Parents as “Speech Therapists”

By Lauren Lowry
Hanen Certified Speech-Language Pathologist

Traditionally, speech therapy with preschoolers involved parents bringing their child to a speech-language pathologist at a clinic. After an assessment, if the speech-language pathologist recommended it, the parent would bring the child for regular speech therapy. In this case, the sessions would be conducted by the speech-language pathologist, who would use specific techniques and strategies to improve the child’s communication. The parent would sit and watch the therapy, either in the room or behind a 2-way mirror. After the session, the parent would be given activities to practice with the child at home.

Changes to the Parent’s and Speech-Language Pathologist’s Role

Over the last several years, the roles of the speech-language pathologist and parent have changed a great deal. Parents are no longer observers of the therapy; they are an essential part of their child’s intervention. This shift in roles is based upon the following:

Children learn to communicate during everyday activities and conversations with the important people in their lives – mainly their parents
Parents have many more opportunities to interact with their child in meaningful everyday situations than a therapist does
Parents know their child best and are her/his first teacher

Parents are no longer observers of the therapy; they are an essential part of their child’s intervention.

Hanen Programs recognize parents as “key players” in their child’s intervention. The programs are designed to help parents learn how to promote their young child’s communication at home. Under the guidance of a Hanen Certified speech-language pathologist, parents learn to use specific language-building strategies with their child during everyday activities. These strategies both motivate the child to communicate and help him develop more mature communication skills. There is no structured teaching involved. “Therapy” happens whenever parent and child are together, and the child learns while communicating about all the things that are most interesting, familiar and important to him.

In this way, “speech therapy”:

is extended into every part of the child’s day
involves communication between child and parent, not child and therapist
involves play and daily activities (such as mealtime, bath time and bed time) that are familiar and meaningful to the child, instead of unfamiliar clinic-based activities
can happen on an ongoing basis in the child’s comfortable surroundings
is motivating and fun for the child!

When the speech-language pathologist teaches parents language strategies that parents then use whenever they are with their child, “therapy” becomes a natural part of the family’s interactions with their child. This is known as “parent-implemented intervention”.

But does this really work? Are parents able to:

make a difference in their child’s progress?
help their child as much as a speech-language pathologist can?

Many parents wonder about their ability to help their child. They might feel that a speech-language pathologist, who has specialized training, would be better able to teach their child. But this is not necessarily the case...

A review of studies on “Parent-Implemented Intervention”

A recent journal article by two researchers from Vanderbilt University, Megan Roberts and Ann Kaiser, reviewed 18 different studies which evaluated parent-implemented intervention offered to groups of parents. Eight out of these 18 studies were based on Hanen Programs. The remaining studies were on other programs in which parents were trained to promote their child’s communication.

How parents influence their child’s language development

The authors begin their article by citing research that shows that children’s communication improves when parents:

interact more with their child
respond to their child’s attempts to communicate
use “child-directed speech” (talk about what the child is focused on or interested in, using simplified, melodic speech)
emphasize important words in a sentence (e.g. “you’re eating a BANANA!”)
expand on what the child has said (e.g. Child says, “Key”. Parent says, “Yes that’s the key for the car.”

The Review of Studies on Parent-Implemented Intervention

Parent-implemented intervention is effective not only because the parent plays a key role, but because intervention becomes an ongoing process; every interaction with the child becomes an opportunity to build his or her language learning.

The authors explain that many studies have shown that parents can be taught how to promote their child’s communication, and that their children improve as a result. However, Robert and Kaiser wanted to look at all the studies together to see whether all parent-implemented intervention programs had the same or similar results. They also wanted to compare the results of several of these studies, ensuring that children with a wide variety of communication difficulties were represented, such as:

children with Language Impairment
children with Autism Spectrum Disorder
children with Developmental Delay

The children’s progress in the 18 studies included in the review was compared to the progress of children in a “control group”, who received:

no therapy; or
therapy delivered by a speech-language pathologist; or
other types of services in the community

What the Study Review Found

As a result of participating in parent-implemented training programs, parents successfully learned the strategies and used them when interacting with their child.
Parents had a positive effect on their child’s communication development. Parents’ use of strategies led to improvements in their child’s expressive skills (nonverbal communication as well as speech), understanding, vocabulary, grammar, and the frequency with which their child communicated.
Parents were just as effective at helping their child as speech-language pathologists were. In fact, parents were actually more effective than speech-language pathologists when working on improving the child’s understanding of language and grammar.
Children with a variety of language difficulties made good progress when their parents were trained to help them. This includes children with Language Impairment, Autism Spectrum Disorder, and Developmental Delay.

Bottom Line: Parents Make a Difference!

This study shows that children with a variety of communication difficulties make good progress when their parents learn to use specific techniques designed to improve the children’s communication skills. It also shows that trained parents are as effective - if not more effective in some cases - than speech-language pathologists at helping their child. This confirms that parents should be partners with speech-language pathologists in the therapy process.

Research shows that children with communication difficulties make the most progress when they receive early intervention. The best kind of early intervention involves the parents and is intensive. Parent-implemented intervention is effective not only because the parent plays a key role, but because intervention becomes an ongoing process; every interaction with the child becomes an opportunity to build his or her language learning. As Kaiser and Robert’s review shows, Hanen Programs and other programs that provide effective training to parents, can make a significant difference to a child’s language outcomes.

Note regarding ongoing speech therapy services: Parent-implemented intervention in these studies lasted on average 26 hours over many weeks. After the parent-implemented program ends, many children still require ongoing speech therapy. While the children show improvement in their communication skills, parents still need guidance from the speech-language pathologist as the child’s skills change and develop. The kind of intervention offered will vary; it may involve consultation to parents, direct therapy or offering parents a program to implement in the home.

References

Roberts, M., & Kaiser, A. (2011). The Effectiveness of Parent-Implemented Language Intervention: A Meta-Analysis. American Journal of Speech-Language Pathology, 20, 180-199.

For more than 35 years, The Hanen Centre has taken a leading role in the development of programs and resources for parents and professionals to help all preschool children develop the best possible language, social and literacy skills, including those children with or at risk of language delays and those with developmental challenges such as Autism Spectrum Disorder.