Teaching Parenting Skills At Doctor Visits Helps Children’s Behavior

By Vanessa Rancaño

As researchers have come to understand how poverty and its stresses influence children’s brain development, they’ve begun untangling how that can lead to increased behavior problems and learning difficulties for disadvantaged kids.

Rather than trying to treat those problems, NYU child development specialists Adriana Weisleder and Alan Mendelsohn want to head them off.

They say they’ve found a way: Working with low-income parents when they bring babies and young children to the pediatrician. They’ve been able to reduce key obstacles to learning like hyperactivity and difficulty paying attention, according to research published Wednesday in the journal Pediatrics.

The researchers recruited mothers with newborns to participate in the study and divided them into three groups. One group received standard pediatric care, which includes some basic coaching on reading to kids. The second went home with books, toys and informational pamphlets, and the third worked with a trained child development professional for about 30 minutes before or after each checkup. The specialist filmed each mother and child reading or playing together for a few minutes, talked to the mother about the positive things she did with her child and sent her home with the video.

At 3 years old, 50 percent fewer children in the video interaction group who were most at risk showed signs of hyperactivity compared with those who got standard pediatric care. The results were positive, though less remarkable, for the video group as a whole.

Improving a child’s ability to focus, regulate behavior and cooperate with other kids can help a child learn. “If [children are] controlling their behavior, not overreacting and paying attention, they will be taking in more information from learning activities,” says early childhood expert Susan Landry, director of the Children’s Learning Institute, who wasn’t involved in the study. “All those things help in the classroom to be a better student.”

The results show that a relatively cheap form of intervention works, the researchers say, and could be used to reach a big swath of the population, including families who are often hard to reach because parents work multiple jobs or phones get disconnected.

By using pediatric checkups as a way to engage parents, the researchers say they could reach every child without burdening parents with additional transportation or logistical demands. “We’re leveraging the relationship they already have with the pediatric clinic,” Weisleder says.

While home visits to provide this sort of one-on-one behavioral training can cost between $1,500 and $10,000 per child per year (models vary widely), the video program costs around $200. David Willis, director of the federal Health Resources and Services Administration’s Early Childhood Home Visiting Program, notes that the home visit program is far more intensive than the NYU video method, with families getting between 25 and 30 visits per year. Each lasts at least an hour.

“The families we serve are some of the most challenged families in the country,” Willis says. Home visits are an important resource for them, but he estimates the program reaches only 1 to 3 percent of families who could benefit from it. “To simultaneously have this program that’s likewise focused on promoting positive parenting and brain development in the youngest families is really significant,” he says.

Landry thinks the video intervention could be embedded into almost any type of pediatric setting for very little cost. “That’s something all of us have been searching for, “she says. Her team at the University of Texas Health Science Center at Houston is working to make home visits by child development specialists more affordable by giving parents iPads so they can work remotely with experts.

The findings don’t just apply to disadvantaged families. As a pediatrician, the first advice Mendelsohn gives families when kids have behavior problems is to think not about discipline but rather positive steps.

“Can you start to pay attention to your child when your child is being good?” he asks. Negative interactions can turn into a cascade, he says, in which parents feel worse about themselves, which influences kids negatively, which ultimately makes things even harder for parents. “Kids misbehave because it’s their job,” he says. “It’s our job to be able to help them learn and regulate their behavior.”

Simple Number, Complex Impact: How Many Words Has A Child Heard?

In Courtney Banks’ apartment in Chicago’s Kenwood neighborhood, Michelle Saenz opens a laptop.

Banks’ youngest child, 18-month-old son, Rasean Wright, squirms and flops on his mother’s lap.

He’s why Saenz is here: to help Banks talk to her son, to build the little boy’s brain.

She is part of a project called the Thirty Million Words Initiative, developed at the University of Chicago after researchers found that children in poor households often hear fewer words spoken to them than youngsters in more comfortable families.

Specifically, 30 million fewer words by the age of 3. And the kids who start behind can stay behind once they get to school, contributing to a growing achievement gap between poor and better off students.

So Saenz asks Banks what kind of books she’s reading with her son.

“When you trace it all back, really the fundamental thing that grows human brains in the first three years of life is parent talk and interaction. And there is no way around it,” says Dana Suskind, a pediatric surgeon at the University of Chicago Hospital and the founder of the Thirty Million Words Initiative. “The brain is hard-wired to learn from human language and interaction.”

Suskind conducted close to 200 surgeries to install cochlear implants in the ears of children, to help them hear. Over the years, she came to see first-hand, in the operating room and X-rays, that hearing words vitalizes the brains of infants.

“The language comes in: You get these neural connections building the sort of architecture of the brain. It’s really the foundation for all thinking and learning,” she says. “I always say that language is the nutrition for the developing brain.”

It’s not just a question of developing vocabulary, she says: That interaction helps the brain develop to handle things like tying your shoe.

“It’s the first three years of life, or the first five years of life, that helps build all of those skills,” says Suskind, who has published a book about her initiative that goes by the same same.

She acknowledges there are many reasons why low-income children might hear fewer words.

“It is a complex situation, and certainly families who live in poverty, there are so many stressors that impact a parent’s ability to interact with their children. Generally families from lower-income backgrounds, the science shows, don’t interact as much.

