A Customised, Intensive Parent-Child Interaction Therapy for Children With Down Syndrome: Findings From a Real-World Pilot Effectiveness Study.

Four families only, all mothers White-Irish and university educated, all either at home or in flexible work, so this says nothing about families without those advantages. No control group, and the people coding the videos knew whether they were watching a baseline or an intervention session, so they may have seen what they expected to see. Children's language was measured before and after only, with no statistical testing, and the authors state that any change cannot be attributed to the programme. One child's post-programme language sample was never collected because the session was cancelled. Follow-up lasted four weeks. Changes in language in children with Down syndrome are thought to take longer to appear than changes in parents. The therapists had never delivered JEMT before, and fidelity averaged 74%, dropping to 33.3% when a child disengaged and the session had to be abandoned, so some sessions were not delivered as intended. The programme was shortened from the original 24 to 28 sessions over four months to 22 sessions over about eleven weeks, and parents moved to the next tier after two weeks whether or not they had met the criterion, so the original protocol was not tested as designed. Children with a diagnosis of autism or a significant hearing or vision difficulty were excluded. Families came through a semi-private Down syndrome service whose therapists said they had more leeway than a public service would.

The authors declare no conflicts of interest. Families were recruited through Down Syndrome Ireland, a part-subsidised service for people with Down syndrome, and the two therapists who delivered the programme worked there. The programme was modelled on the Vanderbilt KidTalk approach and the therapists were trained remotely by a US clinician-researcher; the first and last authors, both SLTs, supervised the therapists and the data collection.

Do not take this as evidence that the programme improves children's language. Child communication was measured before and after with no control group and no statistical testing, the authors say themselves the changes cannot be attributed to the intervention, and the child who gained most on the observed communication measures was the one whose standardised language score fell.