Project Activities
This efficacy trial will compare EMT implemented by parents and therapists at home to a community "business as usual" comparison condition. Sixty children will be recruited and randomly assigned to each of two experimental conditions (EMT and Comparison) and will be followed longitudinally over 18 months. All children will be pretested, and results will be used to set language-learning targets. Children in the treatment group and their parents will work with therapists in 24 one-hour sessions. Children will be assessed at four time points (before and after the intervention, at 6 months and 12 months post-intervention), leading to a description and comparison of individual language growth trajectories over a period of 18 months.
Structured Abstract
Setting
The study will take place in Tennessee.
Sample
One hundred twenty children ages 24 -36 months who exhibit significant co-occurring delays in productive and receptive language skills (below 10th percentile for age group) will be included in the study.
Experimental applications of EMT typically have included four sequential steps: (a) arranging the environment to increase the likelihood that the child will initiate interaction with the adult; (b) selecting specific language targets appropriate to the child's skill level (e.g., using –s with plural nouns); (c) responding to the child's initiations with prompts for elaborated language consistent with the child's targeted skills; and (d) functionally reinforcing the child's communicative attempts by providing access to requested objects, continued adult interaction, and feedback in the form of expansions and confirmations of the child's utterances.
Parents are taught to use EMT at home during 24 individual training sessions led by an experienced therapist. Standardized written and verbal information, modeling through therapist demonstration, role playing, video examples, viewing video of previous sessions, therapist feedback and support, and evaluation of child progress are used to teach parents the EMT procedures.
Research design and methods
The design involves random assignment to either EMT or a control "business as usual" condition. The key question in this efficacy study is whether the intervention works when implemented as designed. Thus, researchers will take steps to ensure and measure the fidelity of the EMT implementation and amount of language intervention treatments received by participants in both the experimental and control conditions. Children will be assessed four times over an 18-month period.
Control condition
The control group will receive the community "business as usual" condition. This will include children who receive language intervention and those that do not, children enrolled in childcare and children cared for by their parents. These conditions represent the natural variability in treatment for this population and researchers will carefully document this variation.
Key measures
Six types of measures will be used: (a) screening measures to determine participant inclusion; (b) baseline status measures of child and family; (c) standardized tests and other assessments of children's language assessed over time; (d) measures of child behavior and social skills over time reported by parents and teachers; (e) observational measures of parent-child interactions, including, direct measures of parent's implementation of EMT and measures of the child's language learning environment at home; and (f) measures of parent stress, competence related to parenting, and support for language.
Data analytic strategy
Researchers will test the efficacy of the intervention over time using individual growth curve models. These models will be used to test intervention effects by detecting differences between treatment and control groups in linear slopes (rates of change) over the four waves of measurement from pretest to the 18-month follow-up. Researchers will also examine how parent and child characteristics moderate the efficacy of the EMT language intervention, which may be important for understanding the conditions (presence of key child and parent characteristics) for which the EMT intervention protocol improves language and social and behavioral outcomes.
People and institutions involved
IES program contact(s)
Products and publications
Products: Researchers will provide evidence on whether: parent-plus-therapist implemented EMT improves language development, as well as children's behavior and social skills, over time; certain child characteristics measured at pre-treatment moderate language development for children; a relationship exists between parent support for language development and subsequent children's language development; there are corollary effects of participation in parent-plus-therapist-implemented EMT on parents and, if so, what the nature of the effects are; and, if fidelity standards developed in previous studies can be achieved for parent and therapist implementation of EMT in this study. Researchers will also provide a review of the costs of EMT when compared to business as usual in the community.
Book chapter
Kaiser, A.P. (2014). Using Single Case Designs in Comprehensive Programs of Research. In T. Kratochwill, and J. Levin (Eds.), Single-Case Intervention Research: Methodological and Statistical Advances (pp. 309-323). Washington, DC: American Psychological Association.
Journal article, monograph, or newsletter
Kaiser, A.P., and Roberts, M.Y. (2013). Parents as Communication Partners: An Evidence Based Strategy for Improving Parent Support for Language and Communication in Everyday Settings. Perspectives on Language Learning and Education, 20(3): 96-111. doi:10.1044/lle20.3.96
R?oberts, M.R., Kaiser, A.P. Wolfe, C., Bryant, J., and Spidalieri, A. (2014). Effects of the Teach-Model-Coach-Review Instructional Approach on Caregiver use of Language Support Strategies and Children's Expressive Language Skills. Journal of Speech, Language, and Hearing Research, 57(5): 1851-1869. doi:10.1044/2014_JSLHR-L-13-011
Roberts, M., and Kaiser, A. (2012). Assessing the Effects of a Parent-Implemented Language Intervention for Children With Language Impairments Using Empirical Benchmarks: A Pilot Study. Journal of Speech, Language, and Hearing Research, 55: 1655-1670 . doi:10.1044/1092-4388(2012/11-0236)
Roberts, M.Y., and Kaiser, A.P. (2011). The Effectiveness of Parent-implemented Language Interventions: A Meta-analysis. American Journal of Speech-Language Pathology, 20(3): 180-199. doi:10.1044/1058-0360(2011/10-0055
Questions about this project?
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