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Hutton JS, Huang G, Crosh C, DeWitt T, Ittenbach RF. Shared reading with infants: SharePR a novel measure of shared reading quality. Pediatr Res 2023; 93:976-984. [PMID: 35854086 DOI: 10.1038/s41390-022-02178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/08/2022]
Abstract
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.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Clare Crosh
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Tekin U, Alpgan Ö. Association Between Screen Time of Mobile Devices and TV and School Readiness in Preschool Children: A Cross-Sectional Study. Dev Neuropsychol 2023; 48:47-55. [PMID: 36847341 DOI: 10.1080/87565641.2023.2183957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
We aimed to investigate the relationship between screen time and school readiness. A total of 80 ppreschool children were included. Parents were interviewed about their children's daily screen time. The Metropolitan Readiness Test was utilized. Results showed that the school readiness of those with a total screen time of 3 hours or less was significantly higher. TV time was inversely associated with reading readiness (B=- 2.30,p < .001), whereas mobile device time was inversely associated with both reading (B = -0.96,p = .04) and numbers readiness (B = -0.98,p = .02). This study point to the importance of supervising children's screen use, and of awareness of parents and professionals.
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Affiliation(s)
- Uğur Tekin
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Clinic of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Ömer Alpgan
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Clinic of Child and Adolescent Psychiatry, Istanbul, Turkey
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Hill ME, Martin A, DeMauro SB. Reading to the Preterm Infant: Parent Perspectives on Barriers and Facilitators. Acad Pediatr 2023; 23:148-154. [PMID: 36055450 DOI: 10.1016/j.acap.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To describe parent-reported barriers and facilitators to reading to preterm-born infants, both in the neonatal intensive care unit (NICU) and at home. We hypothesized that families of preterm infants face unique barriers previously not described in the literature, and that understanding barriers from the parent perspective will uncover strategies for improving the NICU environment and cognitive home environment and allow refinement of current reading programs. METHODS We performed a qualitative study of parents of 0 to 12 month corrected age infants presenting to neonatal follow-up clinic. Infants were born <33 weeks gestational age or with birth weight ≤1500 grams. Parents completed a semistructured interview about reading practices. Answers to open-ended questions were coded to highlight key themes. RESULTS We reached thematic saturation after interviewing 23 parents of 28 infants. Parent-generated items about barriers and facilitators to reading in the NICU and at home were each coded into 4 themes. Competing responsibilities and believing that reading was developmentally inappropriate were 2 shared themes for barriers to reading in both the NICU and home environment. Support people and understanding developmental impact were 2 shared themes for facilitators to reading in both the NICU and home environment. CONCLUSIONS This qualitative work elucidates new targets for novel programs intended to support cognitive development of high-risk preterm infants. Addressing the unique, parent-reported barriers that we have identified and supporting adoption of the facilitators could increase word exposure for preterm infants, starting in the NICU and continuing at home.
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Affiliation(s)
- Morgan E Hill
- Division of Neonatology, Department of Pediatrics (ME Hill, A Martin, SB DeMauro), Children's Hospital of Philadelphia - Roberts Center for Pediatric Research, Philadelphia, PA
| | - Ashley Martin
- Division of Neonatology, Department of Pediatrics (ME Hill, A Martin, SB DeMauro), Children's Hospital of Philadelphia - Roberts Center for Pediatric Research, Philadelphia, PA
| | - Sara B DeMauro
- Division of Neonatology, Department of Pediatrics (ME Hill, A Martin, SB DeMauro), Children's Hospital of Philadelphia - Roberts Center for Pediatric Research, Philadelphia, PA; Division of Neonatology, Department of Pediatrics (SB DeMauro), University of Pennsylvania Perelman School of Medicine.
