# Pram Good, Stroller Bad...What? No wonder this is a "report".

A recent post up at the Frontal Cortex points approvingly to a study of strollers, prams, toddlers and parental conversation. Jonah Lehrer concludes:

It would be nice to see this research filter down to stroller manufacturers, so that even cheap plastic strollers allow the infant to interact with the parent.

Very interesting. Must be strong evidence, no? And after all, we all want our little wackaballoons to be as smart and advanced as possible, do we not?

Good
The take home message of the UK National Literacy Trust press release is:

The most popular style of baby buggies - those that face away from the pusher - may be undermining children's development. Children in such buggies are significantly less likely to talk, laugh, and interact with their parents, than are those in buggies that face the pusher, according to the first ever research study on the psychological effects of buggies on babies. It is published today by Talk To Your Baby, the early language campaign of the National Literacy Trust, an independent charity that aims to change lives through literacy. It was funded by the Sutton Trust.

Okay, first bad sign is the lack of a citation to a peer reviewed journal article. Hmm. Moving along, there's a link to another page with an even more aggressive summary:

The report concludes that life is emotionally impoverished for too many babies in buggies facing away from their pusher. Therefore, TTYB calls on manufacturers and retailers to create more affordable two-way facing buggies. Parents with such models should utilise the face-to-face option as standard, so that young children and their carers can talk and listen to each other as they are out and about.

and finally the actual report in pdf form. More evidence of a lack of formal peer review. Calling the blogosphere and OpenScience fans I suppose. Lehrer's post was a bit on the credulous side I fear, so let's get to it.
The biggest part of the report is from a field observational study:

The final sample comprised data on 2722 parent-infant pairs. This derives from a total of 39 hours of observations carried out by the 57 volunteers, conducted over two months during the summer and autumn of 2008 (August and October). Observations were collected in 54 cities and towns throughout the UK, located in 22 regions.

It's a covert observational study so some things such as child age were estimated. The first obvious issue I thought of on reading the Frontal Cortex brief is covered in the first "research question" table on page 7. For the under 1 yr old babies 60% were in strollers and 34% were in prams (6% carried, none walking). For 1-2 year olds 86% in strollers and 4% in prams (3% carried, 7% walking). For the 2+ year old demographic, 37% in strollers, 2% in prams, 3% carried and 58% walking. Hmm. This would seem to me to be a major confound unless we know something about the major dependent variable (time parents are talking to kid) across the age ranges in most settings.
Then we come to the second data table on page 8 in which we learn that the under 1 yo babies were vocalizing only 5% of the time and sleeping 35% of the time whereas for the 2+ yo kids they were vocalizing 38% of the time and sleeping only 2% of the time! Crying was the same at 2% across age groups.
Okay, now down on page 9 of the report we come to the percent of parents that were talking to their kids. Rates were pretty low wiht 13% talking to under 1 yo babies, 17% to the 1-2yo and 35% talking to 2+ yo kids. Eleven percent of parents were talking when using a stroller and 25% with a buggy however carryied (46%) or walking (47%) children received much more parental conversation. (And here I'm trying VERY hard not to speculate that most of the conversation for new walkers revolved around "Get away from the kerb", "stay out of Missus McGillicudy's flowers, "c'mon keep walking luv'" and the like.) So we're not getting very convincingly away from the idea that the amount of parental vocal attention correlates best with age of the child.
Back up to the end of page 8 the table reports that of awake babies, 12% in strollers were vocalizing versus 17% of pram babies...AHA! except oops, 6% of stroller babies were twisting around trying to get their parent's attention (versus 1% of pram babies). So basically the same number are engaging in interaction with the parent and frustratingly the data do not get at the key issue. Namely, are parents ignoring their vocalizing or attention-attracting stroller babies relative to pram babies? The analysis doesn't tell us. Oh wait, here we go. Down on page 10-11 we discover that attempts to get the parent's attention via crying or turning around were unsuccessful in the 8% that tried it.
Really? Crying babies were being ignored by the parent? This suggests we have more factors to look into having to do with parental proclivity to respond to baby's every exhibited need or to let them cry it out. Temporary frustration measures caught in the brief-sampling study versus sustained parental traits. Which reminds us to ask if those parents who use prams are a very different type of parent from those who use strollers, in which case mandating a pram style would not necessarily increase parental interaction with baby.
So part two of the study was an experimental manipulation in which 20 mother-infant pairs participated in a walk in which stroller / pram configuration was evaluated in each pair over half the distance. Mothers talked more when the baby was facing them. It's a nice first try but under the circumstances highly unsatisfying. The mothers were not blinded to the study manipulations from what I can tell, probably couldn't be given that it was repeated measures. I mean gee, how obvious would it be? It was a one-time deal so the novelty for mothers who were unused to a given configuration would be high. Who knows if behavior would be sustained under real world conditions. The aforementioned issues having to do with innate parenting traits are important given the relatively small sample size, no doubt influenced by who was available to participate in a study.
And finally the study seemed to focus only on the in motion phase of a trip in a stroller/pram. From personal experience there is a great deal of variation in what a parent does with a child when out and about with the stroller. Some will essentially get the kid out and carry it at the slightest stop for shopping, coffee, whathaveyou. Others will leave the kid in the stroller or pram no matter what. So the percentage of the overall time in the day the kid is in the stroller / pram versus being held/carried is also important.
There are a lot of fairly obvious questions to ask. Questions that in many cases I bet would pose substantial problems should this thing be submitted to peer review for publication. Not that there is anything wrong with the studies conducted, they are just preliminary or incomplete. It appears to me to be far to early to use these data as good evidence that stroller manufacturers should be somehow called upon or tut-tutted to make rear-facing carriers.

