PAR Spring 2021 Synthesis Table Name: Madeline Quinn

Research Question: What strategies and techniques can parents use to support children who are considered late talkers?

Importance of topic: there is a disconnect between research and implementation in the world of EI. Research can be difficult to
translate into strategies that parents can understand and use. There is also not a lot of research on parent-implemented strategies
for children with language delays, so translating the research that is already there is even more important to the field of EI and
speech.

Settings
CitationAuthor/

Participants Independent Variable Dependent Results Social Validity/Usability

Variable
Title
Using the Teach- Enhanced Milieu Teaching With Preschool Children Who

(Kaiser & Roberts, 2013)

At home and/or in a clinic

77 children EMT strategies: a) environmental Children’s Parents who received Shows how intervention
Words and SignsTeaching Parents Parent-Implemented Enhanced Milieu

intellectual arrangement: placing toys child language skills training in EMT had a provided at home by parents
Have Intellectual Disabilities

disabilities can’t reach without help
between 30 b) responsive interaction:
and 54 connecting to child’s play and
months old focus of interest
with normal c) specific language modeling:
hearing examples of specific language
targets appropriate for child
d) expansions: adding words to
child’s utterances
e) milieu teaching prompts:
responding and reinforcing
child’s target behaviors through
access and verbala)feedback
between child’sAlternating
Kaiser, 2016)(Wright &
(2 or 3-word positive impact on their increases level of exposure
semantic child’s language; used more and demonstrates importance
structures and milieu teaching and of including strategies in
vocabulary) and responsive interactions daily routines; children with
parents’ use of ID need high, consistent
language exposure to language support
facilitating strategies to help generalize
strategies based skills to variety of contexts;
on EMT supports idea of NE

4 children EMT strategies: matched turns: Parent’s use of Parents who were taught Supports idea of coaching for
Model-Coach- Teaching With

between the adult imitating or labeling a EMT based on EMT strategies through parents; provides information
ages of 28 child’s communication turn b) TMCR model; TMCR had higher on how to maximize adult
and 33 target talk: using specific target child’s total use generalization and learning to better support the
months old words and having adult model of words, based consistent use of strategies; children; highlights the
and their them for the child c) expansions: on children’s language use importance of teaching,
parents adding words to the child’s independence varied depending on the modeling and reviewing new
 (Hatcher & Page, 2019)
Intervention for Teaching Enhanced

At the home of the child

4 children EMT strategies: a) matched turns: Parent’s use of Revealed positive gains in Supports research indicating

to Parents of Parent-Implemented Language

between the adult verbal communication turns
ages of 34 that immediately followed a
months and child’s turn (mirroring- imitation
46 months and mapping- verbal labeling)
old and their b) expansions: adding words to
parents the child’s utterances and
replacing words to be
grammatically correct
c) time delays: expectant waiting
to encourage request from child
d) milieu prompting: adult verbal
responses in form of wh-
questions choice questions or
“say” prompts
Statusof
EMT strategies language abilities of the effectiveness and importance
and child’s children; parents showed an of parent-implemented
language (i.e. increase in use of strategies intervention; shows how
mean length when taught how to individualized instruction for
utterance and implement them on their parents can impact parents’
vocabulary own abilities to implement
size) strategies regardless of
background; however, only
valid for play contexts and
was not analyzed in other
daily routines such as
mealtimes or joint book
reading

clinic roomSpeech therapy

(Kazemi, &

3 children EMT strategies: a) notice- Mothers’ use of Notice-response strategy Indicates EMT strategies may
Milieu Adaptation

with language response: identify child’s EMT strategies was easiest for mothers to be used across cultures and
Persian

delays communicative efforts and implement, while have the potential to be

between the describe their activities expanding was hardest; use successful regardless of
Low-Socioeconomic
Strategies

ages of 24 b) balanced turn-taking: watch of TCMR to teach background; supports

Mohebinejad,

and 30 for communicative shifts, wait strategies had positive usefulness of TMCR method
Enhanced

3months old for child to communicate

a) followand effect on consistency
children and of adult learning and supports
Milieu

Lang,

Child’s classroom

children EMT strategies: child’s Child’s use of Revealed Demonstrates how EMT can
Output
Teaching

with ASD lead: imitating child’s motor and VOCA (voice increased communicative be used not only by parents
between the play behaviors output acts using VOCA when but teachers as well; fast
lly, & Dickson, 2006)(Olive, De La Cruz, Davis, Chan,
Enhanced

ages of 3- and b) environmental arrangement: communication taught using EMT acquisition shown in this
Teaching and a Voice

5- years old setting preferred objects in sight aid), gestural strategies; all three children study suggests EMT used in
Milieu

and their but out of reach communication had increase in naturalistic settings and daily
teachers or c) most-to-least prompting: acts and verbal spontaneous/independent routines than increase level of
tion Aid on the Requesting ofThe Effects of

teaching physical, verbal models, mand- communication communicative acts, both mastery for new skills in
assistants models, gestures, and time delays acts for VOCA and children, supporting idea of
d) expansion paired with gestural/verbal naturalistic and embedded
reinforcement: giving requested communication learning opportunities
object while modeling correct
request response using the child’s
VOCA
e Children with Autism
References:

Hatcher, A., & Page, J. (2019). Parent-Implemented Language Intervention for Teaching Enhanced Milieu Teaching Strategies to Parents of Low-

Socioeconomic Status. Journal of Early Intervention, 42(2), 122–142. https://doi.org/10.1177/1053815119873085

Kaiser, A. P., & Roberts, M. Y. (2013). Parent-Implemented Enhanced Milieu Teaching With Preschool Children Who Have Intellectual Disabilities.

Journal of Speech, Language, and Hearing Research, 56(1), 295-309. doi:10.1044/1092-4388(2012/11-0231)

Kazemi, Y., & Mohebinejad, F. (2020). Persian Adaptation of Enhanced Milieu Teaching for Iranian Children With Expressive Language Delay.

Iranian Rehabilitation Journal, 99–112. https://doi.org/10.32598/irj.18.1.930.1

Olive, M. L., De La Cruz, B., Davis, T. N., Chan, J. M., Lang, R. B., O’Reilly, M. F., & Dickson, S. M. (2006). The Effects of Enhanced Milieu

Teaching and a Voice Output Communication Aid on the Requesting of Three Children with Autism. Journal of Autism and Developmental

Disorders, 37(8), 1505–1513. https://doi.org/10.1007/s10803-006-0243-6

Wright, C. A., & Kaiser, A. P. (2016). Teaching Parents Enhanced Milieu Teaching With Words and Signs Using the Teach-Model-Coach-Review

Model. Topics in Early Childhood Special Education, 36(4), 192–204. https://doi.org/10.1177/0271121415621027