Examining Caregivers’ Independence in Early Intervention Home Visit Sessions

In recent years, the field of early intervention (EI) has had to cope with a significant increase in the number of children with developmental delays. Given the realities of reduced funding for services and the forthcoming prevalence of children with significant delays, it is even more important to build proficient and independent caregivers. Coaching is the primary mechanism for advancing caregiver capacity in home-based EI sessions; however, little is known about its potential to support caregivers to independently use development-enhancing behaviors associated with positive child outcomes including teaching, responsiveness, encouragement, and affection. Moreover, researchers and providers lack evidence regarding which coaching strategies are best suited to build caregiver independence. Data from a single case multiple baseline across participants study collected through an IES Goal 2 intervention development study (Woods, Salisbury, & Snyder, 2013) were used to examine how a delineated coaching process affected the ability of caregivers to take the lead in promoting their children’s learning in the context of daily activities. In addition, the elements of coaching that correspond to caregiver initiations of development-promoting behaviors were investigated. One EI provider coached four culturally diverse caregivers to use development- enhancing strategies with their children who evidenced moderate-severe disabilities. The coaching process designated by the acronym SOOPR, include targeted information sharing (S), observation and provision of opportunities for the caregiver to practice new skills with provider feedback (OO), problem solving and reflection (P), and review of the EI session (R). Results reveal that all four caregivers increased their initiations of three of four development-promoting behaviors: teaching, responsiveness, and encouragement. The descriptive data across sessions for each triad suggest that as the intervention progressed, the frequency of specific coaching strategies decreased and this may have fostered the caregivers’ opportunities to take the lead in the sessions. In addition, a consistent pattern of direct proportionality between caregiver rate of improvement after the intervention and caregiver initiations during the intervention was also identified. No consistent patterns were found between specific or individual coaching strategies and caregiver initiations. Taken together, findings from this investigation support the overall value of the SOOPR coaching framework and its effectiveness for teaching caregivers to identify learning opportunities and embed interventions strategies in various contexts. Study limitations and implications for research and practice are discussed.