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BACKGROUND: The Video Interaction Project (VIP) is a healthcare-based intervention that provides real-time video-feedback of parent-child play and reading interactions to families with children aged 0 to 36 months. Although evidence from randomized controlled trials demonstrates improved early relational health, including responsive parenting, after three to five VIP visits, the minimal effective dose in real-world implementations is unknown. This study aimed to determine the minimal effective dose of VIP during a real-world implementation for changing responsive parenting behaviors. METHODS: We performed a longitudinal prospective study of 183 dyads at a public hospital pediatric clinic. Responsive parenting behaviors were assessed with an observational checklist utilized as part of standard VIP practice at baseline and two follow-up VIP visits. RESULTS: Multilevel models adjusted for baseline sociodemographics (child's sex and age, and maternal education) and time between visits showed that responsive parenting behaviors during parent-child reading and play significantly increased after a single VIP visit (Cohen's d = 0.52, p < 0.05) with additional impact following completion of a second visit (cumulative for 2 visits: d = 0.76, p < 0.05). CONCLUSIONS: A single VIP visit is associated with increased responsive parenting behaviors. Findings support offering VIP widely, regardless of capacity to ensure attendance at multiple visits. IMPACT: This is the first study showing the minimal effective dose of the Video Interaction Project (VIP) for increasing responsive parenting behaviors. Responsive parenting behaviors increased by over 22% following a single VIP visit, with a cumulative increase of 37% following the second visit compared to baseline. Findings have important implications for implementation and scalability of pediatric-based preventive programs that support early relational health through activities such as reading and play.
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Late talkers are a heterogeneous group of children who experience delayed language development in the absence of other known causes. Late talkers show delays in expressive phonological development, but less is known about their receptive phonological development. In the current study, U.S. monolingual English-speaking typical talkers (TTs) (n = 23, mean age = 26.27 months, 57% male; 78.3% White) and late talkers (n = 22, mean age = 24.57 months, 59% male, 72.7% White) completed a Looking-While-Listening task to assess their sensitivity to mispronunciations. Results revealed that late talkers and TTs looked to the referent of a word for a shorter duration when it was mispronounced than when it was correctly pronounced, suggesting they were sensitive to mispronunciations. However, there were no significant differences between the two groups in their sensitivity to mispronunciations.
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Transtornos do Desenvolvimento da Linguagem , Percepção da Fala , Criança , Masculino , Humanos , Pré-Escolar , Feminino , Idioma , Desenvolvimento da Linguagem , Percepção AuditivaRESUMO
Laboratory observations are a mainstay of language development research, but transcription is costly. We test whether speech recognition technology originally designed for day-long contexts can be usefully applied to this use-case. We compared automated adult word and child vocalization counts from Language Environment Analysis (LENATM) to those of transcribers in 20-minute play sessions with Spanish-speaking dyads (n = 104) at 1;7 and 2;2. For adult words, results indicated moderate associations but large absolute differences. Associations for child vocalizations were weaker with larger absolute discrepancies. LENA has moderate potential to ease the burden of transcription in some research and clinical applications.
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Laboratórios , Fala , Adulto , Criança , Linguagem Infantil , Coleta de Dados , Humanos , Idioma , Desenvolvimento da LinguagemRESUMO
Recent advances in large-scale data storage and processing offer unprecedented opportunities for behavioral scientists to collect and analyze naturalistic data, including from underrepresented groups. Audio data, particularly real-world audio recordings, are of particular interest to behavioral scientists because they provide high-fidelity access to subtle aspects of daily life and social interactions. However, these methodological advances pose novel risks to research participants and communities. In this article, we outline the benefits and challenges associated with collecting, analyzing, and sharing multi-hour audio recording data. Guided by the principles of autonomy, privacy, beneficence, and justice, we propose a set of ethical guidelines for the use of longform audio recordings in behavioral research. This article is also accompanied by an Open Science Framework Ethics Repository that includes informed consent resources such as frequent participant concerns and sample consent forms.
