Smart Beginnings
Smart Beginnings is a tiered approach designed to promote school readiness and positive behavioral outcomes for children ages 0–3 that combines the Video Interaction Project (VIP) program with the Family Check-Up® (FCU) program. All families receive VIP, which aims to use regularly scheduled pediatrician visits to support child development, school readiness, and educational outcomes. In VIP sessions, coaches focus on increasing responsive parenting, a parenting style where parents learn to observe their child’s behavior, interpret their cues, and act in a way that meets the child’s needs. Beginning when the child is 6 months of age, VIP coaches administer screenings for parent, parenting, and child risk factors. If the coach identifies the family as having additional risks, the coach asks the parent if they’d like to participate in FCU. FCU is a brief, strengths-based intervention that aims to improve parenting skills and family management practices.
For the VIP intervention, trained VIP coaches meet with the parent and child together either before or after the child’s regularly scheduled pediatric well-child visit. During the VIP session, coaches encourage parental behaviors that support children’s social-emotional, cognitive, and language growth. To support children’s social-emotional growth, coaches talk to parents about perspective-taking, responsiveness, engagement in children’s interests, giving positive feedback and affection, and avoiding anger and harsh discipline. To support children’s cognitive and language growth, coaches help parents structure tasks at an appropriate level for the child's abilities, label objects and actions, repeat and expand on what the child says, have back-and-forth conversations, and ask questions.
Each VIP session typically includes three activities: (1) parents receive learning materials, (2) coaches record and review a video of the parent and child, and (3) parents and coaches fill out a written Parent Guide. First, each session begins with the parent and the coach discussing the parent's goals for their child’s social-emotional and cognitive-language development and strategies to meet these goals. During this discussion, the coach provides the parent with developmentally appropriate learning materials (e.g., a toy, book, or both) selected to promote pretend play, verbal engagement, and early literacy. The coach then suggests ways that the parent can use the toy or book at home to engage with their child. Second, after this discussion, the coach records a 3–5minute video of the parent and child exploring the new toy or book together. Coaches then review the video with the parent to reinforce positive interactions and identify additional opportunities for interaction. Finally, the coach and parent work together to complete a written, visit-specific Parent Guide pamphlet that reinforces lessons learned during the session and includes suggestions for interacting with the child through play, shared reading, and daily routines.
FCU consists of three main components: (1) an initial interview that involves rapport building and motivational interviewing to explore parental strengths and challenges related to parenting and the family context; (2) an ecological family assessment that includes parent and child questionnaires, a teacher questionnaire for children that are in school, and a videotaped observation of family interactions; and (3) tailored feedback that involves reviewing assessment results and discussing follow-up service options for the family. Follow-up services may include clinical or support services in the community. They may also include the Everyday Parenting program, which is a parenting management program that is typically delivered by the FCU provider.
Smart Beginnings is rated as a promising practice because at least one study achieved a rating of moderate or high on study design and execution and demonstrated a favorable effect on a target outcome.
Date Research Evidence Last Reviewed: Jul 2023
Sources
The following sources informed the program or service description, target population, and program or service delivery and implementation information: the program or service manual, the program or service developer’s website, and the studies reviewed.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.
Target Population
Smart Beginnings is designed to serve parents and children ages 0–3.
Dosage
In Smart Beginnings, VIP includes up to 14 sessions. Each session lasts 30–45 minutes. VIP sessions are designed to be delivered in conjunction with regularly scheduled pediatric well-child visits from birth to 3 years. These well-child visits occur every few months during infancy and toddlerhood and then less frequently as children get older.
VIP coaches conduct a screening when the child is 6 months old to determine whether a family is eligible for FCU. For eligible families, the FCU provider schedules the three main FCU components individually with families based on their availability. After completing the feedback session, families may choose to complete follow-up services up through age 3 years. These follow-up services can vary in intensity and duration based on family interest and need.
Location/Delivery Setting
Recommended Locations/Delivery Settings
Smart Beginnings can be delivered in a variety of settings. Coaches typically deliver VIP in pediatric healthcare or community settings. Coaches can also deliver VIP virtually in the home. FCU providers deliver FCU in a variety of settings, including in pediatric healthcare or other health settings, the home, schools, and Native American tribal communities.
Location/Delivery Settings Observed in the Research
- Home
- Hospital/Medical Center
Education, Certifications and Training
To deliver Smart Beginnings, coaches and providers must meet the educational and training requirements for VIP and FCU.
