JCPSLP Vol 22 No 2 2020

Learning from our clients

Parent perspectives on receiving support for enhancing parent–child interactions Estelle Pretorius, Sally Clendon, and Tara McLaughlin

Capacity-building practices actively promote the skills and abilities of parents to provide development-enhancing learning opportunities for their child. Speech-language pathologists (SLPs) use parent-implemented interventions to enhance parent–child interactions, often using a training and coaching approach. In this article, we present feedback from three New Zealand parents of young children on the autism spectrum regarding their experience of a training and coaching intervention offered by an SLP. Parent feedback stems from a broader research project that explored the impact of an intervention targeting parents’ implementation of interaction promoting strategies and embedded naturalistic interaction practices. This article describes the significance of coaching parents to use more systematic and precise practices in their interactions with their child and how this approach could be applied in the context of speech-language services. E xperts in the field of early intervention for children on the autism spectrum advocate for the provision of naturalistic and responsive learning opportunities (Salisbury et al., 2018; Sandall, McLean, & Smith, 2000; Snyder, Hemmeter, Sandall, McLean, & McLaughlin, 2013; Snyder, Rakap, Hemmeter, McLaughlin, Sandall, & McLean, 2015). Naturalistic interventions address functional skills, offer targeted learning opportunities embedded in naturally occurring activities, and promote contextually meaningful learning (Snyder, McLaughlin, & Bishop, 2018). Sandall et al. (2000) concur that children learn essential skills in social communication and language when they participate in naturally occurring routines and activities. As parents are often referred to as children’s first teachers (McConachie & Diggle, 2007; Stephan & Manning, 2017), they can play an essential part in providing these targeted learning opportunities. The promotion of parents as capable communication partners has gained significant interest and support from speech-language pathologists (SLPs) and early intervention practitioners (Kemp & Turnbull, 2014; Meadan, Ostrosky,

Zaghlawan, & Yu, 2009; Roberts & Kaiser, 2011; Salisbury et al., 2018; Stephan & Manning, 2017). Ideally, families of young children on the autism spectrum engage in speech-language pathology services early on, as these services have been shown to be effective in improving the child’s social communication and language outcomes through active and meaningful parent engagement (Sandall et al., 2000; Wetherby & Woods, 2006). Furthermore, parent-led or parent-implemented interventions endorse the principles of family-centred practice, by engaging parents as collaborative partners in the delivery of early intervention services (Division for Early Childhood (DEC), 2014; Dunst, Boyd, Trivett, & Hamby, 2002; Dunst & Dempsey, 2007; Fitzgerald, 2004; Salisbury et al., 2018; Sandall et al., 2000; Woods, Wilcox, Frieman, & Murch, 2011). In the field of early intervention for young children on the autism spectrum, training and coaching interventions are promoted as opportunities for parent capacity-building and individualised support (McConachie & Diggle, 2007; Meadan et al., 2009; Ministry of Health and Education, 2016; Wetherby & Woods, 2006). Training and coaching support offered in naturally occurring family settings not only extends knowledge and promotes skill acquisition, but it also impacts on parents’ sense of empowerment and confidence (Dunst et al., 2002; Dunst & Dempsey, 2007). Salisbury and colleagues (2018) concur that individualised planning support and feedback from an early intervention specialist can be valuable when supporting parents in developing embedded practices. In response to the growing demand for effective and individualised support for parents of young children on the autism spectrum, there has been an increase in training and coaching interventions targeting parents as the agents of change (Fitzgerald, 2004; Stephan & Manning, 2017; Woods et al., 2011). Internationally recognised parent education programs such as the Hanen More Than Words Program (Weitzman, 2013), the Early Start Denver Model (Rogers and Dawson, 2010), and the DIRFloortime approach (Greenspan & Wieder, 2006) are widely used and have ecological validity. Furthermore, training and coaching programs that offer parents support through individualised planning, focused observation and practice, individualised feedback using video, and joint problem-solving have been shown to be effective in promoting the development and generalisation of skills (Rush, Shelden, & Hanft, 2003; Salisbury et al., 2018; Stephan, 2015; Stephan & Manning, 2017). Given that parents are encouraged to play such an important role in their child’s early intervention journey, it is

KEYWORDS AUTISM

SPECTRUM DISORDER EARLY INTERVENTION EMBEDDED INTERVENTIONS INTERACTION SUPPORT PARENT PERSPECTIVES TRAINING AND COACHING THIS ARTICLE HAS BEEN PEER- REVIEWED

Estelle Pretorius (top) and Sally Clendon

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JCPSLP Volume 22, Number 2 2020

Journal of Clinical Practice in Speech-Language Pathology