Encouraging Play Helps Parents Better Support Their Children's Development

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NYU Grossman School of Medicine and NYU Langone Health

Dec 13, 2022, 16:23 ET

NEW YORK, Dec. 13, 2022 /PRNewswire/ -- Guiding parents to play and read with their babies increased parental support of their children's cognitive development by the time they turned two—setting the stage for children's improved school readiness by age four.

This is the finding of a new study led by researchers at NYU Grossman School of Medicine; NYU Steinhardt School of Culture, Education, and Human Development; and the University of Pittsburgh. The work evaluated the effects of a parental education and support program they developed, called Smart Beginnings, for primarily Black and Hispanic children growing up in low-income and under-resourced communities.

Smart Beginnings is an integration of two programs – Video Interaction Project (VIP) and the Family Check-Up (FCU).

Previous studies had shown that children in minoritized, low-income families are more likely to have behavioral problems, such as hyperactivity from prolonged toxic stress (an abnormal stress response that often coincides with lack of caregiver support and reassurance), and to perform more poorly in school, according to the researchers.

For the study, 403 newborns in New York and Pittsburgh were voluntarily enrolled by their mothers, with half randomly assigned to receive Smart Beginnings while the rest received standard pediatric primary care. Most of the mothers were married or had a live-in partner, and all were eligible for Medicaid. Almost all were Black or Hispanic.

As part of the VIP component of Smart Beginnings, mothers were videotaped with their infants for three to five minutes during routine monthly check-ups as they played with a new toy such as cars or black and white patterned blocks. A trained coach encouraged interaction as they played. Mothers took home the videotape and educational pamphlets and were encouraged to repeat the playtime at home. As the children got older, books were also given to the parents to read to the children.

In the FCU component of Smart Beginnings, at the six-month mark, the reading and playtime activities were followed up by a visit with a social worker at home or at the well-child clinic for families that had additional family management issues or child behavior problems. Lasting as long as two hours, these conversational sessions were designed to screen for signs of family problems such as symptoms of depression in the mother, evidence of family violence, and lack of food. Counseling and government services were offered as needed. The social worker conducted another in-depth visit a year later.

Analysis of the program, published in the Journal of Pediatrics online Dec. 5, showed that by two years of age, scores for parents of 203 children who were randomly assigned to receive Smart Beginnings were significantly higher among three broad survey and observational measures of cognitive development and the home environment compared with scores of parents for 200 children who had been randomly chosen to receive standard pediatric primary care. This group receiving standard care still went for monthly visits to the pediatrician but did not receive any videotaped play and coaching, nor any sessions with a social worker.

"Our study adds to the evidence that positively stimulating cognitive development from infancy to toddlerhood through coaching of parents and home visits that encourage play and reading can dramatically improve the child-parent relationship, and shape the child's social, emotional, and academic development later in life," says study lead investigator Elizabeth B. Miller, PhD, an assistant professor in the Department of Population Health at NYU Langone Health.

"Programs such as Smart Beginnings can possibly help reduce the disparities in early childhood development that disproportionately impact Black and Hispanic children in America," adds Miller.

"Smart Beginnings offers offers an efficient and effective strategy to promote childhood cognitive development from infancy through to toddlerhood," says senior study investigator Pamela Morris-Perez, PhD.

"Because our program is delivered directly from the pediatrician's office, it reaches mothers of newborns where they are most likely to go as part of their routine family care, and it tailors resources to family strengths and needs," says Morris-Perez, a professor of applied psychology at the NYU Steinhardt School of Culture, Education, and Human Development and an affiliated professor at the NYU School of Global Public Health.

Miller says the cost of the Smart Beginnings program, which is ready to be implemented and scaled, is about one-tenth the cost of other interventional programs with similar goals.

Funding for the study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health, grant R01HD076390.

Besides Miller and Morris-Perez (co-principal investigator), other NYU study investigators are Alan Mendelsohn (co-principal investigator) Erin Roby, PhD; Lerzan Coskun, PhD; Marc Scott, PhD; and Juliana Gutierrez, BA. Other study co-investigators are Yudong Zhang, PhD, at Northwestern University in Chicago; Johana Rosas, PhD; and Daniel Shaw, PhD (co-principal investigator), at the University of Pittsburgh in Pennsylvania.