CARING: The Impact of a Parent-Child, Play-Based Intervention to Promote Latino Head Start Children's Social-Emotional Development.

CARING is a preventive, play-based, parent-child intervention designed to promote preschoolers' social-emotional development by strengthening their bonds with their parents. We describe the qualitative impact of the CARING Preschool program on Latino preschool children and their parents. One hundred and eleven Latino families participated in a larger study of the efficacy of the CARING preschool program. Of these families, 40 participated in this qualitative study. We invited families to participate in a focus group after completing the intervention. We used an inductive approach based on grounded theory to identify thematic categories. Parents reported substantial changes in themselves, their children and the quality of their relationships with their children as a result of their participation in CARING. Parents also reported an increased understanding of their children's needs, their ability to use at home the skills learned during the intervention, and improved parent-child communication. In addition, parents reported the social skills and self-regulation abilities of their children improved. These findings highlight the promise of preventive, low-cost interventions for families facing socioeconomic and psychosocial adversity, and their potential role in strengthening parent-child relationships. Results highlight cultural parenting practices and implications for intervention with Latino families.

The role of cognitive stimulation at home in low-income preschoolers' nutrition, physical activity and body mass index.

BACKGROUND: Early childhood obesity disproportionately affects children of low socioeconomic status. Children attending Head Start are reported to have an obesity rate of 17.9%.This longitudinal study aimed to understand the relationship between cognitive stimulation at home and intake of junk food, physical activity and body size, for a nationally representative sample of 3- and 4-year old children entering Head Start. METHODS: We used The Family and Child Experiences Survey 2006. Cognitive stimulation at home was measured for 1905 children at preschool entry using items from the Home Observation Measurement of the Environment Short Form. Junk food consumption and physical activity were obtained from parent interviews at kindergarten entry. BMI z scores were based on CDC national standards. We analyzed the association between early cognitive stimulation and junk food consumption, physical activity and BMI, using multinomial and binary logistic regression on a weighted sample. RESULTS: Children who received moderate levels of cognitive stimulation at home had a 1.5 increase in the likelihood of consuming low amounts of junk food compared to children from low cognitive stimulation environments. Children who received moderate and high levels of cognitive stimulation were two and three times, respectively, more likely to be physically active than those in low cognitive stimulation homes. No direct relationship was identified between cognitive stimulation and BMI. CONCLUSION: Prevention and treatment efforts to address early childhood obesity may consider strategies that support parents in providing cognitively stimulating home environments. Existing evidence-based programs can guide intervention in pediatric primary care.

Screen time use in children under 3 years old: a systematic review of correlates.

BACKGROUND: A large percentage (68%) of children under age 3 use screen media, such as television, DVDs and video games, on a daily basis. Research suggests that increased screen time in young children is linked to negative health outcomes, including increased BMI, decreased cognitive and language development and reduced academic success. Reviews on correlates of screen time for young children have included preschool age children and children up to age 7; however, none have focused specifically on correlates among infants and toddlers. As research suggests that screen media use increases with age, examining correlates of early media exposure is essential to reducing exposure later in life. Thus, this paper systemically reviews literature published between January 1999 and January 2013 on correlates of screen time among children between 0 and 36 months of age. METHODS: Two methods were used to conduct this review: (1) Computerized searches of databases (PubMed, PsycINFO, ERIC, Medline); and (2) Reference sections of existing reviews and primary studies. Inclusion criteria were: (1) The article included separate data for children 36 months and younger, (2) English language, (3) peer reviewed article, (4) analysis reported for screen viewing as a dependent variable, (5) original research article and, (6) examined correlates or associations between screen time and other demographic, contextual or behavioral variables. Articles were compiled between 2011 and 2013 and evaluation occurred in 2012 and 2013. RESULTS: The literature search identified 29 studies that met inclusion criteria. These studies investigated a total of 33 potential correlates, which were examined in this review. Findings suggest demographic variables most commonly correlated with high screen time among infants and toddlers are child's age (older) and race/ethnicity (minority). Child BMI, maternal distress/depression, television viewing time of the mother and cognitive stimulation in the home environment were also associated with screen media use. Studies reported that child sex, first born status, paternal education, non-English speaking family, two-parent household, number of children in the home and non-parental childcare were not associated with screen time among children aged 0-36 months. Associations were unclear (fewer than 60% of studies report an association) for maternal age, maternal education and household income. The remaining correlates were investigated in fewer than three studies and thus not coded for an association. CONCLUSIONS: The correlates identified in this study point to avenues for intervention to reduce screen time use in young children. However, further research is necessary to explore a number of environmental, socio-cultural and behavioral correlates that are under-examined in this population and may further inform prevention and intervention strategies.

