Shared Reading Quality and Brain Activation during Story Listening in Preschool-Age Children

Early Family Experiences and Neural Activity in Rural Pakistani Children: The Differential Role of Gender

Adversity within low- and middle-income countries (LMICs) poses severe threats to neurocognitive development, which can be partially mitigated by high-quality early family experiences. Specifically, maternal scaffolding and home stimulation can buffer cognitive development in LMIC, possibly by protecting underlying neural functioning. However, the association between family experiences and neural activity remains largely unexplored in LMIC contexts. This study explored the relation of early family experiences to later cognitive skills and absolute gamma power (21-45 Hz), a neural marker linked to higher-order cognitive skills. Drawing data from the PEDS trial, a longitudinal study in rural Pakistan, we examined maternal scaffolding at 24 months and home stimulation quality at 18 months as predictors of verbal IQ, executive functions, and absolute gamma at 48 months for 105 mother-child dyads (52 girls). Maternal scaffolding interacted with gender to predict absolute gamma power, such that higher maternal scaffolding was related to higher gamma more strongly for girls. Maternal scaffolding also interacted with absolute gamma to predict executive functions, such that higher gamma was related to better executive functions only when maternal scaffolding was average to high. Individual differences in early family experiences may partially buffer the neural underpinnings of cognitive skills from adversity in LMIC.

Early Literacy Developmental Activities and Pre-Kindergarten Learning Skills in the Context of Childhood Adversity

OBJECTIVE

School readiness (SR) encompasses a wide range of skills that affect children's ability to succeed in school and later in life. Shared reading is an important strategy that assists children in gaining SR skills, whereas adverse childhood experiences (ACEs) negatively affect a child's SR. This study assessed if early literacy developmental activities (shared reading, singing, or storytelling) were associated with improved SR among children with and without ACEs.

METHODS

2020-2021 National Survey of Children's Health data were used for analysis. We identified children aged 3-5 years to assess their exposure to ACEs, participation in reading/storytelling/singing, and overall SR.

RESULTS

In a sample of 17,545 children, 29% of children were exposed to one or more ACEs. Seventy-seven percent of children with no ACEs received daily early literacy developmental activities compared to 23% of children who experienced any ACE. On ordinal logistic regression, daily early literacy developmental activities were associated with 56% greater odds of higher SR among children not exposed to ACEs (OR: 1.56; 95% CI: 1.29, 1.88; P < .01). Among children exposed to ACEs, daily early literacy developmental activities were also associated with higher SR (OR: 1.50; 95% CI: 1.06, 2.13; P = .02).

CONCLUSIONS

Shared reading, storytelling, and singing are associated with improved SR in both children who have and have not been exposed to ACEs. However, children exposed to ACEs had fewer experiences with early literacy developmental activities. Future efforts should address the barriers that limit shared reading, singing, or storytelling for children exposed to ACEs.

Executive functions abilities in preschool-age children are negatively related to parental EF, screen-time and positively related to home literacy environment: an EEG study

Environmental factors such as Home Literacy Environment (HLE), screen time, and parental executive functions (EF) may influence the development of the child's EF. The purpose of this study was to determine the effect of these factors on behavioral and neurobiological measures of EF in 4-year-old children. Electroencephalogram (EEG) data were collected while children performed the Attention Network Task (ANT), showing a smaller difference between incongruent and congruent conditions is related to better EF abilities. Data were analyzed using an Event-Related Potential (ERP) technique focusing on the N200 and P300 components (reflecting executive control and orienting attention, respectively). N200 and P300 differences (delta) between amplitudes and latencies for the incongruent and congruent conditions were computed and correlated with child EF skills, HLE, screen exposure, and parental EF. Screen exposure was associated with lower EF in children and their parents. Additionally, smaller differences between N200 amplitudes and latencies for the incongruent vs. congruent conditions were associated with higher HLE scores. In contrast, greater differences between P300 amplitudes and latencies were related to longer screen time. HLE was positively associated with EF's neurobiological (EEG) and behavioral measures, and screen time was negatively associated with these measures. This study also highlights the important relationship between parental EF (i.e., family predisposition) and EF's neurobiological and behavioral measures in their children.

Longitudinal trajectories of brain development from infancy to school age and their relationship to literacy development

Reading is one of the most complex skills that we utilize daily, and it involves the early development and interaction of various lower-level subskills, including phonological processing and oral language. These subskills recruit brain structures, which begin to develop long before the skill manifests and exhibit rapid development during infancy. However, how longitudinal trajectories of early brain development in these structures supports long-term acquisition of literacy subskills and subsequent reading is unclear. Children underwent structural and diffusion MRI scanning at multiple timepoints between infancy and second grade and were tested for literacy subskills in preschool and decoding and word reading in early elementary school. We developed and implemented a reproducible pipeline to generate longitudinal trajectories of early brain development to examine associations between these trajectories and literacy (sub)skills. Furthermore, we examined whether familial risk of reading difficulty and a child's home literacy environment, two common literacy-related covariates, influenced those trajectories. Results showed that individual differences in curve features (e.g., intercepts and slopes) for longitudinal trajectories of volumetric, surface-based, and white matter organization measures in left-hemispheric reading-related regions and tracts were linked directly to phonological processing and indirectly to second-grade decoding and word reading skills via phonological processing. Altogether, these findings suggest that the brain bases of phonological processing, previously identified as the strongest behavioral predictor of reading and decoding skills, may already begin to develop early in infancy but undergo further refinement between birth and preschool. The present study underscores the importance of considering academic skill acquisition from the very beginning of life.

