Published on October 6th, 20141
Program Evaluation of a Parent Education Session: A Quality Improvement Initiative
Evidence suggests that early intervention is integral to the success of treatment for speech-language disorders in young children (McCain and Mustard, 1999; Reynolds, 2004). Given that funding constraints have lengthened wait times for publicly funded early intervention speech-language services, parents have a key role to play in recognizing and responding to their child’s delays. As such, it is imperative that parents learn effective strategies to promote their child’s development. It was with these three factors in mind — the importance of early intervention, increasing wait times and necessity of parental use of effective strategies — that the clinical and management team at the First Words Preschool Speech and Language (PSL) Program initiated the development of the Parent Education Program.
There have been very few studies that assess the effectiveness of group-based parent education programs. Research into parent training programs for children whose primary delay or disorder is suspected to be in the speech/language domain is also limited. As such, the findings from this study provide early evidence for the success of a standardized parent education program, including early intervention strategies, in situations where there is a long wait time for a young child with a speech-language disorder.
First Words Parent Education Program
First Words PSL developed the Parent Education Program to support parents by providing an educational service while their child is on the waiting list for a speech-language assessment. A team of speech-language pathologists (S-LPs) and communication health assistants from First Words PSL in Ottawa developed and refined the program, which was taught in a group seminar format. The team standardized the program so that each member could present the same material consistently.
There were four phases to this study, each characterized by specific inquiries:
- Phase 1) Is parent education a valuable service for our program? Do parents learn content from the session?
- Phase 2) Do parents retain what they’ve learned until their child’s assessment (12-16 weeks after the parent education session)?
- Phase 3) Are there differences in parents’ learning and retention of content when the session is provided in a small (maximum of 12 families) versus a large (maximum of 30 families) group?
- Phase 4) Will improvements to the session (i.e., adding interactive problem-based discussion, adding video clips or re-ordering the content) aid parents’ learning, retention and use of strategies? What kind of qualitative feedback do parents give regarding the revised session?
First Worlds PSL held parent education sessions twice a month in a group seminar format. There were seven groups in all, encompassing a total of 151 parents. Each session was roughly two hours long. A certified S-LP presented information about speech and language delays as well as strategies to promote speech/language skills. The S-LP also led group discussions and encouraged parents to ask questions. The information was presented in a dynamic manner with explicit examples and PowerPoint slides. Parents took handouts home for their own future reference and to share with others in the child’s life.
For Phase 1, we developed a pre- and post-session questionnaire to measure how well parents learned the material we presented to them. This questionnaire contained nine questions (seven multiple choice and two true/false; see Appendix A). Parents filled out the questionnaire immediately before and after the education session. In Phase 2, we added an additional questionnaire for parents right before their child’s assessment (12-16 weeks after the session). In Phase 3, we gave the questionnaire to two different-sized groups of parents (small and large). In Phase 4, we added three new open-ended questions. Two were part of the pre-session questionnaire and asked parents to identify why they were seeking S-LP services and what they wanted to learn from the sessions. We added the third to the post-session measure asking parents to list any strategies they learned from the session that they had used with their child. After the session in Phase 4, we provided parents with a questionnaire to rate their satisfaction with the program (see Appendix B).
Results from Phases 1, 2 and 3 indicated that parents learned the majority of the information presented. Parents also retained the information until their child’s assessment (Phase 2). We observed no real differences between the large and small group settings in learning or retention (Phase 3). Results from Phase 4, as compared with those from Phase 3, showed that the use of more robust teaching techniques increased the parents’ learning and knowledge retention, especially with respect to intervention strategies. Finally, the majority of parents indicated that the program was both a valuable and desired service, as evidenced by statements made directly by parents who participated in the program. One parent said this of the program: it “made me more aware of how to model speech and to keep sentences short and to the point.” Another said it “[helped me to feel] reassured that we were on the right track.”
This study showed that a group-based parent education program is an effective means of providing parents with both essential information concerning their child’s speech/language skills and strategies to promote optimal outcomes. Parents can implement the strategies at home with their child while waiting for an assessment; as such, the program is a means of providing necessary early intervention. That there was no noteworthy difference in parent learning in relation to session size was an important finding for the efficient allocation of clinicians’ time; in our case, it allowed the S-LP to use that extra time to provide more assessments. This observation is very valuable given that wait times for meeting with S-LPs have continued to increase and that this trend seems unlikely to change in the near future.
McCain, M. N. and Mustard, J. F. (1999). Reversing the Real Brain Drain: Early Years Study. Report. Toronto: Ontario Children’s Secretariat.
Reynolds, A. J. (2004). Research on Early Childhood Interventions. Children and Youth Services Review, 26. 15-38.
About the authors:
Robin Gaines, PhD, S-LP(C), CCC-SLP, Reg. CASLPO is a clinical researcher with the Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa and a clinical speech-language pathologist at the Children’s Hospital of Eastern Ontario. Robin and her colleagues at the First Words Preschool Speech and Language Program present the Parent Education program as part of their clinical service to families.
Carol Theoret-Douglas, M.Sc., S-LP(C), Reg. CASLPO is Director, Rehabilitation Program and Chronic Pain Service at the Children’s Hospital of Eastern Ontario. A graduate of McGill, she has worked in school care, community-based private practice and the hospital setting. Carol supports profession-specific and interprofessional research at CHEO and is an associate investigator at the CHEO Research Institute.