Department-funded evaluation (findings for Making Online Decisions (MOD))
Meets WWC standards with reservations
because it is a cluster randomized controlled trial with high individual-level non-response, but provides evidence of effects on individuals by satisfying the baseline equivalence requirement for the individuals in the analytic intervention and comparison groups.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Characteristics of study sample as reported by study author.
English language learners
This intervention is delivered through home visiting. The intervention was implemented in the homes of families and children in 13 Early Head Start programs in four midwestern states.
The families in the study were at, or below, the federal poverty level. Only 1 of the 146 families had a monthly income of more than $3,000. Thirty-two percent of the families were headed by a single parent and 68 percent of caregivers were married. Thirty-seven percent of the families' primary caregiver had some college (up to a BA degree). Eighty-eight percent of the families spoke English as their primary language while 14 percent spoke Spanish.
About 60 percent of the children were male and about 40 percent were female. Their average age was 21.3 months. All children scored at least one standard deviation below their age-based benchmark on the ECI.
All but one of the home visitors were women, and all but six were White. Sixty percent of the home visitors had at least some college experience, up to a BA degree, and 11 percent had some experience in graduate school, up to an MA degree.
The Making Online Decisions (MOD) intervention is an online adaptive system that guides data-based intervention decision-making of home visitors who work with infants and toddlers at risk for language delay. The MOD system is one of the few adaptive interventions designed specifically to help home visitors individualize intervention services for infants and toddlers.
The home visitors in the intervention group implemented the MOD to guide their use of the ECI assessment with the children and their use of the Promoting Communication for Accelerating Language in Kids (PC TALK) strategies with the parents.
The home visitors followed five steps that addressed five questions: 1) Is there a problem? 2) What is causing the problem? 3) What intervention should be used? 4) Is the intervention being done? 5) Is the intervention working? Home visitors implemented these steps to varying degrees, which the researchers organized into three implementation stages. Twenty-nine home visitors implemented stage 1 (MOD steps 1 to 3), 15 implemented stage 2 (MOD steps 1 to 4), and 12 implemented stage 3 (MOD steps 1 to 5). The authors call this "natural variation."
The comparison group was a business-as-usual group that implemented PC TALK, which the intervention group also implemented. PC TALK is a manualized set of strategies and tools designed to extend caregivers’ use of language-promoting strategies across daily routines. The strategies included (a) arranging the environment, (b) following the child’s lead, (c) commenting and labeling, (d) imitating and expanding, (e) open-ended questioning, (f) time delay, (g) positive attention, and (h) providing choices.
Support for implementation
The home visitors in the intervention group received a 1-hour training on how to use the MOD. The training included completing MOD steps, entering checklists, and printing MOD-recommended PC TALK strategies.