Assignment: Defining/identifying home routines

Assignment: Defining/identifying home routines

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Assignment: Defining and identifying home routines

2 Defining and identifying home routines (play, social, and daily)

Group discussion then individual discussion with coach)

Discuss home play observations Group discussion

Responsive strategies Group discussion, video examples, role-play

Confirm parent and child goals Individual discussion with coach

3 Teaching new vocabulary through responsive strategies

Group discussion, individual planning with coach

Discuss child progress, homework, and use of responsive strategies at home

Group discussion and then individual discussion with coach

4 Environmental arrangement strategies

Group discussion, modeling with classroom examples, individual discussion and planning with coach

Discuss child progress, homework, and use of responsive strategies at home

Group discussion and then individual discussion with coach

5 Modeling Group discussion, modeling, role- play, individual discussion with coaches

Discuss child progress, homework, and use of responsive strategies, environmental arrangement strategies at home

Group discussion and then individual discussion with coach

6 Individual conferences to review child and parent progress and make recommendationsb

Note. LAPE = Language and Play Everyday. aFidelity was measured using group session checklists for each session. bCovered in final individual session for Cohort 3.

218 Topics in Early Childhood Special Education 33(4)

Language Scale 4th edition (PLS-4; Zimmerman, Steiner, & Pond, 2002) was administered to measure the child’s receptive and expressive language. The Vineland Adaptive Behavior Scales (VABS-II; Sparrow, Cicchetti, & Balla, 2005) was completed through parent interview and was used to measure the child’s daily living, social, and motor skills. In addition, the parent-completed CDI-2 measured the child’s verbal vocabulary and was used as part of the inclusion criteria and as an outcome measure.

Play and routine observations. Toddler and parent progress was measured using summative and formative measures. Prior to the start of LAPE each parent−child dyad partici- pated in two videotaped samples in their homes (collected on the same day). During a 10-min play sample, parents played with their toddlers using a standard set of toys pro- vided by the authors. The toys included dolls, cups, plates, books, blocks, and games (e.g., Mr. Potato HeadTM). In a 10-min routine sample, parents interacted with their chil- dren during a parent-identified routine. Parents selected mealtime, diapering, dressing, or getting ready for bed. During pre-LAPE observations, parents were instructed to interact with their children using any strategies they nor- mally use to encourage their children to communicate. The same play and routine activities were videotaped again immediately after LAPE (i.e., post) and at a 3-month follow-up. During these sessions, parents were instructed to use LAPE strategies. Five graduate students transcribed and coded all videos after establishing 90% interobserver agree- ment (IOA) on nonstudy videos. Four parent variables were coded: (a) responsivity (RE), (b) target level talk (TLT), (c) questions (Q), and (d) other language-enhancing behaviors (O-LEBs). These are described in Table 3. Two child vari- ables were calculated: (a) mean length of utterance (MLU; mean number of words per child utterance) and (b) initia- tions (see Table 6).

Progress monitoring. Parents monitored their use of the LAPE strategies and progress toward self-selected goals. As described previously, the parents completed a respon- sivity log every week. If a parent did not bring a completed log with them to a group or individual session, the coach asked the parent to complete it before the group session began. During group and individual sessions, the parents reviewed their progress as reflected on their log, and dis- cussed with their coaches the progress toward their self- selected goals. Following intervention, parents also completed the LAPE Goal Questionnaire, which asked them to indicate whether LAPE helped them meet their goals for themselves and their children.

Interobserver agreement. Twenty-eight (58%) randomly selected play and routine session videos (i.e., including at least 20% of videos across dyads, sessions, time) were

independently coded by a second coder to calculate interob- server agreement (IOA). IOA was calculated using the point-by-point method (Kennedy, 2005). IOA averaged 90.7% (82.0%–96.6%) across dyads, sessions, behaviors, and time.

Fidelity. The authors measured implementation fidelity and intervention fidelity. Implementation fidelity refers to the procedures used to support the parents’ use of LAPE strate- gies; intervention fidelity refers to the parents’ use of indi- vidual strategies with their toddlers (Dunst et al., 2008b). Implementation fidelity was collected in three ways. First, a checklist was created for the group sessions outlining the planned components of the sessions (e.g., “discuss parent and child progress at home,” “review the strategy Repeat and Add”). Students (who were not presenting or coaching) used the checklist designed for LAPE group sessions to measure implementation fidelity of every group session. This ensured the group training components were similar across cohorts. The number of planned components for group sessions ranged from 5 to 12. The group session implementation fidelity averaged 93.6% (range = 78%– 100%) across sessions and cohorts. Second, the first or sec- ond author completed fidelity checklists at all individual sessions. These outlined the planned components of indi- vidual sessions to ensure the coaches conducted these ses- sions as planned and that they were similar across dyads. The number of planned components for individual sessions ranged from 9 to 12. The individual sessions implementa- tion fidelity averaged 90.42% (range = 77%–100%) across sessions, dyads, and cohorts. Occasionally a parent would want to spend extra time working on a specific strategy or a routine was cut short, and the coach would decide to skip or spend less time on a component. Thus, the implementation fidelity indicated coaches completed most of the planned components, but were flexible and responsive to parent and toddler needs (McWilliam, 2012). Third, attendance was recorded at all group sessions. Two parents missed one group session each, and missed content was reviewed dur- ing a make-up session. Intervention fidelity was measured using a weekly review of the parent-completed responsivity log. All eight parents reported consistently using the LAPE strategies at home.

Assignment: Defining/identifying home routines

Social validity. Social validity was measured in two ways. First, parent satisfaction with the group trainings was mea- sured after each group session with an anonymous ques- tionnaire. These ratings were consistently high. Second, at the end of LAPE parents rated their satisfaction with the goals, procedures, and outcomes with an anonymous social validity questionnaire. The overall mean for the nine items on the questionnaire was 5.32 (i.e., the scale ranged from 1 = strongly disagree to 6 = strongly agree), which signi- fied strong social validity. Parents indicated LAPE was

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effective for increasing their children’s communication skills across daily routines (M = 5.14) and during play inter- actions (M = 5.21). Moreover, they reported using LAPE strategies outside of the home (M = 4.64) and stated that they would recommend the LAPE program to other parents with toddlers with communication delays (M = 5.86).

Program Outcomes

Multiple measures were used to evaluate parent and child outcomes from LAPE. Initially, outcome analyses were

conducted by cohort. However, there were no differences identified across cohorts. Thus, given the small number of dyads, outcomes were analyzed individually and are pre- sented as such in the subsequent sections (see Tables 5 and 6).

Parent Outcomes

Responsivity (RE). Parents demonstrated variability in RE during pre-LAPE observations, and seven parents increased their RE following intervention. In general, parents were