SUMMARIZE (6) SCIENTIFI RESEARCH DOCUMENTS

Dow

AJSLP

Research Article

aCommunicat Education an

Corresponden

Editor-in-Chi Editor: Carla

Received Mar Revision rece Accepted Jan https://doi.org Publisher Not Practice for D

Amer

nloaded from:

Exploring the Cultural Validity of Parent- Implemented Naturalistic Language Intervention Procedures for Families From Spanish-Speaking Latinx Homes

Lauren M. Cycyka and Lidia Huertaa

Purpose: This study addressed the cultural, linguistic, and contextual validity of parent-implemented naturalistic language interventions for young children from Latinx homes. Parents’ perspectives on the acceptability of commonly delivered intervention procedures were explored. Method: Thirty-seven parents from Spanish-speaking Latinx backgrounds with children under the age of 6 years participated. Four focus groups were completed. Parents responded to 14 procedures regarding the intervention implementers, settings, activities, strategies, and language. Structural and emergent coding was used to explore procedural acceptability and parents’ rationales for perceiving each procedure as acceptable, not acceptable, or neutral. Results: Substantial intracultural variability in parents’ acceptance of specific procedures and the reasons for

ion Disorders and Sciences, Department of Special d Clinical Sciences, University of Oregon, Eugene

ce to Lauren M. Cycyk: [email protected]

ef: Julie Barkmeier-Kraemer Wood

ch 26, 2019 ived August 5, 2019 uary 13, 2020 /10.1044/2020_AJSLP-19-00038 e: This article is part of the Forum: Innovations in Clinical ual Language Learners, Part 2.

ican Journal of Speech-Language Pathology • Vol. 29 • 1241–1259 • August

https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

their perspectives was observed. Parents’ perspectives evinced both individualist and collectivist orientations toward child language development. Several suggestions regarding promising adaptations for early language interventions that may overlap with evidence-based parent-implemented naturalistic language intervention procedures emerged. Conclusion: The findings highlight the variability within the Latinx community that is likely to impact the cultural validity of early language interventions for children and families from this background. Considerations for enhancing interventions to achieve cultural congruency and promote child outcomes are provided. Supplemental Material: https://doi.org/10.23641/asha. 12315713

C hildren from Latinx1 backgrounds are a large and growing population served by speech-language pathologists (SLPs) in early intervention. Approx-

imately one in four children in the United States today is Latinx, and this proportion is expected to increase to one in three children by the year 2050 (Federal Interagency Forum on Child and Family Statistics, 2017). Disability prevalence studies suggest that between 13% and 20% of children, regardless of ethnicity, will present with signifi- cant delay or difficulties in their language development before 6 years of age (Centers for Disease Control and Prevention, 2015; Reilly et al., 2010; Zubrick et al., 2007).

Because early difficulties with language development hinder children’s future academic and social development (e.g., Duff et al., 2015; Hammer et al., 2017), evidence- based language interventions provided before the age of 6 years are highly recommended. Thus, the purpose of this study was to explore the validity of parent-implemented naturalistic language interventions (PI-NLIs) in the con- text of Latinx families. With this information, SLPs will be better prepared to meet the legal and professional mandates that guide early interventions.

According to federal law (Individuals with Dis- abilities Education Act [IDEA], 2004) and professional guidelines in early intervention (American Speech-Language- Hearing Association [ASHA], 2008, 2017; Division for Early Childhood of the Council for Exceptional Children [DEC], 2014), interventions for language disorders must

1The inclusive term “Latinx” is used throughout this article as a gender-neutral substitution for Latino and Latina to refer to individuals of North American, South American, Cuban, Dominican, Puerto Rican, and Spanish descent.

Disclosure: The authors have declared that no competing interests existed at the time of publication.

2020 • Copyright © 2020 American Speech-Language-Hearing Association 1241

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

be responsive to the cultural and linguistic backgrounds of children and their families. This means that interven- tions are reviewed for their sociocultural appropriateness and modified when needed to align with the cultural per- spectives of families, their use of home language(s), and the everyday contexts of their lives. SLPs cannot assume that existing interventions will meet the needs of all families. Consulting families about their beliefs, values, and prac- tices related to early language development and collabo- rating to support family priorities in interventions avoid this assumption. Working with families to identify cultur- ally and linguistically responsive approaches also ensures that the interventions SLPs provide are family centered, as required by law (IDEA, 2004) and widely considered best practice in early intervention (ASHA, 2008; DEC, 2014). Because PI-NLIs are common to early intervention, SLPs need access to information that helps to consider the relevance of these interventions with Latinx families and supports responsive and family-centered services.

PI-NLIs “PI-NLIs” is an umbrella term that refers to inter-

ventions in which parents learn to deliver specific language- facilitating strategies to their children within interactions across daily life. Examples include prelinguistic milieu teaching, enhanced milieu teaching, focused stimulation, and the Hanen Parent Program. In this approach, the parent is the primary interventionist (as opposed to the SLP), and the naturally occurring, everyday interactions shared by the parent and child form the intervention con- text. Teaching parents to become interventionists is based on the premise that children’s early development is best fostered by the individuals with whom they are closest (Bronfenbrenner, 1979; Phillips & Shonkoff, 2000). The focus on parent–child interactions is supported by a large body of literature linking parental language input to early child language outcomes (e.g., Zauche et al., 2016). Fur- thermore, these interactions are thought to be natural and frequent for young children, thereby providing ample op- portunities to practice functional communication.

The effectiveness of PI-NLIs for supporting children with language concerns and their parents from non-Latinx backgrounds is well established. Two meta-analyses have found that PI-NLIs enhance the expressive vocabulary and general oral language abilities of young children with lan- guage disorders (Heidlage et al., 2020; Roberts & Kaiser, 2011). Roberts and Kaiser (2011) also found that children’s receptive language abilities improved as a result of PI-NLIs; however, this finding has not been consistent (Heidlage et al., 2020). Significant advances in parents’ responsive- ness and use of language models with their children follow- ing participation in PI-NLIs have also been noted (Roberts & Kaiser, 2011; Te Kaat-van den Os et al., 2017). In addi- tion, there is some evidence that the gains made by chil- dren and their parents generalize to untrained contexts and are maintained over time (Akamoglu & Meadan, 2018).

1242 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Yet, the vast majority of this research has taken place with families of Anglo-European descent; Latinx families are rarely included. For example, a recent review of 21 PI-NLI studies published between the years 2000 and 2016 identified only five that included Latinx families—a total of 10 participants across all five studies (Akamoglu & Meadan, 2018). Not included in this review were studies by Ijalba (2015) and Peredo et al. (2018), which specifically targeted mothers who were Latina. Ijalba taught 12 mothers of 3-year-old children with language delays to facilitate language within routines (qualifying this study as a PI-NLI) and when using interactive picture books. Peredo et al. trained three mothers to use language facilitation strategies during play with their toddlers with language disorder. Importantly, these researchers adapted the intervention to align with the linguistic and cultural backgrounds of Latinx families prior to delivery. In both studies, children showed gains in their productive vocabulary. The mothers who participated in Peredo et al. also improved their use of language facilitation strategies (e.g., expansion), which generalized to untrained activities and were maintained 1 month postintervention. Moreover, the mothers in Ijalba and Peredo et al. expressed satisfaction with the interven- tions. Hence, emerging evidence suggests that PI-NLIs may be valid and effective for supporting Latinx families, particularly when participants’ language and culture are considered in the design. However, the cultural, linguistic, and contextual appropriateness of these interventions warrants further investigation.

Sociocultural Perspectives on PI-NLIs Language development is strongly influenced by chil-

dren’s sociocultural contexts of learning (Rogoff, 2003; Schieffelin & Ochs, 1986; Vygotsky, 1978), which includes the culturally informed beliefs, values, and practices of their parents. Long-standing sociocultural norms inform parents’ views and approaches toward interactions with their young children and the kinds of supports provided at home for early language development (Cycyk & Hammer, in press; Hammer et al., 2007; Rodriguez & Olswang, 2003; Rogoff et al., 1993; Schieffelin & Ochs, 1986). Similarly, sociocultural backgrounds influence parental perspectives on the causes and remedies for language disorders (García et al., 2000; Rodriguez & Olswang, 2003). As such, lan- guage interventions that match parents’ beliefs, values, and practices may be more successful than those that do not, leading to greater family satisfaction, participation, and out- comes (Bailey et al., 1999; García Coll et al., 2002; Griner & Smith, 2006; Larson et al., 2020). Thus, an awareness of the underlying cultural orientations that inform parenting is essential to consider the match between PI-NLIs and the sociocultural backgrounds of Latinx families.

The well-known continuum of cultural orientation from individualism (or independence) to collectivism (or interdependence) is particularly relevant to parenting and child development (e.g., Greenfield & Cocking, 1994; Greenfield et al., 2006; Lynch & Hanson, 2004). Simply,

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

individualism orients toward individual autonomy and personal success, whereas collectivism orients toward inter- dependence and group success. Extended to parenting, in- dividualistic cultures tend to prioritize support for child independence and individuality, whereas collectivist cul- tures tend to emphasize the child’s responsibility to and compliance with the group. All cultures exhibit elements of individualism and collectivism, and individuals who affili- ate with particular cultures also vary dynamically along this continuum (e.g., Tamis-LeMonda et al., 2008). Yet, the dominant culture of the United States (as linked to Anglo-European ancestry) is characterized as highly indi- vidualistic, whereas countries in Latin America and Latinx immigrant communities in the United States are described as collectivist (e.g., Caldera et al., 2015; Greenfield & Cocking, 1994; Hofstede, 2001; Lynch & Hanson, 2004). Importantly, most PI-NLIs have been developed in societies dominated by individualism (i.e., United States, Australia; Hofstede, 2001). Accordingly, PI-NLIs are largely informed by individualistic values for child development that may contrast with the collectivist values held by some Latinx communities.

Traditionally, PI-NLIs advocate for parents to value child initiation and leadership in interactions, to support balanced turn-taking, and to ask questions and provide frequent responses that promote child verbal expression during dyadic parent–child interactions. As reviewed in detail by van Kleeck (1994) and supported by the work of Greenfield et al. (2006), these behaviors are well suited to fostering child independence in individualistic families where parents are the primary caregivers and verbally as- sertive, expressive children are celebrated as equal commu- nication partners. Families oriented toward collectivism may not find such strategies compatible with their child- rearing goals. Instead, maintaining adult authority in inter- actions with children and guiding children to become com- pliant, respectful, deferent, and competent in multiparty interactions with several caregivers may be preferred. As such, using directives and supporting child comprehension may be favored over asking questions and fostering child expression. Indeed, when Guiberson and Ferris (2019b) observed Latinx caregivers interacting with their 2-year-old children, the majority of caregivers used an interdependent (i.e., collectivist) interactional style that endorsed adult direction over child independence. Moreover, PI-NLIs may promote school-related activities, such as sharing books with young children or teaching pre-academic concepts (e.g., Ijalba, 2015). Collectivist families who prioritize child social behavior may place less emphasis on these tasks than individualistic families who favor academic knowl- edge (Greenfield et al., 2006; Reese & Gallimore, 2000). However, these examples represent the extremes of the individualism–collectivism continuum as applied to PI-NLIs; as no culture is homogeneous, intracultural variation is expected.

