So whats so great about book-

sharing?

Lynne Murray and Peter Cooper

 Characteristics of optimal language
environment
Parentese - simplified utterances, repetitive.
Child centred: pitched at childs developmental
level, builds on childs capacity (e.g., extensions,
expansions), solicits best performance (e.g.,
prompt questions)
Predicts language development
Mostly studied in conversations at home
 Book-sharing context
Early evidence of privilege of book-sharing
- Classic study of Ninio and Bruner (1978) -
book- sharing a language acquisition device
e.g., 75% all pointing and naming done in
context of book-sharing
More recent evidence of privilege of BS for emotion
and mental state talk (Adrian et al., 2005)
Frequency of book sharing predicts child literacy
and language, independent of SES
 Book-sharing core techniques
Follow the childs interest
Engage child as active partner
Possible even with small infants in terms
of exploration
 Book-sharing core techniques
Engaging older child as an active partner (dialogic)

Talk in response to childs developing understanding e.g.,

- Point and name words not known
- Ask where is the..? for word understood
but which the child cant say
- Ask what is..? for word child can say
- Ask why? for reasoning/theory of mind
- Link to childs experience
 Specific benefits
1. Reference - names for objects, actions, mental
states

2. Enriching understanding - elaborating, making

links

3. Theory of Mind skills - understanding emotions,

intentions and perspectives
 Helen Oxenbury baby books
Drawings are simple, prototypical
Reference - Pointing and naming characters and things

Babys
hand
Babys bottom Babys tummy

baby another baby

baby and another baby
 Reference - Pointing and naming actions

Baby blowing, Baby blowing

Baby banging Baby banging
Reference and concept formation
Iteration of the same referential term across
multiple, varying, examples builds up the link
between the word and the concept
2. Enriching understanding
Acting out and making links
Mummy brushing
babys hair

Yes, like brushing your hair

Like brushing
your hair
Linking: Doggys tongue. Your tongue
 Making wider links with book material

Carer connects the content of the book to

things familiar to the child

- for example, comparing a dog in the

book to a neighbourhood dog, and to the
infants knowledge of what dogs do
 3. Theory of Mind Skills
Talking about more complex topics, such as
feelings, intentions and perspectives can be
simpler in the book-sharing context than in real
life, where events happen too quickly for
reflection, and it may be less threatening in
being removed from reality
 (i) Talking about feelings

When children know about feelings and can talk

about them, they can:
make sense of their own feelings
understand other people, and get along with them
(parents emotion talk predicts better child social
adjustment)
Talking about feelings

A baby monkey
realises he wants
his mummy,
feels sad, and
then feels happy
when reunited
 Talking about Feelings (Training slide)
Help your child understand feeling words like 'happy',
'angry worried, by highlighting the characters
expressions, and linking them to their feelings

Look at his face: the little monkey The monkeys have great big smiles,
looks so sad! they look very happy!
 (ii) Talking about intentions
Childrens understanding of intentions affects how
they respond to others
(e.g. how they would react if they know someone bumped
into them by accident, or pushed them on purpose)

When children know about intentions, they can:

make sense of their own behaviour
understand other people, and get along with them
 Talking about intentions (training slide)
You could ask:
Why is Harry running
downstairs with the
brush?

(Give your child time to think)

Do you think its because

he doesnt want to have a
bath?
 (iii) Talking about Perspectives
If children can understand that people can have
different perspectives, they can understand why
they might behave differently

They will then be more able to avoid

misunderstandings and problems, and also help
others

Children who are good at perspective-taking

get on better with other children and are less
likely to have behaviour problems
 Talking about perspectives (training slide)
Harry is covered in seaweed. We know that he is Harry BUT
the other people dont know this.
They think he is a sea monster.
So you could ask:
Why is the little girl scared of Harry?
Is it because she thinks that Harry is a sea monster?
 So, whats so great about book-
sharing?
Multiple benefits, including that:
Pointing and naming facilitates reference
Extensions and linking build on child
knowledge
Socratic questioning (wh questions) develops
linguistic and cognitive competence
Affords discussion of mental states, emotions,
intentions, and perspectives
Opportunity for one-to-one closeness
 Psychometrics 101:
what do we mean by an Effect Size?
0.20 - 0.50 = small ES
0.50 - 0.80 = medium ES
>0.80 = large ES
 The First Trial:
Accelerating Language Development through
Picture Book Reading
Whitehurst et al 1988

30 21-35 month old children middle class families from Long

Island all of whom read to their children randomised to
index and control groups

Index parents (mostly mothers) provided with training in dialogic

reading over 4 weeks two face to face 30 minute sessions &
two phone calls

Expressive language ES = 1.18

Receptive language ES = 0.58
 The Most Recent Trial:
Engaging Fathers in Effective Parenting for Pre-
School Children using Shared Reading: an RCT
Chacko et al 2017
Used book-sharing training as a vehicle for Behavioural Parent
Training (consistency, routines, attention/ignoring, praise, etc)

126 Spanish speaking low income families with 4 year olds in New York
randomised to index and control groups
Index group received 8 weekly 90 minute group session (6-12 fathers)
run by trained facilitators while the children were facilitated in
structured play

Eyberg Child Behavior Inventory - ES = 0.51

Preschool Language Scale - Receptive ES = 0.52
- Expressive ES = 0.51
 Why might book-sharing fail
Goldfeld et al, 2011
Large population based Australian cluster RCT with
8 month old children

