The tasks associated with parenthood can be overwhelming. Most parents have access to a wealth of written materials, media, and web-based resources to assist them. For parents who have cognitive limitations (CL), however, these resources are typically inaccessible or incomprehensible. Specialized training for parents who have CL remains scarce nationwide with no systemic support from state or federal governments. Professionals are ill-equipped to adequately support these families in three major ways: (1) uncertainty about how to identify parents who have CL, (2) limited knowledge and understanding about how to best support parents who have CL, and (3) the lack of training materials geared to the learning needs of this group. Without appropriate support, positive parent and child outcomes in families headed by parents who have CL are limited, seriously compromising the potential healthy development of over 120,000 babies are born in the United States each year to mothers with CL. Thus, there is a serious public health need for flexible, appropriate and engaging parent education training materials for parents who have CL and the professionals supporting them. In Phase I we: developed a parent training program, My Bedtime Routine, for professionals to use with parents who have CL, conducted a feasibility evaluation of the program and held a program review with a panel of social service professionals and at-risk parents. The results of the evaluation were encouraging. Parent participants established bedtime routines or improved their already-established routines, and experienced less stress and more fun with their children at bedtime. Use of My Bedtime Routine also led to improvement in the quantity and quality of professional-provided support. We believe these Phase I results justify expanding and completing the program. We propose to expand the program in Phase II and evaluate the program using a delayed, treatment-control group design with 80 pairs of parents and support professionals to assess the efficacy of the program in: 1) increasing professionals' knowledge, skills and confidence related to working with parents who have CL, 2) increasing the quantity of support offered by professionals to the targeted parents, 3) improving the quality of the relationship between professionals and targeted parents, and 4) improving parents' skills in the program topic areas.
