Parent-Implemented Communication Research Articles

Parent-implemented augmented communication intervention and young children with Down syndrome: an exploratory report.

Young children with Down syndrome (DS) present with speech and language impairments very early in childhood. Historically, early language intervention for children with DS included manual signs, though recently there has been an interest in the use of speech-generating devices (SGDs). This paper examines the language and communication performance of young children with DS who participated in parent-implemented communication interventions that included SGDs. Specifically, we compared the functional vocabulary usage and communication interaction skills of children with DS who received augmented communication interventions (AC) that included an SGD with those children with DS who received spoken communication intervention (SC). Twenty-nine children with DS participated in this secondary data analysis. These children were part of one of two longitudinal RCT studies investigating the effectiveness of parent-implemented augmented communication interventions in a larger sample of 109 children with severe communication and language impairments. There were significant differences between children with DS in the AC and SC groups in terms of the number and proportion of functional vocabulary targets used and the total vocabulary targets provided during the intervention at sessions 18 (lab)and 24 (home). Overall, the AC interventions provided the children with a way to communicate via an SGD with visual-graphic symbols and speech output, while the children in the SC intervention were focused on producing spoken words. The AC interventions did not hinder the children's spoken vocabulary development. Augmented communication intervention can facilitate the communication abilities of young children with DS as they are emerging spoken communicators.

TELETHERAPY- AN INNOVATIVE WAY OF TREATMENT IN THE FIELD OF OCCUPAIONAL THERAPY IN PAKISTAN

Teletherapy is an emerging and enlarging tool for having treatment in occupational therapy in rehabilitation sciences among occupational therapists all over the world mainly in Pakistan, especially during the era of COVID-19. A lot of studies have been done already highlighting the paramount of teletherapy around the world but it is a new rising mode of treatment in Pakistan coming to light. Therapists and Patients throughout the country making the most of this treatment way respectively and hence this method of treatment while using of technologies is highly being appreciated. The aim of this study is to foster and encourage the use of this technology in third-world countries like Pakistan. It is the most used treatment tool during COVID-19 among occupational therapists all over the country and is highly appreciated in order to cut-down the negative circumstances of a one-to-one session in which therapist and patient is in highly close contact to each other. This course of action has advocate the on-going rehabilitation treatment and has kept away people from COVID-19 expansion to the most extent. In this study, a 5years old boy was included with an under-diagnostic process within the umbrella term of genetic disorder. Having genetic disorder, his sessions were taken in tele-clinic using video call technology during COVID-19. In this process, AOTA Occupational Therapy Tele-Health Decision Guide, AOTA Occupational Profile Template, AOTA Advisory Opinion for the Ethics Commission Teletherapy, i-PiCS-Internet-Based Parent-Implemented Communication Strategies Program, and modeling strategy were followed.

Telepractice parent-implemented training and coaching in a rural area in the UK: Impact on mothers and their children with autism

BackgroundParent-implemented interventions are reported to have positive outcomes for both children with autism and their parents. Online parent training and coaching have been increasingly used as an effective alternative or supplemental to traditional face-to-face services, especially after the start of the Covid-19 pandemic. The purpose of this study was to examine the extent to which parents of children with autism can implement a set of newly acquired strategies and the impact these had on their children’s communication skills. MethodFour mother–child dyads from a rural area in the UK participated in the study following a multiple-baseline design across strategies. Asynchronous training and synchronous coaching were provided, all online. ResultsThe present study extended the results of the original US based study it replicated (Meadan et al., 2016). Mothers learned to use the targeted naturalistic teaching strategies they were trained and coached in (i.e., i-PiCS- internet-based Parent-implemented Communication Strategies) and their children’s responsiveness and initiations of communication increased and were mostly maintained after the end of the study. Changes in the mothers’ use of strategies were observed in many cases even after training only, and the strategy of time delay was linked to increases in the children’s initiations of communication. ConclusionsThis replication study showed that i-PiCS is an appropriate intervention to use with mothers of children with autism in the UK and telepractice training and coaching can be a feasible and effective service delivery method.