• I will offer you an observational study with an n=1 whackaballoon. The researcher was pushing her newborn infant around the mall in a stroller where the infant faced her. She was so into making goo-goo eyes and babbling at said infant, and not paying attention to where she was walking, that she walked said stroller, full speed, right into a pole.
So, yeah, the little whackaballoon may have gained two IQ point by getting to chat with Mommy, but he lost 5 getting crashed into a pole.

• I always have figured that babies would be more stimulated by looking at where they are going, rather than just staring at the same ugly mug all day.

• #2I always have figured that babies would be more stimulated by looking at where they are going, rather than just staring at the same ugly mug all day.

Watch it, PP...

• bob says:

I'm with PP. Even if they're vocalizing more, does it really mean they're going to develop better? Maybe they're just having a good time watching their surroundings. Is stroller time really that important overall that we should be stressing about this?

• Dave says:

I think the key is to put your kid in the stroller facing forward, so your cigarette ash doesn't drop in their face. Plus, that the roof of the stroller then makes a nice shelf for your beer and a bag of chips.

• ianqui says:

Another issue is how much interaction is necessary and/or sufficient to make your kid normal or even exceptional. Sure, the kid might be in a stroller for an hour a day, but if you communicate with them for the other 8 or 9 hours that they're awake during the day and that's an adequate amount to make your kid exceptional, then the hour in the stroller is kind of moot. (I guess this is kind of what Bob #4 is saying.)

• Who the hell cares what's good for the baby? How about for the wild-eyed parent who will veer towards homicide if s/he can't get at least twenty minutes of carrying on an adult conversation and looking at something OTHER than a baby?

• DSKS says:

And USCIS laughed at me when I applied for refugee status. It's readily apparent that my native island has gone stark raving bonkers - possibly with some wildly communicable strain of BSE - and that it's simply not safe to abide there anymore. Not that this nation isn't batshit crazy, too, but at least one can arm oneself.

