DEPARTMENT OF PEDIATRICS

Research Projects

We have several active research projects and research interests.  All have been approved by the Institutional Review Board (IRB) at NYUMC and/or ReASoN at Health and Hospitals Corporation (HHC).

The BELLE Study

The ‘BELLE 0-3 Study’ is an NIH-funded randomized control trial of two parent intervention programs: the Video Interaction Project (VIP) and Building Blocks (BB).

Mothers were enrolled shortly after the birth of their newborns and randomized into one of three groups: VIP, Building Blocks, or care as usual (control). 

Mother/child dyads have participated in follow-up assessments, starting at 6 months of age and continuing every 1-2 years through elementary school (which is currently ongoing).  All assessments are done by researchers who are blind to study group.  These assessments have included measures of:

  • Parenting and parent-child interactions
  • Child development (e.g., cognitive, language, socio-emotional)
  • School readiness and school achievement
  • Family well-being (e.g., parenting stress, maternal depression)
  • Exposure to television and media

Findings from this study have shown impacts of VIP 0-3 on:

The BELLE 3-5 Study

The 'BELLE 3-5 Study' is a randomized control trial that builds on the BELLE 0-3 Study and studies a preschool version of VIP: VIP 3-5.

When infants from the VIP and control groups of the original BELLE 0-3 study reached three years of age, they were re-randomized to receive VIP from 3 - 5 years of age (VIP 3-5), or to receive care as usual from 3 -5 years of age (control).  This resulted in four study groups: 1) mother/child dyads who participated in continuous VIP from birth to age 5; 2) mother/child dyads who participated in VIP from birth to age 3 only; 3) mother/child dyads who participated in VIP from ages 3 to 5 only; and 4) mother/child dyads who never participated in VIP (control).

As in BELLE 0-3 study, mother/child dyads have participated in follow-up assessments, starting at 36 months of age and continuing every 1-2 years through elementary school (which is currently ongoing).  All assessments are done by researchers who are blind to study group.  

Our research for BELLE 3-5 is still in progress, but our findings from this study show additive impacts of VIP 0-3 and VIP 3-5 on parent-child interactions and child development, including:

  • Enhanced reading, play, and verbal interactions in the home
  • Reduced behavior problems for preschool children

BELLE Studies: Ongoing Research

We have been following the participants in the BELLE 0-3/3-5 Studies since birth, and the children from this cohort are now in elementary school.   We continue to study the impacts of VIP on these participants through elementary school.  Ongoing analyses in this sample include: 

  • Videotaped parent-child play interactions
  • Naturalistic samples of parent-child language interactions
  • Children’s narratives
  • Observations of children’s engagement and behavior in the classroom
  • Biologic measures of children’s stress
     

Smart Beginnings

Smart Beginnings is an NIH-funded, multi-site randomized control trial that is studying a comprehensive approach to the promotion of school readiness in low-income families through enhancement of positive parenting. This approach integrates two evidence-based interventions: 1) a universal primary prevention program in pediatric primary care (VIP); and 2) a targeted secondary/tertiary prevention program delivered in the home (Family Check-Up (FCU) for families identified as having additional risks. Assessments of parenting and child development will take place at regular intervals during the infant and toddler period.

This study is being done in collaboration with Dr. Pamela Morris at New York University as well as Dr. Daniel Shaw at the University of Pittsburgh.

This study is currently enrolling parent/infant dyads for newborns born at Bellevue Hospital Center.  A second cohort of participants will be enrolled at the University of Pittsburgh.

For more information about Smart Beginnings, click here.

 

Implementation study of the Video Interaction Project

In addition to studying the efficacy of positive parenting interventions, we are interested in understanding how to best deliver these interventions at scale in a way that maximizes impact, is cost-effective, and reaches families at need.

In 2013, we began offering the Video Interaction Project (VIP) as part of routine pediatric care at Woodhull Medical Center in Brooklyn, NY.  Woodhull Medical Center services primarily low-income families, and VIP is now available in English and Spanish at no cost to all children between birth and 3 years who are receiving well-child care at Woodhull.

This expansion to Woodhull represented the first time that VIP was offered on a clinic-wide scale, and we have been studying factors that affect VIP’s successful implementation and families’ participation and engagement in the program.

 

City’s First Readers

In 2014, the Video Interaction Project became a partner program in City’s First Readers (CFR), a city-wide initiative that seeks to close poverty-related gaps in school readiness through building linkages between literacy-promotion programs across multiple platforms, in order to surround children and families with opportunities to build strong foundations in early literacy. This unique initiative, which has been developed and funded through the New York City Council and directed by Literacy Inc. (LINC), connects VIP with other literacy-promotion programs in pediatric primary care (Reach Out and Read (ROR), community settings (including the NYC public library system and Committee for Hispanic Children and Families), home visiting (Parent-Child Home Program), and early childhood education (JumpStart).