“But I think that understanding the science allows us to understand why we need social policies that support families in having time with their children, parental leave — those issues are important for helping close the achievement gap.”

Some have objected that her program doesn’t acknowledge other forms of communication between a parent or child, or how relationships might vary between children and parental figures. Other critics point out that the initiative involves ivory-tower academics telling poor families how to parent.

“My response is … that keeping the science away from people I would not consider an ethical thing,” Suskind says.

And, she says, her program is created in partnership with parents.

“The beauty of the science is that it really demonstrates how powerful parents are. It’s not skipping around parents,” she says. “I always say, no socioeconomic group has cornered the market on wanting their children to be happy and successful.

Back at Banks’ apartment, the mother of five says she looks forward to Saenz’s visits.

“I’ve learned a lot in the few weeks that I have been doing this, and kind of keeping their behaviors under control,” she says. “I actually see my youngest kids learning from this experience.”

Still, five healthy children are rarely “under control” at the same time. At times, a home visit can resemble a comedy sketch — an earnest academic, trying to get a squirming baby to look at something while the chaos of life goes on around them.

“This is real life. You know, I always say we’re looking to not only impact the individual parent, but our ultimate goal is a population-level shift, where this idea isn’t about a bunch of University of Chicago academics allowing parents to understand this, but this becomes part of the groundwater.

“And it doesn’t happen on one home visit, it doesn’t happen with one intervention,” she says. “It happens when an idea takes hold in a population.”

The idea, in this case, is that the words parents utter to their children have lasting impact.

“Who knew that something that looked so throwaway could be so incredibly powerful?” Suskind asks.

Power of pre-K gets boost from new report countering Vanderbilt study

By Marta W. Aldrich

On the heels of a major five-year study questioning the long-term effectiveness of Tennessee’s publicly funded pre-kindergarten program, a new regional report calls on states to raise the quality of such programs and make early childhood development a priority.

The report, released Tuesday by the Southern Regional Education Board, said investments during a child’s critical first years can increase the likelihood of high school graduation, college attainment and workforce readiness.

“Economically, it’s a no-brainer,” said Kentucky Gov. Steve Beshear, who chaired the Early Childhood Commission that developed the report with national experts during a two-year project.

The commission’s work offers a counterpoint to a landmark study released in September by Vanderbilt’s Peabody College of Education, which upends conventional wisdom about the power of preschool. Vanderbilt researchers found that at-risk students who participated in Tennessee’s Voluntary Pre-K program showed significant gains initially, but by third grade performed worse than non-participants on both academic and behavior measures.

While the Vanderbilt data and a 2011 state comptroller’s report have some Tennessee lawmakers questioning the wisdom of more pre-K investments, state Rep. Mark White of Memphis said Monday that the bigger takeaway is that Tennessee must improve the quality of its early childhood programs.

“We don’t need to throw out the baby with the bathwater,” said White, one of three Tennessee lawmakers who served on the SREB commission. “Pre-K, done well and done appropriately, does help, especially in urban areas like Memphis where children face a lot of challenges.”

The commission recommends that its 16 member states boost the quality of both pre-K programs and teacher training — and align curricula from pre-K through third grade so that children’s learning builds over time.

Those are key messages for Tennessee leaders mulling over the Vanderbilt study, says Joan Lord, vice president of education data, policy research and programs for SREB.

“There’s a whole body of research that tells us that gains don’t fade away if you have a high-quality program that’s well-aligned from pre-K through the third grade,” Lord said on the eve of the report’s release.

She said pre-K teachers also must be trained to provide the kind of small-group interaction that can develop high-cognitive functioning in children.

“This is not a babysitting enterprise. It’s not child care,” Lord said. “It’s an educational enterprise. We need to understand what a high-functioning pre-K looks like.”

White, who represented Tennessee on the commission along with Rep. Harry Brooks (R-Knoxville) and Sen. Delores Gresham (R-Somerville), said the state should “slow down and examine the quality of our programs and level of teacher training.”

“A year ago, we looked at putting more money into pre-K but put everything on hold because we knew the Vanderbilt study was coming out. Now I think it’s time to move forward, but let’s not throw away the good just because it’s not perfect,” White said.

“In urban areas like Memphis, we have many children coming out of toxic environments and they need a jumpstart to be ready for kindergarten,” White said. “I have principals and teachers tell me that if it wasn’t for pre-K, these kids wouldn’t be ready. They are so far behind.”

Tennessee’s Voluntary Pre-K program, which was started in 2005 and cost about $86 million in 2013-14, serves about 18,000 children.

1.3 Million Florida Children Under Age 6 Will Be Part of the Workforce in 2030

Career and college readiness efforts frequently focus on ensuring high school students have the skills needed to succeed in postsecondary education or job training. However, the foundation of many skills needed for 21st-century jobs is established in the earliest years.

Early childhood education is essential for a child’s development of both cognitive and non-cognitive skills. Preparing our youngest students to learn provides a foundation for future success and helps them develop important skills such as self-discipline, persistence and cooperation–skills that are essential to their future success and a quality workforce.

 

Early-Learning-Infographic

 

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