Effectiveness of a parent-implemented language intervention for late-to-talk children: A real-world retrospective clinical chart review

Abstract

Background: Previous research has examined the impact of early language interventions on the linguistic skills of late-to-talk children. However, we have little understanding of how such interventions impact communicative participation (i.e., the ability to communicate in real-world contexts) or what factors influence individual response to these interventions. Aims: (1) To evaluate the effectiveness of Target WordTM – The Hanen Program® for Parents of Children Who are Late Talkers, for improving the communicative participation skills of children who are late-to-talk. (2) To explore predictors of Target Word participation-based outcomes. Methods & Procedures: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word program at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) and MacArthur-Bates Communicative Development Inventories at three time points: pre-intervention, post-intervention, and after a 3-month consolidation period. Regression analysis explored the relation between children’s communicative participation outcomes and potential predictors of change identified by 26 Target Word certified speech and language therapists/pathologists. Outcomes & Results: At the end of intervention, 75% of children had made a clinically significant change on the FOCUS. Clinicians proposed verbal imitation, language development stagnation, and parent interaction style as the top predictors of communicative participation outcomes. Of these, only verbal imitation pre-intervention predicted communicative participation change following the Target Word program. Conclusions & Implications: The Target Word program can facilitate the development communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximize outcomes for children with limited verbal imitation.

Selecting and tailoring implementation interventions: a concept mapping approach

“…Despite its strong psychometric properties and initial implementation efforts, the adoption and consistency of use of the FOCUS continued to vary across the 30 PSL Program regions [27,28]. For instance, clinicians at some PSL program regions stopped collecting and reporting FOCUS data.…”

Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review

“…Original 50-item FOCUS (n=20) 13,15,16,[18][19][20][22][23][24][25][26][27][28][29][32][33][34][35][37][38][39] FOCUS-F (n=1) 42 FOCUS-G (n=1) 41 FOCUS-I (n=1) 40 FOCUS-34 (n=2) 20,21 FOCUS Thomas-Stonell et al 15 Case series 4 Thomas-Stonell et al 16 Case series 4 Hidecker et al 19 Case series 4 Kwok et al 20 Case series 4 Cunningham et al 21 Case series 4 Thomas-Stonell et al 22 Case series 4 Washington et al 23 Cohort 3 Washington et al 24 Cohort 3 Namasivayam et al 26 Cohort 3 Pennington et al 27 Case series 4 McLeod et al 28 Randomized trial 2 Namasivayam et al 29 Cohort 3 Washington et al 38 Case series 4…”

“…18 Seven other studies also reported FOCUS scores together with CFCS classifications, included children who were lower-functioning, and documented meaningful change across all CFCS levels. [19][20][21][22][23][24][25] Factors impacting development…”

“…Use as a descriptive tool (n=3) [32][33][34] Use as a discriminative tool (n=1) 35 Use outside the validated age range Use with children >5y11mo (n=3) 24,27,34 Use with children <18mo (n=4) [19][20][21][22] Other adaptations Using only some FOCUS questions (n=1) 34 Use with typically developing children (n=1) 40 on the FOCUS. 35 Although the FOCUS has not been validated for this purpose, it may be useful for documenting the functional impact of a child's language impairment, a requirement for diagnosing developmental language disorder.…”

“…Two reported meaningful change during a baseline period before intervention, but this was only observed for some of the children who were under 18 months of age. 20,21 All children were 18 months or older at the start of treatment when communicative participation change was assessed. Studies that included children older than 5 years 11 months also reported clinically meaningful changes in children's communicative participation.…”