CFR utilizes a number of mechanisms to link programs, including distribution of information through pamphlets and text messages, and engaging in referral across programs (e.g., enrolling families in the NYC public library system during health care visits). Through a research study in two high-need communities (Bushwick, Brooklyn and Hunts Point, Bronx) we are studying the extent to which these strategies: 1) increase families’ participation in early-literacy programs, and 2) enhance families’ engagement in reading aloud and play with their young children.

To find out more about City’s First Readers, visit www.citysfirstreaders.com
 

Understanding Parent-Child Interactions in the Home

Our lab is very interested in understanding factors that affect the quantity and quality of parent-child interactions in the home, and how this relates to children’s developmental outcomes.  This is an active area of research in our lab, illustrated by the following projects:

Cognitive Home Environment

To facilitate assessment of the cognitive home environment we developed [StimQ <link to StimQ tab>], an office-based questionnaire designed to measure the quantity and quality of cognitive stimulation provided in the home.  Research using StimQ has revealed that provision of cognitive stimulation is positively associated with cognitive and language development for children in low-income families (Tomopoulos et al., 2006).  StimQ has also been used to show that engagement in reading and play in the home is positively associated with maternal education and literacy (Green et al., 2009) and with maternal attitudes about reading aloud at the time of delivery (Berkule et al., 2008) and is negatively associated with children’s media exposure (Tomopoulos et al., 2007).

Home Language Environment

We have also begun using innovative technology called LENATM to collect and analyze day-long audio recordings of infants’ natural language environments.  Analysis of these recordings will enable us to: 1) describe trajectories of parent-child verbal interactions during the first year of life in low-income Latino families, 2) investigate family risk and protective factors that affect the quantity and quality of infants’ early language environments, and 3) examine links between household chaos and the quality of language interactions in the home.  This study was funded through a Young Investigator Award from the Academic Pediatric Association and Reach Out and Read and a KiDS of NYU Langone Award to Dr. Adriana Weisleder.

Biologic Indicators of Child Self-Regulation and Stress

We are also very interested in understanding how children’s environments affect their developing physiology. We are currently studying environmental factors related to infants’ attention, self-regulation, and stress.

Assessing infant attention and self-regulation using NIRS

We are studying whether Near Infrared Spectroscopy (NIRS), an optical-imaging technology, can be utilized as a neurophysiologic indicator of infant attention in infants from low socioeconomic (SES) homes.  A key goal of this study is to examine associations between positive parent-child interactions and early infant attention assessed both neurophysiologically (NIRS) and behaviorally (in a habituation-dishabituation procedure).

Using hair cortisol to measure children’s stress physiology

We are currently examining the impacts of parental stress, parenting styles, and participation in intervention programs on child stress levels, as measured by children’s cortisol levels in elementary school.  This study was funded through a Young Investigator Award from the Academic Pediatric Association and Bright Futures to Dr. Caitlin Canfield.

Enhancing early child development in Brazil

We are also involved in developing and studying an initiative to enhance early child development in Boa Vista, a city in northern Brazil with a very high proportion of families living in poverty.  This project is being done in collaboration with a non-profit organization in Brazil called Instituto Alfa e Beto and the municipal government of Boa Vista.

Our study focuses on a positive parenting program that is being implemented as part of a broader mayor-led initiative called Familia que Acolhe (FQA). The parenting program is being delivered in educational child-care centers and includes: 1) a book-loan program in which children bring books home and exchange them for new ones on a weekly basis, and 2) workshops for parents that provide educational support for reading aloud and other opportunities for interacting with children.  

In a cluster randomized controlled trial, we are comparing children attending child care centers receiving the positive parenting program and those in centers without the parenting program, allowing us to assess whether promotion of positive parenting in educational child care centers results in enhanced early child development and school readiness.

We are also studying whether children participating in educational child care have enhanced school readiness compared to children not participating in educational child care.

Effects of Media Exposure on Child Health and Development

Our lab also examines factors related to media exposure in young children, and its effects on children’s health, behavior, and development.

Our research on the effects media exposure on infants and toddlers has shown that, in a low-income sample:

Research on Reach Out and Read

Previous work by Dr. Mendelsohn has examined impacts of Reach Out and Read, a large-scale program dedicated to increasing school readiness in low-income children by providing books and modeling reading behaviors at pediatric visits.

This work, in collaboration with Mount Sinai School of Medicine and other collaborators, has shown that Reach Out and Read results in enhanced child vocabulary and enhanced reading aloud.

Reach Out and Read is currently offered at more than 5,500 program sites and distributes 6.5 million books per year.  They, along with VIP, are a partner program in City’s First Readers