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Coaching Parents to Support Oral Language Skills during Shared Reading

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Title: Coaching Parents to Support Oral Language Skills during Shared Reading
Language: English
Authors: Jones, Jennifer Call (ORCID 0000-0002-8244-5104), McDonnell, Andrea P., Johnston, Susan S. (ORCID 0000-0003-1868-8969), Blue, Cheri Wild, Tolbert, Malynda
Source: Early Childhood Education Journal. Apr 2023 51(4):651-664.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 14
Publication Date: 2023
Document Type: Journal Articles
Reports - Research
Education Level: Adult Education
Descriptors: Reading Strategies, Program Effectiveness, Parent Education, Coaching (Performance), Program Implementation, Prompting, Oral Language, Language Skills
DOI: 10.1007/s10643-022-01327-0
ISSN: 1082-3301
1573-1707
Abstract: Dialogic reading is a shared reading intervention which has been shown to increase children's oral language skills. Although dialogic reading has been heavily researched and replicated with a variety of populations, this study uniquely focused on outcomes when parents of children with a developmental delay from low socioeconomic status homes were coached to implement dialogic reading with their child in their home. Using a multiple probe design across three parent-child dyads, researchers examined the effects of the modified dialogic reading intervention package on participating parents and their children. When provided with evidence-based training and coaching sessions, all parents were able to implement the intervention with fidelity and increased the number of open-ended prompts and expansions they used with their child during shared reading. Two of the three children's oral language skills appeared to improve throughout the course of the study preparing them for future success in their literacy development.
Abstractor: As Provided
Entry Date: 2023
Accession Number: EJ1369624
Database: ERIC
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  Value: <anid>AN0162357326;5mx01apr.23;2023Mar14.06:38;v2.2.500</anid> <title id="AN0162357326-1">Coaching Parents to Support Oral Language Skills During Shared Reading </title> <p>Dialogic reading is a shared reading intervention which has been shown to increase children's oral language skills. Although dialogic reading has been heavily researched and replicated with a variety of populations, this study uniquely focused on outcomes when parents of children with a developmental delay from low socioeconomic status homes were coached to implement dialogic reading with their child in their home. Using a multiple probe design across three parent–child dyads, researchers examined the effects of the modified dialogic reading intervention package on participating parents and their children. When provided with evidence-based training and coaching sessions, all parents were able to implement the intervention with fidelity and increased the number of open-ended prompts and expansions they used with their child during shared reading. Two of the three children's oral language skills appeared to improve throughout the course of the study preparing them for future success in their literacy development.</p> <p>Keywords: Dialogic reading; Coaching; Oral language; Shared reading; Parent-implemented interventions</p> <p>Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10643-022-01327-0.</p> <hd id="AN0162357326-2">Introduction</hd> <p>Reading proficiency has been identified as predictive of academic achievement throughout schooling years (Lonigan et al., [<reflink idref="bib20" id="ref1">20</reflink>]). Conversely, difficulty in learning to read has been associated with poor academic outcomes (Catts et al., [<reflink idref="bib7" id="ref2">7</reflink>]). Children with disabilities struggle with and are slower to develop emergent literacy skills than their same-age peers (Whitehurst & Lonigan, [<reflink idref="bib39" id="ref3">39</reflink>]). This is partially due to the challenges of participating in shared reading for children with disabilities, including the fact that it is a highly social, language-based activity (Justice & Kaderavek, [<reflink idref="bib15" id="ref4">15</reflink>]). Accountability measures are holding early childhood education programs to high academic standards, including explicitly teaching early literacy skills to prepare children to be successful in learning to read (U.S. Department of Health and Human Services, [<reflink idref="bib31" id="ref5">31</reflink>]). Poor literacy skills in elementary school can remain with children as they continue throughout school (Froiland et al., [<reflink idref="bib14" id="ref6">14</reflink>]). Emergent literacy skills, including oral language, are the building blocks to children's literacy development (Dickinson et al., [<reflink idref="bib10" id="ref7">10</reflink>]). Given the importance of these skills, it is critical that parents understand and can implement effective strategies for building oral language in their children, especially for those with developmental delays or disabilities.</p> <hd id="AN0162357326-3">Emergent Literacy</hd> <p>Emergent literacy skills are strong predictors of later success in learning to read (Whitehurst & Lonigan, [<reflink idref="bib39" id="ref8">39</reflink>]). The National Early Literacy Panel identified oral language as moderately correlated with at least one measure of later literacy outcomes (NELP, [<reflink idref="bib25" id="ref9">25</reflink>]). Dickinson ([<reflink idref="bib10" id="ref10">10</reflink>]) argued that this finding minimized the importance of oral language on reading as the direct and indirect effects of language development can be seen years after children learn to read and not only during the few years examined by the panel. Additional research supports the finding that oral language skills are predictive of reading comprehension later in life (Kendeou et al., [<reflink idref="bib17" id="ref11">17</reflink>]) and that preschool is a crucial time for children to develop oral language and vocabulary (Wasik & Iannone-Campbell, [<reflink idref="bib33" id="ref12">33</reflink>]). One way to measure children's oral language development is through their mean length of utterance (MLU), or "the average length of utterance based on a count of the number of individual morphemes in each utterance" (Williamson, [<reflink idref="bib40" id="ref13">40</reflink>], p. 1). On average, a typical preschool child speaks in six or more-word utterances (Williamson, [<reflink idref="bib40" id="ref14">40</reflink>]). Whitehurst and Lonigan ([<reflink idref="bib39" id="ref15">39</reflink>]) found that many children with disabilities struggled to develop oral language skills, including vocabulary. Children's vocabulary development is one element of oral language and has been shown to play a critical role in how well children learn to read (Whitehurst & Lonigan, [<reflink idref="bib39" id="ref16">39</reflink>]). Dialogic reading (DR) is an evidence-based practice shown to increase children's oral language skills and vocabulary by engaging them in conversation during shared reading through questions, expansions, and modeling (Whitehurst, [<reflink idref="bib37" id="ref17">37</reflink>]).</p> <hd id="AN0162357326-4">Dialogic Reading</hd> <p>The What Works Clearinghouse, a consortium of researchers established by the U.S. Department of Education's Institute of Education Sciences, has published two intervention reports on DR (WWC, [<reflink idref="bib35" id="ref18">35</reflink>], [<reflink idref="bib36" id="ref19">36</reflink>]). The mnemonic device PEER (<bold>p</bold>rompt a child to participate verbally, <bold>e</bold>valuate the accuracy of the child's response, <bold>e</bold>xpand on the child's utterance, <bold>r</bold>epeat the prompt), is used to teach adults the steps to follow in DR. The acronym CROWD is used to teach five types of prompts. For example, while reading the children's book <emph>Chicka Chicka Boom Boom</emph> (Martin, [<reflink idref="bib23" id="ref20">23</reflink>]), an adult could use one or more of the following prompts with a child: <bold>c</bold>ompletion (e.g., Chicka Chicka Boom _______), <bold>r</bold>ecall (e.g., What happened to the coconut tree?), <bold>o</bold>pen-ended (e.g., What do you see in the picture?), wh- (e.g., What is that?), and <bold>d</bold>istancing (e.g., Tell me a time when you climbed a tree.) (Whitehurst, [<reflink idref="bib37" id="ref21">37</reflink>]).