Smart Beginnings integrates two interventions:
This program is designed for low-income families with toddlers at risk for conduct problems.
An RCT conducted in the USA had a total final sample of 403 families (Roby et al. 2021) randomly assigned into the intervention and control conditions; 200 families were in NYC and 203 in Pittsburgh. Participants were children and their parents, across a broad range of locations, race and ethnic background (primarily low-income Latinx and Black/African American). There were many between-site differences, with NYC primarily Latinx and Pittsburgh primarily Black/African American participants. Mothers in NYC had higher rates of marriage and cohabitation and were less likely to be high school graduates. No significant differences emerged between the treatment and control groups across baseline variable data.
The review did not identify any evidence that the program has been evaluated in Australia or with First Nations communities.
Caregiver cognitive stimulation, Parent-child interaction: The program positively impacted multiple domains of parent-reported cognitive stimulation, including reading, verbal responsivity, and teaching behaviours; and significantly improved parent-child interaction, including parental support for cognitive development, language quantity, and language quality.
These findings replicate previous research on the effect of VIP on cognitive stimulation and parent-child interactions, and widen the generalisability of findings due to the comprehensive set of survey and observational measures and a more demographically diverse sample.
The impacts are notable given substantial research demonstrating that the above caregiver behaviours mediate the relationship between poverty and school readiness. This has implications for long-term educational trajectories. The results are especially significant given that replication of findings in the behavioural sciences is often challenging.
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Overall, the program had a positive effect on client outcomes.
Promising research evidence:
Smart Beginnings includes the Video Interaction Project (VIP) as a universal primary prevention strategy. In the study, the program wasprovided to all families with children randomly assigned to the treatment group at birth, and Family Check-Up was provided to treatment families with identified psychosocial risks beginning at 6 months.
In the VIP program, Bachelor’s level educated coaches hired for this project delivered fourteen 25-30 minute sessions in paediatric primary care to families with children from birth to 3 years. Coaches received a 3-day training course and ongoing supervision.
Every VIP session follows the same format. The coach provides a developmentally appropriate learning material (book, toy) to the parent to engage them in interaction with their child. The coach records a short video of the parent and child interacting with the book or toy, and immediately reviews the video with the parent, identifying and reinforcing strengths in the interaction and encouraging self-reflection. The coach also provides the parent with a copy of the video; a personalised pamphlet with information about age-specific developmental milestones (e.g., making sounds at 6 months); age-specific suggestions for engaging with their child (e.g., imitating infant sounds at 6 months); a developmentally appropriate toy (e.g., hand puppets), and the parent’s goals for interacting with their child at home.
Family Check-Up is an evidence-based home visiting model that seeks to reduce the development of early disruptive behaviour and motivate parents to engage in services that improve parenting practices. Whereas VIP begins at birth in the Smart Beginnings model, families do not begin receiving Family Check-Up until the infant is 6 months.
Information not provided
This study had many strengths, including a multimethod assessment across a geographically, racially and ethnically diverse sample. It had the following limitations:
One RCT conducted in the USA with a sample of 403 families (Roby et al. 2021).
17 Feb 2023
We acknowledge Aboriginal people as the First Nations Peoples of NSW and pay our respects to Elders past, present, and future.
Informed by lessons of the past, Department of Communities and Justice is improving how we work with Aboriginal people and communities. We listen and learn from the knowledge, strength and resilience of Stolen Generations Survivors, Aboriginal Elders and Aboriginal communities.
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