Promoting Early Language Development Through Parent-child Book Reading in Costa Rica

Language Development Clinical Trial

Official title:

Early Childhood Interventions to Reduce Inequality in Educational Opportunities

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04978766
• Other study ID #: 723-B9-343
• Secondary ID: R019-SABI-00235
• Status: Completed
• Phase: N/A
• Start date: August 13, 2021
• Est. completion date: September 10, 2022

Study information

• Verified date: December 2023
• Source: Universidad de Costa Rica
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to analyze the effect of an interactive parent-child book reading intervention. The intervention includes two components: the provision of five children's books to parent-child dyads and information about how to practice interactive book reading. The investigators expect to find an effect of this intervention on a) infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies.

Description:

The foundations of optimal health, growth and development are forged early in life, when income-related gaps in learning opportunities already exist in Costa Rica. It is therefore important for the government to mitigate the effects of these gaps through programs targeting the development of academic, behavioral, socioemotional and economic abilities. Key to the success of such programs is to consider physical health, nutrition, responsive care and early learning. Multiple government-led initiatives in Costa Rica had been carried out in order to provide adequate programs for infants and young children. Evidence of these efforts are observed in the low rates attained in infant mortality, malnutrition and anemia, as well as the high coverage of the current immunization program. However, policies targeting early learning in children under 36 months of age are incipient and government initiatives in this regard are relatively recent.

The purpose of this study is to promote early language development, a central component of early learning. Our goal is to implement and evaluate a low-cost intervention targeting parents of infants who benefit from the existing immunization program of the public health services offered by the Caja Costarricense del Seguro Social (Costa Rican Social Security Fund).

The investigators will use an experimental design to randomly assign 15- to 17-month-old infants and their caregivers to one of two groups: a control group or an experimental group. In the experimental group, caregivers will receive a package including five children's books and 36 text messages with information on how to practice interactive book reading with their children. This information will be delivered over a period of 12 weeks. The control group will not receive any treatment during the implementation of the intervention.

In order to measure the efficacy of the intervention, the investigators will evaluate a) infants' expressive vocabulary, b) parent-child reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies at baseline (15-17 months of age) and at posttest (18-20 months of age) in the control and the experimental group. After posttest, the control group will receive the complete intervention.

The investigators expect to find an effect of the interactive book reading intervention on a) infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 184
• Est. completion date: September 10, 2022
• Est. primary completion date: September 10, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 15 Months to 17 Months

Eligibility

Inclusion criteria for infants:

• Age limits: 15 months to 17 months.

• Sex: All.

• Infant was born full term (= 37 weeks).

• Infant is raised in a monolingual Spanish-speaking home.

Inclusion criteria for mothers:

• Mother knows how to read and write.

• Mother has access to cell phone with internet.

Exclusion Criteria:

• Neither caregivers nor infants must have any significant known physical, mental or learning disability.

Related Conditions & MeSH terms

• Language Development

Intervention

Behavioral:
• Interactive Book Reading
The intervention is a package including five children's books and information on how to practice interactive book reading. Information includes 36 audiovisual products delivered via text messaging over a 12-week period. Products include: An introductory video about interactive book reading, along with a written list of recommendations on how to practice interactive book reading. Two videos of child development experts explaining the benefits of interactive reading. Thirty written text messages strengthening content provided in the videos. Three audio messages guiding the progress of the intervention. Based on Abraham and Michie's (2008) taxonomy of behavior change techniques, one audiovisual product prompts specific goal settings, 13 provide instruction, one provides information on consequences, 10 prompt practice, three use follow-up prompts, one prompts self-monitoring of behavior, one models or demonstrates the behavior and six prompt barrier identification.