</p> <p>Although DR was first researched in middle-class homes when implemented by mothers of children who were developing typically (Whitehurst et al., [<reflink idref="bib38" id="ref22">38</reflink>]), it has since been successfully implemented by teachers in child-care centers and early childhood classrooms (Lonigan & Whitehurst, [<reflink idref="bib21" id="ref23">21</reflink>]). Additionally, positive outcomes have been found with children from low-income homes (Valdez-Menchaca & Whitehurst, [<reflink idref="bib32" id="ref24">32</reflink>]), children at-risk for disabilities (Lonigan et al., [<reflink idref="bib20" id="ref25">20</reflink>]), children with mild to moderate language delays (Crain-Thoreson & Dale, [<reflink idref="bib9" id="ref26">9</reflink>]), and children with disabilities including autism spectrum disorder (Fleury & Schwartz, [<reflink idref="bib13" id="ref27">13</reflink>]), developmental delays, attention deficit hyperactivity disorder, and cleft palate (Rahn et al., [<reflink idref="bib29" id="ref28">29</reflink>]). DR has also been successfully modified based upon individual child needs. Specifically, Fleury and Schwartz ([<reflink idref="bib13" id="ref29">13</reflink>]) added a set of special prompts when working with children with autism spectrum disorder and found that regardless of the severity of the child's diagnosis, the modified dialogic intervention increased all nine of the children's verbal participation during reading sessions and knowledge of book-specific vocabulary. These findings add to the literature which suggests that a modified form of DR can be used to increase oral language skills in children with developmental delays or disabilities.</p> <hd id="AN0162357326-5">Coaching Models</hd> <p>Coaching models have been successfully used in early intervention to teach parents to implement interventions with their children including naturalistic and communication support strategies (Brown & Woods, [<reflink idref="bib2" id="ref30">2</reflink>]; Lane et al., [<reflink idref="bib18" id="ref31">18</reflink>]). These models are based on adult learning theories which posit that, "adults are self-directed, learn best when actively engaged in authentic contexts, and have opportunities for problem solving and reflection" (Brown & Woods, [<reflink idref="bib3" id="ref32">3</reflink>], p. 116). In examining the coaching process and triadic relationship between a parent, child, and interventionist, Brown and Woods ([<reflink idref="bib3" id="ref33">3</reflink>]) found that providing parents opportunities to practice while receiving feedback and guidance from an interventionist or having the interventionist step back and observe helped support parents in learning to implement an intervention. Several of these coaching practices including observation, practice, and feedback are discussed in <emph>The Early Childhood Coaching Handbook</emph> (Rush & Shelden, [<reflink idref="bib30" id="ref34">30</reflink>]) which served as the framework for this study.</p> <hd id="AN0162357326-6">Home Literacy Environment</hd> <p>Given that the home literacy environment plays a significant role in the development of emergent literacy skills and was found to be related to preschool children's oral language development (Burgess et al., [<reflink idref="bib4" id="ref35">4</reflink>]), coaching parents in the home environment is warranted. Children in low socioeconomic homes may have less access to materials and activities which target early literacy skills (Federal Interagency Forum on Child & Family Statistics, [<reflink idref="bib12" id="ref36">12</reflink>]) and often demonstrate below-average scores on measures of vocabulary (Burris et al., [<reflink idref="bib5" id="ref37">5</reflink>]). The unique challenges that can be associated with living in poverty including limited access to resources (Bradley & Corwyn, [<reflink idref="bib1" id="ref38">1</reflink>]) coupled with the stress of raising a child with a disability (Lindo et al., [<reflink idref="bib19" id="ref39">19</reflink>]) could make a parent-implemented intervention like DR seem overwhelming. Just as DR has been modified to meet the individual needs of children, it can be modified to meet the individual needs of adults implementing the intervention. The modified dialogic reading (MDR) intervention followed the four procedural steps of traditional DR explained earlier (prompt, evaluate, expand, repeat). However, rather than training parents to use all five prompts, this intervention focused on one type of prompt (open-ended prompts) because of their effectiveness in promoting language development (Meacham et al., [<reflink idref="bib24" id="ref40">24</reflink>]).</p> <hd id="AN0162357326-7">Research Questions</hd> <p>Several studies on DR or a modified DR intervention have included children from low socioeconomic status homes, and others have included children with disabilities. However, a study in which parents of children with a developmental delay from low socioeconomic status homes were coached at home to implement DR with their child could not be located in the literature at the time of this study. As such, this study uniquely focused on training and coaching parents who qualified for Head Start preschool based on income to implement the MDR intervention package with their child who had a developmental delay in their homes. Research questions included:</p> <p></p> <ulist> <item> After receiving training and coaching on the MDR intervention, do parents use more open-ended prompts (OEPs) and expansions (EXPs) during a shared reading session with their child than before receiving training and coaching?</item> <p></p> <item> Without receiving ongoing coaching, are parents able to maintain their use of OEPs and EXPs during a shared reading session with their child using familiar books?</item> <p></p> <item> Without receiving ongoing coaching, are parents able to generalize their use of OEPs and EXPs during a shared reading session with their child using unfamiliar books?</item> <p></p> <item> Does the MDR intervention package increase the oral language of preschool children during shared reading sessions?</item> <p></p> <item> After receiving training and coaching, with what degree of fidelity do parents implement the MDR intervention?</item> </ulist> <hd id="AN0162357326-8">Methods</hd> <p></p> <hd id="AN0162357326-9">Recruitment and Inclusion Criteria</hd> <p>Institutional review board approval was obtained through the first author's institution prior to recruiting participants. Researchers recruited parent–child dyads from Head Start preschool classrooms in the intermountain west. Preschool teachers were asked to identify children in their class who were (a) on an individualized education plan (IEP) and receiving special education services, (b) able to attend to a story (i.e. look at a book an adult is reading at least half of the time and stay in the general area) for at least 5 min, (c) able to follow one-step directions more than half of the time, and (d) able to speak in at least two-word phrases in English (excluding echolalia) and understand most of what an adult said to them. Parents were also asked to be able to read simple children's books in English. Six parent–child dyads were recruited to participate in the study, but only three dyads finished the intervention. One parent dropped out of the study shortly after the initial meeting. Another parent withdrew after the first baseline session due to medical and financial concerns unrelated to the study. A third parent was randomly selected from the six recruited dyads to receive training and intervention sessions last. Because she only completed two intervention sessions prior to the end of the study at the end of the school year, these data were excluded from the final analysis.</p> <hd id="AN0162357326-10">Parent and Child Participants</hd> <p>The three parent–child dyads who finished the intervention received trainings and intervention sessions in the following order (parent/child): Candace/Oakley, Mandy/Alison, and Maria/Gabriella (pseudonyms). All parent participants were the children's mothers. Candace had an associate degree and delivered packages. After the study began, she disclosed she was a student in special education throughout elementary and secondary school. Mandy had a GED and delivered newspapers. She was participating in drug court when the study began, in addition to attending beautician school full-time. Maria received a high school diploma and was a waitress. She was a single mom who worked full-time. All parents qualified for Head Start preschool programs based on their annual income. Child participants were female (as all eligible parents happened to have a female preschool-aged child), ranged from ages 4–5, had an eligibility classification of development delay and attended inclusive Head Start preschools. English was the home language of all participating children. English and Spanish were spoken in Maria's home, but she spoke English while implementing the intervention. Table 1 contains additional information about parent–child dyads including demographics and IEP information.