Language development, linguistic input, and linguistic racism

Language development is both remarkable and unremarkable. It is remarkable because children learn the language(s) around them, signed or spoken, without explicit instruction or correction. It is unremarkable because children have done this for thousands of years without worldwide incident or catastrophe. Yet, much research on this organic developmental phenomenon relies on an empirical falsehood: "quality" linguistic input is necessary to facilitate language development. "Quality" is a value judgment, not a structural feature of any human language. I argue selectively legitimizing some linguistic input as "quality" is possible only through mischaracterizing what language is. This falsehood is also linguistic racism because it is based on a deficit perspective of the early linguistic experiences of a subset of children, specifically racialized children. I explore how linguistic racism stalls our collective understanding of language development and promotes an environment of bad science. This article is categorized under: Linguistics > Language Acquisition Psychology > Language Neuroscience > Development.

Beliefs and Motivations Regarding Early Shared Reading of Parents From Low-Income Households: A Qualitative Study

OBJECTIVE

Parent-child "shared" reading is a catalyst for development of language and other emergent literacy skills. The American Academy of Pediatrics recommends that parents initiate shared reading as soon as possible after birth. Persistent disparities exist in reading resources, routines, and subsequent literacy outcomes, disproportionately impacting low-income households. We sought to understand beliefs, motivations, and experiences regarding shared reading during early infancy among parents from low-income households.

METHODS

In this qualitative exploratory study, parents of infants aged 0 to 9 months from low-income households who had initiated shared reading ("readers") and those who had not ("nonreaders") were purposefully recruited to participate in individual semistructured virtual interviews. These interviews were coded using inductive thematic analysis by a 3-member team with diverse backgrounds.

RESULTS

A total of 21 parents participated (57% readers, 86% mothers). Infants were 86% African American/Black, with a mean age of 3 months. Barriers noted by readers and nonreaders were i) competing demands on time, ii) lack of resources, and iii) parental mental health. An additional barrier noted solely by nonreaders was iv) it's too early/baby is not ready. Two benefits of reading were noted by both groups: 1) parents as child's first teachers and 2) reading catalyzes the child's development. Benefits noted exclusively by readers included 3) reading begets more reading, 4) bonding, 5) "it works," and 6) "two-for-one" shared reading (other children involved).

CONCLUSIONS

This study provided insights into barriers and benefits regarding shared reading by socioeconomically disadvantaged parents of infants and has the potential to inform reading-related guidance and interventions.

Screen time, brain network development and socio-emotional competence in childhood: moderation of associations by parent-child reading

BACKGROUND

Screen time in infancy is linked to changes in social-emotional development but the pathway underlying this association remains unknown. We aim to provide mechanistic insights into this association using brain network topology and to examine the potential role of parent-child reading in mitigating the effects of screen time.

METHODS

We examined the association of screen time on brain network topology using linear regression analysis and tested if the network topology mediated the association between screen time and later socio-emotional competence. Lastly, we tested if parent-child reading time was a moderator of the link between screen time and brain network topology.

RESULTS

Infant screen time was significantly associated with the emotion processing-cognitive control network integration (p = 0.005). This network integration also significantly mediated the association between screen time and both measures of socio-emotional competence (BRIEF-2 Emotion Regulation Index, p = 0.04; SEARS total score, p = 0.04). Parent-child reading time significantly moderated the association between screen time and emotion processing-cognitive control network integration (β = -0.640, p = 0.005).

CONCLUSION

Our study identified emotion processing-cognitive control network integration as a plausible biological pathway linking screen time in infancy and later socio-emotional competence. We also provided novel evidence for the role of parent-child reading in moderating the association between screen time and topological brain restructuring in early childhood.

Increasing Vocabulary and Listening Comprehension During Adapted Shared Reading: An Intervention for Preschoolers with Autism Spectrum Disorder

PURPOSE

This study examined the improvement in vocabulary and listening skills of children with ASD through adapted shared reading. It also investigated the generalisation effect of this increase to new books and social validity.

METHODS

A multiple probe across participants design was used to investigate the effect of ASR (adapted shared reading) on the vocabulary and listening comprehension skills of young children with autism spectrum disorder (ASD). The participants were Turkish-speaking children diagnosed with ASD attending a preschool special education institution in Turkey. The researcher analysed the data obtained from the baseline, intervention, generalization and mastery phases using the visual analysis method.

RESULTS

Following the intervention, all three participating children gradually improved their vocabulary and listening comprehension skills. The findings suggest that young children with ASD can participate in and benefit from shared reading interventions with support.

CONCLUSION

The adapted shared reading method (ASR) is an effective method for increasing the vocabulary and listening comprehension skills of young children with ASD.

Neural synchrony underlies the positive effect of shared reading on children's language ability

Although it is well recognized that parent-child shared reading produces positive effects on children's language ability, the underlying neurocognitive mechanisms are not well understood. Here, we addressed this issue by measuring brain activities from mother-child dyads simultaneously during a shared book reading task using functional near infrared spectroscopy hyperscanning. The behavioral results showed that the long-term experience of shared reading significantly predicted children's language ability. Interestingly, the prediction was moderated by children's age: for older children over 30 months, the more the shared reading experience, the better the language performance; for younger children below 30 months, however, no significant relationship was observed. The brain results showed significant interpersonal neural synchronization between mothers and children at the superior temporal cortex, which was closely associated with older children's language ability through the mediation of long-term experience of shared reading. Finally, the results showed that the instantaneous quality of shared reading contributed to children's language ability through enhancing interpersonal neural synchronization and increasing long-term experience. Based on these findings, we tentatively proposed a theoretical model for the relationship among interpersonal neural synchronization, shared reading and children's language ability. These findings will facilitate our understanding on the role of shared reading in children's language development.

Early childhood education language environments: considerations for research and practice

The importance of developing early language and literacy skills is acknowledged by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) as a global human rights issue. Indeed, research suggests that language abilities are foundational for a host of cognitive, behavioral, and social-emotional outcomes. Therefore, it is critical to provide experiences that foster language acquisition across early learning settings. Central to these efforts is incorporating assessments of language environments into research and practice to drive quality improvement. Yet, several barriers may be preventing language environment assessments from becoming widely integrated into early education. In this brief, we review evidence on the types of experiences that promote language development, describe characteristics of language environment assessments, and outline practical and philosophical considerations to assist with decision-making. Further, we offer recommendations for future research that may contribute knowledge regarding strategies to assess and support language development. In addressing both areas, we highlight the potential for early childhood language environments to advance equity.

