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At the time of this review, Baby TALK has been studied as part of the evaluation of the RefugeeOne program in Chicago, IL (Hilado, Leow, & Yang, 2019; Hilado, Leow, & Yang, 2018). 

For information on Baby TALK as a parenting curriculum, please see the Parenting Curricula for Home-Based Delivery Database. 

Rigorous Design: Baby TALK was evaluated in a randomized control trial.

Sample and Generalizability: The sample included 200 families with children between 3 and 36 months old. Families were referred by a refugee resettlement program in Chicago. About half of the sample was East Asian, with several African, Near Eastern, South Asian, Latin American, and Caribbean families. Families were predominantly low-income.

Training: Home visitors participated in a four-day core training and received supervision twice a month. Fidelity of implementation was assessed as part of supervision. It was also assessed by analyzing the documentation home visitors completed before and after each home visit. The study did not present an analysis of the home visitors' fidelity to the intervention.

Parenting Outcomes: Parents reported lower parental stress and trauma symptoms after one year of participating in Baby TALK. However, these outcomes were not significantly different from those of families who did not participate. In addition, home visitors reported observing more positive parenting practices after one year of participating in Baby TALK. The parenting practices of families in the control group were not assessed. 

Child Outcomes: The evaluation investigated the effect of one year of participation in a home visiting program using Baby TALK on children's language development and social and emotional development. Children who participated in the program had more gains in language development after one year than children who did not participate in home visiting. They also had higher scores on social and emotional development after one year. However, these gains in social and emotional development were not significantly different from the gains of children who did not participate in home visiting. 

References:

Hilado, A., Leow, C., & Yang, Y. The Baby TALK – RefugeeOne Study: A Randomized Controlled Trial Examining Home Visiting Services with Refugees and Immigrants. Report submitted to the U.S. Department of Health and Human Services, Home Visiting Evidence of Effectiveness (HomVEE) Review, January 2018.

Hilado, A., Leow, C., & Yang, Y. “Understanding Immigration Trauma and the Potential of Home Visiting Among Immigrant and Refugee Families.” Zero to Three Journal, 39(6), (July 2019): 44–53.
 

Home Visiting Practices and Interactions: Baby TALK promotes home visiting practices and interactions that research has shown to be effective in engaging parents. The curriculum is grounded in critical concepts, such as "building relationships," "going where families are," and "coming alongside" through partnerships with families rather than through giving advice. Baby TALK provides guidance on effective communication with families using the mnemonic OPERA: open-ended questions, pause, make eye contact, repeat, avoid judgment, ask opinion, advise last. The Encounter Protocols provide conversation prompts for the home visitor to engage the parents in discussing their child's interests and behaviors and to reflect on the quality of connection with the family. Examples of prompts include "What new behaviors have you observed your baby doing?" and "How did I connect with the family?" Additionally, the curriculum utilizes an approach and strategies that reflect the perspective of parents as adult learners. For example, the Baby TALK White Paper describes the importance of facilitating effective parenting rather than simply prescribing an approach for parents to follow. The curriculum materials promote the use of active listening, reflection, and affirmation of parental competence.

Parenting Practices: Baby TALK promotes teaching practices, learning experiences, and developmentally appropriate content that are effective in supporting positive child outcomes. The curriculum encourages parents to engage in sensitive, responsive interactions to build secure attachment relationships with children. For example, the monthly resources provide reflective prompts for the parent to think about their interactions with their child (e.g., "What changes have you noticed in his reaction to your voice? How do you think talking with him affects his mood or state?"). A variety of resources provide guidance on how to support social skills and emotional regulation (e.g., Let's Talk Kids articles). The curriculum consistently promotes the use of routines as learning opportunities and guides parents to support play and exploration throughout the day (e.g., Dressing, Diapering, Feeding, and Bath Time Fun). The curriculum offers guidance to promote language-rich interactions and strategies for engaging children in shared read-alouds, but provides limited guidance on how to effectively support the use of a home language and children who are DLLs.