</p> <p>Table 1 Demographic information of parent–child dyads</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Parent name</p></th><th align="left"><p>Parent age</p></th><th align="left"><p>Parent home language</p></th><th align="left"><p>Highest education level</p></th><th align="left"><p>Occupation</p></th><th align="left"><p>Child name</p></th><th align="left"><p>Child age</p></th><th align="left"><p>Preschool time (weekly)</p></th><th align="left"><p>IEP service time (weekly)</p></th><th align="left"><p>IEP goals</p></th></tr></thead><tbody><tr><td align="left"><p>Candace</p></td><td align="left"><p>30</p></td><td align="left"><p>English</p></td><td align="left"><p>Associate degree</p></td><td align="left"><p>Package deliverer</p></td><td align="left"><p>Oakley</p></td><td align="left"><p>5</p></td><td align="left"><p>4 days, 3 hours a day</p></td><td align="left"><p>10 min. academic/cognitive</p><p>5 min. personal/social</p><p>20 min. speech/language</p></td><td align="left"><p>Participate in activity (5 min.)</p><p>Take turns with peers</p><p>Understand verbal concepts</p><p>Follow two-step directions</p><p>Repeat 5-word sentence</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>40</p></td><td align="left"><p>English</p></td><td align="left"><p>GED</p></td><td align="left"><p>Newspaper carrier</p></td><td align="left"><p>Alison</p></td><td align="left"><p>5</p></td><td align="left"><p>4 days, 7 hours a day</p></td><td align="left"><p>40 min. academic/cognitive</p><p>20 min. behavioral support</p><p>20 min. speech/language</p></td><td align="left"><p>Point to 10 letters</p><p>Identify 8 shapes</p><p>Follow two-step directions</p><p>Verbal language 10 times a day</p><p>Use pronoun "I"</p><p>Use 100 basic concept words</p><p>2 conversational exchanges</p><p>Use final consonants</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>35</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>High school diploma</p></td><td align="left"><p>Waitress</p></td><td align="left"><p>Gabriella</p></td><td align="left"><p>4</p></td><td align="left"><p>4 days, 8 hours a day</p></td><td align="left"><p>40 min. academic/cognitive</p><p>20 min. language skills</p><p>100 min. speech/language</p></td><td align="left"><p>Name 8 body parts</p><p>Identify 10 colors</p><p>Attend at group time (5 min)</p><p>Follow preschool routines</p><p>Answer yes/no questions</p><p>Label 20/30 nouns, 15/30 verbs</p><p>Follow one-step directions</p></td></tr></tbody></table> </ephtml> </p> <hd id="AN0162357326-11">Setting and Materials</hd> <p>All training, coaching, and shared reading sessions took place in the home in a space identified by parents as relatively free from distractions where they could comfortably read with their child. If siblings were present during training and coaching sessions, a member of the research team entertained them with books, puppets, puzzles, games, or an iPad. The first author selected 10 books from Classroom Kit A of Read Together, Talk Together (Pearson Early Learning, [<reflink idref="bib28" id="ref41">28</reflink>]). Read Together, Talk Together are book sets compiled to help teachers and parents implement DR with children ages 2–5. Books in Read Together, Talk Together have a similar number of words per page and number of pages per book. Four nonfiction titles were eliminated as DR may lend itself more easily to books with a story (e.g., fiction). The 10 selected books were randomly divided into Set A (six books) and Set B (four books) to measure if parents maintained their use of OEPs and EXPs using familiar books (Set A) and generalized these skills using unfamiliar books (Set B).</p> <hd id="AN0162357326-12">Dependent Variable</hd> <p>The dependent variable (DV) was the combined number of OEPs and EXPs parents used with their child during a shared reading session (Table 2). Researchers defined a shared reading session as the time it took parents to read two books with their child. All data on the DV were collected and coded independently by research team members as they reviewed video recordings of shared reading sessions.</p> <p>Table 2 Operational definitions of dependent variable</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Dependent variable</p></th><th align="left"><p>Definition</p></th><th align="left"><p>Examples</p></th><th align="left"><p>Nonexamples</p></th></tr></thead><tbody><tr><td align="left"><p>Open-ended prompt (OEP)</p></td><td align="left"><p>Adult reader encourages the child to describe what is happening in the picture. These prompts may have multiple correct answers (Fleury & Schwartz, <xref ref-type="bibr" rid="bibr13">2017</xref>; Pearson, <xref ref-type="bibr" rid="bibr28">2002</xref>; Whalon et al., <xref ref-type="bibr" rid="bibr34">2013</xref>)</p></td><td align="left"><p>What do you think is happening?</p><p>What do you see?</p><p>What is the dog doing?</p><p>What happened?</p></td><td align="left"><p>Is he happy?</p><p>Why do you think that happened?</p><p>What's this?</p><p>Tell me what this is</p></td></tr><tr><td align="left"><p>Expansions (EXP)</p></td><td align="left"><p>Adult reader expands on child's response by (1) mentioning part of the child's original response and (2) adding new information (Pearson, <xref ref-type="bibr" rid="bibr28">2002</xref>; Whalon et al., <xref ref-type="bibr" rid="bibr34">2013</xref>)</p></td><td align="left"><p>Child: <italic>Sad</italic></p><p>Parent: <italic>Yeah, Peter feels sad</italic></p><p>Child: <italic>Falled down</italic></p><p>Parent: <italic>Peter fell down</italic></p><p>Child: <italic>No</italic></p><p>Parent: <italic>No, the dog was scratching his back on the floor</italic></p></td><td align="left"><p>Child: <italic>Sad</italic></p><p>Parent: <italic>Yeah, Peter is crying</italic></p><p>Child: <italic>Falled down</italic></p><p>Parent: <italic>Peter slipped on the ice</italic></p><p>Child: <italic>No</italic></p><p>Parent: <italic>No, I think you're right</italic></p></td></tr></tbody></table> </ephtml> </p> <hd id="AN0162357326-13">Child Variables</hd> <p>In addition to parent outcomes, this study also examined the effects of the MDR intervention package on the oral language development of participating children by examining their number of utterances, rate of utterances per minute, mean length of utterances using morphemes, and number of different words used during shared reading sessions. This process included transcribing 30% of randomly selected video recordings of shared reading sessions and calculating these measures across all study phases and participants.</p> <hd id="AN0162357326-14">Independent Variables</hd> <p>The independent variables were three trainings and five coaching sessions per parent–child dyad with the first author who acted as the coach. The Parent Implemented Modified Dialogic Reading Intervention Training and Coaching Manual (Call, [<reflink idref="bib6" id="ref42">6</reflink>]) is included in supplemental materials. Each training session lasted approximately 45 minutes and coaching sessions lasted approximately 30 minutes.</p> <p> <emph>The Early Childhood Coaching Handbook</emph> (Rush & Shelden, [<reflink idref="bib30" id="ref43">30</reflink>]) outlines the coaching model which served as the framework for coaching sessions in this study. Rush and Shelden ([<reflink idref="bib30" id="ref44">30</reflink>]) discussed five research-based coaching practice characteristics: (<reflink idref="bib1" id="ref45">1</reflink>) joint planning (<reflink idref="bib2" id="ref46">2</reflink>) observation (<reflink idref="bib3" id="ref47">3</reflink>) action/practice (<reflink idref="bib4" id="ref48">4</reflink>) reflection; and (<reflink idref="bib5" id="ref49">5</reflink>) feedback. Joint planning is when a coach and learner agree about action items for the learner to practice between coaching sessions. Throughout study implementation, this occurred during coaching sessions as parents thought of an action item and the coach wrote it on the <emph>Coaching Plan</emph> (Rush & Shelden, [<reflink idref="bib30" id="ref50">30</reflink>], p. 77, used with permission). Observation occurred each time a parent watched the coach model steps of the intervention and each time the coach observed a parent do the intervention. Parents had multiple opportunities to practice the intervention during trainings and coaching sessions. Each week during coaching sessions, parents reflected by talking about how the action item they decided upon the previous week went as well as any changes they thought needed to be made. Finally, providing feedback to a learner with the purpose of improving understanding or skills is a vital part of any coaching model. This occurred as the coach reinforced parents during training and coaching sessions by pointing out what was working well in addition to areas for improvement. These coaching practice characteristics have been used in previous research studies but are sometimes referred to by a different term (Brown & Woods, [<reflink idref="bib2" id="ref51">2</reflink>]; Lane et al., [<reflink idref="bib18" id="ref52">18</reflink>]).