Exploring Language Development Support for Foster Children: A Scoping Review of Interventions for Foster Care Families.

PURPOSE: Children in foster care are at an increased risk for language delays and disorders, and foster parents can play a significant role in preventing delays in early language development. This scoping review explored empirical studies that included foster parent training programs for families with foster children under the age of 5 years. METHOD: Using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews), multiple databases were searched, and resulting article titles and abstracts were screened for inclusion in the review. Each study that met inclusion criteria was then coded for the training methods used to teach foster parents intervention strategies and the targeted outcomes of the intervention. RESULTS: A total of 24 studies were identified. Of the 24 studies reviewed, all included interventions focused on increasing parent-child relationships and decreasing child challenging behaviors, but few included opportunities for foster parents to practice using intervention strategies with their foster child. None of the studies focused specifically on strategies for promoting children's language development. When outcomes across the studies were reviewed, only two focused on children's language. CONCLUSIONS: The results of this review point to the need for more research on language interventions that can be implemented by foster parents. The discussion focuses on the important role speech-language pathologists can play in the prevention of early language delays or disorders in young foster children. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21714311.

Effects of a brief parenting intervention on Latinx mothers and their children.

Parent-Child Interactions (PCI) is a home visit parenting intervention designed to promote positive parenting and deter punitive approaches to child behavior management. With attention to the importance of providing efficacious interventions for families from diverse backgrounds, this study used a subsample from a larger randomized controlled trial (RCT) to examine the efficacy of PCI intervention among Latinx participants. PCI was offered to 170 at-risk Latinx mother-child dyads, of whom the majority were primarily Spanish speaking. Dyads were randomly assigned to an intervention or a wait-list control condition. Path analysis modeling was used to examine parenting outcomes as a mediator of program efficacy between group assignment and children's long-term functioning. Results suggest that Latinx parent and child functioning benefited from PCI intervention 6 months following intervention. Specifically, model results indicated significant indirect effects of the PCI intervention on (1) cooperative child behavior and (2) children's externalizing behaviors 6-months posttreatment via parenting at post test, with mother-child dyads assigned to the treatment condition, relative to the control, demonstrating better functioning 6-months posttreatment. Overall, findings contribute to increased understanding of parenting intervention implementation among Latinx families. Recommendations for future study are discussed.

Interacciones entre padres e hijos (Parent-Child Interactions, PCI) es una intervención en la crianza con visitas a los hogares diseñada para promover la crianza positiva y desalentar los métodos correctivos de manejo del comportamiento infantil. Con atención a la importancia de ofrecer intervenciones eficaces para las familias de distintos orígenes, en este estudio se utilize una submuestra de un ensayo controlado aleatorizado más grande para analizar la eficacia de una intervención de PCI entre participantes latinas. Se ofreció la PCI a 170 díadas de madres e hijas latinas en riesgo, de las cuales la mayoría eran principalmente hispanohablantes. Las díadas se asignaron aleatoriamente a un grupo de intervención o de control en lista de espera. Se utilizó el modelo de análisis de ruta para analizar los resultados de la crianza como mediadora de la eficacia del programa entre la distribución a los grupos y el funcionamiento a largo plazo de las niñas. Los resultados sugieren que el funcionamiento de las madres latinas y las niñas se benefició de la intervención de PCI seis meses después de la intervención. Específicamente, los resultados del modelo indicaron efectos indirectos significativos de la intervención de PCI en (1) el comportamiento cooperativo de las niñas y (2) las conductas de exteriorización de las niñas seis meses después del tratamiento mediante la crianza en la evaluación posterior, donde las díadas madre e hija asignadas al grupo de tratamiento, respecto del de control, demostraron un major funcionamiento seis meses después del tratamiento. En general, los resultados contribuyen a una mayor comprensión de la implementación de intervenciones en la crianza entre las familias latinas. Se comentan las recomendaciones para futuros estudios.

Progress Toward a Multisectoral Community Intervention Approach to Prevention of the Word Gap.

