2020 - Ajslp 20 00037

AJSLP
Research Article
Coaching Parents of Children With

Developmental Disabilities to Implement
a Modified Dialogic Reading Intervention
Using Low Technology via Telepractice
Lauren M. Pierson,a Julie L. Thompson,a J. B. Ganz,a Sanikan Wattanawongwan,a
April N. Haas,a and Valeria Ylladesa
Purpose: Storybook reading provides a naturalistic context telepractice. Maintenance and generalization sessions were
to promote bonding and increase oral communication also conducted.
between the reader and child. This study investigated Results: A functional relation was observed between parent
the impact of modified dialogic reading procedures, which implementation and telepractice coaching.
included a prompting component on the language skills of Conclusion: While the child responses to comprehension
children with autism spectrum disorder and Down syndrome questions did not change, changes in the parent
in the children’s homes. implementation of modified dialogic reading procedures in
Method: A multiple-probe-across-participants design was response to coaching via telepractice were noted in this study.
used to investigate the efficacy of the intervention for this Supplemental Material: https://doi.org/10.23641/asha.
population. Parent training and coaching were provided via 13382831
T
he ability to proficiently read is a skill that is im- comprehend what is read (Nation et al., 2006; Ratz, 2013).
portant for participation in society and one that is There are numerous treatment methods and tools that can be
often taken for granted. Approximately 43 million tailored to the relative strengths and weaknesses associated
individuals are not able to interact with texts at a basic level with developmental disabilities.
(Organization for Economic Cooperation and Development, Children’s picture books are a part of many families’
2013), which impacts academic outcomes (Sonnenschein daily routines. Parents who start reading to their children
et al., 2010), relationships (Miles & Stipek, 2006), employ- in early childhood have been shown to increase later literacy
ment (Sum, 1999), and quality of life (DeWalt et al., 2004). skills (American Academy of Pediatrics, 2017). Books can
These difficulties likely start at an early age and continue increase the number of different words children hear, which
into adulthood. also predicts later vocabulary levels (Hart & Risley, 2003).
A recent study by the Centers for Disease Control and Storybooks are also used by educators, speech-language
Prevention found 16% of parents interviewed had a child pathologists, and other stakeholders to teach concepts and
with a developmental disability such as autism spectrum help generalize skills previously taught to children with and
disorder (ASD) or intellectual disability (ID; Zablotsky without disabilities in a naturalistic context (Satterlund, 2016;
et al., 2019). The reading profiles of individuals with ASD Ukrainetz, 2005; Ukrainetz & Trujillo, 1999). Early childhood
and ID can be variable, with some demonstrating an excep- educators use books to reinforce skills during large group ac-
tional ability to decode words while others struggle to tivities, typically have classroom libraries, and provide tubs
of books for children to read during center time (Kaderavek
& Justice, 2002). Researchers have also used storybooks as
a
Department of Educational Psychology, Texas A&M University, intervention tools and shown improvements in language
College Station skills (e.g., Hargrave & Sénéchal, 2000; Huebner, 2000;
Correspondence to Lauren M. Pierson: trojacekl@gmail.com Lever & Sénéchal, 2010; Lonigan & Whitehurst, 1998;
Editor-in-Chief: Julie Barkmeier-Kraemer Snow & Goldfield, 1983; Whitehurst et al., 1988). Spe-
Editor: Erinn H. Finke cifically, shared storybook reading has been used with in-
Received February 27, 2020 dividuals who have language impairments (e.g., Justice et al.,
Revision received May 7, 2020
Accepted September 25, 2020 Disclosure: The authors have declared that no competing interests existed at the time
https://doi.org/10.1044/2020_AJSLP-20-00037 of publication.
American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021 • Copyright © 2020 American Speech-Language-Hearing Association 119
Downloaded from: https://pubs.asha.org Hui Ting Sum on 09/28/2022, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions
2018), are typically developing (e.g., Skibbe et al., 2018), have question (Fleury & Schwartz, 2017). In this study, the PEER
ASD (e.g., Fleury & Hugh, 2018), and have Down syndrome strategy was also modified to accommodate the needs of
(e.g., Lim et al., 2018). individuals with intellectual and developmental disabilities
by providing a system of least prompts (i.e., extend [PEEER];
American Speech-Language-Hearing Association [ASHA],
Dialogic Reading 2006; Hudson et al., 2014; Mims et al., 2009). Should the
Dialogic reading (DR) is a specific treatment package child give an incorrect answer to a comprehension ques-
deemed by the What Works Clearinghouse (2010) of the U.S. tion, parents were taught to implement the extend strategy,
Department of Education as an intervention that has “poten- which included (a) provision of answer choices for partici-
tially positive impacts” on the language skills of children pants with greater communication needs; (b) verbal prompts
who have disabilities. Researchers have used DR in a variety such as repeating the question, redirection to the task, or
of settings, such as the home with parents as interventionists, rephrasing the question; (c) reduction of answer choices; (d)
and training procedures frequently use didactic teaching with gestural prompts such as pointing to the picture of the cor-
incorporated modeling. In addition, it appears that posi- rect answer while verbally saying the correct answer; and (e)
tive outcomes may still be a result for studies that do not fully full physical prompts moving the child’s hand to the picture of
implement all DR procedures (Towson et al., 2017), thus the correct answer.
providing more room for adaptations to be made to meet
the needs of those with differing ability levels (Whalon
et al., 2013). Augmentative and Alternative Communication
The initial use of DR was introduced by Whitehurst Research in this area has also been extended for use with
et al. (1988) in which they provided general DR procedures individuals who require augmentative and alternative com-
consisting of prompting the child to communicate by asking munication (AAC) due to speech-language deficits (Browder
different types of questions, providing a response to the child et al., 2011; Lund et al., 2017; Mucchetti, 2013). Specifically,
by expanding upon their utterance or modeling the correct those with ASD or ID may have communication abilities
response, and the introduction of more complex questions ranging from nonverbal to individuals with mild social-
as the child is ready. Procedures were expanded to include communication deficits (Boat & Wu, 2015; Kasari et al.,
two parts to instruction. Part 1 included prompting the child 2013; Tager-Flusberg & Kasari, 2013), necessitating the
by asking “what” questions, following up with questions, need to choose the appropriate AAC system according to
incorporating models of correct language, providing praise, individual ability level. Forms of AAC range from unaided/
following the child’s lead, and encouraging the implementer no-tech (e.g., utilizes body parts and no other equipment),
to promote dialogue. Part 2 consisted of the introduction of low-tech (e.g., picture book, picture board), or high-tech
more complex questions and expanding what the child says (e.g., dedicated communication device, technology applica-
to model more syntactically complex utterances (Arnold et al., tion; Ganz & Simpson, 2019) forms. AAC may supplement
1994). The approach was then formalized using the mnemonic residual speech or replace oral communication for those
PEER and CROWD (National Research Council, 1999; with none (Hustad & Miles, 2010), and the use of multiple
Whitehurst et al., 1994). The PEER mnemonic stands for communication modalities (e.g., oral speech, signing, and
“prompt, evaluate, expand, and repeat.” The CROWD picture book) of communication may be the most feasible
mnemonic stands for “completion, recall, open-ended, wh- way for individuals to get their message across (Ganz &
questions, and distancing.” Completion questions are those re- Simpson, 2019).
quiring the child to fill-in-the-blank with an appropriate
answer. Recall questions are those that recall specific details
from the story that have already been read. Open-ended ques- Telepractice
tions are those that require inferencing skills or recognition of The delivery of interventions via technology for indi-
emotions. Wh-questions are those that begin with words such viduals with disabilities is becoming more common (Nelson
as “who,” “what,” or “where” and can be answered based on et al., 2018). Telepractice can be defined as the use of tech-
the information from the page. Distancing questions are those nology as a medium to connect clients, interventionists, and
that relate the concepts from the book to personal experiences. individuals with other areas of expertise for the purposes
Strategies for PEER include prompt child participation by of assessment and intervention. Benefits of telepractice
asking one of the CROWD questions, evaluate the accuracy over traditional service delivery options include lower costs,
of the child response, expand the child’s response by verbally higher treatment acceptability, and access to features such
adding additional words to the response the child gives and as screen sharing to enhance communication and education
provide praise (e.g., “great job!”, high-five, “way to go!”), (ASHA, n.d.; Reese et al., 2013; Sutherland et al., 2018;
and then ask the question again (repeat). Researchers such Wales et al., 2017). The delivery of intervention procedures
as Fleury and Schwartz (2017) have modified the intervention using technology incorporates participation models such
by utilizing a system of least prompts in their intervention with synchronous, asynchronous, and hybrid. Asynchronous
children who have ASD. Paraprofessionals delivered least models allow stakeholders to access material (e.g., written
intrusive to most intrusive prompts when children provided instructions, video examples, online training content) at a
the incorrect answer to a question or did not answer the convenient time. Synchronous models are characterized by
120 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021
live meetings held via online platforms or the telephone. Research Question 3: What are parents’ opinions of
Finally, hybrid models are those that use both synchronous the goals, outcomes, and procedures of this intervention?
and asynchronous models. Stakeholders involved in inter-
ventions via telepractice report a better understanding of
the concepts introduced asynchronously when elaborated Method
upon during synchronous sessions, increased opportunities to
Experimental Design
provide feedback to those implementing interventions, and
more confidence in implementing the intervention through A multiple-probe-across-participants design was used
discussion (Chung et al., 2020). for this study. The primary dependent variable for this study
was parent implementation of the modified DR procedures,
and the secondary dependent variable was the number of
Coaching comprehension questions the child answered correctly. The
While using telepractice, researchers use various coach- baseline condition consisted of the parent reading the story-
ing procedures. Aspects of coaching include viewing the stake- books in absence of modified DR training via telepractice.
holder implement the intervention procedures (e.g., live or The intervention condition was characterized by the parent
uploading a video for later viewing) and the provision of receiving training and coaching on the modified DR strate-
written and verbal feedback, making sure to also provide gies via telepractice. Condition changes were made when
praise. Self-reflection and the inclusion of a time for questions parent implementation data for modified DR procedures
are also helpful (Snodgrass et al., 2017). Researchers have were stable. Participants in subsequent tiers began interven-
implemented interventions delivered via telepractice models tion when intervention data (i.e., three data points) for par-
that have shown positive treatment outcomes (Coufal et al., ticipants in preceding tiers were stable or demonstrated a
2018; Gabel et al., 2013). In a study by Simacek et al. (2017), downward trend. The next tier’s stability was determined in
researchers coached parents to conduct functional analysis terms of trend more so than variability. Some variability
and functional communication training procedures at a dis- was acceptable due to the naturalistic nature of this inter-
tance. Results indicated that child requesting skills demon- vention. Randomization was used for all elements of base-
strated by both low-tech and high-tech modalities improved line and intervention, including participant order in tiers,
as a result of the coaching procedures delivered via distance. book reading calendars, and videos assigned for interob-
Researchers discussed benefits of telepractice delivery such server agreement (IOA).
as a lower cost alternative to face-to-face delivery and use of
the functional communication training intervention to add
to the interventions already being provided (Simacek et al., Participants and Settings
2017). In another study, parents of children with ASD were Participants were recruited from the south central
coached to deliver a communication intervention via dis- United States. Institutional review board approval at Texas
tance. Parents demonstrated the ability to deliver the inter- A&M University was obtained prior to study implementa-
vention components to their child, and increases in child tion (No. IRB2019-1744D). Potential participants were
communication skills were noted. Researchers indicated recruited by distributing flyers and letters to child care
that telepractice offered an on-demand format conducive centers, libraries, preschools, parents, individuals at univer-
to busy schedules that likely reduces the chance of parents sities, clinics, and early childhood centers. Approximately
dropping out of the intervention (Douglas et al., 2018). While 30 contacts were made for the recruitment of participants.
the results of these studies are promising, no studies using Inclusion criteria for child participants were (a) English as
telepractice to deliver storybook reading interventions with a primary language; (b) ages 5–8 years; (c) scores of below
AAC as a response mode to individuals with developmen- or well below expected on the Peabody Picture Vocabulary
tal disabilities have been published to our knowledge. Re- Test–Fifth Edition (PPVT-5; Dunn, 2018), which indicates
searchers trained parents to implement the intervention their ability level is below that of their peers; (d) evidence
procedures via a hybrid approach to telepractice. of a developmental disability determined by educational
The purpose of this study was to determine if teleprac- eligibility or medical diagnosis of ID, ASD, and/or devel-
tice can be used to teach parents of children with develop- opmental delay; (e) ability to stay engaged in an activity
mental disabilities to implement modified DR procedures for approximately 3–10 min with assistance; (f ) ability to
with fidelity. A low-tech communication option was avail- point to 10 white index cards on pages attached to 10 dif-
able to all participants. Research questions include the ferent pages of a book during a book reading activity; and
following: (g) answer 80% or less comprehension questions about a
Research Question 1: What is the effect of parent storybook correctly. Inclusion criteria for parents were
coaching via telepractice on the parent implementation (a) previous experience reading to their child, (b) willing-
of modified DR procedures? ness to follow treatment procedures, (c) willingness to
Research Question 2: What is the effect of parent participate in online meetings for coaching sessions, and
coaching of modified DR strategies delivered via teleprac- (d) willingness to work with their child each week to imple-
tice on the language skills of young children with development the intervention strategies. Speaking English and
mental disabilities? access to technology were not specific parent inclusion
Pierson et al.: Coaching Parents of Children With Developmental Disabilities 121

