Examining bidirectional effects of therapist coaching statements on parenting skill acquisition in caregivers of children with developmental delay and behavior problems

Behavioral parenting interventions decrease early childhood behavior problems by improving parenting skills. Additionally, parenting skills have been associated with increases in child language production. During sessions for some behavioral parenting interventions, such as Parent-Child Interaction Therapy (PCIT), therapists provide live coaching to caregivers to use parenting skills during sessions. However, limited research has examined the association between therapist coaching statements and parenting skills acquisition, especially among ethnic minority families and non-English speaking families who are at greater risk of dropping out of treatment. Understanding the role of therapist and caregiver language used during interventions is critical in optimizing treatment outcomes.

This dissertation is comprised of three manuscripts focused on caregiver and therapist language during behavioral parenting interventions, and the impact on caregiver and child outcomes. First, I examined caregiver language after participating in a brief behavioral parenting intervention and the impact of caregiver language on child language acquisition (n = 58). This study showed that caregivers who participated in the intervention provided more linguistic input, which indirectly influenced child language. Following this study, I became interested in understanding the role therapists play in caregiver skill acquisition, specifically examining therapist coaching statements in the brief parenting intervention for infants (n = 24). This pilot study showed that therapist coaching statements predicted caregiver skills at the following session. Additionally, preliminary language differences between English and Spanish speaking therapists were observed.

The third study builds on the previously described two studies by examining the bidirectional associations between therapist coaching statements and parenting skill acquisition. As well as the effect on externalizing behavior problems in children with developmental delay in a predominantly Latinx and bilingual sample of families (n = 75). Findings from the third paper suggest there are associations between therapist coaching statements and parenting skills, however no bidirectional associations were found.

This collection of work encourages the understanding of language used during behavioral parent trainings to understand the long-term consequences in caregiver skill acquisition and child behavior. Findings will help improve the effectiveness of behavioral parent training, as well as the future training of clinicians to optimize treatment outcomes.

Major Professor: Dr. Daniel M. Bagner