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Crosh CC, Sherman SN, Valley JE, Parsons A, Gentry A, Glusman M, Hutton JS, Copeland KA. Beliefs and Motivations Regarding Early Shared Reading of Parents From Low-Income Households: A Qualitative Study. Acad Pediatr 2024; 24:486-493. [PMID: 38290573 DOI: 10.1016/j.acap.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
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.
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Affiliation(s)
- Clare C Crosh
- Department of Pediatrics and Academic Medicine (CC Crosh), Advocate Children's Hospital - Oak Lawn, Oak Lawn, Ill.
| | | | - Jais E Valley
- Department of General and Community Pediatrics (JE Valley), Children's National Hospital, Washington, DC
| | | | - Arin Gentry
- College of Arts and Sciences (A Gentry), University of Cincinnati, Cincinnati, Ohio
| | - Mariana Glusman
- Northwestern University Feinberg School of Medicine Section of Primary Care (M Glusman), Chicago, Ill
| | - John S Hutton
- Division of General and Community Pediatrics (JS Hutton and KA Copeland), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (JS Hutton and KA Copeland), College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Kristen A Copeland
- Division of General and Community Pediatrics (JS Hutton and KA Copeland), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (JS Hutton and KA Copeland), College of Medicine, University of Cincinnati, Cincinnati, Ohio
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Hutton JS, Piotrowski JT, Bagot K, Blumberg F, Canli T, Chein J, Christakis DA, Grafman J, Griffin JA, Hummer T, Kuss DJ, Lerner M, Marcovitch S, Paulus MP, Perlman G, Romeo R, Thomason ME, Turel O, Weinstein A, West G, Pietra PHD, Potenza MN. Digital Media and Developing Brains: Concerns and Opportunities. Curr Addict Rep 2024; 11:287-298. [PMID: 38606363 PMCID: PMC11003891 DOI: 10.1007/s40429-024-00545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 04/13/2024]
Abstract
Purpose of Review The incorporation of digital technologies and their use in youth's everyday lives has been increasing rapidly over the past several decades with possible impacts on youth development and mental health. This narrative review aimed to consider how the use of digital technologies may be influencing brain development underlying adaptive and maladaptive screen-related behaviors. Recent Findings To explore and provide direction for further scientific inquiry, an international group of experts considered what is known, important gaps in knowledge, and how a research agenda might be pursued regarding relationships between screen media activity and neurodevelopment from infancy through childhood and adolescence. While an understanding of brain-behavior relationships involving screen media activity has been emerging, significant gaps exist that have important implications for the health of developing youth. Summary Specific considerations regarding brain-behavior relationships involving screen media activity exist for infancy, toddlerhood, and early childhood; middle childhood; and adolescence. Transdiagnostic frameworks may provide a foundation for guiding future research efforts. Translating knowledge gained into better interventions and policy to promote healthy development is important in a rapidly changing digital technology environment.
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Affiliation(s)
- John S. Hutton
- Division of General and Community Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA and Division of General and Community Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX USA
| | | | - Kara Bagot
- Departments of Psychiatry & Pediatrics, Addiction Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Fran Blumberg
- Division of Psychological and Educational Services, Fordham University, New York, NY USA
| | - Turhan Canli
- Departments of Psychology and Psychiatry, Stony Brook University, Stony Brook, NY USA
| | - Jason Chein
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA USA
| | - Dimitri A. Christakis
- Center for Child Health Behaviour and Development, Seattle Children’s Research Institute, Departments of Pediatrics, Psychiatry, and Health Services, University of Washington, Seattle, WA USA
| | - Jordan Grafman
- The Shirley Ryan AbilityLab & Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - James A. Griffin
- The National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, USA
| | - Tom Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN USA
| | - Daria J. Kuss
- International Gaming Research Unit and Cyberpsychology Group, NTU Psychology, Nottingham Trent University, Nottingham, UK
| | - Matthew Lerner
- Departments of Psychology, Psychiatry & Pediatrics, Stony Brook University, Stony Brook, NY, USA and AJ Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Stuart Marcovitch
- Department Of Psychology, University of North Carolina Greensboro, Greensboro, NC USA
| | | | - Greg Perlman
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY USA
| | - Rachel Romeo
- Departments of Human Development & Quantitative Methodology, Hearing & Speech Sciences, and Neuroscience & Cognitive Sciences, University of Maryland College Park, College Park, MD USA
| | - Moriah E. Thomason
- Departments of Child and Adolescent Psychiatry and Population Health, New York University, New York University Grossman School of Medicine, New York, NY USA
| | - Ofir Turel
- College of Business and Economics, California State University, Fullerton, CA USA
- Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Aviv Weinstein
- The Isadore and Ruth Kastin Chair for Brain Research, Department of Psychology and Behavioral Science, Ariel University, Ariel, Israel
| | - Gregory West
- Department of Psychology, University of Montreal, Montreal, Canada
| | - Pamela Hurst-Della Pietra
- Children and Screens: Institute of Digital Media and Child Development, Jericho, NY USA
- Department of Family, Population and Preventive Medicine, Stony Brook Medicine, Stony Brook, NY USA
| | - Marc N. Potenza
- Departments of Psychiatry, Child Study and Neuroscience, Connecticut Mental Health Center, Yale School of Medicine, Wu Tsai Institute, Yale University, New Haven, CT 06517 USA
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Kelly KJ, Hutton JS, Parikh NA, Barnes-Davis ME. Neuroimaging of brain connectivity related to reading outcomes in children born preterm: A critical narrative review. Front Pediatr 2023; 11:1083364. [PMID: 36937974 PMCID: PMC10014573 DOI: 10.3389/fped.2023.1083364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
Premature children are at high risk for delays in language and reading, which can lead to poor school achievement. Neuroimaging studies have assessed structural and functional connectivity by diffusion MRI, functional MRI, and magnetoencephalography, in order to better define the "reading network" in children born preterm. Findings point to differences in structural and functional connectivity compared to children born at term. It is not entirely clear whether this discrepancy is due to delayed development or alternative mechanisms for reading, which may have developed to compensate for brain injury in the perinatal period. This narrative review critically appraises the existing literature evaluating the neural basis of reading in preterm children, summarizes the current findings, and suggests future directions in the field.