Because the Latinx population is highly diverse, parental views on PI-NLIs are likely to represent this di- versity. While Latinx parents of young children generally

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

report a stronger affiliation with collectivism, collectivist and individualistic values have been noted among groups of Latinx parents (e.g., Grau et al., 2015; Rodriguez & Olswang, 2003). Moreover, individual parents may express both orientations in their parenting (Guiberson & Ferris, 2019b; Hammer et al., 2007; Rodriguez & Olswang, 2003; Tamis-LeMonda et al., 2008). Guiberson and Ferris (2019b), for example, found that some Latinx caregivers who ad- hered to independent or interdependent interactional styles used behaviors with their young children that represented the opposing cultural orientation. This variation has been explained, in some cases, by parents’ affiliation with the dominant individualism of the United States (as represented by their acculturation, generational status, English proficiency, and/or length of residence), education level, and socioeco- nomic status (Grau et al., 2015; Rodriguez & Olswang, 2003; Suizzo et al., 2019; Tamis-LeMonda et al., 2008). The con- text and child’s stage of development also provoke shifts in cultural orientation (Tamis-LeMonda et al., 2008), sug- gesting that parents’ experiences with the individualistic values endorsed in U.S. early childhood education (ECE) and early intervention settings may also influence perspec- tives on PI-NLIs. Therefore, instead of relying on the socio- cultural orientation traditionally ascribed to Latinx parents to determine the validity of PI-NLIs, parents of diverse Latinx identities should be directly consulted for their views.

Parent Perspectives for Exploring Cultural Validity of Existing Interventions

The process of exploring the perspectives of potential intervention consumers is referred to as “social validity,” widely considered critical for ensuring that interventions are acceptable to stakeholders and can be effectively imple- mented (Wolf, 1978). This process has also been referred to as “cultural validity” or “ecological validity” (Foster & Mash, 1999) to encompass cultural, linguistic, and contex- tual fit. Social validity can be investigated across three dimensions (Kazdin, 1977; Wolf, 1978), including the sig- nificance of the goals of the intervention, the acceptability of the procedures of the intervention (including approaches and strategies), and the importance of the outcomes of the intervention. Prior research has found that Latinx parents of young children with and without language disorders value language as a crucial developmental goal (Cycyk & Hammer, in press; Méndez Pérez, 2000) and are pleased with the outcomes of language interventions (Ijalba, 2015; Peredo et al., 2018). Thus, this study explores the social validity of common procedures of PI-NLIs. In other words, this study addresses “treatment acceptability,” as defined by Kazdin (1981) as the “judgments of lay persons, clients, and others of whether the procedures proposed for a treat- ment are appropriate, fair, and reasonable for the problem or client” (p. 493). As parents are crucial stakeholders in PI-NLIs, their judgments on treatment acceptability are particularly important. Improved child language outcomes have been found when parents perceive PI-NLI strategies as socially valid (Dunst et al., 2016).

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1243

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

In-depth descriptions of the naturalistic contexts for early language learning valued by some families from Latinx backgrounds are currently available (e.g., Cycyk & Hammer, in press). Earlier work has also hypothesized how parents from Latinx backgrounds may perceive cer- tain naturalistic early language intervention strategies (Cycyk & Iglesias, 2015; van Kleeck, 1994). These authors have suggested cultural, linguistic, and contextual adapta- tions to match families’ natural approaches to early lan- guage learning in order to improve the acceptability of such interventions. However, few researchers have system- atically asked parents for their thoughts on discrete and specific intervention procedures commonly utilized in PI-NLIs. Instead, small numbers of Latinx parents of chil- dren receiving early language interventions have responded to general queries on how they perceived the intervention and its procedures as a whole (Ijalba, 2015; Kummerer & Lopez-Reyna, 2009; Kummerer et al., 2007; Peredo et al., 2018). Moreover, these parents provided their feedback while children received the interventions or after the inter- ventions were completed. Asking parents to react to proce- dures prior to intervention delivery helps to develop precise adaptations ahead of time that may enhance the social validity of the intervention (Strain et al., 2012).

The procedures of PI-NLIs to be appraised for accept- ability in the current study emerge from common charac- teristics of existing PI-NLIs, as revealed in research reviews by Akamoglu and Meadan (2018), Barton and Fettig (2013), Law et al. (2004), and Te Kaat-van den Os et al. (2017), as well as meta-analyses by Heidlage et al. (2020) and Roberts and Kaiser (2011). These procedures can be categorized by the most recurrent intervention implemen- ters, settings, activities, language facilitation strategies, and language(s) of intervention. See Table 1 for detailed defini- tions. Mothers are overwhelmingly selected as the parent who implements the strategies. Most often, the setting is children’s homes. The activities that tend to be targeted are parent–child play and shared book reading, regardless of whether these activities are routine for the family. Frequent language-facilitating strategies include following the child’s lead, praising the child for communication attempts, imi- tating the child’s communication attempts, expanding the child’s communication attempts, ensuring that parent–child conversational turns are balanced, linguistically mapping the child’s activities, asking open-ended questions, increas- ing the general quantity of talk, arranging the environmen- tal (i.e., placing materials in view but out of reach, limiting television), and teaching pre-academic concepts alongside language facilitation. In addition, the language of interven- tion (Spanish and/or English) is a key consideration for children from Latinx homes. Many Latinx children are ex- posed to Spanish while learning English (Federal Interagency Forum on Child and Family Statistics, 2017). Because few studies on PI-NLIs have included families who speak lan- guages other than English (Akamoglu & Meadan, 2018; Guiberson & Ferris, 2019a), PI-NLIs have mostly been delivered in English. Yet, support for both languages in early interventions for children exposed to Spanish and

1244 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

English is considered best practice (Guiberson & Ferris, 2019a).

Purpose of the Study In order to provide early language interventions that

are responsive to the sociocultural backgrounds of children from Latinx- and Spanish-speaking homes, the social valid- ity of existing PI-NLIs for this population must be exam- ined. This exploratory study represents a pioneering step toward meeting this need by exploring the perspectives of a modest number of parents, many of whom were mothers from Mexican backgrounds. First, we asked, which com- mon PI-NLI procedures do parents perceive as acceptable? Second, we asked, what are the reasons that parents view common PI-NLI procedures as acceptable or not? In some cases, this question was also asked about possible alterna- tives to existing PI-NLI procedures as informed by prior literature (Cycyk & Hammer, in press; Cycyk & Iglesias, 2015; van Kleeck, 1994). As a starting point, parents whose children did not have identified language disorders were included to investigate broad sociocultural viewpoints that had not been influenced by the presence of child disability or the families’ prior receipt of early intervention services. The findings of this study will introduce SLPs to the wide range of perspectives Latinx parents may hold toward early language intervention procedures and highlight the importance of including families in intervention planning. With this information, SLPs may be better prepared to collaborate with families to identify relevant cultural, lin- guistic, and contextual adaptations that meet professional mandates for early intervention (ASHA, 2008; DEC, 2014). Moreover, this study may serve as a catalyst for future research that seeks to develop socially valid PI-NLIs that align with the sociocultural backgrounds of families who are Latinx. Increasing the social validity of PI-NLIs may ultimately lead to benefits in the effectiveness of such inter- ventions (Dunst et al., 2016). The University of Oregon’s Institutional Review Board approved this study.

Method Participants

Thirty-seven parents who had at least one child un- der the age of 6 years without parental concerns for their communication development participated. Refer to Table 2 for parents’ background information. The parents were recruited from four ECE centers in the Pacific Northwest and northeastern United States. Two of these centers provided dual language education models, whereas two instructed in English only. Staff members of the ECE cen- ters approached parents with information about the study and enrolled those who were eligible. Most participants were mothers (n = 34). Three fathers also participated. The parents were 32.3 years of age on average (SD = 5.9 years). Most caregivers (n = 26, 70.3%) identified as Mexican, whereas the remainder identified as Guatemalan (n = 5),

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Table 1. Overview of common procedures of parent-implemented naturalistic language interventions (PI-NLIs).

Intervention component Common procedure Definition

Intervention implementer Mothers are trained to implement PI-NLIs

The caregiver who is taught and trained to implement language facilitation strategies

Intervention setting Intervention takes place in the home The setting in which the intervention is delivered Intervention activities Language facilitation encouraged

during parent–child play and shared book reading

The activities within which language facilitation strategies are taught to caregivers and/or targeted with children

Language facilitation strategies

Following the child’s lead Allowing the child’s interest to determine material and activity selection and following this interest to build communication opportunities

Praising the child for communication Reacting to the child’s communication attempts positively, often with a specific comment and smile

Imitating the child’s communication Repeating verbatim the child’s preceding vocalization or verbalization

Expanding the child’s communication Adding a single infected word to the child’s preceding nonverbal or verbal communication attempt

Balancing parent–child conversational turns

Matching the number of adult communication turns to the child’s number of communication turns

Linguistically mapping the child’s activities

Providing the child with a linguistic model that reflects the meaning of the child’s previous communication attempt

Asking open-ended questions Asking wh-questions that prompt the child to communicate in a more elaborated form (e.g., “what happened?”)

Increasing the quantity of talk Increasing the amount of linguistic input provided to the child (e.g., number of words, utterances)

Arranging the environment (e.g., limiting television, materials in view but out of reach)

Organizing and managing situations that increase the likelihood that the child will communicate, such as placing a desired item out of reach but in view of the child

Teaching pre-academic concepts Practicing or explicitly teaching counting, shapes, letters, letter sounds, colors, and other pre-academic concepts

Language of intervention PI-NLIs delivered predominantly in English*

The language or language(s) in which language facilitation strategies are delivered to the child

Note. Definitions adapted from McCauley and Fey (2006) and Paul et al. (2018).

*Few PI-NLIs have been delivered to speakers of languages other than English. Ijalba (2015) and Peredo et al. (2018) delivered PI-NLIs in Spanish.

Dow

Puerto Rican (n = 2), Dominican (n = 1), Salvadorian (n = 1), Argentinean (n =1), or as more than one Latinx ethnicity (n = 1). The majority of parents (94%) were immigrants to the United States. They had lived in the United States for an average of 14.6 years (SD = 6.3, range: 7–38 years). Most parents (43%) had some schooling but no high school diploma. Forty percent had a high school diploma, and 14% had a bachelor’s degree. All parents spoke Spanish at home. Parents reported that an aver- age of 3.2 children lived in their homes. Of the children younger than the age of 6 years, the children averaged 2.2 years of age. Most parents (96%) reported an annual family income that was less than $40,000. A $100 gift card and a meal during the focus group were provided for participating.