criteria for this study, although both were determined at the of ASD, anxiety, expressive and receptive language delays,
initial parent meeting held online. and global developmental delay were reported by the parent.
First, the interventionist met with each family online Isaac was able to stay in the area and engaged in the book
to determine if they and their children met inclusionary cri- reading activity when held by his mother. Leah (34 years of
teria for the study. Second, the interventionist met with the age), mother of Isaac, primarily implemented the interven-
parents and children in person at their home to complete tion. Jared (35 years of age), father of Isaac, also participated.
the initial book reading activity, parent interview, PPVT-5, The mother and father were in attendance at all training and
and the Vineland Adaptive Behavior Scales–Third Edition parent coaching sessions. Isaac used items such as sensory
(Vineland-3; Sparrow et al., 2016). Five families were toys that vibrated, malleable dough, and the opportunity to
assessed for participation, and four families met inclusion read a book of choice as reinforcers.
criteria. One dyad did not meet inclusion criteria due to
PPVT-5 scores that were in the expected range in relation Solomon (Ruth)
to their peers and the ability to answer 100% of compre- Solomon, a Caucasian male participant, was age
hension questions about a storybook correctly. Three parent– 6 years 1 month at the start of the study. Medical diagno-
child dyads and one parent–child triad participated in the ses of Down syndrome, global developmental delay, and
study. Family members could be occasionally seen or heard pediatric restless leg syndrome were reported by the parent.
in background of videos. Refer to Tables 1 and 2 for details Ruth (38 years of age), mother of Solomon, implemented
of parent and child information, respectively. the intervention. Solomon most frequently used the game
Shark Bite as a reinforcer after book reading sessions.
Aaron (Anna)
Aaron, a male participant, was 7 years 3 months of Interventionist
age at the start of the study. Diagnoses of ASD and speech-
language delay were reported. Anna (43 years of age ), mother The primary researcher and study implementer was a
of Aaron, implemented the intervention. Ethnicity information doctoral student with 10 years of experience working with
was requested by the interventionist; however, Anna was not children who have disabilities in clinical and educational
responsive to contacts following completion of the interven- settings. The interventionist held a master of science degree
tion condition. Aaron used items/activities such as time on the in communication disorders, state teaching certifications,
computer, making baked goods or candy, and watching a tele- and speech-language pathology licensure at the time of the
vision program as reinforcers during baseline and intervention. study. All interviews, assessments, training, and coaching
sessions were completed by the interventionist. The inter-
ventionist did not have a prior relationship with any partic-
Benjamin (Candace)
ipants, with the exception of Candace, who was involved
Benjamin, a Hispanic Caucasian male participant, was
in a parent training project where the interventionist served
5 years 9 months of age at the start of the study. The parent
as her parent coach.
provided results of Vineland-3 recently given to the child by
school district personnel. A primary educational diagnosis of
ASD and secondary diagnoses of speech-language impairment Materials
and pragmatic language impairment were reported. Candace Book Selection
(50 years of age), mother of Benjamin, implemented the inter- Four sets of five commercially available children’s
vention. Benjamin was not observed to use a preferred item as books were purchased for the intervention. Books were cho-
a reinforcer at the end of the book reading sessions. sen from a list of books provided by Owens and Robinson
(1997) if they were descriptive, narrative, contained appeal-
Isaac (Jared and Leah) ing illustrations, contained words, and were appropriate for
Isaac, a Caucasian male participant, was 5 years of age children in prekindergarten to second grade. Each book
at the start of the study. Medical and educational diagnoses was less than $4.50. The five books used during the DR
Table 1. Parent demographic information.
Participant Occupation Education level Previous experience Room/dimensionsa
Anna Homemaker Some college Trainings Dining/—

Candace Teacher BS Trainings and RE Living/14 ft × 14 ft
Leah/Jared COTA/engineer Associates/BS BT/none Bedroom/10 ft × 12 ft
Ruth Teacher MS Trainings Family office/13 ft × 15.5 ft
Note. Dash (—) indicates that data were not collected. Trainings = reported trainings were parent trainings for applied behavior analysis
(Anna) and teacher trainings as part of occupation (Candace and Ruth); BS = bachelor of science; RE = research experience; COTA=certified
occupational therapist assistant; BT = behavior technician; MS = master of science.
a
All settings in place familiar to child and dimensions are approximate.
Table 2. Child demographics.
Participant PPVT-5 SS PPVT-5 interpretation VABS-3 SSa Communication mode Services received
Aaron 79 Below expected 121 Verbal; sentences SPED, ST, OT

Benjamin 79 Below expected 80 Verbal; sentences SPED, ST, OT
Isaac 67 Well below expected 40 Sign, gestures, AAC ST, ABA
Solomon 56 Well below expected 50 Gestures, AAC SPED, APE, OT, ST, PT
Note. PPVT-5 = Peabody Picture Vocabulary Test–Fifth Edition; SS = standard score; VABS-3 = Vineland Adaptive Behavior Scales–Third
Edition; Communication mode = child communication mode prior to the study; SPED = special education; ST = speech-language therapy;
OT = occupational therapy; AAC = augmentative and alternative communication; ABA = applied behavior analysis; APE = adapted physical
education; PT = physical therapy.
a
M = 100, SD = 15.
procedures were Charlie Needs a Cloak (DePaola, 1974), in. in diameter. The interventionist wrote the number of each
Geraldine’s Blanket (Keller, 1988), The Knight and the question set in the center of the circle with a black marker
Dragon (DePaola, 1998), Rosie’s Walk (Hutchins, 1968), and placed each circle in the top right corner of the question
and Alexander and the Terrible, Horrible, No Good, Very set page. The intervention materials were hole-punched, or-
Bad Day (Viorst, 1972). The interventionist wrote the page ganized by book title using dividers, and placed in a three-
number in the corner of each book page using a black ring binder. Book choices and CROWD questions with
marker prior to the intervention. picture answer choices were reviewed by an expert in literacy
prior to the implementation of the study.
Questions and Picture Answer Choices Book Reading Calendars