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Affiliation(s)
- Kaitlyn J. Kelly
- Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - John S. Hutton
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of General & Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Nehal A. Parikh
- Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Maria E. Barnes-Davis
- Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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5
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Crosh CC, Barsella A, Van Slambrouck L, Notario PM, Li Y, Parsons AA, Hutton JS. Exploratory Mixed-Methods Study of a Primary Care-Based Intervention Promoting Shared Reading During Infancy. Clin Pediatr (Phila) 2022; 61:475-484. [PMID: 35383480 DOI: 10.1177/00099228221085825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Clare C Crosh
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Adam Barsella
- Advocate Children's Hospital-Oak Lawn, Oak Lawn, IL, USA
| | | | | | - Yi Li
- Advocate Aurora Research Institute, Downers Grove, IL, USA
| | - Allison A Parsons
- Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - 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.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Monteiro R, Fernandes S, Hutton JS, Huang G, Ittenbach RF, Rocha NB. Psychometric properties of the ScreenQ for measuring digital media use in Portuguese young children. Acta Paediatr 2022; 111:1950-1955. [PMID: 35648466 PMCID: PMC9546278 DOI: 10.1111/apa.16439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
AIM Digital media use is prevalent among children and linked to potential developmental and health risks, but validated measures of children's digital media use are lacking. The aim of this study was to validate the Portuguese version of the ScreenQ with three distinct children's age groups. METHODS Parents of children living in Portugal completed an online survey including the 16-item version of the ScreenQ and items related to home activities and digital media use. A combination of classical and modern theory (Rasch) methods was used for analysis. RESULTS A total of 549 mothers and 51 fathers of 325 girls and 322 boys from 6 months to 9 years and 11 months-old responded to the survey. Point-measure correlations were all positive and endorsement of item values were within acceptable ranges. Cronbach's coefficient α was acceptable for a new measure and test-retest reliability was high. Statistically significant correlations were found between ScreenQ total scores and relevant demographic, play-related, parenting, and digital media-use items. CONCLUSION The Portuguese version of the ScreenQ exhibited sound psychometric properties, including internal consistency and concurrent validity referenced to external items. Higher ScreenQ scores were correlated with higher digital media multitasking, lower parent-child interaction, and higher concerns regarding child's learning and behaviour.
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Affiliation(s)
- Rita Monteiro
- University of Vigo Ph.D. program in Educational and Behavioral Sciences Vigo Spain
- School of Health Polytechnic Institute of Porto Porto Portugal
| | - Sandra Fernandes
- Portucalense Institute for Human Development (INPP) Department of Psychology and Education Portucalense University Porto Portugal
| | - John S Hutton
- Division of General and Community Pediatrics Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
- Reading and Literacy Discovery Center Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
| | - Guixia Huang
- Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital University of Cincinnati College of Medicine Cincinnati
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Abstract
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics recommends literacy promotion as well as routine developmental surveillance during well-child visits to improve academic, relational, and health outcomes. In this study, we examined the possible association between shared reading and social-emotional problems among young children. METHODS We conducted a retrospective review of longitudinal records for children aged 30 to 66 months presenting for visits to an academic pediatric primary care center between July 1, 2013, and February 1, 2019. The outcome was evidence of social-emotional problems, defined by an Ages and Stages: Social Emotional Questionnaire (ASQ:SE) score above the established cutoff. The predictor was caregiver-reported frequency of shared reading (most = 5-7 days per week, some = 2-4 days per week, rarely = 0-1 days per week) at a previous visit. Generalized linear models with generalized estimating equations were used to assess the association between the longitudinal outcome and predictor, adjusting for child demographics and needs reported on routine social history questionnaires. RESULTS Analyses included 5693 children who completed at least 1 ASQ:SE (total of 7302 assessments) and had shared reading frequency documented before each ASQ:SE assessment. Children were predominantly Black (75%) and publicly insured (80%). Sixteen percent of ASQ:SE scores were suggestive of social-emotional concerns; 6% of caregivers reported sharing reading rarely. Children with rare shared reading had a higher risk of an ASQ:SE above cutoff compared with those with shared reading on most days (adjusted risk ratio, 1.62; 95% confidence interval, 1.35-1.92). CONCLUSIONS Less-frequent caregiver-reported shared reading was associated with higher risk of social-emotional problems in young children presenting for primary care. This highlights potential relational and social-emotional benefits of shared reading.