Alignment with the ELOF: A thorough review of all the curriculum indicates that Baby TALK is fully aligned with the ELOF domains and sub-domains. The curriculum materials, including learning experiences, learning goals, parenting practices, and guidance support children across the ELOF sub-domains. Several activities are provided in the resources each month to promote development in different areas. Although not every month's materials include resources for each domain of development, overall the curriculum does address all domains across the various monthly resources and materials.

Learning Goals: Baby TALK specifies measurable, developmentally appropriate goals for children's learning and development that are consistently supported by the learning experiences. The learning goals are based on the IELG, with one or two specific standards referenced within monthly activities. The curriculum provides guidance on how to engage families in identifying individual goals for their child's learning and development. Family Resource Assessment & Monitoring includes a section to assess the family's needs for resources related to child development concerns. The Baby TALK Individual Family Service Plan form, provided by the curriculum, is used to document goals agreed on by the parent and family support staff member, including goals related to child development.

Ongoing Observation: Baby TALK describes a process for observing and discussing children's development and using this information for home visit planning. The Encounter Protocol for each month includes explicit guidance to promote regular observation of the child by the home visitor and the parent during the visit. For example, at 1 Month activities, "Simply look at the baby with the parents for 10–30 seconds. Does the baby look to the parent or caregiver for praise or approval?" The Personal Encounter Documentation form requires the home visitor to note specific child behaviors observed during the visit. Then, the document HV Guideline for Preparation encourages the home visitor to reflect on past observations when planning the next visit (e.g., "What parent-child interactions have I observed in the past that I will build on during this encounter?"). Additionally, the Baby TALK monthly activities use the prompt, "Let's wonder together," with open-ended questions the home visitor can use to encourage parents to share their ongoing observations of their child (e.g., At 2 Months activities: "What changes have you noticed in your baby's awareness of her body parts? What does she like to do with her hands and feet?"). Similar prompts can be found in other monthly activity files. 

Standardized and Structured Assessment Instruments: Baby TALK makes a reference to standardized and structured assessment instruments to assess developmental progress. However, it provides minimal guidance on how home visitors can engage parents in collaboratively using standardized instruments to assess children's development. Specifically, the Baby TALK White Paper mentions the Ages and Stages Questionnaires, the Hawaii Early Learning Profile, and the Battelle Developmental Inventory as instruments to conduct developmental screenings, a process different from assessment. The Individual Family Case File Checklist mentions that developmental assessment should be "ongoing/every 6 months." No further guidance is provided within the curriculum materials on how standardized and structured assessments are to be incorporated into the program. Although the curriculum provides a structured assessment tool called the Family Resource Assessment & Monitoring, which includes a section to discuss family concerns, needs, and resources pertaining to the child's health and development, it only covers broad topics rather than specific skills and developmental milestones.

Relationships with Parents and Families: Baby TALK offers specific guidance and a process for how to build positive relationships with families. Guidance is integrated throughout the curriculum materials. For example, the Encounter Protocol provides a process for each encounter with the family that promotes respectful, collaborative relationships. In preparing for the home visit, the Encounter Protocol prompts the home visitor to "prepare with an open mind" and "recognize what I bring to the interaction." It also provides tips for respectful communication (e.g., "avoid judgment," "ask opinion"), open-ended questions, and observation prompts to learn about the family' strengths and needs. Further, each of the monthly activities from birth through 36 months provide open-ended questions and prompts that elicit the parent's perspective on their child's development. They also promote home visitor-parent interactions that are built on trust and respect toward parents as the agent of change in promoting their child's development (e.g., "How might you ask questions that will help him figure out …").

Responsive Interactions with Parents and Families: The curriculum provides general principles and some strategies on how to engage in responsive interactions with parents. It recommends meeting the family where they are, using active listening, and eliciting information about family needs to provide individualized services. For example, there is a "Preparation" section in all Encounter Protocols that reminds home visitors, "It is crucial to have the courage to meet every family without preconceptions or prepared programs, to come open-minded and ready to listen, not knowing in advance what form our intervention may take." In another section, "Affiliation," the Encounter Protocol discusses how to effectively and authentically communicate with families using OPERA listening. Each Encounter Protocol ends with reflective questions (Reflection-On-Action) to promote responsiveness to the family's needs when planning future visits (e.g., "Did I hear or understand a concern from the family that I can follow up on?"). While the curriculum provides general direction on responsive interactions with families, it lacks more specific guidance embedded in the materials for responsive interaction with culturally and linguistically diverse families.