The person conducting the intervention typically pre- Parents were provided with four calendars of book
pares CROWD questions related to the book prior to the readings. Books were read in the order listed on the calen-
book reading activity. During the book reading activity, the dar. The interventionist randomly ordered books using a
stakeholder moves through the steps of the modified DR random number generator for baseline, intervention, and
strategy beginning with prompt. Stakeholders working with maintenance sessions (Haahr, 2010). Another book was
individuals with disabilities can use the techniques com- chosen if the same book was drawn 2 times in a row. Each
bined with the most appropriate mode of communication family received a different calendar.
for the child to enhance oral language skills (Morgan &
Meier, 2008). For the purposes of this study, the interven- Reinforcers
tionist created questions using the CROWD framework. A “first/then” board, created by the interventionist and
Questions developed were appropriate for the listening provided to the parent, was used to motivate the student to
comprehension levels of children in kindergarten through complete the storybook reading tasks (Premack, 1959). A
second grade. At least two inference questions (open-ended), picture of a book was printed in the “first” box, and rein-
approximately an equal number of recall and wh-questions, forcing items (e.g., item/activity name written on a piece of
and one distancing question were constructed for each ques- paper) were placed in the “then” box by the parent. Parents
tion set. The page number corresponding to the book page chose reinforcers based on the results of the preference as-
for which the parent was to ask the question was written be- sessment and/or their knowledge of child preferences.
fore each question. Three different sets of 10 questions were
created for each book, and four picture answer choices were Technology
created for each question. A combination of photographs Training and coaching sessions were completed on
taken directly from the picture book and stock photos taken WebEx, a secure, HIPAA-compliant, free, web-based plat-
from the web were obtained for each comprehension ques- form. Parents accessed WebEx and recorded book reading
tion picture answer choice. Stock photos from the web were session videos using their computer, tablet, or smartphone.
taken when there was not a good picture from the book. For Parents also used Google Drive to upload their storybook
example, if milk was the answer to a CROWD question and reading videos and access intervention materials. The inter-
there were no available visuals from the book, a stock photo ventionist provided written and oral directions during the
was found depicting milk. Picture answer choices (approxi- baseline training meeting to assist parents with uploading
mately 1 in. × 1 in.) were centered in four attached black the videos to the Google Drive.
boxes (approximately 2 in. × 2 in.) under each question,
and five questions with picture answer choices were located
on each page. Use of picture answer choices was consid- Independent Variable
ered low-tech AAC for this study. Question and answer The independent variable for this intervention was the
sets were printed in color on white cardstock. Each set was parent reading storybooks with modified DR procedure in
color coded using green, pink, or orange circular labels 0.75 training and coaching via telepractice. The interventionist

trained parents to implement the baseline and DR proce- reference. The cheat sheet contained information about
dures during one training session for each condition. setting up the book reading session, the anticipatory set pro-
cedures, CROWD questions, and PEEER strategy. A flow
Anticipatory Set chart for the intervention procedures can be found in Sup-
Intervention procedures incorporated an anticipatory plemental Material S2.
set, which served as a way to activate prior knowledge
(Klingner et al., 2015). Anticipatory set procedures were Coaching
used during the storybook reading intervention to preview Parents participated in synchronous coaching sessions
elements of the story, generate conversation about the front occurring 1 time per week on a mutually agreeable day and
cover of the book, or talk about what may happen in the time. Prior to the meeting, the interventionist watched all of
book based on the pictures (Spooner et al., 2014, 2009). the recorded videos the parent uploaded the week prior to
The parents were instructed to begin the storybook session the meeting and prepared written feedback (i.e., asynchro-
by handing the book to their child. Parents encouraged their nous activities). During the meeting, at least one video clip
child to look at the title while pointing to it, and then the was watched, and verbal feedback was provided. Feedback
parent read the title. The parents discussed the pictures on was provided on the preparation of materials and imple-
the front of the book using the child’s preferred communi- mentation of the anticipatory set. The parents were shown
cation modality. Next, the parent prompted the child by graphs depicting parent fidelity of the modified DR inter-
saying, “What do you think this story will be about?” Then, vention data and the data on the number of questions the
the parent talked about an experience related to something child was able to answer correctly. Narrative feedback about
seen on the front cover of the book. Finally, the parent overall parent performance and child behavior was given.
was asked to respond to their child and follow their lead in Parent behaviors were modeled, and/or role play occurred.
terms of conversation interest. Procedures for the anticipa- Feedback specific to the communication needs of each child
tory set can be found in Supplemental Material S1. participant was also given. For example, Leah, Jared, and
Ruth were encouraged to elicit verbal communication by
Training verbally modeling the correct answer and providing explicit
Intervention training consisted of didactic teaching prompts, such as “tell me hen.” Anna and Candace were
using an interventionist prepared presentation. Didactic encouraged to use more open-ended questions during gen-
teaching is a systematic delivery method for teaching infor- eralization book readings and provide more syntactically
mation (Albaradie, 2018). The synchronous presentation complex expansions. An increase in wait time and use of
began with a discussion about the benefits of reading story- less intrusive prompts were also suggested during coaching
books to children (Hargrave & Sénéchal, 2000; Huebner, sessions. Coaching sessions lasted approximately 60 min.
2000; Lever & Sénéchal, 2010; Lonigan & Whitehurst, 1998;
Strasser et al., 2013), and a discussion of common concerns
related to storybook reading followed. The interventionist
Dependent Variable and Measures
then introduced DR using a combination of text and a video Primary Dependent Variable
(Lonigan, 2011a). Levels of CROWD were introduced using The primary dependent variable was the parent im-
a video and text (Lonigan, 2011b). The PEEER portion of plementation of the modified DR intervention procedures.
the intervention was introduced through text with definitions Parent behavior responses were the correct implementation
of each of the parent implementation strategies. Then, the of PEEER components of the modified DR strategy for each
interventionist presented a video of the intervention being question asked during each book reading session. For the
implemented to children in a group format (CONNECT purposes of this modified DR intervention, the evaluate
Modules, n.d.). Instruction on the system of least prompts component was not measured because the authors consid-
followed, and parents were taught a prompting hierarchy ered it to be a private event inside the parent. Data reported
to be used during the intervention (Ledford & Chazin, 2016). as averages for the PEEER and anticipatory set strategies
The parents then engaged in role-play activities in which the can be found in Figure 1.
parents and interventionist played the role of parent and
child during a book reading activity. First, the interven- Secondary Dependent Variable
tionist presented a sample storybook and related CROWD The secondary dependent variable was child answers
questions. The interventionist played the role of the parent, to comprehension questions that are correct, prompted
and the parent played the role of the child. Then, the parent correct, prompted incorrect, or incorrect. Raters evaluated
played the role of the interventionist using one of the inter- child answers according to descriptions located in Table 3.
ventionist-provided books or a book of their choice. In- Revealing the picture answer choices for Aaron and Benjamin
structions for the reading procedure were presented on the was counted as a prompt because they initially demonstrated
screen to help the parent move through the strategies. The high rates of independent correct responses during the first
interventionist provided verbal feedback about the parent’s four baseline probes. Isaac and Solomon were allowed to
role-playing performance. see the picture answer choices due to lower rates of indepen-
Asynchronous portions of the intervention consisted dent correct responses during the first four baseline probes.
of provision of the presentation and a cheat sheet for future Correct and prompted correct child data for the secondary
Figure 1. Parent implementation dialogic reading procedures.

Table 3. Child comprehension question answer descriptions.
Behavior Description
Correct Child independent correct oral answer using words or word approximations, book picture point, sign, or answer
choice picture point within 10 s.
Prompted correct Child provides incorrect response. Parent provides system of least prompts. Child provides oral answer using
words or word approximations, book picture point, sign, or answer choice picture point within 10 s.
Prompted incorrect Child provides an incorrect response. Parent provides system of least prompts. Child provides an incorrect
response within 10 s.
Incorrect Child provides incorrect response to a question within 10 s. Parent does not provide system of least prompts.
dependent variable can be found in Figure 2. Both are re- question corresponding to the page number being read in
ported as percentages. this condition was done to allow for consistent data collec-
tion between baseline and intervention conditions. After
reading, parents were told to upload the video to the drive
Assessment Measures
within 24 hr of the book reading session. Parents were
The PPVT-5 (Dunn, 2018) and Vineland-3 (Sparrow
instructed to refrain from delivering prompts related to
et al., 2016) were used as one part of the assessment pro-
the question during the baseline condition. Parents were
cess. The PPVT-5 is a norm-referenced measure used to assess
asked to video-record three to four book reading sessions
vocabulary skills and designed to be part of a comprehensive
per week.
language evaluation. The Vineland-3 is a norm-referenced
assessment used to assess adaptive behavior skills and was
Intervention
used as a measure to describe current functioning for the
One intervention training session lasting an average
purposes of this study.
of 60 min and provided via telepractice was completed
for each family. Before reading, procedures were identi-
Procedure cal to the baseline condition. During reading, parents were
instructed to read the words on the page, talk about the page,
Baseline
read the question corresponding to the page number being
Prior to baseline, one training session lasting an aver-
read, and carry out the remainder of the PEEER steps. Parents
age of 20 min and provided via telepractice was conducted
were encouraged to record one video per day. If more
for each family. The session began by reviewing the binder
than one video per day needed to be recorded, parents
and storybooks provided by the interventionist. The binder
were instructed to wait at least 1 hr between book reading
included the question sheets, the first/then board, and pref-
sessions.
erence assessment data sheets. Parents were taught to ad-
minister free operant preference assessments. The free Generalization
operant procedure was chosen because of its ease of imple- Generalization data were collected during baseline,
mentation (Chazin & Ledford, 2016). Directions for the free intervention, and maintenance conditions. Parents were
operant procedure included the following: (a) Set up the instructed to read a book that they own or one from the
environment with toys to choose from or move to a natural library in the same place they are conducting baseline and
environment where toys are already available, (b) observe if intervention sessions. Parents formulated 10 questions based
the child walks up to an item or picks up the item and the on the CROWD questioning strategy, and no instructions
length of time the child interacts with the item, (c) record in- were given in regard to the answer choice format. Procedures
formation about each item the child engages, and (d) list items for generalization were the same as intervention.
that are present but were not motivating for the child. Partici-
pants were provided the data sheet created by Chazin and Maintenance
Ledford (2016). Parents were encouraged to use preferred Maintenance data were collected 1 week after the
items or activities chosen by the child during the preference intervention condition ended. The same procedures were
assessment as reinforcers during the baseline condition. followed for the intervention condition. A coaching session
Procedures for before, during, and after reading were was not provided during the week maintenance took place.
reviewed. Before reading, parents were instructed to find a An interventionist-provided book and a generalization
quiet place for each book reading session, gather the first/ book chosen by each family were read during the main-
then board, place the storybook in front of the child, and tenance condition. Maintenance data were collected for
place the answer choices in front of the child. During read- Benjamin, Isaac, and Solomon.
ing, parents were instructed to read the words on the page,
talk about the page, and then read the question correspond-
ing to the page number being read, because this type of ex- Data Collection
change is a part of natural caregiver reading behavior (Bus Continuous recording procedures and counts were
& van Ijzendoorn, 1997; Symons et al., 2005). Reading the used to determine the frequency of behaviors (Ledford &
Figure 2. Child correct and prompted correct responses to questions.