Procedure Four focus groups were completed, ranging from 60

to 90 min in length. Between six and 11 parents partici- pated in each focus group. Each parent attended one focus group in their corresponding ECE center and stayed for its entirety, whereas their children were cared for in a sepa- rate classroom. The focus groups were led in Spanish by

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

the first author who identifies as White of European ances- try. The second author, who identifies as Latina, was also present for two of the focus groups. Both authors are nation- ally certified SLPs and speak Spanish.

First, the parents completed the informed consent process. Then, the parents provided basic demographic in- formation on a written questionnaire available in Spanish and English. Questions were taken from the Center for Early Care and Education Research: Dual Language Learner Parent Questionnaire (Hammer et al., 2015), which was originally validated with 317 Latinx parents of young chil- dren. Support in the form of reading the questions and potential responses aloud was provided for two parents with low literacy levels.

Next, the moderator explained the focus group pro- cedures and purpose. A standardized script was then used to ask for parents’ perspectives on 14 procedures common to PI-NLIs specific to intervention implementers, settings, activities, language facilitation strategies, and language(s) of intervention. As a reminder, these procedures were determined from information provided by reviews and meta- analyses that revealed the characteristics of PI-NLIs available in the literature, specifically Akamoglu and Meadan (2018), Barton and Fettig (2013), Heidlage et al. (2020),

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1245

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Table 2. Demographics of participating parents (N = 37).

Demographics 1 Demographics 2 n % M SD Range

Sex Female 34 92 Male 3 8

Age 32.3 5.9 21–46 Ethnicity Mexican 26 70

Guatemalan 5 13 Puerto Rican 2 5 Dominican 1 3 Salvadorian 1 3 Argentinean 1 3 Puerto Rican & Dominican 1 3

Immigration status Born outside of the United States 34 92 Born in the United States 2 5 Unknown 1 3

Age of arrival to the United States (years)a 34 18.9 6.8 3–32 Length of residency in the United Statesa 34 14.6 6.3 7–38 Education level No schooling 2 5

Some high school 14 38 High school diploma or GED 15 40 Bachelor’s degree 5 14 Unknown 1 3

Marital status Married or has a long-term partner 28 76 Single 7 19 Unknown 2 5

Employment status Employed 21 57 Not employed 16 43

No. children in the home 1.5 1–10

Note. GED = General Educational Diploma. aOnly includes participants born outside of the United States.

Dow

Law et al. (2004), Roberts and Kaiser (2011), and Te Kaat- van den Os et al. (2017). These procedures included (a) tar- geting mothers as interventionists, (b) participating in intervention in the home, (c) engaging in parent–child play and book reading, (d) following the child’s lead, (e) prais- ing the child for communication, (f) imitating the child’s communication, (g) expanding the child’s communication, (h) balancing parent–child conversational turns, (i) linguis- tically mapping the child’s activities, (j) asking open-ended questions, (k) increasing the quantity of talk, (l) arranging the environment (i.e., placing materials in view but out of reach, limiting television), (m) teaching pre-academic con- cepts, and (n) using one language in intervention. Exam- ples of these procedures were provided during the focus group to enhance understanding. The moderator also asked prompt questions related to potential adaptations of the procedures when appropriate, as guided by earlier discus- sions of culturally congruent approaches to early lan- guage development in Latinx contexts (Cycyk & Hammer, in press; Cycyk & Iglesias, 2015; van Kleeck, 1994). Par- ents responded verbally, and the focus groups were audio- recorded.

See Supplemental Material S1 for the focus group script. The script was developed through a collaborative translation process that involved Spanish speakers of varied Latinx ethnicities and dialects to ensure cultural and linguistic validity across participants (Douglas & Craig, 2007).

1246 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Data Analysis The focus groups were transcribed verbatim by fluent

Spanish-speaking research assistants familiar with the dia- lect(s) of the participants. Each transcript was reviewed in its entirety by a second Spanish-speaking research assistant to ensure transcription accuracy.

Then, all of the parental comments relevant to a single PI-NCI procedure were compiled into separate docu- ments to explore perspectives on the acceptability of each procedure discretely (rather than of PI-NCIs as a whole). Exploration of discrete procedures is recommended to under- stand which aspects of a particular intervention function well for a given population (Blase & Fixsen, 2013). Next, the authors independently reviewed each document line by line in the original language(s) and applied a hybrid qualitative coding approach that was simultaneously de- ductive and inductive in nature to meet the purposes of this study. To identify parents’ perspectives on the accept- ability of each intervention procedure (and the frequency of these viewpoints), the authors utilized structural coding, a deductive analytical technique in which predetermined codes are applied to categorize qualitative data. This ap- proach is considered appropriate for exploratory research, as it organizes meaningful content for further in-depth quali- tative analysis and permits data quantification to identify the frequency of perspectives (Saldaña, 2016). Thus, the authors independently applied predetermined codes to all

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

parental comments that represented acceptance (A), non- acceptance (NA), or neutral (N) perspectives toward the procedure. The neutral code was applied when parents expressed either (a) the absence of an opinion or (b) that the procedure was acceptable in some situations and unac- ceptable in others (i.e., conditionally acceptable). Note that relevant comments served as the unit of analysis (rather than individual parents who may have provided more than one response to each procedure or no response). Similar codes have been applied in research on consumer prefer- ences (e.g., Bos et al., 2013).

To explore the reasons underlying parents’ perspec- tives on the acceptability of each PI-NCI procedure, the authors also employed emergent coding. Emergent coding is a type of content analysis derived from grounded theory and considered a complementary inductive analytical approach to structural coding (Charmaz, 2014; Saldaña, 2016). Immediately following application of a structural code to parental comments that expanded beyond “yes,” “no,” or “I don’t know,” the authors assigned an emergent code (word or phrase) that labeled the parents’ stated rea- son for accepting, not accepting, or maintaining neutral views on the procedures.

Next, the authors discussed their independent appli- cation of codes. Consensus was reached on all disagree- ments through discussion. The final structural and emergent codes representing all relevant comments were entered into an electronic database, and the number of A, NA, and N codes were calculated. The frequency and type of codes were reviewed for differences between focus groups. Al- though some focus groups discussed specific procedures at greater length than others, the patterns of distribution of codes were similar across focus groups and no major dif- ferences were identified. Thus, data from the four focus groups were combined, and the percentages of acceptance, nonacceptance, and neutrality out of total comments for each procedure were determined. As the final step in emer- gent coding, the codes representing the reasons for parents’ perspectives were integrated into a smaller number of themes that represented patterns across parental comments (Charmaz, 2014; Saldaña, 2016).

Finally, coding reliability was determined. The authors recoded 35% of randomly selected parental comments, spanning all of the intervention procedures across the four focus groups. Codes for acceptance and for rationale were applied and then compared to the original analysis. Inter- rater coding reliability was found to be 86% for acceptance and rationale codes.

yo lo llamo como la sexta bendición que uno como mujer tiene. Para empezar, uno hace esa conexión, y…casi uno hace la mayoría de las cosas. Papá trata, pero (como que) como que yo siempre he visto que esa conexión no se hace al cien con un papá.

I call it like the sixth blessing that a woman has. To start, one makes this connection, and… almost does the majority of things. Dad tries, but (it’s like) it’s like I have always seen that that connection doesn’t reach 100% with a dad.

Results Acceptability of Procedures

To answer the first question specific to which PI-NLI procedures parents found acceptable, the percentage of total comments indicating acceptance, neutral views, and nonacceptance toward each PI-NLI procedure was reviewed (see Table 3 for details). Substantial variability in parents’

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

acceptance of the most common PI-NLI procedures was observed, with the exception of praising children and teach- ing pre-academics (endorsed by 100% of parental comments). Facilitating language in activities other than play (vs. focus- ing solely on parent–child play), providing preselected limited choices (vs. always following the child’s lead), and delivering intervention in two languages (vs. only one lan- guage) were also supported by 100% of parental comments. Additional procedures that garnered substantial support (80%–96% of comments indicated acceptance) included (a) the activities of parent–child play and shared book read- ing and (b) the language-facilitating strategies of expansion, linguistic mapping, asking open-ended questions, and in- creasing the quantity of talk throughout the day. Moderate support (50%–79% of comments indicated acceptance) was observed for the language-facilitating strategies of imitation, balanced parent–child conversational turns, and limiting television. The following procedures received limited sup- port (< 50% of comments indicated acceptance): mothers as the sole intervention implementers, home as the inter- vention setting, the language-facilitating strategies of fol- lowing the child’s lead and placing items out of reach, and using one language in intervention. No single procedure reflected a complete lack of parental acceptance.

Reasons for Parental Perspectives To answer the second research question about why

parents perceived PI-NLI procedures as acceptable, themes that described the reasons parents provided for accepting, not accepting, and holding neutral views toward each PI- NLI procedure were determined. These themes are pre- sented by categories of PI-NCI procedures, as described in the Method section. Quotes are included in their original language(s) with English translation.

Intervention Implementers Parents who supported mothers as the interventionist

believed that mothers are children’s primary caregivers and teachers in the early years: “Ellos aprenden todo casi (de) de las mamas, lo que uno les va enseñando y todo eso” [They learn almost everything (from) from moms, what one is teaching them and all that]. One father expressed that fathers may be less involved in early child-rearing due to work schedules and time constraints. Other parents shared that mothers have a special bond with children distinct from other caregivers, which one father noted as helpful for upholding rules. One mother stated:

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1247

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Table 3. Acceptability of common parent-implemented naturalistic language intervention procedures and potential alternatives.

Procedure Total comments Acceptance (%) Neutral (%) Nonacceptance (%)

Intervention implementers Mothers as interventionists 30 11 (37) 11 (37) 8 (27) Others as interventionistsa 35 30 (86) 5 (14) 0 (0)

Intervention setting Home 34 13 (38) 13 (35) 6 (26)

Intervention activities Parent–child play 25 23 (92) 2 (8) 0 (0) Other activities besides playa 20 20 (100) 0 (0) 0 (0) Shared book reading 50 48 (96) 2 (4) 0 (0)

Language facilitation strategies Follow child’s lead 47 5 (11) 27 (57) 15 (32) Preselected limited choicesa 13 13 (100) 0 (0) 0 (0) Praise children 28 28 (100) 0 (0) 0 (0) Imitation 30 22 (73) 5 (17) 3 (10) Expansion 16 14 (87) 2 (13) 0 (0) Balanced parent–child conversational turns 16 12 (75) 4 (25) 0 (0) Linguistic mapping of the child’s activities 12 10 (83) 1 (8) 1 (8) Ask open-ended questions 22 20 (91) 0 (0) 2 (9)

Increase quantity of talk (all day) 26 23 (88) 3 (12) 0 (0) Increase quantity of talk (specific activities)a 10 7 (70) 3 (30) 0 (0) Out of reach 24 9 (38) 11 (46) 4 (17) Limit television 31 18 (58) 13 (42) 0 (0) Coview televisiona 12 6 (50) 0 (0) 6 (50) Teach pre-academics 24 24 (100) 0 (0) 0 (0)

Intervention language One language 16 6 (41) 0 (0) 10 (59) Two languagesa 14 14 (100) 0 (0) 0 (0)

aAlternative procedures probed in the current study.

