Linda Forssman

The Impact of Book-Sharing on Infant Language and Cognitive Development: A Randomized Controlled Trial

Children s cognitive development, literacy, and educational outcomes are influenced by the quality of the family environment. Early intervention programs that promote positive parenting behaviors and child cognition has great potential to positively influence children s school readiness and thereby support social equality. In the current project, we will conduct a randomized controlled trial to evaluate the effects of a book-sharing intervention for caregivers and their 10-month-old children. The intervention is conducted over eight weeks and is designed to stimulate parent-child interactions and child cognition. It involves teaching interactive scaffolding techniques for caregivers to apply during book-sharing with their child. Participating parent-infant dyads (n = 144) will be randomized to a training group or an active control group. Data will be collected at baseline, post-intervention and at two follow-ups when the infant participants are 18 and 36 months of age. The current project will uniquely contribute by evaluating the effectiveness of a book-sharing intervention with infant participants and by holding the potential to demonstrate cognitive and neural mechanisms that are involved in language acquisition. By including long-term follow-ups, we will be able to clarify the durability of the intervention effects and whether they transfer to later developing cognitive and language skills that are critical for subsequent academic progress.
Final report
A commonly advocated parental practice to promote young children’s language and cognitive development is the sharing of picture books. Previous intervention studies have shown that this practice is particularly beneficial when parents use techniques that actively involve the child in the reading activity. The aim of this research project was to investigate the effects on an interactive shared book reading intervention targeting parents with infants around 10 to 12 months of age. Specifically, we were interested in examining intervention effects on children’s cognitive, socio-cognitive, and language abilities, as well participating parents’ ability to support their child’s language development. Previous studies have shown positive effects of interactive shared book reading on language development in preschool-aged children (around 2 to 5 years old), but few studies have investigated whether this effect can be replicated in younger children. Furthermore, few studies in this research area have examined intervention effects beyond language development, as well as possible mechanism that can explain intervention effects on language development.

The study was a randomized controlled trial (the REaL trial; registration number ISRCTN22319305 Data were collected at pre-assessment (about one week before the intervention started), at post-assessment (about one week after the intervention ended), and at two follow-up assessments 6 and 12 months after the intervention ended. Outcome data was collected using child-friendly assessments with eye tracking, EEG systems, video-recorded structured observations and parental reports.

Participating parent-child dyads were randomized to an intervention group (n = 59) or an active control group (n = 56). The intervention program was delivered by a trained group leader weekly for five consecutive weeks to groups of approximately 4-6 parent-child dyads. Each group session (60 minutes) was organized around specific shared book reading techniques with the goal of actively engaging the child during in the shared reading activity. Participating parents in the intervention group were also encouraged to use the techniques during daily shared book reading sessions with their child for at least 10 minutes between the five group sessions. Participants in the active control group were also invited to five group sessions during five consecutive weeks. The group sizes and time commitment for these sessions were equivalent to the intervention group sessions. For this group, psychoeducation regarding children’s general development was provided. After the last group session, participating parents in both the intervention group and active control group were asked to complete a survey regarding their experience of the group sessions.

After a pilot phase, recruitment for the RCT study started in January 2020. Due to the COVID-19 pandemic, recruitment was paused for the first time between February and May 2020, and during several additional periods. Recruitment for the study was completed in August 2021, and the study was significantly delayed at this stage. Data collection was completed in the fall of 2022, and data analysis is ongoing. At the time of writing, one peer-reviewed article has been published. Additional publications (peer-reviewed articles) are in progress and will be submitted for publication during the year. The research project has been presented in a scientific article (in the form of a study protocol, Forssman & Gottwald, 2022). Preliminary results have been presented at local and international research conferences and have also resulted in a number of psychology master’s theses. See the list of publications. Collaborations with open preschools in Uppsala and Stockholm (Sweden) is being carried out to disseminate information about the method to the general public.

At present, the project’s main results are as follows:

(i) Based on attendance statistics and participant reports, the intervention showed good feasibility and adherence to the recommendation to used interactive shared reading on a daily basis. There were no significant differences between the intervention group and the active control group in terms of attendance of or reported satisfactions with the group meetings.
(ii) The study showed intervention effects on participating parent’s scaffolding ability at post-assessment. This finding is important as few previous studies in the field have examined intervention effects on parenting abilities.
(iii) At 18 months of age, an intervention effect was observed on children’s language development (vocabulary), and this effect was moderated by the degree of improvement in aforementioned parenting ability. No intervention effects on children’s language abilities were observed at post-assessment (approximately one week after the intervention ended), indicating that more time is needed before this type of training of parent’s shared reading behaviors affects children’s abilities (Forssman & Gottwald, 2022). Follow-up analysis will investigate whether this effect is robust and persists at 24 months of age.
Grant administrator
Uppsala University
Reference number
SEK 3,746,000.00
Psychology (excluding Applied Psychology)