Gast, 2018). All baseline, intervention, and maintenance completed the survey in the middle of the intervention con-
book reading sessions were video-recorded by parents. dition. Feedback from parents was discussed and integrated
The first author watched, coded, and graphed data from into the intervention. Survey components included rating of
all videos. Parent and child data were collected using a the ease of use of procedures, materials, generalizability of
checklist that can be provided by the first author upon intervention with other people in their home, cost effective-
request. Averages related to PEEER and the anticipatory ness of intervention, and overall rating of parent views on
set were calculated by dividing the total number of strate- effectiveness of intervention and appropriateness of treat-
gies the parent implemented by the total number of possible ment goal.
opportunities the parent had to implement the strategy and
multiplying that quotient by 100. In addition, data for the Visual Analysis
number of modified DR component implementation oppor-
tunities missed per condition and the percentage of compo- The data were analyzed using visual analysis. Analy-
nents correctly implemented can be found in Table 5. The sis of data within and between conditions was completed.
number of opportunities missed per condition was calculated The interventionist analyzed the data based on level, trend,
by counting the number of times the parent did not imple- variability, immediacy of effect, and stability (Vannest &
ment a strategy when given the opportunity. Ninci, 2015). The interventionist expected a low, stable level
and trend for baseline data followed by a gradual increase in
data for the intervention condition.
IOA
Three doctoral students with previous experience Statistical Analysis
conducting single-case studies completed IOA. Raters
were masked to the study condition and trained by the Statistical analyses accompanied the visual analysis
first author with a small number of videos to at least component for this intervention. Tau-U was used as the
80% agreement. Data were collected for approximately primary statistical analysis tool because all data points can
30% of the data points for all participants in all condi- be used, it allows for control of baseline trend, and it has
tions. Retraining occurred if agreement was below 80% high sensitivity (Parker et al., 2011). Data were analyzed
for the anticipatory set, child independent answers to using a free online Tau-U calculator (Vannest et al., 2016).
comprehension questions, or parent implementation of Tau-U values range from −1 to 1. Effects can be interpreted
the PEEER strategy. Disagreements were resolved via as 0.93–1.00 (strong to very strong effects), 0.80–0.92 (mod-
discussion. Agreement calculations were calculated using erate effects), 0.65–0.79 (low effects), and ≤ 0.64 (no to very
point-by-point agreement, which is the number of agree- low effects; Ganz et al., 2017).
ments divided by number of agreements plus disagreements
multiplied by 100 (Ledford & Gast, 2018). Four IOA per- Results
centages across two observers were lower than 80% due to
confusion about the timing of anticipatory set procedures, Statistical analysis of data revealed an omnibus Tau-
failure to indicate extend was used if prompts were deliv- U value for parent PEEER implementation of 0.82 (90% CI
ered, and counting other plausible answers to distancing [0.5655, 1]), indicating that parent training and coaching
questions as correct. Retraining occurred following these via telepractice had a moderate effect on parent implemen-
four instances. tation of modified DR procedures. Individual effects for
individual parents ranged from 0.64 to 1.00. Effect sizes
align with visual analysis. The effect sizes were 1.00 (strong
Training Fidelity and Procedural Integrity to very strong effect) for Anna, 0.68 (low effect) for Candace,
Training fidelity data were collected for the sessions 0.64 (no to very low effect) for Leah and Jared, and 0.96
in which the interventionist trained the parent to carry out (strong to very strong effect) for Ruth.
the baseline or intervention procedures via video. Baseline
training for Anna was not recorded due to a recording mal- Parent Implementation Data
function. Procedural integrity data were also collected for
100% of the coaching sessions in which the interventionist Anna
gave the parent feedback about the book reading session Data for parent implementation of PEEER components
videos. A second rater watched the videos, and a percent- during baseline have no trend (average = 54%, range: 50%–
age of agreement was taken. Agreement for one training 57%). An immediacy of effect can be observed for data be-
fidelity video was below 80%; thus, retraining was necessary tween baseline and intervention. Data for PEEER strategy
in that instance. Data are presented in Table 4. implementation during intervention are variable and have no
trend (average = 90%, range: 82%–97%). Generalization data
were 50% in baseline, while data in intervention were 84%
Social Validity and 100%. Data for anticipatory set strategy implementa-
A social validity survey soliciting parent ratings in tion in baseline have no trend or variability (average = 20%,
the form of a 5-point Likert scale was adapted from a ques- range: 20%–20%). An initial immediacy of effect can be
tionnaire developed by Roberts and Leko (2013). Parents observed between baseline and intervention conditions.
Table 4. Procedural integrity, training fidelity, and interobserver agreement.
Parent name PI TF BL TF IV Child PEEER Anticipatory set
Anna 100% — 100% 90% 90% 93%

(100%–100%) (100%–100%) (80%–100%) (87%–94%) (80%–100%)
Candace 100% 100% 89% 85% 89% 97%
(100%–100%) (100%–100%) (89%–89%) (70%–100%) (80%–100%) (80%–100%)
Leah/Jared 96% 100% 75% 90% 92% 89%
(89%–100%) (100%–100%) (75%–75%) (70%–100%) (83%–100%) (60%–100%)
Ruth 100% 100% 100% 92% 93% 87%
(100%–100%) (100%–100%) (100%–100%) (80%–100%) (88%–100%) (40%–100%)
Note. Dash (—) indicates that data were not collected. The mean is followed by the range in parenthesis. PI = procedural integrity; TF BL =
training fidelity baseline; TL IV = training fidelity intervention.
Intervention data are variable, with no trend at the be- are 80%, 80%, and 80%. In the maintenance condition, PEEER
ginning of intervention and a decreasing trend toward data were 97% and 93% (generalization), while anticipatory
the end of intervention (average = 63%, range: 20%–80%). set data were 100% and 80% (generalization).
Generalization data were 20% in baseline, while data in
intervention were 80% and 60%. Maintenance data were
requested by the interventionist; however, Anna was not re- Ruth
sponsive to contacts following completion of the intervention Data for PEEER strategy implementation in baseline
condition. have no trend and are variable (average = 42%, range:
18%–53%). An immediacy of effect can be observed be-
tween baseline and intervention conditions. Intervention
Candace
data have a decreasing trend (average = 80%, range: 76%–
Data for parent implementation of PEEER components
84%). Generalization data are 53% in baseline, while data
during baseline are variable and have no trend (average =
in intervention are 82% and 79%. Data for anticipatory set
68%, range: 58%–78%). An initial immediacy of effect can be
implementation in baseline have no trend and are variable
observed between baseline and intervention points. Data for
(average = 42%, range: 20%–60%). An immediacy of effect
PEEER in intervention are variable with an increasing
can be observed between baseline and intervention condi-
trend (average = 91%, range: 78%–97%). Generalization
tions. Intervention data have no trend and are variable (av-
data were 79% in baseline, while data in intervention were
erage = 88%, range: 60%–100%). Generalization data are
69% and 90%. Baseline anticipatory set procedure imple-
20% in baseline, while data in intervention are 80% and
mentation data are variable and have no trend (average =
100%. In the maintenance condition, PEEER data were 78%
17%, range: 0%–20%). An immediacy of effect can be ob-
and 80% (generalization), while anticipatory set data were
served between baseline and intervention. Data for antici-
100% and 100% (generalization).
patory set in intervention have an increasing trend (average
= 70%, range: 60%–80%). Generalization data were 20% in
baseline, while data in intervention were 40% and 80%. In Modified DR Components Missed
the maintenance condition, PEEER data were 81% and A breakdown of parent implementation of DR com-
82% (generalization), while anticipatory set data were 80% ponents can be found in Table 5. Anna missed 51 strategy
and 60% (generalization). implementation opportunities and implemented 50% correctly
in baseline, while 26 implementation opportunities were
Leah and Jared missed and 88% were implemented correctly in interven-
PEEER strategy implementation data in baseline have tion. Candace missed 62 strategy implementation oppor-
no trend and are variable (average = 68%, range: 50%– tunities and implemented 67% correctly in baseline, while
78%). An immediacy of effect between baseline and inter- 23 implementation opportunities were missed and 88%
vention can be observed with the exception of the first data were implemented correctly. Leah and Jared missed 107 im-
point in intervention. PEEER strategy implementation data plementation opportunities and implemented 67% correctly
during intervention have no trend and are variable (aver- in baseline, while 45 implementation opportunities were
age = 81%, range: 23%–97%). Generalization data are 70% missed and 81% were implemented correctly in interven-
in baseline, while data in intervention are 94%, 77%, and 90%, tion. Ruth missed 240 implementation opportunities and
respectively. Anticipatory set data in baseline have no trend implemented 41% correctly in baseline, while 38 opportuni-
(average = 15%, range: 0%–20%). An immediacy of effect ties were missed and 80% were implemented correctly in
from baseline to intervention is apparent. Data in interven- intervention. The greatest number of opportunities missed
tion have no trend (average = 80%, range: 80%–80%). Gener- across participants occurred for expand and repeat proce-
alization data are 20% in baseline, while data in intervention dures. When comparing the number of strategies missed

