Social Communication and Parent Verbal Responsiveness Across Interaction Contexts in Toddlers on the Autism Spectrum.

PURPOSE: Interactions with caregivers during the ordinary activities that occur as families go about their everyday lives are critical to supporting children's acquisition of social communication and language skills. The purpose of this study was to examine child communication and parent verbal responsiveness across interaction contexts in 211 children (Mage = 20 months) on the autism spectrum (n = 121), with developmental delay (n = 46), or with typical development (n = 44). METHOD: Families participated in up to eight activities during an hour-long, video-recorded home observation. We tested differences in the strength of associations between diagnostic group and interaction context using linear mixed-effects models, with child rate per minute of communication and proportions of parent follow-in comments and directives as outcome variables. Child communicative functions expressed across contexts were also examined. RESULTS: Children across groups communicated at significantly higher rates per minute during book sharing and play with people compared to other interaction contexts. Most child communication was for the function of joint attention during book sharing, for social interaction during play with people, and for behavior regulation during necessary activities such as family chores and meals. On average, parents of children responded using proportionally more follow-in comments during book sharing and play compared to necessary activities, during which parents used more follow-in directives. CONCLUSION: Results provide a glimpse into the dyadic communication that may occur within everyday activities at home, which supports the need for future intervention research and may aid clinicians seeking to identify activities that serve as important contexts for intervention.

Examining the Family-Centeredness of Speech-Language Pathologists Working With Children Who Use Augmentative and Alternative Communication.

PURPOSE: Family-professional partnerships are important for youth learning to use aided augmentative and alternative communication (AAC). This study examined the family-oriented beliefs and practices of speech-language pathologists (SLPs) working with preschool and school-aged children learning to use aided AAC (aged 3-21 years), specifically during the COVID-19 pandemic. METHOD: Participants were 25 SLPs who participated in an individual semistructured interview. Qualitative analysis was used to identify and describe groups of SLPs based on commonalities and differences in their beliefs and practices working with families. The characteristics of SLPs in each group was also explored descriptively (e.g., race/ethnicity, work setting, caseload). RESULTS: SLPs clustered into three groups based on their beliefs and practices: (a) professionally centered, (b) family-allied, and (c) family-focused. SLPs varied across these groups in how they planned services, offered training/coaching, communicated, shared resources, offered emotional support, and adapted to and with different families. CONCLUSIONS: Findings indicate the need to support greater family-centeredness in AAC services by building on the strengths of SLPs in the field. Promoting strong family-professional partnerships could in turn improve outcomes for students who use AAC. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25044125.

Augmentative and Alternative Communication Services During the COVID-19 Pandemic: Contextual Determinants of the Parent-Speech-Language Pathologist Partnership.

PURPOSE: The COVID-19 pandemic caused significant changes for family-professional interactions. Many services shifted to telepractice, with new opportunities for parents and speech-language pathologists (SLPs) to partner for service delivery. Parent-coached models of augmentative and alternative communication (AAC) intervention provide positive outcomes for children; however, SLPs have reported difficulty building strong partnerships with families. The shift to telepractice during the COVID-19 pandemic provided a unique context to examine factors influencing parent-SLP partnerships, particularly for parents with children who use aided AAC. METHOD: Twenty-five parents and 25 SLPs who engaged in services with children and youth from 3 to 21 years of age who used aided AAC during the initial stages of the COVID-19 pandemic in June 2020 participated. Semistructured interviews were conducted individually with parents and SLPs to understand perspectives on whether the change in service delivery facilitated or hindered family-oriented practice. Inductive qualitative analysis was used to analyze information about the factors impacting parent-SLP partnerships. RESULTS: The parent-SLP partnership was influenced by setting and systemic determinants, and intrinsic determinants to the parent and the SLP that included their history and rapport, beliefs about partnering, and knowledge and skills. These determinants served as barriers or facilitators to their partnership. CONCLUSIONS: It is essential to consider the relationship, expectations, and knowledge and skills that SLPs and parents bring to the partnership, along with extrinsic structural factors that can impact this partnership. Positive rapport, valued partnership, and an openness to sharing knowledge through teaming and collaboration provided for positive parent-SLP partnerships.

