Alan L. Mendelsohn
A pediatric primary care program that promoted reading out loud and playing with children aged 0 to 5 years resulted in a reduction of hyperactivity and attention problems at the age when the children started school, according to study results published in Pediatrics.
“In an NIH/National Institute of Child Health and Human Development-funded randomized controlled trial, we showed that a birth to 3 year pediatric parenting program (Video Interaction Project [VIP]) was associated with improved attention and reduced hyperactive and aggressive behaviors at school entry, two years after program completion,” Alan L. Mendelsohn, MD, of the pediatrics department, School of Medicine, New York University, and Bellevue Hospital Center, New York, told Infectious Diseases in Children. “Continuation of the VIP program from age 3 to 5 years resulted in even greater impacts.”
The researchers performed a randomized control trial at Bellevue Hospital Center, an urban hospital serving low-income families, to determine how the Video Interaction Project (VIP), a pediatric primary care intervention, would impact social-emotional development at school entry by promoting “positive parenting.” through reading aloud and playing. There were two phases to the intervention, infant through toddler (VIP birth to 3 years [VIP 0-3]) and preschool age (VIP 3 to 5 years [VIP 3-5]). Mother and infant dyads were enrolled and randomly assigned postpartum between November 2005 and October 2008.
In the initial enrollment, participants were assigned to VIP 0-3, control 0-3 years and a third group without school entry (Building Blocks [BB]). At 3 years, a second random assignment of participants included the families in VIP 0-3, and control 0-3 years to VIP 3-5 or control 3-5 years. The BB cohort did not participate in the 3-year program.
There were 675 families enrolled in the postpartum portion of the trial, including 450 who were randomly assigned to VIP 0-3 or control 0-3 years, with 61.1% completing a 4.5-year assessment. Of the 450 families in VIP 0-3 or control 0-3 years, 296 were randomly assigned at 3 years, with 85.1% completing a 4.5-year assessment.
Parents and children in the VIP group read or played using provided learning materials and were video recorded by a bilingual facilitator, who reviewed the videos with the parents. Parent-report Behavior Assessment System for Children, Second Edition, which included social skills, attention problems, hyperactivity, aggression and externalizing problems, was used to measure social-emotional development at 4.5 years.
There was an independent association between VIP 0-3 and VIP 3-5 and improved 4.5-year Behavior Assessment System for Children, Second Edition T-scores (Cohen’s d) ~ –0.25 to –0.30. A reduction in hyperactivity was associated combined VIP 0-3 and VIP 3-5 (d = –0.63; P =.001).
Reduction of “clinically significant hyperactivity” also was achieved in the VIP 0-3 cohort (RR reduction for overall sample, 69.2%; P = .03; RR reduction for increased psychosocial risk, 100%; P = .006).
“Pediatricians can let parents know that early literacy activities such as reading aloud, pretend play, teaching and talking beginning at birth can help support behaviors that will be important for learning when children enter school,” Mendelsohn said. “Pediatric early literacy programs, such as Reach Out Read and VIP can make a very big difference for families.” – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.