 Pediatricians provision of parenting-focused anticipatory guidance often does not meet parents needs; the few studies that have investigated primary-care based strategies to promote positive parenting rely on time-intensive, high-cost interventions, thereby limiting their generalizability. Therefore, the Purposeful Parenting was developed as a universal program of enhanced anticipatory guidance. At each well-child visit in the first year of a childs life, Purposeful Parenting provides parents with: 1 scripted anticipatory guidance and handouts focused on the childs emerging social-emotional and linguistic SEL skills, brain development and the importance of responsive parenting; and 2 a reminder item e.g., a Smile at Me onesie that allows for in-office role modeling and promotes practicing of an age-specific, nurturing parent-child interaction. If an in-office intervention is missed e.g. parent cancels visit, interventionist out sick the intervention will be delivered by telephone if possible by the site-based clinical interventionists and the reminder items will be mailed. 