Effects of mobile device use on emotional and behavioral problems in the CBCL among preschoolers: Do shared reading and maternal depression matter?

INTRODUCTION

Although mobile devices are used ubiquitously, studies on their detrimental effects on preschoolers are limited. Furthermore, no study has considered shared reading and mobile device usage simultaneously. Therefore, this study examined the effects of mobile devices and shared reading on preschoolers' development along with the effects of maternal depression on this association.

MATERIALS AND METHODS

Mothers of 202 children aged 2-5 years were recruited in Taiwan. Maternal self-reported questionnaires on mobile device usage, shared reading, and child's emotional and behavioral development were collected. Multiple linear regression models were used for analyses.

RESULTS

Mothers' higher usage time on mobile devices and an education level of college or less were significantly associated with the child's exceeding recommended use of mobile devices. Particularly among depressed mothers, preschoolers' exceeding recommended use of mobile devices was associated with more sleep (β = 9.87, 95% confidence interval [CI] = 1.34, 18.40) and attention (β = 7.20, 95% CI = 1.50, 12.91) problems, whereas shared reading was associated with less somatic complaints (β = -16.19, 95% CI = -32.22, -0.15) and withdrawn (β = -21.50, 95% CI = -40.52, -2.47), compared with their respective counterparts.

CONCLUSION

Our study suggested the beneficial effects of shared reading. Moreover, we highlighted the adverse effects of preschoolers' exceeding recommended use of mobile device on sleep and attention problems, especially for children of mothers with depression.

Sex differences, asymmetry, and age-related white matter development in infants and 5-year-olds as assessed with tract-based spatial statistics

The rapid white matter (WM) maturation of first years of life is followed by slower yet long-lasting development, accompanied by learning of more elaborate skills. By the age of 5 years, behavioural and cognitive differences between females and males, and functions associated with brain lateralization such as language skills are appearing. Diffusion tensor imaging (DTI) can be used to quantify fractional anisotropy (FA) within the WM and increasing values correspond to advancing brain development. To investigate the normal features of WM development during early childhood, we gathered a DTI data set of 166 healthy infants (mean 3.8 wk, range 2-5 wk; 89 males; born on gestational week 36 or later) and 144 healthy children (mean 5.4 years, range 5.1-5.8 years; 76 males). The sex differences, lateralization patterns and age-dependent changes were examined using tract-based spatial statistics (TBSS). In 5-year-olds, females showed higher FA in wide-spread regions in the posterior and the temporal WM and more so in the right hemisphere, while sex differences were not detected in infants. Gestational age showed stronger association with FA values compared to age after birth in infants. Additionally, child age at scan associated positively with FA around the age of 5 years in the body of corpus callosum, the connections of which are important especially for sensory and motor functions. Lastly, asymmetry of WM microstructure was detected already in infants, yet significant changes in lateralization pattern seem to occur during early childhood, and in 5-year-olds the pattern already resembles adult-like WM asymmetry.

Shared reading with infants: SharePR a novel measure of shared reading quality

BACKGROUND

The AAP recommends "shared" reading from early infancy for healthy development. However, many families are uncertain how to read most enjoyably and effectively with infants, especially from underserved backgrounds. Shared reading quality (interactivity) moderates benefits yet is challenging to measure. SHARE/STEP is a new model of shared reading quality at this age incorporating evidence-based behaviors.

OBJECTIVE

To test the SharePR parent-report measure of caregiver-infant reading quality.

METHODS

This study involved mother-infant dyads in two unrelated trials in an obstetric (0-2 months old) and pediatric (6-9 months old) clinic. SharePR is a 10-item measure based on the SHARE/STEP model. Analyses involved descriptive statistics, measures of psychometric integrity, and correlations with home literacy environment (HLE).

RESULTS

There were 99 dyads in the younger (1.2 + 0.5 months) and 108 dyads in the older groups (6.6 + 1.1 months). A majority were of non-white race (73%, 96%) and low-socioeconomic status (56%, 44% in-poverty). SharePR administration time was under 2 min and scores were normally distributed at each age. Psychometric properties were strong in terms of internal consistency and reliability. Scores were positively correlated with HLE for the older group (p < 0.05).

CONCLUSIONS

SharePR may be an efficient tool to quantify shared reading quality with infants, warranting further investigation.

CLINICAL TRIALS

Data for these analyses were collected via two unrelated trials led by the lead author (J.S.H.). For the younger cohort, this is registered on the ClinicalTrials.gov website, ID# NCT04031235. For the older cohort, this is registered on the ClinicalTrials.gov website, ID# 2017-6856.

IMPACT

The AAP recommends caregiver-child ("shared") reading beginning in infancy, yet many families are uncertain how to do so. Verbal and social-emotional interactivity during shared reading ("quality") moderates benefits and is often low in families from disadvantaged backgrounds, yet is challenging to measure. SharePR is a 10-item parent-report measure of shared reading quality based on a novel conceptual model incorporating evidence-based behaviors (SHARE/STEP). SharePR exhibited promising psychometric properties in two separate samples of mothers of younger and older infants. SharePR is a potentially useful measure of shared reading quality at this formative age, for research and to frame early reading guidance.