• Oh DM you are so late to the party. The mommy blogs tore this to shreds when it first came out.
PP - I don't about your mug but mine is pretty damn hot.:)

• skeptic says:

Maybe if the baby spends 24/7 in the pram then it matters which way it is facing. otherwise there is something to be said about over analyzing things to the point of absurdity.
Does EVERYTHING have to matter and be a big deal just because it involves babies? this is almost as absurd as my friends who shuttle their infants around to goodness knows how many "enrichment" classes as soon as they are out of the womb, all to try and ensure they will maximize their chances of "getting ahead" later in life, whatever that means. I'm sorry, but I really don't think it makes a difference if an infant takes a world music course or not. Things like that, and "reports" on prams like this, are just marketing schemes to sell more products and services to gullible, paranoid and egotistical parents and support the multibiliion-dollar baby/childcare products industry.

• acmegirl says:

Yes, I can agree that this can only be called a preliminary study. But, I do think it would be nice if there were more options for rear-facing strollers that were designed for older children AND didn't cost an arm and a leg.
Thing 2 is constantly trying to talk to me while riding in our Maclaren, and she does not give up easily. Plus, since she has recently discovered that she, and no one else in the family, is royalty, she does not turn around to face me. When she hits about 95dB, I have to stop walking, come around to the front of the stroller, and kneel down to tell her to shut, I mean find out what she is asking me. Forget about her development - I've got places to go!

• DuWayne says:

Both he who is occasionally stroller bound and he who was stroller bound, wee on this report. They have too many things to see to want to stare at me or momma.

• I love ScientistMother.

• JLK says:

Yay! A psych topic! Sweeeet.
My biggest problem with a lot of "research" in psychology is that even if there is useful information to gain from the pursuit of a particular topic, there is often NO WAY to GET that information in a nice, neat, experimental method that could be considered solid.
Let's assume that it has been experimentally proven that verbal interaction with babies improves development overall. (It's not, by the way, because that would be an unethical study to experimentally conduct under controlled conditions.) Say it with me, folks, we all know the words: Correlation does not equal causation! *sing-song voice*
Here's how the study would need to be conducted:
1. Parents would need to be evaluated across multiple parenting style metrics to make sure that they are all equal as far as that goes.
2. The infants would all need to be identical twins, ages known and documented.
3. Parents are told they are being given a new stroller/pram to try out and give their feedback on, one of each, randomly assigned to each of the twins. Parents are told that the same baby must always be put in the same stroller/pram.
4. Parents are observed, unbeknownst to them, while they take the babies out in the strollers/prams, with measurements taken of verbal interaction. (Maybe hide a tape recorder in the stroller/pram or even a hidden camera.)
5. Measure the amount of time the parent spends talking to the child - measure number of words, number of sentences, number of "silly sounds" and length of each "conversation" as well as length of pauses.
6. Compare those measurements for the twin pairs, and then across the entire sample. Test results for significance.
7. Repeat.
8. Repeat again.
9. Repeat in another country.
10. Repeat in another culture.
11. Submit for PEER REVIEW.
Now that we all know how the study could be done right, we can now see why it can't be done. First, it would be HUGELY expensive. Who the hell is going to pay for such a thing? A stroller/pram company, sure. Maybe. If you work for them, perhaps as part of their research and development team. In that case, they're gonna want clear results.
Secondly, finding enough pairs of identical twin babies around the same age is a challenge in itself, let alone finding willing parents, and parents whose parenting styles match up across metrics well enough to remove that as a confounding variable. By the time you found a large enough participant pool, the babies wouldn't be babies anymore. So you'd have to do it with small samples, over and over and over again. It would take forever, and as mentioned above, cost $. When it comes to research in psychology, I feel like everyone needs to follow the mantra: "If you're gonna do something, do it right." I feel really bad for parents nowadays - getting fed all sorts of bullshit from the media about how and how not to raise their kids based on shoddy research. I can only imagine how many soon-to-be moms are going to be running around the UK looking for prams, telling everyone they know "I read this article that says prams are better for babies because they let you talk to them more while you push them around!" And the pram industry booms. • JLK says: Oh, and I forgot to add: ....and mothers who use strollers will be subject to criticism and hard looks as they walk with their infants for "obviously not caring about their babies' development. • Susannah says: And who says you can't talk to the kid while her back is to you? Or from over her head? Who says the kid doesn't welcome a time to watch the world go by and reflect on it quietly? Who says a kid or a parent has to be a chatterbox? And how do they get from "doesn't talk to Mommy when they're out walking" to "emotionally impoverished"? (From personal observations (family, friends, mall shoppers), the model that seems to provide the most interaction is the lightweight umbrella stroller, facing away from the parent; it gets turned around to face him at coffee shops and mall food fair tables; it has no roof or wide sides that hamper direct eye contact; a parent can even walk beside it, steering with one hand (my frequent method).) • I'm sorry, but I really don't think it makes a difference if an infant takes a world music course or not. Oh, sure that's easy for you to say! Go ahead, snuff out the musical development of the next Bob Marley! • J-Dog says: JLK - Yes, I think you are correct! However, I do have to relate the methodology and results of my own test - sample size 3 kids - stroller facing away. Mom and I talked to all 3 kids or 100% of kids sampled, while they were facing away, and all kids did just great in school. The results of this non-government funded study was that since all 3 were identified as "gifted" it clearly indicates that parents using prams should be prosecuted for child abuse. Maybe I should have applied for grant money? • amhovgaard says: This report is just silly - here in Norway all the cool parents carry their babies kangaroo-style now. • Becca says: random sidenote: "Crying was the same at 2% across age groups. " *thinks*: hmmm, maybe this parenting isn't as terrifying as I'd always assume. 2% seems like a lot when you're in the middle of it, but objectively, there should be a lot of other stuff to balance it out... *thinks again*: on the other hand, that could be 100% of the babies crying 2% of the time... or 2% of the babies crying 100% of the time! And I've got that kind of 1/50 luck... *shudder* On topic-ish: Everyone knows babies should be held in backpacks. That way, when you are unsuspectingly about to eat a Mama Tish's raspberry Italian ice at the Taste of Chicago, baby can swoop in with the suprise announcement that she is ready for solid food! And that she likes raspberry Italian ice. Also, I fondly remember my umbrella stroller. They make excellent ride on vehicles for young whackaballoons at play to push each other on long after they can run on their own two feet. • DSKS says: To use a study as flawed as this one as a platform on which to pressure public policy is nothing short of disgraceful. It reminds me of a recent rant by Stephen Fry in which he derides the absurdity of pc prudes in Broadcasting Standards demanding that TV show characters be shown to correctly use their seatbelts