Peer Support: Baby TALK provides specific guidance on how to bring families together to facilitate peer support. The Guideline for Group Preparation resource provides reflective prompts to help the home visitor plan group activities for families. Factors to consider include materials, information from the curriculum that will be shared with the family, things to observe during the group activity, and developmental behaviors to support. The Group Encounter Documentation provides the home visitor with a tool for recording the interactions (e.g., parent-to-child, parent-to-parent, and child-to-child) that took place within the group activity, any concerns about families, family support systems, and reflections on the activity.

Professional Development: Baby TALK provides both comprehensive standardized initial training and ongoing professional development opportunities. There is a four-day Core Certification training that is required to purchase the curriculum. It covers a variety of topics to support curriculum implementation, including, but not limited to, supporting family engagement and parental mastery, facilitating parent-child interactions, and relating to families with cultural humility. In addition, technical assistance is provided through site visits or off-site interactive technology, which may provide individualized supports to programs.

Curriculum Materials to Support Implementation: Baby TALK includes a comprehensive, systematic set of user-friendly materials embedded throughout the curriculum to facilitate understanding and implementation of the curriculum. There are a variety of forms to guide the home visitor in planning the home visit, as well as documenting and reflecting on what occurred during the visit. The resources for each month of development (e.g., Encounter Protocols, Developmental Perspectives, Activities) also reference specific principles and strategies pertaining to home visitor-parent interactions as a constant reminder of the philosophy and approach of the curriculum.

• Fidelity Tool: The curriculum provides a tool for implementation fidelity called the Baby Talk Model Fidelity and Self-Assessment Tool. It covers questions pertaining to key components of the curriculum: the "12 Words" (Build a System, Screen Every Family, Identify the Need, Deliver Appropriate Services), the foundational "Critical Concepts," and protocols for family encounters. The tool contains "yes and no," open-ended, and Likert-scale questions to review the extent to which the program was implemented with fidelity and quality. There is also the Baby TALK Quality Confirmation Process document, which is used to examine the fidelity of the program overall, with a specific section to evaluate the quality of reflective supervision.

Family-Child Relationship: The curriculum consistently offers specific guidance and a process for how home visitors facilitate nurturing relationships between parents and children. For example, the HV Guideline for Preparation includes the question, "What parent-child interactions have I observed in the past that I will build on during this encounter?" Guidance can also be found in the Developmental Perspectives articles, which explain development from the point of view of the child to help the parent respond more appropriately to their child. Further, during each visit at each month of age, birth through 36 months, the Personal Encounter Documentation form has the home visitor describing their observations of the parent-child interaction in great detail (e.g., looking at things like holding, eye contact, talking, calming/comforting, smiling/laughing, serve and return, and play behaviors). 

Active Exploration and Play: The curriculum provides specific guidance on how parents can create ongoing opportunities to engage children in active exploration, movement, and play. For example, the "Children's Play" resource in the Family Fun series, discusses play as the "work" of childhood and provides tips for parents on how to support their child's play ("What Is My Role as a Parent in My Child's Play?"). The Homemade Toy series provides a range of activities to engage families in positive communication and play with children using homemade toys (e.g., Cloth Pin Drop; Bells on Their Toes; Fun with Blocks). The activities emphasize parents' role in encouraging children's play and exploration. Finally, the curriculum's monthly activities encourage parents to engage children in play, movement, and exploration. For example, at 6 months, the activity encourages parents to provide the baby with toys they can grasp and transfer between hands and to observe the baby's reaction (e.g., "Let's have you set some toys around her and see what happens."). 

