Project MAMaS (Mobile Apps for Maternal Support)

This project aims to reach millions of mothers in refugee camps with mobile audio apps that recognize their vital role as primary caregiver and help them discover their power to improve their baby's development through increased talk and playful interaction.  Short, daily messages recorded by culturally compatible audio guides will provide mothers with support and inspiration while helping them develop "talking as teaching" skills.

Refugee camps are typically early childhood deserts that do little to promote development of babies ages 0 - 3, and if mothers are unaware of the developmental importance of providing infants and toddlers with lots of verbal interaction, a child's cognitive, social-emotional, and language skills suffer.  MAMaS will help mothers engage in more "serve and return" opportunities, encourage baby's expressive skills, use diverse vocabulary, experiment with wordplay, expose them to print, and provide a home environment that provides greater stimulation and learning opportunities.

The importance of verbal interaction to early development is well known, and a lack of exposure to rich vocabulary, print resources, and meaningful conversational exchanges impedes a child's cognitive, social-emotional, and language skills.  Infants and toddlers are especially at risk since the birth to three years are a time of rapid development when the brain produces over one million synapses per second. 

Experiences are what shape the brain, and maternal depression, poverty, chaotic living situations, substance abuse, and domestic violence are all factors that limit the amount of nurturing interactions a baby receives.  Such "Adverse Childhood Experiences (ACEs)" impact a child's brain development; when multiple ACES are occurring they negatively shape a child's lifelong health and well being. 

Even previously resilient children in stable families are affected when disasters affect their community.  Add whole scale terror, death, and disruption due to violence and war, and young children are dangerously vulnerable to delayed or regressive development. And, because their primary caregiver has also experienced trauma, making supportive assistance available to them is essential so that they in turn, can provide a sense of stability and be a source of stimulation for their children.

Sixty million people around the world are refugees or displaced; 51% are children. It's estimated that 22 million are 0-5 year olds, and each day hundreds more are born in camps around the world.  To paraphase the United Nations High Commissioner on Refugees (1994), "children are vulnerable, dependent, and developing," and as such, they are exquisitely sensitive to the trauma of fear, displacement, hunger, and disruption.  When combined with inadequate opportunities for stimulating play and safe exploration, they are at risk for developmental delays. Their mothers, who have also experienced loss, may struggle to give their baby the attention and rich verbal interaction they need. 

Fortunately, there is an opportunity to provide support and encouragement to these mothers using their smart phones.  In some rescue camps 67% women have smart phones; 94% of family units do. Mobile apps that provide audio coaching in their mother tongue can reach these mothers at scale with verbal affirmation and ways they can create a more stimulating, enriching environment for their children. Even in an uncertain world, the future will certainly come.  We can help mothers help their babies reach their potential and prepare them for whatever lies ahead.

Our solution is to develop and disseminate multiple versions of an audio coaching app that provides culturally and linguistically appropriate affirmation and support to mothers while also encouraging increased levels of verbal interaction with their infants and toddlers.

Our work has been in the U.S., where we are in the process completing an audio coaching app called Time2Talk2Baby. This app grew out of the critical need for an evidence-based intervention that can be brought to scale and significantly improve early development among economically and socially disadvantaged children. 

Our approach has proven to be quite promising. We recently undertook a  randomized controlled trial with 90 mothers which resulted in significant changes in maternal behaviors and perspectives.  Moreover, the treatment group babies experienced statistically significant levels of additional language development as compared to the control group.  We also found a positive correlation between mothers' usage levels and children's increased receptive and expressive language skills.

Our methods are based on the premise that interventions aimed at improving verbal interactions with infants must have a specific emphasis on spoken language.  To this end, the app offers short, 30-45 second audio messages daily that help parents develop the habit of talking more frequently to babies while also modeling easy ways they can make their home environment a richer, more stimulating place of learning. The audio clips use a personal, informal approach that offers words of encouragement, songs, rhymes, topics of the day, and talking tips that are age-appropriate to their baby.  Time2Talk2Baby will be available in English and Spanish, for distribution in the Americas. 

