Increasing a Parent’s Practice of Enhanced Milieu Teaching Strategies to

Enhance a Toddler’s Communication in Parent-Child Play Interactions

Introduction Methodology Results

Ø Early Intervention (EI) is a system of services that provides
support to parents of children, birth to age 3, with disabilities
and developmental delays.
Ø EI develops and enhances parents’ capacity to support their
child’s development through Evidenced-Based Practices
(EBPs) such as coaching, modeling, and implementing learned
Study Design: AB single-subject study with baseline and intervention conditions Ø Coaching a parent on EBPs and building their capacity to use these
practices in play increased the parent’s use of EMT strategies.
Participants: parent and their 22-month-old child with identified developmental delays Ø The child’s use and initiation of gestures, single-words, and multi-
Setting: The child’s natural environment, family’s home words increased.
Coaching Sessions: Plan Parent Fidelity of Intervention
130

strategies. Baseline Intervention

•
120

Ø The focus of this single subject research study is promoting Joint Plan for visits and parent use between visits
110
• Coaching on strategies (serve & return)
language development through everyday play-interactions and 100

parent use of Enhanced Milieu Teaching (EMT) strategies • Practice strategies with support (teaching materials) Feedback Observe 90

• Reflective feedback
through serve-and-return play interactions. 80

Frequency
70
Independent variable (IV):
Research Question 60

• Prompting: Prompt with wait for the child's response 50

1. What are the effects of coaching a parent on EBPs and their • Child-led play: Join in play in the same manner as the child
40

Reflection Practice
30
ability to use these practices within their daily routines? • Labeling/commenting: verbally describe the child's action or item 20
2. What are the effects of parental use of EBPs on parent-child • Specific praise: comment positively on the desired behavior 10

play interactions (such as child-led play)? 0

B1-2/16/24 B2-2/21/24 B3-2/23/24 I1-2/29/24 I2-3/6/24 I3-3/20/24 I4 I5
Dependent variable (DV): Sessions

Composite Prompt Child-led Label/comment Feedback

Research Synthesis • Gestures: physical movement to communicate

• single-words: Single word matching the adult form 130
Child Communication

Authors Focus Results Social Validity • multi-words: Two or more words matching the adult form 120
Baseline Intervention

Hemmeter, M. Parents’ All children had an Parents reported high 110

L., & Kaiser, understanding increase in levels of satisfaction with 100

Data Collection Plan:
A. P. (1994) and use of targeted the intervention and with 90

enhanced milieu behaviors. changes in their Coding: 80

teaching. children.
➢ Frequency of child dependent variables (response or initiation)

Frequency
70

Authors Focus Results Social Validity 60

➢ Frequency of parent’s use of EMT strategies (IV) 50

Wright, C. A., Training parents High levels of Parent training may aid
& Kaiser, A. P. of children with fidelity were in teaching skills to 40

(2017) developmental achieved. All children with varied Baseline: recorded three, 10-minute videos of play interactions 30

delays to learn parents increased developmental needs. with parent and child 20

and implement their use of EMT Intervention: recorded 10-minute play interaction after each 10

EMT strategies. strategies. 0

coaching session B1-2/16/24 B2-2/21/24 B3-2/23/24 I1-2/29/24

Sessions
I2-3/6/24 I3-3/20/24 I4 I5

Authors Focus Results Social Validity Composite

Responding Word
Initation Gestures
Initation Multi-word
Responding Gestures
Responding Multi-word
Initation Word

Hatcher, A., & Parent- Immediate A training program using

Page, J (2020) implemented increase in EMT can increase
EMT training and accuracy for all parents’ use of
Teaching Materials
their use of strategies after the strategies with their child Discussion
strategies when introduction of the with language delay
the intervention is intervention. within play.
delivered to All children Ø The results align with prior research indicating that parental use
parents from low- showed an of EBPs in parent-child play increases a child’s communication
SES in a home- increase in and interactions in play.
based setting. communication.
Ø Parent reported an increase in the child’s use of single and
Authors Focus Results Social Validity multiple words.
Peterson P., Teaching EMT to Parents used the Parents in multiple-risk Ø Parent reported the child’s play is more interactive and his words
Carta J. J., parents in strategies learned families were able to are more engaging.
Greenwood C. multiple-risk during learn and use EMT and
(2005). families. intervention. The maintain some of them Ø Early Intervention Providers should feel confident using EMT
children had over time. when coaching families on communication strategies.
positive outcomes. The contents of this poster were developed under a grant from the US Department of
Education (DOE), #H325K120174. However, those contents do not necessarily represent the
policy of the US DOE, and you should not assume endorsement by the Federal Government.