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Thompson LA, Liberty R, Corr A. "Does your baby watch TV?": The associations between at-home TV watching and laboratory challenge cortisol are different for young infants and their mothers. Dev Psychobiol 2022; 64:e22236. [PMID: 35191526 DOI: 10.1002/dev.22236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/24/2021] [Accepted: 12/05/2021] [Indexed: 11/07/2022]
Abstract
This longitudinal study examined associations between at-home TV watching and the biological stress response (cortisol) during a laboratory infant cognitive challenge task in 240 3- and 5-month infants and their mothers. Cortisol levels were lower in mothers of 5-month-old infants whose infants were exposed to TV at home, compared to mothers of infants that were not TV-exposed. Cortisol patterns were different across three laboratory sampling intervals for 3-month-old infants as a function of TV watching, revealing a sharp increase in laboratory cortisol only for infants who were exposed to TV at home. In contrast, there was no effect of TV exposure in 5-month-old infants' cortisol. Infant temperament and demographic measures were included as control variables in regression models to predict maternal and infant cortisol. At 3 months, for the T3 cortisol sampling interval, and at 5 months across all three sampling intervals, maternal cortisol levels were significantly predicted by infant TV exposure after accounting for variance due to these control variables. Our findings show the strong influence of the infant TV-exposure factor in the biological stress response of mothers of young infants, and suggest that infant TV exposure may influence self-regulation in 3-month-old infants.
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Affiliation(s)
- Laura A Thompson
- Clinical Psychology Program, Fielding Graduate University, Las Cruces, New Mexico, USA.,Psychology Department, New Mexico State University, Las Cruces, New Mexico, USA
| | - Rebecca Liberty
- Clinical Psychology Program, Fielding Graduate University, Las Cruces, New Mexico, USA
| | - Alora Corr
- Clinical Psychology Program, Fielding Graduate University, Las Cruces, New Mexico, USA
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Infant media use: A harm reduction approach. Infant Behav Dev 2021; 64:101610. [PMID: 34298189 DOI: 10.1016/j.infbeh.2021.101610] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 05/28/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022]
Abstract
There are a myriad of potentially harmful developmental outcomes associated with infant digital media use. Studies revealing risk associated with early media use have informed the current American Academy of Pediatrics (AAP) recommendations that discourage most digital media use among children under 18 months of age. Recent research advances, however, suggest potential benefits of technology engagement in this age group. Additionally, surveys of parents reveal that most infants engage with digital media for at least 30 min a day, exceeding the AAP recommendations. In response to these discoveries and cultural trends, some scholars have made compelling cases to adapt the AAP guidelines for infants. A helpful model for developing infant digital media use guidelines for families may be the harm reduction approach. The intent of this review is to suggest adaptations to the AAP guidelines for infant media engagement using a harm reduction framework. This review describes the challenge of restrictive guidelines, briefly summarizes the harm reduction approach, provides a review of risks and benefits associated with infant media use in each developmental domain (physical, cognitive, and socioemotional), summarizes correlates of infant screen media use, and examines intervention strategies for reducing screen time. The paper concludes with examples of possible adaptations to current AAP infant media use recommendations using harm reduction and bioecological frameworks.
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Jain VG, Kessler C, Lacina L, Szumlas GA, Crosh C, Hutton JS, Needlman R, Dewitt TG. Encouraging Parental Reading for High-Risk Neonatal Intensive Care Unit Infants. J Pediatr 2021; 232:95-102. [PMID: 33453203 DOI: 10.1016/j.jpeds.2021.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/25/2020] [Accepted: 01/07/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To assess whether a citywide structured book-sharing program (NICU Bookworms) designed to promote reading to infants while admitted in the neonatal intensive care unit (NICU) would increase parental reading behaviors (≥3-4 days/week) in the NICU and after discharge home, including high-risk parents who do not themselves enjoy reading. STUDY DESIGN The NICU Bookworms program comprised staff training, parent education, and building a literacy-rich environment. In this quasi-experimental intervention study, parents of medically high-risk NICU graduates <6 months of age were administered a questionnaire at their first NICU follow-up clinic visit. The survey incorporated questions from the StimQ-I READ subscale to assess home reading environment and shared reading practices. RESULTS A total of 317 infants were enrolled, 187 in an unexposed comparison group and 130 in the intervention group. Parents exposed to Bookworms were significantly more likely to read ≥3-4 days per week while in the NICU (34.5% vs 51.5%; P = .002; aOR, 2.2; 95% CI, 1.2-4.0), but reading at home did not differ (67.9% vs 73.1%; P = .28; aOR, 0.99; 95% CI, 0.5-1.8). However, among parents who did not themselves enjoy reading, frequency was significantly higher both in the NICU (18.4% vs 46.1%; P = .009; aOR, 5.0; 95% CI, 1.2-21.5) and at home (36.9% vs 70%; P = .003; aOR, 3.7; 95% CI, 1.1-12.9). A qualitative thematic analysis found that Bookworms decreased parental stress, enhanced bonding, and supported positive parent-infant interactions. CONCLUSIONS A book-sharing intervention in the NICU increased parent-reported reading aloud during hospitalization and among parents disinclined to read for pleasure, both in the NICU and following discharge. This change may have been mediated by enhancement of parent-infant interactions.
