Tag Archives: at risk children

Feed, Read, Play and Thrive (Article)

Malnutrition can stunt child development, but what about improper and infrequent social interaction? Could isolation inhibit a child’s psychological growth? Dr. Paul Gertler of the University of California at Berkley thinks it can. Dr. Gertler and his colleagues set out to determine if providing appropriate socialization could help disadvantaged children succeed in the academic and employment worlds. Maybe programs such as “Feeding America” would be more effective if social welfare agencies were able to improve the parent-child interaction. Could proper socialization of young children really make that much of a difference? To answer this question, Dr. Gertler conducted a twenty-year longitudinal study of malnourished Jamaican babies. His results are amazing! On a weekly basis from the ages of one to four, researchers provided structured positive social interaction and nutritional support to the experimental group, solely nutritional supplements to one control group, and no support at all to the final control group. At age twenty, the nutrition-plus-social-interaction group were earning 25% more than the controls, less likely to commit a crime, more physically fit, and more successful in school. The success of the experimental group over the controls led Dr. Gertler to conclude that nutrition is not the only factor controlling a disadvantaged child’s well being—frequent and healthy social interaction can help prepare a child for a productive life. Although many programs provide adequate food to struggling families, offering healthy social interactions to toddlers and young preschoolers may be just as important. Is it surprising that giving young children attention and stimulating their language/cognitive development can have a positive impact on their adult lives? The Head Start Program was designed in the 1960’s to provide social and cognitive stimulation to low income children, ages 3-5 years. Today, a similar kind of assistance is available through The Early Head Start program, reflecting the changing tide in child development research. We now know that by helping a child learn language and social skills from a very young age, we improve their chance of achieving success. With what we have learned recently about the negative effects of stress and deprivation on infants and toddlers combined with this new information that social skills training in very young children can dramatically improve their lives, we can begin improve academic and societal performance and maybe even help win the war on poverty.  Let’s hope so. Your comments are welcome at www.docsmo.com. Until next time.

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Smo Notes: 1. http://www.sciencemag.org/content/344/6187/998 Written collaboratively by Sam Allen and Paul Smolen M.D.

“Instant Replays”, Not just for football anymore! (Article)

As a new school year starts, teachers and parents are once again confronted with the reality that many children are not ready to start school and do not have adequate language skills to excel in school. These children come predominantly from poor backgrounds and are already far behind when they first enter school. It is estimated that a child from a poor home knows only 25% of the vocabulary that a child from a “privileged” background knows. To overcome this deficit in language and to promote school readiness among low-income children, the Bellevue Hospital in New York outpatient pediatric clinic pioneered what they call the VIP or (Video Interaction Project).


VIP takes advantage of the periodic checkups when parents bring their children to the hospital’s well childcare clinic for their routine healthcare visits.  Before or after seeing the doctor, participating families have a session with a child development specialist who sits down with the parent and child, and observes their interactions, even recording some of it on tape. The specialist will later play back the video to the parent and give them suggestions and feedback about their own parent-child interactions, reinforcing the positive behavior and allowing time for self-reflection and growth.


Research shows that the VIP approach is having a positive effect on the low income families studied so far because the parent gets to actually see what their parenting looks like on tape, giving them a totally different perspective on their own parenting skills. Sometimes when you are doing things one way for a long time, it can be hard to see better alternatives. The advice given by the specialist is individualized, so the parents can know exactly what behavior to change.


The VIP project is designed to improve the language skills of the low-income children it serves. In addition to parent coaching, the VIP sessions also provide educational pamphlets for parents, age appropriate toys and books.The results of the first phase of study are now in showing that  VIP was effective. On average, VIP parents were more responsive verbally to  their children, read more to them, and generally improved their parenting skills compared to parents who did not participate.The research continues to find ways to give low-income children a better chance at school success. The doctors leading the study plan to do more research to see if VIP can be applied to other low-income groups. Not everyone is born knowing how to be a parent, and VIP seems like a great way to help parents improve the critical skills that might help.  Let’s wish them tremendous success.


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 Smo Notes:



Written collaboratively by Catherine Wu and Paul Smolen M.D.