Dosage, Fidelity, and Child Outcomes in a Small Randomized Controlled Trial of EMT en Español

Abstract

The purpose of the current study was to examine the dosage and fidelity of EMT en Español strategies that are posited to drive change in child outcomes. The study is a re-analysis of data collected during the National Institutes of Health (NIH) R21 grant “Teaching Spanish-speaking Caregivers to Implement EMT en Español: A Small Randomized Trial.” Data from caregiver child interactions (CCX) at pre-test, post-test, and follow-up were coded for target level language within matched turns, the putative active ingredient in the intervention. Additionally, data from a comprehensive caregiver fidelity checklist representing implementation of the package of EMT en Español component was collected. The relation between caregiver’s dosage and fidelity of the intervention and child language and communication outcomes were analyzed using t-tests and linear regression models. Results indicated that caregivers in the intervention group increased their dosage of the active ingredient and overall fidelity scores significantly more than those caregivers in the control group at both post-test and follow-up. Dosage and fidelity at post-test were predictors of child conceptual vocabulary at follow-up. The findings from this study have potential importance for early intervention and clinical practice.