Parent-implemented Language Intervention Research Articles

Effectiveness of a parent-implemented language intervention for late-to-talk children: a real-world retrospective clinical chart review

Purpose: This study aimed to: (1) evaluate the effectiveness of Target WordTM – The Hanen Program® for Parents of Children Who are Late Talkers for improving the real-world communicative participation skills of children who are late-to-talk, and (2) explore predictors of change in children’s communicative participation skills.Method: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word programme at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) at pre-intervention, post-intervention, and after a 3-month consolidation period and scores were compared across the three assessment points. Regression analysis was then used to explore the relation between changes in children’s communicative participation skills and potential predictors of change identified by 25 Target Word certified speech-language pathologists.Result: At the end of intervention, 75% of children had made a clinically significant change in communicative participation skills. Clinicians proposed verbal imitation, language development stagnation and parent interaction style as the top predictors of change in communicative participation skills. Of these, only verbal imitation at pre-intervention predicted change in communicative participation following the intervention.Conclusion: The Target Word programme can facilitate the development of communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximise outcomes for children with limited verbal imitation.

Parent-Implemented Language and Communication Interventions for Children with Developmental Delays and Disabilities: a Scoping Review

The purpose of this article was to review and examine the empirical literature on parent implemented naturalistic language interventions aimed at supporting language development of young children with disabilities. A scoping review of 21 parent-implemented naturalistic language intervention studies published between 2000 and 2016 was conducted to (a) identify and report the types of naturalistic strategies used in research studies, (b) identify the characteristics of study participants, and (c) collate and summarize the effects of parent implemented intervention studies. All 21 studies reported positive outcomes for parents and children and indicated that parents could implement naturalistic strategies with their young children. Results of parent-implemented language interventions are discussed. Limitations of the present review as well as the current literature are identified. Implications for research and practice are addressed following the literature review.

Inferential language use by school-aged boys with fragile X syndrome: Effects of a parent-implemented spoken language intervention

This study examined the impact of a distance-delivered parent-implemented narrative language intervention on the use of inferential language during shared storytelling by school-aged boys with fragile X syndrome, an inherited neurodevelopmental disorder. Nineteen school-aged boys with FXS and their biological mothers participated. Dyads were randomly assigned to an intervention or a treatment-as-usual comparison group. Transcripts from all pre- and post-intervention sessions were coded for child use of prompted and spontaneous inferential language coded into various categories. Children in the intervention group used more utterances that contained inferential language than the comparison group at post-intervention. Furthermore, children in the intervention group used more prompted inferential language than the comparison group at post-intervention, but there were no differences between the groups in their spontaneous use of inferential language. Additionally, children in the intervention group demonstrated increases from pre- to post-intervention in their use of most categories of inferential language. This study provides initial support for the utility of a parent-implemented language intervention for increasing the use of inferential language by school aged boys with FXS, but also suggests the need for additional treatment to encourage spontaneous use.

The Longitudinal Effects of Early Language Intervention on Children's Problem Behaviors.

Researchers examined whether a parent-implemented language intervention improved problem behaviors 1year after intervention. Ninety-seven children with language delays (mean age at 12-month follow-up=48.22months) were randomized to receive Enhanced Milieu Teaching (EMT) language intervention or business as usual treatment. Twelve months after the intervention ended, children in the EMT intervention condition displayed lower rates of parent-reported externalizing, internalizing, and total problem behaviors. A mediation analysis revealed that the relation between EMT and problem behaviors was partially mediated by child rate of communication for both internalizing and total problem behaviors. A developmental framework is proposed to explain the impact of EMT on problem behaviors, and future lines of research are discussed.

Distance delivery of a parent-implemented language intervention for young boys with fragile X syndrome.

In addition to significant cognitive delays, boys with fragile X syndrome display phenotypic characteristics that include delays in language, inattention, social anxiety, and escape-maintained challenging behaviors. Despite these challenges, families affected by fragile X syndrome often have limited access to center-based intervention programs. The present study utilized a multiple baseline design across participants to examine the preliminary effectiveness of a 12-week, parent-implemented spoken language intervention for three 5- to 7-year-old boys with fragile X syndrome. The goal of the intervention was to teach the biological mothers of each boy to use a set of verbally responsive language support strategies while participating in shared book reading activities with her child. All aspects of the intervention, including pre- and post-treatment measures, were delivered into the family's home via distance video teleconferencing. Results from this study provide preliminary support for the efficacy of this parent-implemented language intervention approach by demonstrating generalized improvements in both targeted maternal strategy use and measures of child spoken language. The present study expands upon prior language intervention research utilizing distance delivery of services for families affected by fragile X syndrome. Additionally, the study provides early support for the feasibility of collecting pre- and post-treatment assessments at a distance.

