Synthesis Table by: Kathy Supple

Citation Summary of the Study Participants Research

Design
Length of
Intervention
Independent Variables Dependent
Variables
Instruments
Fey, M., Warren, S.,
Brady, N., Finestack, L.,
Bredin-Oja, S.,
Fairchild, M., Sokol, S.,
& Yoder, P. (2006).
Early Effects of
Responsivity
Education/Prelinguistic
Milieu Teaching for
Children With
Developmental Delays
and Their Parents.
Journal of Speech,
Language, and Hearing
Research, 49, 526-547.


Parents were taught
responsivity
education/prelinguistic
milieu teaching to
implement with their
children (ages ranged
from 24-33 months)
who had no more than
10 expressive words or
signs. The parents who
implemented the
intervention saw an
increase in their
childrens rate of
requesting.
51 children 24 to
36 months old with
developmental
delay or disability.
All participants had
mild to moderate
mental retardation,
no diagnosis of
autism, no more
than 10 words or
signs, normal vision
and hearing, and
upper body motor
skills adequate to
perform basic
gestures such as
reaching.
50 mothers and 1
father participated
in the RE
component.
Random
assignment
(25 kids) to a
treatment
group vs. (26
kids) a no
treatment
group.
6 months. *Waiting (provide the
child an opportunity
to communicate with
you by simply waiting
for your child to do
something you can
interpret.
*Linguistic mapping
(put your childs
gestures into words,
for example if the
child points to his/her
cup you say, cup, oh
you want a drink? or
if your child looks at
something then looks
at you, you say what
the child was looking
at).
*Following the childs
lead in play (if the
child is stacking
blocks, you sit beside
the child and stack
blocks, if the child is
looking at a book, you
sit beside the child
and look at a book)


* Clinicians waited
The childs rate of
requesting (how
often the child is
gesturing to ask for
something; like
pointing to the
cookies or a toy),
rate of commenting
(how often parents
picked up on their
childs intentional
gestures and eye
gazes), and rate of
intentional acts
(how often the
children gestured
for something, or
gazed at something
in an attempt to
share an interest
with someone else).

Parental use of
verbal responses
that recode their
childs intended
meanings (Parents
observing their
children and
commenting on
what they believe
Parents and
their children
were video and
audio taped
during book
sharing,
computers
were used for
coding, the
Bayley Scales
of Infant
Development,
and the Infant
Scale of the
MacArthur
Communicative
Developmental
Inventory:
Words and
Gestures
Synthesis Table by: Kathy Supple

for, prompted, and
responded to the
childs nonverbal
communicative efforts
consistent with intent.
their child is trying
to sayif the child
points, the parents
says, oh you are
pointing to the ball,
if the child gazes at
something, parent
says, oh you are
looking at the
_____.).

Fey, M., Yoder, P.,
Warren, S., & Bredin-
Oja, S. (2013). Is More
Better? Milieu
Communication
Teaching in Toddlers
With Intellectual
Disabilities. Journal of
Speech, Language, and
Hearing Research. 56,
679-693.
The authors wanted to
see if more MCT would
provide better
outcomes and they
found that more is not
always better for all
children. The study
suggests that children
with interest in objects
and meaningful play
skills may benefit from
more MCT.
64 children (18-27
months old) with
intellectual and
communication
delay with no
diagnosis of
autism, 20 or less
spoken or signed
words, Bayley
score between 55
and 75, normal
hearing in at least
one ear, normal or
corrected vision,
motor skills
sufficient to sit
unsupported and
engage in play
Single
Subject,
Random
assignment
of either one
1 hour low
intensity (31
children), or
five 1 hour
high intensity
(33 children)
MCT sessions
per week.
9 months Responsivity
education where all
caregivers had to read
a book, It Takes Two
to Talk, and complete
9 one hour sessions
individually in their
homes within the first
3 months of the study.
Specifically the
parents goals were to
increase their
responsiveness to
their childs play
actions and attempts
to communicateby:
*waiting (parent
simply waits for the
child to act or
communicate),
*following the childs
lead (play whatever
the child is playing),
Child
communication
behaviors including:
requests (pointing,
looking at
something,
following
someone/somethin
g with their eyes,
taking your hand or
clothes and pulling
you to something),
commands
(grunting, throwing
a cup/shoe/coat at
you because they
want a drink, or to
go outside), protests
obligating someone
to respond (saying
no, refusing to put a
coat on), comments
(saying something in
MacArthur
Communicative
Development
Inventories:
Words and
Gestures,
Bayley Scales
of Infant and
Toddler
Development,
3
rd
edition,
ProcoderDV
software,
videotaping
Synthesis Table by: Kathy Supple

