Reach Out and Read when implemented with fidelity is a two generational intervention, as are Head Start, Video Interaction Project, Circle of Security and many home visitor programs. The presence of a safe, stable and secure relationship with important adults is a strong mitigating influence on the stress response of young children. Adult education and job skills programs coupled with quality early childhood programs may be an opportunity to benefit both parent and child. What is your experience with strategies for community pediatricians that are not integrated or co-located programs, but embedded in periodic health maintenance/anticipatory guidance visits during the first three years?
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