The Problem

Lack of predictable and stable daily routines at home can make it hard for children to develop executive function skills. These skills are crucial to a child’s ability to filter distractions, prioritize tasks, set and achieve goals, and control impulses. All are important behaviors for getting along with others and doing well in school. Later in life, these same skills are essential for adults in their roles as parent, employee, friend, and citizen.

The Theory of Change

When adult caregivers and their children work together to plan and execute consistent routines, they build executive function skills and enhance parent-child interactions. Consistent routines allow children to know what comes next, plan, act, reflect on their behavior and compare it to their plans, and resist temptations and distractions. As a result, they help children feel more secure in an otherwise unpredictable and uncertain environment. In addition, regular family routines can decrease parental stress. Read more about how theories of change guide program design and evaluation.

Our hypothesis:

• The intervention will be well tolerated and feasible for low income families.
• The intervention will lead to the development of more consistent routines.
• Children and parents will show significant increases in executive function performance.

Intervention: The “How”

This intervention has completed its second pilot at three sites in the United States and Canada that deliver services to families living with low incomes. Over the course of 8 to 12 regular sessions, trained staff coached groups of parents on concepts such as mindfulness, planning ahead, increasing autonomy, scaffolding, and reflection. These concepts are embedded in activity cards that have a colorful, easy-to-use format. Parents used these at home with their children to build and practice their own family routines. Data analysis is currently being conducted on the 89 parent-child dyads that were enrolled in this pilot.

Assessments being used to evaluate this project:

• Minnesota Executive Function Scale (MEFS). A touch-screen, tablet-based behavioral measure of executive function.
• Theory of Mind Scale. Assesses children on their understanding of different perspectives, access to knowledge, beliefs, emotions, and intent of language.
• Parental Stress Index. Self-reported stress levels of parents.
• Family Self-Assessment Rubric. Families assess their routines at home.
• Family Reflection Form. Families reflect on their experience.

What We’ve Learned

• Parents are very interested in an intervention that supports regular family routines.
• Parents are especially interested in the mindfulness component of the intervention.
• A coaching/practice component to the workshops is necessary for building new skills.

In addition, once the strategy is proven feasible and effective, team members will have access to thousands of children and families collectively for larger-scale testing, and connections to Head Start and Early Head Start would allow for further scale up beyond the current partners. By simultaneously testing the intervention in two countries, momentum can be built for international exposure and uptake.