Table 5. Number of modified dialogic reading component opportunities missed per condition.
No. of modified dialogic reading components

Baseline Intervention Maintenance
Parent Baseline generalization Intervention generalization Maintenance generalization Total
Anna n=3 n=1 n=6 n=2 — —

Prompt 0 [100] 0 [100] 3 [95] 0 [100] — — 3
Extend 3 [85] 0 [100] 3 [93] 0 [100] — — 6
Expand 27 [10] 10 [0] 9 [84] 3 [85] — — 49
Repeat 21 [0] 3 [0] 11 [80] 2 [82] — — 37
Total 51 [50] 13 [50] 26 [88] 5 [91] 95
Candace n=6 n=1 n=6 n=2 n=1 n=1
Prompt 0 [100] 0 [100] 0 [100] 0 [100] 0 [100] 0 [100] 0
Extend 0 [100] 0 [100] 1 [97] 0 [100] 0 [100] 1 [0] 2
Expand 28 [52] 3 [70] 6 [90] 1 [94] 0 [100] 1 [89) 39
Repeat 34 [6] 3 [25] 16 [61] 6 [45] 6 [0] 1 [0] 66
Total 62 [67] 6 [79] 23 [88] 7 [88] 6 [81] 3 [86] 107
Leah and Jared n=8 n=1 n=6 n=3 n=1 n=1
Prompt 4 [95] 0 [100] 7 [83] 0 [100] 0 [100] 0 [100] 11
Extend 6 [92] 0 [100] 7 [87] 2 [88] 0 [100] 0 [100] 15
Expand 32 [60] 2 [78] 11 [82] 3 [90] 0 [100] 0 [100] 48
Repeat 65 [20] 10 [0] 20 [67] 6 [71] 1 [89] 2 [50] 104
Total 107 [67] 12 [69] 45 [81] 11 [88] 1 [97] 2 [93] 178
Ruth n = 10 n=1 n=5 n=2 n=1 n=1
Prompt 14 [90] 0 [100] 0 [100] 0 [100] 0 [100] 0 [100] 14
Extend 31 [69] 2 [80] 0 [100] 0 [100] 0 [100] 0 [100] 33
Expand 96 [3] 7 [30] 1 [98] 1 [95] 0 [100] 1 [86] 106
Repeat 99 [0] 10 [0] 37 [23] 14 [22] 9 [0] 5 [0] 174
Total 240 [41] 19 [53] 38 [80] 15 [80] 9 [55] 6 [74] 327
Note. Dash (—) indicates that data were not collected. n = number of sessions; [ ] = percentage implemented correctly.
between baseline and intervention conditions, participants 40%–70%). No immediacy of effect was noted between
missed more strategies in baseline than in intervention. baseline and intervention conditions. Intervention data are
variable (average = 57%, range: 30%–80%). Generalization
data are 40% in baseline, while data in intervention are 30%
Child Data and 30%. In the maintenance condition, prompted correct
Aaron data were 40% and 90% (generalization), while correct data
Data for correct responses to comprehension questions were 60% and 10% (generalization).
in baseline have a descending trend (average = 40%, range:
30%–50%). No immediacy of effect was noted between base- Isaac
line and intervention conditions. Intervention data have an Data for correct responses to comprehension questions
ascending trend (average = 30%, range: 10%–40%). General- in baseline have no variability or trend (average = 0%, range:
ization data are 50% in baseline, while data in intervention 0%–0%). There was an immediacy of effect between baseline
are 60% and 90%. Data for prompted correct responses to and intervention, with the exception of the first data point.
comprehension questions in baseline have an ascending trend Intervention data are variable and have no trend (average =
(average = 57%, range: 50%–60%). No immediacy of effect 13%, range: 0%–30%). Generalization data are 0% in base-
was noted between baseline and intervention conditions. In- line, while data in intervention are 50%, 40%, and 50%. Data
tervention data have no trend (average = 60%, range: 50%– for prompted correct responses to comprehension questions
70%). Generalization data are 50% in baseline, while data in baseline are variable and have no trend (average = 69%,
in intervention are 40% and 10%. range: 20%–100%). No immediacy of effect was noted be-
tween baseline and intervention conditions. Intervention
Benjamin data are variable (average = 65%, range: 20%–90%). Gener-
Data for correct responses to comprehension ques- alization data are 80% in baseline, while data in intervention
tions in baseline are variable (average = 38%, range: 20%– are 50%, 40%, and 50%. In the maintenance condition, cor-
60%). No immediacy of effect was noted between baseline rect data were 20% and 70% (generalization), while prompted
and intervention conditions. Intervention data are variable correct data were 80% and 20% (generalization).
(average = 35%, range: 20%–60%). Generalization data are
60% in baseline, while data in intervention are 60% and Solomon
70%. Data for prompted correct responses to comprehension Data for correct responses to comprehension questions
questions in baseline have no trend (average = 57, range: in baseline have no variability or trend (average = 2%, range:
0%–10%). An immediacy of effect is not present between with the number of independent and prompted behaviors
baseline and intervention. Intervention data have no trend their child exhibited during the intervention condition. Par-
or variability (average = 2%, range: 0%–10%). Generali- ents also reported an increased awareness of their own
zation data are 0% in baseline, while data in intervention behavior while reading children’s books as a result of the
are 10%, 10%, and 50%. Data for prompted correct responses intervention and have used the intervention procedures when
to comprehension questions in baseline are variable and have reading to their other children.
no trend (average = 9%, range: 0%–20%). An immediacy
of effect was noted between baseline and intervention con- Procedure
ditions. Intervention data are stable for the first three data Overall, parents positively rated intervention proce-
points and can be characterized by a descending trend for dures. Results of the social validity questionnaire indicated
the last three data points (average = 96%, range: 80%–100%). that the intervention was organized (average = 4.5), mate-
Generalization data are 80% in baseline, while data in inter- rials were organized (average = 4.75), and procedures were
vention are 90%, 90%, and 40%. In the maintenance condi- easy to understand (average = 4). Participants reported that
tion, correct data were 0% and 50% (generalization), while their children grew tired of interventionist-provided books
prompted correct data were 100% and 40% (generalization). toward the end of the intervention. Candace had difficulty
with technology aspects of the intervention but also re-
Social Validity ported that the intervention would be useful for students
in her classroom. Ruth had some difficulty with having
Social validity ratings can be found in Table 6. Over- her child stay seated at the beginning of the intervention
all, parents rated this intervention to be socially valid but but indicated improvements in the child’s ability to sit on
reported some difficulty with child behavior and interven- the social validity questionnaire.
tion procedures.
Goals Discussion
The parents stated that the goals are very important In this study, parents were remotely taught to imple-
for their children. Average ratings for the importance of ment modified DR strategies with their children with dis-
the goals targeted for this intervention was 4.75, with the abilities. Given the complexity of this multicomponent
majority of participants rating the intervention goals a 5. intervention and the variability of parent responding a
functional relation could not be definitively determined.
Outcomes No change in child responses as a result of the interven-
Overall, outcomes of the study were positive. Parents tion were noted, with the exception of a small change in
felt the child was able to learn the skills taught (average = one participant. Overall, parents deemed the interven-
4.5), the intervention was beneficial (average = 5), and that tion to be socially valid and provided helpful feedback
there are noticeable changes in behavior as a result of the about the intervention. This research study extends pre-
intervention (average = 4.75). Leah and Jared were pleased vious work studying the impact of AAC during shared
Table 6. Participant social validity ratings.
Leah and
Questions Anna Candace Jared Ruth Average
How would you rate the overall organization of the procedures for this research project? 4 5 4 5 4.5
How would you rate the organization of the materials used for this intervention? 4 5 5 5 4.75
How would you rate the ease of use of the children’s book used for this intervention? 4 5 4 5 4.5
Do you believe you could use the materials and instructional methods for other children living 4 5 4 5 4.5
in your home?
Do you feel that the procedures used for the intervention are easy to understand? 3 5 4 4 4.
Is it difficult to use the intervention for your child? 4 1 4 2 2.75
Did your child’s challenging behaviors make it difficult to use the storybook reading lessons? 2 1 2 3 2.
Was your child able to learn the skills you were teaching? 4 5 4 5 4.5
Did the intervention interfere with your typical daily activities? 3 1 3 5 3.
Do you feel that the intervention was beneficial to your child? 5 5 5 5 5.
Did your child enjoy the book reading lessons? 4 5 4 4 4.25
Did your child feel successful during the intervention? 5 5 4 4 4.5
Do you think the skills that your child is learning are important skills? 5 5 4 5 4.75
Do you feel that there are noticeable changes in behavior as a result of this intervention? 5 5 4 5 4.75
Are you happy with the procedures and results of this study? 4 5 4 5 4.5
Do you think the intervention was efficient and cost effective? 5 5 5 5 5.
Note. Scale: 1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree.

