Implementation Strengths Weaknesses Primary Findings Usability Overall Rating Fey, M., Warren, S., Brady, N., Finestack, L., Bredin-Oja, S., Fairchild, M., Sokol, S., & Yoder, P. (2006). Early Effects of Responsivity Education/Preling uistic Milieu Teaching for Children With Developmental Delays and Their Parents. Journal of Speech, Language, and Hearing Research, 49, 526-547.
Efficacy of PMT and RE/PMT over the short term (6 months for example) is supported. Also, persistent efforts to modify and intensify this intervention are warranted to further enhance the outcomes for children. There was fidelity in the implementation of the intervention. The children receiving RE/PMT were videotaped once a month and graduate assistants who were uninformed about the specific details of the study or goals viewed the videos and they were able to accurately tell when PMT was being used as well as the goals. *treatment group vs. no treatment group *weekly meetings by investigators to support clinicians *videotaping of a session for each child once a month for review and discussion *use of graduate students to view the videos with no knowledge of the study *Possible coder biases because the second coder was not always unaware of the child group assignments , *sample size of 51 is small, *effects of PMT were reported even when another intervention may have been happening at the same time, and *the study provides no example of how children performed after intervention RE/PMT can be applied clinically with medium size effects on the childs rate of intentional communication after 6 months. I believe this type of intervention could easily be used in the home. I like the use of RE along with PMT especially since the parent is the number one teacher and the person embedding the intervention into daily routines in natural environments. ***** Synthesis Table page 2 by: Kathy Supple
Fey, M., Yoder, P., Warren, S., & Bredin-Oja, S. (2013). Is More Better? Milieu Communication Teaching in Toddlers With Intellectual Disabilities. Journal of Speech, Language, and Hearing Research. 56, 679-693. High intensity MCT is less than desired for children who do not have positive, meaningful play skills, however children who have meaningful play skills with a wide variety of toys may benefit from larger doses of MCT weekly. Fidelity of implementation is valid because the clinicians successfully delivered the intervention at the planned dose, frequency, and duration. *clinicians were supervised twice monthly with one session being videotaped *9 month intervention *samples were coded by 2 teams of trained coders who did not know participant group assignment. *No control group (no- treatment group) *only 2 levels of intensity (HI and LI)
More MCT is not always better for all children. If the children have meaningful play skills and interest in objects then increasing MCT may have a moderate effect on outcomes. I can see where parts of this study are useful and I would implement the strategies, however, for intervention only purposes I believe 5 times a week is excessive and doesnt give the power to the parents as does coaching. *** Hancock, Terry & Kaiser, Ann (1996). Siblings Use of Milieu Teaching at Home. Topics in Early Childhood Special Education, 16 (2), 168-190. The outcomes were measured once a month for three consecutive months after termination of the intervention phase. Also, parents and siblings were interviewed 1 year after their participation in this study. All 3 parents reported sibling involvement in interventions resulted in positive, long- lasting changes in both children. All 3 siblings reported they learned their brothers competencies. The effects of siblings applications of milieu teaching (modeling and man- model) were similar to parents, teachers, and teaching assistants were trained. All techniques of milieu teaching were not utilized because of the age of the sibling. All 3 children showed an increase in the frequency of total target use (spontaneous and prompted). This would help my practice by providing me with strategies to offer parents that they can use during daily routines while including siblings in natural environments.
Kaiser, A., & Parents of young Fidelity was high There was a Clinical Parents who I can absolutely use *** Synthesis Table page 2 by: Kathy Supple
Roberts, M. (2013). Parent- Implemented Enhanced Milieu Teaching With Preschool Children Who Have Intellectual Disabilities. Journal of Speech, Language, and Hearing Research. 56, 295-309. children with intellectual disabilities can learn, generalize, and maintain naturalistic teaching strategies with their children. for therapists use of EMT strategies and for all parent training variables. Fidelity for parent feedback in the clinic was low possibly due to the children wanting to leave the clinic room at the end of sessions not providing the therapist with enough time to summarize the session. large number of participants, majority of participants participated in a 12 month follow up, generalizatio n from clinic to home. setting, limited diversity in the population, parents were highly educated and middle class, and testers knew the procedures of the study and the condition the parents and children were assigned. received the EMT training increased their use of responsive interaction, expansions, language modeling, and MT prompts. Parents use of MT strategies had a positive impact on their children. Also, parents can learn to generalize and maintain their use of naturalistic teaching strategies with their children. some of the strategies provided in this study such as environmental arrangement, responsive interaction, modeling language targets, and expanding language by modeling them, coaching them, and encouraging parents to utilize them while I provide feedback to parents in home visits. Togram, B., & Erbas, D. (2010). The Effectiveness of Instruction on Mand Model-One of the Milieu Teaching Techniques. Eurasian Journal of Educational A training program is effective in teaching participants to conduct mand- model procedure in a classroom utilizing group seminar, High fidelity All sessions were video taped for reliability and watched/coded by a researcher. Training sessions for the teacher was one-to- one setting, literature review was completed prior to this study to find One teacher working with 3 students, time limitations caused the findings to not be generalized, All participants showed progress following training. Also, the training program developed to teach mand model is I can see early intervention specialist utilizing this strategy to coach parents on the mand model that is useful in encouraging their childs communication. ** Synthesis Table page 2 by: Kathy Supple
Research. 38, 198-215 individual meetings, video demonstrations, and performance feedback. strength in teachers utilizing milieu teaching. also the same target words were used for all children so again no generalizati on. effective and participants need training to teach it correctly. Yoder, P., & Warren, S. (2002). Effects of prelinguistic Milieu Teaching and Parent Responsivity Education on Dyads Involving Children With Intellectual Disabilities. Journal of Speech, Language, and Hearing Research. 45, 1158-1174. Results varied among children in regards to responsivity education/preling uistic milieu teaching. Some children accelerated growth in communication, however, others decelerated growth. Due to the varied findings, the authors suggested linguistic goals for children who are using comments often and children with few comments may be best served by prelinguistic goals. Low fidelity due to low reliability possibly stemming from the low variability of participants and one participant possibly mis- scoring the form on at least one occasion. Control group vs. RPMT group, sessions were videotaped and coded. Intervention happened in the childs classroom and if a child missed a session it was not made up. Coders and examiners were not blind to treatment assignment so there is a high probability of bias. The RPMT treatment accelerated how often children initiated requests and comments. Although the findings were different with different children, there are some great strategies here that could be of value to an early intervention practitioner (for example: environmental arrangement where a gaze shift is okay for a requestbut once that is mastered then modeling reaching or giving). ***