Home language and literacy environment and its relationship to socioeconomic status and white matter structure in infancy

The home language and literacy environment (HLLE) in infancy has been associated with subsequent pre-literacy skill development and HLLE at preschool-age has been shown to correlate with white matter organization in tracts that subserve pre-reading and reading skills. Furthermore, childhood socioeconomic status (SES) has been linked with both HLLE and white matter organization. It is important to understand whether the relationships between environmental factors such as HLLE and SES and white matter organization can be detected as early as infancy, as this period is characterized by rapid brain development that may make white matter pathways particularly susceptible to these early experiences. Here, we hypothesized that HLLE (1) relates to white matter organization in pre-reading and reading-related tracts in infants, and (2) mediates a link between SES and white matter organization. To test these hypotheses, infants (mean age: 8.6 ± 2.3 months, N = 38) underwent diffusion-weighted imaging MRI during natural sleep. Image processing was performed with an infant-specific pipeline and fractional anisotropy (FA) was estimated from the arcuate fasciculus (AF) and superior longitudinal fasciculus (SLF) bilaterally using the baby automated fiber quantification method. HLLE was measured with the Reading subscale of the StimQ (StimQ-Reading) and SES was measured with years of maternal education. Self-reported maternal reading ability was also quantified and applied to our statistical models as a proxy for confounding genetic effects. StimQ-Reading positively correlated with FA in left AF and to maternal education, but did not mediate the relationship between them. Taken together, these findings underscore the importance of considering HLLE from the start of life and may inform novel prevention and intervention strategies to support developing infants during a period of heightened brain plasticity.

Impact of home literacy environment on literacy development of children with hearing loss: A mediation model

Reading presents an unsolved difficulty for children with hearing loss and research on factors influencing their literacy development is very limited. This work aimed to study the influence of home literacy environment (HLE) on literacy development of children with hearing loss and explore possible mediating effects of reading interest and parent-child relationship. 112 Chinese children with hearing loss were surveyed for scales of HLE, literacy development, reading interest, and parent-child relationship. Result analysis showed that HLE significantly predicted literacy development of children with hearing loss and this effect was no longer significant after including reading interest and parent-child relationship as variables. Further, HLE significantly predicted reading interest and parent-child relationship, each of which predicted literacy development and played a significant mediating role in HLE’s influence on literacy development. These findings provide educational tips for families of children with hearing loss.

Chronic pediatric diseases and risk for reading difficulties: a narrative review with recommendations

Literacy is a major social determinant of health, rooted in skills that develop during early childhood. Children arriving at kindergarten unprepared to learn to read are more likely to have low reading proficiency thereafter. General and health literacy are highly correlated, affecting understanding of health conditions, treatment adherence, and transition to self-care and adult healthcare services. The American Academy of Pediatrics (AAP) recommends literacy and school readiness promotion during well-visits and neurodevelopmental surveillance is emphasized across primary and subspecialty care. While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and chronic medical conditions are less appreciated and under-researched. This review applies an eco-bio-developmental framework to explore literacy across five complex chronic conditions affecting millions of children worldwide: asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease. In each, integration of an efficient reading brain network may be impacted by direct factors, such as ischemia, anesthesia, and/or medications, and also indirect factors, such as altered parent-child routines, hospital stays, and missed school. By integrating literacy into care management plans for affected children, pediatric primary care and specialty providers are poised to identify risks early, target guidance and interventions, and improve academic and health outcomes. IMPACT: While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and/or chronic medical conditions such as asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease are substantial, less appreciated, and under-researched. General and health literacy are highly correlated, with implications for the understanding one's health condition, treatment adherence, and transitioning to self-care, which is especially important for children with complex and/or chronic illness. Pediatric primary care and specialty providers are poised to integrate reading and literacy into care management plans for children with complex and/or chronic illness, including early screening, guidance, support, and interventions.

Predictive brain signals mediate association between shared reading and expressive vocabulary in infants

The ability to predict upcoming information is crucial for efficient language processing and enables more rapid language learning. The present study explored how shared reading experience influenced predictive brain signals and expressive vocabulary of 12-month-old infants. The predictive brain signals were measured by fNIRS responses in the occipital lobe with an unexpected visual-omission task. The amount of shared reading experience was correlated with the strength of this predictive brain signal and with infants' expressive vocabulary. Importantly, the predictive brain signal explained unique variance of expressive vocabulary beyond shared reading experience and maternal education. A further mediation analysis showed that the effect of shared reading experience on expressive vocabulary was explained by the infants' predictive brain signal. This is the first evidence indicating that richer shared reading experience strengthens predictive signals in the infant brain and in turn facilitates expressive vocabulary acquisition.

“Let’s Read Together”: A Parent-Focused Intervention on Dialogic Book Reading to Improve Early Language and Literacy Skills in Preschool Children

Many children are at risk for reading difficulties because of inadequate emergent literacy skills. It is widely accepted that development of emergent literacy skills is strictly related to children’s early literacy experiences at home and school. Dialogic reading is an evidence-based intervention to promote the language skills of preschool children. This study examined the feasibility and efficacy of a parent-focused dialogic book reading intervention that aimed to foster the early language and literacy skills of pre-school children. A sample of 40 Italian preschoolers (Mage = 62.9 months, SD = 6.3) and their parents were divided into three groups: treatment group (n = 12); information group (n = 12) and control group (n = 16). The efficacy of the intervention for oral language skills was examined by analyzing the improvements from pre- to post-intervention in children’s oral language outcomes, through ad hoc and standardized tasks; specifically, by measuring proximal and distal abilities. Additionally, we analyzed the intervention effects on parent–child interaction and dialogic behaviors during shared book reading. Results suggest that a relatively brief intervention (6 weeks) using dialogic book reading strategies can lead to sustained improvements in early language and literacy skills in preschoolers (both proximal and distal) and in parent dialogic behaviors during shared book reading.

Exploratory Mixed-Methods Study of a Primary Care-Based Intervention Promoting Shared Reading During Infancy

Parent-child "shared" reading can be a rich source of language exposure. Clinic-based programs, notably Reach Out and Read (ROR), are intended to enhance this. However, ROR has been traditionally introduced at 6 months and only recently expanded to younger ages. This study explored efficacy of an intervention delivered during pediatric well visits promoting shared reading prior to 6 months old, in terms of home reading attitudes and routines. The intervention group received children's books and anticipatory guidance about benefits of shared reading, whereas the control group received general age-related anticipatory guidance. Surveys were administered at the child's newborn (pre-intervention) and 6-month (post-intervention) well visits. Significant findings at 6 months included more frequent shared reading (P = .03), greater comfort reading at this age (P = .01), and greater importance attributed to shared reading (P = .04) in the intervention group relative to controls. These support the expansion of early literacy interventions such as ROR into early infancy.