Children learn language through the interactions they have with their parents/caregivers beginning at birth. Hart and Risley (1995) discovered an inequity in the home language input children received from parents/caregivers. Children reared in low-income families received less input (conversations, turns) from parents than did children reared in more advantaged families. Less language input was linked to a disparity in children's vocabulary learning by age 3. The long-term result of this social determinant of early language/literacy learning is a life trajectory of poor educational, economic, and health attainment for many children in families with limited resources, at vast cost to individuals, communities, and the nation. What is needed is an approach to word-gap prevention that is capable of achieving positive individual, community, and population outcomes. Translating research into practice, we developed the Bridging the Word Gap Community Action Planning Guide (BWG-CAPG) using a combined behavior-analytic, community psychology, and public health framework for this purpose (Greenwood et al., 2017). We also developed a progress-monitoring measure, the online BWG Community Check Box Evaluation System, to provide feedback on a community's actions and progress in implementing their plan. Results from an initial pilot investigation within and across three community sectors in a large urban city were promising. BWG Community Check Box results indicated a number of desired outcomes: (a) capacity development and mobilization, (b) community implementation actions, and (c) community changes in practices, programs, and policies. Implications are discussed.

Language Skills, Behaviour Problems, and Classroom Emotional Support among Preschool Children from Low-income Families.

The purpose of this study was to examine the relationship between language skills and behavioural problems and the potential moderating role of the quality of classroom emotional support in this relationship among 242 preschool children from low-income families. The Preschool Language Scale-5 was administered individually to each child. The quality of classroom emotional support was measured using the Emotional Support domain of the Classroom Assessment Scoring System for Pre-Kindergarten. Teachers and parents completed the Child Behaviour Checklist for Ages 1½-5. Results indicated the inverse relationship between language skills and behaviour problems varied by the level of classroom emotional support provided by teachers. Specifically, children with lower language skills exhibited higher levels of behaviour problems in classrooms where teachers provided lower levels of emotional support. Findings from this study have important implications for enhancing teachers' emotional support aimed at children with lower language skills and for future research.

Automated Language Environment Analysis: A Research Synthesis.

Purpose: The Language Environment Analysis (LENA®) represents a breakthrough in automatic speech detection because it makes one's language environment, what adults and children actually hear and say, efficiently measurable. The purpose of this article was to examine (a) current dimensions of LENA research, (b) LENA's sensitivity to differences in populations and language environments, and (c) what has been achieved in closing the Word Gap. Method: From electronic and human searches, 83 peer-reviewed articles using LENA were identified, and 53 met inclusionary criteria and were included in a systematic literature review. Each article reported results of 1 study. Results: Originally developed to make natural language research more efficient and feasible, systematic review identified a broad landscape of relevant LENA findings focused primarily on the environments and communications of young children but also older adults and teachers. LENA's automated speech indicators (adult input, adult-child interaction, and child production) and the audio environment were shown to meet high validity standards, including accuracy, sensitivity to individual differences, and differences in populations, settings, contexts within settings, speakers, and languages. Researchers' own analyses of LENA audio recordings have extended our knowledge of microlevel processes in adult-child interaction. To date, intervention research using LENA has consisted of small pilot experiments, primarily on the effects of brief parent education plus quantitative linguistic feedback to parents. Conclusion: Evidence showed that automated analysis has made a place in the repertoire of language research and practice. Implications, limitations, and future research are discussed.

Long-Term Impact of a Cell Phone-Enhanced Parenting Intervention.

Home visiting programs support positive parenting in populations at-risk of child maltreatment, but their impact is often limited by poor retention and engagement. The current study assessed whether a cellular phone-supported version (PCI-C) of the Parent-Child Interactions (PCI) intervention improved long-term parenting practices, maternal depression, and children's aggression. Low-income mothers ( n = 371) of preschool-aged children were assigned to one of the three groups: PCI-C, PCI, and a wait-list control (WLC) group. Parenting improved in both intervention groups between baseline and 12-month follow-up compared to the WLC. Children in the PCI-C group were rated to be more cooperative and less aggressive than children in the WLC. The results offer evidence of the long-term effectiveness of PCI and the additional benefits of cellular phone supports for promoting intervention retention and improving children's behavior.

Conceptualizing a Public Health Prevention Intervention for Bridging the 30 Million Word Gap.