Early Language Intervention Using Distance Video-Teleconferencing: A Pilot Study of Young Boys With Fragile X Syndrome and Their Mothers.

This study examined the effects of a naturalistic parent-implemented language intervention on the use of verbally responsive language by mothers of 6 young boys with fragile X syndrome. The intervention included parent education sessions and clinician coaching delivered onsite and by distance video-teleconferencing. A single-case multiple baseline across participants was used to examine intervention effects on maternal use of language support strategies. A nonparametric analysis was used to evaluate the relative effectiveness of onsite compared with distance coaching sessions. Mothers increased their use of utterances that followed into their child's focus of attention and prompted child communication acts. Intervention effects were not observed for maternal contingent responses to child communication, possibly due to the limited number of spontaneous communication acts children produced. Children showed moderate increases in the use of prompted communication acts, whereas intervention effects on spontaneous communication acts were more modest and variable. Comparable increases in maternal strategy use were observed during onsite and distance sessions. No previous study has examined a distance-delivered parent-implemented language intervention for young boys with fragile X syndrome. Mothers were able to increase their use of verbally responsive language. Intervention efficacy might be enhanced by incorporating an augmentative and alternative communication device for some children and a more concerted focus on increasing the frequency of child communication acts. Findings provide preliminary support for the efficacy of the distance delivery format.

Enhancing the Communication Abilities of Preschoolers at Risk for Behavior Problems

Communication deficits are frequently associated with externalizing behavior problems in preschoolers but, in most cases, unsuspected in clinical practice. This exploratory study evaluated the effectiveness of a relatively brief parent-implemented language intervention on preschoolers at risk for behavior problems. Participants were randomly allocated either to an experimental group (n = 16) or to an untreated control group (n = 16). An intervention of eight group sessions, aiming at enhancing parent verbal responsiveness and communication strategies, was implemented over 2 months. Results showed that this intervention created several improvements such as an enhancement of parental responsiveness and a trend toward increased child referential communication abilities and decreased child behavior problems. These effects persisted 6 months after the intervention. Despite some limitations and the need for a replication of these results, the findings highlight the importance of preventive interventions on parent–child communication and interactions in supporting the communication needs of children with externalizing behavior difficulties.

Simplifying Parental Language or Increasing Verbal Responsiveness, What is the Most Efficient Way to Enhance Pre-schoolers’ Verbal Interactions?

Literature shows that parent-implemented language interventions have positive effects on children language skills. Nevertheless, studies in this field suffer from two limitations. This pilot study compared the efficiency of two brief self-implemented interventions, each aiming to manipulate a specific parenting language variable, on a non-clinical sample of preschoolers. Sixty participants were randomly allocated to: (1) Responsive group: forty-minute intervention in order to enhance the parents’ responsiveness (20 participants), (2) Structural group: forty-minute intervention in order to simplify the parental language (20 participants), (3) Control group: forty-minute program that did not deal with parental issues (20 participants). A parent/child play session was administered before and after the intervention in order to make a pre-post comparison. Results showed several modifications only after the responsive intervention, including an equilibration of parent/child turn-taking. First, results demonstrated that increasing parent’s responsiveness is more efficient than simplifying parental language to enhance verbal interactions. Second, as these patterns of communication are associated with language and behavioral development, it would be a first step toward the creation of brief and cost-effective responsive interventions for prevention purposes in pre-schoolers.

Effectiveness of a parent-implemented language and literacy intervention in the home language

Few studies explore parent-implemented literacy interventions in the home language for young children with problems in language acquisition. A shift in children’s use of the home language to English has been documented when English is the only language of instruction. When parents are not proficient in English, such language shift can limit communication at home. In this study we examine a parent-implemented language-literacy intervention in the home language on building vocabulary in preschool children with difficulty acquiring language. Twenty-four mother–child dyads were randomly assigned to an intervention or to a comparison group. Mothers in the intervention group learned how to stimulate language literacy through play, reading, and routine activities at home. They received interactive picture books in Spanish. Findings showed substantial gains in expressive vocabulary in Spanish, in English, and for conceptual scores (total vocabulary minus duplets) for children in the intervention group. Mothers’ perceptions regarding use of the home language improved after the intervention. Findings suggest that mothers in the intervention group were able to transform their children’s home educational environment into an additive one, where the home language was valued.

