Human Development and Family Studies, Michigan State University, East Lansing.
Vanderbilt University, Nashville, TN.
Am J Speech Lang Pathol. 2021 May 18;30(3):1157-1169. doi: 10.1044/2021_AJSLP-20-00230. Epub 2021 May 4.
Purpose Family members are an integral support for children with complex communication needs (CCN). However, there is limited research exploring "whole family" intervention to support children with CCN, including evidence-based approaches such as aided language modeling and innovative delivery options such as telepractice. The purpose of this study was to explore whether the use of telepractice-based training and coaching is a valid means of delivering intervention to the whole family unit to implement aided language modeling. Method A 4-year-old child with CCN who uses a speech-generating device and her four family members participated in the study. A single-case multiple-probe design across the four dyads was used to determine the effect of the memory aid, namely, via telepractice intervention to teach family members to provide aided language modeling with fidelity during natural routines. Results We found that telepractice-based training and coaching increased family members' high-fidelity models and rate of modeling. The target child also showed an increase in independent communication and rate of augmentative and alternative communication use. Social validity interviews indicated that the participants found the intervention to be socially valid. Conclusions Given the findings of this study, speech-language pathologists should encourage the involvement of the whole family in augmentative and alternative communication interventions. Future research should examine the impact of training and coaching all family members together in their natural environment, explore specific adaptations for participants, and investigate the effects of intervention delivered by speech-language pathologists who work directly with families and utilize family-centered practices.
目的 家庭成员是有复杂沟通需求（CCN）儿童的重要支持。然而，目前针对支持有 CCN 儿童的“整个家庭”干预措施的研究有限，包括辅助语言建模等基于证据的方法和远程实践等创新的提供方式。本研究旨在探索基于远程实践的培训和指导是否是向整个家庭单元提供干预以实施辅助语言建模的有效手段。 方法 一名 4 岁的有 CCN 儿童使用言语生成设备，她的四位家庭成员参与了研究。使用跨四个对子的单个案例多个探针设计来确定记忆辅助工具的效果，即通过远程实践干预来教导家庭成员在自然常规中忠实地提供辅助语言建模。 结果 我们发现，基于远程实践的培训和指导提高了家庭成员的高保真模型和建模率。目标儿童的独立沟通和辅助沟通使用的比率也有所增加。社会有效性访谈表明，参与者认为干预措施具有社会有效性。 结论 鉴于这项研究的结果，言语语言病理学家应该鼓励整个家庭参与辅助和替代沟通干预。未来的研究应该考察在自然环境中一起培训和指导所有家庭成员的影响，探索针对参与者的具体调整，并研究由直接与家庭合作并利用以家庭为中心的实践的言语语言病理学家提供的干预措施的效果。
