TMW Center for Early Learning + Public Health, University of Chicago, Chicago, IL.
TMW Center for Early Learning + Public Health, University of Chicago, Chicago, IL.
J Pediatr. 2020 Jun;221:72-80. doi: 10.1016/j.jpeds.2019.12.021. Epub 2020 Jan 24.
To examine the mediating role of socioeconomically disadvantaged parents' knowledge of early cognitive and language development at the first postpartum visit in the relation between education and caregiving behaviors at 9 months.
Parental knowledge was assessed at the 1-week newborn visit (n = 468); anticipatory guidance received and desired at 1-month (n = 212) and 6-month (n = 191) visits were reported; and caregiving behaviors toward infants during a teaching task were observed at 9-month visit (n = 173).
We found substantial variation in knowledge and caregiving behaviors. Parents who had more knowledge of infant development at 1 week were more likely to respond to cues (r = 0.18; P < .05) and foster social-emotional (r = 0.17; P < .05) and cognitive growth (r = 0.20; P < .05) at 9 months. Importantly, the indirect effect of education on cognitive growth fostering at 9 months through knowledge at 1 week was significant, controlling for primary language and number of other children in the home (infancy: β = 0.06; B = 0.07; SE = 0.04; 95% CI, 0.007-0.165; early childhood: β = 0.04; B = 0.06; SE = 0.03; 95% CI, 0.008-0.152). Open-ended responses indicated that anticipatory guidance in the first 6 months focused on infant physical growth; however, parents did not request additional anticipatory guidance from their pediatricians.
This study sheds light on the importance of promoting parental knowledge about cognitive and language development to foster parental cognitive stimulations and language inputs during the first year of life. This study highlights the important role of anticipatory guidance on cognitive and language development during the earliest well-child visits and the need to better understand parental baseline knowledge to tailor anticipatory guidance to the family strengths and needs.
探讨社会经济地位处于不利地位的父母在产后第一访时对早期认知和语言发展知识的中介作用，以及这种知识与 9 个月时养育行为之间的关系。
在新生儿出生后 1 周（n=468）时评估父母的知识水平；在 1 个月（n=212）和 6 个月（n=191）时报告接受和期望的预期指导；在 9 个月（n=173）时观察在教学任务中婴儿的养育行为。
我们发现知识和养育行为存在很大差异。在 1 周时对婴儿发育知识较多的父母更有可能对线索做出反应（r=0.18；P<.05），并在 9 个月时促进社交情感（r=0.17；P<.05）和认知成长（r=0.20；P<.05）。重要的是，在控制了家庭中主要语言和其他儿童数量后，教育对 9 个月时认知成长促进的间接效应通过 1 周时的知识是显著的（婴儿期：β=0.06；B=0.07；SE=0.04；95%CI，0.007-0.165；幼儿期：β=0.04；B=0.06；SE=0.03；95%CI，0.008-0.152）。开放性回答表明，前 6 个月的预期指导侧重于婴儿的身体发育；然而，父母并没有要求儿科医生提供更多的预期指导。
本研究阐明了促进父母对认知和语言发展知识的重要性，以促进父母在生命的第一年对认知刺激和语言输入的刺激。本研究强调了预期指导在最早的幼儿健康访视中对认知和语言发展的重要作用，以及需要更好地了解父母的基线知识，以便根据家庭优势和需求调整预期指导。