Nurturing the reading brain: home literacy practices are associated with children's neural response to printed words through vocabulary skills

Previous studies indicate that children are exposed to different literacy experiences at home. Although these disparities have been shown to affect children's literacy skills, it remains unclear whether and how home literacy practices influence brain activity underlying word-level reading. In the present study, we asked parents of French children from various socioeconomic backgrounds (n = 66; 8.46 ± 0.36 years, range 7.52-9.22; 20 girls) to report the frequency of home literacy practices. Neural adaptation to the repetition of printed words was then measured using functional magnetic resonance imaging (fMRI) in a subset of these children (n = 44; 8.49 ± 0.33 years, range 8.02-9.14; 13 girls), thereby assessing how sensitive was the brain to the repeated presentation of these words. We found that more frequent home literacy practices were associated with enhanced word adaptation in the left posterior inferior frontal sulcus (r = 0.32). We also found that the frequency of home literacy practices was associated with children's vocabulary skill (r = 0.25), which itself influenced the relation between home literacy practices and neural adaptation to words. Finally, none of these effects were observed in a digit adaptation task, highlighting their specificity to word recognition. These findings are consistent with a model positing that home literacy experiences may improve children's vocabulary skill, which in turn may influence the neural mechanisms supporting word-level reading.

Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children

OBJECTIVE

To estimate feasibility, usability and efficacy of a mobile parenting app (Rx for Success; RxS) to enhance reading guidance provided to parents of young children during well-visits.

METHODS

This trial was conducted at a clinic serving primarily families of Hispanic ethnicity and low-socioeconomic status (SES) where Reach Out and Read (ROR) is standard practice. It involved 252 parent-child dyads in 2 age groups (~6-months old, ~18-months old) randomized during well-visits to receive RxS or a children's book modeling alternatives to screen time (Control) by research coordinators. RxS involves videos, activities and "push" messages. Follow-up assessments were conducted approximately 6 months later, including impression and use, shared reading behaviors, child language and screen time.

RESULTS

A total of 217 dyads completed both visits (110 RxS, 107 Control). Time to introduce RxS was under 3 minutes and 32% of parents experienced largely minor performance issues. Parent impression of RxS was favorable for both age groups at baseline and follow-up, though use was infrequent, attributable to a desire for more relevant and updated content. Significant findings favoring RxS included shared reading as a favorite activity, more frequent shared reading reported at 12 months and higher language scores at 24 months. Screen time was equivalent between cohorts, exceeding American Academy of Pediatrics guidelines.

CONCLUSIONS

A mobile app introduced to parents of young children from low-SES backgrounds was feasible during well-visits, rated as helpful, and effective to enhance shared reading at younger and language at older ages. While a potentially impactful enhancement to ROR, features needing improvement were identified.

Effects of familiarity on child brain networks when listening to a storybook reading: A magneto-encephalographic study

Parent-child book reading is important for fostering the development of various lifelong cognitive and social abilities in young children. Despite numerous reports describing the effects of familiarity on shared reading for children, the exact neural basis of the functional network architecture remains unclear. We conducted Magnet-Encephalographic (MEG) experiments using graph theory to elucidate the role of familiarity in shared reading in a child's brain network and to measure the connectivity dynamics of a child while Listening to Storybook Reading (LSBR), which represents the daily activity of shared book reading between the child and caregiver. The LSBR task was performed with normally developing preschool- and school-age children (N = 15) under two conditions: reading by their own mother (familiar condition) vs. an experimenter (unfamiliar condition). We used the phase lag index (PLI), which captures synchronization of MEG signals, to estimate functional connectivity. For the whole brain network topology, an undirected weighted graph was produced using 68 brain regions as nodes and interregional PLI values as edges for five frequency bands. Behavioral data (i.e., the degree of attention and facial expressions) were evaluated from video images of the child's face during the two conditions. Our results showed enhanced widespread functional connectivity in the alpha band during the mother condition. In the mother condition, the whole brain network in the alpha band exhibited topographically high local segregation with high global integration, indicating an increased small-world property. Results of the behavioral analysis revealed that children were more attentive and showed more positive facial expressions in the mother condition than in the experimenter condition. Behavioral data were significantly correlated with graph metrics in the mother condition but not in the experimenter condition. In this study, we identified the neural correlates of a familiarity effect in children's brain connectivity dynamics during LSBR. Furthermore, these familiarity-related brain dynamics were closely linked to the child's behavior. Graph theory applied to MEG data may provide useful insight into the familiarity-related child brain response in a naturalistic setting and its relevance to child attitudes.

Development of an Eco-Biodevelopmental Model of Emergent Literacy Before Kindergarten: A Review

IMPORTANCE

Literacy has been described as an important social determinant of health. Its components emerge in infancy and are dependent on genetic, medical, and environmental factors. The American Academy of Pediatrics advocates a substantial role for pediatricians in literacy promotion, developmental surveillance, and school readiness to promote cognitive, relational, and brain development. Many children, especially those from minority and underserved households, enter kindergarten unprepared to learn to read and subsequently have difficulty in school.

OBSERVATIONS

Emergent literacy is a developmental process beginning in infancy. Component skills are supported by brain regions that must be adequately stimulated and integrated to form a functional reading network. Trajectories are associated with genetic, medical, and environmental factors, notably the home literacy environment, which is defined as resources, motivation, and stimulation that encourage the literacy development process. Eco-biodevelopmental models are advocated by the American Academy of Pediatrics, and these models offer insights into the neurobiological processes associated with environmental factors and the ways in which these processes may be addressed to improve outcomes. Emergent literacy is well suited for such a model, particularly because the mechanisms underlying component skills are elucidated. In addition to cognitive-behavioral benefits, the association of home literacy environment with the developing brain before kindergarten has recently been described via neuroimaging. Rather than a passive approach, which may subject the child to stress and engender negative attitudes, early literacy screening and interventions that are administered by pediatric practitioners can help identify potential reading difficulties, address risk factors during a period when neural plasticity is high, and improve outcomes.

