Discussion: Family-Centered Approach

Discussion: Family-Centered Approach

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Discussion: Family-Centered Approach

Topics in Early Childhood Special Education 2014, Vol. 33(4) 212 –224 © Hammill Institute on Disabilities 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0271121413497520 tecse.sagepub.com

Topical Article

Language development is a primary task of the first few years of life. Delays in language often are primary indica- tions of developmental delays and are likely to impact development across all domains. While there is variation in the rate and timing of language development, the sequence of language milestones is generally predictable among chil- dren within cultures. Most typically developing toddlers acquire a core vocabulary of functional words by their 2nd year of life (Crais, 1990). However, some toddlers exhibit delayed vocabulary acquisition associated with identified disorders (e.g., Down syndrome) or diagnosed develop- mental delays (American Speech-Language-Hearing Association, 2005). In addition to children with known dis- orders and delays, 15% of toddlers develop language at a slower pace without any concomitant delays in other devel- opmental domains (Desmarais, Sylvestre, Meyer, Bairati, & Rouleau, 2008). While a subset of these toddlers will catch up to typically developing children by the preschool years, some will have persistent delays (Paul, 2000; Rescorla, 2002). Recent federal data indicated that the number of infants and toddlers with delays served under Part C Early Intervention (EI) increased from just under 190,000 (1.6% of all infants and toddlers) in 1998 to over 320,000 (2.2%) in 2007 (U.S. Department of Education, 2012) and sug- gested that 8% to 12% of preschool children have language delays (U.S. Preventive Services Task Force, 2006).

Children with language delays are more likely to experi- ence literacy delays (van der Schuit, Peeters, Segers, van Balkom, & Verhoeven, 2009) and social, emotional, or behavioral problems (van Daal, Verhoeven, & van Balkom, 2007). The effects of language impairments are cumulative and might impact later school success if not addressed early.

Family-Centered Approach

A family-centered approach is central to the general phi- losophy and framework of EI (McWilliam, 2010, 2012; Powell & Dunlap, 2010). Research consistently supports EI approaches that focus on enhancing parent and caregiver capacity to meet the needs of infants and toddlers (Bruder & Dunst, 2000). For example, research indicated that increased parent responsivity is associated with enhanced child lan- guage skills (Dunst & Trivette, 2009a) and improved devel- opmental outcomes (Baggett et al., 2010). Several recent

497520 TECXXX10.1177/0271121413497520Topics in Early Childhood Special EducationMoore et al. research-article2013

1University of Oregon, Eugene, USA 2University of Colorado Denver, USA

Corresponding Author: Heather W. Moore, Communication Disorders and Sciences Program, 5284 University of Oregon, Eugene, OR 97403-5284, USA. E-mail: [email protected]

A Program for Improving Toddler Communication Through Parent Coaching

Heather W. Moore, PhD, CCC-SLP1, Erin E. Barton, PhD, BCBA-D2, and Maria Chironis, MS1

Abstract The purpose of this manuscript was to describe a community-based program, Language and Play Everyday (LAPE), aimed at evaluating effective practices for enhancing parents’ capacity to increase their toddlers’ communication skills. LAPE was a parent education program focused on coaching parents to embed naturalistic language-enhancing strategies within daily routines. Participants included eight families of toddlers with expressive communication delays ranging in age from 22 to 36 months. LAPE was delivered using group and individual sessions. After participating in the program, parents increased their responsivity and use of other language-enhancing behaviors. Social validity measures indicated that parents were satisfied with procedures, goals, and outcomes of the project. Moreover, children improved their expressive language skills. Implications for future research and application are discussed.

Keywords infants and toddlers, speech and language delays, parent coaching

Moore et al. 213

reviews and meta-analyses support EI approaches that focus on enhancing parents’ responsivity and capacity to support their children’s development. Dunst and his colleagues identified specific essential characteristics of parent respon- sivity related to improved child developmental outcomes. Effective parents responded contingently, based on the child’s focus or intent, and in mutually reinforcing ways (Dunst & Trivette, 2009a; Trivette, Dunst, & Hamby, 2010). Moreover, approaches that promoted full participa- tion of families in assessment and intervention were related to improved child outcomes (Dunst, Trivette, & Hamby, 2006, 2007, 2008a).

For infants and toddlers, responsive interactions with parents during daily routines and activities provide essential opportunities for learning and promoting development. In fact, the influence of parents on child development is criti- cal; parents are the most significant facilitators of learning for infants and toddlers (Powell & Dunlap, 2010). Thus, EI should focus on family coaching (i.e., supporting their abil- ity to enhance their child’s development) rather than pro- viding direct service to the child. This focus on the family ensures the child has multiple learning opportunities during meaningful routines and activities (Jung, 2003; McWilliam,

2010). A family-centered approach means practitioners focus on increasing the quality of parent−child interactions within daily routines and activities, which is likely to enhance family quality of life (McWilliam, 2010). Several family coaching practices have been identified based on family-centered practices and adult learning principles (Powell & Dunlap, 2010; Rush & Shelden, 2011; Sandall, Hemmeter, Smith, & McLean, 2005). These coaching prac- tices (see Table 1) emphasize the families’ strengths and values, identify natural learning opportunities within daily routines and activities, and use evidence-based adult learn- ing strategies to build parents’ capacity to enhance their children’s development (Campbell & Sawyer, 2007).