Kazemi Y, Mohebinejad F. Persian Adaptation of Enhanced Milieu Teaching for Iranian Children With Expressive Language Delay. Iranian Rehabilitation Journal 2020; 18 (1) :99-112
URL:
http://irj.uswr.ac.ir/article-1-1044-en.html
1- Child Language Research Cluster, Department of Speech Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Abstract: (4252 Views)
Objectives: This study aimed at adapting and examining the applicability of the Teach-Model-Coach-Review model of the Enhanced Milieu Teaching (EMT) approach for improving Iranian mothers’ language strategies while interacting with their toddlers with expressive language delay.
Methods: In a single-subject multiple-baseline across-behavior study, the mothers of 3 toddlers with expressive language delay attended a series of intervention sessions to be taught how to modify their interaction strategies/behaviors, including noticing and responding, turn-taking, and expanding. Their behaviors were video-recorded, and the percentages of mother’s behaviors were calculated. Visual analysis and an Improvement Rate Difference (IRD) metric were provided to document the mothers’ progress. Fidelity was checked, using a checklist of items taught by the clinician, as well as a quality check of the sessions.
Results: Mothers indicated the improved levels of strategy usage after receiving EMT and maintained their skills at criterion levels after the termination of the intervention. IRD for notice-respond, turn-taking, and expanding was 0.88, 0.91, and 0.88 for FA’s mother, respectively. IRD was 0.92 and 1 for AM’s mother. The two strategies of notice-response and turn-taking showed IRDs of 1 and 0.66 for KA’s mother.
Discussion: Iranian speech therapists employ a Persian-adapted edition of the Teach-Model-Coach-Review model of EMT with confidence to follow the improvement of parents’ strategies usage within an early intervention course of management of child language delay. The model provides a systematic education of parents to address the communication needs of their children.
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● Enhanced milieu teaching in the form of Teach-Model-Coach-Review has been adapted to Persian.
● Persian-adapted Teach-Model-Coach-Review improves Iranian mothers’ language strategies.
● The Teach-Model-Coach-Review model provides a systematic way of parents’ education of language strategies.
Plain Language Summary
Parents of children with communication problems cannot sometimes use language strategies efficiently while interacting with their children. So, it may affect the children’s communication skills in the natural environment. A model called Teach-Model-Coach-Review that follows the principles of milieu teaching makes the parents’ education more systematic and comprehensive. The current study adopted this model to Iranian society to provide Iranian speech therapists with the first systematic protocol for parents, whose children’s expressive language is delayed. The language strategies that were targeted in this study included noticing and responding, turn-taking, and expanding.Four children with their mothers attended a series of speech therapy sessions. We asked the mothers to look at different strategies modeled by the clinician. Then, they were asked to react to each strategy, and they were coached during performing strategies with their children. All steps were video-recorded and, finally, the clinician reviewed all steps with the mother by watching the recordings and provided feedback to the mothers. Iranian mothers learned and used all language strategies with high levels of accuracy and their children showed improvements in vocabulary targets. Hence, it is suggested that Iranian speech therapists implement this model in clinical settings to make the parents’ education more systematic and effective.
Article type:
Original Research Articles |
Subject:
Speech therapy Received: 2019/07/21 | Accepted: 2019/10/22 | Published: 2020/03/1
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