</p> <hd id="AN0162357326-15">Social Validity</hd> <p>Kazdin ([<reflink idref="bib16" id="ref53">16</reflink>]) defined social validity as "changes in behavior that are clinically significant or actually make a difference in the client's life" (p. 427). To determine whether the goals of the study were socially valid, parents answered questions about shared reading on an initial paper and pencil questionnaire before the study began (Table 3). The questionnaire contained eight questions about shared reading behaviors at home. After each parent had implemented the intervention for several weeks, a research team member interviewed them. The interviews were audio recorded for transcription purposes, lasted approximately 5 minutes, and contained seven questions about what feedback, suggestions, and concerns parents had about the intervention and any changes they had seen in their child or themselves since starting the intervention. Near the end of the study, parents completed a final paper and pencil questionnaire to measure whether they considered the intervention valuable (see supplemental materials).</p> <p>Table 3 Parent responses on initial questionnaire (IQ) and final questionnaire (FQ)</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Question</p></th><th align="left"><p>Participant</p></th><th align="left"><p>IQ</p></th><th align="left"><p>FQ</p></th></tr></thead><tbody><tr><td align="left" rowspan="3"><p>How many times a week do you read to your child at home?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>5–6</p></td><td align="left"><p>5–6</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>1–2</p></td><td align="left"><p>5–6</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>1–2</p></td><td align="left"><p>1–2</p></td></tr><tr><td align="left" rowspan="3"><p>How many times a week does your child ask you to read to them at home?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>7 + </p></td><td align="left"><p>7 + </p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>3–4</p></td><td align="left"><p>3–4</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>0</p></td><td align="left"><p>1–2</p></td></tr><tr><td align="left" rowspan="3"><p>How many times a week does your child look at books him/herself?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>7 + </p></td><td align="left"><p>7 + </p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>3–4</p></td><td align="left"><p>3–4</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>1–2</p></td><td align="left"><p>1–2</p></td></tr><tr><td align="left" rowspan="3"><p>How much do you enjoy reading to your child at home?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>Don't enjoy it</p></td><td align="left"><p>Really enjoy it</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>Enjoy it</p></td><td align="left"><p>Enjoy it</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>Enjoy it</p></td><td align="left"><p>Really enjoy it</p></td></tr><tr><td align="left" rowspan="3"><p>How much does your child enjoy being read to at home?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>Really enjoy it</p></td><td align="left"><p>Really enjoy it</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>Really enjoy it</p></td><td align="left"><p>Really enjoy it</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>Enjoy it</p></td><td align="left"><p>Really enjoy it</p></td></tr><tr><td align="left" rowspan="3"><p>When you read to your child, how often do they ask you questions or make comments?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>Sometimes</p></td><td align="left"><p>All the time</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>Sometimes</p></td><td align="left"><p>Often</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>Not often</p></td><td align="left"><p>Often</p></td></tr><tr><td align="left" rowspan="3"><p>When you read to your child, how long do they stay interested in the book?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>7+ min</p></td><td align="left"><p>7+ min</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>5–6 min</p></td><td align="left"><p>5–6 min</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>1–2 min</p></td><td align="left"><p>7 + min</p></td></tr><tr><td align="left" rowspan="3"><p>How important is it to read to your child at home?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>Very important</p></td><td align="left"><p>Very important</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>Very important</p></td><td align="left"><p>Very important</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>Very important</p></td><td align="left"><p>Very important</p></td></tr><tr><td align="left" rowspan="3"><p>After completing the study, how useful was the modified dialogic reading intervention?</p></td><td align="left"><p>Candace</p></td><td align="left"><p>NA<sup>a</sup></p></td><td align="left"><p>Very useful</p></td></tr><tr><td align="left"><p>Mandy</p></td><td align="left"><p>NA<sup>a</sup></p></td><td align="left"><p>Very useful</p></td></tr><tr><td align="left"><p>Maria</p></td><td align="left"><p>NA<sup>a</sup></p></td><td align="left"><p>Very useful</p></td></tr></tbody></table> </ephtml> </p> <p> <sups>a</sups>The final question was not asked on the initial questionnaire</p> <hd id="AN0162357326-16">Design</hd> <p>The theoretical framework for the study design was a variation of the multiple baseline design known as a multiple probe design across participants (O'Neill et al., [<reflink idref="bib26" id="ref54">26</reflink>]). A multiple probe design is well-suited for a skill or behavior that is unlikely to change without intervention and may be challenging to unlearn (O'Neill et al., [<reflink idref="bib26" id="ref55">26</reflink>]). There were four sequential phases including baseline, intervention phase 1, intervention phase 2, and maintenance/generalization. The training period took place between baseline and intervention phases. Data on the DV was not taken during the training period.</p> <hd id="AN0162357326-17">Procedures</hd> <p></p> <hd id="AN0162357326-18">Baseline</hd> <p>During baseline, parents were asked to read to their child "like you normally would." The child selected two books from Set A. Parents read both books with their child one time and returned the books to the research team. In the second session, children selected two books from the remaining four books in Set A (excluding the two selected the previous session). Again, parents were asked to read each of the books with their child one time and returned the books to the team. In the third session, parents read the two remaining books in Set A with their child. In the case of a fourth baseline session, children were presented with the full set of six books in Set A and asked to select two books. A researcher video recorded baseline sessions and two research team members independently coded recordings to determine the combined number of OEPs and EXPs parents used each session. As data stabilized across three consecutive probes, the first parent moved into the training period and a probe of the DV was taken for remaining parents in the baseline phase.</p> <hd id="AN0162357326-19">Training Period</hd> <p>At the beginning of the first training, the child was asked to select two books from Set A. The child was then given an iPad with educational games or other toys to play with during the training. The coach introduced parents to DR with a video (shown on a laptop) of a parent modeling each step of the PEER sequence (prompt, evaluate, expand, repeat) and explained the purpose of DR. Next, parents were given a handout (see supplemental materials) that went over each PEER step in the sequence. The coach taught parents how to ask OEPs within the context of shared reading. Parents came up with examples of OEPs and wrote them down on post-it notes which they placed in the two books from Set A to remind them to ask OEPs. They practiced reading one of the books to their child while asking the OEPs written on post-it notes as the coach gave them feedback.</p> <p>In the second training session, the child selected two books from the remaining four books in Set A. The child was given an iPad with educational games or other toys to keep them occupied. During this training, parents learned about the second and third steps of the PEER sequence. Parents wrote down new examples of OEPs on post-it notes specific to the content of the two new books. Next, they watched video examples of parents expanding on a child's utterance. After watching several video examples, parents practiced with their child by asking the new OEPs they wrote on post-it notes and expanding on their child's utterance while receiving feedback from the coach.