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Confidencialidade , Privacidade , Gravação em Vídeo , Pesquisa Comportamental , Coleta de Dados , Ética em Pesquisa , Humanos , Consentimento Livre e EsclarecidoRESUMO
OBJECTIVE: To investigate pathways by which interventions that promote shared reading and play help prevent child behavior problems. We examined whether family processes associated with the family investment pathway (eg, parental cognitive stimulation) and the family stress pathway (eg, mothers' psychosocial functioning) mediated impacts of a pediatric-based preventive intervention on child behavior. STUDY DESIGN: The sample included 362 low-income mothers and their children who participated in a randomized controlled trial of the Video Interaction Project, a pediatrics-based preventive intervention that promotes parent-child interactions in the context of shared reading and play. Parent-child dyads were randomly assigned to group at birth. Three mediators-parental cognitive stimulation, maternal stress about the parent-child relationship, and maternal depressive symptoms-were assessed at child ages 6 and 36 months. The outcome, child externalizing behaviors, was assessed at 36 months. We used a series of path analytic models to examine how these family processes, separately or together, mediated the impacts of the Video Interaction Project on child behavioral outcomes. RESULTS: Intervention impacts on child behavior were mediated by enhancements in cognitive stimulation and by improvements in mothers' psychosocial functioning. A sequential mediation model showed that Video Interaction Project impacts on cognitive stimulation at 6 months were associated with later decreases in mothers' stress about the parent-child relationship and that this pathway mediated intervention impacts on child behavioral outcomes at 3 years of age (P = .023). CONCLUSIONS: Using an experimental design, this study identifies pathways by which parent-child interactions in shared reading and play can improve child behavioral outcomes. TRIAL REGISTRATION: Clinicaltrials.gov: NCT00212576.
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Comportamento Infantil , Relações Pais-Filho , Poder Familiar , Jogos e Brinquedos , Leitura , Transtornos do Comportamento Infantil/epidemiologia , Desenvolvimento Infantil , Pré-Escolar , Cognição , Depressão Pós-Parto , Feminino , Hospitais Urbanos , Humanos , Lactente , Estudos Longitudinais , Masculino , Mães , Pais/psicologia , Pobreza , Atenção Primária à Saúde/organização & administração , Projetos de Pesquisa , Classe Social , População Urbana , Gravação em Vídeo , WashingtonRESUMO
OBJECTIVE: To determine the early impacts of pediatric primary care parenting interventions on parent cognitive stimulation in low socioeconomic status families and whether these impacts are sustained up to 1.5 years after program completion. STUDY DESIGN: This randomized controlled trial included assignment to 1 of 2 interventions (Video Interaction Project [VIP] or Building Blocks) or to a control group. Mother-newborn dyads were enrolled postpartum in an urban public hospital. In VIP, dyads met with an interventionist on days of well-child visits; the interventionist facilitated interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interactions. In Building Blocks, parents were mailed parenting pamphlets and learning materials. We compare the trajectories of cognitive stimulation for parents in VIP and control from 6 to 54 months. RESULTS: There were 546 families that contributed data. VIP was associated with enhanced reading, parent verbal responsivity, and overall stimulation at all assessment points, with analyses demonstrating a 0.38 standard deviation increase in cognitive stimulation overall. Trajectory models indicated long-term persistence of VIP impacts on reading, teaching, and verbal responsivity. CONCLUSIONS: VIP is associated with sustained enhancements in cognitive stimulation in the home 1.5 years after completion of the program and support expansion of pediatric interventions to enhance developmental trajectories of children of low socioeconomic status. TRIAL REGISTRATION: Clinicaltrials.gov: NCT00212576.
