This study investigated predictive relations between preschoolers’ (N 310) behavioral regulation and emergent literacy, vocabulary, and math skills. Behavioral regulation was assessed using a direct measure called the Head-to-Toes Task, which taps inhibitory control, attention, and working memory, and requires children to perform the opposite of what is instructed verbally. Hierarchical linear modeling (HLM) was utilized because children were nested in 54 classrooms at 2 geographical sites. Results revealed that behavioral regulation significantly and positively predicted fall and spring emergent literacy, vocabulary, and math skills on the Woodcock Johnson Tests of Achievement (all ps .05). Moreover, growth in behavioral regulation predicted growth in emergent literacy, vocabulary, and math skills over the prekindergarten year (all ps .05), after controlling for site, child gender, and other background variables. Discussion focuses on the role of behavioral regulation in early academic achievement and preparedness for kindergarten.

Links between behavioral regulation and preschoolers' literacy, vocabulary, and math skills.

Objectives To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. Data sources We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. Review methods We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. Results We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on health care service use or health outcomes. Two studies suggested numeracy may mediate the effect of disparities on health outcomes. We found no evidence concerning oral health literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. Conclusions The field of health literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for health literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) health literacy; and examining mediators and moderators of the effect of health literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions.

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Health literacy interventions and outcomes: an updated systematic review.

The authors examined a new assessment of behavioral regulation and contributions to achievement and teacher-rated classroom functioning in a sample (N = 343) of kindergarteners from 2 geographical sites in the United States. Behavioral regulation was measured with the Head-Toes-Knees-Shoulders (HTKS) task, a structured observation requiring children to perform the opposite of a dominant response to 4 different oral commands. Results revealed considerable variability in HTKS scores. Evidence for construct validity was found in positive correlations with parent ratings of attentional focusing and inhibitory control and teacher ratings of classroom behavioral regulation. Hierarchical linear modeling indicated that higher levels of behavioral regulation in the fall predicted stronger levels of achievement in the spring and better teacher-rated classroom self-regulation (all ps < .01) but not interpersonal skills. Evidence for domain specificity emerged, in which gains in behavioral regulation predicted gains in mathematics but not in language and literacy over the kindergarten year (p < .01) after site, child gender, and other background variables were controlled. Discussion focuses on the importance of behavioral regulation for successful adjustment to the demands of kindergarten.

/pdf/a-structured-observation-of-behavioral-self-regulation-and-2upspt9cir.pdf

A structured observation of behavioral self-regulation and its contribution to kindergarten outcomes.

Behavioral, neuropsychological, and brain imaging research points to a dedicated system for processing number that is shared across development and across species. This foundational Approximate Number System (ANS) operates over multiple modalities, forming representations of the number of objects, sounds, or events in a scene. This system is imprecise and hence differs from exact counting. Evidence suggests that the resolution of the ANS, as specified by a Weber fraction, increases with age such that adults can discriminate numerosities that infants cannot. However, the Weber fraction has yet to be determined for participants of any age between 9 months and adulthood, leaving its developmental trajectory unclear. Here we identify the Weber fraction of the ANS in 3-, 4-, 5-, and 6-year-old children and in adults. We show that the resolution of this system continues to increase throughout childhood, with adultlike levels of acuity attained surprisingly late in development.

/pdf/developmental-change-in-the-acuity-of-the-number-sense-the-1bvey21r6z.pdf

Carrie L. Farris

Papers

Links between behavioral regulation and preschoolers' literacy, vocabulary, and math skills.

Touch your toes! Developing a direct measure of behavioral regulation in early childhood