VIP typically requires coaches to have a bachelor’s degree in a relevant field and knowledge of child development. In some circumstances, coaches may have an associate’s degree with additional background or experience in early childhood development.
The VIP Center of Excellence (COE) delivers required training for coaches. This includes a 3-day start-up training course delivered in-person or remotely, onsite visits, remote supervision, and refresher videoconference seminars. Coaches must also complete any additional training or regulatory requirements specific to the implementing site, such as site-specific training or background checks.
Sites interested in implementing VIP must complete an onboarding process with the VIP COE. This process includes a preliminary site visit, completion of a site implementation worksheet, hiring and training a VIP coach, identifying a VIP Champion who will facilitate local engagement and coordinate with the COE, creating a list of existing local resources for families, and identifying spaces for program delivery that meet program requirements. Programs may implement a pilot phase before launching the program. After launch, sites complete site protocols on a regular basis to monitor program implementation.
For FCU, providers must participate in training to become a Qualified FCU Provider. The training is offered in three formats: (1) an in-person 2-day training; (2) an online training consisting of an e-learning course and two webinars; and (3) a hybrid training consisting of an e-learning course, a 1-day in-person training, and 1-hour consultation sessions that occur before and after training. Providers who complete the training receive one year of access to the FCU Resource Website which houses the manual, instructional videos, and other materials needed to implement each step of FCU. Qualified FCU Providers can also become a Certified FCU Provider if they submit videotaped sessions and meet fidelity criteria.
Program or Service Documentation
Book/Manual/Available documentation used for review
The following two resources are used to implement Smart Beginnings:
Mendelsohn, A. L., Berkule Johnson, S., Cates, C. B., Custode, A., Matalon, M., Weisleder, A., Seery, A., Kinsner, K., Flynn, V., & Dreyer, B. P. (2021). Video Interaction Project (VIP) - Program manual. NYU Grossman School of Medicine.
Dishion, T. J., Gill, A. M., Shaw, D. S., Risso-Weaver, J., Veltman, M., Wilson, M. N., Mauricio, A. M., & Stormshak, B. (2019). Family Check-Up in early childhood: An intervention manual (2nd ed.). Child and Family Center, University of Oregon.
Available languages
VIP materials are available in English. FCU materials are available in English and Spanish.
Other supporting materials
Family Check-Up® Intervention Process
For More Information
Website: https://steinhardt.nyu.edu/ihdsc/projects/smart
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Smart Beginnings |
|---|---|
| Identified in Search | 1 |
| Eligible for Review | 1 |
| Rated High | 0 |
| Rated Moderate | 1 |
| Rated Low | 0 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Adult well-being: Positive parenting practices |
0.21
8 |
1 (16) | 362 |
Favorable:
7 No Effect: 9 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Adult well-being: Positive parenting practices |
0.21
8 |
1 (16) | 362 |
Favorable:
7 No Effect: 9 Unfavorable: 0 |
- |
| Study 14945 - Smart Beginnings vs. Routine Primary Care (Miller, 2022) | |||||
| StimQ2 – Toddler: Total Score (18 Month Interim Assessment) |
0.21
8 |
- | 326 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Support for Cognitive Development (18 Month Interim Assessment) |
0.13
5 |
- | 326 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Support for Language Quantity (18 Month Interim Assessment) |
0.13
5 |
- | 326 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Support for Language Quality (18 Month Interim Assessment) |
0.12
4 |
- | 326 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Cognitive Stimulation Factor (18 Month Interim Assessment) |
0.14
5 |
- | 326 | - | 0 |
| Study 14945 - Smart Beginnings vs. Routine Primary Care (Roby, 2021) | |||||
| StimQ2 – Infant: Total Score |
0.28
*
10 |
- | 362 | - | 0 |
| StimQ2 – Infant: Reading |
0.23
*
9 |
- | 362 | - | 0 |
| StimQ2 – Infant: Parental Involvement in Developmental Advance |
0.25
*
9 |
- | 362 | - | 0 |
