Infant Achievements Intervention Improves Caregiver Implementation Fidelity and Infant Social Communication Outcomes: A Preliminary Randomized Clinical Trial.
Rebecca J Landa, Rachel Reetzke, Christine Reiner Hess
PMID 40318004WHAT IT FOUND
Coaching parents about twice a week for around eight weeks in responsive play techniques improved how consistently they used them, and improved their infants' joint attention and engagement with them, compared with developmental information alone.
Key findings
01Caregivers who received coaching used the coached strategies more than caregivers who received developmental information only, both straight after the intervention and at follow-up.
02Infants in the coached group showed greater increases in initiating joint attention and in time spent in coordinated joint engagement from baseline to post-intervention. The joint attention gain was still there at follow-up; the joint engagement gain was not.
03The coached group gained more on a nonverbal cognitive measure and on the caregiver-reported speech composite, but there was no group difference over time on the Mullen Expressive Language or Receptive Language scales or on the CDI word counts.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample is small and the intervention and follow-up periods were short. The authors describe the results as preliminary and say replication in a larger sample is needed. The groups were not balanced at the start: the Infant Achievements infants were younger and had lower nonverbal cognitive scores, lower caregiver-reported speech scores, fewer words understood, and fewer bids to initiate joint attention. The analyses adjusted for age, nonverbal score and, where needed, the baseline value of the outcome, but adjustment cannot fully remove those differences. Families were not asked to stop any treatment they were already receiving, and the paper does not report which other services the infants were getting, so it is not possible to separate the effect of the coaching from anything else the families were doing. The Infant Achievements intervention was a package: coaching, video feedback, a weekly stream of toys and a specific set of strategies. Which parts mattered, or whether all of them were needed, cannot be told from this study. Families were mostly not economically or racially diverse, and the authors say future work is needed in more diverse samples before the findings can be generalised. One family assigned to the coached group could not start home visits because of COVID-19 restrictions, and three families switched from in-person to telehealth visits with delayed post-intervention and follow-up assessments.
Declared interests
The work was supported by a National Institutes of Health extramural grant. The authors state that they have no conflicts of interest to disclose.
The easy way to misread this
Do not read this as proof that coaching parents improves children's language. The Mullen Expressive Language and Receptive Language scales, the standardised language measures, showed no group difference over time, and the positive findings come from a small preliminary trial in which the two groups were already different at the start.
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