In-home communication intervention training for parents of multiply handicapped children.

Two major questions derived from social-interactional theory were addressed: What are the effects of an in-home communication training program for parents on (1) the acquisition of child-training skills (imitating/animating and expectant waiting) by parents of developmentally delayed children who have severe language impairments and autistic features and (2) the acquisition of communication behaviors in the children themselves? Questions regarding the social value of the intervention and effects on parent-child interactions were also addressed. Four mothers were taught two parent-training skills (imitating/animating and expectant waiting) during two in-home training sessions. Following the parent training, the mothers conducted training sessions in their homes with their children for 10 minutes, three times per week for 8-12 weeks. All sessions were videotaped and frequency counts taken of the target parent skills and child target behaviors. A single subject experimental research design was used incorporating a multiple baseline across two parental child-training skills (i.e., imitating/animating, expectant waiting). Data were analyzed visually as is customary in single subject experimentation, and direct behavioral counts showed that all four mothers demonstrated increases in the frequency with which they used the child-training skills following treatment. Increases in four child behavior frequencies (i.e., vocal utterances, social responding, social initiating, and intelligible words spoken) were also noted. The ECO Scales Interaction Profile results supported direct behavioral count data, showing significantly improved parent-child interactions for the subject dyads over three conditions (p < .034). Additionally, Parental Consumer Satisfaction Questionnaire results indicated that the intervention was positively perceived by the parents. Furthermore, the utility of single subject experimentation procedures in clinical nursing practice was clearly demonstrated in this research, and the findings support nurse-conducted, in-home parent training as a practical and socially valid means of addressing the complex needs of chronically disabled children and their families.