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Affiliation(s)
- Keith J Martin
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Andrew F Beck
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Yingying Xu
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Gregory A Szumlas
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - John S Hutton
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Clare C Crosh
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kristen A Copeland
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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Hutton JS, Huang G, Wiley C, DeWitt T, Ittenbach RF. Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children. Acad Pediatr 2021; 21:977-987. [PMID: 34020099 DOI: 10.1016/j.acap.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/28/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022]
Abstract
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.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
| | - Catherine Wiley
- Community Health Center at Connecticut Children's Hospital (C Wiley), Hartford, Conn
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
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Farah R, Dudley J, Hutton JS, Greenwood P, Holland S, Horowitz-Kraus T. Maternal depression is associated with decreased functional connectivity within semantics and phonology networks in preschool children. Depress Anxiety 2021; 38:826-835. [PMID: 34010495 DOI: 10.1002/da.23168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Maternal depression is characterized by a lack of emotional responsiveness and engagement with their child, which may lead to the child's decreased cognitive, and language outcomes all related to the child's future reading outcomes. The relations between maternal depression and functional connectivity in neural circuits supporting language in the child was explored. METHODS Eleven 4-year-old girls completed language abilities assessment and resting-state functional magnetic resonance imaging scan. Their mothers completed the Beck's Depression Inventory (BDI) to examine maternal depression when the child was 12 months old and at the age of 4. Functional connections within the child's resting-state phonology, semantics, language networks were correlated with maternal BDI scores at the age of 4 years. RESULTS Higher maternal depression was associated with the child's decreased within the semantic and phonological networks connectivity during rest. Higher maternal depression at 4 years moderated the relationship between early depression scores and functional connectivity within the phonological network. CONCLUSIONS Maternal depression in the first year of life is related to functional connections of phonological processing and enhanced by current maternal depression levels. We conclude that after a mother gives birth, resources should be provided to minimize depressive symptoms and interventions should be applied to support their child's language development for future reading acquisition.
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Affiliation(s)
- Rola Farah
- Educational Neuroimaging Center, Faculty of Biomedical Engineering, Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel
| | - Jonathan Dudley
- Division of General and Community Pediatrics, Reading and Literacy Discovery Center, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA
| | - John S Hutton
- Division of General and Community Pediatrics, Reading and Literacy Discovery Center, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA
| | - Paige Greenwood
- Division of General and Community Pediatrics, Reading and Literacy Discovery Center, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA
| | | | - Tzipi Horowitz-Kraus
- Educational Neuroimaging Center, Faculty of Biomedical Engineering, Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel.,Division of General and Community Pediatrics, Reading and Literacy Discovery Center, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA
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Abstract
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.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lauren Hoffman
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Educational Neuroimaging Center, Faculty of Education in Science and Technology, Technion, Haifa, Israel.,Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Perri Klass
- Department of Pediatrics, New York University School of Medicine, New York
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Hutton JS, Dudley J, Huang G, Horowitz-Kraus T, DeWitt T, Ittenbach RF, Holland SK. Validation of The Reading House and Association With Cortical Thickness. Pediatrics 2021; 147:peds.2020-1641. [PMID: 33542146 DOI: 10.1542/peds.2020-1641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics recommends literacy and school readiness promotion during well visits. The Reading House (TRH) is a children's book-based screener of emergent literacy skills in preschool-aged children. Vocabulary, rhyming, and rapid naming are core emergent skills, and reading abilities are associated with thicker cortex in the left hemisphere. Our objective was to expand validity of TRH relative to these skills and explore association with cortical thickness. METHODS Healthy preschool-aged children completed MRI including a T1-weighted anatomic scan. Before MRI, TRH and assessments of rapid naming (Comprehensive Test of Phonological Processing, Second Edition), rhyming (Pre-Reading Inventory of Phonological Awareness), vocabulary (Expressive Vocabulary Test, Second Edition), and emergent literacy (Get Ready to Read!) were administered. Analyses included Spearman-ρ correlations (r ρ) accounting for age, sex, and socioeconomic status (SES). MRI analyses involved whole-brain measures of cortical thickness relative to TRH scores, accounting for covariates. RESULTS Seventy children completed assessments (36-63 months old; 36 female) and 52 completed MRI (37-63 months; 29 female). TRH scores were positively correlated with Comprehensive Test of Phonological Processing, Second Edition (r ρ = 0.61), Expressive Vocabulary Test, Second Edition (r ρ = 0.54), Get Ready to Read! (r ρ = 0.87), and Pre-Reading Inventory of Phonological Awareness scores (r ρ = 0.64; all P < .001). These correlations remained statistically significant across age, sex, and SES groups. TRH scores were correlated with greater thickness in left-sided language and visual cortex (P-family-wise error <.05), which were similar for higher SES yet more bilateral and frontal for low SES, reflecting a less mature pattern (P-family-wise error <.10). CONCLUSIONS These findings expand validation evidence for TRH as a screening tool for preschool-aged children, including associations with emergent skills and cortical thickness, and suggest important differences related to SES.
