Promoting Early School Readiness in Primary Health Care
Promoting Early School Readiness in Primary Health Care
This project will measure the degree to which parenting programs based in pediatric primary
 care can be effective in promoting language development and school readiness in at-risk young
 children.

 The study is a randomized controlled trial in which two different primary care-based
 parenting programs will be compared to a control group in a population that is at risk on the
 basis of poverty. The two programs represent varying levels of low intensity, but each has
 the same goals: enhancing parent-child interaction in order to improve language, cognitive
 and social-emotional development and ultimately promote school readiness and school
 performance.

 One program is called the "Video Interaction Project". While waiting to see the primary care
 provider for well child care, the family meets with a child development specialist, who
 videotapes the parent and infant interacting together. The videotape is then rewound and
 watched together by the parent (and infant!) and child development specialist. This leads to
 a discussion about child development, infant cues and parenting, with the child development
 specialist building on observed strengths in the interaction. In addition, families are
 provided with parenting pamphlets developed for the project, and with inexpensive
 developmentally stimulating toys.

 The other program is called the "ASQ-Building Blocks Project". This project employs a public
 health approach to facilitate parental engagement in child development. Families are sent
 monthly newsletters that focus on child development, infant cues and parenting; included with
 each newsletter is an inexpensive, developmentally stimulating toy. In addition, families
 periodically receive Ages and Stages Questionnaires, which they complete and mail back to the
 program. Based on the questionnaires, the program determines whether the infant has screened
 positive for possible developmental delay and provides this information to both the family
 and the primary care provider.

 This study will test 2 hypotheses:

 1. Primary care based parenting interventions can impact parent-child interaction, early
 child development and school readiness.

 2. Interventions of differing intensity will have impacts of differing magnitude depending
 on the risk level of the family.
This project will measure the degree to which parenting programs based in pediatric primary
 care can be effective in promoting language development and school readiness in at-risk young
 children. The study will represent a collaboration between the Department of Pediatrics at
 New York University School of Medicine - Bellevue Hospital Center, the Medical and Health
 Research Association of New York City, Inc., and the Center for Research on Culture,
 Development and Education at New York University Steinhardt School of Education. Initial
 funding was provided by NICHD for 4 years. NICHD provided 5 additional years of competing
 renewal funding beginning in July, 2010.

 The study is a randomized controlled trial in which two different primary care-based
 parenting programs will be compared to a control group in a population that is at risk on the
 basis of poverty. The two programs represent varying levels of low intensity, but each has
 the same goals: enhancing parent-child interaction in order to improve language, cognitive
 and social-emotional development and ultimately promote school readiness and school
 performance.

 One program is called the "Video Interaction Project". While waiting to see the primary care
 provider for well child care, the family meets with a child development specialist, who
 videotapes the parent and infant interacting together. The videotape is then rewound and
 watched together by the parent and child development specialist. This leads to a discussion
 about child development, infant cues and parenting, with the child development specialist
 building on observed strengths in the interaction. In addition, families are provided with
 parenting pamphlets developed for the project, and with inexpensive developmentally
 stimulating toys.

 The other program is called the "ASQ-Building Blocks Project". This project employs a public
 health approach to facilitate parental engagement in child development. Families are sent
 monthly newsletters that focus on child development, infant cues and parenting; included with
 each newsletter is an inexpensive, developmentally stimulating toy. In addition, families
 periodically receive Ages and Stages Questionnaires, which they complete and mail back to the
 program. Based on the questionnaires, the program determines whether the infant has screened
 positive for possible developmental delay and provides this information to both the family
 and the primary care provider.

 The study will take place at Bellevue Hospital Center, a public hospital serving low
 socioeconomic status families from throughout New York City. Infant-mother dyads will be
 enrolled during the postpartum period and followed through age 2 years. Periodic assessments
 will be performed of parent-child interaction and child developmental outcome.

 At age 3 years, VIP and control families were re-randomized to receive either additional VIP
 from age 3 to 5 years or to control during that period. This factorial design will allow for
 assessment of dose and timing in relation to outcomes.

 We further plan to follow children into school, so that we can assess long-term educational
 outcomes including standardized test scores. Should long-term funding be obtained, we will
 follow children through high school to assess intervention impacts on graduation rates.
Inclusion Criteria:

 -  Intention to receive primary care in the well-child clinic (FCC or newborn clinic) at
 Bellevue Hospital Center.

 -  Intention to remain in the New York City area for at least 3 years.

 -  Primary caregiver's language is English or Spanish.

 -  Birthweight 2000gm or higher

 -  Gestational age 35 weeks or higher

 Exclusion Criteria:

 -  Significant newborn medical complication

 -  Significant congenital anomaly or syndrome