Early childhood experience is a social determinant of children's health and well-being. The well-being of young children is founded on their relationships and interactions with parents and family members in the home, caregivers, and teachers in early education, and friends and families in the greater community. Unfortunately, the early language experience of infants and toddlers from low-income families is typically vastly different than children from middle- and higher-income families. Hart and Risley (Meaningful differences in the everyday experience of young American children. Brookes, Baltimore, 1995) described a "30 Million Word Gap" experienced by age four for children from poor families compared to economically advantaged families as measured by the number of words delivered by adults in the home to their children. This discrepancy between groups is associated with a deficit in vocabulary growth over time (Hart and Risley in Meaningful differences in the everyday experience of young American children. Brookes, Baltimore, 1995; in The social world of children learning to talk. Brookes, Baltimore, MD, 1999; in Am Educ (Spring), 1-9. http://isites.harvard.edu/fs/docs/icb.topic1317532.files/09-10/Hart-Risley-2003.pdf , 2003), and readiness when they enter preschool and kindergarten compared to their more advantaged classmates. The purpose of this paper is to conceptualize a population-level public health prevention approach to research addressing the harmful impacts of the Word Gap. The approach includes use of evidence-based practices to improve children's language environments to foster their early language and literacy learning in early childhood. After a brief review of the Word Gap, we discuss four aspects: a conceptual framework, a community leadership team as driver of the local intervention, evidence-based language interventions for reducing the gap and promoting child language, and the measurements needed. Implications are discussed.

Efficacy of a Supplemental Phonemic Awareness Curriculum to Instruct Preschoolers With Delays in Early Literacy Development.

Purpose: Children who do not develop early literacy skills, especially phonological awareness (PA) and alphabet knowledge, prior to kindergarten are at risk for reading difficulties. We investigated a supplemental curriculum with children demonstrating delays in these skills. Method: A cluster randomized design with 104 preschool-age children in 39 classrooms was used to determine the efficacy of a supplemental PA curriculum, PAth to Literacy. The curriculum consists of 36 daily scripted 10-min lessons with interactive games designed to teach PA and alphabet skills. A vocabulary intervention (Story Friends), which also uses a small-group format, served as the comparison condition. Results: Multilevel modeling indicated that children in the experimental condition demonstrated significantly greater gains on the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) First Sound Fluency (Dynamic Measurement Group, 2006) and Word Parts Fluency (Kaminski & Powell-Smith, 2011) measures. Educational relevance was evident: 82% of the children in the experimental condition met the kindergarten benchmark for First Sound Fluency compared with 34% of the children in the comparison condition. Teachers reported overall satisfaction with the lessons. Conclusions: Results indicated that the vast majority of children demonstrating early literacy delays in preschool may benefit from a supplemental PA curriculum that has the potential to prevent reading difficulties as children transition to kindergarten.

Embedded Instruction Improves Vocabulary Learning During Automated Storybook Reading Among High-Risk Preschoolers.

PURPOSE: We investigated a small-group intervention designed to teach vocabulary and comprehension skills to preschoolers who were at risk for language and reading disabilities. These language skills are important and reliable predictors of later academic achievement. METHOD: Preschoolers heard prerecorded stories 3 times per week over the course of a school year. A cluster randomized design was used to evaluate the effects of hearing storybooks with and without embedded vocabulary and comprehension lessons. A total of 32 classrooms were randomly assigned to experimental and comparison conditions. Approximately 6 children per classroom demonstrating low vocabulary knowledge, totaling 195 children, were enrolled. RESULTS: Preschoolers in the comparison condition did not learn novel, challenging vocabulary words to which they were exposed in story contexts, whereas preschoolers receiving embedded lessons demonstrated significant learning gains, although vocabulary learning diminished over the course of the school year. Modest gains in comprehension skills did not differ between the two groups. CONCLUSION: The Story Friends curriculum appears to be highly feasible for delivery in early childhood educational settings and effective at teaching challenging vocabulary to high-risk preschoolers.

"My Baby & Me": effects of an early, comprehensive parenting intervention on at-risk mothers and their children.

This study examined the efficacy of a multimodule parenting intervention, "My Baby & Me," that began prenatally and continued until children reached 2.5 years of age. The intervention targeted specific parenting skills designed to alter trajectories of maternal and child development. Of 361 high-risk mothers (193 adolescents, 168 adults) enrolled across 4 states, half were randomly assigned to the high-intensity (HI) home visitation coaching program (55 sessions), and half to a low-intensity (LI) condition that included monthly phone calls from a coach, printed informational materials, and community resource referrals. Videotaped observations of mother-child play were coded at 5 time points for multiple maternal and child behaviors and skills. Compared to mothers in the LI group, mothers in the HI group showed higher levels of contingent responsiveness, higher quality verbal stimulation, and more verbal scaffolding by 30 months, with higher levels of warmth and greater decreases in physical intrusiveness and negativity when their children were 24 months. By 30 months, children in the HI group showed more rapid increases and higher levels of engagement with the environment, expressive language skills, and social engagement, as well as more complex toy play and fewer problem behaviors than those in the LI group. Gains in maternal responsive behaviors mediated the effects of the intervention on child outcomes. Results were comparable for adolescent and adult mothers. A strong theoretical framework, consistent focus on maternal responsiveness, high dosage, and trusting relationships with coaches are thought to explain the positive outcomes.