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Cognição/fisiologia , Aprendizagem/fisiologia , Relações Pais-Filho , Poder Familiar/psicologia , Atenção Primária à Saúde/métodos , Leitura , Gravação em Vídeo/métodos , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Método Simples-Cego , Fatores de TempoRESUMO
A large number of children are exposed to more than one language. One well-established method of assessing early vocabulary development in monolingual children is parent report; however, its use in bilingual/multilingual contexts is less established and brings unique challenges. In this methodological scoping review, we reviewed studies of early vocabulary development using parent report with bilingual/multilingual children (January 1980-March 2022). A total of 576 articles were screened, yielding 101 studies for analysis. The number of studies on bilingual/multilingual vocabulary has grown in the last two decades; yet representation of the world's languages remains sparse. The majority of studies assessed bilingual/multilingual children's vocabulary in each language and used instruments adapted for linguistic and cultural characteristics. However, the field could benefit from standardized reporting practices regarding definitions of bi/multilingualism, selection of reporters, and tool development and is in critical need of studies that develop, validate, and norm parent report instruments specifically for the bilingual/multilingual case.
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Early vocabulary development is crucial for future cognitive and academic outcomes, and parent-child booksharing has been recognized as a powerful home literacy practice to promote word learning. However, evidence about the link between booksharing and language development in diverse cultural and socioeconomic settings is currently limited, hindering the formulation of a broadly applicable framework to understand the favorable conditions for early vocabulary development. This study explores the relationship between booksharing and early receptive and expressive vocabulary in a sample of 183 mothers and their toddlers in Costa Rica, a context where reading is not a common practice and children have limited access to books. Mothers completed an interview about their booksharing practices and reported children's receptive and expressive vocabulary. Results demonstrated a positive link between maternal booksharing and children's expressive vocabulary. Child gender moderated the link between booksharing and receptive vocabulary, exhibiting a stronger association in girls than in boys. Mothers with lower education levels reported higher expressive vocabulary scores for their children than mothers with higher education levels. These findings underscore the significance of booksharing in the home literacy environment, even in cultural contexts with distinct reading practices. Moreover, they highlight the need to incorporate sociocultural factors into comprehensive accounts concerning the role of booksharing in early word learning.
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Infants differ substantially in their rates of language growth, and slow growth predicts later academic difficulties. In this study, we explored how the amount of speech directed to infants in Spanish-speaking families low in socioeconomic status influenced the development of children's skill in real-time language processing and vocabulary learning. All-day recordings of parent-infant interactions at home revealed striking variability among families in how much speech caregivers addressed to their child. Infants who experienced more child-directed speech became more efficient in processing familiar words in real time and had larger expressive vocabularies by the age of 24 months, although speech simply overheard by the child was unrelated to vocabulary outcomes. Mediation analyses showed that the effect of child-directed speech on expressive vocabulary was explained by infants' language-processing efficiency, which suggests that richer language experience strengthens processing skills that facilitate language growth.
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Desenvolvimento da Linguagem , Percepção da Fala/fisiologia , Vocabulário , Pré-Escolar , Feminino , Hispânico ou Latino/etnologia , Humanos , Individualidade , Lactente , Masculino , Relações Pais-Filho , Pobreza/psicologia , Classe SocialRESUMO
This research revealed both similarities and striking differences in early language proficiency among infants from a broad range of advantaged and disadvantaged families. English-learning infants (n = 48) were followed longitudinally from 18 to 24 months, using real-time measures of spoken language processing. The first goal was to track developmental changes in processing efficiency in relation to vocabulary learning in this diverse sample. The second goal was to examine differences in these crucial aspects of early language development in relation to family socioeconomic status (SES). The most important findings were that significant disparities in vocabulary and language processing efficiency were already evident at 18 months between infants from higher- and lower-SES families, and by 24 months there was a 6-month gap between SES groups in processing skills critical to language development.
