1. Children randomized to a one-on-one mother-child intervention scored higher in imitation/play and attention than those who only received educational materials in the mail. Those children also scored lower in hyperactivity, separation distress and externalizing problems.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Socioemotional disparities between poverty-struck and affluent children is an area of recent focus in the United States’ pediatrics community. The widening gap contributes to decreased school readiness, adjustment, and academic performance in poor children. Authors of the current study sought to evaluate whether interventions that promoted parent-child interactions through reading aloud and play could enhance socioemotional outcomes. Researchers stratified mother-child dyads into 1 of 3 intervention groups: a Video Interaction Project (VIP) group that received one-on-one intervention, a Building Block (BB) group that received educational materials in the mail, and a control group that received standard pediatric primary care. Findings indicated that while those in the BB group demonstrated some significant improvement from baseline, children in the VIP group scored significantly higher in imitation/play and attention, and lower on hyperactivity, separation distress, and hyperactivity. This study was limited by resource constraints preventing the follow-up of those in the BB group past 24 months. In addition, socioemotional outcomes were self-reported by parents, which introduces bias. Nonetheless, this low-cost pediatric primary care intervention was effective in enhancing socioemotional development among children in poverty, suggesting that pediatricians could play an important role in the prevention of poverty-related disparities in school readiness.
In-Depth [randomized controlled trial]: Participants included 463 mother-child dyads at Bellevue Hospital Center, an urban hospital in New York serving low-income families. Dyads were randomized into 1 of 3 groups: VIP, BB, and a control group. VIP added a one-on-one intervention during well-child visits that utilized video recordings of parent-child interactions and provided feedback and self-reflective activities, encouraging positive parenting behaviors. Those in the BB group received newsletters in the mail that encouraged positive parenting behaviors. Control group recipients received standard pediatrics primary care. Follow up was conducted at 6, 14, 24, and 36 months, with the exception of the BB group, in which there was no follow up past 24 months. The Infant-Toddler Social and Emotional Assessment (ITSEA) was used to measure imitation/play, attention, and separation distress, the main measures of socioemotional development. At 14 months, VIP children scored significantly higher in imitation/play than those in the BB group (effect size* (ES): 0.49; p<0.01). At 24 months, VIP children demonstrated higher scores in attention than control (ES: 0.30, p<0.05). Furthermore, a significant positive interaction was found between BB and age for imitation/play, in which BB children had improved attention scores, as compared to the control group (p<0.05). At 36 months, VIP children had significantly reduced hyperactivity (ES: 0.27, p<0.05) and externalizing problems (ES: 0.27, p<0.05), as compared with control children.
*Effect size is a measure of the magnitude of a treatment effect, with a value of 0.10 considered small, 0.30 medium, and 0.50 large.
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