Interactions that Extend Children's Learning: The curriculum provides some specific guidance for how parents can extend young children's exploration, thinking, and communication. On the Personal Encounter Documentation form, the home visitor records the extent to which the parent demonstrated play behaviors, including "Engagement" (e.g., the parent initiated interaction), "Encouragement" (e.g., the parent offered some verbal or physical support), and "Extension" (e.g., parent initiated an extension of the play activity). The monthly activities provide some guidance for parents on how to extend children's learning. For example, in the 15-month Fish activity, it prompts parents to "continue the learning during bath time by talking about fish, asking the child to wiggle and splash like a fish, and to pour water to and from containers." While the monthly activities consistently include guidance in the form of reflective prompts for parents (e.g., "How do you think she likes doing this activity?"), concrete supports to extend children's learning are not consistently embedded throughout curriculum materials. 

Individualization: Baby TALK describes the importance of building on a family's culture and home language. The curriculum materials emphasize engaging authentically with families and ensuring that supports are individually meaningful and relevant to families (e.g., Quality Confirmation Standards on Adult/Child Interactions and Curriculum). However, minimal guidance is embedded in curriculum materials on how to offer learning experiences that build on the families' culture and home language. Guidance to support a child's special needs is also lacking.

Environment: The curriculum provides guidance for how to use the home environment to support exploration and development. For example, the Developmental Perspectives for 8 Months instructs parents to make their home environment safe for exploration through child-proofing (e.g., baby gates, cabinet locks, removing choking hazards). 16-Month Activities encourages the parent to find safe places for the child to climb, either outdoors or at home, by creating a safe obstacle course. A limitation is that no specific guidance is provided about making the home learning environment accessible for a child with a disability, suspected delay, or other special need.

Learning Materials: The curriculum provides guidance for using learning materials in the home environment to promote open-ended exploration. The Homemade Toys series provides guidance on how to make homemade toys and use everyday household items. There are many examples of using homemade toys and materials found in the home to support learning experiences. For example, how to make a "Touch and Feel Book," using materials from home, and how to use everyday kitchen items such as measuring cups, spoons, and funnels to support learning experiences. However, there is no specific guidance for how to incorporate learning materials that are accessible to children with disabilities, suspected delays, or other special needs. 

Routines: Baby TALK provides specific guidance, embedded throughout the curriculum, on how to support parents and families in establishing developmentally appropriate routines that foster learning. For example, resources such as "Goodnight Toddler," "Toilet Training," and "Daily Schedules" provide guidance and strategies for helping parents establish predictable routines for children. Additionally, Cycles & Routines contains documents on "Dressing, Diapering, Feeding," "Value of Daily Schedule," "Bedtime Routine," and "Bath Time Fun," all of which explain the learning opportunities within these routines.

Interactions: The curriculum recognizes the importance of cultural responsiveness. For example, the Baby TALK White Paper describes the importance of "valuing each family's culture and traditions and honoring these traditions in program practices." Training materials provide guidance on cultural responsiveness. The curriculum also cites research that shows how the home visitor's non-judgmental, optimistic attitude about parents is more likely to lead to increased family participation and positive family outcomes. However, the curriculum materials provide no further guidance for engaging in culturally responsive interactions with diverse children and families.

Learning Experiences: While the curriculum emphasizes responsiveness in general, there is minimal guidance in the materials on how to plan or adapt learning experiences based on families' traditions, cultures, and values. There are some references to culture in a few sources. For example, in the 2-Month Activities, the reflective questions include the following prompts: "How might you encourage your baby to understand who she is? Your family's culture? How did you learn about who you are and the family you come from?"

Linguistic Responsiveness: The Baby TALK curriculum does not provide guidance for how to intentionally support the development and learning of children who are DLLs.

