The impact of dialogic book-sharing training on infant language and attention: a randomized controlled trial in a deprived South African community.
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 8 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.
School of Psychology and Clinical Language Sciences, Winnicott Research Unit, University of Reading, Reading, UK.
Zahir
Z
Vally
School of Psychology and Clinical Language Sciences, Winnicott Research Unit, University of Reading, Reading, UK.|Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
Lynne
L
Murray
Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
Mark
M
Tomlinson
School of Psychology and Clinical Language Sciences, Winnicott Research Unit, University of Reading, Reading, UK.|Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
Peter J
PJ
Cooper
D000328:Adult; D001288:Attention / Q000502:physiology*; D001877:Books; D002657:Child Development / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007802:Language; D007804:Language Development; D008297:Male; D009035:Mothers / Q000523:psychology*; D011203:Poverty; D011932:Reading; D013019:South Africa
Dialogic; attention; book-sharing; language