Cultural Adaptation of Parent-Implemented Early Communication Interventions: A Scoping Review

Parent-implemented early communication interventions are commonly delivered to culturally and linguistically diverse families. Although there is evidence from fields such as public health or psychology, there is little guidance regarding what elements to culturally adapt for parent-implemented speech-language pathology interventions. This scoping review addresses this gap by identifying parent-implemented early communication interventions that have been culturally adapted and describing which intervention components were adapted. Definitions of culture, use of adaptation frameworks, and adaptation guidelines, policies, and recommendations are also reported. The databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PsycINFO, and Embase via OVID were searched. Supplementary search methods, including hand-searching of references and a gray literature search, were also conducted. Covidence software was used to deduplicate, collate, and review articles. Population, intervention, study, and cultural adaptation data were extracted and synthesized using the Ecological Validity Framework. Twenty-one articles were included from the database and supplementary searches. No studies defined culture, and only three used cultural adaptation models or frameworks to guide adaptation. Studies varied greatly in what they adapted; language adaptations, such as translation, were conducted most frequently, and intervention goals were rarely adapted. Only three studies obtained parent feedback to inform cultural adaptation for future recommendations. More clarity in the reporting of cultural adaptation for communication interventions is required. Cultural adaptation frameworks are useful tools to guide adaptation but can be difficult to operationalize. Additional research in this area is necessary to help clinicians provide culturally responsive, parent-implemented communication interventions. https://doi.org/10.23641/asha.20416107.

A Module-Based Telepractice Intervention for Parents of Children with Developmental Disabilities.

In the current study, we describe a study of the Internet-based Parent-implemented Communication Strategies-Storybook (i-PiCSS). I-PiCSS is an intervention program designed to train and coach parents to use evidence-based naturalistic communication teaching (NCT) strategies (i.e., modeling, mand-model, and time delay) and reading techniques while reading storybooks with their young children with disabilities. Three participating parents were trained via online modules and coached via telepractice technologies (videoconferences). Zoom videoconference software was used for all coaching sessions. Using a single case multiple-baseline design across NCT strategies within each family, we examined, (a) parents' fidelity use of the three NCT strategies, (b) parents' use of book reading techniques, and (c) child language and communication outcomes. After self-directed training and remote coaching, parents used modeling, mand-model, and time delay strategies with higher rates and fidelity (accuracy). Children initiated more communicative acts upon parents' use of time delay and increased their numbers of single-and multiple-word responses.

A Parent-Implemented Shared Reading Intervention via Telepractice

We describe a study of the internet-based Parent-Implemented Communication Strategies–Storybook (i-PiCSS), an intervention designed to train and coach parents to use evidenced-based naturalistic communication teaching (NCT) strategies (i.e., modeling, mand-model, and time delay) and RTs while reading storybooks with their young children with disabilities. Three participating parents were trained and coached via telepractice technologies (videoconferences, video editing software). Zoom software was used for videoconferencing and Camtasia software was used to record the training and coaching sessions and to edit the recorded session for feedback delivery purposes. Using a single-case multiple-baseline design across NCT strategies within each family, we examined (a) parents’ fidelity use of the three NCT strategies, (b) parents’ use of book RTs, and (c) child language and communication outcomes. The entire intervention period lasted 8 weeks. After training and coaching, parents used the modeling, mand-model, and time delay strategies with higher rates and higher quality (accuracy). Children initiated more communicative acts upon parents’ use of time delay and increased their numbers of single- and multiple-word responses.

Corrigendum to Parent-Implemented Communication Strategies During Storybook Reading

Corrigendum to Parent-Implemented Communication Strategies During Storybook Reading

Using Masked Raters to Evaluate Social Validity of a Parent-Implemented Communication Intervention

Interventions designed for children with disabilities and their families should be socially valid. Parent-implemented Communication Strategies-Storybook (PiCSS) is an intervention package designed ...

Using Masked Raters to Evaluate Social Validity of a Parent-Implemented Communication Intervention

Interventions designed for children with disabilities and their families should be socially valid. Parent-implemented Communication Strategies-Storybook (PiCSS) is an intervention package designed to coach parents on shared storybook reading and naturalistic teaching strategies. In PiCSS program, the participating parents used the communication teaching strategies with high fidelity, and children responded more to their parents’ communication. To evaluate the social validity of PiCSS, we designed video-based rating surveys and collected data from masked raters (college students and practitioners). In total, 120 raters evaluated 12 1-min video clips. Quantitative analyses revealed that all raters scored coaching videos significantly higher than baseline videos for parent and child outcomes, indicating the PiCSS program had positive outcomes in parent–child interactions.

Parent-Implemented Communication Strategies During Storybook Reading

Children with developmental disabilities (DD) may experience delays in their ability to speak and communicate with their parents, peers, and others. These children often benefit from evidence-based, parent-implemented communication interventions. In the current study, two mothers were trained and coached to use storybook reading techniques and evidence-based naturalistic communication teaching strategies (i.e., modeling, mand-model, and time delay) while reading books with their children with DD. Using a multiple-baseline design across naturalistic teaching strategies, the following three components were examined: (a) mothers’ use of book reading techniques, (b) mothers’ rate and fidelity in using the three naturalistic teaching strategies, and (c) children’s communication outcomes. After training and coaching, the mothers used the modeling, mand-model, and time delay strategies with higher rates and higher fidelity. The children initiated more communicative acts upon their mothers’ use of time delay. The mothers reported that the training and coaching helped them implement the strategies and led to improvements in their children’s communication skills.