Project MAMaS uses the same approach, but focuses on mothers in camps for refugees and displaced families. And, we propose to incorporate the use of Artificial Intelligence to pinpoint a user's location and gain information about the demographics of the camp's population; a critical need if we are to provide stories, songs, rhymes, and other types of messaging that takes into account language, cultures, and customs of those living there.  AI will also provide information about the camp's built and natural environment so we can offer concrete suggestions for ways they can use available resources to stimulate their child's learning.

If selected as a solver, we would develop partnerships with AI tech experts, humanitarian organizations, women's networks, and cultural advisors to meet the unique needs of these women.

Every mother wants their baby to grow up to be healthy, strong, smart, and kind.  Mothers in refugee camps are no different, yet little to nothing is available to help them promote their child's brain development, cognition, and language skills.  This lack of support for mothers' efforts to nurture and stimulate their babies makes refugee camps early childhood deserts. Factor in a mother's stress, depression, boredom, and preoccupation with meeting basic needs and it practically ensures that a young child's developmental needs are neglected.

Innovative use of technology can play a role in mediating these conditions.  A mobile audio coaching app that provides a friendly, encouraging female voice daily or several times a week in their native language can speak directly to mothers and suggest ways to promote their baby's development. This will build upon their parenting skills, improve their feelings of efficacy, and even help them enjoy their baby more as they see them reach their milestones.

Content will be aligned with their culture, so the messaging will provide a "personal" approach that encourages mothers to retain and pass along the traditions, songs, rhymes, and stories specific to their homeland.  In addition, their specific resource-poor circumstances will be acknowledged by giving them ways to use both the built and natural environment as points of learning, and suggestions for ways to "make something out of nothing," including toys, dolls, and books that support exploration, fine and gross motor skills, print awareness and conversational exchange.

Many refugees are using smartphones to stay in touch and document their experiences. Project MAMaS would use this common technology for the NEW purpose of providing audio coaching and instruction to refugee mothers of 0 - 3 year olds. We would create native apps (both iOS and Android platforms) with the following UI features:

1) Age-appropriate content: Messages would start at babies' current age and grow in concepts and suggestions as they grow.  2) Range of content: 42 different categories provide diverse content.  3) Favorites: Mothers can mark messages to easily listen again.  4) Social Share: Mothers can send individual messages to others via email, SMS, or by sharing on Whatsapp or Facebook.  5) Push notification: Users will receive an alert that a new audio is ready, which also serves as a reminder to engage with their child.  6) Ease of use: Mothers can simply click to access the audio clip when they receive a notification.  7) Artificial Intelligence: Using AI to identify their location and current environment, the app could update them on available services and resources in the camp and also address the surrounding landscapes and built environment and suggest ways mothers could use these resources to increase verbal interaction and build vocabulary. This includes ways they could transform the camp's various resources into toys and games. 8) Messaging would be in the mother tongue of those using the app [i.e. Syrian and Burmese]. 9) Culturally compatible content would support maintenance of traditions.

Understanding the characteristics of specific groups of parents is key when designing any capacity-building intervention. Our app (Time2Talk2Baby) takes into account the fact that in the U.S. over 40% of adults read at the 4th grade level or below, as do 68% of 8th graders, (i.e. future parents).

Parenting apps currently on the market aren't designed to accommodate parents and caregivers who read at low levels, and remarkably, none focus specifically on expanding the use of language with babies and young children. Speaking to this need, our audio format does not require any reading; with just a simple click on the screen users of any education level can benefit from innovative verbal content. 

Our approach has tremendous potential for helping parents interact more and use diverse vocabulary with their babies. Using a randomized controlled trial to evaluate our prototype, we found a statistically significant difference between treatment and control group children; mothers who used the program affected positive change in their child's developmental trajectory, and more use correlated with better language skills.  Moreover, mothers liked it, and found the messaging to be both personable and enjoyable.

Our app is still being completed (requiring 1,000+ audio messages, in English and Spanish, and on both iOS and Android platforms), but the strength of our pilot indicates that the same methods and format can be applied across the world to girls and women who want and need to do more to improve their children's development.

Our app is still not yet complete and not currently serving users.  See below for our goals for this, and other apps.

By the end of 2020 our aim is to have completed all content for our app. We will then follow that with a randomized controlled trial of 240 low income mother-child pairs.  Our aim is to have objective confirmation of the app's value, using the resources of 4 different universities, and promote it as an evidence-based intervention.  By the end of the testing period we hope to have 1,000 + additional users. 