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Affiliation(s)
- John S Hutton
- Divisions of General and Community Pediatrics and .,Reading and Literacy Discovery Center and
| | - Jonathan Dudley
- Reading and Literacy Discovery Center and.,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Guixia Huang
- Biostatistics and Epidemiology, College of Medicine, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Tzipi Horowitz-Kraus
- Divisions of General and Community Pediatrics and.,Reading and Literacy Discovery Center and.,Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Educational Neuroimaging Center, Technion Israel - Institute of Technology, Haifa, Israel; and
| | - Thomas DeWitt
- Divisions of General and Community Pediatrics and.,Reading and Literacy Discovery Center and
| | - Richard F Ittenbach
- Biostatistics and Epidemiology, College of Medicine, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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13
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Kraus D, Vannest J, Arya R, Hutton JS, Leach JL, Mangano FT, Tenney JR, Byars AW, DeWitt TG, Horowitz-Kraus T. Reading in children with drug-resistant epilepsy was related to functional connectivity in cognitive control regions. Acta Paediatr 2020; 109:2105-2111. [PMID: 31999871 DOI: 10.1111/apa.15201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/12/2019] [Accepted: 01/27/2020] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to define whether individuals with drug-resistant focal epilepsy also used regions related to cognitive control to facilitate reading. METHODS We focused on patients with drug-resistant focal epilepsy in 2011-2014, who were aged 8-20 years and were being treated at the Cincinnati Children's Hospital, USA. They performed a verb generation functional magnetic resonance imaging task known to involve language and cognitive control, as well as a formal reading assessment. The reading scores were correlated with functional connectivity of the anterior cingulate cortex (ACC) using seed-to-voxel analysis. RESULTS There were 81 potential patients and 13 (seven females) met the inclusion criteria. Their age at seizure onset was 0-13 years, and they had a mean age of 12.66 ± 3.17 years at the time of the study. Individuals with epilepsy demonstrated average intelligence and word reading ability. Their reading scores were positively correlated with functional connectivity between the ACC and regions related to emotional processing (right amygdala), learning and language processing (left cerebellum) and visual processing. CONCLUSION Our results support the role that the ACC plays in proficient reading among children with drug-resistant epilepsy, even in those with epileptogenic foci in areas related to language.
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Affiliation(s)
- Dror Kraus
- Institute of Child Neurology, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel
| | - Jennifer Vannest
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ravindra Arya
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - James L Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Francesco T Mangano
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jeffrey R Tenney
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Anna W Byars
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas G DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Educational Neuroimaging Center, Faculty of Biomedical Engineering, Technion, Haifa, Israel.,Faculty of Education in Science and Technology, Technion, Haifa, Israel
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Hutton JS, Dudley J, Horowitz‐Kraus T, DeWitt T, Holland SK. Associations between home literacy environment, brain white matter integrity and cognitive abilities in preschool-age children. Acta Paediatr 2020; 109:1376-1386. [PMID: 31854046 PMCID: PMC7318131 DOI: 10.1111/apa.15124] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 01/08/2023]
Abstract
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.
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Affiliation(s)
- John S. Hutton
- Division of General and Community Pediatrics
- Reading and Literacy Discovery Center Cincinnati Ohio
| | - Jonathan Dudley
- Reading and Literacy Discovery Center Cincinnati Ohio
- Pediatric Neuroimaging Research Consortium University of Cincinnati College of Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio
| | - Tzipi Horowitz‐Kraus
- Division of General and Community Pediatrics
- Reading and Literacy Discovery Center Cincinnati Ohio
- Pediatric Neuroimaging Research Consortium University of Cincinnati College of Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio
- Educational Neuroimaging Center Biomedical Engineering Technion Israel
| | - Tom DeWitt
- Division of General and Community Pediatrics
- Reading and Literacy Discovery Center Cincinnati Ohio
| | - Scott K. Holland
- Reading and Literacy Discovery Center Cincinnati Ohio
- Pediatric Neuroimaging Research Consortium University of Cincinnati College of Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio
- Medpace, Inc Cincinnati OH
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15
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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
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16
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Affiliation(s)
- Perri Klass
- Department of Pediatrics, New York University School of Medicine, New York.,Arthur L. Carter Journalism Institute, New York University, New York
| | - John S Hutton
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Thomas G DeWitt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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17