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Desenvolvimento da Linguagem , Classe Social , Vocabulário , Desenvolvimento Infantil , Pré-Escolar , Cognição , Etnicidade , Feminino , Humanos , Lactente , Idioma , Aprendizagem , Masculino , Pobreza , Reprodutibilidade dos Testes , Fatores de TempoRESUMO
PURPOSE: This study examines online speech processing in typically developing and late-talking 2-year-old children, comparing both groups' word recognition, word prediction, and word learning. METHOD: English-acquiring U.S. children, from the "When to Worry" study of language and social-emotional development, were identified as typical talkers (n = 67, M age = 27.0 months, SD = 1.4; Study 1) or late talkers (n = 30, M age = 27.0 months, SD = 2.0; Study 2). Children completed an eye-tracking task assessing their ability to recognize both nouns and verbs, to use verbs to predict an upcoming noun's referent, and to use verbs to infer the meaning of novel nouns. RESULTS: Both typical and late talkers recognized nouns and verbs and used familiar verbs to predict the referents of upcoming nouns, whether the noun was familiar ("You can eat the apple") or novel ("You can eat the dax"). Late talkers were slower in using familiar nouns to orient to the target and were both slower and less accurate in using familiar verbs to identify the upcoming noun's referent. Notably, however, both groups learned and retained novel word meanings with similar success. CONCLUSIONS: Late talkers demonstrated slower lexical processing, especially for verbs. Yet, their success in using familiar verbs to learn novel nouns suggests that, as a group, their slower processing did not impair word learning in this task. This sets the foundation for future work investigating whether these measures predict later language outcomes and can differentiate late talkers with transient delays from those with language disorders.
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Transtornos do Desenvolvimento da Linguagem , Fala , Humanos , Pré-Escolar , Criança , Aprendizagem , Idioma , Aprendizagem Verbal , Linguagem Infantil , Transtornos do Desenvolvimento da Linguagem/psicologia , VocabulárioRESUMO
PURPOSE: Late talkers (LTs) are a group of children who exhibit delays in language development without a known cause. Although a hallmark of LTs is a reduced expressive vocabulary, little is known about LTs' processing of semantic relations among words in their emerging vocabularies. This study uses an eye-tracking task to compare 2-year-old LTs' and typical talkers' (TTs') sensitivity to semantic relationships among early acquired words. METHOD: U.S. monolingual English-speaking LTs (n = 21) and TTs (n = 24) completed a looking-while-listening task in which they viewed two images on a screen (e.g., a shirt and a pizza), while they heard words that referred to one of the images (e.g., Look! Shirt!; target-present condition) or a semantically related item (e.g., Look! Hat!; target-absent condition). Children's eye movements (i.e., looks to the target) were monitored to assess their sensitivity to these semantic relationships. RESULTS: Both LTs and TTs looked longer at the semantically related image than the unrelated image on target-absent trials, demonstrating sensitivity to the taxonomic relationships used in the experiment. There was no significant group difference between LTs and TTs. Both groups also looked more to the target in the target-present condition than in the target-absent condition. CONCLUSIONS: These results reveal that, despite possessing smaller expressive vocabularies, LTs have encoded semantic relationships in their receptive vocabularies and activate these during real-time language comprehension. This study furthers our understanding of LTs' emerging linguistic systems and language processing skills. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23303987.
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Transtornos do Desenvolvimento da Linguagem , Semântica , Criança , Humanos , Pré-Escolar , Desenvolvimento da Linguagem , Vocabulário , LinguísticaRESUMO
Considerable evidence demonstrates the importance of the cognitive home environment in supporting children's language, cognition, and school readiness more broadly. This is particularly important for children from low-income backgrounds, as cognitive stimulation is a key area of resilience that mediates the impact of poverty on child development. Researchers and clinicians have therefore highlighted the need to quantify cognitive stimulation; however existing methodological approaches frequently utilize home visits and/or labor-intensive observations and coding. Here, we examined the reliability and validity of the StimQ2, a parent-report measure of the cognitive home environment that can be delivered efficiently and at low cost. StimQ2 improves upon earlier versions of the instrument by removing outdated items, assessing additional domains of cognitive stimulation and providing new scoring systems. Findings suggest that the StimQ2 is a reliable and valid measure of the cognitive home environment for children from infancy through the preschool period.
