Parent-Training as an Intervention to Help Children with Speech Delays

The Hanen Centre’s program called It Takes Two to Talk is designed for parents of children birth to age 5 with language delays. The program teaches parents strategies to teach children to add language to interactions, adjust everyday routines to encourage turn-taking, and to follow a child’s lead. These strategies taught to parents are also great tools for SLPs to use during therapy. This program aims for early intervention to help children with language delays during a crucial period of language development, rather than continuing on the stipulation that children will outgrow the delays they are presenting.

Interactive Focused Stimulation

The interactive model of language intervention states that “contingent, simplified language input provided by caregivers elicits the motivational and informational functions that help the child make comparisons between the nonlinguistic and linguistic contexts, and induce the relationships between objects, actions, external events, and words.”^[1] Basically, it works by increasing the opportunities that children have to learn, initiate, and participate in conversation. There are a few different parent input techniques, such as participating in activities that a child likes, interactions that promote turn-taking, and parent-modeling to help with comprehension.^[2]

Interactive focused stimulation has a specific language target, where each parent interaction is focused on a language target, such as verbs for example. The Hanen Program is an example of focused stimulation, and this particular study, titled “Interactive Focused Stimulation for Toddlers With Expressive Vocabulary Delays,” involved giving mothers target words to incorporate into daily routines and activities that the children were interested in. Once the words were mastered in daily routines, the target words were then used in new contexts. Finally, the target words were replaced with words that the child understood but did not use and then added two-word combinations.

The study found that those children with language delays, or late-talkers, often have a similar language development pattern as those children without delays. Once the proper teaching structure was put in place and the children had more opportunities to learn and replicate the language they were seeing, their lexical growth improved significantly.^[3]

• Reference

  Girolametto, L et al., “Interactive Focused Stimulation For Toddlers with Expressive Vocabulary Delays,” Journal of speech and hearing research. 39, no. 6 (1996): 1274-83, doi:10.1044/jshr.3906.1274

• In-Text References

  1. Girolametto, L et al., “Interactive Focused Stimulation For Toddlers with Expressive Vocabulary Delays,” Journal of speech and hearing research. 39, no. 6 (1996): 1274, doi:10.1044/jshr.3906.1274

  2. Girolametto et al., “Interactive Focused Stimulation,” 1275.

  3. Ibid, 1281.

Social Conversation Skills in Children with Developmental Delays

Parent training programs such as The Hanen Program is also effective for those children with developmental delays. Children with developmental delays often struggle with social-conversational skills such as turn-taking, joint reference, topic initiation, and responsiveness, all of which are skills targeted by interactive focused stimulation. Since DD children struggle with these conversational skills, they often don’t receive the feedback necessary to improve their language development from both parents and peers, and in response don’t initiate communication attempts to improve.^[1]

In the study titled, “Improving the Social-Conversational Skills of Developmentally Delayed Children: an Intervention Study,” The Hanen Program was used in an 11-week training program for parents of preschool-aged developmentally delayed children to look at turn-taking, contingent responsiveness, topic control, and topic maintenance. The study found that “the children initiated more topics, were more responsive to their mother’s preceding turns, and use more verbal turns and a more diverse vocabulary than the control group children.”^[2]

The study also points out that although these parent-training interventions are effective, it is also important to counsel parents on realistic expectations of treatment outcomes. Not all children will progress at the same pace, and some children have severe delays that involve years of consistent and persistent therapy and parental intervention. Parents may “become discouraged with their child’s progress or overlook the value of improvements in language use,” so it’s important to counsel parents and set realistic expectations for the children while celebrating the progress the child has made.^[3]

• Source

  Girolametto, L E. “Improving the Social-conversational Skills of Developmentally Delayed Children: An Intervention Study,” The Journal of speech and hearing disorders. 53, no. 2 (1988): 156-67, doi:10.1044/jshd.5302.156.

• In-Text References

  1. Girolametto, L E. “Improving the Social-conversational Skills of Developmentally Delayed Children: An Intervention Study,” The Journal of speech and hearing disorders. 53, no. 2 (1988): 156, doi:10.1044/jshd.5302.156.

  2. Girolametto, “Improving the Social-Conversational Skills,” 156.

  3. Ibid, 165.