From the Journals

Sensitive, responsive parenting improves child language skills

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‘Language nutrition’ deserves urgency, too

Parental sensitive responsiveness and warmth, as explored in the meta-analysis by Madigan et al., is important, but so is the overall “language nutrition” children receive, wrote Heidi M. Feldman, MD, PhD.

“Pediatric clinicians routinely counsel families about food nutrition. We should address language nutrition with similar urgency,” Dr. Feldman suggested.

She pointed out that the two features of parenting explored in the meta-analysis are only part of the picture; other ingredients in language nutrition include the quantity of child-directed speech, the quality of the language input, and the nature of caregiver interactions with children, “beyond responsivity and warmth.”

“Meta-analyses on the topic of language development are extremely helpful,” Dr. Feldman wrote. “However, now we also need well-designed treatment studies to inform us about the nature and intensity of interventions to improve language-learning environments and child outcomes.”

Dr. Feldman , who is with the department of pediatrics at Stanford (Calif.) University, made these comments in an accompanying editorial in Pediatrics ( doi: 10.1542/peds.2019-2157 ). She had no financial relationships related to the commentary nor potential conflicts of interest to disclose.


 

FROM PEDIATRICS

Parental sensitive responsiveness, more than warmth, was associated with better child language skills, according to a meta-analysis in Pediatrics.

Mother and child clapping Mapodile/E+/Getty Images

Sheri Madigan, PhD, of the department of psychology at the University of Calgary (Alta.) and the Alberta Children’s Hospital Research Institute, also in Calgary, and colleagues brought together 37 studies of the association of either parental sensitive responsiveness, warmth, or both with children’s language skills. The studies ranged in sample sizes from 9 mother-child dyads to 1,026. For the purposes of the study, sensitive responsiveness was defined as “a parent’s ability to perceive and interpret the child’s signals and cues and to respond to those signals and cues promptly and appropriately,” and warmth was defined as “caregiver physical affection or their positive affective quality during contact and involvement with the child.”

Across 36 samples with a total of 7,315 dyads, an association was seen between sensitive responsiveness and child language, with a correlation coefficient of 0.26 (95% confidence interval, 0.21-0.33), whereas the analysis exploring parental warmth with 13 samples (1,961 dyads) found a somewhat weaker association, with a correlation coefficient of 0.16 (95% CI, 0.09-0.21), according to the investigators.

“A sensitive-responsive parent can build on the moment-to-moment shifts in children’s attention, providing a finely tuned enhancement to the child’s experience,” the researchers suggested in regard to the greater effect seen with sensitive responsiveness. “Neural development is thought to occur through internalization of these finely tuned, reciprocal interactions. Warmth, on the other hand, does not involve contingency or reciprocity.”

Interestingly, moderator analyses revealed variations in effect sizes according to socioeconomic status – with greater effect sizes associated with lower socioeconomic status.

“A possible interpretation of this finding is that maternal sensitive responsiveness is particularly advantageous to children’s language when they are raise in socially disadvantaged families,” they wrote, noting that such an interpretation would be in line with previous research that showed “the protective effect of high-quality parent-child interactions in the context of adversity.”

Limitations of the analysis include that meta-analyses of observational studies are correlational in nature and are generally unable to demonstrate inferences about causality. Another is that the studies in this analysis were limited to children who developed in typical fashion, which limits generalizability to children with language delay, intellectual disability, autism, or hearing/vision difficulties. The analysis was also limited to only mother-child dyads, so the effects of paternal parenting are absent.

“The findings indicate a moderate association between sensitive-responsive parenting and children’s language skills,” the researchers concluded. “Sensitive responsiveness is a modifiable risk that has been successfully trained in parents in randomized trials and shown to improve language development of children.”

A grant from the Social Sciences and Humanities Research Council was awarded to the two of the study’s authors. Two authors’ individual contributions were supported by funding from the Alberta Children’s Hospital Foundation. The authors indicated they have no financial relationships relevant to this article or conflicts of interest to disclose.

SOURCE: Madigan S et al. Pediatrics. 2019 Sep 24. doi: 10.1542/peds.2018-3556.

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