Shared Picture Book Reading and Language Development
The Early Intervention Foundation
Tuesday, March 26, 2019
Training parents to share picture books with their children has long been seen as a strategy to support development through scaffolding early cognition and language development.
- Authors: Dowdall et al (2019)
It has been argued that the presentation of simple images devoid of detail or elaboration, in combination with the fact that children can explore picture books at their own pace, makes them a particularly effective way of supporting the embedding of words and concepts. Observational studies have also shown that mothers label objects more frequently and provide more consistent feedback during shared reading than during other activities, such as play. Frequency of shared reading has been shown to predict language development.
Dialogical book-sharing interventions focus on working with parents on an individual or group basis to introduce them to the interactive principles of book sharing, including asking open-ended questions, providing praise and encouragement, and frequent labelling in response to the child's focus of interest. A small number of studies have shown that filming mothers reading to their children and then providing constructive feedback provides benefits in terms of children's language acquisition and frequency and enjoyment of book sharing for parents. Small-scale evaluations of the use of video to teach dialogical reading techniques, which offers benefits in terms of cost-effectiveness - have also shown promise.
Yet it has been noted that there are barriers to shared reading for socio-economically disadvantaged families, including access to books and the observation that families experiencing high-levels of adversity are less likely than more advantaged families to use a style of book sharing that is associated with better language outcomes. This raises questions about whether book-sharing initiatives focused on parent-child interaction and targeting less well-off families will lead to improvements in language acquisition.
The research
Nicholas Dowdall and colleagues' recent study reviewed the evidence for the effectiveness of book-sharing interventions by looking at 19 randomised controlled trials involving more than 2,500 participants, with children ranging from eight months to five and a half years old. Eleven of the included studies were conducted in the US with the remaining eight spread across other high- and middle-income countries. There was considerable variation in the intensity of support provided, ranging from a nurse spending five minutes discussing the importance of shared reading during a home visit, to a programme involving 18 sessions delivered in the mother's home. Ten of the studies involved multiple sessions exceeding one hour of training.
Studies varied in the demographics of their participants, with some working with a predominantly middle-class population while others focused on low-income groups. Eight of the studies worked with a population in which the majority of participants had a tertiary education, while 10 worked with a population in which the majority had not received this level of education. One study did not report on caregiver education. The majority of interventions (15) were administered face-to-face with the others making use of instructional videos or phone calls.
The authors found encouraging results, with evidence of small to moderate impact on expressive language - how an individual uses verbal and non-verbal communication to convey their wants and needs - and on receptive language - how they comprehend language. They also found a large impact on caregivers' competency in shared reading.
The authors suggest that the impact on expressive language may be larger due to shared reading initiatives encouraging child interaction and seeking to elicit a verbal response. However, they also acknowledge that recent research has questioned whether there is a valid distinction between expressive and receptive language.
They found tentative evidence that the intensity of the intervention played a role in the size of difference it made in child and caregiver outcomes, with low-intensity interventions (which they defined as less than one hour in duration) associated with minimal impact. They also found an association between delivery mechanism and impact, with group-based interventions showing larger effects. They suggest this may be because group programmes offer more opportunity for social support to participants, although they advise this is interpreted with caution given the low number of studies included. In contrast to previous studies, the authors found that the age of the child and the education level of the caregiver had no effect on the outcome, nor did the income level of the country where the evaluation was run.
Implications for practice
There are limitations to this research which the authors acknowledge. One issue is that the majority of the studies included in the analysis were conducted in the US, meaning we need to be cautious in interpreting their relevance in other countries. A second is that few of the studies included long-term follow-up, meaning we do not know if the improvements persisted.
- Nevertheless, this work does show the promise of book-sharing initiatives as a way of improving children's language outcomes.
- The fact that age, parental education and country income do not seem to alter the effectiveness of the intervention highlights both the wide potential of shared reading initiatives.
- At the same time, the link between intensity of interventions and their impact underlines the need to ensure they are designed in a way that supports parents' needs.
FURTHER READING
Shared Picture Book Reading Interventions for Child Language Development: A Systematic Review and Meta-Analysis, N Dowdall, GJ Melendez-Torres, L Murray, F Gardner, L Hartford, PJ Cooper, Child Development (2019)
Language as a Child Wellbeing Indicator, J Law, J Charlton, K Asmussen, Early Intervention Foundation (2017)
Key Competencies in Early Cognitive Development: Things, People, Numbers and Words, K Asmussen, J Law, J Charlton, D Acquah, L Brims, I Pote, T McBride, Early Intervention Foundation (2018)
- The Early Intervention Foundation is a What Works Centre that champions and supports the use of effective early intervention to improve the lives of children and young people at risk of experiencing poor outcomes.