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PCP interventions focused on reading aloud, play, enhance development in children

Primary care physicians should expand pediatric-based parenting programs, such as Video Interaction Project, to enhance socio-emotional outcomes and prevent behavioral problems in children before school entry, according to data published in Pediatrics.

“Pediatric primary health care provides a significant opportunity for population-level, primary intervention of school readiness disparities through promotion of positive parenting (eg, using the Reach out and Read [ROR] and Healthy Steps programs), given the frequency and near universality of well-child visits and the opportunity to leverage existing health care infrastructure,” Adriana Weisleder, PhD, of the department of pediatrics, New York University School of Medicine/Bellevue Hospital Center, and colleagues wrote. … “However, it is unknown whether pediatric interventions seeking the primary prevention of disparities through promotion of parent-child interactions in reading aloud and play can also enhance socio-emotional development.”

To determine the socio-emotional effects of pediatric primary care interventions that promote reading aloud and play on toddlers, specifically among low-income, primarily-immigrant households, the researchers conducted a single-blind, three-way randomized controlled trial. They enrolled 675 mother-child dyads at Bellevue Hospital Center, randomly assigning them to one of three groups. One group received interventions based on the Video Interaction Project (VIP), an enhancement of ROR in which an interventionist uses video recordings to promote parents’ self-reflection and encourage positive behaviors. The second group used the Building Blocks (BB) method, a lower intensity intervention involving mailed newsletters highlighting positive parenting strategies. The third group was the control, which received standard pediatric care, including ROR.

The researchers analyzed socio-emotional outcomes from 14 to 36 months for children in VIP and BB versus controls, noting mother-reported child social skills, imitation/play, attention, separation distress, hyperactivity, aggression and externalizing of problems. In all, a total of 463 families contributed data to the study.

According to the researchers, children in the VIP group scored higher than controls on imitation/play and attention, and lower on separation distress, hyperactivity and externalizing problems, with effect sizes of approximately 0.25 SD for the sample as a whole and 0.5 SD for families with additional psychosocial risks, such as homelessness, involvement with child protective services, significant financial hardship, the mother reporting being a victim of violence, smoking or alcohol use during pregnancy, and previous mental illness. Children in BB made greater gains in imitation/play compared with controls (P < .01).

“This study showed that pediatric primary care interventions focused on promotion of positive parenting through reading aloud and play can enhance socio-emotional development among children in poverty,” Weisleder and colleagues wrote. “Given the potential for low cost and population-level reach of primary care interventions, these findings suggest that the pediatric platform should play an important role in primary prevention poverty-related disparities in school readiness.” – by Jason Laday

Disclosure: The authors report no relevant financial disclosures.