VIP practice at baseline and two follow-up VIP visits. RESULTS:Multilevel models adjusted for baseline sociodemographics (child's sex and age, and maternal education) and time between visits showed that responsive parenting behaviors during parent-child reading and play significantly increased after a single VIP visit (Cohen's d = 0.52, p < 0.05) with additional impact following completion of a second visit (cumulative for 2 visits: d = 0.76, p < 0.05). CONCLUSIONS:A single VIP visit is associated with increased responsive parenting behaviors. Findings support offering VIP widely, regardless of capacity to ensure attendance at multiple visits. IMPACT/CONCLUSIONS:This is the first study showing the minimal effective dose of the Video Interaction Project (VIP) for increasing responsive parenting behaviors. Responsive parenting behaviors increased by over 22% following a single VIP visit, with a cumulative increase of 37% following the second visit compared to baseline. Findings have important implications for implementation and scalability of pediatric-based preventive programs that support early relational health through activities such as reading and play.
PMID: 38040989
ISSN: 1530-0447
CID: 5616822

Validation of the StimQ2: A parent-report measure of cognitive stimulation in the home

Cates, Carolyn Brockmeyer; Roby, Erin; Canfield, Caitlin F; Johnson, Matthew; Raak, Caroline; Weisleder, Adriana; Dreyer, Benard P; Mendelsohn, Alan L
Considerable evidence demonstrates the importance of the cognitive home environment in supporting children's language, cognition, and school readiness more broadly. This is particularly important for children from low-income backgrounds, as cognitive stimulation is a key area of resilience that mediates the impact of poverty on child development. Researchers and clinicians have therefore highlighted the need to quantify cognitive stimulation; however existing methodological approaches frequently utilize home visits and/or labor-intensive observations and coding. Here, we examined the reliability and validity of the StimQ2, a parent-report measure of the cognitive home environment that can be delivered efficiently and at low cost. StimQ2 improves upon earlier versions of the instrument by removing outdated items, assessing additional domains of cognitive stimulation and providing new scoring systems. Findings suggest that the StimQ2 is a reliable and valid measure of the cognitive home environment for children from infancy through the preschool period.
PMCID:10365315
PMID: 37486914
ISSN: 1932-6203
CID: 5591962

Reading Aloud, Self-Regulation, and Early Language and Cognitive Development in Northern Brazil

Piccolo, Luciane da Rosa; Weisleder, Adriana; Oliveira, João B A; Mazzuchelli, Denise S R; Lopez, Aline Sá; Neto, Walfrido D; Cates, Carolyn B; Mendelsohn, Alan L
OBJECTIVES/OBJECTIVE:In this study, we examined (1) whether a reading aloud intervention, Universidade do Bebê (UBB), had impacts on self-regulation; (2) whether effects on child outcomes were mediated by self-regulation; and (3) whether effects of UBB were explained through a sequential pathway of impact, including cognitive stimulation in the home, parent-child interactive reading, and self-regulation. METHODS:We performed a cluster randomized controlled trial of UBB in child care centers serving low-income children (mean age 37.4 months; SD = 6.5) in Northern Brazil. The child care centers were randomized to receive UBB or standard care (control). Families in UBB could borrow children's books weekly and participate in monthly workshops focused on reading aloud. Parent-child dyads (n = 484, intervention = 232, control = 252) were evaluated at baseline and 9 months later on: child self-regulation, vocabulary, intelligence quotient (IQ), working memory, and phonological memory and measures of cognitive stimulation in the home and parent-child interactive reading. Multilevel analyses accounted for baseline performance, sociodemographics, and clustering within centers and sites. RESULTS:The UBB group showed significantly higher self-regulation (Cohen's d = 0.25), compared with the control group, particularly in the subdomains of Attention (d = 0.24) and Impulse Control (d = 0.21). Previously shown impacts of UBB on receptive vocabulary, IQ, and working memory were mediated by self-regulation. Effects of UBB on self-regulation and child outcomes were partially explained through cognitive stimulation in the home and parent-child interactive reading. CONCLUSION/CONCLUSIONS:Self-regulation represents an important mechanism by which reading aloud interventions affect language and cognitive outcomes. Investigators should consider the role of self-regulation when refining interventions, seeking to prevent poverty-related disparities.
PMID: 34224503
ISSN: 1536-7312
CID: 4932962

Improving Parent-Child Interactions in Pediatric Health Care: A Two-Site Randomized Controlled Trial

Roby, Erin; Miller, Elizabeth B; Shaw, Daniel S; Morris, Pamela; Gill, Anne; Bogen, Debra L; Rosas, Johana; Canfield, Caitlin F; Hails, Katherine A; Wippick, Helena; Honoroff, Julia; Cates, Carolyn B; Weisleder, Adriana; Chadwick, Kelly A; Raak, Caroline D; Mendelsohn, Alan L
BACKGROUND AND OBJECTIVES/OBJECTIVE:Heterogeneity in risk among low-income families suggests the need for tiered interventions to prevent disparities in school readiness. Smart Beginnings (SB) integrates two interventions: Video Interaction Project (VIP) (birth to 3 years), delivered universally to low-income families in pediatric primary care, and Family Check-Up (6 months to 3 years), targeted home visiting for families with additional family risks. Our objective was to assess initial SB impacts on parent-child activities and interactions at 6 months, reflecting early VIP exposure. METHODS:Two-site randomized controlled trial in New York City (84% Latinx) and Pittsburgh (81% Black), with postpartum enrollment and random assignment to treatment (SB) or control. At 6 months, we assessed parent-child interactions through surveys (StimQ, Parenting Your Baby) and observation (video-recorded play, coded by using Parent-Child Interaction Rating Scales - Infant Adaptation). RESULTS:< .001). Thus, significant effects emerged across a broad sample by using varied methodologies. CONCLUSIONS:Findings replicate and extend previous VIP findings across samples and assessment methodologies. Examining subsequent assessments will determine impacts and feasibility of the full SB model, including potential additive impacts of Family Check-Up for families at elevated risk.
PMID: 33608413
ISSN: 1098-4275
CID: 4793982

Promoting Global Early Child Development Through Play: Two Sustainable, Effective Models

da Rosa Piccolo, Luciane; Weisleder, Adriana; Mendelsohn, Alan L
PMID: 33148770
ISSN: 1098-4275
CID: 4664242