Terry B. Hancock

Teaching Parents New Skills to Support Their Young Children's Development

Teaching parents new skills to support the development of their young children with developmental disabilities has been controversial in the field of early intervention even though there is considerable empirical evidence supporting this approach. We propose that teaching parents to implement family-centered interventions can be highly effective by: (a) allowing parents to choose when to learn new skills; (b) teaching parents strategies that are empirically based, well-matched to their childs developmental needs, and intended to be implemented in naturally occurring interactions between parents and children; and (c) teaching parents in a skillful and individualized manner. We outline the skills that parent educators need in order to be effective, then, we discuss a model for preparing professionals to teach parents. Throughout this article, we draw on empirical data and anecdotal examples from our ongoing research on teaching parents naturalistic language intervention strategies.

Parent-Reported Behavioral Problems and Language Delays in Boys and Girls Enrolled in Head Start Classrooms

Early emergent patterns of behavioral problems, social skill deficits, and language delays were examined in 259 three-year-old children enrolled in Head Start classrooms. The Child Behavior Checklist for Children Ages 2 to 3 (CBCL/2–3) and the Social Skills Rating System (SSRS, Pre-School Version) were completed by the childrens primary caregivers. Language skills were assessed using the Preschool Language Scale (PLS)-3 and the Peabody Picture Vocabulary Test (PPVT)-III. Findings indicated that this population is at elevated risk for behavioral and language problems. Approximately 25% of both boys and girls showed clinical/subclinical levels of internalizing problem behavior on the CBCL. More than 20% of boys scored in the clinical range for externalizing problems. Children with behavioral problems were more likely to have low language scores than were their peers without behavioral problems. Nearly half of the children scored in the category “lower than average” for social skills on the SSRS. Children with low social skills were more likely to have low language scores than were their peers with average social skills. The need to screen for early emergent behavioral problems, the potential contribution of poor language skills to childrens problem behavior, and implications for early intervention are discussed.

The Effects of Trainer-Implemented Enhanced Milieu Teaching on the Social Communication of Children with Autism

This study examined the effects of Enhanced Milieu Teaching on the social communication skills of preschool children with autism when delivered by trained interventionists. A modified single-subject design across four children was used to assess the childrens acquisition, maintenance, and generalized use of language targets and social communication skills as a result of the intervention. Observational data indicated that all children showed positive increases for specific target language use at the end of 24 intervention sessions, and these results were maintained through the 6 month follow-up observations. There was also evidence of positive changes in the complexity and diversity of language for children on observational measures. Three of the four children also generalized these positive language effects to interactions with their mothers at home, with the greatest changes seen immediately after the intervention. Parent satisfaction with the intervention procedures and child outcomes were high.

Teacher-Reported Behavior Problems and Language Delays in Boys and Girls Enrolled in Head Start.

Behavior problems, social skill deficits, and language delays were examined in 332 three-year-old children enrolled in Head Start. Teachers completed the Caregiver Teacher Report Form/2-5 (CTRF/2-5) and the Social Skills Rating System (SSRS, Pre-School Version). Language skills were assessed using the Preschool Language Scale (PLS-3) and the Peabody Picture Vocabulary Test (PPVT-III). Findings indicated that this population is at elevated risk for behavioral, social, and language problems. Boys showed elevated levels of behavior problems across all measures. Both boys and girls displayed low language scores, with boys significantly lower than girls on both auditory and expressive skills. Boys with behavior problems were more likely to have low language skills than were their male peers without behavior problems; this pattern was not as clearly defined for girls. Teacher years of experience, child gender, and PLS-3 scores were significant predictors of CTRF scores. The results of the study are discussed in terms of strategies for identifying children at highest risk for persistent problem behavior.

Parent and teacher agreement on child behavior checklist items in a sample of preschoolers from low-income and predominantly African American families.

In this study we examined parent and teacher agreement at the item level of the newly revised Child Behavior Checklist/1½–5 (CBCL/1½–5) and Caregiver–Teacher Report Form/1½–5 (CTRF/1½–5) in 505 preschool children from low-income and predominantly African American families. Parents generally rated more children as having problem behaviors than did teachers. Lack of agreement between parents and teachers at the item level was indicated by low correlation coefficients, kappa values, and co-identification of children with specific behavior problems. High levels of parent–teacher agreement were obtained only when rank orders of problem behaviors were compared. No significant sex effect was found on parent and teacher agreement at the item level. Problem behaviors most often indicated by parents and teachers reflected the roles and responsibilities of parents and teachers in the home and school settings. Our findings suggest informant and setting specificity of parent- and teacher-identified problem behaviors in young children.