*imitating play acts
and gestures (copying
what the child is
doing),
* Vocalizations
(copying the sounds
or words a child is
making/saying) ,
*eye contact (looking
at the child and trying
to have the child look
at you), and
*commenting on the
childs play and
objects of attention
(parent says what the
child is doing and/or
talks about what the
child is looking at),
*put the childs
nonverbal
communication acts
into words,
* add to what the
child says (ex. Child
says ball parent says
bounce it), and to
copy and add meaning
(ex. Child says ball
and parent says, yes,
its a ball.).
PMT was used to
increase nonverbal
communication acts.
regards to what
they are doing or
what they see),
intentional
communication acts
(coming to an adult
to tell a story, ask
for something, or
show something of
interest), and the
number of words
produced (how
many words does
the child say).

Parent
responsiveness to
their childs
intentional
communication
attempts (how often
are parents
responding..smiling,
or saying something
in response to their
childs intentional
communication).
Synthesis Table by: Kathy Supple

Clinicians
*arranged the
environment to
provide opportunities
for the children to
communicate (ex.
Putting an object of
interest such as a
favorite toy in a see
through bag or box
just out of the childs
reach to encourage
the child to come to
you and communicate
that they want it)
*they followed the
childs lead,
*interrupted play (if a
child is playing alone
the clinician got
involved with the
play)
*used prompts to get
the children to
produce target
communication acts
(for ex. The clinician
would tell the child
what they wanted the
child to say, say
eat.)
* stated verbally
what the child was
looking at or reaching
Synthesis Table by: Kathy Supple

toward.
MT was utilized to
increase the
frequency of the
childs verbal
communication
attempts. The
clinician
* used prompts to
encourage the child
to speak the target
word (showing the
child a ball)
, then
* directly stated what
they wanted the child
to say if that did not
work (say ball). The
MT session ended
with the clinician
expanding on
something the child
said (ex. Child says
ball clinician says
yes, thats a ball.).
Hancock, Terry &
Kaiser, Ann (1996).
Siblings Use of Milieu
Teaching at Home.
Topics in Early
Childhood Special
Education, 16 (2), 168-
190.
The effects of teaching
3 older siblings to use
milieu teaching with
their younger sibling
who has a language
delay was successful
because the younger
siblings
responsiveness and
3 sibling dyads:
each with an older,
typically
developing female
ages 8-12, and a
younger preschool-
age male with a
communication
delay, ranging from
A single-
subject,
multiple
baseline
design across
subjects to
determine
the effects of
the
Around
three
months
Intensive training for
siblings focusing on
milieu teaching
techniques (4 sessions
lasting 45 minutes
each). Play sessions
twice each week
immediately following
the completion of the
Balanced
conversational turns
(sibling takes a turn,
child takes a turn),
verbal initiations
(child gestures or
uses a word or
words to ask for
something or show
Sequenced
Inventory of
Communicatio
n Development
(SICD)
completed on
the target
children to find
their
Synthesis Table by: Kathy Supple

their verbal initiations
increased. Also, the
interactions between
siblings during the
intervention was
positive.
4 -6 years (target
children).
intervention
on the
behavior of
the siblings
and the
target
children. The
study
consisted of
3 consecutive
phases:
baseline,
intervention,
and follow-
up.
intensive training in
the home for 30-45
minutes.
*sibling gets to read a
manual describing the
intervention
*clinician discusses
the information in the
manual with the
sibling
*sibling watches
video tapes of other
siblings modeling
milieu teaching with
children who had
language delays
*sibling watches
video of
himself/herself
during baseline then
asking the sibling if
they can identify
times they could
apply milieu teaching
*sibling role plays
milieu techniques
with clinician
*sibling applies milieu
teaching (modeling:
sibling shows how to
do something such as
play with a toy, and
mand: sibling makes a
verbal request like,
something), and
targeted utterances
in response to
teaching attempts
(child follows
siblings lead or
answers siblings
question).
Increasing
productive
language(child starts
to talk more with
purposeasking for
something or
sharing an interest).
expressive
language
delays. Tape
recorder to
collect
observational
data from the
home.
Intensive
teaching
sessions were
conducted by f
female with
masters-level
degree in child
development
and 3 yrs.
Experience in
implementing
milieu teaching
with children.
Synthesis Table by: Kathy Supple

what is this?) then
gets immediate
feedback from the
clinician.
Kaiser, A., & Roberts,
M. (2013). Parent-
Implemented
Enhanced Milieu
Teaching With
Preschool Children
Who Have Intellectual
Disabilities. Journal of
Speech, Language, and
Hearing Research. 56,
295-309.
This study was
conducted to see if
there were benefits to
training parents to
implement naturalistic
language interventions
such as enhanced
milieu teaching to their
children with
intellectual disabilities.
The results indicated
that there are clearly
benefits.
77 children
between ages 30
and 54 months
with nonverbal IQ
between 50 and
80, PLS score less
than the 11
th

