Coaching Caregivers of Children who are Deaf or Hard of Hearing.

This study explored the impact of a caregiver training intervention on caregivers' use of individually selected facilitative language techniques (FLTs) with their children (ranging from 14 to 27 months of age) who were deaf or hard of hearing. In addition, the study sought to identify real-time relationships between caregiver input and child output. Finally, the Language ENvironment Analysis (LENA) system was used to assess generalization of intervention gains to the natural environment. Intervention was delivered via a telehealth approach to train four caregivers to utilize a targeted FLT with their child. Pre-baseline LENA recordings guided selection of treatment targets, and post-intervention LENA recordings were used to assess generalization to the natural environment. All caregivers demonstrated increases in use of their targeted FLT in structured intervention sessions and maintained them 2-6 weeks after the conclusion of intervention. All children demonstrated an increase in their developmentally appropriate vocalizations in tandem with caregiver FLT increases. Results indicate that coaching can be used to increase caregiver responsiveness, changes which were found to carry over into the home environment.

The relationship of audibility and the development of canonical babbling in young children with hearing impairment.

This article investigated the relationship between age at onset of canonical babbling and audibility of amplified speech in children with hearing impairment. Thirteen children with severe-profound hearing impairment and two children with normal hearing participated in a longitudinal investigation of vocalization development. A nonconcurrent multiple baseline design was used to analyze vocalization recordings obtained during two phases (hearing aid [HA] and cochlear implant [CI]). Audibility during HA and CI use was calculated using the Speech Intelligibility Index (SII). Earlier ages of canonical babble onset were related to greater audibility of the speech signal during HA use. Children who developed canonical babble had an SII of .35 or greater. SII was a statistically significant predictor of age of onset of canonical babble. Results support the concept of an "essential" level of audibility for onset of canonical babble. Findings are discussed relative to their methodological and clinical implications regarding treatment decision making.

Evaluation of a pre-treatment assessment to select mand topographies for functional communication training.

Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which mand topographies to incorporate into FCT. In the current study, a mand topography assessment was conducted following functional analyses to identify the proficiency with which individuals used several different mand topographies. Two mand topographies (high and low proficiency) were then compared during FCT-based treatments. FCT was more effective when the mand topography identified as high proficiency was incorporated into FCT as compared to FCT that included the lower proficiency response. The results are discussed in terms of the need for individualized assessment procedures for selecting mand topographies that are targeted during FCT.