</p> <p>The third and final training taught parents the final step of the PEER sequence. Parents began by writing new OEPs on post-it notes and placing them throughout the last two books in Set A. Parents watched video examples of the entire PEER sequence and practiced implementing all the steps while receiving feedback from the coach. After completing three training sessions, each parent started intervention phase 1 which included weekly coaching sessions in the home with the coach. Once a parent met the pre-established criterion of 75% fidelity for 2 consecutive weeks as measured by the intervention fidelity checklist (see supplemental materials), the next parent in baseline began the training period conditional upon stable data.</p> <hd id="AN0162357326-20">Coaching Sessions</hd> <p>Parents began participating in coaching sessions in intervention phase 1. Just before the coaching session began, parents read two child-selected books from Set A with their child for data collection of the DV. The child was then given an iPad with educational games or other toys. Each coaching session started with an activity-focused question that would draw parents' attention to a goal they had set for themselves (e.g., <emph>Last week you decided to ask your child what she saw in the pictures. How did that go?</emph>). During the first coaching session, this item was omitted as parents had not yet come up with a goal. The coach then followed up on action items agreed upon in the previous coaching session. During the next portion of the coaching session, the coach observed parents implementing the MDR intervention with their child. Data on the DV was not collected during this portion of the coaching session. Following a period of observation, the coach shared feedback with parents and asked a reflection question (Rush & Shelden, [<reflink idref="bib30" id="ref56">30</reflink>]). Parents reflected on how the intervention went as the coach took notes on the <emph>Coaching Plan</emph> (Rush & Shelden, [<reflink idref="bib30" id="ref57">30</reflink>], p. 77). The coach asked parents what goal they would like to work on the upcoming week. The coach took a picture of the <emph>Coaching Plan</emph> and left the original copy with parents.</p> <hd id="AN0162357326-21">Intervention Phase 1</hd> <p>Parents were asked to implement the intervention 5 days a week with their child using the two child-selected books from Set A which were left at the home. Throughout intervention phase 1, parents were asked to leave post-it notes in the books with examples of OEPs they had written during each training session. During the second coaching session, the coach presented the child with the four remaining books in Set A (not including the two books selected by the child the first session) and asked them to select two different books to keep at home. The coach exchanged these books with those read the previous week. Parents were instructed to read the two books as they practiced the intervention that week leaving the post-it notes in the books. The third coaching session, the coach brought the last two books in Set A and presented them to the child in exchange for the two books read the previous week. Once again, parents were asked to leave the post-it notes in as they read.</p> <hd id="AN0162357326-22">Intervention Phase 2</hd> <p>Once a parent met the pre-established criterion of implementing the intervention with 75% fidelity for 2 consecutive weeks, they transitioned to intervention phase 2. Parents were asked to continue implementing the MDR intervention 5 days a week. Data collection continued via weekly shared reading sessions followed by a coaching session. Post-it notes were removed from all books to see if parents were able to keep using OEPs and EXPs without those visual supports. In addition, parents were given the entire set of six books in Set A to keep at their home to maintain their child's interest in shared reading by allowing the child to choose which two books they wanted to read each session. By this point, children had been exposed to all six books in Set A.</p> <hd id="AN0162357326-23">Maintenance and Generalization</hd> <p>Once a parent met the pre-established criterion in intervention phase 2, they moved into the maintenance/generalization phase. Coaching sessions ended and parents were asked to continue implementing the MDR intervention with their child 5 days a week. The purpose of this phase was to determine if parents would maintain their use of OEPs and EXPs during a shared reading session using familiar books (Set A) and generalize these skills using unfamiliar books (Set B). The research team continued a weekly video recording for data collection.</p> <hd id="AN0162357326-24">Interobserver Agreement and Treatment Integrity</hd> <p></p> <hd id="AN0162357326-25">Dependent Variable</hd> <p>Interobserver agreement between research team members on the combined number of OEPs and EXPs parents used during a shared reading session was assessed for at least 25% of randomly selected sessions across all study phases and participants using a frequency-ratio agreement (O'Neill et al., [<reflink idref="bib26" id="ref58">26</reflink>]). Two observers independently reviewed video-recorded sessions while coding for the DV. Before the study began, the research team met four times to learn about operational definitions of the DV (Table 2) and practiced coding videos. Between each meeting, team members independently coded videos. Disagreements were discussed at subsequent meetings. After the final meeting, interobserver agreement between the first author and team members was an average of 93%.</p> <hd id="AN0162357326-26">Child Variables</hd> <p>Interobserver agreement between the first author and a research team member was assessed on children's oral language development as measured by their MLU using morphemes for 30% of shared reading sessions across all study phases and participants using a frequency-ratio agreement (O'Neill et al., [<reflink idref="bib26" id="ref59">26</reflink>]). Experts recommend a minimum of 50 intelligible utterances to reliably calculate MLU (Williamson, [<reflink idref="bib40" id="ref60">40</reflink>]). For the purposes of this study, during reading sessions when a child used 30 or fewer intelligible utterances, MLU was not calculated. Interobserver agreement was calculated on the child's number of utterances for these sessions.</p> <hd id="AN0162357326-27">Parent Intervention Fidelity</hd> <p>To determine whether parents implemented the MDR intervention as they had been trained, two researchers independently completed an intervention fidelity checklist (see supplemental materials). The checklist assessed if parents completed each step of the PEER sequence over the first six trials of a shared reading session. When parent implementation fell below 75%, the coach reviewed each step of the PEER sequence during the next coaching session and provided additional support through modeling and specific feedback. A second researcher independently completed the intervention fidelity checklist for 33% of randomly selected reading sessions across all study phases (excluding baseline) with all participants using a frequency-ratio agreement (O'Neill et al., [<reflink idref="bib26" id="ref61">26</reflink>]).</p> <hd id="AN0162357326-28">Coaching Implementation Fidelity</hd> <p>To determine the fidelity with which the coach offered training and coaching sessions, two research team members, excluding the coach, completed implementation fidelity checklists (see supplemental materials) for each training and coaching session by independently reviewing video recordings. The training session checklist included 14 items divided into three categories: coach introduces new step/s of PEER sequence, coach models new step/s, parent practices new step/s with child. The coaching session checklist contained 14 items divided into sections related to: activity-focused question and follow up, observation and reflection on action, and joint planning. The first author assessed interobserver agreement between the two research team members for 100% of training sessions and 30% of randomly selected coaching sessions.</p> <hd id="AN0162357326-29">Data Analysis</hd> <p>Researchers plotted the DV on a multiple baseline graph and visually analyzed the level, trend, and variability of data within and across each study phase to interpret the results (O'Neill et al., [<reflink idref="bib26" id="ref62">26</reflink>]). Effect sizes were calculated using nonoverlap of all pairs (Parker & Vannest, [<reflink idref="bib27" id="ref63">27</reflink>]). Social validity data from closed-ended questions on the initial questionnaire were compared to responses on the final questionnaire (Table 3). Interview questions were transcribed and analyzed for common themes to determine the appropriateness of the intervention procedures. Results from the intervention fidelity checklist were analyzed by computing the total average percent of parent intervention fidelity for each parent. Likewise, the total average percent of coaching implementation fidelity was calculated.