Development of an Individualized Responsive Feeding Intervention-Learning Early Infant Feeding Cues: Protocol for a Nonrandomized Study.

BACKGROUND: Responsive infant feeding occurs when a parent recognizes the infant's cues of hunger or satiety and responds promptly to these cues. It is known to promote healthy dietary patterns and infant weight gain and is recommended as part of the Dietary Guidelines for Americans. However, the use of responsive infant feeding can be challenging for many parents. Research is needed to assist caregivers recognize infant hunger or satiety cues and overcoming barriers to using responsive infant feeding. OBJECTIVE: The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach, SS-OO-PP-RR ("super," Setting the Stage, Observation and Opportunities, Problem Solving and Planning, Reflection and Review), to promote responsive infant feeding. Guided by the Obesity-Related Behavioral Intervention Trials model, this study aims to test the feasibility and fidelity of the LEIFc intervention in a group of mother-infant dyads. METHODS: This pre-post quasi-experimental study with no control group will recruit mothers (N=30) in their third trimester (28 weeks and beyond) of pregnancy from community settings. Study visit 1 will occur prenatally in which written and video material on infant feeding and infant hunger and satiety cues is provided. Demographic information and plans for infant feeding are also collected prenatally via self-report surveys. The use of responsive infant feeding via subjective (survey) and objective (video) measures is recorded before (study visit 2, 1 month post partum) and after (study visit 5, 4 months post partum) intervention. Coaching on responsive infant feeding during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR approach at study visits 3 (2 months post partum) and 4 (3 months post partum). Infant feeding practices are recorded via survey, and infant weight and length are measured at each postpartum study visit. Qualitative data on the LEIFc intervention are provided by the interventionist and mother. Infant feeding videos will be coded and tabulated for instances of infant cues and maternal responses. Subjective measures of responsive infant feeding will also be tabulated. The use of responsive infant feeding pre-post intervention will be analyzed using matched t tests. Qualitative data will be examined to guide intervention refinement. RESULTS: This study initially began in spring 2020 but was halted because of the COVID-10 pandemic. With new funding, recruitment, enrollment, and data collection began in April 2022 and will continue until April 2023. CONCLUSIONS: After refinement, the LEIFc intervention will be tested in a pilot randomized controlled trial. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs that serve vulnerable populations-those that often have infant feeding practices that do not align with recommendations and are less likely to use responsive infant feeding. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44329.

The BabyTok Project: Examining the Feasibility and Acceptability of a Light-Touch Social Media Project for Infant-Toddler Teachers.

High-quality early care and education is a known protective factor for infants and toddlers who experience early childhood poverty, especially for early communication outcomes. However, the quality of care is variable in the United States, and efforts to increase the quality of interactions is impeded by cost and high rates of turnover in the field. In this paper, we explore a low-cost, light touch social media intervention that uses the TikTok platform to increase infant-toddler teachers' (ITTs) knowledge of early communication and social interactions while validating the important role that ITTs play in the lives of young children. We use a mixed method, pre-post design to explore the feasibility and acceptability of the BabyTok project from the vantage point of the ITT participants. Teachers offered positive feedback about the content, delivery of the intervention through TikTok and the impact on their feelings about their role in helping young children learn. Supplementary Information: The online version contains supplementary material available at 10.1007/s10643-022-01426-y.

Augmentative and alternative communication services during the COVID-19 pandemic: impact on children, their families and service providers.

The closure of schools and healthcare facilities across the United States due to COVID-19 has dramatically changed the way that services are provided to children with disabilities. Little is known about how children who use augmentative and alternative communication (AAC), their families and their service providers have been impacted by these changes. This qualitative study sought to understand the perspectives of parents and speech-language pathologists (SLPs) on how COVID-19 has affected children, families, services providers and the delivery of AAC-related communication services. For the study, 25 parents and 25 SLPs of children who used aided AAC participated in semi-structured interviews, with data analyzed using qualitative thematic analysis. Parents and SLPs highlighted wide disparities in how children have been impacted, ranging from views of children making more progress with communication and language than before the pandemic to worries about regression. A complex system of factors and processes may explain these differences. COVID-19 will have lasting impacts on the lives of children with complex communication needs. This research highlights the crucial role of family-service provider partnerships and access to quality AAC services for children during the pandemic and into the future.

