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
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The Importance of Parent Training in Early Language Intervention:The Hanen Approach Cindy Smith • The Hanen Centre
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 language interventionists? i t ti i t ?
The Importance of Parent Training in Early Language Intervention: The Hanen Approach
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?
Cindy Smith, B. App. Sc. Speech-language Pathologist Hanen Instructor and Australasian Representative
Why start early?
Why train parents to be interventionists?
Some children we can predict will have communication delays e.g. Down Syndrome, GDD
Need to work with the people who are closest to the child
Studies on brain plasticity and brain development
Know them the best
Long term impact on academic success, social competence, behaviour
gg vested interest Have the biggest Spend the most time
Savings to society in terms of long-term need for support
Promotes family well being
Clegg, Hollis, Mawhood & Rutter, 2005 Johnson, Beitchman & Brownie, 2010 Tomblin, Zhang, Buckwalter & O’Brien, 2003 Tomblin, Zhang, Buckwalter, Catts, 2000
(Crnic & Stormshak, 1997)
What the experts say about working with families...
Kaiser and Roberts Meta Analysis (2011) Meta-analysis - combined results of 18 studies that examined parent-implemented intervention
“Active involvement by families is critical. Without it, intervention is unlikely to be successful - any short term effects are unlikely to be long-lasting”.
Compared experimental with control groups (control groups either non-treatment, therapist-delivered, or business as usual)
Bronfenbrenner Bronfenbrenner, 1974
Children average 24-36 months (range: 15-77 mos) “The earlier parents of children with disabilities are involved in intervention programs, the better the outcomes”.
All interventions were between 10-13 weeks (less than 26 hours of parent training) All programs taught responsive strategies
Rossetti, 2001 5
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The Importance of Parent Training in Early Language Intervention:The Hanen Approach Cindy Smith • The Hanen Centre
2. Do parent-implemented interventions positively affect child language outcomes?
1. Did parent training positively affect parents’ use of strategies?
YES!
YES!
Positive impact on... Positive & significant effects on: • receptive ti & expressive i language l and vocabulary • expressive morpho-syntax • rate of communication
• parent responsiveness • parent’s use of language models • rate of communication with their child
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3. Is intervention more effective when delivered by a parent?
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4. Do the effects of parent-implemented interventions differ for children with or without intellectual difficulties?
YES... for some language constructs
NO... except for expressive vocabulary
• receptive language – parents more effective • expressive syntax – parents more effective
(larger effect size for children without ID) No difference in most language constructs for these two groups
No significant difference in other constructs between intervention delivered by parent and SLP
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It Takes Two to Talk® Research Randomized Controlled Trial, JSHR,1996
Parent Changes:
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Outcomes of Study on It Takes Two to Talk (1996)
Child Changes:
less directive; more responsive p
social gains – increase in joint attention and turn taking
language input slower, less complex
had larger vocabularies and a greater variety of words
used more focused stimulation than control group
used more multi-word sentences used more target words (in structured and free play situations)
© Hanen Early Language Program, 2012. All rights reserved.
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The Importance of Parent Training in Early Language Intervention:The Hanen Approach Cindy Smith • The Hanen Centre
Let’s look at...
What about Malaysia?
Approximately 3.5 million children under the age of 6
1. Why do we want to start early with children with communication delays?
Worldwide estimate that 7% of children have a language delay, due to various etiologies
2. Why should we train parents and carers to be language i t interventionists? ti i t ?
Number of SLPs in Malaysia
3. What is The Hanen Centre & what is the It Takes Two to Talk® Program?
Potentially 245,000 children with communication delay
4. What is involved in It Takes Two to Talk?
What is The Hanen Centre? A Not-For-Profit Charitable Organization
Service
Resources
Training
Membership
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Facilitating a Child’s Communication
Hanen Programs…
Two critical components to facilitating communication Both need to be present in order for the child to benefit
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The Importance of Parent Training in Early Language Intervention:The Hanen Approach Cindy Smith • The Hanen Centre
What’s the missing piece?
What’s the missing piece here?
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For children’s communication to develop, they need both….
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The Hanen approach is based on Social-Interactionist theory: The child is able to process language input more easily when adult input is responsive
Interaction
Responsive input facilitates language learning because it: is more motivating for the child, thereby increasing his participation in the interaction
Language Input
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Interaction? Language? Or Both?
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
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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 language i t interventionists? ti i t ? 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?
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© Hanen Early Language Program, 2012. All rights reserved.
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The Importance of Parent Training in Early Language Intervention:The Hanen Approach Cindy Smith • The Hanen Centre
Responsive Social Interaction Strategies
Responsive Social Interaction Strategies
Second…
First…
Interaction-promoting
Child-centered strategies (increase child initiations)
Be face to face
Match turns
Observe, Wait Listen
Imitate
(increase initiations)
Cue for a turn
Follow child’s lead
Appropriate balance of questions and comments
OWL
Join in
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It Takes Two to Talk® Schedule
Responsive Social Interaction Strategies And finally… Language Modeling
Hand
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That’s your hand. Your hand is soooo dirty!
Group Session 1: Let Your Child Lead Group Session 2: Follow Your Child’s Lead Video Feedback #1
Interpret child’s message
Group Session 3: Take Turns to Keep the Interaction Going Group p Session 4: Add Language g g to the Interaction Group Session 5: Add Language to Build Understanding
Label – variety of words
Video Feedback #2
Highlight, use repetition
Group Session 6: Let’s Play! Group Session 7: Sharing Books
Expand
Video Feedback #3
Extend topic
Group Session 8: Moving Forward with Music & Closing 27
Framework for Teaching Strategies
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What do parents say?
Hook the learner in – g establish a reason for learning
Plan for home written 4
1
3
2
Practice, Practice, Practice!! Provide the information simulated and “mental” – interactive, practical, relevant
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The Importance of Parent Training in Early Language Intervention:The Hanen Approach Cindy Smith • The Hanen Centre
The Value of Videotaping
What else do parents say?
Parent begins to try to apply strategies to interactions with their child.
Parent starts to see some change in child or interaction & with our help attributes it to own change in behaviour
Parent starts to learn program strategies.
Parent starts to change attitude, beliefs Guskey 2002
What parents say about video feedback?
How to get involved?
www.hanen.org – Online Store
3 Day training for SLPs
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References Law, Garrett & Nye (2011) The Efficacy of Treatment for Children
with Developmental Speech and Language Delay/Disorder: A MetaAnalysis. Journal of Speech, Language and Hearing Research
Girolametto, L., Pearce., P., & Weitzman, E. (1996). Interactive
focused stimulation for toddlers with expressive vocabulary delays. JJournall off S Speech h and dH Hearing i R Research, h 39 39, 1274 1274-83. 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.org
© Hanen Early Language Program, 2012. All rights reserved.
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