PiCs: Telepractice coaching for a parent of a child who is hard-of-hearing

ABSTRACTServices for families of young children with low-incidence disabilities (e.g. deaf/hard-of-hearing, DHH) are expensive to deliver and may not be available in all geographic regions. Parents of children who are DHH may be taught and coached to implement strategies to encourage communication. The purpose of this single-case multiple-baseline design study was to implement and assess telepractice teaching and coaching of a parent whose child is hard-of-hearing. The parent was taught to implement naturalistic teaching strategies for communication using the Parent-implemented Communication Strategies (PiCS) protocols (Meadan, H., Angell, M. E., Stoner, J. B., & Daczewitz, M. E. (2014). Parent-implemented social-pragmatic communication intervention: A pilot study. Focus on Autism and other Developmental Disabilities, 29, 1–16. doi:10.1177/1088357613517504). Results varied across strategies, and the parent expressed satisfaction with the goals, procedures, and outcomes of the intervention. Implications include recommendations for practitioners and researchers.

Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial.

Purpose Despite advances in cochlear implant and hearing aid technology, many children with hearing loss continue to exhibit poorer language skills than their hearing peers. This randomized pilot trial tested the effects of a parent-implemented communication treatment targeting prelinguistic communication skills in infants and toddlers with hearing loss. Method Participants included 19 children between 6 and 24 months of age with moderate to profound, bilateral hearing loss. Children were randomly assigned to the parent-implemented communication treatment group or a "usual care" control group. Parents and children participated in 26, hour-long home sessions in which parents were taught to use communication support strategies. The primary outcome measures were the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 2003), a measure of child prelinguistic skills, and parental use of communication support strategies during a naturalistic play session. Results Parents in the treatment group increased their use of communication support strategies by 17%. Children in the treatment group made statistically significant more gains in speech prelinguistic skills ( d = 1.09, p = .03) as compared with the control group. There were no statistically significant differences in social and symbolic prelinguistic skills; however, the effect sizes were large ( d = 0.78, p = .08; d = 0.91, p = .10). Conclusions This study provides modest preliminary support for the short-term effects of a parent-implemented communication treatment for children with hearing loss. Parents learned communication support strategies that subsequently impacted child prelinguistic skills. Although these results appear promising, the sample size is very small. Future research should include a larger clinical trial and child-level predictors of response to treatment.

Teaching Parents Enhanced Milieu Teaching With Words and Signs Using the Teach-Model-Coach-Review Model

Measuring treatment fidelity is an essential step in research designed to increase the use of evidence-based practices. For parent-implemented communication interventions, measuring the implementation of the teaching and coaching provided to the parents is as critical as measuring the parents’ delivery of the intervention to the child. Both levels of measurement are important in translating research into effective practice. In a single-case multiple-baseline design, the effectiveness of the teach-model-coach-review model for teaching Enhanced Milieu Teaching (EMT) Words and Signs to parents of young children with Down syndrome was evaluated. Implementation of parent training was completed with high fidelity. In addition, there was a functional relation between the implementation of the parent training and parents’ use of the specific EMT intervention strategies. The findings of this study replicate and extend previous studies suggesting systematic teaching and coaching can be effective in improving parent use of naturalistic communication strategies.

Internet-Based Parent-Implemented Intervention for Young Children With Autism

Both naturalistic communication and parent-implemented interventions are evidence-based practices for young children with disabilities, but demonstrations of effective methods for teaching parents to implement naturalistic interventions successfully with their children are still warranted. The purpose of this study was to examine the effects of a training and coaching program on parent implementation of naturalistic teaching strategies and on concomitant child communication skills using a telepractice service-delivery model (i.e., Internet-Based Parent-Implemented Communication Strategies [i-PiCS]). We found that parents learned to implement the targeted naturalistic teaching strategies with fidelity when, and only when, they were provided with training and coaching over the Internet. The parents’ implementation of these strategies also corresponded with positive changes in their children’s communication skills. The limitations and implications of this investigation are discussed.

