Developing Parents Plus: A Parent-Implemented Language Intervention for Preschool Children With Developmental Language Disorder

• In Event: Using Iterative Development to Design Equitable and Culturally Responsive Early Childhood Interventions

Abstract

Purpose. Developmental language disorder (DLD) is the most prevalent disability in preschoolers (Hussar et al., 2020). Children with DLD have significant deficits in comprehension and/or expression of language (Baron et al. 2018). Without intervention, children with DLD are at risk for sub-optimal school readiness skills, reading difficulties in school-age years, and adult underemployment (Dubois et al., 202; Hammer et al., 2017; Justice et al., 2015). When parents are trained to use evidence-based language strategies, children's language skills improve (Roberts et al., 2019). To provide a feasible way to educate parents, we iteratively developed and tested Parents Plus -- a fully online intervention delivered through an app and remote practice-based coaching. The session’s purpose is to describe the development phases and report Parents Plus’s social validity.

Theoretical Framework. We drew upon the social validity framework to iteratively develop Parents Plus. Social validity is critical when developing interventions to be used in natural settings. Researchers typically consider three elements: (a) intervention goals are important, (b) procedures and content are acceptable, and (c) outcomes are meaningful (Larson et al., 2020; Strain et al., 2012).

Method. Following recommended practices by social validity experts (Larson et al., 2020; Strain et al., 2012), we collected data: (a) on perspectives of the goals, content/procedures, and outcomes; (b) before, during, and after intervention use, and (c) through both qualitative and quantitative methods. In Step 1, we formed parent and professional advisory boards who guided initial development. In Steps 2 and 3, five and seven parent-child dyads participated in an abbreviated and full-length field test, respectively. In Step 4, we conducted a randomized-controlled trial (RCT) with 16 parents who completed Parents Plus. Participants were English-speaking parents with a preschool child with DLD who had no severe cognitive or sensory delays or significant phonological disorders.

Data Sources. For the advisory board phase, researchers took detailed notes during each meeting. For the field tests and RCT, we collected social validity data via (a) questions embedded into the app modules (field tests only), (b) questions asked during the weekly implementation meetings; and (c) an end-of-intervention survey.

Results. The initial advisory board phase resulted in four lessons that led to the refinement of the app modules: (a) be more explicit about the intervention goal; (b) present content with empathy; (c) add content on child’s behavior; and (d) create visual appeal. Results from the field trials and RCT are provided in Tables 1 and 2. In sum, parents’ perceptions of Parents Plus’s social validity were very positive. Parents were very satisfied with the content and procedures of the app and coaching experience and reported positive outcomes for their and their children’s learning. Revisions were made based on these findings, such as development of new app modules and exemplar videos, including a video library.

Scholarly Significance. It is imperative that researchers create programs that are socially valid. The iterative development of Parents Plus resulted in a feasible and useful program, which is promising for scaling the program to be used more widely.

Authors

• Brook Sawyer, Lehigh University

• Carol Scheffner Hammer, Teachers College, Columbia University

• Julie Smith, University of Virginia

• Julie Santoro, DeSales University