Locations

Country	Name	City	State
Costa Rica	Área de Salud (CCSS), Desamparados 2	Desamparados	San José
Costa Rica	Área de Salud (CCSS), Santo Domingo de Heredia	Santo Domingo	Heredia

Sponsors (2)

Lead Sponsor	Collaborator
Universidad de Costa Rica	Caja Costarricense de Seguro Social

Country where clinical trial is conducted

Costa Rica, 

References & Publications (10)

Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008 May;27(3):379-87. doi: 10.1037/0278-6133.27.3.379. — View Citation

Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, McCoy DC, Fink G, Shawar YR, Shiffman J, Devercelli AE, Wodon QT, Vargas-Baron E, Grantham-McGregor S; Lancet Early Childhood Development Series Steering Committee. Early childhood develo — View Citation

Cusick SE, Georgieff MK. The Role of Nutrition in Brain Development: The Golden Opportunity of the "First 1000 Days". J Pediatr. 2016 Aug;175:16-21. doi: 10.1016/j.jpeds.2016.05.013. Epub 2016 Jun 3. No abstract available. — View Citation

Dreyer, B. P., Mendelsohn, A. L., & Tamis-LeMonda, C. S. (1996). Assessing the child's cognitive home environment through parental report; reliability and validity. Early Development and Parenting: An International Journal of Research and Practice, 5(4),

Instituto Nacional de Estadística y Censos. (2018). Mortalidad Infantil y Evolución Reciente 2018 I Semestre. Datos Preliminares. Volumen 1, Año 14.

Jackson-Maldonado, D., Marchman, V. A., & Fernald, L. C. (2013). Short-form versions of the Spanish MacArthur-Bates Communicative Development Inventories. Applied Psycholinguistics, 34(4), 837-868.

Ministerio de Salud, Instituto Nacional de Estadística y Censos, & Fondo de las Naciones Unidas para la Infancia. (2018). Encuesta de mujeres, niñez y adolescencia (EMNA).

Mol, S. E., Bus, A. G., De Jong, M. T., & Smeets, D. J. (2008). Added value of dialogic parent-child book readings: A meta-analysis. Early education and development, 19(1), 7-26.

Muhinyi, A., & Rowe, M. L. (2019). Shared reading with preverbal infants and later language development. Journal of Applied Developmental Psychology, 64, 101053. https://doi.org/10.1016/j.appdev.2019.101053

Suskind, D. L., Leung, C. Y., Webber, R. J., Hundertmark, A. C., Leffel, K. R., Suskind, E., Hernandez, M. W., & Graf, E. (2018). Development of the survey of parent/provider expectations and knowledge (SPEAK). First Language, 38(3), 312-331.

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in infant expressive vocabulary	Infant expressive vocabulary will be measured with the short form (SF) Spanish versions of the MacArthur-Bates Communicative Development Inventories (CDI). Parents will complete version I (CDI-SFI) of the inventory at baseline and version II (CDI-SFII) of the inventory at posttest. Scores on the CDI-SFI inventory range from 0 to 104. Scores on the CDI-SFII inventory range from 0 to approximately 100-135, depending on the complexity of the participant's linguistic production. For both inventories, higher scores indicate a better outcome.	Baseline [15 to 17-months] and Posttest [18 to 20-months].
Secondary	Change in parental report of reading activities	Parental report of reading activities will be measured with the Spanish version of the Reading Subscale (READ) of the Cognitive Home Environment Questionnaire (StimQ-Toddler). Scores range from 0 to 19. Higher scores indicate a better outcome.	Baseline [15 to 17-months] and Posttest [18 to 20-months].
Secondary	Change in parental expectations and knowledge about language development	Parental report of expectations and knowledge about language development will be measured with the Spanish version of the Survey of Parent/Provider Expectations and Knowledge (SPEAK), a self-administered questionnaire assessing expectations and knowledge about early childhood cognitive and language development. Scores range from 0 to 54. Higher scores indicate a better outcome.	Baseline [15 to 17-months] and Posttest [18 to 20-months].
Secondary	Change in parental use of interactive book reading strategies	Video recordings of parent-child dyads reading books at baseline and posttest will be analyzed for quantity of interactive book reading strategies. Videos will be first transcribed and subsequently coded according to the following coding categories: word tokens, word types, mean length of utterance, number of questions and pointing tokens. Range of scores depends on participants' communicative/linguistic production. Higher scores indicate a better outcome.	Baseline [15 to 17-months] and Posttest [18 to 20-months].