storybook reading implemented in classrooms (Finke et al., the initial book reading session conducted in the home by
2017; Quinn et al., 2020; Sennott, 2013; Tan, 2014), by the first author while Julia was watching. Parent exposure to
researchers in homes (Golloher, 2018), and by parents in parts of the prompting procedure prior to intervention train-
homes (Akamoglu & Meadan, 2019) by teaching parents ing could have impacted parent implementation data. Sec-
to implement this intervention utilizing a low-technology ond, there were no training fidelity data collected in baseline
AAC system via telepractice. for one parent. Third, books were preselected without con-
Considering the results of this intervention in light of sideration for child and parent preferences. Fourth, masked
previous research is invaluable and can inform future prac- raters were not used for the collection of IOA data, which
tice. Some researchers have found that parents are able to could be a source of observer bias for this study (Ledford &
implement shared reading interventions with children who Gast, 2018). Fifth, it should be noted that the interventionist
use AAC (Akamoglu & Meadan, 2019; Kent-Walsh et al., had a prior coaching history with one dyad, which could
2010; Na, 2015), while others have found variable parent have impacted intervention implementation and the gen-
implementation for studies conducted in naturalistic environ- eralizability of the outcome. Finally, the evaluate portion
ments, such as in the home (Golloher, 2018; Whalon et al., of this modified DR intervention was not measured in this
2016). Similar to this study, Whalon et al. found that parents study, and it is an integral part of the DR strategy. In the
demonstrated some difficulty with implementing the expand spirit of the evolution of DR procedures (Arnold et al., 1994;
strategy. In contrast to this study, researchers have found National Research Council, 1999; Whitehurst et al., 1994,
increases in child behaviors such as turn-taking (Kent-Walsh 1988), we considered this intervention to be another varia-
et al., 2010), commenting (Na, 2015), and participation tion of the strategy suitable for individuals with develop-
(Golloher, 2018), while others have indicated that child mental disabilities.
data were more variable (Edmister & Wegner, 2015; Vogler-
Elias, 2009).
Differences in the results of this study could be due Future Research
to the complexity of the current intervention. Parents were Future research could incorporate high-technology
coached to implement DR components, provide prompts devices when answering questions as an additional option
after evaluating the child’s response, and also moderate for communication. Additional studies could also use books
any behaviors that occurred during the book reading activ- targeting social skills because storybook reading provides a
ity. Minimal training was provided to the parents about the natural context for discussion. While cost-effectiveness and
provision of reinforcement. An additional focus on deliver- feasibility have to be taken into consideration (Ledford &
ing reinforcement may have increased the child’s motivation Gast, 2018), masked raters can be used in future studies.
to participate in the intervention and subsequently improve Researchers found that the greatest number of missed im-
outcomes. These ideas are of practical importance for practi- plementation opportunities occurred for the expand and
tioners choosing the appropriate intervention for a client and repeat portions of the intervention, while parents were
researchers working to expand upon previous research. able to implement the prompt and extend portions of the
Technological challenges during the implementation intervention. Future studies could further explore these
of the modified DR procedures via telepractice were evident intervention components. Finally, if critical to the effective-
and warrant discussion. While remote delivery was chosen to ness of DR, future studies can consider using an evaluate
reach children with disabilities who live in locations without definition such as the one from a study by Towson in which
access to service providers, because it may potentially researchers define evaluation as “a verbal affirmation of the
save travel time, and could result in a reduction in the child’s response” or one from a study by Blom-Hoffman
amount money spent on fuel (ASHA, n.d.; Reese et al., where it is defined as “Parent evaluates what the child says
2013; Sutherland et al., 2018; Wales et al., 2017), parents by praising the child, repeating what the child says, or gently
struggled to upload videos due to lack of technological knowl- correcting the child’s answer” (Blom-Hoffman et al., 2007;
edge and decreased home upload speeds (Fawns, 2019; Towson et al., 2019).
Lerman et al., 2020; Scheerder et al., 2019). Researchers
and manufacturers could invest time to educate users about
the devices used or provide video tutorials. Environmental Conclusions
modifications such as decreasing the number of people in
the household using the Internet during telepractice sessions In conclusion, while some of the child participants
could also be suggested (Lerman et al., 2020). Greater atten- demonstrated improvements in unprompted behaviors, the
tion to technological problems and the ingenuity to come up secondary dependent variable, this change was not consis-
with innovative solutions are warranted by all stakeholders. tent across all behaviors. Tentative evidence that parents
can learn to implement some components of modified DR
when trained and coached via telepractice was found as a
result of this modified DR intervention. Thus, the vari-
Limitations ability of the data makes it difficult to definitely say that
Limitations to this study exist. First, the interven- changes in parent outcome data had a positive impact on
tionist inadvertently provided prompts to Stephen during the children.
References DePaola, T. (1998). The knight and the dragon. Prentice Hall.
DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., &
Akamoglu, Y., & Meadan, H. (2019). Parent-implemented com- Pignone, M. P. (2004). Literacy and health outcomes. Journal
munication strategies during storybook reading. Journal of of General Internal Medicine, 19, 1228–1239. https://doi.org/
Early Intervention, 41, 300–320. https://doi.org/10.1177/ 10.1111/j.1525-1497.2004.40153.x
1053815119855007 Douglas, S. N., Kammes, R., & Nordquist, E. (2018). Online com-
Albaradie, R. S. (2018). Perception of students and teachers about munication training for parents of children with autism spectrum
didactic teaching: A cross-sectional study. Perception, 7(2), disorder. Communication Disorders Quarterly, 39, 415–425.
107–115. https://doi.org/10.4103/sjhs.sjhs_28_18 https://doi.org/10.1177/1525740117727491
American Academy of Pediatrics. (2017). Reading with children start- Dunn, D. M. (2018). PPVT-5: Peabody Picture Vocabulary Test–
ing in infancy gives lasting literacy boost: Shared book-reading Fifth Edition. Pearson.
that begins soon after birth may translate into higher language Edmister, E., & Wegner, J. (2015). Repeated reading, turn taking,
and vocabulary skills before elementary school. ScienceDaily. and augmentative and alternative communication (AAC).
Retrieved December 16, 2019, from www.sciencedaily.com/ International Journal of Disability, Development and Educa-
releases/2017/05/170504083146.htm tion, 62(3), 319–338. https://doi.org/10.1080/1034912X.2015.
American Speech-Language-Hearing Association. (n.d.). Teleprac- 1020920
tice. Retrieved February 10, 2020, from https://www.asha.org/ Fawns, T. (2019). Postdigital education in design and practice.
prpprinttemplate.aspx?folderid=8589934956 Postdigital Science and Education, 1, 132–145. https://doi.org/
American Speech-Language-Hearing Association. (2006). Roles 10.1007/s42438-018-0021-8
and responsibilities of speech-language pathologists in diagnosis, Finke, E. H., Davis, J. M., Benedict, M., Goga, L., Kelly, J.,
assessment, and treatment of autism spectrum disorders across Palumbo, L., Peart, T., & Waters, S. (2017). Effects of a
the life span [Position statement]. http://www.asha.org/policy least-to-most prompting procedure on multisymbol message
Arnold, D. H., Lonigan, C. J., Whitehurst, G. J., & Epstein, J. N. production in children with autism spectrum disorder who
(1994). Accelerating language development through picture use augmentative and alternative communication. American
book reading: Replication and extension to a videotape train- Journal of Speech-Language Pathology, 26(1), 81–98. https://
ing format. Journal of Educational Psychology, 86(2), 235–243. doi.org/10.1044/2016_AJSLP-14-0187
https://doi.org/10.1037/0022-0663.86.2.235 Fleury, V. P., & Hugh, M. L. (2018). Exploring engagement in
Blom-Hoffman, J., O’Neil-Pirozzi, T., Volpe, R., Cutting, J., & shared reading activities between children with autism spectrum
Bissinger, E. (2007). Instructing parents to use dialogic reading disorder and their caregivers. Journal of Autism and Develop-
strategies with preschool children: Impact of a video-based mental Disorders, 48, 3596–3607. https://doi.org/10.1007/s10803-
training program on caregiver reading behaviors and children’s 018-3632-8
related verbalizations. Journal of Applied School Psychology, Fleury, V. P., & Schwartz, I. S. (2017). A modified dialogic read-
23(1), 117–131. https://doi.org/10.1300/J370v23n01_06 ing intervention for preschool children with autism spectrum
Boat, T. F., & Wu, J. T. (2015). Clinical characteristics of intellec- disorder. Topics in Early Childhood Special Education, 37(1),
tual disabilities. In T. F. Boat & J. T. Wu (Eds.), Mental disor- 16–28. https://doi.org/10.1177/0271121416637597
ders and disabilities among low-income children (pp. 169–178). Gabel, R., Grogan-Johnson, S., Alvares, R., Bechstein, L., &
The National Academies Press. Taylor, J. (2013). A field study of telepractice for school in-
Browder, D. M., Lee, A., & Mims, P. (2011). Using shared stories tervention using the ASHA NOMS K–12 database. Commu-
and individual response modes to promote comprehension and nication Disorders Quarterly, 35(1), 44–53. https://doi.org/
engagement in literacy for students with multiple, severe dis- 10.1177/1525740113503035
abilities. Education and Training in Autism and Developmental Ganz, J. B., Morin, K., Foster, M. J., Vannest, K. J., Tosun, D. G.,
Disabilities, 46(3), 339–351. Gregori, E., & Gerow, S. (2017). High-technology augmentative
Bus, A. G., & van Ijzendoorn, M. H. (1997). Affective dimension and alternative communication for individuals with intellectual
of mother-infant picturebook reading. Journal of School Psy- and developmental disabilities and complex communication
chology, 35(1), 47–60. https://doi.org/10.1016/S0022-4405(96) needs: A meta-analysis. Augmentative and Alternative Com-
00030-1 munication, 33(4), 224–238. https://doi.org/10.1080/07434618.
Chazin, K. T., & Ledford, J. R. (2016). Preference assessments. 2017.1373855
Evidence-Based Instructional Practices for Young Children Ganz, J. B., & Simpson, R. (2019). Interventions for Individuals
With Autism & Other Disabilities. https://ebip.vkcsites.org/ with autism spectrum disorder and complex communication
preference-assessments/ needs. Brooks.
Chung, M. Y., Meadan, H., Snodgrass, M. R., Hacker, R. E., Sands, Golloher, A. N. (2018). Adapted shared storybook reading: A study
M. M., Adams, N. B., & Johnston, S. S. (2020). Assessing the of its application for children with autism spectrum disorders in
social validity of a telepractice training and coaching interven- home settings. Focus on Autism and Other Developmental Dis-
tion. Journal of Behavioral Education, 29, 382–408. https://doi. abilities, 33(1), 35–46. https://doi.org/10.1177/1088357616681281
org/10.1007/s10864-020-09372-8 Haahr, M. (2010). Random.org: True random number service.
CONNECT Modules. (n.d.). Dialogic reading with Katy. https:// School of Computer Science and Statistics, Trinity College.
www.connectmodules.dec-sped.org/connect-modules/resources/ http://www.random.org
videos/video-6-10/ Hargrave, A. C., & Sénéchal, M. (2000). A book reading interven-
Coufal, K., Parham, D., Jakubowitz, M., Howell, C., & Reyes, J. tion with preschool children who have limited vocabularies:
(2018). Comparing traditional service delivery and telepractice The benefits of regular reading and dialogic reading. Early
for speech sound production using a functional outcome mea- Childhood Research Quarterly, 15(1), 75–90. https://doi.org/
sure. American Journal of Speech-Language Pathology, 27(1), 10.1016/S0885-2006(99)00038-1
82–90. https://doi.org/10.1044/2017_AJSLP-16-0070 Hart, B., & Risley, T. R. (2003). The early catastrophe: The 30 mil-
DePaola, T. (1974). Charlie needs a cloak. Prentice Hall. lion word gap by age 3. American Educator, 27, 4–9.

