Caregiver-Implemented Interventions in Pediatric Speech-Language Pathology: Lessons Learned from Practice-Based Research

Abstract

Caregiver-implemented interventions are often used by speech-language pathologists to support children’s early language development by empowering caregivers to facilitate children’s language learning in everyday contexts. The Hanen Centre is a globally recognized organization that trains speech-language pathologists to deliver caregiver- implemented interventions. Two Hanen programs focus on supporting the language development of children with more general communication needs – Target Word and Learning Language and Loving It. The Target Word program aims to improve the language and communicative participation skills of children who are late-to-talk. The Learning Language and Loving It program engages early childhood educators in supporting children’s language learning in childcare contexts. This dissertation explored the effectiveness, feasibility, and cultural appropriateness of these programs in applied contexts. Study 1 evaluated the effectiveness of the virtual Target Word program. A constrained longitudinal data analysis approach was used to examine differences in vocabulary, morphology, phonology and communicative participation for children in immediate and waitlist control groups. Clinically meaningful gains in communicative participation and statistically significant gains in phonology were associated with families’ program involvement, however most other scores in expressive vocabulary, morphosyntax, and communicative participation were not statistically different between groups. Study 2 assessed parent-child interaction quality during video-recorded play-based interactions for the same families who participated in Study 1. Parent-child interactions were coded using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) and data were analyzed using constrained longitudinal data analysis. No group differences were observed at any point. Study 3 aimed to understand Red River Métis Early Childhood Educators’ perceptions of the feasibility and the cultural appropriateness of the strategies recommended in the Learning Language and Loving It program. A think aloud interview approach was used to capture participants’ views. A thematic analysis revealed three themes related to the feasibility of program strategies, and two themes identified suggested cultural adaptations and considerations for Red River Métis childcare centres. This dissertation provides insight into the effectiveness of caregiver-implemented interventions and key cultural considerations for those working with Red River Métis children and their caregivers. Practical implications for research and practice in pediatric speech-language pathology are also identified.Kathryn Hatherly, 202