Report
Teaser, summary, work performed and final results
Periodic Reporting for period 1 - IMPACT (Improving parent and child interaction to enhance oral language development)
Teaser
Across Europe, up to 5.8 million children and youths are affected by language problems. Language difficulties result in poorer academic outcomes, worse job opportunities, and poorer economic and health well-being. A major societal challenge and Europe 2020 priority is reducing...
Summary
Across Europe, up to 5.8 million children and youths are affected by language problems. Language difficulties result in poorer academic outcomes, worse job opportunities, and poorer economic and health well-being. A major societal challenge and Europe 2020 priority is reducing social inequalities, which could be addressed by investing in the early years and addressing the inequities in early language development. Impoverished home language environments are shown to contribute to existing and increasing inequalities across Europe. One approach to improving child oral language skills and reducing inequalities is to identify parent-child interaction interventions for promoting the home language environment, with the potential to be incorporated into universal services across Europe.
Thus, the objectives of this fellowship are to:
1) Understand expectations and experiences of parents in disadvantaged areas who take part in parent-child interaction programmes aimed at promoting child oral language skills;
2) Determine the feasibility and reliability of an observational rating scale of parent-child interaction for use by health visitors/community health nurses to identify children most likely to benefit from parent-focused interventions for improving child oral language;
3) Review practices across Europe for promoting parent-child interaction, and provide recommendations for identifying children most likely to benefit from parent-focused intervention.
At a time when action is needed, this project will make a significant contribution to advancing the science of the field and also to addressing the major societal challenge in the UK and across Europe of reducing inequalities.
Work performed
In 2017, study 1 was carried out, exploring the expectations and experiences of parents from disadvantaged areas attending parent-child interaction programmes. Ten parents were recruited to participate in face-to-face interviews conducted in the home. Interviews were then transcribed and data analysed. A manuscript reporting these study findings, Levickis et al, has been submitted to IJLCD.
Study 2 tested the feasibility of training child health nurses to use the observational rating scale, PaRRiS (Parental Responsiveness Rating Scale), to identify families most likely to benefit from parent-focused interventions. Five child health nurses were recruited and trained to use PaRRiS. Nurses then conducted ratings of parent-child interactions (n=30) during routine 27 month child health visits. The researcher then rated video recordings of the interactions to determine reliability. Phone interviews were conducted with nurses to get feedback on the training and implementation of PaRRiS. A manuscript reporting findings is in preparation for submission to the European Journal of Public Health. Findings from studies 1 and 2 were presented at 8 international conferences, including language specific and public health conferences, in 2017 and 2018.
The fellow hosted a parent-child interaction stakeholders meeting, September 5th, 2018 at Newcastle University and invited health and educational professionals with a focus on the early years to attend. The fellow presented study 1 and 2 findings and the meeting provided an opportunity for stakeholders to put forward their perspectives in light of these research findings and to explore new and innovative ways of promoting quality parent-child interaction to enhance early language development that can be realistically achieved. The best methods for dissemination of study findings to practitioners and families was also discussed. Research findings will be disseminated to practitioners in the form of research snapshots.
The fellow’s supervisor has been leading a COST Action focusing on interventions for children with language impairment across Europe. To address the third project objective and examine practices around promoting parent-child interaction across Europe, the fellow included questions related to parent-child interaction programmes in the COST Action practitioner survey. The fellow collaborated with COST members to submit a manuscript for publication to the Journal of Communication Disorders.
Findings from study 1 showed that parents’ understanding of child language development and difficulties and their own expectations of intervention, as well as their role within it need to be considered. Engagement of parents in parent-child interaction programmes can contribute not only to the effectiveness of intervention, but also to the parents’ capability to act as ‘agent of change’ for their child’s language learning. In addition, cultural diversity needs to be considered as these families may have very different expectations and may place different cultural values on the importance of parent-child interaction.
Findings from study 2 showed that it is possible to train child health nurses to reliably measure parental responsiveness using PaRRiS during a brief 5 minute free-play observation. Findings also showed that in this sample, whereby half the sample of families were from the 10% most deprived UK areas, there was no evidence of a relationship between social disadvantage and PaRRiS ratings. Thus, while there is an association between social disadvantage and poorer quality parent-child interaction, targeting only socially disadvantaged families with parent-child interaction interventions will not necessarily reduce inequalities.
In study 3 the fellow and co-authors used COST Action IS1406 survey data to explore from an international perspective working with parents and families of children with developmental language disorders. In total, 4024 practitioners responded from
Final results
The PaRRiS has the potential to be incorporated into already existing universal health services to provide child health nurses with an additional tool for identifying children most likely to benefit from early intervention aimed at promoting better language learning. Based on IMPACT project findings and the parent-child interaction stakeholder meeting discussions, the fellow is seeking funding to develop an online training version of PaRRiS for child health nurses. Online training will provide child health nurses in regional and rural areas to have greater access to this type of training, as child health nurse training is often \'city-centric\'. Thus, there is potential to reach \'under-served\' populations who are likely to benefit from and most need support in promoting their child\'s language development.