in order to provide role models for children... even while those same characters are presented tearing around after criminals at 90 mph and firing guns out of the side window. This study seems similarly misguided. In a world where the vast majority of childhood psychological disorders are brought about by well-characterized causes ranging from parental abuse and neglect, inappropriate nutrition, hereditary disorders, drug abuse, impractical education policies and a host of other more socially pressing issues, the idea that facing them backward in a pram is going to substantially enhance their lot in life is just plain ridiculous. It's seems funny until you consider that real money was squandered on this asinine exercise, and that it further serves to confuse the public about the true form of the scientific enterprise at a time when this is already under attack from all manner of pseudoscience-loving crackpots. • DrugMonkey says: DSKS, one of the joys of being a scientist-parent is the discovery of the mountain of oft-mutually-exclusive parenting wisdom and advice communicated to you with great enthusiasm and confidence. My picking up on this was an anticipation that the email spam would soon be flying from well-meaning parenting friends and (although not in our case) busy body mothers in law. apparently since I'm not on the "mommy blog" (srsly, are you pulling my leg or trying to troll me into trouble with that?) circuit this has already started making the rounds... for anyone who isn't a parent who wants to get an inkling for what I'm talking about start with searches for "fetal monitoring cesarean section risk". you will spot the obvious flaw i a heartbeat... • Y'know, even though it has been *years* since either of the sprogs was a stroller-rider (even at a protest), I almost dumped a list of advantages (for parent and child) of strollers over prams. But we're past the strollers and prams -- and, one hopes, past the same heightened level of well-meaning buttinskis telling us how we're permanently damaging our kids by doing X or not doing Y. Both sprogs rode in strollers as soon as their necks and backs were strong enough for them. If it hurt their cognitive development, then I am frightened at what they might have become if transported longer in a pram. Finally, whoever invented those cupholders that attach to stroller handles (so they hold the parental java) is a genius deserving of a Nobel Prize. • DSK Samways says: "DSKS, one of the joys of being a scientist-parent is the discovery of the mountain of oft-mutually-exclusive parenting wisdom and advice communicated to you with great enthusiasm and confidence." I'm currently being initiated into that very experience (telling the nipper's grandmother that her advice is not well regarded by the AAP is an experience always as welcome as a fart in a spacesuit; "WELL, IT NEVER DID YOU NO 'ARM DID IT!"). I think the internet makes it even worse, as well. A whole galaxy of ways in which one can fail one's children as a parent at the touch of a button stacked in the search engine right next to a whole galaxy of reasons to ignore that information. Now, if the gummint spent some dimes on a study investigating the deleterious effects of persistently confusing parents as to whether their children are or are not destined for a lifetime of mental illness and/or sudden agonizing death, I think there might be some merit to it. • I'm not sure if was making the rounds, I think a more apt description would be calling BS on the study. • Tsu Dho Nimh says: The mums who are pushing high-interaction prams are those who are using the pram like a battering ram as they interact with the baby. "Ohhh, look Fruit-of-my-womb, there's a 1-foot wide gap in the line. Let's shove the 3-foot wide, 120-lb pram through it and see how many people fall down. Can you count how many"? And using the pram as a repository for shopping finds is universal. Somewhere under the department store logo bags might be a baby, if it's still able to breathe. • nm says: You people are awesome. If I wasn't writing 9 papers and two grants I would have to start up the BAD EPIDEMIOLOGY BLOG (probably with the Rogue Epidemiologist who beats me to it most of the time and is far funnier). That study is total, total and utter BS. The results description provided by DM is almost as far as you need to read. "39 hours of observations carried out by the 57 volunteers were collected in 54 cities and towns" Now try to imagine training 57 people from 54 different cities to do this properly and then only having them do it for 39 hours? Covert observation of mothers and babies in 54 cities- ethical approval must have been a real bastard on that one i would think? Now try to imagine analysing this data properly to account for observer and locality given that there seem to be almost no localities with more than one observer? Given that the observers had to guess everything about the participants since they were spying on them one could imagine confounding from practically every source known utterly invalidates any conclusions that you might pluck from the air. JLK inadvertantly highlights a common problem in Psych Research. There is no account and no thought about how participants are selected- which is why so much 'research' is done on undergraduates in psychology departments. In this case the observer selection would also be important since there may be almost as many observers as inadvertant participants. And how does an observer pick someone to observe exactly? This is an excellent example of junk science. • nm says: Apologies. My HTML skills ruined that quotation I provided. I have truncated it in the middle. There should be a >snip> between volunteers and collected. • niewiap says: WTF??? Seriously, do people have nothing better to do than to look at babies in strollers vs. prams? Let alone this study being bad science as pointed out by everyone, how about not letting these wackaballoons sit in front of the TV 24/7 instead of deliberating over the stroller vs. pram question. Geeeez... •  Support level Reader :$5.00 USD - monthly Supporter : $10.00 USD - monthly Sustainer :$25.00 USD - monthly Angel : \$1,200.00 USD - yearly
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