Si yo trabajo en la mañana, tú te quedas en la tarde. Entonces, sí, como cada uno necesita saber en qué parte aporta para llevar a cabo eso.

we take turns, like, with the kids, right? If I work in the morning, you stay in the evening. So, yes, each of us needs to know how to contribute to accomplish that [child development].

Dow

Parents who held neutral perspectives largely indi- cated that targeting mothers as interventionists was condi- tionally acceptable. These parents shared that mothers might be the appropriate target in some homes, whereas fathers (or other critical caregivers) might be more appro- priate targets in other homes depending on who will give primary care to the child.

Parents who did not accept this strategy insisted that all of the child’s caregivers should be included in interven- tions because all caregivers are responsible for supporting child development. One mother stated, “Es como un team- work como que estamos todos en el equipo alrededor de esa criatura que está aprendiendo” [It’s like teamwork like we are all on a team surrounding this creature that is learning]. In particular, parents were adamant that mothers and fathers share child-rearing roles equally, although other family members were also mentioned. In part, multi- ple involved caregivers were necessary to accommodate a family’s work schedules:

pero yo creo que dependen (del, del, del) de la parte principal, mamá, papá, y hermanos. Porque el trabajo creo que es de todos, y si hay una buena comunicación y todos hacemos…en este país es difícil porque la mayoría trabajamos mucho y nos turnamos, como, a los hijos, ¿no?

But I believe that it depends (on on on) on the principal part [of the family], mom, dad, and siblings. Because the work, I believe, is everyone’s, and if there is good communication and we all do it…in this country it is difficult because the majority of us work a lot and

(table continues)

1248 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

When the option to include all family members in intervention was offered as an alternative, most comments indicated support for this idea. This addressed parents’ concerns about leaving out critical caregivers who promote child development, especially fathers and siblings. Parents also shared that fathers, in particular, benefit from the support of interventions for effective child rearing. One father believed that parents can work together to balance their respective strengths and weaknesses for raising chil- dren. Yet, a few comments expressed a neutral position. These parents suggested that traditional cultural perspec- tives, such as machismo (i.e., male chauvinism), may limit the involvement of some caregivers:

en mi caso, soy mexicana, y en mi país, hay mucho machismo. Yo siempre he dicho machismo tonto porque (es, es) es nada, es por—pero desafortunadamente hay mucho. Y, y eso no se quita cuando llegamos aquí. Mucha gente todavía está aquí a pesar

In my case, I’m Mexican, and in my country, there is a lot of male chauvinism. I have always said ‘stupid male chauvinism’ because (it’s, it’s) it’s nothing, it’s because—but unfortunately there is a lot. And, and that doesn’t go away when we arrive here. Many people are still here

(table continues)

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

de que es un sistema diferente como dicen a veces fifty-fifty.

[in this situation] even though it’s a different system [for sharing duties], like they sometimes say fifty-fifty.

Dow

Similarly, one parent voiced concern about involving grandparents, as older family members may hold tradi- tional folk perspectives on child development. This parent said the following:

Nosotros venimos a conocer una intervención temprana o medico familiar o requerir vacunas para el niño. En mi cultura o la cultura de mi madre, todos esos solucionaban con un remedio. Entonces a veces es difícil involucrar a los abuelos o las gentes de tercera edad porque tienen otra visión de cómo arreglar el problema. Nosotros ahora lo vemos con una visión, con estrategia. Tratamos de envolver a toda la familia, lo que antes la familia no lo hacía.

We came to know an early intervention or family physician or my child requires vaccinations. In my culture or the culture of my mother, all of that is solved with a [traditional] remedy. So sometimes it’s difficult to involve grandparents or the elderly because they have another view of how to solve the problem. Now we see it with a vision, with strategy. We try to involve the whole family, which the family didn’t do before.

estoy barriendo y le digo ‘mijo, I’m sweeping and I tell him ‘son,

Intervention Setting Parents who accepted the home as the intervention set-

ting shared several reasons for this view. Some parents be- lieved that home sessions created a stronger link between the interventionist and the family as the home offered an oppor- tunity to learn more about the family’s unique culture and to support problem solving in the family’s everyday context:

El maestro se siente bienvenido dentro de la casa porque hay un mensaje que le importa a los papás y que ellos quieren aprender de ese mensaje. Y también las reglas de la escuela y como funciona y que cosas se hacen en la escuela. Es como seguir haciendo lo que hacemos en la escuela en la casa.

The teacher feels welcomed inside the home because there is a message that is important to parents and that they want to learn from this message. And also the school rules and how it works and the things that children do in school. It’s like continuing to do what we do in school in the home.

ven por el recogedor’ o ‘tráeme esto, la escoba.’ Y a veces a ellos al principio cuando empiezan a hablar que no saben cómo se llama la escoba y le digo, ‘la escoba.’ ‘Esto es una escoba.’

get the dustpan’ or ‘bring me this, the broom.’ And sometimes at the beginning when they are learning to talk they don’t know the name for broom and I tell him ‘broom.’ ‘This is a broom.’

Other parents discussed the home as the most natural and comfortable setting for the child or believed that inter- vention in the home was easier than going to another loca- tion. Despite these views, parents recounted difficulty scheduling home visits outside of working hours.

Parents who expressed neutral perspectives on the home as an intervention setting believed that any interven- tion setting could be beneficial for the child. For example, some children may pay closer attention in the home than in the classroom/clinic or vice versa. Parents also expressed that their needs may dictate the setting (e.g., availability of transportation).

Parents who did not accept the home as the inter- vention setting pointed to convenience and child outcomes.

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Regarding convenience, parents preferred other locations for ease of scheduling and to avoid having a visitor in a “messy” home. Specific to child outcomes, parents believed group intervention with peers would facilitate learning; this was not possible at home.

Intervention Activities Parents shared their perspectives on the common

PI-NLI activities of parent–child play and shared book reading. They were also asked about alternatives.

Parent–child play. Parents overwhelmingly agreed that parent–child play provided opportunities to support child development in communication, cognition, and pre- academics. Although less frequently mentioned, parents also endorsed this strategy because play fosters deeper parent–child relationships in an enjoyable activity for both parties. The parents who felt neutral about parent–child play expressed that play was important but they had lim- ited time to play with their child. No comments suggested a lack of acceptance for this activity.

Parents were further asked if activities besides play would be appropriate for supporting early communication development. All of the comments in response supported the use of alternative activities to play because parents be- lieved these activities also supported child development. The most frequent examples of language-facilitating activi- ties given by parents included household chores and bath- ing routines. For example, one mother described how she supported child language while cleaning the house:

In addition, sing-alongs, diaper changes, and cooking were suggested as activities to support communication. For some parents, focusing on communication in these activi- ties addressed having limited time for play; other activities simply occurred more regularly and, therefore, offered more frequent opportunities to support development. Par- ents further shared that participation in some activities, particularly household chores, also taught children how to contribute to the household. One parent was advised by her ECE program to target communication in everyday rou- tines, but she expressed difficulty in determining how to do so.

Shared book reading. Parents gave various reasons for accepting book reading. Most commonly, parents be- lieved that children need experience with books to support general learning in both languages and acquisition of lan- guage and literacy skills, specifically. For example, parents believed that books provide practice for children to learn Spanish and English and/or that books are a source for learning new words. Parents further noted that their young

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1249

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

children enjoyed books and, through this activity, would develop a love for reading. Two parents shared that their ECE programs promoted book reading in the home. Addi- tional reasons for supporting book reading included its po- tential to replace less desirable activities (e.g., television), to support bedtime routines and behavior, and to align with parental reading hobbies. Parents also described how they read books with their children, often describing inventing stories with the illustrations. This approach avoided the challenge of reading in English, which many parents did not speak well. Books in Spanish were reportedly difficult to find, although some parents located Spanish language books via their local library, ECE book lending programs, or the Internet. Other parents attempted to read in English, asked older children to read in English, or encouraged their younger children to tell the story. One parent described how she invented stories:

no precisamente que ellos lo lean porque todavía están chiquitos, ¿verdad? Pero ellos cuando abren un libro y ellos lo hojean hoja por hoja hasta el final, y pues yo si… no le voy leyendo, pero le voy contando lo que dice, lo que está ahí, las cosas que están, que colores son, todo todo, aunque no lo lea.

Not precisely that they read it [the book] because they are still little, right? But that when they open a book and they turn page by page until the end, and well I yes…I don’t go on reading [the words], but I go on telling them what it says, what is there, the things that are there, what colors they are, everything everything, although not reading it.

porque si uno acostumbra a los niños a hacer lo que ellos quieren, ellos van a acostumbrar a hacer lo que ellos quieren…. Como cosas que no son buenas para ellos o cosas que no se tienen que hacer. Entonces que pienso que tiene que haber un límite…. No, también hay cosas que hay que permitir que ellos

Because If one gets children used to doing whatever they want, they are going to get used to doing what they want to do…. Like things that aren’t good for them or things that they should not do. So I think that there should be a limit…. No, there are also things you have to allow them to do,

Another parent described how her older child sup- ported Spanish and English exposure while reading to her younger siblings.

La niña de once años luego se sienta…a los dos de sus hermanitos. Se sienta a…estar leyendo ahí…en español y aunque no es lo que esté en el libro, pero ella le está poniendo a explicar en español. Les lee en inglés y les está explicando en español los dibujos que tiene.

The 11-year-old [daughter] sits down with both of her younger siblings. She sits... there to read...in Spanish and although it’s not what’s [written] in the book, but she is explaining in Spanish. She reads to them in English and she’s explaining in Spanish the [book’s] pictures.

hagan, pero tampoco hay cosas que no hay que permitir y que nosotros tenemos que poner los limites que ellos no pueden hacer…. Seguimos la iniciativa dependiendo de cual es la necesidad.

but there are also things that you don’t have to allow and that we have to put limits on what they cannot do…. We follow the initiative depending on what’s the need.

no debemos de ser dictadores, tampoco, ¿verdad? Pero yo creo que la iniciativa la llevamos, nosotros. Sí, ellos deben de seguir las reglas (en en) en el sentido de decir, okay, o porque tú piensas que va a ser así. No, no tiene que ser así por eso, o sea, también dice uno te quiere dar una explicación el porque no, pero la mayoría de las veces si uno los deja, ellos quieren la iniciativa siempre.