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Affiliation(s)
- Viral G Jain
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL.
| | - Christy Kessler
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Linda Lacina
- Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Greg A Szumlas
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Clare Crosh
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - John S Hutton
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Reading & Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert Needlman
- Department of Pediatrics, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH
| | - Thomas G Dewitt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Reading & Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Coyne SM, Holmgren HG, Keenan-Kroff SL, Petersen S, Stockdale L. Prenatal Predictors of Media Use During Infancy. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:377-383. [DOI: 10.1089/cyber.2019.0477] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sarah M. Coyne
- School of Family Life, Brigham Young University, Provo, Utah
| | | | | | - Sarah Petersen
- School of Family Life, Brigham Young University, Provo, Utah
| | - Laura Stockdale
- School of Family Life, Brigham Young University, Provo, Utah
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Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK. Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children. JAMA Pediatr 2020; 174:e193869. [PMID: 31682712 PMCID: PMC6830442 DOI: 10.1001/jamapediatrics.2019.3869] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE The American Academy of Pediatrics (AAP) recommends limits on screen-based media use, citing its cognitive-behavioral risks. Screen use by young children is prevalent and increasing, although its implications for brain development are unknown. OBJECTIVE To explore the associations between screen-based media use and integrity of brain white matter tracts supporting language and literacy skills in preschool-aged children. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of healthy children aged 3 to 5 years (n = 47) was conducted from August 2017 to November 2018. Participants were recruited at a US children's hospital and community primary care clinics. EXPOSURES Children completed cognitive testing followed by diffusion tensor imaging (DTI), and their parent completed a ScreenQ survey. MAIN OUTCOMES AND MEASURES ScreenQ is a 15-item measure of screen-based media use reflecting the domains in the AAP recommendations: access to screens, frequency of use, content viewed, and coviewing. Higher scores reflect greater use. ScreenQ scores were applied as the independent variable in 3 multiple linear regression models, with scores in 3 standardized assessments as the dependent variable, controlling for child age and household income: Comprehensive Test of Phonological Processing, Second Edition (CTOPP-2; Rapid Object Naming subtest); Expressive Vocabulary Test, Second Edition (EVT-2; expressive language); and Get Ready to Read! (GRTR; emergent literacy skills). The DTI measures included fractional anisotropy (FA) and radial diffusivity (RD), which estimated microstructural organization and myelination of white matter tracts. ScreenQ was applied as a factor associated with FA and RD in whole-brain regression analyses, which were then narrowed to 3 left-sided tracts supporting language and emergent literacy abilities. RESULTS Of the 69 children recruited, 47 (among whom 27 [57%] were girls, and the mean [SD] age was 54.3 [7.5] months) completed DTI. Mean (SD; range) ScreenQ score was 8.6 (4.8; 1-19) points. Mean (SD; range) CTOPP-2 score was 9.4 (3.3; 2-15) points, EVT-2 score was 113.1 (16.6; 88-144) points, and GRTR score was 19.0 (5.9; 5-25) points. ScreenQ scores were negatively correlated with EVT-2 (F2,43 = 5.14; R2 = 0.19; P < .01), CTOPP-2 (F2,35 = 6.64; R2 = 0.28; P < .01), and GRTR (F2,44 = 17.08; R2 = 0.44; P < .01) scores, controlling for child age. Higher ScreenQ scores were correlated with lower FA and higher RD in tracts involved with language, executive function, and emergent literacy abilities (P < .05, familywise error-corrected), controlling for child age and household income. CONCLUSIONS AND RELEVANCE This study found an association between increased screen-based media use, compared with the AAP guidelines, and lower microstructural integrity of brain white matter tracts supporting language and emergent literacy skills in prekindergarten children. The findings suggest further study is needed, particularly during the rapid early stages of brain development.
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Affiliation(s)
- John S. Hutton
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jonathan Dudley
- Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio,Educational Neuroimaging Center, Biomedical Engineering, Technion, Israel
| | - Tom DeWitt
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Scott K. Holland
- Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio,Medpace Inc, Cincinnati, Ohio
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