Promoting Cognitive Stimulation in Parents Across Infancy and Toddlerhood: A Randomized Clinical Trial

Overview

Journal J Pediatr

Specialty Pediatrics

Date 2022 Dec 8

PMID 36481243

Authors

Elizabeth B Miller

Erin Roby

Yudong Zhang

Lerzan Coskun

Johana M Rosas

Marc A Scott

Juliana Gutierrez

Daniel S Shaw

Alan L Mendelsohn

Pamela A Morris-Perez

Affiliations

Soon will be listed here.

Abstract

Objective: To test the impact of the fully integrated Smart Beginnings model on parental support of cognitive stimulation from 6 to 24 months across infancy and toddlerhood.

Study Design: This was a single-blind, 2-site randomized clinical trial of the Smart Beginnings intervention. Enrollment took place at birth in postpartum units of hospitals in New York City and Pittsburgh, Pennsylvania, with a consecutive sample of 403 mother-infant dyads. Smart Beginnings combines a Video Interaction Project-14-session universal primary prevention program delivered in the pediatric clinic at the time of well-child visits birth-36 months-with potential for Family Check-Up-3-4 sessions targeted secondary prevention home-visiting program. The principal outcome was parental support of cognitive stimulation assessed via parent survey and video-recorded observations of parent-child interactions. Ordinary least squares and mixed effects regressions were conducted.

Results: Families were mostly Black/African-American (50%) or Latinx (42%); all were Medicaid eligible (100%). Smart Beginnings significantly promoted cognitive stimulation during infancy and toddlerhood for most survey outcomes across time, including StimQ common total (effect size [ES] = 0.25, P = .01) and READ Quantity (ES = .19, P = .04) and Quality (ES = .30, P = .001). For the observations, the impact of Smart Beginnings varied by time, with significant impacts at 6 (ES = 0.37-.40, P < .001) and 24 (ES = 0.27-.30, P < .001) months, but not 18 months.

Conclusions: Smart Beginnings positively promotes cognitive stimulation from infancy through toddlerhood using the integrated model. This study adds to the body of research showing preventive interventions in pediatric primary care and home visiting can support early relational health including parental support of cognitive stimulation.

Trial Registration: NCT02459327.

Citing Articles

Cognitive Stimulation and Maternal Feeding Styles in Families with Low Incomes: Impacts from a Randomized Clinical Trial.

Miller E, Hails K, Canfield C, Morris-Perez P, Shaw D, Mendelsohn A Acad Pediatr. 2024; 25(2):102588.

PMID: 39389163 PMC: 11842215. DOI: 10.1016/j.acap.2024.09.012.

An early parenting intervention focused on enriched parent-child interactions improves effortful control in the early years of school.

Bennett C, Westrupp E, Bennetts S, Love J, Hackworth N, Berthelsen D Child Dev. 2024; 96(1):355-374.

PMID: 39359116 PMC: 11693840. DOI: 10.1111/cdev.14166.

Enhancing early language and literacy skills for racial/ethnic minority children with low incomes through a randomized clinical trial: The mediating role of cognitively stimulating parent-child interactions.

Miller E, Canfield C, Roby E, Wippick H, Shaw D, Mendelsohn A Child Dev. 2023; 95(4):1172-1185.

PMID: 38153204 PMC: 11211242. DOI: 10.1111/cdev.14064.

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

Piccolo L, Roby E, Canfield C, Seery A, Weisleder A, Cates C Pediatr Res. 2023; 95(5):1295-1300.

PMID: 38040989 PMC: 11423954. DOI: 10.1038/s41390-023-02916-4.

Promotion of Positive Childhood Experiences and Early Relational Health in Pediatric Primary Care: Accumulating Evidence.

Roby E, Canfield C, Seery A, Dreyer B, Mendelsohn A Acad Pediatr. 2023; 24(2):201-203.

PMID: 37748538 PMC: 10939971. DOI: 10.1016/j.acap.2023.09.008.

References

Duncan G, Ziol-Guest K, Kalil A . Early-childhood poverty and adult attainment, behavior, and health. Child Dev. 2010; 81(1):306-25. DOI: 10.1111/j.1467-8624.2009.01396.x. View

Dreyer B . Closing the Gap: Interventions to Ameliorate Inequities in Early Brain Development and School Performance in Poor Children. J Pediatr. 2020; 221:8-10. DOI: 10.1016/j.jpeds.2020.02.004. View

Olds D . The nurse-family partnership: An evidence-based preventive intervention. Infant Ment Health J. 2017; 27(1):5-25. DOI: 10.1002/imhj.20077. View