We shouldn’t be dictators either, right? But I believe we [parents] take the initiative. Yes, they [children] should follow the rules (in in) in the sense of saying, okay, or because you think that it should be that way. No, it doesn’t have to be this way for that, I mean, one also wants to give you an explanation of why not, but the majority of times, if one lets them, they [children] will always want the initiative.

Two parents shared their views that book reading was conditionally acceptable due to personal circumstances. One parent explained that she did not often have time to read with her child, whereas the other parent stated that her child preferred other activities. These parents valued book reading for enhancing language development but were limited by contextual circumstances. No parents indicated that they did not accept shared book reading altogether.

Language Facilitation Strategies Parents responded to the language-facilitating strate-

gies of following the child’s lead, praising children for

1250 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

communication, imitating children’s communication, expand- ing children’s communication, providing balanced parent– child conversational turns, linguistically mapping the child’s activities, asking open-ended questions, increasing the quantity of talk throughout the day, maintaining items out of reach, limiting television, and teaching pre-academics. Parents also shared their views on alternative procedures, including providing preselected limited choices, increasing the quantity of talk in specific activities, and coviewing television.

Follow the child’s lead. The few comments revealing acceptance for following the child’s lead were attributed to advice from professionals. For example, one parent explained that an ECE practitioner recommended this strategy to support child learning and communication.

Parents who held neutral perspectives agreed that young children could make some choices in the home that parents were willing to accept. Specifically, children should not be allowed to make choices about food, store purchases, or television programming. However, parents expressed a level of comfort with allowing the child to choose clothing and toys. These parents wished to establish a limit specific to following the child’s lead. For example, one parent stated the following:

Parents who did not accept following the child’s lead provided several reasons why. For example, some parents believed that parents, not children, controlled the household:

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

Relatedly, parents worried that giving children choices would not benefit their development. In particular, parents shared that children would make poor choices that risk their safety, health, or family resources or would become manipulative or spoiled if given control.

When parents were queried about providing prese- lected limited choices to their children, all of their comments suggested endorsement of this alternative as a way to sup- port child development and well-being. Parents shared that some situations would permit flexibility in providing limited control to the child:

Es como una combinación de las dos en balance justo. O sea, seguir el interés del niño pero ver realmente cual es nuestro interes detrás del interés del niño. ¿No? por ejemplo a mi hija le encanta Peppa Pig y ella puede ver Peppa Pig todo el día pero entonces yo busco otras estrategias como rompecabezas de Peppa Pig o stickers de Peppa Pig... Entonces seguimos la iniciativa que me encanta Peppa Pig pero en otra, con otra idea. Entonces ella está feliz y yo estoy feliz porque esta trabajando y haciendo otra cosas a parte de Peppa Pig.

It’s like a combination of both in fair balance. Or rather, following the interest of the child but seeing really what is our interest underlying the child’s interest. Right? for example, my daughter loves Peppa Pig and she could watch Peppa Pig all day but so I look for other strategies like puzzles of Peppa Pig or stickers of Peppa Pig…. So we follow the initiative that I love Peppa Pig but in another, with another idea. So she is happy and I am happy because she is working and doing other things besides Peppa Pig.

para nosotros están de acuerdo es una falta de educación que un chiquito se meta en la plática de los adultos, pero si estamos sentados en una mesa platicando de cómo nos fue nuestros días—Si yo le pregunto a él, ¿cómo te fue en la escuela? ¿qué comiste? ¿qué hiciste? ¿cuál juego jugaste? Tengo que responder a las preguntas que él me haga a mi también.

For us it’s generally agreed that it’s a lack of good manners for a little one to jump into the conversation of adults, but if we are sitting at a table talking about how our days were—If I asked him, how was school? What did you eat? What did you do? What game did you play? I have to respond to the questions that he asks me too.

Praise children. All comments related to the practice of praising children suggested acceptance of this practice. However, parents’ endorsement of this strategy did not appear to be related to supporting child communication. Instead, parents described praise as a way to encourage desired behavior, such as maintaining children’s motiva- tion and attention to household chores. Importantly, parents tended to focus on praising older children rather than younger children in earlier stages of development.

Imitation. Parents who accepted imitating children’s communication attempts provided several rationales. First, parents suggested that imitating created enjoyable shared moments between the parent and the child that strength- ened their relationship. Second, parents believed that imita- tion had the potential to support children’s communication, learning, or general development. One mother described, “Les puedo uno imitar unos sonidos que ellos hacen e imi- tar los sonidos y a la vez decirles que es la palabra o la cosa que uno le está ensenando. (Y este) y ellos así van aprendiendo también” [One can imitate some sounds that they make and imitate the sounds and also tell them the word or thing that one is teaching them. (And this) and that way, they start learning too]. It should be noted that one parent was advised by an ECE practitioner to imitate the young child.

Parents who held neutral perspectives toward imita- tion specified that imitation was an appropriate strategy at times depending on the child’s age or the individuals pres- ent. Parents expressed that imitation is appropriate with

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

children in the early stages of learning language (i.e., toddlers) or children with communication concerns, but imitation is not appropriate for older children (i.e., pre- schoolers). These parents thought it was important to in- troduce “real words” with proper pronunciation at some point, which suggested that parents equated imitation with what is commonly described as “baby talk.” Two parents shared that imitation could be an embarrassing or shame- ful practice to undertake in public when other adults were present.

Two parents who did not accept imitation believed that it could be harmful to child communication develop- ment. One parent said, “Es como que le pones una barrera, como que lo limitas más…. tienes que hablarle con pala- bras claras” [It’s like you put up a barrier for him, like you limit him more.... You have to speak to him with clear words].

Expansion. Despite the general endorsement of this strategy, few reasons were provided to justify why parents supported this strategy; however, two parents reported that they had learned this strategy through their ECE pro- grams. Parents who conditionally accepted this strategy shared their concerns that the child would view expansions as punitive and, resultantly, would feel bad when expan- sions were provided. No comments specified a total lack of acceptance of expansion. (Note that due to time limita- tions, one focus group did not discuss this strategy.)

Balanced parent–child conversational turns. Parents who accepted equal turn-taking with their young children shared their beliefs that taking turns in conversation with young children improved communication between parents and children and also helped children to feel that they had something important to contribute to conversations. Par- ents who did not accept turn-taking in all circumstances stated that use of this strategy depended on the content and participants of the conversation. One parent explained the following:

This example was repeated by other parents. Parents believed that children should not take turns during adult conversations but could participate when invited into the conversation by the parent. No comments suggested a lack of acceptance of turn-taking.

Linguistic mapping. Parents who accepted the strat- egy of narrating the activities of their young children

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1251

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

sí, no tener alejado lo que corre peligro a ella, pero por decir nosotros en este caso las cosas de comida ella va y lo agarra…. lo que si le guardamos en alto es que las galletas, o sea, cosas así porque digo no me gusta que coma mucho, pero si lo que es fruta, queso, yogurt, es muy bueno para ella a su salud.

Yes, not having things that are a danger to her, but to say that in this case, she can go and grab food…. What we do keep up high are the cookies, or rather, things like that because I say I don’t like her to eat much, but if it’s fruit, cheese, yogurt, it’s very good for her health.

Dow

shared that this strategy supported language development by creating opportunities for children to imitate and to deepen their world knowledge. One parent noted that this strategy supported communication better than asking questions. Another parent learned this strategy through her ECE pro- gram. The only parent whose comment suggested that this strategy was conditionally acceptable thought that narration limits the opportunities children have to produce language (if there was an imbalance of adult vs. child talk). One par- ent commented that this strategy was not acceptable; this parent described herself as quiet and preferred music.

Ask open-ended questions. Parents who accepted asking open-ended questions of their children (vs. close- ended questions) described that open-ended questions could provoke lengthier conversations with children who were already talking as well as prompt children attending ECE programs to share their school experiences. Other reasons for supporting open-ended questions included strengthen- ing the parent–child relationship, showing concern for the child’s well-being, and increasing home language exposure. No responses suggested neutral perspectives on this strat- egy. Of the two comments expressing a lack of acceptance for this strategy, only one was linked to a rationale: The parent had received professional advice to ask fewer ques- tions of the child.

Increase quantity of talk. Parents who accepted increas- ing talk across the day provided two reasons for endorsing this strategy. First, parents believed that talking more to young children created an open dialogue that builds trust and strengthens the parent–child relationship. The second reason parents gave was their belief that this strategy sup- ports communication development, including access to the home language. One parent included both reasons when responding to this strategy: “Eso ayuda muchísimo tanto en el vocabulario de los niños para que haya esa comunicación y confianza entre padres y los niños” [That helps a lot with children’s vocabulary as well as with establishing communi- cation and trust between parents and children].

The parents who held neutral views reflected condi- tional acceptance of this strategy for two reasons. Parents expressed that the acceptability of this strategy depended on the child’s age and abilities (e.g., older children would likely talk less or need less parental language input to engage in conversation). Another parent expressed that the quan- tity of talk could be increased only when the family was home and had time available to attend to the child’s com- munication. No parents expressed that this strategy was unacceptable.

When asked if they would prefer focusing on specific activities during which to increase the quantity of talk rather than trying to increase the quantity of talk throughout the day, several comments supported this idea as a way to com- bat child-rearing challenges. Parents shared having limited free time with their children, often feeling exhausted in the moments they did have, and trying to balance the demands of several children with varied communication abilities. Thus, the idea of designating specific activities for focusing on targeted talk with their young children was appealing.

1252 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Three comments indicated a neutral perspective on this strategy. These parents described that this was an appropri- ate alternative when they had time to focus on their young children or during activities that they deemed appropriate for young children’s participation.

Out of reach. Parents next discussed the environmen- tal arrangement strategy of keeping items out of reach of the child to prompt the child to initiate communication. Parents who indicated that this strategy was generally acceptable provided two reasons for this belief. First, parents favored this strategy for maintaining control over special toys, food consumption, and child safety. Second, parents believed this strategy supported communication as children would practice requesting for desired items more often.

The parents who held neutral perspectives were clear that this strategy was conditionally acceptable, specifying items that were appropriate to keep out of reach. One par- ent stated the following:

Like this parent, parents favored keeping special toys, unhealthy foods, or dangerous items out of the child’s reach. This also allowed parents to maintain control and organization in their homes.

Parents who did not accept this strategy expressed that having items in reach allowed the child to get needs met when the parent was occupied. Another parent com- mented that she still requires her child to ask permission to use items within reach, which she felt fostered communica- tion, patience, and discipline without the need for placing items out of reach.

Limit television. Parents further responded to reduc- ing young children’s exposure to television. Parents who accepted limiting television explained that current televi- sion programming did not support child development. Par- ents believed that many programs geared toward children (e.g., Sponge Bob, Spider-man) were too violent or show- cased rude or disrespectful behavior that children should not learn. Some parents also expressed their belief that tele- vision limited communication development. One mother described this scenario when her son watched Telletubbies: “Él estaba hablando de una manera incorrecta porque él escuchaba a los muñecos hablar de esa manera” [He was talking incorrectly because he was listening to the dolls [characters] talking that way]. Similar concerns were shared

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Figure 1. Parental acceptance of procedures by underlying individualistic–collectivist orientation.

