PARENT-CHILD INTERACTION THERAPY: A FAMILY BASED INTERVENTION FOR CHILDREN WITH HEARING LOSS

Elizabeth Adams, Ph.D.; Lori Day, Ph.D.; Nancy Mellon, M.S.; Meredith Ouellette, M.S.

The River School - Washington, DC

Parent Involvement in Intervention

¨  There is increasing evidence that interventions that facilitate parent engagement often result in improved development and outcomes

¨  Why is parent participation critical? ¤  Parents serve as primary language models ¤  Parents create learning environments ¤  Parent interaction is directly related to language development

Houston & Bradham, 2011

Parents and Language Development

¨  Maternal sensitivity predicted significant increases in language growth for children with cochlear implants ¤  Linguistic stimulation for the child is only related to language growth in

the context of maternal sensitivity

¤  Effects for maternal sensitivity and cognitive stimulation were similar to effects for age of implantation

¨  Quality of parent language is related to overall cognitive development

¨  Parental emotional availability and maternal responsiveness correlates with language learning and developmental play

Pressman et al., 1999; Spencer & Meadow-Orlans, 1996; Quittner et al., 2013

Parent-Child Interaction Therapy

¨  Parent Coaching Interventions should be executed systematically

¨  Effective Treatment – highest level of support for efficacy

¨  Parent-Child Interaction Therapy n  Originally developed for children with disruptive behavior

disorders and their families n  Modified for use with a range of populations

n  Children between the ages of 2 and 7

Eyberg, Nelson, & Boggs, 2008

Copyright 2006 Sheila Eyberg

Child-Directed Interaction

Parent-Directed Interaction

attention

Parent follow the child’s lead - Play therapy skills - Positive attention skills - Differential attention

- Language development Foundation/Attachment phase

Parent leads the child - Clear communication - Consistency - Reasoning skills

Discipline phase

Eyberg, Nelson, & Boggs, 2008; PCIT International

Coaching

PCIT – Modified for Language Intervention

¨  Modified PCIT – Parent Coaching for language intervention ¨  Parents are taught specific skills to utilize Indirect Language Stimulation:

¤  Facilitative language techniques n  Labeled Praise n  Reflections

n  Expansion n  Extension/Expatiation n  Buildups and Breakdowns n  Recast Sentences

n  Imitation n  Description (Parallel-talk)

n  Information Description (Self-talk) n  Enjoyment n  Practice PRIDE

Eyberg, Nelson, & Boggs, 2008; PCIT International

Child Directed Interaction

Praise Reflect Imitate Describe Enthusiasm/Enjoy

Give Commands Ask Questions Criticize

DO! DON’T

Eyberg, Nelson, & Boggs, 2008; PCIT International

Parent Skill Changes in River Pilot Study

¨  Participants: 8 River School Families

¨  Parent verbalizations coded at baseline and during treatment (DPICS).

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DO Skills Series1

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DON'T Skills

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Participant 6

Results from paired-samples t-tests, with a Bonferroni correction, revealed that there was a statistically significant increase in positive parenting skills (t(6)=7.713, p< .000), and a significant decrease in negative parenting skills (t(6)=4.889, p=.003).

Parent Changes by Skill

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Questions Commands Critical Comments

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Change in Child Behavior

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ECBI Pre-Post Data

Participant 1

Participant 2

Participant 3

Participant 4

Participant 5

Participant 6

Results from paired-samples t-tests, with a Bonferroni correction, revealed that there was a statistically significant improvement in child behavior (t(6) = 5.310, p = .002).

Thank you!

¨  Thank you for your attention! ¨  Special thanks to:

¤  The River School ¤  PCIT International

n  www.pcit.org

¨  For more information and training opportunities: ¤  Elizabeth Adams-Costa, Ph.D. – eadams@riverschool.net

References Cohen, N.J. (2001). Language impairment and psychopathology in infants, children, and adolescents. Thousand Oaks, CA: Sage.

Dunn, L.W., & Dunn, L.M. (1981). Peabody Picture Vocabulary Test- Revised (Forms L and M). Circle Pines, MN: American Guidance Service.

Eyberg, S.M. (1999) PCIT Manual. Available on-line at www.PCIT.org [see PCIT Information and Material].

Eyberg, S.M., & Boggs, S.R. (1989). Parent training for oppositional-defiant preschoolers. In C. E. Schaefer & J. M. Briesmeister (Eds.), Handbook of parent-training: Parents as co-therapists for children’s behavior problems (pp 105-132). New York: John Wiley & Sons.

Hart, B., & Risley, T.R. (1995). Meaningful differences in the everyday experience of young American children. Baltimore: Paul H. Brookes Publishing Co.

Houston, K.T. & Bradham, T.S. (2011). Parent engagement in audiologic habilitation: Increasing positive outcomes for children with hearing loss. The ASHA Leader; July 05.

Hubbell, R. (1981). Children’s language disorders: An integrate approach. Englewood Cliffs, NJ: Prentice-Hall.

Lacroix, V., Pomerleau, A., Malcuit, G., Seguin, R., & Lamarre, G. (2001). Cognitive and language development of children during the first three years of life with respect to maternal vocalizations and toys at home: Longitudinal study of a high-risk population. Canadian Journal of Behavioral Science, 33, 65-76.

References Paul, R. (2001). Language disorders from infancy through adolescence and assessment and intervention. St. Louis, MO: Mosby, Inc.

Pressman, L., Pipp-Siegal, S., Yoshinaga-Itano, C., and Deas, A. (1999). The relation of sensitivity to child expressive language gain in deaf and hard-of-hearing children whose caregivers are hearing. Journal of Deaf Studies and Deaf Education, 4: 294-304.

Quittner, A.L., Cruz, I., Barker, D.H., Tobey, E., Eisenberg, L.S., & John K. Niparko, J.K. (2013). Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years. The Journal of Pediatrics, 162(2), 343-348.

Spencer P.E., & Meadow-Orlans, K.P. (1996). Play, language and maternal responsiveness: a longitudinal study of deaf and hearing infants. Child Development, 67, 3176-3191.

Tempel, A.B., Wagner, S. M., & McNeil, C.B. (2008). Parent-Child Interaction Therapy and language facilitation: The role of parent-training on language development. Journal of Speech-Language Pathology & Applied Behavior Analysis, 3.2-3.3, 78-94.

Webster-Stratton, C., & Hammond, M. (1999). Marital conflict management skills, parenting style, and early-onset conduct problems: Processes and pathways. Journal of Child Psychology and Psychiatry, 40(6), 917-927.

Zaidman-Zait, A., & Most, T. (2005). Cochlear implants in children with hearing loss: Maternal expectations and impact on the family. Volta Review, 105, 129-150.