CONCLUSIONS AND RELEVANCE

Neuroimaging and behavioral evidence inform an eco-biodevelopmental model of emergent literacy that is associated with genetic, medical, and home literacy environmental factors before kindergarten, a time of rapid brain development. This framework is consistent with recommendations from the American Academy of Pediatrics and provides insights to help identify risk factors and signs of potential reading difficulties, tailor guidance, and provide direction for future research.

A Combined Reach Out and Read and Imagination Library Program on Kindergarten Readiness

OBJECTIVES

Sharing books with preschoolers is known to improve kindergarten readiness. Both Reach Out and Read (ROR) and Dolly Parton's Imagination Library (DPIL) have shown positive effects on book sharing at home. We developed a novel combined ROR/DPIL program and examined the effect on kindergarten readiness assessment (KRA) scores.

METHODS

At urban ROR primary care sites, patients <5 years living in the city school district were enrolled from July 2015 through January 2019 in the ROR/DPIL program when seen for a clinic visit. The literacy subtest of the KRA was examined for participants entering kindergarten in the fall of 2016, 2017, and 2018. The "on-track" rate of participants was compared with nonparticipant groups.

RESULTS

A total of 797 kindergarten-aged ROR/DPIL participants were matched to Ohio KRA scores for 2016, 2017, and 2018 school years. The percentages of students "on-track" on KRA literacy subtests increased significantly by cohort (2016, 42.9% [95% confidence interval (CI): 34.9%-50.9%] versus 2017, 50.9% [95% CI: 44.9%-56.9%] versus 2018, 58.3% [95% CI: 53.3%-63.3%], P = .004). ROR/DPIL participants were compared with a proportionate stratified random sample of 1580 non-ROR/DPIL peers. On-track in literacy did not significantly differ between groups (2016 [P = .262], 2017 [P = .653], 2018 [P = .656]), nor did they differ after restricting analysis to economically disadvantaged children (2016 [P = .191], 2017 [P = .721], 2018 [P = .191]).

CONCLUSIONS

With these results, we suggest that a program combining literacy anticipatory guidance at clinic visits and more books in the home can potentially improve kindergarten readiness. Pediatric health care providers can play an important role in promoting kindergarten readiness through literacy promotion.

Read, speak, sing: Promoting early literacy in the health care setting

This statement will help health care providers assess and advise on early literacy with families in almost any practice setting. It defines emergent literacy skills, including early language learning and storytelling, and explores the benefits of reading, speaking, and singing with infants and toddlers for both children and caregivers. Book sharing at bedtime and other language-related routines positively affect family, relational, and social-emotional health. Early exposure to any language, when spoken at home, can benefit literacy learning in other languages children may encounter. Specific recommendations for clinicians counselling families on early literacy are included.

Intervention based on shared story reading: effect on low and high challenge reading and writing tasks

PURPOSE

to investigate the effectiveness of an intervention proposal based on shared story reading for reading comprehension, written narrative and word reading/writing.

METHODS

44 children were divided into two groups according to their performance in a reading comprehension test - The first group, G1, consisted of children with reading comprehension difficulty, and the second, G2, consisted of children who did not have difficulties. All children were evaluated regarding reading/writing isolated words, reading comprehension of sentences, and written narrative. After this evaluation, G1 children participated in an intervention program (15 meetings) that stimulated shared story reading. After this intervention, all children were reevaluated. Intra- and intergroup data were analyzed statistically by applying appropriate statistical tests, with the level of significance set at >0.05%.

RESULTS

after the intervention program, G1 children showed significant improvement in the variables evaluated. In the intergroup analysis, at the time of evaluation, G1 differed from G2 in reading/writing, reading comprehension, ability to correctly judge the verbs, and in textual coherence. At reassessment, G1 matched G2 in textual coherence and approached G2 in reading/writing isolated words and reading comprehension.

CONCLUSION

shared story reading promoted the development of low and high level reading and writing skills, being more effective for high-level strategies (example: written narrative). It is suggested that a specific program for orthographic questions be associated.

Lisez, parlez, chantez : la promotion de l'alphabétisation précoce dans le milieu de la santé

Le présent document de principes aidera les dispensateurs de soins à évaluer l'alphabétisation précoce dans les familles et à leur donner des conseils, et ce, dans presque tous les contextes d'exercice. On y définit les habiletés d'alphabétisation émergente, y compris l'apprentissage précoce du langage et des récits oraux, et on y explore les bienfaits de la lecture, de la parole et de la chanson auprès des nourrissons et des tout-petits, tant pour eux que pour les adultes qui en sont responsables. La lecture partagée au coucher et d'autres habitudes liées au langage ont un effet positif sur la santé familiale, relationnelle et socioaffective. L'exposition précoce à la langue parlée à la maison peut contribuer à l'alphabétisation dans les autres langues auxquelles l'enfant pourrait être exposé. On y trouve enfin des recommandations particulières pour les cliniciens qui conseillent les familles en matière d'alphabétisation précoce.