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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: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK. Functional Connectivity of Attention, Visual, and Language Networks During Audio, Illustrated, and Animated Stories in Preschool-Age Children. Brain Connect 2019; 9:580-592. [PMID: 31144523 DOI: 10.1089/brain.2019.0679] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The American Academy of Pediatrics recommends that parents read with their children early and often and limits on screen-based media. While book sharing may benefit attention in children, effects of animated content are controversial, and the influence of either on attention networks has not previously been studied. This study involved functional magnetic resonance imaging (fMRI) of three separate active-task scans composed of similar 5-min stories presented in the same order for each child (audio → illustrated → animated), followed by assessment of comprehension. Five functional brain networks were defined a priori through literature review: dorsal attention network (DAN), ventral attention network (VAN), language (L), visual imagery (VI), and visual perception (VP). Analyses involved comparison of functional connectivity (FC) within- and between networks across formats, applying false discovery rate correction. Twenty-seven of 33 children completed fMRI (82%; 15 boys, 12 girls; mean 58 ± 8 months old). Comprehension of audio and illustrated stories was equivalent and lower for animation (p < 0.05). For illustration relative to audio, FC within DAN and VAN and between each of these and all other networks was similar, lower within-L, and higher between VI-VP, suggesting reduced strain on the language network using illustrations and imagery. For animation relative to illustration, FC was lower between DAN-L, VAN-VP, VAN-VI, L-VI, and L-VP, suggesting less focus on narrative, reorienting to imagery, and visual-language integration. These findings suggest that illustrated storybooks may be optimal at this age to encourage integration of attention, visual, and language networks, while animation may bias attention toward VP.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Reading and Literacy Discovery Center, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jonathan Dudley
- Reading and Literacy Discovery Center, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Pediatric Neuroimaging Research Consortium, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Reading and Literacy Discovery Center, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Pediatric Neuroimaging Research Consortium, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Educational Neuroimaging Center, Technion, Israel
| | - Tom DeWitt
- Division of General and Community Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Reading and Literacy Discovery Center, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Scott K Holland
- Reading and Literacy Discovery Center, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Pediatric Neuroimaging Research Consortium, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Medpace, Inc., Cincinnati, Ohio
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Hutton JS, Justice L, Huang G, Kerr A, DeWitt T, Ittenbach RF. The Reading House: A Children's Book for Emergent Literacy Screening During Well-Child Visits. Pediatrics 2019; 143:peds.2018-3843. [PMID: 31147486 DOI: 10.1542/peds.2018-3843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The American Academy of Pediatrics recommends literacy promotion and developmental assessment during well-child visits. Emergent literacy skills are well defined, and the use of early screening has the potential to identify children at risk for reading difficulties and guide intervention before kindergarten. METHODS The Reading House (TRH) is a children's book designed to screen emergent literacy skills. These are assessed by sharing the book with the child and using a 9-item, scripted scoring form. Get Ready to Read! (GRTR) is a validated measure shown to predict reading outcomes. TRH and GRTR were administered in random order to 278 children (mean: 43.1 ± 5.6 months; 125 boys, 153 girls) during well-child visits at 7 primary care sites. Parent, child, and provider impressions of TRH were also assessed. Analyses included Rasch methods, Spearman-ρ correlations, and logistic regression, including covariates age, sex, and clinic type. RESULTS Psychometric properties were strong, including item difficulty and reliability. Internal consistency was good for new measures (rCo- α = 0.68). The mean TRH score was 4.2 (±2.9; range: 0-14), and mean GRTR was 11.1 (±4.4; range: 1-25). TRH scores were positively correlated with GRTR scores (r s = 0.66; high), female sex, private practice, and child age (P < .001). The relationship remained significant controlling for these covariates (P < .05). The mean TRH administration time was 5:25 minutes (±0:55; range: 3:34-8:32). Parent, child, and provider impressions of TRH were favorable. CONCLUSIONS TRH is a feasible, valid, and enjoyable means by which emergent literacy skills in 3- and 4-year-old children can be directly assessed during primary care.
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Affiliation(s)
- John S Hutton
- Divisions of General and Community Pediatrics and .,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Laura Justice
- Schoenbaum Family Center and Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio
| | | | - Amy Kerr
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Thomas DeWitt
- Divisions of General and Community Pediatrics and.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
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Eismann EA, Pearl ES, Theuerling J, Folger AT, Hutton JS, Makoroff K. Feasibility study of the calm baby gently program: An educational baby book intervention on safe practices related to infant crying. Child Abuse Negl 2019; 89:135-142. [PMID: 30658174 DOI: 10.1016/j.chiabu.2018.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/13/2018] [Accepted: 12/12/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Abusive head trauma (AHT) is a preventable form of child abuse. OBJECTIVE This project used a mixed method design to assess the feasibility of the Calm Baby Gently educational baby book intervention for promoting safe practices related to infant crying in an effort to prevent AHT. PARTICIPANTS AND SETTING Three pediatric practices participated between June 2016 and January 2018, including 1045 caregivers who attended their infant's 2-month well-child visit. METHODS Pediatric providers gave the educational baby book to caregivers at the 1-month well-child visit. Caregivers completed a survey at the 2-month well-child visit on their use and satisfaction with the book and responses to infant crying. Thematic analysis of qualitative feedback was performed. Responses to infant crying were compared quantitatively between caregivers who had and had not read the book. RESULTS Of the 819 caregivers (78%) who received the book, 92% (754) read it, and 51% (421) had another caregiver read it. Caregivers considered the book approachable, understandable, validating, and helpful for improving knowledge and skills related to infant crying. The book was rated more helpful by caregivers of younger age, male gender, and non-white race. Controlling for age, gender, and race, caregivers who read the book were more confident (p = 0.033) and had more knowledge on how to respond appropriately to infant crying (p = 0.019) than caregivers who had not read it. CONCLUSIONS Calm Baby Gently is a feasible and well-received AHT prevention program. Randomized controlled trials are needed to better understand its impact on knowledge, behavior, and AHT rates.