Stevenson M, LEAVITT L, Roach M, Chapman R, Miller J . Mother's speech to their 1-year-old infants in home and laboratory settings. J Psycholinguist Res. 1986; 15(5):451-61. DOI: 10.1007/BF01067725. View

Dunlap M, Lake L, Patterson S, Perdue B, Caldwell A . Reach Out and Read and developmental screening: using federal dollars through a health services initiative. J Investig Med. 2021; . DOI: 10.1136/jim-2020-001629. View

Cates C, Weisleder A, Johnson S, Seery A, Canfield C, Huberman H . Enhancing Parent Talk, Reading, and Play in Primary Care: Sustained Impacts of the Video Interaction Project. J Pediatr. 2018; 199:49-56.e1. PMC: 6063788. DOI: 10.1016/j.jpeds.2018.03.002. View

Roby E, Shaw D, Morris P, Canfield C, Miller E, Dreyer B . Pediatric Primary Care and Partnerships Across Sectors to Promote Early Child Development. Acad Pediatr. 2020; 21(2):228-235. PMC: 8083845. DOI: 10.1016/j.acap.2020.12.002. View

Peacock-Chambers E, Ivy K, Bair-Merritt M . Primary Care Interventions for Early Childhood Development: A Systematic Review. Pediatrics. 2017; 140(6). DOI: 10.1542/peds.2017-1661. View

Peacock S, Konrad S, Watson E, Nickel D, Muhajarine N . Effectiveness of home visiting programs on child outcomes: a systematic review. BMC Public Health. 2013; 13:17. PMC: 3546846. DOI: 10.1186/1471-2458-13-17. View

10.

. Poverty and Child Health in the United States. Pediatrics. 2016; 137(4). DOI: 10.1542/peds.2016-0339. View

11.

Roby E, Miller E, Shaw D, Morris P, Gill A, Bogen D . Improving Parent-Child Interactions in Pediatric Health Care: A Two-Site Randomized Controlled Trial. Pediatrics. 2021; 147(3). PMC: 7924140. DOI: 10.1542/peds.2020-1799. View

12.

Bornstein M, Haynes O, Painter K, Genevro J . Child language with mother and with stranger at home and in the laboratory: a methodological study. J Child Lang. 2000; 27(2):407-20. DOI: 10.1017/s0305000900004165. View

13.

Shaw D, Dishion T, Supplee L, Gardner F, Arnds K . Randomized trial of a family-centered approach to the prevention of early conduct problems: 2-year effects of the family check-up in early childhood. J Consult Clin Psychol. 2006; 74(1):1-9. DOI: 10.1037/0022-006X.74.1.1. View

14.

Baker C, Arnold D, Meagher S . Enrollment and attendance in a parent training prevention program for conduct problems. Prev Sci. 2010; 12(2):126-38. DOI: 10.1007/s11121-010-0187-0. View

15.

Shaw D, Mendelsohn A, Morris P . Reducing Poverty-Related Disparities in Child Development and School Readiness: The Smart Beginnings Tiered Prevention Strategy that Combines Pediatric Primary Care with Home Visiting. Clin Child Fam Psychol Rev. 2021; 24(4):669-683. PMC: 8428206. DOI: 10.1007/s10567-021-00366-0. View

16.

Zaslow M, Weinfield N, Gallagher M, Hair E, Ogawa J, Egeland B . Longitudinal prediction of child outcomes from differing measures of parenting in a low-income sample. Dev Psychol. 2006; 42(1):27-37. DOI: 10.1037/0012-1649.42.1.27. View

17.

Anderson N, Graham S, Prime H, Jenkins J, Madigan S . Linking Quality and Quantity of Parental Linguistic Input to Child Language Skills: A Meta-Analysis. Child Dev. 2021; 92(2):484-501. DOI: 10.1111/cdev.13508. View

18.

Ettinger A, Ray K, Burke J, Thompson J, Navratil J, Chavis V . A Community Partnered Approach for Defining Child and Youth Thriving. Acad Pediatr. 2020; 21(1):53-62. DOI: 10.1016/j.acap.2020.04.011. View

19.

Miller E, Canfield C, Morris P, Shaw D, Cates C, Mendelsohn A . Sociodemographic and Psychosocial Predictors of VIP Attendance in Smart Beginnings Through 6 Months: Effectively Targeting At-Risk Mothers in Early Visits. Prev Sci. 2019; 21(1):120-130. PMC: 6960338. DOI: 10.1007/s11121-019-01044-y. View

20.

Pachter L, Garcia Coll C . Racism and child health: a review of the literature and future directions. J Dev Behav Pediatr. 2009; 30(3):255-63. PMC: 2794434. DOI: 10.1097/DBP.0b013e3181a7ed5a. View