Dow

about cell phones, video games, and the Internet. To limit television and electronic device use, parents described find- ing replacement activities for their children, such as paint- ing, playing, reading, and cleaning.

Parents who expressed conditional acceptance of this strategy believed that television was appropriate at times for their young children for one reason. The television was thought to be a necessary “babysitter” when parents had household chores to complete. Still, these parents spoke of the importance of selecting appropriate television program- ming, offering the examples of Dora the Explorer, PAW Patrol, and shows on Children’s BBC. No parents thought that limiting television was unacceptable.

Regardless of their perspective, many comments reflected the difficulty of limiting television. Parents de- scribed challenging behaviors manifested by their children when television was limited, difficulty attending to the child in the absence of television, and children’s general boredom particularly when the weather was poor and chil- dren could not play outside.

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Parents also responded to the alternative of coview- ing television with their children to support interactional language. Half of the comments suggested acceptance, particularly when children initiate conversations with their parents. In contrast, the other half of comments indi- cated that this option was not acceptable. Parents shared that they did not have time to coview television with their children and/or that talking distracted from children’s enjoyment.

Teach pre-academics. When asked about supporting the pre-academic skills of young children, all comments in- dicated acceptance of this strategy. Parents endorsed this strategy to support child learning outside of educational set- tings. They shared that children enjoyed learning these con- cepts, which were easy to teach in everyday contexts (e.g., play, bath time, meals). One parent stated, “Uno como per- sona mira por donde quiera mira colores, figures, números… entonces no tendría que ser algo difícil de ensenar” [A per- son sees colors, shapes, numbers wherever…so it should not be something difficult to teach].

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1253

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

Intervention Language In addition, parents were asked if the intervention

should be provided in a single language. Parents either ac- cepted or did not accept this approach; no parents shared neutral views. Parents who accepted intervention in a single language generally favored the use of Spanish. For these parents, Spanish language maintenance was important because Spanish was the only language of the home, and some family members did not speak English. Parents also believed that English would be learned with time in school. Two parents shared that their children’s ECE programs supported the families’ use of Spanish at home.

Alternatively, most parents did not feel that interven- ing in one language was acceptable. Comments to this end reflected parents’ beliefs that bilingualism benefits children, leading to stronger brain development, increased capacity to translate for the family, and expanded opportunities for the future. Parents also endorsed the use of Spanish and English in intervention because both languages were spoken by their young children and by various household members. As such, all comments related to the alternative procedure of intervening in both languages indicated support for this approach. Despite generally endorsing bilingualism, some parents expressed their views that learning two languages can be difficult or confusing for children and that code- switching should be discouraged.

Discussion The purpose of this study was to explore the perspec-

tives of a subset of parents of young children from Latinx- and Spanish-speaking backgrounds on the acceptability of procedures common to current PI-NLIs in the field of speech-language pathology. Because Latinx- and Spanish- speaking families have not traditionally been included in the research on PI-NLIs (Akamoglu & Meaden, 2018; Guiberson & Ferris, 2019a), the social validity of PI-NLIs for parents from this background had not been carefully examined. Interventions that are not socially valid may have the unintended effect of alienating families and jeop- ardizing child outcomes (Dunst et al., 2016; Wolf, 1978). Therefore, this study represents a critical starting point for considering the cultural, linguistic, and contextual validity of PI-NLIs in research and practice. The findings not only represent the diversity of perspectives inherent in any pop- ulation united by ethnic affiliation but also general trends that warrant further empirical scrutiny as PI-NLIs con- tinue to be adapted for the increasing number of Latinx families in early intervention.

Variability in Parental Perspectives of the Social Validity of PI-NLIs

The variability in parental perspectives toward exist- ing PI-NLI procedures in this modest sample of parents who were Latinx- and Spanish-speaking is notable. As a group, these parents held perspectives on PI-NLI strategies that simultaneously reflected affiliations with individualism

1254 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

and collectivism (see Figure 1 for an overview). For exam- ple, the individualistic practice of praising children was unanimously endorsed, whereas the individualistic practice of following the child’s lead received little support; instead, the collectivist adaptation of providing preselected choices in which parents control the interaction was preferred. Moreover, individual parents varied in their views about which strategies were acceptable (see Table 3). For instance, parental responses to focusing on mothers as the primary intervention implementer were nearly evenly split between accepting, not accepting, and holding neutral views toward this procedure. Similarly, parents provided varied reasons for their perspectives within acceptability categories. This finding extends previous literature that has observed vari- ability within and across Latinx parents regarding their beliefs, values, and practices toward early language de- velopment and disorder as related to their cultural orien- tations (Cycyk & Hammer, in press; Guiberson & Ferris, 2019b; Hammer et al., 2007; Rodriguez & Olswang, 2003). Given this variability, this study provides evidence that consideration for parents’ unique sociocultural perspectives is necessary to achieve social validity of PI-NLIs.

Prior work has attributed intracultural differences in parents’ cultural orientations to education levels, accultura- tion, socioeconomic status, and developmental context, among other variables (e.g., Tamis-LeMonda et al., 2008). It is further possible that having a child with a disability or interfacing with early education providers or early interven- tion services results in variations in cultural orientation. In- deed, many parents in this study shared that their views were influenced by advice given by early childhood pro- viders. Examining individual differences was not the pur- pose of this study. However, despite some diversity in this sample, most parents in this study were high school graduates, had immigrated from Mexico to the United States, and reported low family incomes. All families had young children without concerns for development attending early education programs. As such, the findings suggest that even subtle intracultural differences among parents who share demographic characteristics and contextual cir- cumstances may matter to the social validity of early lan- guage interventions. Thus, this study serves as an important reminder that sociocultural orientation is dynamic and com- plex and that Latinx communities are not homogenous. On the contrary, acknowledging the variable views of Latinx parents toward PI-NLIs must be a priority for research and practice.

Recent empirical efforts to develop and test PI-NLIs with Latinx- and Spanish-speaking parents have included cultural and linguistic adaptations to better match families’ sociocultural background with good success (Ijalba, 2015; Peredo et al., 2018). However, the variability of parental perspectives observed in this study calls attention to the fact that a one-size-fits-all approach to PI-NLIs for this population is not plausible. Researchers and clinicians are advised to consult directly with Latinx families in their lo- cal communities to learn of their unique perspectives when

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

developing and planning interventions. This study shows that parents can and will express their views on specific intervention procedures when provided with an opportu- nity to do so. This information can be coupled with par- ents’ descriptions of their children’s naturalistic language learning contexts (e.g., Cycyk & Hammer, in press) to de- termine adaptations that enhance the social validity of PI- NLIs for particular families. Through early collaboration with parents in the process of intervention development and planning, the field will be better poised to provide family- centered early language interventions that are culturally, linguistically, and contextually responsive (ASHA, 2008, 2017; DEC, 2014; IDEA, 2004).

Considerations for Enhancing the Cultural Validity of PI-NLIs

Despite the notable variability of parental perspec- tives in this study, there are general trends (see Table 3) that provide insight into potential adaptations of PI-NLIs that may broadly improve PI-NLIs for Latinx families of varying sociocultural orientations. Given the exploratory nature of focus group research, the utility of these adapta- tions for enhancing PI-NLIs cannot be determined without further studies that survey a large number of Latinx parents who represent more substantial diversity, including those with children with language disorders. Nonetheless, parents in this study supported adaptations generally aligned with collectivism, such as including family mothers in addition to children’s mothers as interventionists (especially fathers), facilitating language in activities in addition to parent–child play and shared book reading (e.g., household chores and care giving), directing the choices of children rather than always following the child’s lead, and supporting two lan- guages in intervention instead of one. Moreover, parents’ discussion of shared book reading suggested that adapta- tions may include inventing stories, describing the illus- trations, involving older siblings, and using Spanish to bridge from the English text.

Many of these findings align with previous work that has described the naturalistic practices of Latinx parents toward early child language development (Cycyk & Hammer, in press; Guiberson & Ferris, 2019b). Furthermore, there is evidence that several of these adaptations may benefit child language development. Prior research has shown that the language input of Latinx fathers, broadly, and the specific input used by Latinx mothers to maintain parental author- ity in interactions support child language (Tamis-LeMonda, Baumwell, & Cristofaro, 2012; Tamis-LeMonda, Song, et al., 2012). Research has also determined that the language devel- opment of children in multilingual contexts is better sup- ported with attention to both languages (Guiberson & Ferris, 2019a) and that children benefit from a variety of parental reading approaches (Allison & Watson, 1994). Thus, there are strong indications that incorporating these ad- aptations into PI-NLIs will increase the cultural validity of PI-NLIs for Latinx families while simultaneously supporting child outcomes.

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Perhaps pairing these adaptations with existing PI-NLI language-facilitating strategies that parents in this study also generally viewed as valid may further support families from Latinx backgrounds. These included praising children, expanding child communication, linguistically mapping, asking open-ended questions, increasing the quantity of talk, and teaching pre-academics. The Latinx parents who participated in Guiberson and Ferris (2019b) also reported a preference for talking about their children’s activities, asking their children questions, and teaching colors, letters, and numbers. Moreover, there is emerging evidence that such strategies will support the language development of young Latinx children with language disorders (Guiberson & Ferris, 2019a; Ijalba, 2015; Peredo et al., 2018). Thus, these evidence-based PI-NLI procedures may already achieve cultural relevance for some families from Latinx backgrounds; however, more research is needed before definitive conclu- sions can be drawn about the impact of adapted and nona- dapted PI-NLI procedures on child language disorders.

Limitations and Future Directions There are three primary limitations to this research

that must be acknowledged. First, parents’ use of language- facilitating strategies with their young children was not observed. Thus, it is not possible to explore how the per- spectives of parents mapped onto their actual practices in the home. For example, parents readily endorsed reading books as a valuable strategy for supporting development; however, the frequency with which they read books with their children is unknown. Importantly, prior research has linked parental beliefs to practices relevant to child devel- opment (Keels, 2009; Luster et al., 1989). Yet, future re- search on this topic should include observation of parental behaviors in naturalistic interactional contexts with their children alongside the investigation of parental perspectives on such practices.

Second, this exploratory research is limited to a mod- est number of parents of Latinx heritage who participated in audio-recorded focus groups, thereby limiting generali- zation and direct investigation of intracultural variability. Although focus group research is designed to sample partic- ipants who broadly represent the target community, most parents were from the northeast and Pacific Northwest, had lived in the United States for an average of 14 years, had a high school education or less, and were women of Mexican immigrant descent from low-income homes. All families had children enrolled in early education programs, two of which were dual language programs, potentially predispos- ing parents to particular views on language and learning. As such, the findings may not represent the views of Latinx parents of young children who do not fit this description. Moreover, given the relatively similar backgrounds of the sample and the limitations of audio recording, it was not pos- sible to determine sources of variability in parental perspec- tives (e.g., length of residency, educational status, exposure to dual language programs). Wide distribution of an anonymous social validity survey developed from the exploratory findings

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1255

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

of this study may help to address this limitation with a larger and more diverse sample of Latinx caregivers (e.g., Fitton et al., 2017). This approach may also allow examination of individual variability and encourage parents who may not have felt comfortable sharing their perspectives (e.g., par- ents concerned with immigration status).

