Say what you mean and mean what you say. This adage has been used for many years to guide and focus communication. Communication should convey meaning and be understood by others. Conversely, meaning what you say implies an intent to follow through and implement the message being conveyed.
Every professional field has its own lexicon with words and phrases, and early childhood intervention (ECI) is no exception. ECI professionals use language and lexicons unique to the field, and parents learn to use such terms, especially when communicating with professionals during their child's involvement in ECI. Examples of the words and phrases that make up the lexicon of ECI include IEPs and IFSPs, evidence-based practice (EPB), recommended practices, personnel standards, coaching, fidelity, infant mental health, social emotional interventions, mental health consultation, augmentative and assistive communication (AAC), behavior management (ABA), and trauma-informed interventions and care, to name just a few. Often, these lexicons are used as descriptors to assign meaning to interventions.
Yet the words and phrases that comprise the ECI lexicon may mean different things to different people, under different conditions and contexts, as applied with different children and their families. As an illustration, the word "coaching" is an accepted practice and lexicon in ECI. Rarely is it defined by its purpose, methods, sequence of procedures, training and skills of the coach, situations in which it occurs, with whom, and outcome(s) being measured to document improved child outcomes. Rarer still is the identification of valid and defined indicators of fidelity of a lexicon labeled intervention that are operationalized, easy to use and calculate, and focused on child outcomes.
This lack of specificity is not unique to the lexicon of coaching, as definition is needed for all the words and phrases describing the interventions listed earlier. The need for meaning in communication and implementation applies to any intervention for infants and young children and their families receiving ECI. Our field must do a better job of being clear and descriptive so that everyone, especially parents, understand and experience the intent of the meaning behind the lexicons we use. As our field grows, and the lexicons we use also grow, we must be precise and consistent about meaning, implementation, and outcomes.
CURRENT ISSUE
Our first article, by Jessica Hardy, Ragan McLeod, Chris Sweigart, and Timothy Landrum, focuses on the evaluation of single-case research designs. The authors compare and contrast frameworks for evaluating methodological rigor on high-probability requests to increase compliance in young children. Ten studies were identified and coded using multiple research frameworks. Differences in rigor and study effects were found across the frameworks. The authors conclude with recommendations for determining high-quality research and effective practices for this population.
Our next article, by Jill Pentimonti, Danielle Shaw Attaway, Michael Harris Little, Aleksandra Holod, Virginia Buysse, Dale Walker, and Kathryn Bigelow, is a pilot study that used a randomized controlled trial to evaluate the efficacy of a language intervention with young children in home visiting programs. There were 59 children (aged 18-30 months) assigned to one of three types of home visiting program, and their language skills were assessed pre- and postintervention with the Preschool Language Scale. A two-level hierarchical linear model was used to estimate the impact of the intervention on children's language scores. Results provide evidence for the effectiveness of the parent-implemented language intervention.
Tessa Taylor presents the next article about an oral motor intervention during feeding. A modified withdrawal/reversal design was used to assess the effectiveness of an intervention using redistribution procedures to decrease oral packing and increase swallowing in two children with autism. The intervention used regular texture bites in a short-term (1-2 weeks) home-based program in Australia. Parents were trained, and results showed a decrease in latency to swallow and an increased tolerance to a variety of 90 and 122 regular textured foods across food groups. All goals were met and maintained at 6 months, including increasing independence in self-feeding.
Alicia Azzano, Rebecca Ward, Tricia Vause, and Maurice Feldman present a study with the parents of three children (19, 23, and 26 months old) showing possible early signs of autism spectrum disorder (ASD). Multiple baseline designs across parent and child behaviors evaluated a parent-mediated behavioral intervention: the Parent Intervention for Children At-Risk for Autism (PICARA). The program focused on increasing targeted developmental skills (e.g., responding to name, imitation, requesting) with parents who received home-based individual behavioral skills 1 hr per week for up to 29 sessions, depending on the number of child skills trained and performed. All parent and child skills improved and were maintained during follow-up.
Elizabeth Baltus Hebert, Karen W. Nolan, and Katie Nicole Smith summarized the literature on neuromotor impairment and motor activity limitation in children with ASD. A literature search from 1998 through 2021 using PubMed, EMBASE, and PsycINFO resulted in 78 articles that included the children with autism and motor activity and were consistent with the aims of this literature review. The potential significance of motor activity limitations on development in young children with ASD is discussed, and recommendations are offered for more holistic interventions.
As usual, I would like to thank the authors, for submitting their work to Infants & Young Children, and the reviewers, who assisted the editorial process by offering salient suggestions to bring these manuscripts to publication.
-Mary Beth Bruder, PhD
Editor