Delivering Enhanced Milieu Teaching to Toddlers With Down Syndrome via Hybrid Telepractice: A Single-Case Experimental Design.

IF 2.3 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY American Journal of Speech-Language Pathology Pub Date : 2024-11-04 Epub Date: 2024-10-07 DOI:10.1044/2024_AJSLP-23-00454
Emily D Quinn, Kim Kurin, Alexandria R Cook, Ann P Kaiser
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Abstract

Purpose: This pilot study investigated delivering enhanced milieu teaching tailored for children with Down Syndrome (EMT-DS) through hybrid telepractice.

Method: In this multiple-baseline design across behaviors study, a speech-language pathologist (SLP) taught EMT-DS to three caregivers and their children with DS (22-40 months) using a hybrid service delivery model. Sessions were conducted in person and via telepractice. The SLP taught caregivers EMT-DS, emphasizing the use of (a) four target EMT strategies: matched turns, expansions, time delays, and milieu teaching episodes; (b) augmentative and alternative communication (AAC; manual signs, speech-generating device); and (c) aided AAC modeling. The SLP provided caregiver instruction following the teach-model-coach-review approach. Caregiver outcomes were the accuracy (primary) and frequency (secondary) of EMT strategy use. Child outcomes were exploratory and included the rate of symbolic communication acts, weighted number of communication acts, and number of different words (NDW).

Results: There was a functional relation between the intervention and the accuracy and frequency of EMT strategy use for all three caregivers. All caregivers showed an increase in the accuracy for all four target strategies. Caregivers also increased the frequency of the three EMT strategies: expansions, time delays, and milieu teaching episodes. There were no changes in the frequency of matched turns. Caregiver use of EMT strategies maintained for 6 weeks post-intervention. After caregivers learned EMT strategies, gradual increases in the rate of symbolic communication acts and NDW occurred for all three children.

Conclusion: Results demonstrate the preliminary efficacy of using a hybrid service delivery model to teach caregivers EMT-DS.

Supplemental material: https://doi.org/10.23641/asha.27115252.

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通过混合远程实践为患有唐氏综合症的幼儿提供强化环境教学:单例实验设计。
目的:本试验性研究调查了通过混合远程实践为唐氏综合症儿童提供增强型环境教学(EMT-DS)的情况:在这项多基线设计的跨行为研究中,一名语言病理学家(SLP)采用混合服务提供模式,向三名照顾者及其患有唐氏综合症的儿童(22-40 个月)教授 EMT-DS。课程以面授和远程练习的方式进行。语言康复师教授照顾者 EMT-DS,强调使用 (a) 四种目标 EMT 策略:匹配转折、扩展、时间延迟和环境教学情节;(b) 辅助和替代性交流 (AAC;手动手势、语言生成设备);以及 (c) 辅助 AAC 建模。语言康复师按照 "教学-示范-辅导-回顾 "的方法为护理人员提供指导。护理人员的成果包括使用 EMT 策略的准确性(主要)和频率(次要)。儿童的结果是探索性的,包括象征性交流行为率、加权交流行为数和不同词语数(NDW):结果:干预与所有三位照顾者使用 EMT 策略的准确性和频率之间存在功能关系。所有照顾者使用所有四种目标策略的准确性都有所提高。护理人员还增加了三种 EMT 策略的使用频率:扩展、时间延迟和环境教学情节。配对轮流的频率没有变化。护理人员使用 EMT 策略的情况在干预后保持了 6 周。在照顾者学会 EMT 策略后,所有三名儿童的象征性交流行为和 NDW 的比率都逐渐增加:结果表明,使用混合服务提供模式向照料者传授 EMT-DS 具有初步效果。补充材料:https://doi.org/10.23641/asha.27115252。
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来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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