Language Development
Conditions
Keywords
Book reading, Infancy, Interactive reading, Vocabulary development, Parenting
Brief summary
The purpose of this study is to analyze the effect of an interactive parent-child book reading intervention. The intervention includes two components: the provision of five children's books to parent-child dyads and information about how to practice interactive book reading. The investigators expect to find an effect of this intervention on a) infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies.
Detailed description
The foundations of optimal health, growth and development are forged early in life, when income-related gaps in learning opportunities already exist in Costa Rica. It is therefore important for the government to mitigate the effects of these gaps through programs targeting the development of academic, behavioral, socioemotional and economic abilities. Key to the success of such programs is to consider physical health, nutrition, responsive care and early learning. Multiple government-led initiatives in Costa Rica had been carried out in order to provide adequate programs for infants and young children. Evidence of these efforts are observed in the low rates attained in infant mortality, malnutrition and anemia, as well as the high coverage of the current immunization program. However, policies targeting early learning in children under 36 months of age are incipient and government initiatives in this regard are relatively recent. The purpose of this study is to promote early language development, a central component of early learning. Our goal is to implement and evaluate a low-cost intervention targeting parents of infants who benefit from the existing immunization program of the public health services offered by the Caja Costarricense del Seguro Social (Costa Rican Social Security Fund). The investigators will use an experimental design to randomly assign 15- to 17-month-old infants and their caregivers to one of two groups: a control group or an experimental group. In the experimental group, caregivers will receive a package including five children's books and 36 text messages with information on how to practice interactive book reading with their children. This information will be delivered over a period of 12 weeks. The control group will not receive any treatment during the implementation of the intervention. In order to measure the efficacy of the intervention, the investigators will evaluate a) infants' expressive vocabulary, b) parent-child reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies at baseline (15-17 months of age) and at posttest (18-20 months of age) in the control and the experimental group. After posttest, the control group will receive the complete intervention. The investigators expect to find an effect of the interactive book reading intervention on a) infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies.
Interventions
BEHAVIORALInteractive Book Reading
The intervention is a package including five children's books and information on how to practice interactive book reading. Information includes 36 audiovisual products delivered via text messaging over a 12-week period. Products include: 1. An introductory video about interactive book reading, along with a written list of recommendations on how to practice interactive book reading. 2. Two videos of child development experts explaining the benefits of interactive reading. 3. Thirty written text messages strengthening content provided in the videos. 4. Three audio messages guiding the progress of the intervention. Based on Abraham and Michie's (2008) taxonomy of behavior change techniques, one audiovisual product prompts specific goal settings, 13 provide instruction, one provides information on consequences, 10 prompt practice, three use follow-up prompts, one prompts self-monitoring of behavior, one models or demonstrates the behavior and six prompt barrier identification.
Sponsors
Caja Costarricense de Seguro Social
Universidad de Costa Rica
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Outcomes Assessor)
Masking description
An external collaborator will create the allocation sequence for each of the two participating health centers (stratified randomization). Two independent research assistants will prepare the allocation in sequentially numbered, opaque, sealed and stapled envelopes. Aluminium foil inside each envelope will be used to render the envelope impermeable to intense light. This will allow the allocation sequence to be concealed from the researcher assessing participants at baseline. Once baseline assessment is completed, the next consecutively numbered envelope will be opened to reveal the participant's allocation. Treatment for the experimental group will be provided by two different researchers who will not participate in outcome assessment. A different researcher (outcome assessor), blind to the allocation sequence, to the participant's allocation and to the participant's baseline scores, will complete the participants' assessments during posttest.
Intervention model description
All participants will take baseline measures. After baseline, each participant will be randomly assigned to the control or the experimental group. At posttest, all measures taken at baseline will be evaluated again in all participants.
Eligibility
Sex/Gender
ALL
Age
15 Months to 17 Months
Healthy volunteers
Yes
Inclusion criteria
for infants: * Age limits: 15 months to 17 months. * Sex: All. * Infant was born full term (≥ 37 weeks). * Infant is raised in a monolingual Spanish-speaking home. Inclusion criteria for mothers: * Mother knows how to read and write. * Mother has access to cell phone with internet.
Exclusion criteria
* Neither caregivers nor infants must have any significant known physical, mental or learning disability.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in infant expressive vocabulary | Baseline [15 to 17-months] and Posttest [18 to 20-months]. | Infant expressive vocabulary will be measured with the short form (SF) Spanish versions of the MacArthur-Bates Communicative Development Inventories (CDI). Parents will complete version I (CDI-SFI) of the inventory at baseline and version II (CDI-SFII) of the inventory at posttest. Scores on the CDI-SFI inventory range from 0 to 104. Scores on the CDI-SFII inventory range from 0 to approximately 100-135, depending on the complexity of the participant's linguistic production. For both inventories, higher scores indicate a better outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in parental report of reading activities | Baseline [15 to 17-months] and Posttest [18 to 20-months]. | Parental report of reading activities will be measured with the Spanish version of the Reading Subscale (READ) of the Cognitive Home Environment Questionnaire (StimQ-Toddler). Scores range from 0 to 19. Higher scores indicate a better outcome. |
| Change in parental expectations and knowledge about language development | Baseline [15 to 17-months] and Posttest [18 to 20-months]. | Parental report of expectations and knowledge about language development will be measured with the Spanish version of the Survey of Parent/Provider Expectations and Knowledge (SPEAK), a self-administered questionnaire assessing expectations and knowledge about early childhood cognitive and language development. Scores range from 0 to 54. Higher scores indicate a better outcome. |
| Change in parental use of interactive book reading strategies | Baseline [15 to 17-months] and Posttest [18 to 20-months]. | Video recordings of parent-child dyads reading books at baseline and posttest will be analyzed for quantity of interactive book reading strategies. Videos will be first transcribed and subsequently coded according to the following coding categories: word tokens, word types, mean length of utterance, number of questions and pointing tokens. Range of scores depends on participants' communicative/linguistic production. Higher scores indicate a better outcome. |
Countries
Costa Rica
Outcome results
None listed