Third, these parents had no concerns for their young children’s language development. This study purposely recruited parents whose children had not received early intervention services in order to ensure that parents’ views authentically reflected underlying cultural perspectives on language interventions rather than the influence of previous contact with SLPs or other interventionists. These perspec- tives are useful given that attention is increasingly being paid to supporting the language development of young Latinx children without disorders who are often considered at risk for less-than-optimal language outcomes. However, the presence of child disability may uniquely impact parental perspectives and practices, leading to opinions that differed from those of the parents in the current study. Importantly, it should be noted that the findings of the few studies that have examined the broad views of Latinx parents of young children with language disorders on interventions align with the results of this study (García et al., 2000; Peredo et al., 2018). Regardless, future studies should explore the social validity of PI-NLIs with parents of children with diagnosed language disorders.

Suggestions for Practice At present, research is needed to address approaches

that effectively support clinicians in evaluating the socio- cultural appropriateness of a given intervention and dis- cussing adaptation options with individual families. In the absence of empirical data, four practical steps may be helpful for adapting interventions to families’ unique backgrounds. First, clinicians could review the goals, pro- cedures, and outcomes of the specific intervention(s) under consideration for implementation with a particular family, asking the following (Carter, 2010): (a) “Why might these goals be viewed as significant to a given stakeholder?” (b) “Why might each of these procedures be viewed as acceptable or unacceptable to a given stakeholder?” and (c) “Why or why not might the desired intervention out- comes be viewed as important?” These questions offer the opportunity to reflect on the varied sociocultural, linguis- tic, and/or contextual factors that underlie existing inter- ventions and potentially impact the acceptability of such interventions for families.

Second, clinicians could review the studies that have shown the intervention(s) to be effective for the character- istics of the studies’ participants that may influence per- ceptions of and/or participation in interventions (e.g., cultural orientation, home language, country of origin, and experience with child disability and/or early interven- tion). Clinicians could ask the following: “For whom was this intervention shown to be effective?” and “Does their

1256 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

background match that of the family I am serving now?” A mismatch between the individuals with whom the inter- vention was initially delivered and the family may suggest, in some cases, the potential need for adaptations.

Although these initial steps may offer insights into adaptations, it is important that clinicians do not make as- sumptions. Therefore, the third step is to discuss the inter- vention(s) with the family. The clinician could describe the underlying perspective that informs each intervention com- ponent (as identified in Step 1), be transparent about the populations for whom the intervention is known to be ef- fective (as identified in Step 2), explain that not all families share perspectives on whether these components are accept- able, and ask open-ended questions that permit the family to elaborate on their views (see examples in Hammer, 1998; van Kleeck, 1994). This discussion could also focus on the unique family context, such as work schedules, resource availability, and the individuals responsible for child care. The clinician could initiate this discussion with more than one family member, if families wish to include multi- ple caregivers (with diverse perspectives and practices) in intervention.

The final step is to use this information in collabora- tion with families to adapt the intervention prior to and during its delivery. In accordance with the findings of this study, some intervention components may be preserved while others may be modified to better fit the family’s per- spectives and life contexts (van Kleeck, 1994). Clinicians could communicate the pros and cons of maintaining ver- sus adapting particular intervention components and share the current knowledge base on how adaptations impact child and family outcomes. This open dialogue places the family at the center of the intervention by providing them with the agency to make informed decisions about their child’s care (i.e., choosing between adapted and/or tradi- tional approaches; van Kleeck, 1994). As the intervention proceeds, clinicians could regularly revisit this discussion to ensure the success of adaptations and to address any chang- ing perspectives on the part of the family that may impact future intervention services. Beyond meeting professional and legal mandates for family-centered intervention services (ASHA 2008, 2017; DEC, 2014; IDEA, 2004), this collab- orative approach may strengthen the trust between the family and clinician that can only deepen the therapeutic alliance and support child progress.

Acknowledgments This study was funded by a Faculty Seed Grant from the

Office of the Vice President for Research and Innovation at the University of Oregon. We thank the Office of the Vice President for Research and Innovation at the University of Oregon for funding this project. The authors would also like to thank the staff from the early childhood education centers who supported recruitment for this project and the families who participated. Thank you to the students from the Early Dual Language Devel- opment Laboratory at the University of Oregon whose work facil- itated this study.

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

References Allison, D. T., & Watson, J. A. (1994). The significance of adult

storybook reading styles on the development of young children’s emergent reading. Literacy Research and Instruction, 34(1), 57–72. https://doi.org/10.1080/19388079409558171

American Speech-Language-Hearing Association. (2008). Roles and responsibilities of speech language pathologists in early interven- tion: Guidelines. https://www.asha.org/policy/gl2008-00293/

American Speech-Language-Hearing Association. (2017). Issues in ethics: Cultural and linguistic competence. http://www.asha.org/ Practice/ethics/Cultural-and-Linguistic-Competence/

Akamoglu, Y., & Meadan, H. (2018). Parent-implemented language and communication interventions for children with developmen- tal delays and disabilities: A scoping review. Review Journal of Autism and Developmental Disorders, 5(3), 294–309. https://doi. org/10.1007/s40489-018-0140-x

Bailey, D. B., Jr., Skinner, D., Rodriguez, P., Gut, D., & Correa, V. (1999). Awareness, use, and satisfaction with services for Latino parents of young children with disabilities. Exceptional Children, 65(3), 367–381. https://doi.org/10.1177/001440299906500307

Barton, E. E., & Fettig, A. (2013). Parent-implemented interven- tions for young children with disabilities: A review of fidelity features. Journal of Early Intervention, 35(2), 194–219. https:// doi.org/10.1177/1053815113504625

Blase, K., & Fixsen, D. (2013). Core intervention components: Identifying and operationalizing what makes programs work (ASPE Research Brief). U.S. Department of Health and Human Services.

Bos, C., Van der Lans, I. A., Van Rijnsoever, F. J., & Van Trijp, H. C. (2013). Understanding consumer acceptance of inter- vention strategies for healthy food choices: A qualitative study. BMC Public Health, 13(1), 1073. https://doi.org/10.1186/1471- 2458-13-1073

Bronfenbrenner, U. (1979). Contexts of child rearing: Problems and prospects. American Psychologist, 34(10), 844–850. https:// doi.org/10.1037/0003-066X.34.10.844

Caldera, Y. M., Velez-Gomez, P., & Lindsey, E. W. (2015). Who are Mexican Americans? An overview of history, immigration, and cultural values. In M. Caldera & E. W. Lindsay (Eds.), Mexican American children and families: Multidisciplinary perspectives (pp. 3–12). Routledge. https://doi.org/10.4324/ 9781315814612

Carter, S. (2010). The social validity manual: A guide to subjective evaluations of behavior interventions. Elsevier. https://doi.org/ 10.1016/B978-0-12-374897-3.00013-1

Centers for Disease Control and Prevention. (2015). Communica- tion disorders and use of intervention services among children aged 3–17 years: United States, 2012. https://www.cdc.gov/ nchs/products/databriefs/db205.htm

Charmaz, K. (2014). Constructing grounded theory (2nd ed.). SAGE.

Cycyk, L. M., & Hammer, C. S. (in press). Beliefs, values, and practices of Mexican immigrant families towards language and learning in toddlerhood: Setting the foundation for early child- hood education. Early Childhood Research Quarterly.

Cycyk, L. M., & Iglesias, A. (2015). Parent programs for Latino families with young children: Social, cultural, and linguistic con- siderations. Seminars in Speech and Language, 36(2), 143–153. https://doi.org/10.1055/s-0035-1549109

Division for Early Childhood of the Council for Exceptional Children. (2014). DEC recommended practices in early intervention/early childhood special education 2014. https://www.dec-sped.org/ dec-recommended-practices

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Douglas, S. P., & Craig, C. S. (2007). Collaborative and iterative translation: An alternative approach to back translation. Jour- nal of International Marketing, 15(1), 30–43. https://doi.org/ 10.1509/jimk.15.1.030

Duff, F. J., Reen, G., Plunkett, K., & Nation, K. (2015). Do infant vocabulary skills predict school-age language and literacy out- comes? The Journal of Child Psychology and Psychiatry, 56(8), 848–856. https://doi.org/10.1111/jcpp.12378

Dunst, C. J., Raab, M., & Hamby, D. W. (2016). Interest-based everyday child language learning. Revista de Logopedia, Foniatría y Audiología, 36(4), 153–161. https://doi.org/10.1016/ j.rlfa.2016.07.003

Federal Interagency Forum on Child and Family Statistics. (2017). America’s children: Key national indicators of well-being, 2017. U.S. Government Printing Office.

Fitton, L., Bustamante, K. N., & Wood, C. (2017). The social validity of telepractice among Spanish-Speaking caregivers of English learners: An examination of moderators. International Journal of Telerehabilitation, 9(2), 13–24. https://doi.org/10.5195/IJT. 2017.6227

Foster, S. L., & Mash, E. J. (1999). Assessing social validity in clinical treatment research: Issues and procedures. Journal of Consulting and Clinical Psychology, 67(3), 308–319. https://doi. org/10.1037/0022-006X.67.3.308

García, S. B., Mendez Perez, A., & Ortiz, A. A. (2000). Mexican American mothers’ beliefs about disabilities: Implications for early childhood intervention. Remedial and Special Education, 21(2), 90–120. https://doi.org/10.1177/074193250002100204

García Coll, C., Akiba, D., Palacios, N., Bailey, B., Silver, R., DiMartino, L., & Chin, C. (2002). Parental involvement in children’s education: Lessons from three immigrant groups. Parenting: Science and Practice, 2(3), 303–324. https://doi.org/ 10.1207/S15327922PAR0203_05

Griner, D., & Smith, T. B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43(4), 531–548. https://doi.org/ 10.1037/0033-3204.43.4.531

Grau, J. M., Duran, P. A., Castellanos, P., Smith, E. N., Silberman, S. G., & Wood, L. E. (2015). Developmental outcomes of tod- dlers of young Latina mothers: Cultural, family, and parenting factors. Infant Behavior and Development, 41, 113–126. https:// doi.org/10.1016/j.infbeh.2015.08.001

Greenfield, P. M., & Cocking, R. R. (1994). Cross-cultural roots of minority child development. Erlbaum.

