The impact of dialogic book‐sharing training on infant language and attention: a randomized controlled trial in a deprived South African community

Abstract

Background Dialogic book-sharing is an interactive form of shared reading. It has been shown in high income countries (HICs) to be of significant benefit to child cognitive development. Evidence for such benefit in low and middle income countries (LMICs) is scarce, although a feasibility study of our own produced encouraging findings. Accordingly, we aimed to establish the impact on child language and attention of providing training in dialogic booksharing to carers of infants in an impoverished South African community. Methods We conducted a randomized controlled trial in Khayelitsha, an informal settlement in South Africa. Mothers of infants aged between 14 and 16 months were recruited and randomized to either eight weeks of manualized training in dialogic book-sharing or a no-intervention control group. Independent assessments were made of infant language and attention at baseline and following training. The trial was registered (ISRCTN39953901). Results Ninety one carer-infant dyads were recruited and randomized to the intervention group (n = 49) or the control group (n = 42), 82 (90%) of whom were available for follow-up assessments. On a standardized carer report of infant vocabulary, compared to those in the control group, carers who received the intervention reported a significantly greater increase in the number of words understood by their infants as well as a larger increase in the number of words that their infant understood and could vocalize. Intervention group children also showed substantially greater gains on a measure of sustained attention. Conclusions In line with evidence from HICs, a dialogic book-sharing programme delivered to an impoverished South African sample was shown to be of considerable benefit to the development of child language and focussed attention. The training programme, which is simple and inexpensive to deliver, has the potential to benefit child cognitive development in LMIC contexts where such development is commonly compromised.

Shared Reading Quality and Brain Activation during Story Listening in Preschool-Age Children

“…4 Through the use of specific types of prompts and responses, the caregiver encourages the child to participate in a reciprocal dialogue catalyzed by the story. 4, 5 Behavioral evidence suggests that dialogic reading may confer moderate to large benefits, 6 including expressive language, 7, 8 narrative comprehension, 5 and attention, 9 all foundational emergent literacy skills. 10 Social-emotional benefits are also cited, including increased parent-child bonding and enjoyment of reading.…”

Improving early childhood care and development, HIV-testing, treatment and support, and nutrition in Mokhotlong, Lesotho: study protocol for a cluster randomized controlled trial

“…The ECCD component consists of caregiver training in sensitive “book-sharing” skills, designed to stimulates the child cognitively and encourage caregiver-child engagement [25, 26]. The benefits of dialogic book-sharing have been well-established in high-income countries and include language development, attention, literacy, and school readiness [27].…”

“…The benefits of dialogic book-sharing have been well-established in high-income countries and include language development, attention, literacy, and school readiness [27]. In LMIC, there is limited evidence available, but a previous study in South Africa found that a book-sharing intervention for caregivers of 14–16 month-old infants living in an impoverished periurban settlement proved effective in improving children’s language development, sustained children’s attention as well as socioemotional development, and led to improvements in carer-child interaction, increasing carers’ sensitivity to their infant’s interests and cues [25–27]. In this project, the book-sharing intervention program principles have been combined with a participatory, evidence-based approach to addressing issues around HIV-testing and nutrition education, based on local needs and resources.…”

“…The sessions include group and individual activities and make use of presentations shown on a tablet computer as well as practical exercises. The aim is to convey didactic information, to model key skills, and to facilitate and encourage caregiver in dialogic book-sharing [25]. This is achieved using a group presentation together with video material.…”

“…This is measured using three standardized language measures: the MacArthur Communication Development Inventory [31], a parent-reported measure of early language which was used in the previous study of dialogic book-sharing in Khayelitsha, South Africa [25], the Peabody Picture Vocabulary Test [32], a measure of receptive vocabulary, adapted for use in Lesotho, and the Receptive Language Scale, a subtest of the Mullen Scales of Early Learning [33] which assesses a child’s ability to decode and respond to varying levels of verbal instruction…”