Randomized trial of a cellular phone-enhanced home visitation parenting intervention.

BACKGROUND AND OBJECTIVES: Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC). METHODS: A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors. RESULTS: Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors. CONCLUSIONS: PAT and CPAT conditions improved parenting strategies and child engagement and reduced children's challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress.

Is a Response to Intervention (RTI) Approach to Preschool Language and Early Literacy Instruction Needed?

Preschool experience plays a role in children's development. However, for programs with language and early literacy goals, the question remains whether or not preschool instructional experiences are sufficiently effective to achieve these goals for all children. In a multisite study, we conducted a process-product description of preschool instruction and children's growth and outcomes in typical programs (i.e., Pre-Kindergarten, Title 1, Head Start, Tuition-Based) using a Response to Intervention (RTI) perspective. Results indicated that (a) students in their preschool year prior to kindergarten made small gains, but students starting the year in lower Tier 2 and 3 performance levels did not close initial skills gaps, (b) variations were noted by program types with varying socio-demographics and instructional processes, and (c) the quality of instruction (Tier 1) received by all was low with room for improvement. Implications for future research on the application of the RTI approach and potential benefits are discussed.

Factors influencing mothers' abilities to engage in a comprehensive parenting intervention program.

OBJECTIVE: This research identified the possible factors influencing the ability of mothers perceived to be at the highest risk for child maltreatment to engage in a home visitation program. This study holds significance to public health nursing since home visitation is an integral component of public health nursing practice, with engagement being essential for human interaction and thus nursing care to occur. DESIGN AND SAMPLE: A qualitative descriptive design was used to offer a thematic summary of the experiences of program engagement from the perspective of 4 home visitation coach interventionists from health-related fields and a small sample of purposefully selected mothers involved in a longitudinal prevention study. RESULTS: Qualitative content analysis revealed 3 major themes related to engagement: (1) mothers struggle to meet the emotional needs of the self and the child; (2) mothers lack support in navigating complicated and stressful life events; and (3) mothers' consistency with program engagement is mediated through a trusting and caring relationship with coaches. CONCLUSIONS: Home visitation coaches in this study demonstrated a continuous process of engagement by supporting mothers to explore and discover self-care strategies and ways to navigate life struggles. Over time, a foundation of trust and caring was developed, which in turn increased relationship building and program engagement.

Expanding the reach of preventive interventions: development of an Internet-based training for parents of infants.

There are major obstacles to the effective delivery of mental health services to poor families, particularly for those families in rural areas. The rise of Internet use, however, has created potentially new avenues for service delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling a demand for Internet delivery of mental health services. The authors report on the adaptation of a parenting program for delivery via the Internet, enhanced with participant-created videos of parent-infant interactions and weekly staff contact, which enable distal treatment providers to give feedback and make decisions informed by direct behavioral assessment. This Internet-based, parent-education intervention has the potential to promote healthy and protective parent-infant interactions in families who might not otherwise receive needed mental health services.

Txt u ltr: using cellular phone technology to enhance a parenting intervention for families at risk for neglect.

One of the biggest challenges facing home visiting programs aimed at high-risk families is keeping families involved in the intervention. Cellular phones afford the opportunity for home visitors to maintain regular communication with parents between intervention visits and thus retain high-risk families in parenting interventions. The use of cellular phones may also increase the dosage of intervention provided to families and the fidelity with which parents implement the intervention, thus resulting in improved outcomes for parents and children. This brief report describes the development and initial testing of a parenting program, Planned Activities Training (PAT), which was enhanced through the use of cellular phones to promote the active engagement of parents. PAT is a five-session intervention aimed at improving parent-child interactions, increasing child engagement in daily activities, and reducing challenging child behaviors. To date, 19 parents have completed PAT and cell phone-enhanced PAT, and all have met the 90% correct mastery criterion and demonstrated improvements in their parenting behaviors. Parents have rated PAT and the text messaging and cellular phone call enhancements very positively.