Hudson, M. E., Browder, D. M., & Jimenez, B. A. (2014). Effects www.connectmodules.dec-sped.org/connect-modules/resources/
of a peer-delivered system of least prompts intervention and videos/video-6-4/
adapted science read-alouds on listening comprehension for par- Lonigan, C., & Whitehurst, G. J. (1998). Relative efficacy of par-
ticipants with moderate intellectual disability. Education and ent and teacher involvement in a shared-reading intervention
Training in Autism and Developmental Disabilities, 40(1), 60–77. for preschool children from low-income backgrounds. Early
Huebner, C. E. (2000). Promoting toddlers’ language development Childhood Research Quarterly, 13(3), 263–290. https://doi.org/
through community-based intervention. Journal of Applied 10.1016/S0885-2006(99)80038-6
Developmental Psychology, 21(5), 513–535. https://doi.org/ Lund, S. K., Quach, W., Weissling, K., McKelvey, M., & Dietz, A.
10.1016/S0193-3973(00)00052-6 (2017). Assessment with children who need augmentative and
Hustad, K. C., & Miles, L. K. (2010). Alignment between augmen- alternative communication (AAC): Clinical decisions of AAC
tative and alternative communication needs and school-based specialists. Language, Speech, and Hearing Services in Schools,
speech-language services provided to young children with cere- 48(1), 56–68. https://doi.org/10.1044/2016_LSHSS-15-0086
bral palsy. Early Childhood Services, 4(3), 129–140. Miles, S. B., & Stipek, D. (2006). Contemporaneous and longitudi-
Hutchins, P. (1968). Rosie’s walk. Aladdin. nal associations between social behavior and literacy achieve-
Justice, L. M., Chen, J., Tambyraja, S., & Logan, J. (2018). In- ment in a sample of low-income elementary school children.
creasing caregivers’ adherence to an early-literacy intervention Child Development, 77(1), 103–117. https://doi.org/10.1111/
improves the print knowledge of children with language impair- j.1467-8624.2006.00859.x
ment. Journal of Autism and Developmental Disorders, 48(12), Mims, P. J., Browder, D. J., Baker, J. N., Lee, A., & Spooner, F.
4179–4192. https://doi.org/10.1007/s10803-018-3646-2 (2009). Increasing comprehension of students with significant
Kaderavek, J. N., & Justice, L. M. (2002). Shared storybook read- intellectual disabilities and visual impairments during shared
ing as an intervention context: Practices and potential pit- stories. Education and Training in Developmental Disabilities,
falls. American Journal of Speech-Language Pathology, 11(4), 44(3), 409–420.
395–406. https://doi.org/10.1044/1058-0360(2002/043) Morgan, P. L., & Meier, C. R. (2008). Dialogic reading’s poten-
Kasari, C., Brady, N., Lord, C., & Tager-Flusberg, H. (2013). tial to improve children’s emergent literacy skills and behavior.
Assessing the minimally verbal school-aged child with autism Preventing School Failure: Alternative Education for Children
spectrum disorder. Autism Research, 6(6), 479–493. https://doi. and Youth, 52(4), 11–16. https://doi.org/10.3200/PSFL.52.4.11-16
org/10.1002/aur.1334 Mucchetti, C. A. (2013). Adapted shared reading at school for
Keller, H. (1988). Geraldine’s blanket. Harper Collins. minimally verbal students with autism. Autism, 17(3), 358–372.
Kent-Walsh, J., Binger, C., & Hasham, Z. (2010). Effects of parent https://doi.org/10.1177/1362361312470495
instruction on the symbolic communication of children using Na, J. Y. (2015). Communication about emotions using AAC during
augmentative and alternative communication during storybook storybook reading: Effects of an instruction program for parents
reading. American Journal of Speech-Language Pathology, 19(2), of children with Down syndrome [Unpublished doctoral disserta-
97–107. https://doi.org/10.1044/1058-0360(2010/09-0014) tion]. The Pennsylvania State University, State College.
Klingner, J. K., Vaughn, S., & Boardman, A. (2015). Teaching Nation, K., Clarke, P., Wright, B., & Williams, C. (2006). Patterns
reading comprehension to students with learning difficulties, of reading ability in children with autism spectrum disorder.
2/E. Guilford. Journal of Autism and Developmental Disorders, 36, Article 911.
Ledford, J. R., & Chazin, K. T. (2016). System of least prompts. https://doi.org/10.1007/s10803-006-0130-1
In Evidence-based instructional practices for young children with National Research Council. (1999). Starting out right: A guide to
autism and other disabilities http://ebip.vkcsites.org/system-of- promoting children’s reading success. National Academy Press.
least-prompts https://doi.org/10.17226/6014
Ledford, J. R., & Gast, D. L. (2018). Single case research method- Nelson, S., McDuffie, A., Banasik, A., Feigles, R. T., Thurman, A. J.,
ology: Applications in special education and behavioral sciences. & Abbeduto, L. (2018). Inferential language use by school-aged
Routledge. https://doi.org/10.4324/9781315150666 boys with fragile X syndrome: Effects of a parent-implemented
Lerman, D. C., O’Brien, M. J., Neely, L., Call, N. A., Tsami, L., spoken language intervention. Journal of Communication Disorders,
Schieltz, K. M., Berg, W. K., Graber, J., Huang, P., Kopelman, 72, 64–76. https://doi.org/10.1016/j.jcomdis.2018.02.007
T., & Cooper-Brown, L. (2020). Remote coaching of caregivers Organization for Economic Cooperation and Development. (2013).
via telehealth: Challenges and potential solutions. Journal of OECD skills outlook: First results from the survey of adult skills.
Behavioral Education, 29, 195–221. https://doi.org/10.1007/ OECD Publishing. https://doi.org/10.1787/9789264204256-en
s10864-020-09378-2 Owens , R. E., Jr., & Robinson, L. A. (1997). Once upon a time:
Lever, R., & Sénéchal, M. (2010). Discussing stories: On how a di- Use of children’s literature in the preschool classroom. Topics
alogic reading intervention improves kindergartners’ oral nar- in Language Disorders, 17, 19–48. https://doi.org/10.1097/
rative construction. Journal of Experimental Child Psychology, 00011363-199702000-00004
108(1), 1–24. https://doi.org/10.1016/j.jecp.2010.07.002 Parker, R. I., Vannest, K. J., Davis, J. L., & Sauber, S. B. (2011).
Lim, L., Arciuli, J., & Munro, N. (2018). Shared book reading Combining nonoverlap and trend for single-case research:
behaviours of children with Down syndrome before and after Tau-U. Behavior Therapy, 42(2), 284–299. https://doi.org/
participation in the MultiLit reading tutor program: An ex- 10.1016/j.beth.2010.08.006
ploratory study. Australian Journal of Learning Difficulties, Premack, D. (1959). Toward empirical behaviour laws: Positive
23(1), 31–51. https://doi.org/10.1080/19404158.2017.1367948 reinforcement. Psychological Review, 66(4), 219–233. https://
Lonigan, C. (2011a). Excerpts from: Implementing dialogic reading doi.org/10.1037/h0040891
[Educational video]. U.S. Department of Education. https:// Quinn, E. D., Kaiser, A. P., & Ledford, J. R. (2020). Teaching
www.connectmodules.dec-sped.org/connect-modules/resources/ preschoolers with Down syndrome using augmentative and alter-
videos/video-6-2/ native communication modeling during small group dialogic
Lonigan, C. (2011b). Excerpts from: Implementing dialogic reading reading. American Journal of Speech-Language Pathology, 29(1),
[Educational video]. U.S. Department of Education. https:// 80–100. https://doi.org/10.1044/2019_AJSLP-19-0017
Ratz, C. (2013). Do students with Down syndrome have a specific and coherence questions. Early Education & Development,
learning profile for reading? Research in Developmental Disabilities, 24(5), 616–639. https://doi.org/10.1080/10409289.2012.715570
34(12), 4504–4514. https://doi.org/10.1016/j.ridd.2013.09.031 Sum, A. (1999). Literacy in the labor force: Results from the National
Reese, M., Jamison, R., Wendland, M., Fleming, K., Braun, M. J., Adult Literacy Survey (NCES 1999-470). U.S. Department of
Schuttler, J. O., & Turek, J. (2013). Evaluating interactive vid- Education, National Center for Education Statistics.
eoconferencing for assessing symptoms of autism. Telemedi- Sutherland, R., Trembath, D., & Roberts, J. (2018). Telehealth
cine and E-health, 19(9), 671–677. https://doi.org/10.1089/tmj. and autism: A systematic search and review of the literature.
2012.0312 International Journal of Speech-Language Pathology, 20(3),
Roberts, C. A., & Leko, M. M. (2013). Integrating functional and 324–336. https://doi.org/10.1080/17549507.2018.1465123
academic goals into literacy instruction for adolescents with Symons, D. K., Peterson, C. C., Slaughter, V., Roche, J., & Doyle,
significant cognitive disabilities through shared story reading. E. (2005). Theory of mind and mental state discourse during
Research and Practice for Persons with Severe Disabilities, book reading and story-telling tasks. British Journal of Devel-
38(3), 157–172. https://doi.org/10.1177/154079691303800303 opmental Psychology, 23(1), 81–102. https://doi.org/10.1348/
Satterlund, K. (2016). Approaches to grammar intervention: A look 026151004X21080
at current practice [Doctoral dissertation, University of Minnesota]. Tager-Flusberg, H., & Kasari, C. (2013). Minimally verbal school-
University Digital Conservancy. https://conservancy.umn.edu/ aged children with autism spectrum disorder: The neglected
bitstream/handle/11299/181817/Satterlund_umn_0130M_17107. end of the spectrum. Autism Research, 6(6), 468–478. https://
pdf?sequence=1 doi.org/10.1002/aur.1329
Scheerder, A. J., van Deursen, A. J., & van Dijk, J. A. (2019). Tan, M. (2014). The effectiveness of dialogic reading on the expres-
Negative outcomes of Internet use: A qualitative analysis in sive vocabulary development of children with autism spectrum dis-
the homes of families with different educational backgrounds. orders [Unpublished doctoral dissertation]. Purdue University.
The Information Society, 35(5), 286–298. https://doi.org/10. Towson, J. A., Fettig, A., Fleury, V. P., & Abarca, D. L. (2017).
1080/01972243.2019.1649774 Dialogic reading in early childhood settings: A summary of the
Sennott, S. C. (2013). Empowering children with complex commu- evidence base. Topics in Early Childhood Special Education,
nication needs to use iPad based AAC during shared storybook 37(3), 132–146. https://doi.org/10.1177/0271121417724875
reading [Unpublished doctoral dissertation]. The Pennsylvania Towson, J. A., Green, K. B., & Abarca, D. L. (2019). Reading
State University. beyond the book: Educating paraprofessionals to implement
Simacek, J., Dimian, A. F., & McComas, J. J. (2017). Commu- dialogic reading for preschool children with language impair-
nication intervention for young children with severe neuro- ments. Topics in Early Childhood Special Education, 1–16. https://
developmental disabilities via telehealth. Journal of Autism doi.org/10.1177/0271121418821167
and Developmental Disorders, 47, 744–767. https://doi.org/10. Ukrainetz, T. A. (2005). What to work on how: An examination
1007/s10803-016-3006-z of the practice of school-age language intervention. Contempo-
Skibbe, L. E., Thompson, J. L., & Plavnick, J. B. (2018). Pre- rary Issues in Communication Science and Disorders, 32(Fall),
schoolers’ visual attention during electronic storybook reading 108–119. https://doi.org/10.1044/cicsd_32_F_108
as related to different types of textual supports. Early Child- Ukrainetz, T. A., & Trujillo, A. (1999). “You know, I just don’t
hood Education Journal, 46, 419–426. https://doi.org/10.1007/ know what else you’d do?” Five SLPs’ perspectives on children’s
s10643-017-0876-4 literature in speech-language intervention. Contemporary Issues
Snodgrass, M. R., Chung, M. Y., Biller, M. F., Appel, K. E., in Communication Sciences and Disorders, 26(Spring), 35–48.
Meadan, H., & Halle, J. W. (2017). Telepractice in speech- https://doi.org/10.1044/cicsd_26_S_35
language therapy: The use of online technologies for parent Vannest, K. J., & Ninci, J. (2015). Evaluating intervention effects
training and coaching. Communication Disorders Quarterly, in single-case research designs. Journal of Counseling & Devel-
38(4), 242–254. https://doi.org/10.1177/1525740116680424 opment, 93(4), 403–411. https://doi.org/10.1002/jcad.12038
Snow, C. E., & Goldfield, B. A. (1983). Turn the page please: Situ- Vannest, K. J., Parker, R. I., Gonen, O., & Adiguzel, T. (2016).
ation-specific language acquisition. Journal of Child Language, Single case research: Web-based calculators for SCR analysis
10(3), 551–569. https://doi.org/10.1017/S0305000900005365 (Version 2.0) [Web-based application]. Texas A&M University.
Sonnenschein, S., Stapleton, L. M., & Benson, A. (2010). The rela- Retrieved December 23, 2019, from singlecaseresearch.org
tion between the type and amount of instruction and growth Viorst, J., & Cruz, R. (1972). Alexander and the terrible, horrible,
in children’s reading competencies. American Educational no good, very bad day. Atheneum.
Research Journal, 47(2), 358–389. https://doi.org/10.3102/ Vogler-Elias, D. (2009). A parent-implemented shared storybook
0002831209349215 reading intervention for preschoolers with autism spectrum dis-
Sparrow, S., Cicchetti, D., & Saulnier, C. (2016). Vineland Adap- orders [Unpublished doctoral dissertation]. State University
tive Behavior Scales–Third Edition (Vineland-3). Pearson. of New York, Buffalo.
Spooner, F., Ahlgrim-Delzell, L., Kemp-Inman, A., & Wood, L. A. Wales, D., Skinner, L., & Hayman, M. (2017). The efficacy of
(2014). Using an iPad2 with systematic instruction to teach telehealth-delivered speech and language intervention for primary
shared stories for elementary-aged students with autism. Re- school-age children: A systematic review. International Journal of
search and Practice for Persons With Severe Disabilities, 39(1), Telerehabilitation, 9(1), 55. https://doi.org/10.5195/IJT.2017.6219
30–46. https://doi.org/10.1177/1540796914534631 Whalon, K., Delano, M., & Hanline, M. F. (2013). A rationale
Spooner, F., Rivera, C. J., Browder, D. M., Baker, J. N., & Salas, and strategy for adapting dialogic reading for children with
S. (2009). Teaching emergent literacy skills using cultural con- autism spectrum disorder: RECALL. Preventing School Failure:
textual story-based lessons. Research and Practice for Persons Alternative Education for Children and Youth, 57(2), 93–101.
With Severe Disabilities, 34(3–4), 102–112. https://doi.org/ https://doi.org/10.1080/1045988X.2012.672347
10.2511/rpsd.34.3-4.102 Whalon, K., Hanline, M. F., & Davis, J. (2016). Parent implementa-
Strasser, K., Larraín, A., & Lissi, M. R. (2013). Effects of storybook tion of RECALL: A systematic case study. Education and Train-
reading style on comprehension: The role of word elaboration ing in Autism and Developmental Disabilities, 51(2), 211–220.

