Health Care Visits to Check More Than Just Health?

Study Shows Health Care Providers Can Help with School Readiness During Primary Care Visits

Doctor examining baby

It seems it’s never too early to start thinking about getting your child ready for school. From picture books to educational toys and videos, there’s no shortage of items and programs geared toward helping children to prepare to succeed in school.

But some children, especially those in at-risk families, don’t hear as many words and aren’t read-to on a regular basis; others don’t engage in skill-building play until they start preschool or kindergarten. By that time, researchers say, at-risk children already lag behind peers in school readiness skills. Finding earlier opportunities to intervene and to encourage school readiness and other skills could help to bridge the achievement gap between at-risk children and their peers who are not at risk.

Researchers’ efforts led them to a trusted resource for many families—the health care provider.

Including school readiness interventions in regular well-baby and well-child visits seems a natural fit for a number of reasons, such as:

  • The visits occur frequently.
  • Nearly all families attend the visits because of the immunizations and screenings required for child care and school settings.
  • Parents often have close relationships with their children’s health care provider.
  • The infrastructure for the visits and processes related to payment for visits is already in place.
  • Conducting the interventions during regularly scheduled visits eliminates additional travel for the families.

But would interventions during well-baby and well-child visits really make a difference?

To find out, NICHD-supported researchers, led by Alan L. Mendelsohn, M.D., from New York University and School of Medicine and Bellevue Hospital Center, compared two different interventions that were done during primary care visits with nearly 700 at-risk mother-infant pairs. Once enrolled, all the study participants regularly received children’s books from the Reach Out and Read External Web Site Policy program, which provides books and reading guidance to parents of children ages 6 months and older.

The mom-infant pairs were then randomly assigned to one of three study arms:

  • Standard primary care with no interventions (control group); or
  • Standard primary care plus the Building Blocks intervention program, which included monthly mailings of child development questionnaires, age-related newsletters, and materials with suggested reading and play activities to improve early literacy and child development; or
  • Standard primary care plus the Video Interaction Project, which included meetings with a child development expert during 15 primary care visits during the child’s first 3 years, providing toys and other materials to encourage early literacy and development, and reviewing videotaped sessions of mom-child play with the child development expert, who would point out strengths and give suggestions for additional opportunities for interaction in their homes.

The encouraging results were recently published in the Archives of Pediatrics and Adolescent Medicine. Dr. Mendelsohn and his colleagues found that, at age 6 months, infants in the Video Interaction Project had significantly higher scores than those in the control group on tests of parent-child interaction and engaging in pre-literacy activities. Infants in the Building Blocks group also scored higher than those in the control group, but their improvements were weaker than those of the Video Interaction Project.

Findings from a related study by the same team of researchers, also published in Archives of Pediatrics and Adolescent Medicine, showed that the Video Interaction Project was associated with a reduction in infant exposure to television and other electronic media. Parents in that intervention group reported exposing their children to less media, in part, because of the increase in parent-child interactions.

“These types of projects and findings reinforce the idea that early interventions during well-child visits can increase the quality of parent-child interactions and the amount of time spent doing pre-literacy activities in the home,” said James A. Griffin, Ph.D., who leads the Early Learning and School Readiness (ELSR) Program within the NICHD’s Child Development and Behavior (CDB) Branch, which funded the study.

The ELSR Program supports a variety of projects aimed at understanding the experiences that children need to prepare to learn, read, and succeed in school. Studies to enhance knowledge about preparation, training, and professional development of persons involved in the care and education of young children are also a focus of the Program. You can read about some of the Program’s activities in the ELSR Program section of the CDB Branch Report to the NACHHD Council (PDF - 1.28 MB).

Dr. Mendelsohn and his colleagues will follow infants in the study through first grade to see whether and to what degree the interventions continue to have a positive impact on school readiness and exposure to media.

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Originally posted: January 13, 2011

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