Image: Kaiser, 2017
Children show growth in speech-language skills when parents consistently use the strategies taught in the Season One podcast and the Strategies course. The best results, though, come when you work together with a speech-language pathologist to zero in on your child’s specific needs.
In episode 102 of the podcast I promised to share some research results about the value of working with an SLP. Here's a sampling from one researcher.
I went to a collection of research reports and resources published by Dr. Ann Kaiser and her colleagues at Vanderbilt University. There’s a lot of data to sort through, so I’ve just picked out a few highlights.
The graph displayed at the top of this page came from Dr. Kaiser's presentation about evidence for the value added by parents’ participation in language intervention. MLU is the mean length of utterance, or average length of a child's sentence. The graph shows that the two parent-plus-therapist treatment groups (blue & red) had superior results compared to the two therapist-only treatment groups (green & yellow). This second graph (below) shows similar outcomes. Results on a standardized test of receptive and expressive language (PLS-4) were better for two groups with parent-plus-therapist treatment (blue), versus the groups with therapist-only treatment (green).
WHAT DOES RESEARCH SAY ABOUT PARENT-IMPLEMENTED LANGUAGE INTERVENTIONS?
Dr. Kaiser did a meta-analysis of existing research on parent-implemented programs (Roberts & Kaiser, 2011). A meta-analysis is a study that takes the data from a collection of research papers and analyzes the total results to look for trends and conclusions.
Kaiser’s analysis looked at 18 studies with children between the ages of 18 to 60 months who had a language impairment. Sessions that trained parents to implement the interventions averaged one hour per week for six months.
Results of “parent-implemented intervention had positive, significant effects on receptive and expressive language skills, receptive and expressive vocabulary, expressive morphosyntax, and rate of communication when compared to a control group” according to Roberts & Kaiser (2011).
All children who received treatment learned more words than children with language impairment who did not receive the treatment. Notably, children in the parent-led group used even more words than those in the therapist-led group.
WHAT IS ENHANCED MILIEU THERAPY?
Dr. Kaiser's program is called Enhanced Milieu Therapy (EMT). “Milieu” means the communication environment. EMT combines parent- and therapist-led strategies to provide children with enriched language-learning experiences throughout the day.
Parents are taught a set of strategies to support their child’s development in areas including: receptive language, expressive language, understanding and using more words (receptive and expressive vocabulary), using grammar and longer sentences (morphosyntax), and how often children communicate.
Roberts and Kaiser (2012) found that children in the treatment group speeded up their rate of learning. These children with language impairment learned new language skills as fast as typically developing children.
Children in the treatment group also used more words and scored higher on language tests than the control group who received no treatment.
In another study, Kaiser and Roberts (2013) reported that children had the best outcomes when parents implemented EMT in addition to the therapist.
WHAT MAKES SPEECH-LANGUAGE THERAPY EFFECTIVE?
Researchers are continuing to collect more information about this question. There’s evidence to suggest these factors are important:
Individual sessions with the parent (rather than a large group)
Demonstrations or treatment from the SLP
Coaching parents on using strategies while they interact with their child
Training at home to integrate strategies into daily routines
What the parent brings to the intervention:
Builds on the strong relationship and emotional connection with the child
Gets immediate practical benefits from improved communication with child
Can make quick adjustments to the child’s changing skills and needs
Has frequent opportunities to teach language in functional situations
What the SLP brings to the intervention:
Uses the methods with accuracy and consistency
Knows all the methods from day one of treatment
Knows how to fine tune treatment and can add more strategies as needed
Can introduce a new skill to the child so it’s easier for the parent to implement
SHOULD YOU “WAIT AND SEE” IF YOUR CHILD’S SPEECH AND LANGUAGE DEVELOPS ON ITS OWN?
In their 2012 report, Roberts and Kaiser noticed a sad situation for children in their control group. These 24- to 42-month-old children had language impairments like those in the treatment group but were not selected to take part in the treatment.
Only one of the children in the control group received any speech-language treatment during the time of the study. By the end of the study period, these children had fallen even further behind their peers’ development.
Roberts and Kaiser noted that this is a common occurrence for children with a speech-language delay. They recommend that, even though some late talkers do catch up, a large number do not. It's better to start intervention as soon as the delay is noticed.
If you have questions about your child's speech-language-communication development, you can get help today.