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Desenvolvimento Infantil , Pais , Criança , Humanos , Pré-Escolar , Reprodutibilidade dos Testes , Cognição , PobrezaRESUMO
PURPOSE: Child development milestones are a critical tool for pediatricians and caregivers to use for developmental surveillance. Following review and selection by a panel of subject matter experts, the Centers for Disease Control and Prevention (CDC) published a revised list of milestones across multiple domains of development. Using expressive vocabulary, a key indicator of language development, as an illustrative example, the purpose of this brief review is to evaluate the evidence used to establish the CDC developmental milestones and determine whether the samples used to establish these milestones are representative of U.S. children. METHOD: Authors reviewed the methods and evidence cited to determine the CDC milestones. First, authors identified each language/communication milestone that measured expressive vocabulary as number of words, followed by review of the sources cited in support of each extracted milestone. Then, data related to both milestones and sample characteristics were extracted and compiled as well as compared with data from a validated parent report measure of expressive vocabulary, the MacArthur-Bates Communication Development Inventories. RESULTS: Results indicated that evidence was conflicting, misaligned, or missing for the selected CDC expressive vocabulary milestones. This review also indicated that the samples used to determine the selected CDC expressive vocabulary milestones are not representative of U.S. children. CONCLUSION: The striking paucity of evidence supporting the new CDC milestones for expressive vocabulary illustrates the critical need for future research in this area to establish more accurate milestones for U.S. children, with a focus on culturally inclusive large-scale data.
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Desenvolvimento Infantil , Vocabulário , Criança , Humanos , Desenvolvimento da Linguagem , ComunicaçãoRESUMO
OBJECTIVES: In this study, we examined (1) whether a reading aloud intervention, Universidade do Bebê (UBB), had impacts on self-regulation; (2) whether effects on child outcomes were mediated by self-regulation; and (3) whether effects of UBB were explained through a sequential pathway of impact, including cognitive stimulation in the home, parent-child interactive reading, and self-regulation. METHODS: We performed a cluster randomized controlled trial of UBB in child care centers serving low-income children (mean age 37.4 months; SD = 6.5) in Northern Brazil. The child care centers were randomized to receive UBB or standard care (control). Families in UBB could borrow children's books weekly and participate in monthly workshops focused on reading aloud. Parent-child dyads (n = 484, intervention = 232, control = 252) were evaluated at baseline and 9 months later on: child self-regulation, vocabulary, intelligence quotient (IQ), working memory, and phonological memory and measures of cognitive stimulation in the home and parent-child interactive reading. Multilevel analyses accounted for baseline performance, sociodemographics, and clustering within centers and sites. RESULTS: The UBB group showed significantly higher self-regulation (Cohen's d = 0.25), compared with the control group, particularly in the subdomains of Attention (d = 0.24) and Impulse Control (d = 0.21). Previously shown impacts of UBB on receptive vocabulary, IQ, and working memory were mediated by self-regulation. Effects of UBB on self-regulation and child outcomes were partially explained through cognitive stimulation in the home and parent-child interactive reading. CONCLUSION: Self-regulation represents an important mechanism by which reading aloud interventions affect language and cognitive outcomes. Investigators should consider the role of self-regulation when refining interventions, seeking to prevent poverty-related disparities.
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Leitura , Autocontrole , Brasil , Pré-Escolar , Cognição , Humanos , IdiomaRESUMO
Purpose The language that children hear early in life is associated with their speech-language outcomes. This line of research relies on naturalistic observations of children's language input, often captured with daylong audio recordings. However, the large quantity of data that daylong recordings generate requires novel analytical tools to feasibly parse thousands of hours of naturalistic speech. This study outlines a new approach to efficiently process and sample from daylong audio recordings made in two bilingual communities, Spanish-English in the United States and Quechua-Spanish in Bolivia, to derive estimates of children's language exposure. Method We employed a general sampling with replacement technique to efficiently estimate two key elements of children's early language environments: (a) proportion of child-directed speech (CDS) and (b) dual language exposure. Proportions estimated from random sampling of 30-s segments were compared to those from annotations over the entire daylong recording (every other segment), as well as parental report of dual language exposure. Results Results showed that approximately 49 min from each recording or just 7% of the overall recording was required to reach a stable proportion of CDS and bilingual exposure. In both speech communities, strong correlations were found between bilingual language estimates made using random sampling and all-day annotation techniques. A strong association was additionally found for CDS estimates in the United States, but this was weaker at the Bolivian site, where CDS was less frequent. Dual language estimates from the audio recordings did not correspond well to estimates derived from parental report collected months apart. Conclusions Daylong recordings offer tremendous insight into children's daily language experiences, but they will not become widely used in developmental research until data processing and annotation time substantially decrease. We show that annotation based on random sampling is a promising approach to efficiently estimate ambient characteristics from daylong recordings that cannot currently be estimated via automated methods.
