Early childhood language difficulties can have a snowball effect, impacting children’s ability to learn and express themselves. As director of the Language, Literacy, and Learning Lab in the College of Public Health, Rebecca Alper knows that parent-implemented early language intervention can be very effective—but approaches that work well for some families don’t work as well for others.

There’s been much research on different kinds of interventions and childhood factors that may predict success. But, surprisingly, researchers haven’t closely examined how much the readiness of caregivers themselves to help their children plays a role. With a new five-year, $813,010 grant from the National Institute on Deafness and other Communication Disorders, part of the National Institutes of Health⁽¹⁾, Alper is conducting a study in which she will examine how parent characteristics impact upon both parent-child interaction quality and child outcomes.

“Language intervention for young children often involves a clinician partnering with a parent to maximize the child’s learning environment. However, parents, not just children, have different strengths and challenges that might impact how they interact with their child and are able to deliver early language intervention,” says Alper, who is a licensed speech-language pathologist and assistant professor in the Department of Communication Sciences and Disorders. “Understanding these individual differences could help us provide more effective parent training and improve child language intervention outcomes.”

The particular type of federal grant for this project (classified as a K23) has a mentored career-development component. Alper’s mentorship team includes five highly accomplished researchers: Ann Kaiser, Jamie Reilly, Susan Ellis-Weismer, Joseph McCleery, and Levent Dumenci. K23s are often given to practicing physicians who want to develop patient-oriented research skills. It is less common for PhDs such as Alper to be awarded these types of grants because the research is patient-centered. Her receipt of this award as a speech-language pathologist reflects the value of the proposed research.

The study will focus on children from ages 2 1/2 to 4 who either have a language delay or disorder as their primary area of difficulty or who have a language delay or disorder secondary to autism. The children will be given standardized language assessments to determine if they meet the criteria for receiving the intervention; if not, they might be placed in a comparison group. Parents’ skills will be assessed through a variety of language and learning tasks.

Parents whose children have a language delay or disorder—with or without autism—will then receive training sessions using Enhanced Milieu Teaching strategies developed by Dr. Ann Kaiser. This approach teaches parents how to create language-learning opportunities based on their child’s interests in the moment. The idea is that children learn language best in contexts that are interactive and based on their interests. The quality of the parent–child language interaction will be assessed before and after the parent training. Alper will then examine the relationship between parents’ skills, language interaction quality, and parents’ behavioral change after training.

“When I'm thinking about predictors, the ones that I'm the most interested in are the ones that I might actually be able to modify,” Alper says. “So it’s the caregivers’ language skills, their knowledge of child development, their parenting self-efficacy—do they believe themselves able to effect change in their child?  If a parent brings a child in to work with me in the clinic, maybe I have three 30-minute sessions with that child, right? But if I train a parent on how to deliver high quality interaction, then maybe 12 hours out of the day, they're getting more enriched language input. The ‘dosage’ can be much higher.”

This new research grant will be conducted in parallel with Alper’s existing research focused on developing and testing new approaches to caregiver-implemented early language intervention for children in low socioeconomic status households, which is funded by a grant from the William Penn Foundation.

⁽¹⁾NIH/NIDCD, 1K23DC017763-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.