Department of Pediatrics, University of Washington, Seattle.
Seattle Children's Research Institute, Seattle, Washington.
JAMA Netw Open. 2019 Jun 5;2(6):e195738. doi: 10.1001/jamanetworkopen.2019.5738.
Parent-child interactions are critical for language development in early life.
To test whether a clinic-based intervention was associated with improved home language environment and language development.
DESIGN, SETTING, AND PARTICIPANTS: A pre-post study of a multifaceted clinic-based intervention called Talk It Up was conducted for 61 English- or Spanish-speaking families with children aged 2 to 12 months. Enrollment took place at a single urban pediatric clinic from January to November 2017, with follow-up data collection through May 2018. Analyses took place from June to August 2018.
The 6-month multifaceted intervention consisted of delivering Language Environment Analysis word counts with clinician feedback, coaching, and twice-weekly pushes of brief instructional videos via a commercially available smartphone application.
Baseline and follow-up z scores for adult word counts, parent-child conversational turns, and child vocalizations and language development as measured by the Developmental Snapshot score were compared and adjusted for confounders.
Among 61 families, the mean (SD) child's age at baseline was 5.9 (3.3) months. English was the primary language spoken in the home for 54 families (89%). At follow-up, Talk It Up was associated with significant improvements in adult word counts (mean z score, 0.30; 95% CI, 0.05-0.55), parent-child conversational turns (mean z score, 0.29; 95% CI, 0.002-0.59), and Developmental Snapshot score (mean, 6.59; 95% CI, 0.95-12.23), but there were no improvements in child vocalizations (mean z score, -0.13; 95% CI, -0.49 to 0.24).
A multifaceted clinic-based approach to promote parent-child interactions holds some promise. Future, larger studies are warranted.
亲子互动对儿童早期的语言发展至关重要。
测试基于诊所的干预措施是否与改善家庭语言环境和语言发展有关。
设计、地点和参与者：一项名为“Talk It Up”的基于诊所的多方面干预措施的前后研究，针对 61 个英语或西班牙语家庭的 2 至 12 个月大的儿童进行。招募于 2017 年 1 月至 11 月在一家单一的城市儿科诊所进行，通过一款商业上可用的智能手机应用程序提供语言环境分析字数、临床医生反馈、指导和每周两次的简短教学视频推送，以进行后续数据收集。分析于 2018 年 6 月至 8 月进行。
为期 6 个月的多方面干预措施包括提供语言环境分析字数，以及临床医生的反馈、指导和通过一款商业上可用的智能手机应用程序每周推送两次简短教学视频。
比较并调整了背景和随访时的成人单词计数、亲子对话次数和儿童发声以及发育快照评分测量的语言发展的 z 分数。
在 61 个家庭中，儿童的平均（SD）年龄为 5.9（3.3）个月。54 个家庭（89%）的主要语言是英语。在随访时，Talk It Up 与成人单词计数（平均 z 分数，0.30；95%置信区间，0.05-0.55）、亲子对话次数（平均 z 分数，0.29；95%置信区间，0.002-0.59）和发育快照评分（平均值，6.59；95%置信区间，0.95-12.23）的显著改善相关，但儿童发声（平均 z 分数，-0.13；95%置信区间，-0.49 至 0.24）没有改善。
一种基于诊所的促进亲子互动的多方面方法有一定的前景。未来需要更大规模的研究。
