PARENT-IMPLEMENTED LANGUAGE INTERVENTION

A FAMILY-CENTERED MODEL FOR BUILDING CAREGIVER CAPACITY IN CHILDREN WITH AUTISM SPECTRUM DISORDER

04/11/2014
SPECIAL NEEDS
By Lisa Drake

Every day, educators, therapists, and parents work tirelessly to help children on the autism spectrum reach their potential in areas such as communication, interaction, academics, and daily life skills. With new interventions for children with autism spectrum disorder emerging rapidly, one of the biggest challenges that professionals and caregivers face is deciding which type of intervention to utilize within classrooms, therapy settings, and in the home.

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“Parent-implemented intervention fits with family-centered care in that its goal is not only improved developmental progress for the child, but enhanced family well-being.”

Parent-implemented intervention is gaining popularity as the treatment method of choice in many settings. This form of intervention involves a professional teaching parents to apply specific language intervention strategies to their everyday interactions with their child in order to improve the child’s language development. There is a growing body of research that shows that when parents of children with and without intellectual disabilities (including autism) are taught to implement these strategies, significant, positive changes in the children’s receptive and expressive language skills result. Parent training programs, which constitute parent-implemented intervention are being offered within a growing number of school systems across the country as part of the parent-school collaboration required by Part B state performance indicators.

Parent-implemented intervention fits with family-centered care in that its goal is not only improved developmental progress for the child, but enhanced family well-being. Studies show that an important outcome of family-centered care is an increase in parental knowledge, skills and sense of competency.

Working with parents to help them become sensitive facilitators of their child’s communication development also fits with what is considered best practice in intervention for children with autism. It has been well-documented that treatment for children on the autism spectrum should be intensive and focus on skills that can be used functionally within day-to-day situations. When parents are able to implement intervention at home and in other everyday settings, they can make the most of the teachable moments that happen at any time throughout the child’s day. They are also able to teach the most fundamental skills within a functional context, facilitating generalization of skills.

Programs that have been developed to teach parents how to support their children’s development are most effective when they are designed to meet the needs of adult learners. Such programs accommodate the range of adult learning styles and also incorporate coaching and feedback as part of the learning process. The components of effective coaching include explicit teaching, facilitating parents’ self-awareness and awareness of their child’s efforts to communicate using video recordings that are reviewed together with the provider, and supporting the ongoing learning process through examination, reflection, discussion, and the refinement of their skills.

There are a number of parent-implemented interventions for parents of children with autism. Some of the ones which support a relationship-based approach include DIR/Floortime, which promotes development through child-led interactions, Relationship Development Intervention (RDI), which promotes flexible thinking in children with ASD, and More Than Words® – The Hanen® Program for Parents of Children with Autism Spectrum Disorder, which focuses on adding structure to the child’s everyday experiences to build interaction and communication skills. These programs have different formats and content but they all teach the parent to identify and interact with their child at their developmental level, help parents utilize activities that the child enjoys, and are rooted in the belief that the parent-child interaction is crucial to helping the child reach his potential.

When parents participate in a More Than Words® program, which is led by a Hanen-certified Speech-Language Pathologist, they attend 8 sessions with approximately seven other families. During each session, parents are taught practical, easy to understand strategies that they can start using right away. Some of these strategies include learning how to wait for their child to take a communicative turn, adding a predictable, routinized structure to their child’s everyday activities and building communicative turns into these activities, accommodating the child’s sensory preferences in games like “Chase” and “Tickles” to encourage communication, adding structure and visual supports to increase understanding of language, and following the child’s lead to increase parent-child interaction. Three times during the program, parents bring their children to individual video feedback visits with the Speech-Language Pathologist to facilitate the application of the techniques they have learned in the group sessions. It is during these sessions that the Speech-Language Pathologist can ensure that the parents understand the techniques and strategies taught in the program and that they are effectively being applied within parent-child interactions so that the children can make positive changes in their ability to communicate.

Given that parents of children with ASD have been shown to be less satisfied with the services their child receives and to experience more stress than parents of children with other disabilities, it is important to provide this option to parents of children with autism. These parents are among those most in need of support from the professionals who work with their children. Investing in the education of parents can strengthen the relationship between home and school as parents and educators can truly be collaborative partners in the children’s education. Most importantly, when the connection and shared knowledge between educators, therapists, and parents is strong, the best possible outcomes for children with autism can be achieved.

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