</p> <hd id="AN0162357326-30">Results</hd> <p>This study examined the impact of the MDR intervention implemented by parents from low socioeconomic status homes on their use of OEPs and EXPs within the context of shared reading. It also measured parents' ability to maintain and generalize these skills without coaching using familiar and unfamiliar books as well as the potential impact of the intervention on the oral language development of children during shared reading. Parents' intervention fidelity was also measured.</p> <hd id="AN0162357326-31">Parent Participant Outcomes</hd> <p>Although OEPs and EXPs were analyzed and graphed together (Fig. 1), they were also graphed separately and are included in supplemental materials (Figs. 13, 14). Data were relatively stable in baseline across all parents and data were stable before transitioning to intervention phase 1. All parents showed an immediate increase in their use of OEPs and EXPs when they transitioned to intervention. During intervention phase 2 when visual reminders (post-it notes) were removed from books, parents continued using OEPs and EXPs well above baseline levels. Two parents maintained their use of OEPs and EXPs with familiar (Set A) and unfamiliar (Set B) books during maintenance/generalization.</p> <p>Graph: Fig. 1 Parental use of OEPs and EXPs during shared reading sessions</p> <p>During baseline, Candace did not use any OEPs or EXPs during shared reading sessions. When she transitioned to intervention phase 1, the level immediately increased to 17 OEPs and EXPs. She maintained her use of OEPs and EXPs and showed stable data throughout both intervention phases (mean = 17.4; range = 16–19). Candace was sick for an extended period between the first and second sessions in intervention phase 2. Despite her illness, Candace demonstrated higher frequencies of OEPs during maintenance/generalization than during either of the intervention phases. She was also able to generalize her use of OEPs using Set B books (Fig. 13, supplemental materials). She maintained her use of EXPs with Set A books during maintenance and generalized the skill using Set B books (Fig. 14, supplemental materials). Candace had an effect size of 1 using nonoverlap of all pairs (Parker & Vannest, [<reflink idref="bib27" id="ref64">27</reflink>]) indicating no overlapping data points between baseline and intervention phases.</p> <p>Mandy demonstrated variable use of OEPs and EXPs during baseline (mean = 6.75; range = 4–11) with a decreasing trend in her use of OEPs and EXPs over the first three sessions. Baseline data were stable before Mandy transitioned to intervention phase 1. Her level increased immediately during the first intervention session to 29 OEPs and EXPs and further increased to 50 in the second session. The first author coached Mandy to use fewer OEPs and EXPs during shared reading sessions as 50 seemed excessive for one session. Mandy incorporated this feedback as reflected by a decreasing trend just before intervention phase 2. Across both intervention phases, Mandy used an average of 37.4 OEPs and EXPs per reading session with a range of 29–50. She demonstrated the ability to both maintain and generalize her use of OEPs and EXPs, as shown in her maintenance and generalization probes. Mandy's effect size was also 1 using nonoverlap of all pairs (Parker & Vannest, [<reflink idref="bib27" id="ref65">27</reflink>]).</p> <p>Maria had the highest frequency of OEPs and EXPs in baseline with an average of 9.4 per reading session (range = 5–12). Her data showed an increasing trend across the first four data points of baseline but were stable before she transitioned to intervention phase 1. She showed an immediate increase in level, jumping to 37 OEPs and EXPs in the first intervention session. Maria maintained her use of OEPs and EXPs throughout both intervention phases and had relatively stable data (mean = 40.4; range = 37–44). She was also able to generalize her use of OEPs with Set B books (Fig. 13, supplemental materials). Her use of EXPs dropped during maintenance/generalization to an average of 13.5 per session compared to the average of 24 per session during the intervention phases. Similarly, when given Set B books for the generalization probe, her use of EXPs decreased to 16 (Fig. 14, supplemental materials). While still well above her average of 5.4 EXPs per reading session in baseline, this was lower than her average of 13.5 per session during the intervention phases. Maria had an effect size of 1 using nonoverlap of all pairs (Parker & Vannest, [<reflink idref="bib27" id="ref66">27</reflink>]).</p> <hd id="AN0162357326-32">Child Participant Outcomes</hd> <p>Researchers also examined the oral language of participating children (Table 4). The purpose of assessing child participant outcomes was to see if children made progress on oral language measures during the study, not to establish a causal relationship between the intervention and child outcomes. Oakley showed increases in her number of utterances, rate of utterances per minute, and number of different words used per reading session from baseline to maintenance/generalization. Alison showed decreases in her number of utterances, rate of utterances per minute, and the number of different words used from baseline to maintenance/generalization. Her MLU remained consistent across all study phases. Gabriella showed increases in her number of utterances, MLU, and number of different words used and a decrease in her rate of utterances per minute.</p> <p>Table 4 Oral language outcomes for child participants</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Name</p></th><th align="left"><p>Date</p></th><th align="left"><p>Phase/session</p></th><th align="left"><p>Number of utterances</p></th><th align="left"><p>Rate of utterances per minute</p></th><th align="left"><p>MLU</p></th><th align="left"><p>Number of different words</p></th><th align="left"><p>Length of session</p></th><th align="left"><p>IOA (%)</p></th></tr></thead><tbody><tr><td align="left" rowspan="5"><p>Oakley</p></td><td align="left"><p>01/31</p></td><td align="left"><p>BL/2</p></td><td align="left"><p>3</p></td><td char="." align="char"><p>0.55</p></td><td align="left"><p>a</p></td><td align="left"><p>4</p></td><td align="left"><p>5:37</p></td><td char="." align="char"><p>100<sup>b</sup></p></td></tr><tr><td align="left"><p>03/13</p></td><td align="left"><p>IP1/3</p></td><td align="left"><p>15</p></td><td char="." align="char"><p>2.40</p></td><td align="left"><p>a</p></td><td align="left"><p>43</p></td><td align="left"><p>6:21</p></td><td char="." align="char"><p>93.8<sup>b</sup></p></td></tr><tr><td align="left"><p>03/27</p></td><td align="left"><p>IP2/1</p></td><td align="left"><p>21</p></td><td char="." align="char"><p>2.33</p></td><td align="left"><p>a</p></td><td align="left"><p>60</p></td><td align="left"><p>8:54</p></td><td char="." align="char"><p>95.2<sup>b</sup></p></td></tr><tr><td align="left"><p>05/08</p></td><td align="left"><p>G/1</p></td><td align="left"><p>14</p></td><td char="." align="char"><p>1.47</p></td><td align="left"><p>a</p></td><td align="left"><p>41</p></td><td align="left"><p>9:36</p></td><td char="." align="char"><p>100<sup>b</sup></p></td></tr><tr><td align="left"><p>05/22</p></td><td align="left"><p>M/3</p></td><td align="left"><p>30</p></td><td char="." align="char"><p>2.22</p></td><td align="left"><p>a</p></td><td align="left"><p>61</p></td><td align="left"><p>13:34</p></td><td char="." align="char"><p>100<sup>b</sup></p></td></tr><tr><td align="left" rowspan="6"><p>Alison</p></td><td align="left"><p>02/01</p></td><td align="left"><p>BL/1</p></td><td align="left"><p>118</p></td><td char="." align="char"><p>8.28</p></td><td align="left"><p>4.07</p></td><td align="left"><p>134</p></td><td align="left"><p>14:13</p></td><td char="." align="char"><p>90.7</p></td></tr><tr><td align="left"><p>02/18</p></td><td align="left"><p>BL/2</p></td><td align="left"><p>68</p></td><td char="." align="char"><p>8.77</p></td><td align="left"><p>2.66</p></td><td align="left"><p>72</p></td><td align="left"><p>7:44</p></td><td char="." align="char"><p>98.5</p></td></tr><tr><td align="left"><p>03/27</p></td><td align="left"><p>IP1/2</p></td><td align="left"><p>86</p></td><td char="." align="char"><p>6.62</p></td><td align="left"><p>4.37</p></td><td align="left"><p>112</p></td><td align="left"><p>12:47</p></td><td char="." align="char"><p>90.7</p></td></tr><tr><td align="left"><p>04/19</p></td><td align="left"><p>IP2/2</p></td><td align="left"><p>43</p></td><td char="." align="char"><p>5.06</p></td><td align="left"><p>4.21</p></td><td align="left"><p>82</p></td><td align="left"><p>8:25</p></td><td char="." align="char"><p>86.0</p></td></tr><tr><td