Early Intervention Department Theotokos Foundation Parent programs for communication development of preschool children with Language and/or Social Communication Disorders
Theotokos-EPR-Study-Visit-4NOV21.pdf
By Pari Meravoglou, Speech and Language Therapist
EASPD Early Childhood Intervention THEOTOKOS FOUNDATION, Athens Greece 29th September 2021
What is included:
Information about Hanen programs (About Hanen, theoretical background, program features and objectives)
Implementation at Theotokos Foundation (participants, criteria, adaptations, evaluation and results)
Hanen Programs In 1975, Hanen Centre began pioneering parent- implemented early language interventions
for parents
and professionals to help young children to build the best possible lifelong social, language and literacy skills.
It Takes Two To Talk
More Than Words
Why parental involvement?
Parents have more possibilities to interact with their child in natural situations and to promote generalization
They are in better position to interpret what the child is trying to communicate
Children are more motivated to communicate with familiar persons in familiar and safe settings
Parents are in the best position to have the kinds of meaningful interactions with their child that help him learn. Rosetti (2001), Rakap et al. (2014), Billstedt et al (2007)
Theoretical background
A family-centered model Family is the most important element in a child’s life
A child – centered approach A set of child-centered strategies to increase child’s initiations
A naturalistic approach Intervention becomes an ongoing process in real-life situations
Language acquisition is viewed as an interactive process Parents’ responsiveness to the child’s focus of interest is of outmost importance.
Siller & Sigman, 2002 Mahoney & Perales, 2003 Aldred, Green, & Adams, 2004 Baker, Messinger, Lyons, & Grantz, 2010
Such parental readiness is associated with optimal language development, both receptive and expressive, at preschool and school age (Stock, 2002,)
Program Objectives
Parent education
Early communication intervention
Social support for parents
Research demonstrates both the need for and cost effectiveness of parent training as well as the efficacy of indirect intervention
Parents are as effective as speech-language therapists
Parents positively influence the development of communication (receptive and expressive skills, vocabulary and grammar development)
Children with a variety of language difficulties make good progress (including children with Language Impairment, ASD or Developmental Delay)
There is need to further explore the parental characteristics which bring about optimal results in indirect intervention Law, Garrett & Nye (2010), Roberts & Kaiser (2011), Fey et al (1993)
Implementation of Hanen Parent Program in Greece
Community Mental Health Centre of the 1st Psychiatric Department of the University of Athens (2011-2015)
Theotokos Foundation (2016-2019)
Why we decided to implement a psychoeducational program for parents?
Early intervention service: a long standing work on early intervention.
A family-centered philosophy
Quality policy is to provide families with opportunities to be involved in decisions and choices.
Interdisciplinary team at Theotokos is available to cover parents’ questions on developmental issues. Finally, parental personal psychological concerns do not become the central issue of this workshop, nevertheless the interdisciplinary team can provide the appropriate guidance to parents
Why we decided to implement a psychoeducational program for parents?
Speech and Language Service regularly provides parent counseling concerning language and communication but it was on an individual basis.
Taking into account evidence on indirect intervention as well as clients’ needs we made a decision to hold a parent group.
We assumed that it was going to be time saving.
We also assumed that parents would benefit from sharing ideas and group support. This was one of parents’ suggestions in their past annual evaluation form.
Participation criteria
We address all parents whose children are attending the early intervention program (that is, 2-4 years old, with Language or Communication disorder associated with Intellectual developmental disorders, Communication disorders, Autism spectrum disorders or Global developmental delay )
Acceptance of the participation contract.
Program Procedure
An initial session
Nine group sessions at Theotokos (duration 2h) every second week. At the end of each group session, notes were given as well as individualized “home plans” for practice.
Videotaping sessions : videotaping of a parent-child interaction was followed by videotaping review.
Programmes Features Seeing is Believing: The power of coaching using video feedback Video : a powerful technique
Video review elicits a remarkable insight into effective interaction
Time for individualization
Highlight parents’ communicative behavior instead of their child’s communication difficulties
Participants Group A (2016-17): 8 parents of 4 children Group B (2017-18): 8 parents of 7 children Group C (2018-19): 9 parents of 6 children Group D (2019-20): 6 parents of 7 children Total 25 parents of 17 children Co-ordinators: Two speech and language therapists
Main topics covered Strategies:
Follow your child’s lead to build his confidence and encourage him to communicate
Improve social communication and back-and-forth interactions
Add language to interactions
Adapt the way you play and read books with your child to help him learn language
Moving forward with music
Adaptations
Smaller participants number (6-7 parents)
Two coordinators
Videotaping at Theotokos Foundation Lectures and workshops on topics that parents suggest (feeding, sleeping, toilet training, temper tantrums)
Part of daily program
Follow up meetings
Quantitive evaluation
Pre and post program measures were used to track parents behaviors before and after treatment. By applying an informal checklist we count the number of times parents applied a strategy such as “wait for their child”.
We also documented child’s initiations (non verbal and verbal). Increase in child’s initiations can be correlated with parents’ use of strategies.
Focus on the Outcomes of Communication Under Six
the impact of intervention on the child’s life
the changes to the physical, social and attitudinal environment in which the child lives
the items are related to International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)’s Activities and Participation domain (Thomas-Stonell et al, 2012)
FOCUS Results Comparing the two FOCUS administration Total Scores for each child (pre and post parent group) we had the following data:
11 children in 23 - significant clinical change
3 children in 23 - meaningful clinical change
4 children in 23 - not likely a meaningful clinical change
and 5 in 23 had no change
Qualitative evaluation Parents…
recommended extending the duration of the program.
considered active learning techniques and video coaching very helpful
reported positive outcome in their child’s verbal expression, communicative intent and comprehension
emphasized the team spirit
realized that there are common problems parents face during the child upbringing appreciated the group support and sharing of feelings and experiences.
Qualitative evaluation
According to our documentation:
Often both parents were interested in participating in the program. Attendance was regular.
Most parents were actively involved.
Family real participation in life situations has increased.
All these findings about improvement in family interaction, parents’ empowerment and support converged on the same conclusions, as research review.
• Girolametto, 1988
• Tannock, Girolametto & Siegel, 1992
• Fey, Cleare, Long & Hughes, 1993
• Baxendale & Hesketh, 2003
• Law, Garrett & Nye, 2010
• Roberts & Kaiser, 2011
• Prelock & Hutchins, 2008
• McConachie , Randle, & Le Couteur, 2005
• Girolametto, Sussman, & Weitzman, 2007
• Carter, Messinger, Stone, Celimli, Nahmias, &
• Yoder, 2011 • Patterson & Smith, 2011
• Rakap & Racap, 2014
• Noyan, Ozcebe & Cak Esen, 2020
Pari Meravoglou pmeravoglou@theotokos.gr