| StimQ2 – Infant: Parental Verbal Responsivity |
0.16
6 |
- | 362 | - | 0 |
| Parenting Your Baby Questionnaire: Supporting and Enjoying |
0.06
2 |
- | 362 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Sensitivity |
0.16
6 |
- | 362 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Intrusiveness |
-0.07
-2 |
- | 362 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Support for Cognitive Development |
0.37
*
14 |
- | 362 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Support for Language Quantity |
0.40
*
15 |
- | 362 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Parental Support for Language Quality |
0.37
*
14 |
- | 362 | - | 0 |
| Parent-Child Interaction Rating Scales – Infant Adaptation: Cognitive Stimulation Factor |
0.40
*
15 |
- | 362 | - | 0 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtassoc.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Age or Grade-level
|
Race, Ethnicity, Nationality
|
Gender
|
Populations of Interest*
|
Household Socioeconomic Status
|
| Study 14945 - Smart Beginnings vs. Routine Primary Care | ||||||
| Characteristics of the Children and Youth | ||||||
| New York City, NY, USA; Pittsburgh, PA, USA | 2015 | Average age: 7 months |
50% Black/African American 43% Latinx 4% Other race and/or ethnicity 3% White 1% Asian |
50% Female | -- | -- |
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| New York City, NY, USA; Pittsburgh, PA, USA | 2015 | 7% Teenage mothers less than 20 years old |
45% Black/African American 44% Latinx 7% White 3% Other race and/or ethnicity 2% Asian American |
-- | 100% Mothers and infants from low-income or Medicaid-eligible families enrolled in postpartum hospital units | -- |
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings. The Clearinghouse is currently seeking consultation from experts, including those with lived experience, and input from the public to enhance and improve the display.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated Moderate
Study 14945Roby, E., Miller, E. B., Shaw, D. S., Morris, P., Gill, A., Bogen, D. L., Rosas, J., Canfield, C. F., Hails, K. A., Wippick, H., Honoroff, J., Cates, C. B., Weisleder, A., Chadwick, K. A., Raak, C. D., & Mendelsohn, A. L. (2021). Improving parent-child interactions in pediatric health care: A two-site randomized controlled trial. Pediatrics, 147(3), 1-12. https://doi.org/10.1542/peds.2020-1799
Miller, E. B., Canfield, C. F., Morris, P. A., Shaw, D. S., Cates, C. B., & Mendelsohn, A. L. (2020). Sociodemographic and psychosocial predictors of VIP attendance in Smart Beginnings through 6 months: Effectively targeting at-risk mothers in early visits. Prevention Science, 21(1), 120-130. https://doi.org/10.1007/s11121-019-01044-y
Canfield, C. F., Miller, E. B., Shaw, D. S., Morris, P., Alonso, A., & Mendelsohn, A. L. (2020). Beyond language: Impacts of shared reading on parenting stress and early parent-child relational health. Developmental Psychology, 56(7), 1305-1315. https://doi.org/10.1037/dev0000940
Hails, K. A., Whipps, M. D. M., Gross, R. S., Bogen, D. L., Morris, P. A., Mendelsohn, A. L., & Shaw, D. S. (2021). Breastfeeding and responsive parenting as predictors of infant weight change in the first year. Journal of Pediatric Psychology, 46(7), 768-778. https://doi.org/10.1093/jpepsy/jsab049
Miller, E. B., Roby, E., Zhang, Y., Coskun, L., Rosas, J. M., Scott, M. A., Gutierrez, J., Shaw, D. S., Mendelsohn, A. L., & Morris-Perez, P. A. (2022). Promoting cognitive stimulation in parents across infancy and toddlerhood: A randomized clinical trial. The Journal of Pediatrics, 255, 159-165.e4. https://doi.org/10.1016/j.jpeds.2022.11.013
Reno, R., Whipps, M., Wallenborn, J. T., Demirci, J., Bogen, D. L., Gross, R. S., Mendelsohn, A. L., Morris, P. A., & Shaw, D. S. (2022). Housing insecurity, housing conditions, and breastfeeding behaviors for medicaid-eligible families in urban settings. Journal of Human Lactation, 38(4), 760-770. https://doi.org/10.1177/08903344221108073
Miller, E. B., Whipps, M. D. M., Bogen, D. L., Morris, P. A., Mendelsohn, A. L., Shaw, D. S., & Gross, R. S. (2023). Collateral benefits from a school-readiness intervention on breastfeeding: A cross-domain impact evaluation. Maternal & Child Nutrition, 19(1), Article e13446. https://doi.org/10.1111/mcn.13446
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)