Interactive Dyadic Physical Activity and Spatial Proximity Patterns in 2-Year-Olds and Their Parents.

This study aimed to characterize daily physical activity (PA) behaviors in 2-year-old girls and boys and their parents, with and without an objective measure of dyadic spatial proximity. Urban-dwelling parent⁻toddler dyads (N = 110) wore accelerometers for 7 days, and parents completed a sociodemographic questionnaire. Accelerometers were initialized to collect PA and Bluetooth-based proximity data. After applying wear-time algorithms, n = 65 dyads were further analyzed using a dyadic analysis statistical methodology. Toddler⁻parent sedentary and light PA time were respectively interdependent, conditional on child sex and child-parent proximity, but moderate⁻vigorous physical activity (MVPA) time was not. Toddlers were significantly more active on weekdays and weekends than their parents, and no differences were found in daily PA volumes between girls and boys. In dyads with proximity data (n = 34), analyses of joint (i.e., proximal and mutual) PA time showed that girls participated in significantly more joint PA with their mothers than boys. Children who engaged in ≥60 min of MVPA/day participated in ~2 h of joint PA/day, on average, while children with <60 min of MVPA/day engaged in ~30 min less joint-PA time with their mothers. Boys and girls who participated in higher daily MVPA volumes engaged in joint PA with their mothers across greater relative distances, as compared to less active boys who engaged in joint PA at closer relative distances to their mothers. Toddlers who engaged in ≥60 min of daily MVPA participated in joint PA with their mothers at greater relative distances and for longer durations than less active children. Further research on the dyadic activity⁻proximity relationship is needed across early childhood development.

Parent Involvement in the Getting Ready for School Intervention Is Associated With Changes in School Readiness Skills.

The role of parent involvement in school readiness interventions is not well-understood. The Getting Ready for School (GRS) intervention is a novel program that has both home and school components and aims to improve early literacy, math, and self-regulatory skills in preschool children from socioeconomically disadvantaged families. In this study, we first examined associations between family characteristics and different indices of parent involvement in the GRS intervention. We then examined associations between parent involvement and change in children's school readiness skills over time. Participants were 133 preschool children attending Head Start and their parents who participated in the GRS intervention during the academic year 2014-2015. Parent involvement was operationalized as attendance to GRS events at the school, time spent at home doing GRS activities, and usage of digital program materials, which included a set of videos to support the implementation of parent-child activities at home. Although few family characteristics were significantly associated with parent involvement indices, there was a tendency for some markers of higher socioeconomic status to be linked with greater parent involvement. In addition, greater parent involvement in the GRS intervention was significantly associated with greater gains in children's early literacy, math, and self-regulatory skills. These findings suggest that parent involvement in comprehensive early interventions could be beneficial in terms of improving school readiness for preschoolers from disadvantaged families.

Association of screen time use and language development in Hispanic toddlers: a cross-sectional and longitudinal study.

This study examined the association between screen media use, media content, and language development among 119 Hispanic infants and toddlers. Children and their caregivers were recruited through an urban, Early Head Start program. Duration and content of screen media exposure was measured through a 24-hour recall questionnaire, and language development was measured at baseline and at 1-year follow up. Children in the sample spent an average of 3.29 hours engaged with screen media (median 2.5 hours per day). In both cross-sectional and longitudinal analyses, children who watched over 2 hours of television per day had increased odds of low communication scores. Whereas child-directed media was associated with low language scores, adult-directed media was not. Our findings support the mounting literature on the deleterious impacts of screen media in toddler's language development. Guidance and alternatives to screen media use should be available to families in pediatric practices and early childhood centers.