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Affiliation(s)
- Emily A Eismann
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Eve S Pearl
- Council on Child Abuse, 4531 Reading Rd, Cincinnati, OH, 45229, USA
| | - Jack Theuerling
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Alonzo T Folger
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - John S Hutton
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA
| | - Kathi Makoroff
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA.
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Hutton JS, Dudley J, Horowitz-Kraus T, DeWitt T, Holland SK. Differences in functional brain network connectivity during stories presented in audio, illustrated, and animated format in preschool-age children. Brain Imaging Behav 2018; 14:130-141. [DOI: 10.1007/s11682-018-9985-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Hutton JS, Huang G, Phelan KJ, DeWitt T, Ittenbach RF. Shared reading quality assessment by parental report: preliminary validation of the DialogPR. BMC Pediatr 2018; 18:330. [PMID: 30336785 PMCID: PMC6193299 DOI: 10.1186/s12887-018-1298-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/01/2018] [Indexed: 01/08/2023] Open
Abstract
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.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA. .,Reading and Literacy Discovery Center, Cincinnati, USA.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kieran J Phelan
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA.,Reading and Literacy Discovery Center, Cincinnati, USA
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Abstract
The American Academy of Pediatrics recommends that shared reading commence as soon as possible after birth and screen-based media be discouraged for those less than 18 months old. Early routines can predict long-term use and health outcomes. This longitudinal study involved low-socioeconomic status mothers (n = 282) enrolled in home visiting. Surveys were administered prenatally and at 2 months old regarding shared reading and infant television viewing, and health literacy was screened prenatally. Planned age to initiate reading decreased from 2.8 to 1.8 months old, 80% reading by 2 months old, averaging 1 to 3 days per week, with "too busy" being the major barrier. Planned age for infant TV decreased from 13.2 to 4.3 months old, 68% viewing by 2 months old and more than half daily. TV was observed in 70% of infant sleep environments. Health literacy was correlated with perceived developmental benefits of shared reading (positively) and TV viewing (negatively), 43% of mothers scoring at risk for inadequate levels. A majority cited the prenatal period as opportune to discuss reading and TV.
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Affiliation(s)
- John S Hutton
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Li Lin
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rachel Gruber
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer Berndsen
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas DeWitt
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Robert T Ammerman
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Horowitz-Kraus T, Hutton JS. Brain connectivity in children is increased by the time they spend reading books and decreased by the length of exposure to screen-based media. Acta Paediatr 2018; 107:685-693. [PMID: 29215151 DOI: 10.1111/apa.14176] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/16/2017] [Accepted: 12/01/2017] [Indexed: 12/22/2022]
Abstract
AIM This study compared the time spent using screen-based media or reading on the functional connectivity of the reading-related brain regions in children aged 8-12. METHODS We recruited 19 healthy American children from a private school in Cincinnati, USA, in 2015-6 after advertising the study to parents. The parents completed surveys on how many hours their children spent on independent reading and screen-based media time, including smartphones, tablets, desktop or laptop computers and television. The children underwent magnetic resonance imaging that assessed their resting-state connectivity between the left visual word form area, as the seed area, and other brain regions, with screen time and reading time applied as predictors. RESULTS Time spent reading was positively correlated with higher functional connectivity between the seed area and left-sided language, visual and cognitive control regions. In contrast, screen time was related to lower connectivity between the seed area and regions related to language and cognitive control. CONCLUSION Screen time and time spent reading showed different effects on functional connectivity between the visual word form area and language, visual and cognitive control regions of the brain. These findings underscore the importance of children reading to support healthy brain development and literacy and limiting screen time.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Faculty of Education in Science and Technology; Educational Neuroimaging Center; Technion Israel
- 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
- Pediatric Neuroimaging Research Consortium; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - 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
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Hutton JS, Phelan K, Horowitz-Kraus T, Dudley J, Altaye M, DeWitt T, Holland SK. Shared Reading Quality and Brain Activation during Story Listening in Preschool-Age Children. J Pediatr 2017; 191:204-211.e1. [PMID: 29173308 PMCID: PMC5728185 DOI: 10.1016/j.jpeds.2017.08.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/07/2017] [Accepted: 08/16/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To explore the relationship between maternal shared reading quality (verbal interactivity and engagement) and brain function during story listening in at-risk, preschool-age children, in the context of behavioral evidence and American Academy of Pediatrics, recommendations. STUDY DESIGN In this cross-sectional study, 22 healthy, 4-year-old girls from low socioeconomic status households completed functional magnetic resonance imaging using an established story listening task, followed by videotaped observation of uncoached mother-daughter reading of the same, age-appropriate picture book. Shared reading quality was independently scored applying dialogic reading and other evidence-based criteria reflecting interactivity and engagement, and applied as a predictor of neural activation during the functional magnetic resonance imaging task, controlling for income and maternal education. RESULTS Shared reading quality scores were generally low and negatively correlated with maternal distraction by smartphones (P < .05). Scores were positively correlated with activation in left-sided brain areas supporting expressive and complex language, social-emotional integration, and working memory (P <.05, false discovery rate corrected). CONCLUSIONS Maternal shared reading quality is positively correlated with brain activation supporting complex language, executive function, and social-emotional processing in at-risk, preschool-age children. These findings represent novel neural biomarkers of how this modifiable aspect of home reading environment may influence foundational emergent literacy skills, reinforce behavioral evidence and American Academy of Pediatrics, recommendations, and underscore the potential of dialogic reading interventions to promote healthy brain development, especially in at-risk households.