Resources and Referrals: The curriculum's approach promotes building a system of support and the delivery of appropriate services. Baby TALK emphasizes the importance of providing resources and referring families to resources in the community. Guidance is included to discuss the potential need for referrals at each home visit (e.g., the Referrals Document keeps track of all referrals made by the home visitor to the parents; the Personal Encounter Documentation form includes the question of whether a referral is needed). However, the curriculum does not provide specific guidance for home visitors on how to identify resources or how to support families in referrals relevant to children with disabilities, suspected delays, or other special needs. For example, the Developmental Perspectives for 12-month-olds recommends sharing developmental concerns with the pediatrician, and the pediatrician will "keep an eye on the concern to make sure it is addressed as quickly as possible." No further information is provided on specific services for children identified with a developmental delay (e.g., Early Intervention services under Part C of the Individuals with Disabilities Education Act (IDEA)).

Learning Environment: The curriculum does not include clear suggestions for parents and families about how to set up an appropriate environment and materials to support the development and learning of their child with a disability, suspected delay, or other special need.

Parenting Practices and Interventions: The curriculum provides limited guidance on how home visitors and families can adapt learning experiences for a child with a disability or other special need. For example, in the Let's Talk Kids column, Special Kids, Regular Lives, families and home visitors are reminded that children with special needs are children first. Additionally, another column, When Kids Know Best, briefly mentions the issue of sensory overstimulation and the importance of supporting the child to avoid difficulty with concentration, stress and anxiety, and other significant challenges. Baby TALK lacks more specific strategies related to parenting practices and interventions to support children with special needs.

Individualization Based on Interests: Baby TALK provides some guidance for engaging the home visitor and parent in learning about the child's interests. For example, materials like the Encounter Protocol promote a reflective process that includes open-ended questions (e.g., "Where does your child like to explore? What are some of his favorite books? Does he seem to like sorting and grouping objects?") In addition, there is a Parent Interview form that guides the home visitor to ask the parent about their child's favorite play things. Overall, the curriculum's approach emphasizes the importance of implementing the activities responsively. However, there is no specific guidance on how to tailor activities based on children's individual interests.

Individualization Based on Strengths and Needs: The curriculum provides general guidance for how to tailor home visits based on the strengths and needs of individual children. It discusses the importance of implementing the activities responsively, being sensitive to the development of the child. The Encounter Protocols include a structure and prompts to engage the home visitor and parents in "Observation" (e.g., "How does the toddler show frustration?"), to notice "Developmental Behaviors" (e.g., "Elicit or note expected behaviors and the meaning parents are making of the behavior."), and to consider this information when planning the next family visit. Several resources in the curriculum discuss individual differences (e.g., Temperament). However, the curriculum materials lack specific guidance on how the home visitor can tailor the monthly learning activities to children's individual strengths and needs.    

Family Goals: The Baby TALK curriculum provides a specific process for setting family-level goals in the following three categories: parent-child interaction; child development; and personal, work, academic, and family well-being. The curriculum includes procedures to assess the family's strengths, resources, and areas of need to guide the development of the Individual Family Service Plan form. For example, the form Baby TALK Family Resource Assessment & Monitoring guides the discussion and reflection with the parent on goals and concerns around education, career, and financial capabilities; physical, emotional, and spiritual health; relationships and role models; support systems; and child growth and development. Family Resource Assessment Instructions, an accompanying form, provides further details on goal-setting based on the assessment. Additionally, there are tips within the monthly resources for engaging parents in setting goals.

Ongoing Assessment of Progress Toward Family Goals: Baby TALK includes a specific process and tools for ongoing assessment of progress toward family goals. The Individual Family Service Plan—Goals form indicates goals should be specific, measurable, achievable, realistic, and timely (SMART). The form is to be used for documenting the goal, action steps by the parent, action steps by the family support staff member, target completion date, and progress toward meeting the goal.

Resources and Referrals: Baby TALK consistently promotes discussing with parents the need to seek further resources and referrals. The Personal Encounter Documentation form asks the home visitor to note any resources needed and referrals made during the visit. Similarly, the Family Resource Assessment Instructions form provides questions the home visitor can ask the family about their specific needs for additional resources and referrals for supplementary services. While there are tools to facilitate the process, more explicit guidance is needed to support home visitors on how to refer families to additional resources in the community.