Delivering Enhanced Milieu Teaching Via Telepractice

Abstract

The purpose of this study was to examine whether the Enhanced Milieu Teaching (EMT) Telepractice Program was effective for teaching caregivers to implement EMT language support strategies and whether changes in caregiver behavior were associated with changes in child communication. Three caregivers and their children with language delays aged 19 to 27 months participated in the EMT Telepractice Program. A multiple baseline across behaviors design, replicated across two caregiver-child dyads, was used to evaluate the efficacy of the EMT Telepractice Program. A speech-language pathologist delivered EMT using a blended service delivery model with approximately 39% of sessions delivered in-person and 61% delivered via video-teleconferencing. The speech-language pathologist used the Teach-Model-Coach-Review instructional framework to teach caregivers EMT strategies. There was a functional relation between the EMT Telepractice Program and EMT strategy use for all three caregiver-child dyads. Increases in the number of child communication acts, and a weighted count of child communication were associated with caregiver strategy use for one child. Increases in the number of different words were associated with caregiver strategy use for two of the children. Caregiver use of EMT strategies maintained several weeks after the intervention was completed. The EMT Telepractice Program had cost savings in personnel travel time and mileage and costs less when compared to the anticipated costs of providing all EMT intervention sessions to families in-person.