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New Research Shows that More Than Words® Helps Both Parents and Children!

By Lauren Lowry
Hanen SLP & Clinical Writer
 

More Than Words® is The Hanen Centre’s foundational program for parents of young children who are on the autism spectrum or who have social communication difficulties. The program helps parents learn strategies to build their child’s social communication skills during fun, everyday interactions.

Since it was developed in 1999, More Than Words has been studied several times. Three studies were conducted between 2005-2011 (you can read about these in our parent or professional Research Summaries). Since then, two more studies have been published – one in Malaysia and one in Turkey. Let’s take a look at what each study showed.

Study 1: More Than Words® in Malaysia

Researchers in Malaysia studied 31 children on the autism spectrum who had been receiving regular therapy from a speech language pathologist (SLP). This type of therapy involves the SLP working directly with the child. This is different from the approach taken in More Than Words®, where the SLP helps the parents learn ways to encourage their child’s communication, and the parents are the main people providing the intervention.

Sixteen of the children and their families were enrolled in the More Than Words® Program, and the other 15 children were in a “control group” and continued to receive their usual speech therapy from their SLP. The researchers looked for any changes in the children’s communication and social skills after participating in the program. They also looked at the parents’ ability to use the strategies taught in More Than Words®, such as following the child’s lead and responding to their communication during motivating activities. These types of strategies (known as “responsive strategies”) have been shown to encourage children’s communication development [2,3].

Here’s what the researchers found:

Parents who participated in More Than Words®:
  • learned to be more responsive when interacting with their child – not only did parents learn to be more responsive during the program, but they continued to interact in this way with their child five months after the program ended
  • felt they benefitted from the program – they felt very satisfied with the program, that they benefitted from the home visits, discussions, and video recordings, and felt that More Than Words® positively affected their child’s progress
Parents who did not participate in More Than Words® (in the control group) did not become more responsive when interacting with their child.

Children who participated in More Than Words®:
  • improved more than children in the control group – they improved in many areas, including their understanding and use of language, their communication and social skills, and their use of words and gestures
Children in the control group did show some improvements in their social skills and in the number of words in their vocabulary, but they didn’t improve very much in their understanding or use of language or in their overall communication skills.

Because the children who participated in More Than Words® made greater improvements than the children who received regular speech therapy, the researchers concluded that intervention provided by parents is as good as, if not better than, intervention provided by a therapist [1].


Study 2: More Than Words® in Turkey

Like the study above, researchers in Turkey examined changes in parents and children after they participated in the More Than Words® program [4]. These researchers also wanted to know if the program helped parents feel less stress and anxiety, and whether they felt more confident in their ability to help their child after taking the program.

In this study, fourteen children on the autism spectrum and their parents participated in the More Than Words® program. The researchers noticed many changes in the parents and children after the program:
  • Parents felt much more confident in their ability to help their child
  • Parents’ stress and anxiety decreased
  • Parents learned to use the program strategies and they were more responsive when interacting with their children
  • Children improved in many areas –children improved in their understanding and use of language, their ability to pay attention and be involved in activities, to show emotion, and to start interactions.
  • Children’s skills continued to increase well after the program finished - children’s vocabularies increased during the program, and kept increasing even four weeks after the program finished
Before participating in More Than Words®, the children in this study received therapy either individually or in groups for at least 7 months, but their parents had not received any training. When the researchers compared the progress children made before starting More Than Words® with the progress they showed afterwards, they concluded that:
  • the children’s improvements must have been due to their parents using the More Than Words® strategies
  • teaching parents to help their child can result in faster improvements than are possible with intervention delivered by a therapist without any parent training [2].

 It is widely accepted that parents should be involved in their child’s intervention [5]. The goal of the More Than Words® program is not only to involve parents, but to put them in the “driver’s seat” of their child’s intervention. It provides parents with the skills and confidence they need to foster their child’s social communication development during everyday activities and conversations. In this way, children receive many opportunities throughout their day to communicate during activities that are motivating and fun. Research on the More Than Words® program continues to show that the program accomplishes these goals – it empowers parents to use strategies and builds their confidence, and this results in great progress for their children.


Are you an SLP interested in becoming certified to offer the More Than Words program to families?
Learn more here.


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References

  1. Sokmum, S., Joginder Singh, S. & Vandort, S. (2021). The Impact of Hanen More Than Words Programme on Parents of Children with ASD in Malaysia. Malaysian Journal of Health Sciences, 15(2) 2017: 43-51. doi: http://dx.doi.org./10.17576/JSKM-2017-1502-06
  2. Tamis-LeMonda, C. S., Bornstein, M. H. & Baumwell, L. (2001). Maternal responsiveness and children’s achievement of language milestones. Child Development, 73(3), 748-767.
  3. Masur, E. R., Flynn, V. & Eichorst, D. L. (2005). Maternal responsive and directive behaviours and utterances as predictors of children’s lexical development. Journal of Child Language, 32, 63-91.
  4. Noyan Erbaş, A., Özcebe, E., & Cak Esen, T. (2021). Investigation of the effect of Hanen's “More Than Words” on parental self-efficacy, emotional states, perceived social support, and on communication skills of children with ASD. Logopedics Phoniatrics Vocology, 46(1), 17-27, DOI: 10.1080/14015439.2020.1717601
  5. Zwaigenbaum, L. Bauman, M. L., Choueiri, R., Kasari, C., Carter, A., Granpeesheh, D., Mailloux, Z., Smith Roley, S., Wagner, S., Fein, D., Pierce, K., Buie, T., Davis, P. A., Newschaffer, C., Robins, D., Wetherby, A., Stone, W. L., Yirmiya, N., Estes, A., Hansen, R. L., McPartland, J. C., & Natowicz, M. R. (2015).