Alaina Grissom, Rachel Sinclair, Lydia Barry, Erinn H Finke
SLPs and graduate students consistently recognized evidence-based practices within natural caregiver-child play interactions and frequently noted that caregivers were already using effective strategies without explicit coaching. These findings suggest that both parties have the skills to engage in caregiver coaching in a collaborative, strengths-based process. From this foundation, clinicians can primarily help caregivers refine and strengthen existing interaction routines through specific, feasible micro-adjustments rather than teaching entirely new skills. Consistency between service and preservice SLPs suggests the feasibility of including observation within skilled services taught and expected of graduate clinicians.
PURPOSE: Initial clinical observations help establish a strengths-based caregiver coaching relationship and guide intervention planning. This study examined what caregiver-child communication strategies speech-language pathologists (SLPs) and master's-level graduate students prioritize when making an initial observation of a naturalistic play interaction.
METHOD: Twenty American Speech-Language-Hearing Association-certified SLPs and 20 master's-level graduate students reviewed videos of caregiver-child play interactions and answered open-ended questions related to what they observed in the interactions. Responses were analyzed using directed content analysis focused on strategies related to environmental arrangement and language facilitation relevant to language development.
RESULTS: Across 1,469 coded thought units, participants' comments centered on teachable caregiver actions (facilitation strategies) more than environmental features. There were minimal differences in the quality of comments made by SLPs and graduate students. Generally, participants frequently identified caregivers' naturally occurring strengths while also offering refinements, which aligned with caregiver coaching's emphasis on moving from describing what is happening to suggesting small, feasible changes to enhance child communication.
CONCLUSIONS: SLPs and graduate students consistently recognized evidence-based practices within natural caregiver-child play interactions and frequently noted that caregivers were already using effective strategies without explicit coaching. These findings suggest that both parties have the skills to engage in caregiver coaching in a collaborative, strengths-based process. From this foundation, clinicians can primarily help caregivers refine and strengthen existing interaction routines through specific, feasible micro-adjustments rather than teaching entirely new skills. Consistency between service and preservice SLPs suggests the feasibility of including observation within skilled services taught and expected of graduate clinicians.