More Than Words—The Hanen Program for Parents of Children with Autism Spectrum Disorder: A Teaching Model for Parent-implemented Language Intervention

There has been an increased emphasis on caregiver-implemented intervention in the field of early intervention. However, this form of intervention can be effective only if the provider has the skills to teach, scaffold and coach the caregiver within a supportive, collaborative partnership. This article describes More Than Words—The Hanen Program for Parents of Children With Autism Spectrum Disorder, a manualized parent-implemented intervention for groups of parents and caregivers. In this program, the speech-pathologist assumes the role of mediator, utilizing specific techniques and activities based on adult education principles, providing a multifaceted, collaborative learning experience that enables parents to become effective language facilitators for their child.

Assessing the Effects of a Parent-Implemented Language Intervention for Children With Language Impairments Using Empirical Benchmarks: A Pilot Study

The purpose of this study was to investigate the extent to which a parent-implemented language intervention improves language skills in toddlers at risk for persistent language impairment (LI) as compared with a group of typically developing toddlers. Thirty-four children with LI between 24 and 42 months of age were randomly assigned to a treatment or nontreatment experimental condition. Participants in the treatment group received 24 biweekly 1-hr sessions for 3 months. An additional sample of 28 age- and gender-matched children with typically developing language (TL) was also included. Norm-referenced child assessments and observational measures were used to assess changes in children's language growth. Results from multilevel modeling indicate that children in the treatment group made greater gains than children in the control group on most language measures. Whereas children in the treatment group had lower language scores than children with TL at the end of intervention, the rate of language growth was not significantly different between groups. Child receptive language and parent use of matched turns predicted expressive language growth in both children with and without LI. The results of this preliminary study indicate that parent-implemented interventions may be an effective treatment for children with expressive and receptive LI.

Advances in Early Communication and Language Intervention

Learning to communicate using speech and language is a primary developmental task for young children. Delays in the acquisition of language are one of the earliest indicators of developmental deficits that may affect academic and social outcomes for individuals across the life span. In the period since the passage of PL 99-457, significant progress in research related to language intervention has been made in five areas: (a) the social, symbolic, and prelinguistic foundations to spoken language; (b) parent-implemented language interventions; (c) the language foundations for literacy; (d) the relationship between language and social behavior; and (e) the use of augmented and alternative modes of communication. Although there are indications of important advances in the knowledge base of early identification as well as comprehensive and continuous intervention, preparing professionals to provide effective interventions in natural environments continues to be a challenge for the field.

The Effectiveness of Parent-Implemented Language Interventions: A Meta-Analysis

The purpose of this meta-analysis was to systematically evaluate the effects of parent-implemented language interventions on the language skills of children between 18 and 60 months of age with primary and secondary language impairments. A systematic literature search yielded 18 studies that met the predetermined inclusion and exclusion criteria. Effect sizes for each study were calculated for 7 language outcome variables and analyzed using a random effects model. Separate analyses were conducted for each language outcome and for each comparison group. Outcomes were compared for children with and without intellectual disabilities and for parent report and direct observational language measures. The results indicate that parent-implemented language interventions have a significant, positive impact on receptive and expressive language skills of children with and without intellectual disabilities. Effect sizes (g) for child measures ranged from -0.15 to 0.82 depending on the outcome measure and comparison group. The results of this review indicate that parent-implemented language interventions are an effective approach to early language intervention for young children with language impairments. Critical features of parent-implemented interventions are discussed in terms of implications for practice and future research.

Efficacy of a parent-implemented early language intervention based on collaborative consultation.

A group of five preschool children with developmental disability and their mothers participated in a study into the efficacy of a parent-implemented language intervention. Each parent was included in the team as a consultee, with a speech pathologist and special educator acting as consultants within a collaborative consultation process. Treatment for each child was developed using this process, with specific strategies to increase language production skills decided by the team. Strategies were used within an interactive model of early language intervention. The effectiveness of treatment was determined within a multiple baseline design. For three children, the impact of treatment was evident, but the results were not replicated for the other two children. Descriptive analysis of mothers' communicative behaviours indicated that, following treatment, they tended to direct more utterances to their children, used more models, fewer questions and directives, and more (although limited) teaching strategies.