By year 5 our goal is to have all versions of Time2Talk2Baby (English and Spanish, both in iOS and Android versions) being used by at least 3% of the total market in the U.S, Canada, Central and South America and the Caribbean (34.7 million 0 - 3 year olds in the Americas), or around 1 million downloads annually. 

As a Solver team, we would also aim to have completed several linguistically and culturally appropriate apps for refugee and displaced mothers by the end of Year 3. A short term dissemination goal would be reaching 10% of camps; over 10 years, 80%.  Enrollment could be carried out quickly by humanitarian organizations who see mothers when they first arrive, or in their health care settings.

If just 25% of the mothers in 80% of refugee camps were provided with the app, around 4.4 million children would benefit from a richer verbal environment, enhanced opportunities to learn and play, and better development.

Financing for rigorous testing of our app is our major hurdle.  Because our aim is to have it be designated as an evidence-based tool that physicians and others will want to recommend to parents, randomized controlled trials are essential.  Needless to say, these studies are expensive.

Transforming Time2Talk2Baby into a variety of AI powered apps for Project MAMaS would also require financial support, but also collaboration with women's advocacy and support organizations representative of the variety of ethnicities and cultures being impacted by war and displacement around the world. We currently lack these connections.  Finances for translation and production of multiple versions of the app would also be needed. 

Partnership development is also a barrier.  We would seek partnerships with tech organizations such as OPAL who could recommend needed human and technical resources regarding the incorporation of AI, and we would also need supportive introductions to decision-makers at aid organizations, foundations, and NGOs who would agree to champion dissemination of the app at the camps and settlements they oversee. 

The magnitude of this undertaking would also require administrative and support staff, along with creatives and tech personnel. Travel and communications costs would also be needed.

A proposal to the National Institute of Child Health and Development's Small Business Innovation Research program is being submitted to complete the app and test it using a randomized controlled trial with 240 parent-child pairs.  This $1.7 million project includes advisors and researchers at the University of Kansas, the University of Alabama, and the University of Tennessee Health Science Center's School of Medicine (Department of Pediatrics).  They will carry out subject recruitment and data collection.  Data analysis will be managed by the Research and Evaluation Division of the Department of Family and Preventative Medicine at the University of Arkansas for Medical Sciences. 

Excellent feedback from NICHD and others make us hopeful that we will be funded. Letters of support include, among others - our state's Economic Development Commission, Winrock International, a principal of Promise Venture Studio, and the Alabama Dept. of Education.  A luminary in the field of language development, Dr. Dana Suskind at the University of Chicago School of Medicine is also providing her recommendation. 

As specified above, the resources needed for Project MAMaS would be developed with the help of the Solve MIT program.  We are confident that the connections that are made through and with the program would yield the kind of collaborations that would be required, along with the financing.

An additional SBIR application to support production of the various versions of the Project MAMaS app would also be submitted.

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I am currently the only full-time staff.

I will however, be on-boarding a PhD level project manager, and a creative assistant, and two production assistants. 

Several contractors will also be integral to the project, including two native app developers, three PhD/MD level early childhood experts to review all messaging, and a Spanish translator. We will also contract for a Latina voice-over artist who will record the Spanish version of the content. 

The evaluation component (the RCT) includes 4 PhD/MD level Co-Investigators who will oversee six part-time graduate student research assistants and two clerical staff.

As collaborators in the Time2Talk2Baby project, we each bring different, complementary strengths and backgrounds. 

As Founder and CEO, Dr. Peggy Sissel's area of expertise is in human service, research, adult education, and early childhood emergent literacy - hence her focus on parent education about early childhood, language and literacy.

Dr. Jason Yaun is a practicing pediatrician who also runs the Reach Out and Read emergent literacy program at the University of Tennessee Health Science Center in Memphis. 

Dr. Nikki Edge at the University of Arkansas for Medical Sciences specializes in children's social-emotional development as well as Adverse Childhood Experiences. She is also the Deputy Director of her Research and Evaluation Division, and will lead the analysis. 

Dr. Alana Schnitz at the University of Kansas is an expert in early language development and special education, and also works with the Bridging the Gap Research Network. 

