The Importance of Parent Training in Early Language ...agapesibu.org/.../2012/07/The-Importance-of-Parent-Training-in.pdf · The Importance of Parent Training in Early Language Intervention:The

The Importance of Parent Training in Early Language Intervention:The Hanen ApproachCindy Smith • The Hanen Centre

1© Hanen Early Language Program, 2012. All rights reserved.

The Importance of Parent TrainingThe Importance of Parent Trainingin Early Language Intervention:

The Hanen Approach

Cindy Smith, B. App. Sc. Speech-language PathologistHanen Instructor and Australasian Representative

Let’s look at...

1. Why do we want to start early with children with communication delays?

2. Why should we train parents and carers to be l i t ti i t ?language interventionists?

3. What is The Hanen Centre & what is the It Takes Two to Talk® Program?

4. What is involved in It Takes Two to Talk?

Why start early?

Some children we can predict will have communication delays e.g. Down Syndrome, GDD

Studies on brain plasticity and brain development

Long term impact on academic success, social competence, behaviour

Savings to society in terms of long-term need for support

Clegg, Hollis, Mawhood & Rutter, 2005Johnson, Beitchman & Brownie, 2010Tomblin, Zhang, Buckwalter & O’Brien, 2003 Tomblin, Zhang, Buckwalter, Catts, 2000

Why train parents to be interventionists?

Need to work with the people who are closest to the child

Know them the best

Have the biggest vested interestgg

Spend the most time

Promotes family well being

(Crnic & Stormshak, 1997)

“Active involvement by families is critical. Without it, intervention is unlikely to be successful - any short term effects are unlikely to be long-lasting”.

Bronfenbrenner 1974

What the experts sayabout working with families...

Bronfenbrenner, 1974

“The earlier parents of children with disabilities are involved in interventionprograms, the better the outcomes”.

Rossetti, 2001

5

Kaiser and Roberts Meta Analysis (2011)

Meta-analysis - combined results of 18 studies that examined parent-implemented intervention

Compared experimental with control groups (control groups either non-treatment, therapist-delivered, or business as usual)

6

business as usual)

Children average 24-36 months (range: 15-77 mos)

All interventions were between 10-13 weeks (less than 26 hours of parent training)

All programs taught responsive strategies



1. Did parent training positively affect parents’ use of strategies?

Positive impact on...• parent responsiveness

YES!

• parent’s use of language models• rate of communication with their child

7

Positive & significant effects on:ti & i l

2. Do parent-implemented interventions positively affect child language outcomes?

YES!

• receptive & expressive language and vocabulary

• expressive morpho-syntax• rate of communication

8

3. Is intervention more effective when delivered by a parent?

• receptive language – parents more effective

YES... for some language constructs

• expressive syntax – parents more effective

No significant difference in other constructs between intervention delivered by parent and SLP

9

4. Do the effects of parent-implemented interventions differ for children with or without intellectual difficulties?

NO... except for expressive vocabulary

(larger effect size for children without ID)

10

No difference in most language constructs for these two groups

It Takes Two to Talk® Research Randomized Controlled Trial, JSHR,1996

Child Changes:

social gains – increase in joint attention and turn taking

Parent Changes:

less directive; more responsive

had larger vocabularies and a greater variety of words

used more multi-word sentences

used more target words (in structured and free play situations)

p

language input slower, less complex

used more focused stimulation than control group

Outcomes of Study on It Takes Two to Talk (1996)



What about Malaysia?

Approximately 3.5 million children under the age of 6

Worldwide estimate that 7% of children have a language delay, due to various etiologies

Number of SLPs in Malaysia

Potentially 245,000 children with communication delay

Let’s look at...


2. Why should we train parents and carers to be language i t ti i t ?interventionists?



What is The Hanen Centre?A Not-For-Profit Charitable Organization

Service Resources

Training Membership

16

Hanen Programs…

17

Facilitating a Child’s Communication

Two critical components to facilitating communication

Both need to be present in order for the child to benefit



What’s the missing piece?

19

What’s the missing piece here?

20

For children’s communication to develop, they need both….

Interaction

Language Input

21

The Hanen approach is based on

Social-Interactionist theory:

The child is able to process language input more easily when adult input is responsive

Responsive input facilitates language learning because it:

is more motivating for the child, thereby increasing his participation in the interaction

Is easier for the child as he doesn’t have to use cognitive energy to shift his attention from his interest to that of the adult 22

Interaction? Language? Or Both?

23

Let’s look at...


2. Why should we train parents and carers to be language i t ti i t ?interventionists?





Responsive Social Interaction Strategies

First…

Child-centered strategies (increase child initiations)

25

OWL

Be face to face

Observe, Wait Listen(increase initiations)

Follow child’s lead

Join in


Second…

Interaction-promoting

26

Match turns

Imitate

Cue for a turn

Appropriate balance of questions and comments

And finally… That’s your hand. Your

hand is soooo dirty!

HandLanguage Modeling


27

Interpret child’s message

Label – variety of words

Highlight, use repetition

Expand

Extend topic

It Takes Two to Talk® Schedule

Group Session 1: Let Your Child LeadGroup Session 2: Follow Your Child’s Lead

Video Feedback #1

Group Session 3: Take Turns to Keep the Interaction GoingGroup Session 4: Add Language to the Interactionp g gGroup Session 5: Add Language to Build Understanding

Video Feedback #2

Group Session 6: Let’s Play!Group Session 7: Sharing Books

Video Feedback #3

Group Session 8: Moving Forward with Music & Closing28

Framework for Teaching Strategies

Hook the learner in –establish a reason for learning

Plan for homewritten

29

g

Provide the information – interactive, practical, relevant

234 1

Practice, Practice, Practice!!simulated and “mental”

What do parents say?



What else do parents say?

Parent begins to try to apply strategies to interactions with

their child.

The Value of Videotaping

Parent starts to

Parent starts to seesome change in

child or interaction Parent starts to learn program

strategies.

child or interaction & with our help

attributes it to own change in behaviour

Parent starts tochange attitude,

beliefs Guskey 2002

What parents say about video feedback?

33

How to get involved?

www.hanen.org – Online Store 3 Day training for SLPs

References

Law, Garrett & Nye (2011) The Efficacy of Treatment for Children with Developmental Speech and Language Delay/Disorder: A Meta-Analysis. Journal of Speech, Language and Hearing Research

Girolametto, L., Pearce., P., & Weitzman, E. (1996). Interactive focused stimulation for toddlers with expressive vocabulary delays. J l f S h d H i R h 39 1274 83Journal of Speech and Hearing Research, 39, 1274-83.

It Takes Two to Talk® Research Summary www.hanen.org

Roberts, M. & Kaiser, A. (2011). The Effectiveness of Parent-Implemented Language Intervention: A Meta-Analysis. American Journal of Speech-Language Pathology, 20, 180-199.

Thank you for listening! [email protected]

Program Manager for It Takes Two to Talk [email protected]

For more information on trainings, resources and tips sheets

for parents and professionals see www.hanen.orgwww.hanen.org

Documents

The Importance of Parent Training in Early Language ...agapesibu.org/.../2012/07/The-Importance-of-Parent-Training-in.pdf · The Importance of Parent Training in Early Language Intervention:The