Guiding parents to have pretend play and read aloud with their babies increased parental support of their children's cognitive development and academic skills by the time they turned six—especially for families facing poverty.
This is the finding of a new study, led by researchers at NYU Grossman School of Medicine, New York University, and the University of Pittsburgh, which evaluated the effects of a comprehensive model to support parenting.
Called Smart Beginnings, the approach combines PlayReadVIP (formerly Video Interaction Project) at pediatric check-ups from birth to age 3, in which parents watch themselves on video reading or playing together with a new book or toy to foster skills that support children's development. The second approach is called Family Check-Up in the home, which uses a clinical family management strategies to address difficult child behaviors and other challenges, especially among families facing adversity such as maternal depression.
For the study, 403 mothers and newborns with low incomes in New York City and Pittsburgh enrolled, and half were randomly assigned to receive Smart Beginnings while the rest received standard pediatric primary care.
Analysis of the program, published in Pediatrics online December 15, 2025, showed that increases in cognitive stimulation from videorecorded interactions of parents and children playing at age two resulting from the Smart Beginnings comprehensive model in turn resulted in better academic skills when children reached the first grade.
These findings expand upon earlier work showing similar findings at age four, before children had started elementary school.
Our findings demonstrate that early preventive intervention through Smart Beginnings can result in long-standing impacts in elementary school, even three years after completion of the program," said study lead investigator Elizabeth B. Miller, PhD, an assistant professor in the Department of Population Health at NYU Langone Health. "Importantly, the SB model provides these services at far lower cost than other approaches with similar goals."
According to Miller, the results of this study are critically important for early childhood policy. Findings represent one of the first demonstrations of feasibility and impact for tiered approaches to achieve population-level impacts, providing strong evidence to support recent recommendations by the American Academy of Pediatrics and the National Academies of Sciences, Engineering and Medicine. Findings additionally provide strong support for ongoing implementation and scaling of SB's composite programs - PlayReadVIP and Family Check-Up.
Funding for the study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health, grant R01HD076390.
Besides Miller, other NYU study investigators are Principal Investigators Pamela Morris-Perez and Alan L. Mendelsohn, MD, together with Caitlin F. Canfield, PhD; Ashleigh I. Aviles, PhD; and Erin Roby, PhD. University of Pittsburgh in Pennsylvania investigators are Principal Investigator Daniel S. Shaw, PhD, together with Leah J. Hunter, PhD.
