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Helping Parents Become Effective Language Facilitators - December 2006

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Helping Parents Become Effective Language Facilitators

By: Elaine Weitzman, M.Ed, SLP-CCC - Executive Director, The Hanen Centre.

Speech-language pathologists well know the importance of involving parents in their child’s intervention. However, there are many challenges in the implementation of this family-focused approach. Some of the greatest challenges include encouraging parents to take ownership for promoting their child’s communication development and helping them change their interactive behavior, so they apply communication strategies spontaneously during everyday interactions with their child.

It is not always enough to demonstrate and explain to parents what they need to know in order to facilitate their child’s communication development. The information is frequently unfamiliar, and parents need time to process what they are learning. In addition, changing interactive behavior often involves unlearning some behaviors, while increasing others. This takes time and effort.

There is a considerable body of research on demonstrating the significant role of parental involvement in communication intervention. Using a program called It Takes Two to Talk – The Hanen Program® for Parents, a series of three randomized controlled trials has been conducted, in which children and their mothers who attended It the program were compared with a delayed treatment control group. The three objectives of the program were as follows:
  • Parent education – parents learn some essential, basic concepts about communication and language
  • Early language intervention – parents learn to apply language facilitation strategies flexibly across contexts so intervention becomes a natural part of parent-child interactions.
  • Social support – parents gain both formal and informal social support. The SLP, whose multi-faceted role includes that of group leader, interventionist, coach and counsellor provides more formal support. The parent group itself provides informal support through the sharing of experiences with individuals in similar situations, who can genuinely empathize. This constitutes a vitally important component of the program.

The results of these studies showed that mothers in the experimental group demonstrated decreased directiveness and increased responsiveness, which resulted in an increase in responsiveness, assertiveness and verbal turns of children in the experimental group. In addition, mother-child interactions in the experimental group were more balanced, frequent and longer-lasting. The changes in length and duration of interactive episodes have implications for vocabulary development since mothers' labeling during extended episodes has been shown to lead to growth in their children's receptive vocabulary, and to a much greater expansion in expressive vocabulary in older children (Tomasello & Farrar, 1986). Another important result was parent report of improved family well-being, obtained from parent questionnaires. These indicated secondary treatment effects on family functioning, including positive changes in the children’s behavior and an enhanced parent-child relationship (Tannock & Girolametto, 1992).

A subsequent study of 32 children aged 2 to 3 1/2 years, all of whom had severe expressive language delays, investigated the efficacy of parental involvement programs, (in this case It Takes Two to Talk), adapted to include focused stimulation. The study utilized a pre-test post-test control group design, with random assignment to an experimental group. The mothers in the experimental group participated in an It Takes Two to Talk Program and a delayed treatment control group was wait-listed for the program.

The program, which included parents’ learning the same responsive strategies as in the other studies, included the assignment of ten target words to each child. These words represented objects or function words that were relevant and motivating for the child, had an initial phoneme the child could say and were developmentally appropriate. Parents were taught to use these words repetitively with their child during everyday interactions and daily routines. They also learned to set up and create new routines in which the words could be used repetitively. The results of this study showed that mothers, once again, changed their interactive behavior, including use of target words and reduction in mean length of utterance. These changes in the mothers' interactive behavior and language use were related to significant improvements in their children's language skills compared to the control group. Compared with children in the control group, children whose mothers attended the It Takes Two to Talk Program demonstrated the following:
  • Use of significantly more utterances and a higher rate of words per minute.
  • Larger vocabularies and a greater variety of words.
  • Use of more target words in structured and play situations.
  • Greater spontaneous use of words that had not been targeted.
  • Use of more sentences containing two or more words.

These results demonstrate unequivocally that the changes in both mothers and children were a result of their participation in the program. The program served to "kick start" the children's language development in that once the children were primed to learn new words, they learned the targeted words as well as other words to which they were exposed incidentally. In addition, once the children began to talk more, they progressed rapidly to using longer phrases, suggesting continuity in development from single word use to the acquisition of word combinations (Girolametto, Pearce & Weitzman, 1996a, 1996b).

The results of these studies provide strong evidence of the efficacy of this model of service delivery. The findings indicate that mothers can learn to make significant changes to their interactive behavior and that these changes are associated with changes in the children’s interactive and linguistic behavior. Program that facilitate parental involvement provide SLPs with an effective context for helping parents learn and change their behavior. It also empowers parents, giving them knowledge and skills to play a vital role in their child’s communication development.

Positive feedback from parents who have participated in the program provide confirmation of the results of these studies and take them one step further, providing us with the knowledge that parental involvement programs like It Takes Two to Talk helps families be families – and enjoy their children, while they promote their communication development during everyday interactions.

This Month's Featured Program/Site: The Hanen Centre / "It Takes Two to Talk"

Special Thanks to Elaine Weitzman, Executive Director of The Hanen Centre. The Center's innovative It Takes Two to Talk™ – The Hanen Program® for Parents, a well-known model of family-focused early language intervention for young children with expressive and/or receptive language disorder, adopts the approach that parents need intensive training in a supportive group to become effective language facilitators.

It Takes Two to Talk provides a context for this intensive learning, helping parents learn the basics of communication development, as well as how to implement a childcentered approach to promoting their child’s communication development. It Takes Two to Talk also provides multiple opportunities for parents to practice communication strategies and to receive feedback on their efforts so they can modify their behavior accordingly. It is only this kind of practice which makes behavior change possible.

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Tags: Parental Involvement December 2006 Newsletter SLP Language Article