State of the Practice of Team Science in Speech-Language Pathology and Audiology.

Purpose The purpose of this study was to investigate engagement in collaborative research (team science) and perceptions of related knowledge and skills to inform personnel preparation and workforce development efforts. Method A questionnaire was used to solicit information about the team science-related experiences of 220 doctoral students, faculty, and research scientists in speech-pathology and audiology. Additionally, the questionnaire surveyed participants' perceptions of readiness, benefits, and challenges to team science. Results Results demonstrated low percentages of respondents had received training in collaborative research (17%), and those with training were more likely to engage in cross-disciplinary collaborative research. Group differences were found with female researchers reporting lower psychological safety than male researchers. The most frequently cited advantages of team science included diverse perspectives, collective expertise, innovative ideas, and productivity. Conversely, common challenges included time constraints, finding collaborators, and differing expectations. Implications Because this study yielded group difference in psychological safety between groups that differed in gender and position, results suggest additional efforts may be necessary to ensure that imbalances in the power structure of members are not allowed to dissuade members from actively contributing to team activities. Additional training opportunities in team science could support the degree to which professionals in communication science and disorders engage in collaborative research. Supplemental Material https://doi.org/10.23641/asha.15506034.

Coaching Childcare Providers to Support Toddlers' Gesture Use With Children Experiencing Early Childhood Poverty.

Purpose The purpose of this study is to examine the impact of an intervention in which childcare providers (CCPs) are coached to support toddlers' gesture use during every day classroom routines. Method This study uses a multiple-baseline across strategies single-case experimental design to examine the impact of a coaching intervention on three CCPs' use of communication strategies with toddlers experiencing early childhood poverty. The CCPs were coached with a systematic framework called Setting the Stage, Observation and Opportunities to Embed, Problem-solving and Planning, Reflection and Review as they learned to implement three strategies to support toddlers' gesture use-modeling gestures with a short phrase, opportunities to gesture, and responding/expanding child gestures. CCPs were coached during book sharing and another classroom routine of their choice. Social validity data on the coaching approach and on the intervention strategies were gathered from postintervention interviews. Results The visual analysis and nonoverlap of all pairs' effect size indicates that the coaching intervention had a functional relation with CCPs' use of modeling gestures and responding/expanding gestures during book sharing, play, and circle time. Social validity data indicate that CCPs found the coaching framework supportive of their learning and feelings of self-efficacy, and that the intervention strategies supported their toddlers' communication. Conclusions The coaching framework was used to increase CCP strategy use during everyday classroom routines with toddlers. CCPs endorsed the coaching approach and the intervention strategies. This study adds to the literature supporting efforts to enhance children's earliest language learning environments. Supplemental Material https://doi.org/10.23641/asha.14044055.

Rates of Prelinguistic Communication and Early Symbol Use in Young Children With Down Syndrome: Using a Progress-Monitoring Tool to Model Growth.

Purpose This study aims to provide descriptive data on rates of expressive communication skill use in young children with Down syndrome (DS) across early childhood. Children with DS are known to have delays in expressive communication, but there are little current data on rates of communication in early skills, such as gestures, vocalizations, words, and word combinations. In addition, few studies use measures that offer a composite or "across-skills" view of early development across time. Method This article used a longitudinal descriptive design to generate growth curves for expected rates of communication in young children with DS in 4 major skill elements as measured by the Individual Growth and Development Indicator-Early Communication Index. Using data from 19 children aged 11-42 months with DS, we used hierarchical linear modeling to generate growth curves for children with DS while comparing them to the benchmarked data available for children who are typically developing. Results Results indicate relative strengths in gesture use, a longer period of vocalizations, and lower rates of growth in single and multiple word combinations across time. Children differed significantly from one another on all parameters. Conclusion These data indicate a need to develop and research interventions to support the transition from gestures to words and that support early word combinations in young children with DS.