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Over the years, home visiting programs have been proven to improve the health and well-being of children and their parents by providing much-needed support, education and resources during the challenging months after a child’s birth. But obstacles to expansion remain: Some families are particularly hard to reach and parents may feel uncomfortable inviting strangers into their homes.

A new study shows there may be an effective solution to these challenges: adding parent support programs to regular well check visits at pediatricians’ offices.

The study, which was published in The Journal of Pediatrics in December, looked at Smart Beginnings, a family support program in low-income communities aimed at promoting responsive parent-child interactions during infancy and toddlerhood. The program combines two separate parent-support elements that have independently been proven to improve parenting: video interaction during well-child visits within pediatric offices and brief home visits for select families in need of more support.

Researchers found the program “significantly promoted” parents engaging in cognitively stimulating activities with their children, leading to an increase in talking to children, reading with children and the use of rich language — deliberately exposing children to a broad vocabulary throughout their daily activities.

“It actively promotes these positive things that we think matter for kids,” said Elizabeth Miller, the study’s lead investigator and an assistant professor in the Department of Population Health at NYU’s Grossman School of Medicine. These behaviors continued as children aged from infancy to toddlerhood, suggesting the program is successful at helping parents meet the varying and ever-changing cognitive needs of young children, Miller added.

During the video interactions, a coach meets with the parent, talks about the child’s development, gives the parent a developmentally appropriate book or toy and then records the parent interacting with their child for three to five minutes. That video is then reviewed on the spot with the coach, who reinforces the positive interactions recorded; the parent receives a copy of the video to take home.

The home visits, or family check-ups, are provided to families based on factors such as maternal depression, concerns over child behavior and development or involvement with the state’s child protective services department. These visits are led by a social worker or clinician who can help families connect with other services and provide more tailored parenting and family support. Clinicians focus on supporting parent-child relationships, affirming positive interactions between parents and children and encouraging parents to read and play with their children, feedback that “all parents can benefit from,” Miller said.

Both aspects of the program are meant to be easy for parents to fit into their lives, Miller said. “It’s not super intensive,” she said, “It’s not a ton of burden.” The next step in research on Smart Beginnings is to study outcomes for kids, Miller added. She and her colleagues will now collect school readiness data to determine if the programs are enhancing child language and math outcomes, as well as executive function and behavior.

“Parenting is a critical mediator of school readiness,” Miller said. “The thought is, if we can help parents themselves, will that ultimately affect kids?”

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