Parent-Implemented Language Intervention for Teaching Enhanced Milieu Teaching Strategies to Parents of Low-Socioeconomic Status

2019 ◽  
Vol 42 (2) ◽  
pp. 122-142
Author(s):  
Allison Hatcher ◽  
Judith Page
Keyword(s):  
Low Socioeconomic Status ◽  
Child Language ◽  
Single Case ◽  
Language Intervention ◽  
Language Outcomes ◽  
Baseline Design ◽  
Low Socioeconomic ◽  
Language Support ◽  
Milieu Teaching ◽  
Enhanced Milieu Teaching

In this study, the authors examined the effects of training four parents from low-socioeconomic environments to use Enhanced Milieu Teaching (EMT) with their young children with language delay. Parents were taught to use the following EMT strategies during eight to 10 individualized, home-based sessions: matched turns, expansions, time delays, and milieu teaching prompts. A single-case, multiple-baseline design across behaviors replicated across four parent/child dyads was used to evaluate the parents’ use of the EMT strategies. Child language outcomes were also assessed using pre- and post-intervention language samples. All parents learned and demonstrated use of each language support strategy to set criterion levels. Results from this study indicated a functional relationship between the brief parent-implemented language intervention training and parents’ use of language support strategies. In addition, all four children demonstrated gains in expressive language. Additional research is needed to assess fidelity and dosage of parents’ use of strategies on specific child language outcomes and to determine how to facilitate maintenance of parents’ use of strategies over time.

Generalized Effects of Enhanced Milieu Teaching

1994 ◽  
Vol 37 (6) ◽  
pp. 1320-1340 ◽  
Author(s):  
Ann P. Kaiser ◽  
Peggy P. Hester
Keyword(s):  
Preschool Children ◽  
Language Skills ◽  
Language Intervention ◽  
Multiple Baseline ◽  
Language Delays ◽  
Multiple Baseline Design ◽  
Baseline Design ◽  
Preschool Classrooms ◽  
Milieu Teaching ◽  
Enhanced Milieu Teaching

The primary and generalized effects of Enhanced Milieu Teaching were examined with six preschool children with significant language delays. In a multiple baseline design across children, trainers implemented the naturalistic language intervention during play-based interaction sessions in the children's preschool classrooms. Children systematically increased their use of targeted language skills during the intervention sessions, and these changes were maintained when the treatment was discontinued. Generalized changes in children's communication resulting from the intervention were examined with untrained teachers, peers, and parents. Some generalization to untrained partners was observed for all children. Correlational analyses indicated that greater numbers of child utterances and greater diversity in vocabulary were associated with increased talking and mands for verbalization presented by partners.

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

2016 ◽  
Vol 36 (4) ◽  
pp. 192-204 ◽  
Author(s):  
Courtney A. Wright ◽  
Ann P. Kaiser
Keyword(s):  
Parent Training ◽  
Single Case ◽  
Functional Relation ◽  
Multiple Baseline ◽  
Evidence Based Practices ◽  
Baseline Design ◽  
Milieu Teaching ◽  
Review Model ◽  
Communication Interventions ◽  
Enhanced Milieu Teaching

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.

Hybrid Telepractice Delivery of Enhanced Milieu Teaching: Effects on Caregiver Implementation and Child Communication

2021 ◽  
pp. 1-26
Author(s):  
Emily D. Quinn ◽  
Ann P. Kaiser ◽  
Jennifer Ledford
Keyword(s):  
Service Delivery ◽  
Functional Relation ◽  
Implementation Fidelity ◽  
Strategy Use ◽  
Service Delivery Model ◽  
Delivery Model ◽  
Language Support ◽  
Milieu Teaching ◽  
Support Strategies ◽  
Enhanced Milieu Teaching

Purpose This study investigated the effects of enhanced milieu teaching (EMT) on caregiver implementation of language support strategies and child communication skills using a hybrid telepractice service delivery model. Method Four caregivers and children with language delays aged 18–27 months participated in a multiple baseline across behaviors single-case research design. The therapist provided EMT to each caregiver–child dyad using a hybrid telepractice service delivery model with approximately 40% in-person and 60% telepractice sessions. Caregivers were taught to use five EMT language support strategies: matched turns, target talk, expansions, time delays, and milieu teaching episodes. Caregiver instruction followed the Teach–Model–Coach–Review approach. Caregiver outcomes were two measures of EMT implementation fidelity, accuracy, and frequency of EMT strategy use. Accuracy was measured by the percentage of spoken turns in which caregivers used each strategy correctly. Frequency was measured by the number of spoken turns in which caregivers used each strategy correctly. Child outcomes were number of communication acts, weighted count of communication acts, and number of different words. Results There was a functional relation between the intervention and the accuracy of EMT strategy use for all four dyads, and the frequency of strategy use for three dyads. Caregiver use of EMT strategies maintained for 6 weeks post-intervention. After caregivers learned EMT strategies, gradual increases in the number of communication acts, weighted count of communication acts, and number of different words occurred for three children. Conclusion Results demonstrate the preliminary efficacy of using a hybrid telepractice service delivery model to teach caregivers EMT language support strategies. Supplemental Material https://doi.org/10.23641/asha.14977605