Parent-Implemented Communication Intervention

Collaboration with parents and caregivers to support young children’s communication development is an important component to early intervention services. Coaching parents to implement communication support strategies is increasingly common in parent-implemented interventions, but few studies examine the process as well as the outcomes. We explored the triadic relationships between interventionist, parent, and child within a parent-implemented communication for toddlers with Down syndrome (DS), autism spectrum disorder (ASD), or developmental delays (DD). Time-window sequential analyses revealed that parents were more likely to use communication strategies during or immediately following coaching strategies that encouraged the parents’ active role. Children were more likely to use targeted communication skills immediately following responsive parent interactions. Intervention occurred in similar frequencies across play and non-play routine contexts. This analysis provides preliminary information on understanding potential mediating variables in parent-implemented interventions. Implications for increasing parent capacity-building and child outcomes through coaching are discussed.

Understanding Communication Intervention for Young Children with Autism and Their Parents: Mixing Behavioral and Social Validity Findings

We retrospectively analyzed data from a pilot study that examined the impact of the Internet-based Parent-implemented Communication Strategies (i-PiCS) program (Meadan et al. in Journal of Early Intervention, 2016) on two families whose children primarily used unaided augmentative and alternative communication (AAC). The purpose of this analysis was to explore possible explanations for discrepant findings between behavioral data and social validity data in single-case research. These divergent findings were revealed when we attempted to mix two methods to make assertions about intervention effectiveness. Guided by two hypotheses, we recoded the original pilot study video recordings by introducing new dependent variables that were linked to information gleaned from the social validity assessment (i.e., self-reports by the parents and interventionist). After assessing these new dependent variables, we found support for improvement produced by the i-PiCS program that had not been identified in the original observational recording. We present the methods and results of this secondary analysis and discuss the potential value of using mixed methods to combine observational behavioral data with self-report social validity data in behavioral research.

Effects of a Triadic Parent-Implemented Home-Based Communication Intervention for Toddlers

A series of three multiple-baseline single-case studies with replication across nine parent–child dyads was used to evaluate the effects of a parent-implemented communication intervention on parent and child communication for toddlers with Down syndrome, autism spectrum disorder, and developmental delays. Interventionists coached parents to implement communication strategies and supports in family-identified routines over 24 intervention sessions. Parents demonstrated increased responsive and modeling strategy use, and children exhibited higher rates of targeted communication forms from baseline to intervention phases. For eight of the nine dyads, the gains increased across the intervention phase, and effects were carried over into the maintenance phase. The results support the use of triadic parent-implemented communication interventions that can be implemented in the early intervention system. Clinical and research implications of teaching parents of toddlers with various etiologies to use responsive and modeling strategies through a collaborative family-guided coaching process are discussed.

Do You See a Difference? Evaluating Outcomes of a Parent-Implemented Intervention

The Parent-Implemented Communication Strategies (PiCS) project resulted in the development of an intervention package aimed at enhancing the social communication skills of young children with disabilities and limited expressive language. While the outcomes of the PiCS project seem to be positive, a thorough and comprehensive assessment of social validity was warranted. Wolf (Journal of Applied Behavior Analysis, 11, 203–214, 1978) contended that interventions should be assessed not only for effectiveness but also for social validity. This study of social validity addressed the question, “Was the PiCS project socially valid from an expert perspective?” Our expert evaluators were recruited from three groups: (a) parents of young children with disabilities, (b) early childhood special education teachers, and (c) speech language pathologists who worked with young children with disabilities. Each evaluator viewed video clips of parent–child interactions from pre- and post-intervention sessions, in random order, and completed a questionnaire about parent and child behaviors. The overall findings provided support for the social validity of the PiCS project. Further discussion that examines differences in the ratings of the groups of evaluators and implications for research and practice is provided.

Coaching Parents of Young Children with Autism in Rural Areas Using Internet-Based Technologies: A Pilot Program

The purpose of this paper is to describe a pilot program (i.e., Internet-Based Parent-Implemented Communication Strategies [i-PiCS] program) that provides long-distance training and coaching via the Internet to parents of young children with autism spectrum disorders (ASD). The i-PiCS program is designed to teach parents how to use evidence-based teaching strategies to improve the social communication skills of their children with ASD. We describe components of a parent-training program that capitalizes on evidence-based strategies and highlights the potential for delivering this program via the Internet. Potential barriers, benefits, and implications for practice and research are discussed.

A Model for Coaching Parents to Implement Teaching Strategies With Their Young Children With Language Delay or Developmental Disabilities

This article focuses on the coaching model used in the Parent-Implemented Communication Strategies (PiCS) Project. The PiCS model was used to train and coach parents to deliver naturalistic and visual teaching strategies in their homes with their young children with developmental disabilities. The foundational concepts and rationale for training and coaching parents to implement intervention are discussed. The PiCS coaching model was developed using best practices of early intervention and includes five steps that prepare parents to implement intervention with high quality.