Dr. Alison Hooper at the University of Alabama is also an expert in early language development. 

Dr. Cailin Kerch (also at UA) is a Clinical Assistant Professor specializing in early childhood development and educational programming. 

Each of these people are involved in the creation/review of the audio messages that will be in the app, in addition to their post production roles coordinating their data collection sites.

Our passion, skill, knowledge, expertise, and teamwork are unmatched for a project of this nature. 

As mentioned, our official partners in programming and evaluation are professors at the above universities. 

Our partners for marketing and distribution are being developed, but include the Campaign for Grade Level Reading (GLR), who has expressed interest in promoting Time2Talk2Baby to the over 300 communities in their advocacy and programming network. Dr. Sissel has served on Arkansas' GLR Advisory Board since 2012. 

Reach Out and Read (ROR) will participate as a partner in the Memphis area, and hopefully nationwide, since both Dr. Yaun and Dr. Sissel are closely affiliated with ROR.  Other networks include the Promise Venture Studio's Early Futures Network, and the Early Childhood Innovation Network, both of which Dr. Sissel was selected to join in 2018.

As indicated, we have lots of potential for collaboration for our programming in the United States.  Our international partnerships are nascent, but could potentially include Heifer International and Winrock International (both based in Little Rock), and the Kellogg Foundation, of which Dr. Sissel is a former Fellow.

Words To Grow On is a triple bottom-line social enterprise; a cause-related business innovating ways to improve early development.  Our revenue models vary depending on the product or service.

Time2Talk2Baby will use a freemium revenue model, with income generated through paid, family-focused ads, and a variety of in-app purchases.  

We envision Project MAMaS as a fee-for-service model, paid for by philanthropic grants to NGOs that are earmarked for early childhood development. NGOs would then contract with us to pay a small amount for each person they enroll.

Another revenue model sells products at home parties for parents that provide early development information in a fun, gamified way. Designed to mobilize people to spread the word in their communities about the importance of language interaction to early developmental outcomes, it will recruit independent representatives who earn commission by selling tools that support optimal development, ranging from basic board books for babies to 21st century high tech word counters that measure how much language enrichment parents are giving babies. 

This program also involves a charitable "book match" program, whereby we donate a book for each one a customer buys for charity. Participants at the party can select which nonprofit the books will go to, and even help deliver the books to the program. 

Our long term goal for the "Heart to Heart" home parties is to reach 10% of the 0-3 market using 10,000+ representatives, and generating a yearly revenue of $400 million.

As mentioned, we use several revenue models, depending on the product or service we are providing.  Our Time2Talk2Baby app and "Heart to Heart" home parties are free, but products can be purchased through them.  Per party sales are estimated at a average of $400 - $600 each.  Significant margins and a variety of unique products allow for a healthy bottom line, even after cost + commissions are deducted.

Tangible items, such as books, would be ordered direct from the supplier when a customer purchases them, thereby preventing the need for a large expenditure of inventory and warehousing space.

In-app purchases related to Time2Talk2Baby include unlocking messages previous to enrollment (i.e. if a parent enrolls their baby at six months, they can unlock months newborn to five for a fee). Users can also request  collections of the songs or rhymes in the app.

Money for product development would be sought from the SBIR program.

Revenue from Project MAMaS would come from enrollment fees for each
user, which would be paid by the NGOs coordinating the refugee services.  Using our projected goal of enrolling 4.4 million mothers, even a small fee per each would yield the money needed to run and maintain the program.

Angel investment would help us grow and meet our goals more quickly, but once up and running we are confident that we will remain financially sound. 

I'm applying to SOLVE MIT because I understand the power of networks. 

Since founding Words To Grow On, I have been able to take advantage of a variety of competitions that have challenged me and provided valuable critique, insight, and relationships.  Participation in local pitch events such as One Million Cups, a statewide intensive boot camp for social entrepreneurs, HRSA's 2016 Bridging the Word Gap Competition, and  business incubators has helped me hone my ideas and increased my skills and knowledge in the business of making change. 

One result is that in 2018 I was selected to be part of two important new groups of innovators around early development: most notable is the Early Futures Group, sponsored by Promise Venture Studios, Sesame Workshop, the Omidyar Network, and Harvard's Center for the Developing Child. 

