Children living in poverty or born to teenage parents are at increased risk for developmental delays as well as child neglect. Research has shown that one effective avenue for preventive intervention is teaching parents to recognize and respond to their young children's communicative signals using responsive caregiving behaviors (e.g., warmth and praise, prompt responses linked contingently to the child's signals, following the child's interest, stimulating language, and using positive behavior guidance strategies). However, parents with low education and literacy levels are often limited in the degree to which they can benefit from generic instructional materials such as parenting books and classes. The "Play and Learning Strategies" (PALS) parenting program, which has been shown to be effective with at-risk parents and children in several randomized control studies, addresses the needs of this challenging population through the use of video modeling, guided live practice of target skills, and reflective review and discussion of the parent's own video footage of her interaction with her child. This paper will briefly review literature on the use of video reflection to facilitate skill acquisition within an adult learning framework and then outline the process by which individualized coaching combined with video reflection can bring about positive changes in parenting and child outcomes, using the PALS program as an example.