P2.128: Early Language Promotion Through Public Libraries: An AAP Community Access to Child Health (CATCH) Advocacy Project

Background: The first three years of a child’s life constitute the most critical and rapid period for brain growth and development. Children struggle to catch-up from language deficits that occur during this sensitive period, contributing to critical disparities in school readiness. Public libraries have been identified as an underused community resource that pediatricians should be promoting to improve early literacy and school readiness.

Project Description: Our AAP Community Access to Child Health (CATCH) grant partners with the Denver Public Library (DPL) to promote the early home language environment through libraries. We developed PUPPETalk™ (PUppets to Play, Praise, Educate, and Talk®) as an exceedingly simple, low-cost intervention using finger puppets to support positive, language-rich caregiver-infant interactions. PUPPETalk takes less than one minute to deliver with a finger puppet costing $1. It includes puppets and a handout with suggested activities, which have been made into brief family video demonstrations. For this grant, we created a website allowing families to access these videos by QR code on the handout. We aim to deliver PUPPETalk to 300 families with pregnant moms or infants under 6 months of age, with the goal of widespread dissemination through DPL. Five librarians in DPL’s Early Learning Department completed a 1-hour workshop and are now delivering PUPPETalk as part of existing early literacy programs (e.g., Baby Storytime and LENA Start) in low-income communities. Outcomes focus on feasibility and acceptability as well as changes in child development knowledge through family and librarian surveys. The planning phase is complete, with data collection through August 2025.

Discussion: Studies have shown that increasing home exposure to positive parenting behaviors improves children’s early language experience, leading to better developmental outcomes. Verbally-rich parent-child interactions beginning in early infancy build a critical foundation that supports long-term language learning trajectories. PUPPETalk focuses on preverbal language during one of the earliest and most critical periods of development often not addressed by early intervention programs, offering an innovative opportunity to augment DPL’s existing early literacy programming. PUPPETalk serves as a vehicle for professionals to introduce the importance of early talking and facilitate caregiver-infant interactions, while the actual impact is the caregiver’s subsequent communications to the child long after providing the puppet. Pilot studies are encouraging, suggesting that families receiving PUPPETalk had better outcomes related to maternal postpartum depression, the cognitive home environment, and language and socioemotional development. While research is underway in the medical setting, this project explores the feasibility and acceptability of disseminating PUPPETalk in the community.

Conclusion: Our AAP CATCH grant aims to promote the early home language environment in underserved communities by disseminating PUPPETalk, a simple and low-cost intervention to support language development and early relational health, through a new community partnership with public libraries.