Each time I have put my ideas out there, doors have opened for me which have led to more contacts and bigger collaborations, helped me validate my ideas, and encouraged big thinking. 

I see SOLVE as an important next step in this growth.  I have a pioneering, visionary mindset and take a collaborative, interdisciplinary approach to my work, AND I want to make a big difference in the world.  Should Words To Grow On, and Project MAMaS be selected for Solve MIT it would be an incredible opportunity to connect with the people and resources my team and I need to help make real, significant change for children and families.  

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I would want to partner with NGOs that work with refugees, such as the UNHCR, UNICEF, IRC, BRAC, War Child International, Care, Oxfam, Save the Children, Mercy Corps, and others, for the purpose of collaboration and connecting our solution to their services and settings.

Women's organizations representative of the nationalities and ethnicities of refugees in camps around the world would be sought for their insight and feedback about their cultural traditions and social norms around the role of mother as caregiver and first teacher.  Likewise, information about each of their culture's oral traditions as it relates to caring for babies would be important in order to provide authentic songs, rhymes, and stories in each  version of the app that is developed.

Connecting with AI organizations such as OPAL could provide us with guidance and recommendations for acquiring experts in this area, and best practices. 

Also, I would like to partner with impact investors and philanthropists who also share this vision and believe in this project.

Project MAMaS grew out of the Time2Talk2Baby app, which is designed for parents living in typical communities; structured municipalities, which, even in rural areas consist of homes, parks, schools, grocery stores, police and firefighters.  Each of these entities - and the people who live and work there - are inherent sources of learning and vocabulary for small children.  Time2Talk2Baby's purpose is to help parents use more language with their children while engaging them with that world of people, places, and things around them.

AI is not incorporated into this app because it doesn't really need to be - these constructs of community are nearly universal regardless of where in the world families live. 

Except . . . in refugee camps.  Here, the ubiquitous lines of people, the monotony of tents and huts, and the boredom of the day does little to motivate mothers to inspire curiosity or creativity in their young children, nor engage them in dialog about their world. 

AI is an essential component of a MAMaS app for refugees, so the prize money would be used to develop it.  AI can provide critical context about the setting.  In fact, without it, the suggestions of things to say and do would be useless and inappropriate.  When mothers are displaced, out of their routines, and in unfamiliar surroundings they need information about their new world and how it works so as to center them in time and place, and support their role of mother as first teacher.

Regardless of culture or country, the primary caregivers of children around the world continue to be mothers. Their role is functionally and symbolically powerful in the context of her purview over children, however, as females they are marginalized to lesser or greater extent by social norms, patriarchal restrictions, and cultural expectations. Even in the best of times, surrounded by the stability of kith and kin and the comfort of home, mothers must negotiate the allocation of resources and participation in decision making so they may take care and advocate for the needs of their children. When the worst of times come and families must flee war, disaster, famine, or abuse, women and their children are the most vulnerable.

Mothers who have been victimized by these acute events may be too injured or traumatized to give good care.  Even after finding refuge, they may encounter hardships that are chronic, and the grief, longing, and stress of the situation may impinge their ability to nurture their children. 

Project MAMaS will console them with reminders of the stories and songs of their childhood, help them see themselves as the capable mother they were before these sorrows, and give them support to give their children a richer learning environment, regardless of disaster and displacement.

The prize would be used to reach out to women's organizations for input and to honor women's knowledge by making direct payments to individuals (inside and outside refugee centers) who contribute content to the project.

Few investments yield a higher rate of return than those that are focused on improving the lives of young children.  The Innospark Ventures Prize would help jump start the development of Project MAMaS, not only with the financial assistance it would provide, but also by being affiliated with a group of notables who can offer much in terms of mentorship, guidance, and connections.

Big problems require big solutions, and in today's world that means big thinking, big players, and big data. The data we would be using to support the betterment of children would be garnered from mobile communication providers in order to pinpoint parents' smart phone locations, and then augmented with satellite mapping and weather data to provide information about the physical world around them.  Information from aid groups about camp configurations and settings, maps, and logistics would be used to ensure accurate and timely information about available resources, pending deliveries, and safety issues.

We would hope to use these data under the auspices and regulations of OPAL.