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Desenvolvimento da Linguagem , Multilinguismo , Humanos , Hispânico ou Latino , Idioma , Pais , Fala , Bolívia , Estados UnidosRESUMO
BACKGROUND AND OBJECTIVES: Heterogeneity in risk among low-income families suggests the need for tiered interventions to prevent disparities in school readiness. Smart Beginnings (SB) integrates two interventions: Video Interaction Project (VIP) (birth to 3 years), delivered universally to low-income families in pediatric primary care, and Family Check-Up (6 months to 3 years), targeted home visiting for families with additional family risks. Our objective was to assess initial SB impacts on parent-child activities and interactions at 6 months, reflecting early VIP exposure. METHODS: Two-site randomized controlled trial in New York City (84% Latinx) and Pittsburgh (81% Black), with postpartum enrollment and random assignment to treatment (SB) or control. At 6 months, we assessed parent-child interactions through surveys (StimQ, Parenting Your Baby) and observation (video-recorded play, coded by using Parent-Child Interaction Rating Scales - Infant Adaptation). RESULTS: A total of 403 families were enrolled at child's birth (201 treatment) with 362 (89.8%) assessed at 6 months. Treatment families had increased StimQ, including total score (Cohen's d = 0.28; P < .001) and domains reflecting reading (d = 0.23; P = .02) and teaching (d = 0.25; P = .01), and Parent-Child Interaction Rating Scales - Infant Adaptation, including a cognitive stimulation factor (d = 0.40; P < .001) and domains reflecting support for cognitive development (d = 0.36; P < .001), and language quantity (0.40; P < .001) and quality (d = 0.37; P < .001). Thus, significant effects emerged across a broad sample by using varied methodologies. CONCLUSIONS: Findings replicate and extend previous VIP findings across samples and assessment methodologies. Examining subsequent assessments will determine impacts and feasibility of the full SB model, including potential additive impacts of Family Check-Up for families at elevated risk.
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Intervenção Educacional Precoce/métodos , Relações Pais-Filho , Pediatria , Pobreza , Pré-Escolar , Cognição/fisiologia , Feminino , Visita Domiciliar , Humanos , Lactente , Masculino , Cidade de Nova Iorque , Relações Pais-Filho/etnologia , Poder Familiar , Pennsylvania , Leitura , Método Simples-CegoRESUMO
Recent analyses have revealed that child-directed speech contains distributional regularities that could, in principle, support young children's discovery of distinct grammatical categories (noun, verb, adjective). In particular, a distributional unit known as the frequent frame appears to be especially informative (Mintz, 2003). However, analyses have focused almost exclusively on the distributional information available in English. Because languages differ considerably in how the grammatical forms are marked within utterances, the scarcity of cross-linguistic evidence represents an unfortunate gap. We therefore advance the developmental evidence by analyzing the distributional information available in frequent frames across two languages (Spanish and English), across sentence positions (phrase medial and phrase final), and across grammatical forms (noun, verb, adjective). We selected six parent-child corpora from the CHILDES database (three English; three Spanish), and analyzed the input when children were aged 2 ; 6 or younger. In each language, frequent frames did indeed offer systematic cues to grammatical category assignment. We also identify differences in the accuracy of these frames across languages, sentences positions and grammatical classes.