Receptive language: EF = 0.03

Expressive language : EF = 0.04

Perfunctory training of facilitators

Limited use of the range of possible dialogic reading techniques
Few, brief, and widely spaced out training sessions
Heavy reliance on simply handing out learning materials and books
 So we developed our own Dialogic
Book-Sharing Programmes for South Africa
Designed to enhance child language, cognition,
and socio-emotional development
 The Programme

Manualised intervention based broadly on Whitehurst

programme, with increased intensity/duration/scope
 Techniques
Following the interest of the child
Pointing and naming
Questions (What | Where | Who | Why)
Using Actions
Discussing Emotions
Talking about intentions
Considering Perspectives
Discussing Relationships
 Programme Delivery

A trained facilitator runs group sessions with 4-6 carers

6-8 weekly sessions, each devoted
to a particular topic, using
Powerpoint presentations
with embedded demonstration
video clips
the carer and child are given a
book home each week to share
 One-to-one
After the group session there is a brief one to one
session where the facilitator gives support to the carer
Provides encouragement
Reminds about new techniques
Reiterates old techniques
If necessary, models good practice
 Three overlapping programmes for
parents
Carers of 12-20 month olds
Carers of 20-30 month olds
Carers of 30-60 month olds
(in English, Sesotho, isiXhosa, Afrikaans, Italian, Hindi)
Also a programme for ECD teachers
 Khayelitsha RCT 12-20 month programme
(funded by the DG Murray Trust and the Felix Foundation)

91 families, 14-16 month old children, randomised to:

8-week programme in book-sharing (n=49)
No intervention control group (n=42)

Primary Outcome Measures:

1. Child Language
2. Child Attention

Vally et al (2015) Journal of Child Psychology & Psychiatry

 Trainers

Two local isiXhosa-speaking women carefully selected who had

completed high schooling, ensuring acceptability of intervention to
participants (Phumza Gwaqka, Vuyolwethu Notholi)
Received training before the commencement of the study:
- didactic, video presentations of vignettes, role-play exercises,
video-feedback of mock training sessions
Worked directly from a session by session manual
Support and mentoring provided in once-weekly supervision by a
psychologist
 Parental Report on
Infant Language (CDI)
60

50
Number of words

40

30 Pre
Post
20

10

0
Index Control Index Control

CDI Understands CDI Understands and Says

CDI Understanding: t(80) = 3.25, p = 0.002; d= 1.21

CDI Understands & Says: U= 357.50, z =4.43, p<0.001; d= 0.98
 Infant Attention (ECVT)
50
45
40
35

% 30
25 Pre
20 Post

15
10
5
0
Index Control

Attention: t(80) = 4.91, p<0.001, d = 1.10

 Psychometrics 101:
what do we mean by an Effect Size?
0.20 - 0.50 = small ES
0.50 - 0.80 = medium ES
>0.80 = large ES
 Effects on
Parental Sensitivity and Reciprocity
0,8 1,8
0,7 1,6
0,6 1,4
0,5
1,2
0,4 Book
1
0,3 Book sharing
sharing 0,8
0,2 control
Control 0,6
0,1
0 0,4
-0,1 0,2
-0,2 0

Sensitivity (d=0.78) Reciprocity (d=0.45)

Notably:
Mediation
the impact of the training on
child language was significantly
mediated by enhancement of
maternal reciprocity in book-
sharing
and
The impact of the training on
child focal attention was
significantly mediated by
enhancement of both maternal
reciprocity and sensitivity in
book-sharing
Who Benefits Most?
Towards educational equity
 Two socio-emotional tasks

Helping task the pen task

(modelled on Buttleman et al, 2009)

Imitation task
(based on Meltzoffs idea that imitation reveals social
understanding)
 Effects of Book sharing training on
infant socio-emotional development
(%)
Murray et al (2016) Journal of Child Psychology & Psychiatry

d= 0.62 d=0.59
 Four Current RCTs
Kansas City Pilot RCT supported by the University of Kansas BS (late 2017)
12 month olds
Detailed examination of child attention and joint attention

Khayelitsha Benefits of Early Book Sharing (BEBS) supported by SA MRC ND/MT (early 2018)
Older age group - 23-27 months
Expanded set of outcomes:
theory of mind (social understanding)
positive parenting
child pro-social behaviour
child aggression / externalising behaviours

Lesotho Trial (Mphatlalatsane) supported by USAID MT et al (mid-2018)

Large cluster trial in Mokhotlong district, families with 12-60 month olds
Child nutrition + Book Sharing + HIV prevention
Assessing a wide range of cognitive and socio-emotional outcomes

Reading (UK) Trial (EPICC) supported by the Nuffield Foundation (late 2018)
Cluster trial of families of 3 4 year old children attending Childrens Centres
Could Book-sharing Prevent the
Development of Violence?
 The Mikhulu Trust
A UK charity and a SA NPO

www.mikhulutrust.org

David Jeffery
Director of Operations and Training
David.Jeffery@mikhulutrust.org

Supported by the WHO, the IPPF, the Jim Joel Fund, private
donations from the UK
 Implementation in South Africa
Over 2016/17, following a social franchise model, David
and Vuyokazi have been training and licensing
organisations in South Africa to deliver the programme
to primary caregivers and teachers at ECD Centres

Key Partners:
The Centre for Justice and Crime Prevention
+ Masifunde (Port Elizabeth)
Sikhula Sonke (Cape Town)
Love to Give (Stellenbosch)
Save the Children South Africa (Johannesburg)
Seven Passes (Touwsranton, Western Cape)
 The Mikhulu Trust Wordless Book Series
Little Helpers Lyn Gilbert
The Herd Boy of Mokhotlong Helen Ward
Alls Well that Ends Well Lyn Gilbert