Early Literacy Research Library (ELRL) - Article

Reading Aloud, Play, and Social-Emotional Development

Mendelsohn, A.L., Cates, C.B, Weisleder, A., Johnson, S.B., Seery, A.M., Canfield, C.F., Huberman, H.S., Dreyer, B.P. (2018) Reading Aloud, Play, and Social-Emotional Development. Pediatrics, 141(5), e20173393.,

Access: FREE/Open Access

Publication year


study description

Factorial, single-blind, randomized controlled trial.

core topic(s)

Shared Reading

Population Characteristics

Poverty/Low-Income , Urban

Exposures, Outcomes, Other

Building Blocks , Child Development (general) , Clinic-Based Programs and Interventions , Parent Behaviors and Skills , Parent Knowledge, Attitudes, and Beliefs , Positive Parenting , Programs and Interventions (other) , Social-Emotional , Video Interaction Project


To determine impacts on social-emotional development at school entry of a pediatric primary care intervention (Video Interaction Project [VIP]) promoting positive parenting through reading aloud and play, delivered in 2 phases: infant through toddler (VIP birth to 3 years [VIP 0–3]) and preschool-age (VIP 3 to 5 years [VIP 3–5]).


Video Interaction Project (VIP).

outcomes evaluated

Social-emotional development.


An Urban public hospital serving low-income families (Bellevue Hospital Center ([BHC]).


Factorial randomized controlled trial with postpartum enrollment and random assignment to VIP 0-3, control 0 to 3 years, and a third group without school entry follow-up (Building Blocks) and 3-year second random assignment of VIP 0-3 and control 0 to 3 years to VIP 3-5 or control 3 to 5 years. In the VIP, a bilingual facilitator video recorded the parent and child reading and/or playing using provided learning materials and reviewed videos to reinforce positive interactions. Social-emotional development at 4.5 years was assessed by parent-report Behavior Assessment System for Children, Second Edition (Social Skills, Attention Problems, Hyperactivity, Aggression, Externalizing Problems).

sample size

n=275 (families; aim 1); n=252 families; aims 2 and 3)


Measure of Sociodemographic Characteristics:

      • SES status using Hollingshead 4 factor Index
      • Social Risk Factors: (homelessness, being a victim of violence, involvement with child protection, financial difficulties, food insecurity, smoking or alcohol use during pregnancy, or previous mental illness
      • Maternal literacy: assessed at 6 months in the mother’s preferred language by using the Woodcock-Johnson III and/or the Woodcock and M uñoz-Sandoval‍ Batería III Tests of Achievement, Letter-Word Identification Test

Measure of Social Emotional Development: parent reports using 4 subscales (Social Skills, Attention Problems, Hyperactivity, and Aggression) from the Parent Rating Scales of the Behavior Assessment System for Children, Second Edition (BASC-2)‍ and an Externalizing Problems composite (Hyperactivity and Aggression).


VIP 0-3 and VIP 3-5 were independently associated with improved 4.5-year Behavior Assessment System for Children, Second Edition T-scores, with effect sizes (Cohen’s d) ∼−0.25 to −0.30. Receipt of combined VIP 0-3 and VIP 3-5 was associated with d = −0.63 reduction in Hyperactivity (P = .001). VIP 0-3 resulted in reduced “Clinically Significant” Hyperactivity (relative risk reduction for overall sample: 69.2%; P = .03; relative risk reduction for increased psychosocial risk: 100%; P = .006). Multilevel models revealed significant VIP 0-3 linear effects and age × VIP 3-5 interactions.


Phase VIP 0-3 resulted in sustained impacts on behavior problems 1.5 years after program completion. VIP 3-5 had additional, independent impacts. With our findings, we support the use of pediatric primary care to promote reading aloud and play from birth to 5 years, and the potential for such programs to enhance social-emotional development.


First, attrition resulted in analytic samples comprising greater proportions of Hispanic and/or Latino immigrants with lower SES, and it is possible that less-engaged families could have experienced differences in program impact. Second, assessments were conducted by parent report, which can differ from report by other observers such as teachers and be susceptible to response bias; however, the primary focus of the VIP on reading aloud and play may have reduced socially desirable responses. Third, clinical-level Hyperactivity and/or Externalizing Behaviors on the BASC do not necessarily indicate a diagnosis of attention-deficit/ hyperactivity disorder, and clinical assessments were not available for participating families.