Video- and App-Based Naturalistic Language Instruction (VALI) for Spanish-Speaking Caregivers to Support Bilingual Language Development in Children With or At Risk for Language Delays

The purpose of the research plan is to adapt an existing app, Háblame Bebé, that provides information to Spanish-speaking families about the importance of frequent and responsive verbal interactions with children in the home language but does not provide information on how to embed NLIS within everyday activities and routines to support DLLs with language delay. The current study will develop, refine, and test an adapted version that addresses these shortcomings across three phases. In Phase 1, VALI content and coaching procedures will be adapted and developed for providers to deliver video-based feedback to caregivers. Feedback on the acceptability, usability, and feasibility will be obtained through stakeholder surveys, focus groups, and a field study. Phase 2 will use a single-case design study to test the feasibility and fidelity of implementation of VALI across a small number of provider-caregiver-child triads. The PI will make final revisions to VALI based on feedback from coaches and caregivers. In Phase 3, the PI will conduct a small randomized controlled trial with approximately 30 provider-caregiver-child triads to assess the promise of VALI for improving caregiver use of NLIS in the home language and child language outcomes (receptive and expressive skills in Spanish and English). Fidelity will be assessed through an observational checklist. Feasibility and acceptability of the intervention will be assessed through provider and caregiver checklists and surveys. Data from the single-case design studies will be analyzed using visual and statistical analysis and pilot study data will be analyzed using linear regressions. The PI will also conduct a cost analysis to determine the cost of implementing the final version of the intervention.