scholarly journals A Randomized Case Series Approach to Testing Efficacy of Interventions for Minimally Verbal Autistic Children

2021 ◽  
Vol 12 ◽  
Author(s):  
Jo Saul ◽  
Courtenay Norbury
Keyword(s):  
Speech Production ◽  
Effect Size ◽  
Single Case ◽  
Case Series ◽  
Randomization Test ◽  
Language Outcomes ◽  
Autistic Children ◽  
Minimally Verbal ◽  
Baseline Design ◽  
Case Effect

BackgroundRandomized Controlled Trials (RCTs) are the gold standard for assessing whether an intervention is effective; however, they require large sample sizes in order to detect small effects. For rare or complex populations, we advocate a case series approach as a more realistic and useful first step for intervention evaluation. We consider the importance of randomization to such designs, and advocate for the use of Randomization Tests and Between Case Effect Sizes to provide a robust and statistically powerful evaluation of outcomes. In this tutorial, we describe the method, procedures, and analysis code necessary to conduct robust single case series, using an empirical example with minimally verbal autistic children.MethodWe applied a pre-registered (https://osf.io/9gvbs) randomized baseline design with between-case effect size to a case series (n = 19), to test the efficacy of a novel, parent-mediated, app-based speech production intervention (BabbleBooster) for minimally verbal autistic children. Parent-rated probe scores were used to densely sample performance accuracy over time.ResultsParents were able to reliably code their children’s speech productions using BabbleBooster. A non-significant Randomization Test and small Between-Case Effect Size (d = 0.267), suggested there was no evidence that BabbleBooster improved speech production in minimally verbal autistic children, relative to baseline scores, during this brief period of intervention.ConclusionThe current analyses exemplify a more robust approach to examining treatment effects in rare or complex populations, where RCT may be difficult or premature to implement. To facilitate adoption of this method by researchers and practitioners, we provide analysis code that can be adapted using open source R packages. Future studies could use this case series design to evaluate interventions aiming to improve speech and language outcomes for minimally verbal autistic children, and other heterogeneous and hard to reach populations.

Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽  
2011 ◽  
Vol 32 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Eugene Kinyanda ◽  
Ruth Kizza ◽  
Jonathan Levin ◽  
Sheila Ndyanabangi ◽  
Catherine Abbo
Keyword(s):  
Low Socioeconomic Status ◽  
Sub Saharan Africa ◽  
Psychosocial Risk ◽  
Psychiatric Nurses ◽  
Health Concern ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Low Socioeconomic ◽  
Dsm Iv ◽  
Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

Audio Stories as Incidental Language Teachers

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Ute Ritterfeld ◽  
Timo Lüke
Keyword(s):  
Language Learning ◽  
Low Socioeconomic Status ◽  
Language Teachers ◽  
Control Group ◽  
Low Socioeconomic ◽  
Migrant Families ◽  
Populations At Risk ◽  
Grammatical Skills ◽  
Entertainment Value

Abstract. Audio stories offer a unique blend of narrative entertainment with language learning opportunities as a user’s enjoyment is dependent on their processing of the linguistic content. A total of 138 third- and fourth-graders from low socioeconomic status and migrant families recruited from a metropolitan area in Germany participated in a randomized pre–post follow-up intervention study with a control group. Children listened to a tailored crime story of approximately 90 min over a period of 3 days within the classroom setting. Entertainment value for the age group was established in a pilot study. Outcome variables included semantic and grammatical skills in German and were administered before (pretest), shortly after intervention (posttest), and 2 weeks later (follow-up). We used nonverbal intelligence, reading, comprehension skills, age and sex as control variables. Results indicate a strong positive effect of media reception on language skills. The effectiveness of the intervention is discussed with reference to different linguistic domains, entertainment value, and compensatory effects in populations at risk of language learning deficits.

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