align="left"><p>05/08</p></td><td align="left"><p>M/2</p></td><td align="left"><p>12</p></td><td char="." align="char"><p>1.55</p></td><td align="left"><p>a</p></td><td align="left"><p>12</p></td><td align="left"><p>7:41</p></td><td char="." align="char"><p>100<sup>b</sup></p></td></tr><tr><td align="left"><p>05/20</p></td><td align="left"><p>G/1</p></td><td align="left"><p>49</p></td><td char="." align="char"><p>4.78</p></td><td align="left"><p>4.12</p></td><td align="left"><p>80</p></td><td align="left"><p>10:17</p></td><td char="." align="char"><p>98.0</p></td></tr><tr><td align="left" rowspan="6"><p>Gabriella</p></td><td align="left"><p>01/28</p></td><td align="left"><p>BL/1</p></td><td align="left"><p>88</p></td><td char="." align="char"><p>8</p></td><td align="left"><p>2.76</p></td><td align="left"><p>56</p></td><td align="left"><p>11:01</p></td><td char="." align="char"><p>93.2</p></td></tr><tr><td align="left"><p>02/18</p></td><td align="left"><p>BL/2</p></td><td align="left"><p>157</p></td><td char="." align="char"><p>8.49</p></td><td align="left"><p>2.44</p></td><td align="left"><p>99</p></td><td align="left"><p>18:24</p></td><td char="." align="char"><p>97.5</p></td></tr><tr><td align="left"><p>05/01</p></td><td align="left"><p>IP1/3</p></td><td align="left"><p>143</p></td><td char="." align="char"><p>7.15</p></td><td align="left"><p>6.14</p></td><td align="left"><p>159</p></td><td align="left"><p>20:01</p></td><td char="." align="char"><p>91.0</p></td></tr><tr><td align="left"><p>05/15</p></td><td align="left"><p>IP2/2</p></td><td align="left"><p>137</p></td><td char="." align="char"><p>6.85</p></td><td align="left"><p>6.37</p></td><td align="left"><p>136</p></td><td align="left"><p>19:55</p></td><td char="." align="char"><p>94.9</p></td></tr><tr><td align="left"><p>05/20</p></td><td align="left"><p>M/1</p></td><td align="left"><p>143</p></td><td char="." align="char"><p>6.40</p></td><td align="left"><p>6.54</p></td><td align="left"><p>100</p></td><td align="left"><p>22:30</p></td><td char="." align="char"><p>95.1</p></td></tr><tr><td align="left"><p>05/22</p></td><td align="left"><p>G/1</p></td><td align="left"><p>79</p></td><td char="." align="char"><p>6.20</p></td><td align="left"><p>6.35</p></td><td align="left"><p>102</p></td><td align="left"><p>12:45</p></td><td char="." align="char"><p>97.5</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>BL</emph> baseline, <emph>IP1</emph> intervention phase 1, <emph>IP2</emph> intervention phase 2, <emph>M/G</emph> maintenance/generalization <sups>a</sups>Sessions with 30 or fewer intelligible child utterances were not analyzed for MLU <sups>b</sups>For sessions with 30 or fewer intelligible utterances, IOA was calculated for the number of utterances</p> <hd id="AN0162357326-33">Parent Intervention Fidelity</hd> <p>Parent intervention fidelity fell below 75% twice during the study in the first intervention sessions with Mandy and Maria. The coach reviewed each step of the PEER sequence with parents during the next coaching session. The total average percent of intervention fidelity for Candace, Mandy, and Maria was 94, 86, and 89% respectively.</p> <hd id="AN0162357326-34">Coaching Implementation Fidelity</hd> <p>Coaching implementation fidelity remained above 90% during all training and coaching sessions with both raters calculating a total average of 98% (range = 91–100). Interobserver agreement between the two research team members was an average of 99% (range = 82–100).</p> <hd id="AN0162357326-35">Interobserver Agreement of Dependent Variable</hd> <p>Shortly after the study began, questions arose regarding the operational definitions of OEPs and EXPs (Table 2) causing interobserver agreemement to fall below 80%. The team had two retraining meetings to address these concerns and further clarify definitions. After retraining meetings, interobserver agreement remained above 80% during 14/17 shared reading sessions with a total average of 90% (range = 76–100) across all study phases and participants.</p> <hd id="AN0162357326-36">Social Validity</hd> <p>Overall, parents indicated that participating in this intervention had a positive impact on their own reading behaviors with their child as well as on their child's interest in reading books (Table 3). During the interview, Candace indicated that she loved the intervention because she felt like it was helping Oakley. She said the hardest thing was when she was not in the mood to read because of her own depression and anxiety. She mentioned that because of the intervention, Oakley was more patient, less eager to turn pages, enjoyed the books, and wanted to be more involved in the reading process. Candace said she was not so stressed about having to read every single word on the page which made the process more enjoyable for her as well.</p> <p>For Mandy, the biggest challenge was reading after she got home from work and school. The hardest thing for her daughter, Alison, was the limited number of books from which she could choose. When asked what she would change about the intervention, Mandy suggested adding more books. Mandy stated that Alison seemed more interested in reading and was more attentive than she was before participating in the study. Mandy liked how reading was part of a routine and mentioned that she enjoyed the process more now than she did before the study.</p> <p>Maria also said she felt good about the intervention and that she was very happy with it. She indicated that the hardest thing about the intervention for her was the fact that English was her second language. She said for her daughter Gabriella, the most challenging part about the intervention was to repeat new words Maria would use when expanding on her utterance. She also mentioned how it was hard to read to Gabriella after getting home from work because she was tired. Maria said that Gabriella would grab books and ask her to read them and that she seemed more interested in reading books since participating in the study. She also said she felt better as a mom because she was taking the time to read with her daughter.</p> <hd id="AN0162357326-37">Discussion</hd> <p></p> <hd id="AN0162357326-38">Coaching Practice Characteristics</hd> <p>These findings add to the literature on the use of coaching models to support parents in implementing interventions with their children (Brown & Woods, [<reflink idref="bib3" id="ref67">3</reflink>]). This study's use of the coaching practice characteristics from <emph>The Early Childhood Coaching Handbook</emph> (Rush & Shelden, [<reflink idref="bib30" id="ref68">30</reflink>]) including joint planning, observation, action and practice, reflection, and feedback suggest that these characteristics can be used within a coaching model to teach parents new strategies to implement with their children. This is consistent with previous studies that utilized some or all these coaching practice characteristics (Brown & Woods, [<reflink idref="bib2" id="ref69">2</reflink>]; Lane et al., [<reflink idref="bib18" id="ref70">18</reflink>]). Brown and Woods ([<reflink idref="bib3" id="ref71">3</reflink>]) concluded that observation and guided practice with feedback from the interventionist supported parents' use of intervention strategies. Conversely, joint interactions between the interventionist, parent, and child without specific feedback from the interventionist did not support parents' use of intervention strategies. Receiving feedback from an interventionist during or after parents practice a newly learned skill is an integral part of the coaching process. In this study, parents received feedback in training sessions as they practiced with their child. After a period of observation during each coaching session, the coach provided feedback to parents about what was working well and areas for improvement.</p> <hd id="AN0162357326-39">Challenges to Engaging in Shared Reading</hd> <p>Although all parents implemented the intervention with fidelity and were able to maintain and generalize their skills with familiar and unfamiliar books, they also reported challenges to engaging in the intervention with their child. These included their own mental health issues, not having sufficient time or energy to read with their child and being uncomfortable reading in their second language. At the conclusion of the study, Maria was encouraged to start doing the intervention in both Spanish and English. Several studies on dual language learners show that focusing on early literacy and language development in the home language improves reading and academic outcomes (Duran et al., [<reflink idref="bib11" id="ref72">11</reflink>]).