Facilitating Infant and Caregiver Responsiveness to Improve Language Development Across Economic Levels
Faculty Advisor Name
Rory DePaolis
Department
Department of Communication Sciences and Disorders
Description
Introduction
Language environments for infants from economically disadvantaged homes are consistently reduced in terms of maternal attention to infant babble around 6 to 9 months, reduced maternal and infant gestures that preclude the onset of first words, reduced book sharing, and reduced infant-directed language during the first 12 months of life; all of which negatively impact neural activity critical to brain development (Fernald et al., 2013; Hart & Risley, 1995; Hoff, 2003; Rowe & Goldin-Meadow, 2009). Parent-focused training has been positively associated with child language skills (Roberts et al., 2019) and has been a component of a variety of intervention and prevention models (Harbick et al., 2019) designed to address developmental disparities with at-risk infants.
Methods
The current research is based upon studies that show an impact on language development from increased caregiver contingent responsiveness, increased joint attention, increased infant-directed speech (IDS), increased use of gestures and turn taking (Table 1). We presented these target behaviors to the caregivers as the 3 Ts (Tune in, Talk more, Take turns) inspired by the work of Suskind and colleagues (2015). Designed for caregivers-infants (6-12 months) from low income homes, an 8-session and 1-session intervention were conducted at the JMU Speech-Language Clinic.
The aim of pilot testing was to establish the efficacy of the program model specifically for (1) child language outcomes, (2) caregiver interaction quantity and quality through the use of contingent responses and IDS (3) caregiver knowledge of best practices for child development, and (4) graduate clinician confidence in assessment of infant language development and coaching with caregivers. Intervention group dyads were assessed pre-intervention, immediately post-intervention, and at a 3 month follow-up assessment. Control group dyads participated in the same schedule of assessments but did not receive the intervention until all assessments were complete.
Results & Conclusion
Results indicate positive changes in all targeted outcomes when initial assessments were compared to 4-month follow-up.
1. Infant language skills significantly improved on the Expressive Communication subtest of the Preschool Language Scale (t=3.396, p=.019), and the MacArthur-Bates Communicative Development Inventory Total Gestures Inventory (t=3.268, p=.022).
2. Caregiver quantity and quality of interaction was assessed using a video tape analysis protocol. Caregivers and infants in the intervention more than doubled their time spent in responsive communication patterns during post-assessment compared to the control group.
3. Caregiver knowledge of child development significantly improved according to the Survey of Parent/Provider Expectations and Knowledge (t=6.423, p=.001).
4. Graduate clinicians were significantly more confident (t=7.850, p=.001) in their interactions with parents and skills for infant language assessment following the conclusion of the program given a researcher-created measure of clinician confidence.
Preliminary results indicate that the components of the 8 intervention sessions promote economically disadvantaged infant language outcomes, in addition to advancing caregiver knowledge and improving graduate clinician confidence in working with families with infants.
Table and Figure for Harbick Proposal
Facilitating Infant and Caregiver Responsiveness to Improve Language Development Across Economic Levels
Introduction
Language environments for infants from economically disadvantaged homes are consistently reduced in terms of maternal attention to infant babble around 6 to 9 months, reduced maternal and infant gestures that preclude the onset of first words, reduced book sharing, and reduced infant-directed language during the first 12 months of life; all of which negatively impact neural activity critical to brain development (Fernald et al., 2013; Hart & Risley, 1995; Hoff, 2003; Rowe & Goldin-Meadow, 2009). Parent-focused training has been positively associated with child language skills (Roberts et al., 2019) and has been a component of a variety of intervention and prevention models (Harbick et al., 2019) designed to address developmental disparities with at-risk infants.
Methods
The current research is based upon studies that show an impact on language development from increased caregiver contingent responsiveness, increased joint attention, increased infant-directed speech (IDS), increased use of gestures and turn taking (Table 1). We presented these target behaviors to the caregivers as the 3 Ts (Tune in, Talk more, Take turns) inspired by the work of Suskind and colleagues (2015). Designed for caregivers-infants (6-12 months) from low income homes, an 8-session and 1-session intervention were conducted at the JMU Speech-Language Clinic.
The aim of pilot testing was to establish the efficacy of the program model specifically for (1) child language outcomes, (2) caregiver interaction quantity and quality through the use of contingent responses and IDS (3) caregiver knowledge of best practices for child development, and (4) graduate clinician confidence in assessment of infant language development and coaching with caregivers. Intervention group dyads were assessed pre-intervention, immediately post-intervention, and at a 3 month follow-up assessment. Control group dyads participated in the same schedule of assessments but did not receive the intervention until all assessments were complete.
Results & Conclusion
Results indicate positive changes in all targeted outcomes when initial assessments were compared to 4-month follow-up.
1. Infant language skills significantly improved on the Expressive Communication subtest of the Preschool Language Scale (t=3.396, p=.019), and the MacArthur-Bates Communicative Development Inventory Total Gestures Inventory (t=3.268, p=.022).
2. Caregiver quantity and quality of interaction was assessed using a video tape analysis protocol. Caregivers and infants in the intervention more than doubled their time spent in responsive communication patterns during post-assessment compared to the control group.
3. Caregiver knowledge of child development significantly improved according to the Survey of Parent/Provider Expectations and Knowledge (t=6.423, p=.001).
4. Graduate clinicians were significantly more confident (t=7.850, p=.001) in their interactions with parents and skills for infant language assessment following the conclusion of the program given a researcher-created measure of clinician confidence.
Preliminary results indicate that the components of the 8 intervention sessions promote economically disadvantaged infant language outcomes, in addition to advancing caregiver knowledge and improving graduate clinician confidence in working with families with infants.