Effect of Picture-Book Reading With Additive Audio on Bilingual Preschoolers' Prefrontal Activation: A Naturalistic Functional Near-Infrared Spectroscopy Study

Acquiring a second language (L2) has the power to shape cognition and even the function and structure of the brain. Picture-book reading with additive audio (PRA) is a popular and convenient means of providing L2 exposure for non-balanced bilingual children; however, its contribution to bilingual children’s brain activity is unclear. This study conducted a rigorous bilingual word comprehension experiment and a naturalistic PRA task to explore the effect of L2 processing on brain activation among English as a foreign language (EFL) preschoolers, using functional near-infrared spectroscopy (fNIRS). We found that the two contexts of comprehending English words and bilingual switching (BS), which impose more cognitive control demands, activated the prefrontal cortex (PFC) more than did the condition of comprehending Chinese words. Furthermore, the effect of PFC activity in the condition of picture-book reading with additive English audio (English PRA) was also found to be greater than in the condition of picture-book reading with additive Chinese audio (Chinese PRA); moreover, the effect was modulated by story difficulty. Finally, a positive correlation was shown between EFL children’s English competence and PFC activation through English PRA. This study indicates that the experiences of hearing L2 auditory stories in a picture-book reading activity yielded significant changes to early bilinguals’ PFC functional for cognitive control and language processing.

Associations between home literacy environment, brain white matter integrity and cognitive abilities in preschool-age children

AIM

Caregiver-child reading is advocated by health organisations, citing cognitive and neurobiological benefits. The influence of home literacy environment (HLE) on brain structure prior to kindergarten has not previously been studied.

METHODS

Preschool-age children completed assessments of language (EVT-2, CTOPP-2 Rapid Object Naming) and emergent literacy skills (Get Ready to Read!, The Reading House) followed by diffusion tensor imaging (DTI). Parents completed a survey of HLE (StimQ-P₂ READ), which has four subscales. DTI measures included axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD) and fractional anisotropy (FA).

RESULTS

Forty-seven children completed DTI (54 ± 7 months, range 36-63; 27 girls). StimQ-P₂ READ scores correlated with higher EVT-2, GRTR and TRH scores, controlling for age and gender (P < .01), and also with lower AD, RD and MD in tracts supporting language and literacy skills, controlling for age, gender and income (P < .05, family-wise error corrected). Correlations were strongest for the Bookreading Quantity subscale, including with higher scores on all cognitive measures including CTOPP-2, and also with higher FA in left-lateralised literacy-supporting tracts, controlling for age, gender and income.

CONCLUSION

More nurturing home reading environment prior to kindergarten may stimulate brain development supporting language and literacy skills, reinforcing the need for further study.

Socioeconomic and experiential influences on the neurobiology of language development

PURPOSE

The process by which young children acquire language is an incredible feat subserved by neurobiological language circuitry. While the foundations of brain structure and function are genetically determined, children's experiences during sensitive periods in early life have a significant influence on the development of language systems. The purpose of this review is to provide practitioners with a comprehensive summary of foundational and recent research on the ways that children's early experiences-both favorable and adverse-may influence the neuroanatomy and neurophysiology underlying language development. A specific focus is given to the burgeoning neuroimaging evidence of relationships between socioeconomic status (SES) and brain development, as well as to emerging research on proximal experiences that may serve as the direct mechanisms by which SES influences language development.

CONCLUSION

Findings from the neuroscience field have direct implications for practice in speech language pathology. Specifically, clinicians can have immense influence on crafting supportive language environments during windows of maximal neural influence, both via direct intervention and parent coaching. Practical suggestions are provided for translating research findings to practice.

Hyperconnectivity during screen-based stories listening is associated with lower narrative comprehension in preschool children exposed to screens vs dialogic reading: An EEG study

OBJECTIVES

Dialogic reading (DR) is a shared storybook reading intervention previously shown to have a positive effect on both literacy and general language skills. The aim of this study was to examine the effect of DR compared to screen-based intervention on electrophysiological markers supporting narrative comprehension using EEG.

METHODS

Thirty-two typically developing preschoolers, ages 4 to 6 years, were assigned to one of two intervention groups: Dialogic Reading Group (DRG, n = 16) or Screen Story Group (SSG, n = 16). We examined the effect of intervention type using behavioral assessment and a narrative comprehension task with EEG.

RESULTS

The DRG showed improved vocabulary and decreased functional connectivity during the stories-listening task, whereas the SSG group showed no changes in vocabulary or connectivity. Significantly decreased network strength and transitivity and increased network efficiency were observed in the DRG following intervention. Greater network strength and transitivity at follow-up were correlated with increased vocabulary.

CONCLUSIONS

The results suggest the beneficial effect of DR in preschool-age children on vocabulary and EEG-bands related to attention in the ventral stream during narrative comprehension. Decreased functional connectivity may serve as a marker for language gains following reading intervention.

SIGNIFICANCE

DR intervention for preschool-age children may reduce interfering connections related to attention, which is related to better narrative comprehension.

Dialogic reading vs screen exposure intervention is related to increased cognitive control in preschool-age children

AIM

Shared reading leads to better language and executive functions. This study was designed to examine the effect of dialogic reading compared to screen-exposed intervention on executive functions using behavioural and electroencephalogram measures.

METHODS

The effect of six weeks of dialogic reading intervention on executive functions was examined in 16 children (seven females, 61.73 months, SD 7.07, min-max 50-170) vs 16 children exposed to screen (six females, 64.31 months, SD 64.31, min-max 52-74) recruited through posted ads in daycares in the north of Israel. Behavioural and attention/inhibition electroencephalogram tasks were used to assess the effects of intervention.

RESULTS

Comparisons using t-test showed that the dialogic reading group demonstrated higher executive functions and language scores vs the screen-exposed group. Greater accuracy rates, shorter reaction times and a smaller gap between P300 amplitudes were found for the dialogic reading group compared to the screen group for the electroencephalogram task.

CONCLUSION

Dialogic reading intervention is related to improved executive functions and language abilities compared to screen-based story-telling. Parents and teachers should consider employing this method in preschool children as a facilitator for future academic abilities.

