Tag Archives: child development

“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.


If you like hearing about what is new in the world of pediatrics, take a few moments to explore the hundreds of articles, book reviews, videos, and audio posts at www.docsmo.com.  You’ll be glad you did.  Until next time.

 Smo Notes:



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


Screen Time: The first 2 years (Pedcast)

Today’s podcast is full of practical, relevant information about the effect of screens on very young children. Listeners will find out what the “experts” in child development are learning about the effects of TV and other screens on children less than 2 years of age. Get in on the discussion and listen. You will be glad you did.


DocSmo here, your pedcast host. Thanks for joining me today for another installment of DocSmo.com bringing you relevant parenting information that will help parents from preschool to grad school.

Get ready for a lively discussion of a topic that, until recently, I knew very little about.

Today, I am going to bring you some new research with regards to screen time in children less than 2 years old.

I am going to talk about information that was presented at the October AAP meeting

Based on this research, things looking bad for educational videos but things are looking pretty good for traditional play.

You will see from today’s discussion that experts feel that screen time actually may interfere with parents talking to their children which has the effect of reducing a child’s language stimulation, creative play time, and problem solving abilities.

The conclusions of recent research really make sense;. Children learn best when they have the direct, one on one guidance by a caring adult, especially their parents

Lets explore this a little in today’s podcast.


I encourage you to read the specifics of the AAP statement which I have linked on my site in what I call  Smo notes.  It is really very interesting and I think it may change some of your basic, core concepts about parenting.  It did mine.

I will attempt to summarize the conclusions for you now:

Children, less that 2 years of age do not have good enough language ability to understand much of the content presented by a screen and therefore do not learn language as well from a screen as they do from an parent.

In fact, time they spend watching videos or TV under 2 years of age lessens their time talking to an adult or older child and actually SLOWS their language learning!

Background TV is also harmful as it distracts a parent from talking to their children.  A fact that is born out by recent research.

Infant and toddler programming may be entertaining, but should not be marketed as educational because there is no evidence that it is.

And finally, parents who allow TV in their child’s bedroom may be adversely affecting their child’s quality of sleep not to mention allowing too much screen time.


OK, so that’s what the experts say but let’s talk about the real world.  Easy access to TV and other screens is a fact of our daily lives.  We need to learn to live with them.

I don’t know about you but almost every time I read a new AAP set of recommendations, I begin to feel guilty about the was my wife and I treated our children.  I agree with the AAP that traditional play is better for very young children than watching a screen but I am skeptical about the background exposure argument.

Think about it, you could make the same arguments about radio, books, newspapers, or even having guests at your house. Lots of things interfere with a parent talking to their children.  Should we ban these as well? I think most of us would say not and I suspect that most pediatricians have not followed all the academy recommendations when their children were under 2 years of age.



I think we should think of these new recommendations as goals and not absolutes rules, for instance:

Parents should try and maximize language stimulation to their children. Talk to them and reinforce their language, especially in toddlers.  It is easy to forget that they are learning a new language.

Read to your children whenever you can.

Don’t use the TV as a babysitter.

Try not to have meals in front of a TV,  it is distracting to everyone and inhibits conversation.

Creative toys or real world objects that they can play with and manipulate are much better than educational videos, especially for children under 18 months.

Whenever possible, get down on the floor and play with your children. They learn from imitation and your presence makes exploration fun.

If possible, supervise your children’s TV viewing explaining, teaching, and reinforcing your values as they relate to the show.

And finally, here is an absolute in my mind: do not allow your children to have a TVs or video games in their bedrooms.  Their sleep quality may be harmed and with the screen in their control, enforcing limits on screen time becomes virtually impossible.


Children must be good learners and language is essential to that learning. For a moment, imagine you were dropped off in a country where you spoke none of the language and you needed to learn to communicate as fast as possible.  Which do you think would be the easiest and fastest way to learn the new language;  by being dropped off in a movie theater and watching many, many hours of film or by having a private tutor teach you the language by showing you things, one word at a time?

-The answer is obvious…. The tutor.

-I think this is a good analogy to what young children are up against making sense of their world and is in keeping with the new research.

I hope you found that discussion useful.

My goal is to always bring you practical and relevant information that you can USE.

If you found this information useful, explore the DocSmo library for other topics.

I post a pedcast weekly as well as other content such as short essays and my lunchtime interviews with my partners which I call the lunchroom lowdown.

To get the latest content right away, make sure to subscribe on itunes, like DocSmo on face book or follow me on twitter.

While your at it, tell a friend who might also enjoy learning new things about pediatrics and children.

This is Dr. Paul Smolen, hoping you are able to begin to wean, your young children from the screen


Until next time




Subscribe on iTunes!


Subscribe on iTunes or follow us on Facebook and Twitter!


*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.


All Rights Reserved.