Teaching Parents of Preschoolers at High Risk Strategies to Support Language and Positive Behavior

An AB single-subject design replicated across five participants was used to assess the effects of an intervention that taught parents to support their preschool childrens communication skills and manage their behavior. Children with language delays and emergent behavior problems and their parents from low-SES backgrounds participated. Parents attended 30 individual sessions and were taught to be responsive to their childrens communication and to provide contingent consequences for their childrens behavior. Generalization to interactions at home and maintenance of intervention efforts were assessed. Parents learned the strategies, generalized these strategies to interactions at home, and maintained positive changes 6 months after the intervention. Children showed positive changes in language and behavior during the intervention, but maintenance and generalization of these effects were more variable.

Parents as Cointerventionists: Research on Applications of Naturalistic Language Teaching Procedures

Cointervention is a process in which parents collaborate with professionals to implement an intervention with young children. This article describes the use of naturalistic language teaching procedures by parents as an example of cointervention. Research with parents of young children who have disabilities has shown that teaching parents strategies for supporting language and communication results in changes in child language skills, in parent interaction strategies, and in the quality of the parent-child relationship. Factors to be considered in choosing cointervention as an early intervention model are discussed.

Using Different Measures, Informants, and Clinical Cut-Off Points to Estimate Prevalence of Emotional or Behavioral Disorders in Preschoolers: Effects on Age, Gender, and Ethnicity

The early identification and remediation of emotional or behavior disorders are high priorities for early-childhood researchers and are based on the assumption that problems such as school failure can be averted with early screening, prevention, and intervention. Presently, prevalence, severity, and topography of mental health needs among low-income preschoolers and their families have not been well documented. Tools for screening and intervention for behavior problems in preschool children are few and many of those tools have not been studied within diverse Head Start systems. In this study, five instruments of symptoms and functional impairment, completed by teachers and two completed by parents, were obtained on a sample of 1,781 Head Start children from diverse racial and ethnic backgrounds from the Head Start Mental Health Research Consortium. Clinical cut-off scores were used to identify children who could be considered at relatively serious risk for emotional or behavioral disorders. At-risk classifications using clinical cut-offs at both 1.0 and 1.5 standard deviations for each measure were examined singly and in combination and then compared to the overall sample for age, gender, and ethnicity. Identification of children considered at risk ranged from a low of 1% to a high of 38%, with evidence of differential effects on age, gender, or ethnicity for some individual measures, but these tended to diminish when combinations of symptom and impairment measures were used. Implications for choosing instruments to establish eligibility for emotional or behavioral disorders in preschoolers are discussed.

Cumulative Risk and Low-Income Children's Language Development

This study utilized an electronic data linkage method to examine the effects of risk factors present at birth on language development in preschool. The Preschool Language Scale-3 (PLS-3) was administered to 853 low-income children, and cumulative risk data were abstracted from linked birth records. At least one risk factor was present in 94% of this sample, while 39% were exposed to three or more risk factors. On average, a girls PLS-3 Total Score decreased by 2.3 points with each risk factor; the average decrease for boys was 1.1 point per risk factor. The accumulation of multiple risk factors thus appears to increase the negative effects of poverty. Researchers are encouraged to use historical administrative data sets to support prevention and early identification efforts.

The Effects of Group Training and Individual Feedback on Parent Use of Milieu Teaching.

This study examined the effects of training five parents to use Milieu Teaching procedures with their preschool-aged children with disabilities. In a multiple baseline design across families, parents were trained in two conditions: group instruction with home feedback sessions and intensive home feedback sessions. Parents were trained to use seven environmental arrangement strategies and four Milieu Teaching procedures to facilitate their childrens acquisition of specific communication targets during eight sessions of group training. The results of the study showed modest levels of performance of the language teaching procedures during the group instruction condition although parents did not reach criterion performance levels during the condition. Intensive feedback and coaching was then implemented in the home which resulted in criterion level performance by most parents and in acquisition of the target skills by the children. These results suggest that parents can learn some basic Milieu Teaching skills in a short-term group instruction format, but intensive practice of these skills will be required before parents reach criterion levels of performance. Also, longer term implementation of the Milieu procedures was required before systematic changes in child learning of targets were observed for most children. Factors contributing to variability in parent and child performance are discussed.