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Linguagem Infantil , Sinais (Psicologia) , Adulto , Criança , Inglaterra , Humanos , Linguística , Relações Pais-Filho , Semântica , EspanhaRESUMO
OBJECTIVE: Feeding concerns are common in the first 2 years of life and typically reflect maternal perceptions occurring within the larger context of the parent-child relationship. We aimed to determine whether (1) maternal depressive systems predicted perceived picky eating, mediated by maternal negative perceptions; (2) receipt of the Video Interaction Project (VIP) parenting intervention impacted perceived picky eating through this pathway; and (3) perceived picky eating was associated with child growth or subsequent dietary patterns. METHODS: We performed a partial longitudinal analysis of 187 low-income, predominantly Hispanic mother-child dyads enrolled in a randomized controlled trial of the VIP. Mother-infant dyads were enrolled postpartum in an urban public hospital. Participants randomized to the VIP met with an interventionist on days of well-child visits; sessions were designed to facilitate interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interaction; the curriculum did not contain feeding-specific elements. We used structural equation modeling to determine direct, indirect, and total effects of maternal depressive symptoms, maternal negative perceptions, and the VIP on perceived picky eating. We then tested associations between perceived picky eating and (1) child growth, using multivariable linear regression and multilevel modeling; and (2) subsequent child dietary consumption, using multivariable multinomial logistic regression. RESULTS: Maternal depressive symptoms had significant total effects on negative maternal perceptions (ß = 0.32, p < 0.001) and perceived picky eating (ß = 0.21, p < 0.01) after controlling for potential confounders. This effect was partially mediated by maternal negative perceptions (indirect effect: ß = 0.06, p = 0.04). When used in the model as the predictor, the VIP had a significant total effect on perceived picky eating (ß = -0.16, p = 0.02), which was partially mediated by maternal depressive symptoms and negative perceptions (indirect effect: ß = -0.05, p = 0.02). Perceived picky eating was not associated with child diet at age 2 years or adiposity from 6 months to 3 years. CONCLUSION: Maternal concerns about picky eating may reflect deeper depressive symptoms and negative perceptions of her child's behavior. Interventions designed to facilitate positive parenting in general may lessen feeding-specific concerns, such as picky eating. Although reassurance about growth and nutritional outcomes for children perceived as picky eaters is appropriate, clinicians should also consider probing for underlying symptoms of depression that could lead to eating concerns.
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Depressão/etnologia , Seletividade Alimentar , Hispânico ou Latino/estatística & dados numéricos , Relações Mãe-Filho/etnologia , Mães/estatística & dados numéricos , Poder Familiar/etnologia , Pobreza/etnologia , Adulto , Pré-Escolar , Educação não Profissionalizante , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Adulto JovemRESUMO
OBJECTIVE: To determine whether educational media as actually used by low-income families promote parent-child cognitive stimulation activities. METHODS: We performed secondary analysis of the control group of a longitudinal cohort of mother-infant dyads enrolled postpartum in an urban public hospital. Educational media exposure (via a 24-hour recall diary) and parent-child activities that may promote cognitive stimulation in the home (using StimQ) were assessed at 6, 14, 24, and 36 months. RESULTS: Data from 149 mother-child dyads, 93.3% Latino, were analyzed. Mean (standard deviation) educational media exposure at 6, 14, 24, and 36 months was, respectively, 25 (40), 42 (58), 39 (49), and 39 (50) minutes per day. In multilevel model analyses, prior educational media exposure had small positive relationship with subsequent total StimQ scores (ß = 0.11, P = .03) but was nonsignificant (ß = 0.08, P = .09) after adjusting for confounders (child: age, gender, birth order, noneducational media exposure, language; mother: age, ethnicity, marital status, country of origin, language, depressive symptoms). Educational media did predict small increases in verbal interactions and toy provision (adjusted models, respectively: ß = 0.13, P = .02; ß = 0.11; P = .03). In contrast, more consistent relationships were seen for models of the relationship between prior StimQ (total, verbal interactions and teaching; adjusted models, respectively: ß = 0.20, P = .002; ß = 0.15, P = .006; ß = 0.20, P = .001) and predicted subsequent educational media. CONCLUSIONS: Educational media as used by this sample of low-income families does not promote cognitive stimulation activities important for early child development or activities such as reading and teaching.