The Effects of Therapist and Parent-implemented JASPER-Enhanced Milieu Teaching + Sign on the Expressive Communication of Young Children with Down Syndrome
Windsor, Kelly Sue
The purpose of this study was to extend previous research by examining the effects of concurrent parent and therapist-implemented Joint Attention Symbolic Play and Emotional Regulation-Enhanced Milieu Teaching with Sign Language (J-EMT+Sign) on parent use of J-EMT+Sign strategies with their young children with Down syndrome and to examine the effects of the intervention on the language use of two young children with Down syndrome with mental age below 18 months. In a multiple baseline across parent behaviors, a functional relationship was demonstrated between the Teach-Model-Coach-Review approach for teaching parents the J-EMT +Sign intervention and parent use of the strategies. Child progress in communication could not be attributed to the intervention because changes in child spoken and signed communication were variable and occurred over an extended period of time of parent and therapist intervention. Implementing the intervention during play activities was challenging for parents due to children’s lack of play skills and difficulty remaining engaged with objects and adults for extended periods of time. Future research on J-EMT+Sign with children with Down syndrome with mental age below 18 months should address alternative ways to maximize parent success and to increase the impact of the intervention on child language. These alternatives might include 1) implementing the intervention during routines in which the child readily engages in the activity (e.g., social routines, caregiving activities), and 2) implementing the intervention in several play sessions with the therapist only before introducing the intervention in play sessions with the parent.