What Works Clearinghouse. (2010). What Works Clearinghouse Whitehurst, G. J., Falco, F. L., Lonigan, C. J., Fischel, J. E.,
Intervention report: Early childhood education interventions for DeBaryshe, B. D., Valdez-Menchaca, M. C., & Caulfield, M.
children with disabilities: Dialogic reading. Institute of Education (1988). Accelerating language development through picture
Sciences, U.S. Department of Education. https://ies.ed.gov/ book reading. Developmental Psychology, 24(4), 552–559.
ncee/wwc/EvidenceSnapshot/136 https://doi.org/10.1037/0012-1649.24.4.552
Whitehurst, G. J., Epstein, J. N., Angell, A. L., Payne, A. C., Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson,
Crone, D. A., & Fischel, J. E. (1994). Outcomes of an emer- M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle,
gent literacy intervention in Head Start. Journal of Educa- C. A. (2019). Prevalence and trends of developmental disabilities
tional Psychology, 86(4), 542–555. https://doi.org/10.1037/ among children in the United States: 2009–2017. Pediatrics,
0022-0663.86.4.542 144(4), e20190811. https://doi.org/10.1542/peds.2019-0811

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Coaching Parents of Children With

120 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 121

Table 1. Parent demographic information.

Participant Occupation Education level Previous experience Room/dimensionsa

Anna Homemaker Some college Trainings Dining/—

122 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Aaron 79 Below expected 121 Verbal; sentences SPED, ST, OT

Questions and Picture Answer Choices Book Reading Calendars

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 123

124 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 125

126 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 127

128 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Parent name PI TF BL TF IV Child PEEER Anticipatory set

Anna 100% — 100% 90% 90% 93%

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 129

No. of modified dialogic reading components

Anna n=3 n=1 n=6 n=2 — —

130 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Table 6. Participant social validity ratings.

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 131

132 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 133

134 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

Pierson et al.: Coaching Parents of Children With Developmental Disabilities 135

136 American Journal of Speech-Language Pathology • Vol. 30 • 119–136 • January 2021

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