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Addressing Disparities in Parent Education: Examining the Effects of Learn the Signs/Act Early Parent Education Materials on Parent Outcomes


Early intervention is critical for improved prognosis and quality of life for young children with developmental delays and disabilities. Yet, disparities persist among underserved families with young children. These disparities include knowledge of child development, use of medical providers as referral sources, and later diagnosis. The current study employed a mixed method, randomized controlled trial to examine participant outcomes among low-income, underserved families who received child development information. The information included the 42-page Milestone Moments booklet that was developed by the Centers for Disease Control and Prevention’s Learn the Signs/Act Early initiative. Participants (n = 108) included parents or legal guardians of children ages birth through 5 years. The participants were predominantly Black/African American (86 %) and female (90 %), and all had incomes below the federal poverty level. Study variables related to the location (home vs. child care center) and context (single session vs. extended visits) for delivering the information did not yield significant differences. Yet, there were clear findings that parents who received the booklet reported increased knowledge about child development, a decrease in concern about their own children’s developmental progress, and a positive perception of the booklet. On interview, parents reported learning new information about child development or being reminded of developmental information they had forgotten and the importance of following up with professionals when concerns arose. While not statistically significant, there was a consistent trend toward greater participant outcomes for parents who received materials in the child care setting relative to the home.

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The research reported in this article was supported in part by the National Center on Birth Defects and Developmental Disabilities (NCBDDD) of the Centers for Disease Control and Prevention (CDC) under Cooperative Agreement U01DD000231 to the Association of University Centers on Disabilities (AUCD). The content is solely the responsibility of the authors and does not necessarily reflect the views and policies of CDC, NCBDDD, nor AUCD.

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Correspondence to Emily Graybill.

Appendix: Milestone Moments Fidelity Checklist

Appendix: Milestone Moments Fidelity Checklist

Please check the items that were discussed with the parents

___ Introduced the booklet

___ Inquired about the child’s age

___ Chose to focus on the oldest child age 4 or younger

___ Found the section of the MM that corresponded to the child’s age

___ Described the content on the first page while showing the page to the parent

___ Described the content on the second page while showing the page to the parent

___ Described the content on the third page while showing the page to the parent

___ Described the content on the fourth page while showing the page to the parent

___ Described the section highlighting “red flags” on the bottom of the third and fourth pages while showing the pages to the parent

___ Read the skills listed in the “red flags” section to the parent

___ Told the parent to follow up with the child’s pediatrician if the child has one “red flag”

___ Asked the parents if they had any questions about the MM booklet

___ Asked the parents if they had any questions about the child’s development

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Graybill, E., Self-Brown, S., Lai, B. et al. Addressing Disparities in Parent Education: Examining the Effects of Learn the Signs/Act Early Parent Education Materials on Parent Outcomes. Early Childhood Educ J 44, 31–38 (2016).

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  • Early identification
  • Reducing disparities
  • Parent education materials