|Title:||Developing and Testing a Blended Behavior and Language Intervention for Toddlers at High Risk for Persistent Developmental Language Disorders|
|Principal Investigator:||Kaiser, Ann||Awardee:||Vanderbilt University|
|Program:||Early Intervention and Early Learning [Program Details]|
|Award Period:||4 Years (09/01/2020 - 08/31/2024)||Award Amount:||$1,399,772|
|Type:||Development and Innovation||Award Number:||R324A200193|
Co-Principal Investigators: Hemmeter, Mary Louise; Meeker, Kathleen; Cunningham, Jennifer
Purpose: This project aims to develop and evaluate the promise of Toddler Talk, a model that blends two evidence-based practices – Teaching Pyramid for Supporting the Social Emotional Development of Young Children (Pyramid Model) and Enhanced Milieu Teaching (EMT) – to improve language development in toddlers at high risk for persistent developmental language disorders and poor social and academic outcomes. There are no current early interventions that address this population of young children and the risks associated with the co-occurrence of language and social emotional skills. To achieve this goal, the research team will combine evidence-based professional development strategies (PD) from the Pyramid Model with specific training in EMT strategies and test the effects of the model and the associated PD protocol on teacher implementation of the model and child outcomes.
Project Activities: The research team will use an iterative process to develop Toddler Talk using focus groups, interviews, surveys, single-case design, and field testing. A randomized controlled trial will be used to pilot test the promise of the model and its associated PD on teacher implementation and child language and behavior for toddlers at risk for poor outcomes in these areas.
Products: The primary products of this project include a fully developed model and its PD protocol for supporting early childhood teachers in improving language and behavioral outcomes in at-risk toddlers. The project will also result in peer-reviewed publications and presentations as well as additional dissemination products that reach education stakeholders such as practitioners and policymakers.
Settings: This research will take place in community child care and Early Head Start classrooms serving toddlers from low resource urban and suburban communities in Tennessee, Oregon, and Washington.
Sample: The primary population includes 54 early childhood teachers and 116 toddlers ages 24-36 months within their classrooms (approximately 4 children per classroom). The children will evidence expressive and receptive language delays that put them at high risk for persistent developmental language disorders and social-emotional skill deficits.
Intervention: Toddler Talk will be a Tier 1 intervention blending the Pyramid Model and EMT procedures to teach language and social-emotional skills across the day and in small group activities. The Pyramid Model is a framework of evidence-based practices for promoting social-emotional competence and preventing and addressing challenging behavior. EMT is an evidence-based naturalistic communication intervention that uses responsive interactions, language modeling, and prompting to support communication in ongoing teacher-child interactions. The PD will combine the evidence-based training strategies (Practice-Based Coaching, Teach-Model-Coach-Review) associated with the two models to enhance implementation fidelity.
Research Design and Methods: A rapid cycle iterative design process will be used to examine the conditions under which the Toddler Talk model has an impact and the PD approach that best supports teachers' learning and implementation of the model. The research team will conduct: a) a developmental case study (Year 1), b) a single-case design study (Year 2), c) a field test with repeated measures and randomized comparison group (Year 3), and d) a pilot randomized controlled trial (Year 4). Development of the intervention and PD protocol, establishing the reliability and validity of fidelity measures, and establishing the social validity of the intervention and PD protocol will be embedded within and across these studies as a part of the iterative design process. The team will pilot cost data collection during the field test in Year 3 and conduct the full cost analysis during the pilot test in Year 4.
Control Condition: During the field test and pilot study, teachers in the control group will engage in business-as-usual teaching. They will also receive an 8-hour workshop and Toddler Talk training materials after post-testing.
Key Measures: Qualitative (interviews, focus groups) and quantitative (surveys) responses from practitioners and experts will be used to assess the feasibility, effectiveness, acceptability, and overall satisfaction with the Toddler Talk model and the associated PD protocol. Implementation fidelity measures include the TPITOS EMT for class-wide implementation of the intervention, EMT Global Rating System for use of EMT strategies in small groups, and LABOR observation code for teacher linguistic input. Child language outcomes be measured with the Preschool Language Scales – 5 and the Individual Growth and Development Indicators – Early Communication Indicator. Child social-emotional outcomes will be measured with the Devereux Early Childhood Assessment – Toddler. Finally, costs will be analyzed with the CostOut cost analysis toolkit.
Data Analytic Strategy: To develop the intervention model, the research team will use a mixed methods design utilizing quantitative (descriptive statistics based on surveys) and qualitative (inductive methods based on transcripts and field notes of focus groups) analyses. For the single-case design study, they will use visual analysis with analyses of effect sizes to examine the effects of an initial application of the model. The field test and pilot study will use multi-level modeling to examine primary teacher and secondary child effects of the intervention, as well as additional quantitative and qualitative analyses from survey ratings and interviews to assess the social validity of the model.
Related Projects: Examining the Potential Efficacy of a Classroom Wide Model for Promoting Social Emotional Development and Addressing Challenging Behavior in Preschool Children With and Without Disabilities (R324A070212);An Efficacy Trial of Milieu Teaching Language Intervention in Preschoolers with Language Disorders (R324A090181);Examining the Efficacy of a Classroom-Wide Model for Promoting Social Emotional Development and Addressing Challenging Behavior in Preschool Children with or at-risk for Disabilities (R324A120178)