Dialogic Book-Sharing as a Privileged Intersubjective Space

Early parent-child intervention with Dialogic Book-Sharing: effects on child communicative and socio-emotional development and on parenting. Study protocol for a multicentre randomised controlled trial in Italy

BACKGROUND

Research in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children's learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent-child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent-child communication through the use of wordless picture books, provides a privileged 'intersubjective' space and is highly effective in promoting communication, language, attention, behavioural development and the parent-child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time in Italy for research purposes in Italian health, educational and maternal-child centres.

METHODS

A multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent-child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post-intervention and at 6 months post-intervention with a questionnaire and video recording of parent-child interaction.

DISCUSSION

DBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child's development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood.

TRIAL REGISTRATION

The trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial.

Book-Sharing for Toddlers with Clefts (BOOST): Protocol for a randomized controlled trial of a remote intervention to promote language development in children with cleft palate

BACKGROUND

Children with cleft palate, with or without cleft lip (CP±L), exhibit language delays on average compared to children without clefts. Interventions to address these disparities are scarce. In this multi-center study, Book Sharing for Toddlers with Clefts (BOOST), we will test a remote, parent-focused intervention to promote language development in children with CP±L.

OBJECTIVES

The study will test two primary hypotheses. First, toddlers randomized to BOOST will exhibit better language outcomes than children receiving standard-of-care (SOC). Second, we hypothesize that the BOOST program's effect on language outcomes is mediated by the frequency and quality of parent-child reading interactions.

METHODS

The study is a randomized-controlled trial comparing the BOOST group to a SOC comparison group. We will enroll N = 320 English and/or Spanish-speaking children ages 24-32 months with isolated CP±L (n = 160 per group). Both groups will receive children's books, and parents will record and upload videos of themselves reading the books with their children using a smartphone app developed for the study. Parents will also complete surveys asking whether they read to their children on five randomly selected days each week. In addition, the BOOST group will participate in 3 remote dialogic book-sharing intervention sessions via Zoom. We will code book-sharing videos to assess parents' target skill usage and children's expressive language. End-of-study assessments will include measures of child language outcomes (e.g., clinician-administered measures, parent reports, and naturalistic child language samples).

RESULTS

Enrollment began in April 2024 and will continue through approximately April 2028.

CONCLUSION

The BOOST study will address a critical gap in the literature on interventions to improve language in children with CP±L. The results will inform the care for toddlers with oral clefts and have potential applications for other populations.

Parental Scaffolding during Book-Sharing Predicts Child General Intelligence

While much variance in general intelligence or g is genetic, a substantial environmental component suggests a possible role for parent-child interaction. In particular, previous evidence suggests the importance of parental scaffolding, or provision of cognitive structure to shape child behaviour. A role for scaffolding is consistent with the proposal that, in adult cognition, a critical aspect of g is decomposition of complex problems into a structure of simpler parts. Building on previous work, we recruited 162 parents attending Children's Centres with a child aged 2-4 years, and examined parental scaffolding during a book-sharing activity. Scaffolding was measured as the first principal component of a variety of parental behaviours, including sensitivity, focusing attention, extending comprehension, and promoting child participation. Child g was measured as the first principal component of a broad cognitive battery, including language, attention, working memory, and executive function. Importantly, we assessed contributions of the parent's own intelligence, education, and family income. Though these variables were all associated with both child g and parental scaffolding, scaffolding remained predictive of child g even once the influence of these variables was removed. In contrast to the correlation with cognitive proficiency, scaffolding did not predict child pro-social behaviour. We suggest that parental scaffolding supports the child's development of a broad skill of attentional structuring, promoting the across-the-board cognitive proficiency that is reflected in g.

Parental developmental screening with CARE: A pilot hybrid assessment and intervention with vulnerable families in Colombia

Poverty and scarcity of resources make children in low-and-middle-income countries at risk of not reaching their developmental potential. Despite a near-universal interest in risk reduction, effective interventions like enhancing reading skills in parents to diminish developmental delay remain elusive for the great majority of vulnerable families. We undertook a efficacy study for parental use of a booklet called CARE for developmental screening of children between 36 to 60 months old (M = 44.0, SD = 7.5). All participants (N = 50), lived in vulnerable, low-income neighborhoods in Colombia. The study followed a pilot Quasi-Randomised Control Trial design (i.e., control group participants assigned based on non-random criteria) of parent training with a CARE intervention group compared to a control group. Data was analyzed using two-way ANCOVA for sociodemographic variables' interaction with follow-up results and one-way ANCOVA to evaluate the relations between the intervention and post-measurement of developmental delays and cautions and other language related-skills outcomes, while controlling for pre-measurements. These analyses indicated that the CARE booklet intervention enhanced children's developmental status and narrative skills (developmental screening delay items, F(1, 47) = 10.45, p = .002, partial η2 = .182; narrative devices scores, F(1, 17) = 4.87, p = .041, partial η2 = .223). Several limitations (e.g., sample size) and possible implications for the analysis of children's developmental potential are discussed and considered for future research, along with the effects of the COVID-19 pandemic on the closure of preschools and community care centers.

“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.