Preferred Name

Shiree Conlin Harbick

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.


Date of Graduation


Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Communication Sciences and Disorders


Rory DePaolis

Susan Ingram

Brenda C. Seal

Charlette McQuilkin


Infants are born ready to learn language as one of their most critical developmental tasks, yet infants subject to environmental risk factors related to poverty and low maternal education have been shown to lag behind their peers in language development as early as 8 months of age. Research also indicates the quality of an infant’s language environment can significantly diminish the effects of these risk factors. This quasi-experimental clinical research study explored the effects of a preventive caregiver-infant coaching intervention delivered by graduate student clinicians in a university speech-language pathology program.

Developed based on a systematic review of preventive programs for caregivers-infants, the Facilitating Infant Responsiveness to Stimulate Talking (FIRST) Program provided 36 caregiver-infant dyads with education and experience in evidence-based practices known to support prelinguistic development and provided clinical experience for 70 graduate clinicians in preventive education, infant interaction, and caregiver coaching. Offered to parents of any socioeconomic status with infants ages 6- to 12- months-old, the intervention was hypothesized to be of particular benefit to the 14 participating caregiver-infant dyads from low-socioeconomic (low-SES) backgrounds. The intervention, which combined the individual attention of home visit coaching with peer-group instructive modeling, was offered as an 8-session program (2019), a 1-session program (2020), and a 4-session program (2021). A control group participated in all outcome measurements timepoints (pre-test, post-test, and a 3-month follow-up) prior to receiving a delayed session of intervention.

Scores on measures of caregiver knowledge and beliefs about early language development significantly increased for the 8- and 4-session participants. Time spent in responsive, turn-taking communication patterns significantly increased for 8-session caregivers and infants. Infant standardized expressive communication scores increased significantly in all intervention conditions. Low-SES participant scores on multiple measures of language learning showed boosts not observed in mid-high SES scores. Graduate clinician confidence in both caregiver coaching and infant assessment showed higher gains for higher numbers of intervention sessions. Overall outcomes reveal a promising preventive model for clinical education in speech-language pathology that benefits caregivers, infants, and students and should be replicable in other university settings and communities.



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