Language Matters: Denying the Existence of the 30-Million-Word Gap Has Serious Consequences

Sperry, Sperry, and Miller (2018) aim to debunk what is called the 30-million-word gap by claiming that children from lower income households hear more speech than Hart and Risley () reported. We address why the 30-million-word gap should not be abandoned, and the importance of retaining focus on the vital ingredient to language learning-quality speech directed to children rather than overheard speech, the focus of Sperry et al.'s argument. Three issues are addressed: Whether there is a language gap; the characteristics of speech that promote language development; and the importance of language in school achievement. There are serious risks to claims that low-income children, on average, hear sufficient, high-quality language relative to peers from higher income homes.

Parent-provider paediatric literacy communication: A curriculum for future primary care providers

BACKGROUND

Reach Out and Read promotes early literacy and school readiness by incorporating book delivery and anticipatory guidance into well-child visits. There is a need to train future healthcare providers in the knowledge and skills to communicate with parents/caregivers about early childhood literacy. We developed and evaluated a curriculum to improve learners' knowledge, attitudes, and skills towards the incorporation of parent-provider literacy communication into well-child visits.

METHODS

Family medicine residents (n = 30), physician assistant students (n = 36), and medical students (n = 28) participated in a curriculum consisting of service learning, online didactic training, objective structured clinical exams (OSCEs) and a debriefing session. Standardized patients (SPs; 6 months to 5 years) and standardized patient caregivers were recruited and trained. Learners were evaluated on their abilities to offer books to patients, provide anticipatory guidance, and demonstrate parent-provider communication skills. Knowledge, attitudes, and satisfaction were collected pre- and post-curriculum.

RESULTS

Significant increases in total knowledge were observed after completing curriculum activities (p < 0.001). All attitudes improved after training (p < 0.05). All learners (100%) recommended that caregivers talk back and forth with their 6‑ to 12-month-old babies and make eye contact. Few (18.2%) learners recommended playing games like 'peek-a-boo' while reading. When caregivers evaluated learners' basic parent-provider communication skills, all reported that the learners treated them with respect and used plain language.

DISCUSSION

Our curriculum extends beyond previous studies by measuring recommended books, anticipatory guidance, and communication skills using paediatric SPs and standardized patient caregivers. Curriculum activities can be tailored to best promote parent-provider literacy communication training in other programs.

Maternal reading fluency is associated with functional connectivity between the child's future reading network and regions related to executive functions and language processing in preschool-age children

Reading is an acquired skill that relies on cognitive-control and language abilities. Home reading environment has been positively correlated with activation in parietal-temporal-occipital association cortex supporting mental imagery and narrative comprehension during a story-listening task in preschool-age children. However, the degree to which maternal reading ability influences early brain development, specifically neural circuits involved with language and reading, is not well understood. The current study explored the relationship between maternal reading ability and functional connectivity within the language network, between the language network and networks related to cognitive control and visual processing, as well as between the language network and the entire brain (network-to-voxel analysis) of preschool-age children during a resting state. Thirteen 4-year-old girls and their mothers participated in this study, involving cognitive testing and functional magnetic resonance imaging, including a resting-state scan. Maternal reading ability was negatively correlated with functional connectivity within the child's language network at rest, and also with areas involved in visual processing, cognitive-control, and semantics. These results suggest that children whose mothers exhibit decreased reading ability may demonstrate a greater engagement of the language network and neural circuits related to visual word recognition, cognitive-control, and semantic processing, which later in life support reading.

Shared reading quality assessment by parental report: preliminary validation of the DialogPR

Background

The American Academy of Pediatrics (AAP) recommends shared reading beginning as soon as possible after birth to promote healthy development. Shared reading quality can strongly influence outcomes, especially in children from low-SES households. Dialogic reading is a method developed to enhance verbal interactivity and engagement through book sharing, advocated by the AAP and clinic-based programs such as Reach Out and Read. There is no brief, validated, caregiver report measure of dialogic reading or shared reading quality currently available.

Methods

This cross-sectional study involved 49 healthy mother-child dyads (mean child age 4.5 yrs., SD = 0.6 yrs.) from 2 separate MRI-based studies. The DialogPR was administered by trained research coordinators following MRI, along with the READ subscale of the validated StimQ-P measure of home cognitive environment. The DialogPR consists of eight items developed in consultation with experts in early literacy, based on the PEER/CROWD dialogic reading conceptual model. Estimated reading level is 6th grade. Descriptive statistics were computed at both the item and scale levels. Modern theory Rasch methods were used to analyze all eight DialogPR items along with preliminary estimates of reliability and validity.

Results

Our combined sample involved 15 boys and 34 girls, and was diverse in terms of age, household income, and maternal education. DialogPR administration time was less than 2 min, with no problems reported. The DialogPR demonstrated strong internal consistency and reliability (Cronbach’s alpha = 0.82), and criterion-related validity with the StimQ-P READ (Spearman’s rho coefficient = 0.53). Rasch analysis revealed strong psychometric properties in terms of reliability, variability in item difficulty, and inter-item and item-measure correlations.

Conclusions

Preliminary evidence suggests that the DialogPR may be an efficient means to assess shared reading quality and dialogic reading via caregiver report for clinical and research purposes, warranting further investigation.

Story time turbocharger? Child engagement during shared reading and cerebellar activation and connectivity in preschool-age children listening to stories

Expanding behavioral and neurobiological evidence affirms benefits of shared (especially parent-child) reading on cognitive development during early childhood. However, the majority of this evidence involves factors under caregiver control, the influence of those intrinsic to the child, such as interest or engagement in reading, largely indirect or unclear. The cerebellum is increasingly recognized as playing a "smoothing" role in higher-level cognitive processing and learning, via feedback loops with language, limbic and association cortices. We utilized functional MRI to explore the relationship between child engagement during a mother-child reading observation and neural activation and connectivity during a story listening task, in a sample of 4-year old girls. Children exhibiting greater interest and engagement in the narrative showed increased activation in right-sided cerebellar association areas during the task, and greater functional connectivity between this activation cluster and language and executive function areas. Our findings suggest a potential cerebellar "boost" mechanism responsive to child engagement level that may contribute to emergent literacy development during early childhood, and synergy between caregiver and child factors during story sharing.