An Exploration of Reflective Conversations in Early Intervention Caregiver Coaching Sessions

This descriptive study included a systematic examination of provider and caregiver reflective conversations during caregiver coaching sessions focused on embedded intervention. Transcribed videos from 31 provider–caregiver dyads in two groups (Embedded Practices and Interventions with Caregivers [EPIC] vs. business-as-usual [BAU]) were used for data collection, resulting in a total of 93 transcripts across three different time points. Using methods of directed content analysis, a coding scheme describing various components of shared reflection was developed and used to code transcripts. Coding data were used to explore the rate per minute and relative frequency of types, topics, and spontaneity of reflection. Although there were no statistically significant differences in the frequency and rate of reflective versus nonreflective conversational turns, there were group differences in the reflective topics and specific types of reflective comments and questions posed by participants. Results from this study and others can help the field further define reflection as a coaching strategy and consider the potential utility of different reflective comment and question types to increase caregiver capacity to embed interventions in home routines. Further research is recommended to explicate further definitions and processes for reflection specific to caregiver coaching, including methods used to code reflective conversations and evaluate how reflection impacts caregivers’ intervention implementation.