COLLEGE OF

Examining Caregivers' Implementation Of Naturalistic Communication

EHHS Strategies To Promote Their Child’s Functional Expressive Language
Jessica Hunt
Kent State University, Early Intervention Certificate Program, and Speech Language Pathology M.A. Program

INTRODUCTION METHODS RESULTS

► Early Intervention (EI) is a system of services and supports that help children from ► Participants: Child with expressive language delay age 24 months and his mother 70 Caregiver Implemented EMT Strategy Use
Baseline Intervention
Intervention
birth to 3 years old with developmental delays or disabilities and their families.
► Settings: The home: in the child’s playroom 60

► EI emphasizes importance of child-caregiver interactions within their natural

► Design: AB single-subject design with baseline and intervention conditions 50

environments.

Frequency of Strategy Use

► Procedures: Teach-Model-Coach-Review (Roberts et al, 2014)
40

► Enhanced Milieu Teaching (EMT) is an evidence-based practice that includes a 30

1.Teach: Introduced and explained EMT strategies to caregiver

grouping of strategies that incorporate natural environments and child-lead 20

interactions. 2.Model: Caregiver practiced EMT strategies

10

3.Coach: Student provided specific feedback

RESEARCH QUESTIONS 4.Review: Student and caregiver discussed EMT strategies
0
1 2 3
Session
4 5 6 7

Assistance Sabotage Expansions Specific Feedback Composite

► 1. What are the effects of using the coaching model on caregiver to use EMT:
► EMT Intervention (Independent Variables):
naturalistic communication support strategies? Child Language Use
1.Assistance: Parent will off an item/object within the child’s reach and sight during daily 70 Baseline Intervention

► 2. What are the effects of caregiver implementation of the EMT strategies on the child’s routine or play in which the child will need to request the parent’s help to access. 60

expressive communication in daily routines? 2.Sabotage: Parent will not provide all the material the child needs to complete a task
50
in order to elicit verbal and/or nonverbal requests.

Frequency of Communication
RESEARCH SYNTHESIS 3.Expansions: Parent will not provide all the material the child needs to complete a task 40

in order to elicit verbal and/or nonverbal requests. 30

Source Findings ► Parent Fidelity Measures 20

1.Assistance: Frequency of parent offering an activity or item in which the child needs to
Fey, M. E., Warren, S. F., Responsivity education (RE) and Prelinguistic Milieu
request the parent’s help.
10

Brady, N., Finestack, L. H., Teaching (PMT) can be implemented in early

Bredin-Oja, S. L., Fairchild, M., intervention and can be used effectively over a short 2.Sabotage: Frequency of parent not providing all material to complete a task and 0
1 2 3
Session
4 5 6 7

Sokol, S., & Yoder, P. J. (2006) term prompting with a question about what’s missing to the child. Gestures Vocalizations Single-Word Utterance Mu ltiple-Word Utterance Composite

3.Expansions: Frequency of parent response to child’s gestures, vocalizations, or word

Roberts, M. Y., Kaiser, A. P., Teach-Model-Coach-review instructional approach is
Wolfe, C. E., Bryant, J. D., & an effective approach that interventionists can
Spidalieri, A. M. (2014) implement in their sessions. This approach can be
generalized in many natural environments
Yoder, P. J., & Warren, S. F. RE and PMT are effective approaches interventionists
(2002) can implement in their sessions. This approach can
increase growth in communication and early productive
language.
Windsor, K. S., Woods, J., Caregivers can learn to implement EMT strategies to
Kaiser, A. P., Snyder, P., & embed instruction for both communication and motor
Salisbury, C. (2019) targets concurrently within multiple routines.
Hatcher, A, & Page, J. (2020) Home-based, parent-implemented training programs
using EMT are effective in increasing parent’s correct
implementation of language support strategies with their
child with language delay within the context of play.
They also can improve a child’s expressive language.
The contents of this poster were developed under a grant from the
US Department of Education (DOE), #H325K120174. However, those
contents do not necessarily represent the policy of the US DOE, and
you should not assume endorsement by the Federal Government.
use by modeling the gesture intent and target word by at least two words to narrate
child’s communication attempt.
4.Specific Feedback: Frequency of parent responds to the child communication attempt
by using specific praise and/or providing child with desired item or corrective feedback
► Child Communication Measures (Dependent Variables):
1.Gesture: Physical movements that the child makes to communicate with the adult.
2.Vocalization: Child voicing a non-word or unintelligible verbal utterances
3.Single-Word Utterance: Child voicing a single word
4.Multiple-Word Utterance: Child voicing a combination of two or more words
► Data Collection: Baseline and intervention videos were coded for frequency of parent
fidelity measures and child communication measures.
DISCUSSION
► Similar to previous studies, this study showed that EMT strategies promote
positive parent-child interactions and language development in children.
► This study showed that using the Teach-Model-Coach-Review procedures, the
parent may not actively practice (model) EMT strategies.
► If EI practitioners want to know if parents are implementing strategies in their
daily routines, it can be beneficial to have parents’ record videos of their daily
routines without EI practitioner present (seen in session 7)
► Limitations included: Data collection is still going on, small sample size, and
limited diversity.
► Future directions of this research includes having parents’ record videos of daily
routines without EI practitioner present and see if parents can generalize EMT
strategies.