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Affiliation(s)
- John S. Hutton
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Kieran Phelan
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Jonathan Dudley
- Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Mekibib Altaye
- Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Division of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Tom DeWitt
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Scott K. Holland
- Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Pediatric Neuroimaging Research Consortium, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Division of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
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Hutton JS, Gupta R, Gruber R, Berndsen J, DeWitt T, Ollberding NJ, Van Ginkel JB, Ammerman RT. Randomized Trial of a Children's Book Versus Brochures for Safe Sleep Knowledge and Adherence in a High-Risk Population. Acad Pediatr 2017; 17:879-886. [PMID: 28450082 DOI: 10.1016/j.acap.2017.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/14/2017] [Accepted: 04/15/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Sleep-related infant deaths have plateaued in the past decade, disproportionately affecting low socioeconomic status (SES) families. Printed materials are widely used for anticipatory guidance, yet none for safe sleep has been studied. We tested the efficacy of a specially designed children's book compared to brochures for safe sleep knowledge and adherence, which we hypothesized would be greater due to superior readability and engagement. METHODS This randomized controlled trial involved low-SES mothers (n = 282) enrolled in a home visiting program. Home visitors (n = 56) were randomly assigned to perform safe sleep teaching and assessments during 3 visits: third trimester, 1 week old, and 2 months old, exclusively utilizing a specially designed children's book or brochures, and surveys incorporating the American Academy of Pediatrics' safe sleep recommendations. Outcomes were safe sleep knowledge, adherence, and usefulness of materials, controlling for maternal health literacy. RESULTS Safe sleep knowledge increased across all time points with no overall group difference, though gains for sleep-evocative and general health items varied. Odds of bed sharing were higher and exclusive crib use lower for the brochure group (P < .05). Mothers and home visitors reported similar usefulness, though home visitors reported greater dialogue via the book and mothers in the book group reported more book sharing with their baby. CONCLUSIONS While a specially designed children's book and brochures were equally effective conveying aggregate safe sleep knowledge in low-SES mothers, adherence to exclusive crib use and avoiding bed sharing were greater in the book group, attributable to enhanced dialogue, readability and emotional engagement. Children's books are a promising mode of anticipatory guidance, warranting further investigation.
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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.
| | - Resmi Gupta
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rachel Gruber
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jennifer Berndsen
- Every Child Succeeds, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Thomas 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
| | - Nicholas J Ollberding
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Judith B Van Ginkel
- Every Child Succeeds, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert T Ammerman
- Every Child Succeeds, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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27
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Hutton JS, Phelan K, Horowitz-Kraus T, Dudley J, Altaye M, DeWitt T, Holland SK. Story time turbocharger? Child engagement during shared reading and cerebellar activation and connectivity in preschool-age children listening to stories. PLoS One 2017; 12:e0177398. [PMID: 28562619 PMCID: PMC5451016 DOI: 10.1371/journal.pone.0177398] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 04/26/2017] [Indexed: 11/20/2022] Open
Abstract
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.