</p> <p>The challenge one parent reported of mental health has implications for the sustainability of this and other parent-implemented interventions. One challenge faced by families with a low socioeconomic status is limited access to resources (Bradley & Corwyn, [<reflink idref="bib1" id="ref73">1</reflink>]). In addition, Claessens ([<reflink idref="bib8" id="ref74">8</reflink>]) found that persistent maternal depression was associated with their child's decreased academic performance and increased behavioral issues and school absences in elementary school. These issues can be addressed by early childhood teacher education programs so that future early childhood educators provide appropriate resources and interventions to parents with mental health concerns.</p> <hd id="AN0162357326-40">Child Outcomes</hd> <p>Child outcomes were consistent with previous studies which concluded that DR increased oral language outcomes of young children (WWC, [<reflink idref="bib35" id="ref75">35</reflink>], [<reflink idref="bib36" id="ref76">36</reflink>]). Alison had the most behavioral challenges during sessions including crying, walking away, or refusing to respond to her mother's questions. Such behaviors may have affected the impact the MDR intervention had on Alison's oral language. Alison's behaviors indicate this intervention may be less appropriate and effective for children with behavioral challenges and may need additional modifications to better support and engage them. For example, Alison may have benefited from a larger or different selection of books, as noted by her mother. Specifically, selecting preferred books from her own home may have increased Alison's engagement and decreased challenging behaviors.</p> <hd id="AN0162357326-41">Study Limitations and Future Research</hd> <p>The small number of parents in this study suggest that results should not be generalized to all parents from low socioeconomic homes, nor to all children with a developmental delay. Parents who volunteered to participate may not have represented other parents in similar circumstances. Participating children attended Head Start preschool classes which may have contributed to their oral language growth. Finally, parents were asked to implement the intervention five times a week, but it is unknown how often they did. Areas for future research could include a component analysis to determine whether one type of prompt traditionally used in DR is most effective at increasing children's oral language development. Examining how early childhood teacher education programs are preparing future early childhood educators to support parents with mental health concerns is also recommended.</p> <hd id="AN0162357326-42">Conclusion</hd> <p>Parents play a large role in the development of their children's language skills and have successfully implemented communication interventions targeting these skills (Brown & Woods, [<reflink idref="bib2" id="ref77">2</reflink>]; Lane et al., [<reflink idref="bib18" id="ref78">18</reflink>]). This study showed that when provided with support, parents in lower socioeconomic status homes can implement language strategies with their children within the naturally occurring routine of shared reading. As parents or caregivers ask their children open-ended questions and expand on their utterances, they are building oral language skills which will build a stronger foundation for their child's literacy development (Dickinson et al., [<reflink idref="bib10" id="ref79">10</reflink>]). In addition, creating a routine of systemic, integrated engagement with their child sets the stage for parents' future engagement in their child's education (Mapp et al., [<reflink idref="bib22" id="ref80">22</reflink>]).</p> <hd id="AN0162357326-43">Declarations</hd> <p></p> <hd id="AN0162357326-44">Conflict of interest</hd> <p>We have no conflict of interest to disclose.</p> <hd id="AN0162357326-45">Supplementary Information</hd> <p>Below is the link to the electronic supplementary material.</p> <p>Graph: Supplementary file1 (PDF 576 KB)</p> <p>Graph: Supplementary file2 (PDF 52 KB)</p> <hd id="AN0162357326-46">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0162357326-47"> <title> References </title> <blist> <bibl id="bib1" idref="ref38" type="bt">1</bibl> <bibtext> Bradley RH, Corwyn RF. Socioeconomic status and child development. 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  Data: Coaching Parents to Support Oral Language Skills during Shared Reading
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  Data: <searchLink fieldCode="AR" term="%22Jones%2C+Jennifer+Call%22">Jones, Jennifer Call</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-8244-5104">0000-0002-8244-5104</externalLink>)<br /><searchLink fieldCode="AR" term="%22McDonnell%2C+Andrea+P%2E%22">McDonnell, Andrea P.</searchLink><br /><searchLink fieldCode="AR" term="%22Johnston%2C+Susan+S%2E%22">Johnston, Susan S.</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-1868-8969">0000-0003-1868-8969</externalLink>)<br /><searchLink fieldCode="AR" term="%22Blue%2C+Cheri+Wild%22">Blue, Cheri Wild</searchLink><br /><searchLink fieldCode="AR" term="%22Tolbert%2C+Malynda%22">Tolbert, Malynda</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Early+Childhood+Education+Journal%22"><i>Early Childhood Education Journal</i></searchLink>. Apr 2023 51(4):651-664.
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  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
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  Data: <searchLink fieldCode="DE" term="%22Reading+Strategies%22">Reading Strategies</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Education%22">Parent Education</searchLink><br /><searchLink fieldCode="DE" term="%22Coaching+%28Performance%29%22">Coaching (Performance)</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Implementation%22">Program Implementation</searchLink><br /><searchLink fieldCode="DE" term="%22Prompting%22">Prompting</searchLink><br /><searchLink fieldCode="DE" term="%22Oral+Language%22">Oral Language</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Skills%22">Language Skills</searchLink>
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  Data: 10.1007/s10643-022-01327-0
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  Group: ISSN
  Data: 1082-3301<br />1573-1707
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Dialogic reading is a shared reading intervention which has been shown to increase children's oral language skills. Although dialogic reading has been heavily researched and replicated with a variety of populations, this study uniquely focused on outcomes when parents of children with a developmental delay from low socioeconomic status homes were coached to implement dialogic reading with their child in their home. Using a multiple probe design across three parent-child dyads, researchers examined the effects of the modified dialogic reading intervention package on participating parents and their children. When provided with evidence-based training and coaching sessions, all parents were able to implement the intervention with fidelity and increased the number of open-ended prompts and expansions they used with their child during shared reading. Two of the three children's oral language skills appeared to improve throughout the course of the study preparing them for future success in their literacy development.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2023
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1369624
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1369624
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10643-022-01327-0
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 651
    Subjects:
      – SubjectFull: Reading Strategies
        Type: general
      – SubjectFull: Program Effectiveness
        Type: general
      – SubjectFull: Parent Education
        Type: general
      – SubjectFull: Coaching (Performance)
        Type: general
      – SubjectFull: Program Implementation
        Type: general
      – SubjectFull: Prompting
        Type: general
      – SubjectFull: Oral Language
        Type: general
      – SubjectFull: Language Skills
        Type: general
    Titles:
      – TitleFull: Coaching Parents to Support Oral Language Skills during Shared Reading
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Jones, Jennifer Call
      – PersonEntity:
          Name:
            NameFull: McDonnell, Andrea P.
      – PersonEntity:
          Name:
            NameFull: Johnston, Susan S.
      – PersonEntity:
          Name:
            NameFull: Blue, Cheri Wild
      – PersonEntity:
          Name:
            NameFull: Tolbert, Malynda
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 04
              Type: published
              Y: 2023
          Identifiers:
            – Type: issn-print
              Value: 1082-3301
            – Type: issn-electronic
              Value: 1573-1707
          Numbering:
            – Type: volume
              Value: 51
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Early Childhood Education Journal
              Type: main
ResultId 1