Greenfield, P. M., Trumbull, E., Keller, H., Rothstein-Fisch, C., Suzuki, L. K., & Quiroz, B. (2006). Cultural conceptions of learning and development. In P. A. Alexander & P. H. Winne (Eds.), Handbook of educational psychology (pp. 675–692). Erlbaum.

Guiberson, M. M., & Ferris, K. P. (2019a). Early language inter- ventions for young dual language learners: A scoping review. American Journal of Speech-Language Pathology, 28(3), 945–963. https://doi.org/10.1044/2019_AJSLP-IDLL-18-0251

Guiberson, M. M., & Ferris, K. P. (2019b). Identifying culturally consistent early interventions for Latino caregivers. Communi- cation Disorders Quarterly, 40(4), 239–249. https://doi.org/ 10.1177/1525740118793858

Hammer, C. S. (1998). Toward a “thick description” of families: Using ethnography to overcome the obstacles to providing family-centered early intervention services. American Journal of Speech-Language Pathology, 7(1), 5–22. https://doi.org/ 10.1044/1058-0360.0701.05

Hammer, C. S., Morgan, P., Farkas, G., Hillemeier, M., Bitetti, D., & Maczuga, S. (2017). Late talkers: A population-based study

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1257

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

of risk factors and school readiness consequences. Journal of Speech, Language, and Hearing Research, 60(3), 607–626. https:// doi.org/10.1044/2016_JSLHR-L-15-0417

Hammer, C. S., Rodriguez, B. L., Lawrence, F. R., & Miccio, A. W. (2007). Puerto Rican mothers’ beliefs and home literacy prac- tices. Language, Speech, and Hearing Services in Schools, 38(3), 216–224. https://doi.org/10.1044/0161-1461(2007/023)

Hammer, C. S., Scarpino, S., Cycyk, L. M., Jury, K., & Sawyer, B. (2015). Center for Early Care and Education Research–Dual Language Learner (CECER-DLL) Parent Questionnaire.

Heidlage, J. K., Cunningham, J. E., Kaiser, A. P., Trivette, C. M., Barton, E. E., Frey, J. R., & Roberts, M. Y. (2020). The effects of parent-implemented language interventions on child lin- guistic outcomes: A meta-analysis. Early Childhood Research Quarterly, 50, 6–23. https://doi.org/10.1016/j.ecresq.2018.12.006

Hofstede, G. (2001). Culture’s consequences: Comparing values, be- haviors, institutions and organizations across nations (2nd ed.). SAGE.

Ijalba, E. (2015). Effectiveness of a parent-implemented language and literacy intervention in the home language. Child Lan- guage Teaching and Therapy, 31(2), 207–220. https://doi.org/ 10.1177/0265659014548519

Individuals with Disabilities Education Act, 20 U.S.C. § 1400. (2004). Kazdin, A. E. (1977). Assessing the clinical or applied importance

of behavior change through social validation. Behavior Modifi- cation, 1(4), 427–452. https://doi.org/10.1177/014544557714001

Kazdin, A. E. (1981). Acceptability of child treatment techniques: The influence of treatment efficacy and adverse side effects. Behavior Therapy, 12(4), 493–506. https://doi.org/10.1016/ S0005-7894(81)80087-1

Keels, M. (2009). Ethnic group differences in early head start parents’ parenting beliefs and practices and links to chil- dren’s early cognitive development. Early Childhood Research Quarterly, 24(4), 381–397. https://doi.org/10.1016/j.ecresq.2009. 08.002

Kummerer, S. E., & Lopez-Reyna, N. A. (2009). Engaging Mexi- can immigrant families in language and literacy interventions: Three case studies. Remedial and Special Education, 30(6), 330–343. https://doi.org/10.1177/0741932508321014

Kummerer, S. E., Lopez-Reyna, N. A., & Hughes, M. T. (2007). Mexican immigrant mothers’ perceptions of their children’s communication disabilities, emergent literacy development, and speech-language therapy program. American Journal of Speech-Language Pathology, 16(3), 271–282. https://doi.org/ 10.1044/1058-0360(2007/031)

Larson, A. L., Cycyk, L. M., Carta, J., Hammer, C. S., Baralth, M., Uchikoshi, Y., An, Z. G., & Wood, C. (2020). A systematic review of language-focused interventions for children from cul- turally and linguistically diverse backgrounds. Early Childhood Research Quarterly, 50(Pt. 1), 157–178.

Law, J., Garrett, Z., & Nye, C. (2004). The efficacy of treatment for children with developmental speech and language delay/ disorder: A meta-analysis. Journal of Speech, Language, and Hearing Research, 47(4), 924–943. https://doi.org/10.1044/ 1092-4388(2004/069)

Luster, T., Rhoades, K., & Haas, B. (1989). The relation between parental values and parenting behavior: A test of the Kohn hy- pothesis. Journal of Marriage and the Family, 51(1), 139–147. https://doi.org/10.2307/352375

Lynch, E. W., & Hanson, M. J. (2004). Developing cross-cultural competence: A guide for working with children and their families (3rd ed.). Brookes.

McCauley, R. J., & Fey, M. E. (2006). Treatment of language dis- orders in young children. Brookes.

1258 American Journal of Speech-Language Pathology • Vol. 29 • 124

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Méndez Pérez, A. (2000). Mexican American mothers’ perceptions and beliefs about language acquisition in infants and toddlers with disabilities. Bilingual Research Journal, 24(3), 277–294. https://doi.org/10.1080/15235882.2000.10162766

Paul, R., Norbury, C. F., & Gosse, C. (2018). Language disorders from infancy through adolescence: Listening, speaking, reading, writing, and communicating (5th ed.). Elsevier. https://doi.org/ 10.1016/B978-0-323-44234-3.00008-7

Peredo, T. N., Zelaya, M. I., & Kaiser, A. P. (2018). Teaching low-income Spanish-speaking caregivers to implement EMT en Español with their young children with language impair- ment: A pilot study. American Journal of Speech-Language Pathology, 27(1), 136–153. https://doi.org/10.1044/2017_ AJSLP-16-0228

Phillips, D. A., & Shonkoff, J. P. (2000). From neurons to neigh- borhoods: The science of early childhood development. National Academies Press.

Reese, L., & Gallimore, R. (2000). Immigrant Latinos’ cultural model of literacy development: An evolving perspective on home-school discontinuities. American Journal of Education, 108(2), 103–134. https://doi.org/10.1086/444236

Reilly, S., Wake, M., Ukoumunne, O. C., Bavin, E., Prior, M., Cini, E., Conway, L., Eadie, P., & Bretherton, L. (2010). Pre- dicting language outcomes at 4 years of age: Findings from early language in Victoria study. Pediatrics, 126(6), 1530–1537. https://doi.org/10.1542/peds.2010-0254

Roberts, M. Y., & Kaiser, A. P. (2011). The effectiveness of parent- implemented language interventions: A meta-analysis. American Journal of Speech-Language Pathology, 20(3), 180–199. https:// doi.org/10.1044/1058-0360(2011/10-0055)

Rodriguez, B. L., & Olswang, L. B. (2003). Mexican-American and Anglo-American mothers’ beliefs and values about child rearing, education, and language impairment. American Journal of Speech-Language Pathology, 12(4), 452–462. https://doi.org/ 10.1044/1058-0360(2003/091)

Rogoff, B. (2003). The cultural nature of human development. Oxford University Press.

Rogoff, B., Mistry, J., Göncü, A., & Mosier, C. (1993). Guided participation in cultural activity by toddlers and caregivers. Monographs of the Society for Research in Child Development, 58(8), 179. https://doi.org/10.2307/1166109

Saldaña, J. (2016). The coding manual for qualitative researchers. SAGE.

Schieffelin, B. B., & Ochs, E. (1986). Language socialization across cultures. Cambridge University Press. https://doi.org/10.1017/ CBO9780511620898

Strain, P. S., Barton, E. E., & Dunlap, G. (2012). Lessons learned about the utility of social validity. Education and Treatment of Children, 35(2), 183–200. https://doi.org/10.1353/etc.2012.0007

Suizzo, M. A., Tedford, L. E., & McManus, M. (2019). Parental socialization beliefs and long-term goals for young children among three generations of Mexican American mothers. Jour- nal of Child and Family Studies, 28(10), 2813–2825. https://doi. org/10.1007/s10826-019-01461-1

Tamis-LeMonda, C. S., Baumwell, L., & Cristofaro, T. (2012). Parent–child conversations during play. First Language, 32(4), 413–438. https://doi.org/10.1177/0142723711419321

Tamis-LeMonda, C. S., Song, L., Leavell, A. S., Kahana-Kalman, R., & Yoshikawa, H. (2012). Ethnic differences in mother–infant lan- guage and gestural communications are associated with specific skills in infants. Developmental Science, 15(3), 384–397. https:// doi.org/10.1111/j.1467-7687.2012.01136.x

Tamis-LeMonda, C. S., Way, N., Hughes, D., Yoshikawa, H., Kalman, R. K., & Niwa, E. Y. (2008). Parents’ goals for

1–1259 • August 2020

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions

Dow

children: The dynamic coexistence of individualism and collec- tivism in cultures and individuals. Social Development, 17(1), 183–209. https://doi.org/10.1111/j.1467-9507.2007.00419.x

Te Kaat-van den Os, D. J., Jongmans, M. J., Volman, M. C. J., & Lauteslager, P. E. (2017). Parent-implemented language in- terventions for children with a developmental delay: A sys- tematic review. Journal of Policy and Practice in Intellectual Disabilities, 14(2), 129–137. https://doi.org/10.1111/jppi.12181

van Kleeck, A. (1994). Potential cultural bias in training parents as conversational partners with their children who have delays in language development. American Journal of Speech-Language Pathology, 3(1), 67–78. https://doi.org/10.1044/1058-0360.0301.67

Vygotsky, L. (1978). Mind in society: The development of higher mental processes. Harvard University Press.

nloaded from: https://pubs.asha.org CUNY, Lehman College - Library, Acq Div o

Wolf, M. M. (1978). Social validity: The case for subjective mea- surement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11(2), 203–214. https:// doi.org/10.1901/jaba.1978.11-203

Zauche, L. H., Thul, T. A., Mahoney, A. E. D., & Stapel-Wax, J. L. (2016). Influence of language nutrition on children’s language and cognitive development: An integrated review. Early Child- hood Research Quarterly, 36, 318–333. https://doi.org/10.1016/ j.ecresq.2016.01.015

Zubrick, S. R., Taylor, C. L., Rice, M. L., & Slegers, D. W. (2007). Late language emergence at 24 months: An epidemiological study of prevalence, predictors, and covariates. Journal of Speech, Language, and Hearing Research, 50(6), 1562–1592. https://doi.org/10.1044/1092-4388(2007/106)

Cycyk & Huerta: Validity of PI-NLIs for Latinx Parents 1259

n 12/23/2020, Terms of Use: https://pubs.asha.org/pubs/rights_and_permissions