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Affiliation(s)
- John S. Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Kieran Phelan
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Education Neuroimaging Center, Faculty of Education in Science and Technology, Technion, Haifa, Israel
| | - Jonathan Dudley
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Mekibib Altaye
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Scott K. Holland
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Communication Sciences Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
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Horowitz-Kraus T, Schmitz R, Hutton JS, Schumacher J. How to create a successful reader? Milestones in reading development from birth to adolescence. Acta Paediatr 2017; 106:534-544. [PMID: 28067419 DOI: 10.1111/apa.13738] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/19/2016] [Accepted: 12/30/2016] [Indexed: 12/01/2022]
Abstract
Reading is one of the most important academic abilities that establishes the foundation for a child's success in school. Therefore, early and accurate diagnosis of reading challenges is crucial for prevention of later academic failure. One challenge in early detection of reading difficulties is that the ability to read typically is acquired explicitly when a child is four to six years of age. However, reading ability relies on development of more basic abilities prior to reading acquisition, starting from birth. CONCLUSION Language, cognitive control and literacy milestones can be evaluated and trained from birth to better acquire reading later in life.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Educational Neuroimaging Center; Faculty of Education in Science and Technology; Technion Haifa Israel
- Reading and Literacy Discovery Center; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
- Pediatric Neuroimaging Research Center; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - Rachelle Schmitz
- Reading and Literacy Discovery Center; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - John S. Hutton
- Reading and Literacy Discovery Center; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - Jayna Schumacher
- Reading and Literacy Discovery Center; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
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Hutton JS, Horowitz-Kraus T, Mendelsohn AL, DeWitt T, Holland SK. Home Reading Environment and Brain Activation in Preschool Children Listening to Stories. Pediatrics 2015; 136:466-78. [PMID: 26260716 PMCID: PMC9923605 DOI: 10.1542/peds.2015-0359] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Parent-child reading is widely advocated to promote cognitive development, including in recommendations from the American Academy of Pediatrics to begin this practice at birth. Although parent-child reading has been shown in behavioral studies to improve oral language and print concepts, quantifiable effects on the brain have not been previously studied. Our study used blood oxygen level-dependent functional magnetic resonance imaging to examine the relationship between home reading environment and brain activity during a story listening task in a sample of preschool-age children. We hypothesized that while listening to stories, children with greater home reading exposure would exhibit higher activation of left-sided brain regions involved with semantic processing (extraction of meaning). METHODS Nineteen 3- to 5-year-old children were selected from a longitudinal study of normal brain development. All completed blood oxygen level-dependent functional magnetic resonance imaging using an age-appropriate story listening task, where narrative alternated with tones. We performed a series of whole-brain regression analyses applying composite, subscale, and individual reading-related items from the validated StimQ-P measure of home cognitive environment as explanatory variables for neural activation. RESULTS Higher reading exposure (StimQ-P Reading subscale score) was positively correlated (P < .05, corrected) with neural activation in the left-sided parietal-temporal-occipital association cortex, a "hub" region supporting semantic language processing, controlling for household income. CONCLUSIONS In preschool children listening to stories, greater home reading exposure is positively associated with activation of brain areas supporting mental imagery and narrative comprehension, controlling for household income. These neural biomarkers may help inform eco-bio-developmental models of emergent literacy.
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Affiliation(s)
- John S. Hutton
- Division of General and Community Pediatrics,,Address correspondence to John S. Hutton, MD, Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 7035, Cincinnati, OH 45229. E-mail:
| | - Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics,,Pediatric Neuroimaging Research Consortium,,Communication Sciences Research Center, and
| | - Alan L. Mendelsohn
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, New York
| | - Tom DeWitt
- Division of General and Community Pediatrics
| | - Scott K. Holland
- Pediatric Neuroimaging Research Consortium,,Communication Sciences Research Center, and,Division of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; and
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Horowitz-Kraus T, Hutton JS. From emergent literacy to reading: how learning to read changes a child's brain. Acta Paediatr 2015; 104:648-56. [PMID: 25847632 DOI: 10.1111/apa.13018] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 02/18/2015] [Accepted: 03/31/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED The ability to comprehend language is uniquely human. Behavioural and neuroimaging data reinforce the importance of intact oral language as foundational for the establishment of proficient reading. However, proficient reading is achieved not only via intact biological systems, but also a stimulating Home Literacy Environment. CONCLUSION Behavioural and neuroimaging correlates for linguistic ability and literacy exposure support the engagement of neural circuits related to reading acquisition.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Division of General and Community Pediatrics; Reading and Literacy Discovery Center; Cincinnati OH USA
- Pediatric Neuroimaging Research Consortium; Cincinnati OH USA
- Communication Sciences Research Center; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - John S. Hutton
- Division of General and Community Pediatrics; Reading and Literacy Discovery Center; Cincinnati OH USA
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31
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Abstract
The issue of electronic media use by young children is increasingly important in pediatrics, a major risk factor for numerous chronic conditions. Despite guidelines in place since 1999, screen time is on the rise, aided by new formats removing practically all barriers of use. Key drivers are technological allure, confusion about developmental readiness, and perception of educational value, fueled by potent marketing. This article describes the development of Baby Unplugged, a series of children's board books celebrating "old-school," screen-free childhood. Written by a pediatrician who also owns a children's bookstore, the books were inspired and informed by advocacy projects in the areas of media use and early literacy as a pediatric resident. They reinforce AAP Electronic Media Guidelines, notably discouraging screen-based media under 2 years old, largely by encouraging healthy, fun alternatives. Examples include Pets, Book, and Yard. Multi-sensorial exploration and parent-child engagement are emphasized in a non-prescriptive way, featuring gender and ethnic diversity and activities that are accessible and inexpensive. The author describes challenges faced by pediatricians providing anticipatory guidance for media use, given limited time and resources and the perception that we are out of touch. This is heightened by oft-deceptive marketing of screen-based products more likely to be perceived as "cool." Reach Out and Read is cited as an example of a successful, "cool" intervention, though limited to select populations. Baby Unplugged takes advocacy to the marketplace, where the screen time battle is being lost.
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Affiliation(s)
- John S Hutton
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45209, USA.
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