Kia Timata Pai (Best Start): The effect of teacher-child interactions on young children's oral language and self-regulation

The aim of this project is to conduct a cluster randomised controlled trial (RCT) to evaluate two evidence-based programmes — ENRICH (Enhancing Rich Conversations) and ENGAGE (Enhancing Neurocognitive Growth with the Aid of Games and Exercise) — to support children’s oral language and self-regulation skills in the early childhood years. Through professional development with teachers, we will begin when children are age 1.5 years and follow them to age 6 years. ENRICH is conversation and book-based to foster toddlers' and preschoolers' oral language skills; ENGAGE is games-based to foster preschool children’s self-regulation skills. We will evaluate the effectiveness of targeting oral language alone (ENRICH) versus self-regulation alone (ENGAGE) versus a combined oral language and self-regulation arm (ENRICH + ENGAGE) relative to an active control group (curriculum as usual + child development webinars). The four arms are thus (anticipating 400 children in each): 1) Language only: ENRICH (1.5 to 3 years) plus ENRICH+ (3 to 5 years) 2) Self-regulation only: ENGAGE (3 to 5 years) 3) Combined: ENRICH (1.5 to 3 years) plus ENRICH+ (3 to 5 years) plus ENGAGE (3 to 5 years) 4) Active control: Curriculum as usual + child development webinars ENRICH and ENGAGE will be delivered using a "train the trainer" model in which investigators and trained facilitators with at least 10 years of experience in early childhood education will train professional practice leaders in the BestStart early childhood organisation in small face-to-face or online workshops. Professional practice leaders will receive a 2-day training workshop in the conversational techniques (ENRICH) when children are 1.5 years old on average, and a separate 1-day training workshop in the advanced conversational techniques (ENRICH+) and/or games (ENGAGE) when study children are 3 years old. In between workshops, professional practice leaders will receive booster training sessions every 9 months via face-to-face or video training to explain the new resources and how to use them. The mode of training at workshops will be via background information sessions, interactive activities, and short videos for a total of 12 hours across 2 days at the start of the study at age 1.5 years, a total of 12 hours across 2 days at age 3 years for the combined ENRICH + ENGAGE group, and a total of 6 hours in one day at age 3 years for the ENRICH-only group and for the ENGAGE-only group. The booster training sessions in between workshops will occur every 9 months (at age 2.25, 3.75, and 4.5 years) and will be 2 hours each. Professional practice leaders, all of whom are qualified early childhood educators with at least 10 years of experience in the field, will then train the early childhood teachers in small face-to-face or online groups. Teachers will then use the new techniques with the children in their care. Teachers in the intervention arms will receive new resources (a set of cards specially designed for this study with tips for interactions and games) and new books every 6-9 months. The books will be commercially available, but will contain conversation prompts on each page that have been specially designed for this study. Teachers in intervention arms will invite parents at their centres to learn about the new techniques through information evenings and video links. The intervention will take place in early childhood classrooms on a daily basis from when study children are aged 1.5 to 5 years for ENRICH, and from age 3 to 5 years for ENGAGE. Teachers will be encouraged to use the ENRICH activities at their discretion throughout the day during five routines: mealtimes, nappy changes/clean-up time, book-reading time, free-play time, and group time. Teachers will be encouraged to use the ENGAGE games for up to 30 minutes each day. The ENGAGE-only arm of the intervention will receive the same webinars (on childhood nutrition) as the active control group for the first 1.5 years of the study before the intervention begins at age 3 years. The active control group will continue to receive webinars (on children's friendships) during the preschool phase of the study from ages 3 to 5. Intervention fidelity will be measured in two ways: 1) via teacher self-ratings of the frequency and quality of their delivery of the techniques with individual children on a fortnightly basis; and 2) via videotaped teacher-child interactions in the classrooms once a year on a subset of 24 participating centres, 6 from each arm. Teachers will be provided with feedback on their use of the techniques to maintain and improve fidelity. The trial represents a partnership between BestStart Educare, an external implementation service (Methodist Mission Southern), and a consortium of academics (Emotion Regulation Aotearoa/New Zealand) to provide a culturally responsive intervention with codesigned implementation. This research-informed and collaborative approach entails engaging with our research partners prior to each wave of data collection and teacher training. We provide our partners with the opportunity to review proposed measures and procedures. This approach may lead to adjustments over time in response to partner feedback (e.g., response burden of measures or timeline for assessments) or in response to emerging research evidence.