percentile, at least
10 productive
words observed,
ability to verbally
imitate 7 or 10
words, normal
hearing, and
English as primary
language.
Single
subject
design with
randomized
groups either
parent+thera
pist or
therapist
only.
Not clear,
however it
does state
there are 24
sessions
with 12
home visits
and there is
a 12 month
follow-up
after
intervention
*environmental
arrangement (putting
an object of interest
such as the TV remote
or a cup out of the
childs reach to
encourage them to
ask for it in some way,
or removing most toys
from the environment
to focus on one task,
or purposefully
forgetting to provide
something needed
such as a spoon with
the bowl of cereal)
*responsive
interaction (adult
responds to the childs
communication
attempt by talking to
the child)
*specific language
modeling and
expansions (adult says
words the child
attempts and then
expands ball, yes that
is the red ball.)
*prompts (providing
*Increase parent-
child interaction
(parents respond to
and play with their
child more often)
*increase the
parents
responsiveness to
child
communication
(parents are more
aware of their
childs
communication
attempts and
respond more
often)
*increase the
amount and quality
of linguistic input
(parents are talking
to their children
more and talking
about what their
children are
interested in)
*increase the use of
language-learning
support strategies
(parents are trying
Videotaping,
computer for
data entry,
Leiter-R (norm
referenced
instrument
assessing
reasoning,
visualization,
memory, and
attention for
children 2-20
years), PLS-4,
the Expressive
Vocabulary
test, and
Peabody
Picture
Vocabulary
Test
Synthesis Table by: Kathy Supple

access to requested
objects and verbal
feedback for
communication).
*home based sessions
were 20 minutes
broken up: 10 minutes
for play, then clean-
up, 5 minutes for
snack, and 5 minutes
for a book all using
toys and books
available in the home.
*parents attended a 3
hour workshop
explaining typical child
development then
parents were given
modules providing
examples of
interventions they
were to implement.
interventions such
as environmental
arrangement,
following childs
lead, etc.)
Togram, B., & Erbas, D.
(2010). The
Effectiveness of
Instruction on Mand
Model-One of the
Milieu Teaching
Techniques. Eurasian
Journal of Educational
Research. 38, 198-215.

An instructional
program teaching
mand-model was
effective.
3 children with
developmental
disabilities.
Single-
subject
research
design.
This study
did not
specify.
*mand-model:
requesting (ex.
Caregiver observes
the childs object of
interest (car) and
models the correct
verbalization (yes
thats a car.)
*Percentage of
target word
production by
subjects (the
children said target
words more often).
*assessment
instruments,
digital
handycam, 8
mm
videotapes,
record
sheets/forms,
pencils.



Synthesis Table by: Kathy Supple


Yoder, P., & Warren, S.
(2002). Effects of
prelinguistic Milieu
Teaching and Parent
Responsivity Education
on Dyads Involving
Children With
Intellectual Disabilities.
Journal of Speech,
Language, and Hearing
Research. 45, 1158-
1174.
Parents were taught
responsivity education
and children were
taught prelinguistic
communication
through prelinguistic
milieu teaching
strategies. Children in
this study were all
prelinguistic toddlers
with intellectual
disabilities. There were
improvements in child-
initiated comments
and child-initiated
requests.
39 prelinguistic
toddlers with
intellectual
disabilities and
their primary
caregivers.
Single
subject
design with a
randomized
assignment
to the
responsivity
education/pr
elinguistic
milieu
teaching
group or the
control group
3-4 times a
week for 6
months.
*Adult prompts for
child communication
(expectation that the
child communicate-
what do you want?
look at me upturned
and extended palm)
*Adult prompts for
imitation (say ball,
or do this while
adult models the sign
for eat)
*Adults vocal
imitation of child
vocalizations (child
says abda so adult
says abda)
*Adults compliance
with childs
imperative acts (Child
reaches for something
so adult gives the
child what he/she is
reaching for, or child
points in the direction
of something so the
adult looks at it and
gets excited about it).
*Adults verbal
recoding of the childs
communication act
(child reaches for
something such as a
*Child initiated
requests (child
hands an object to
an adult, points to
something and then
looks at adult,
reaches to adult to
be picked up)
*Child initiated
comments (Child
says uh oh and
looks at adult, child
reaches toward an
object and vocalizes,
child shows object
to adult, vocalizes,
and smiles).
Communicatio
n and symbolic
behavior
scales,
communication
development
inventory-
infant scale,
video taping,
and coding
software.
Synthesis Table by: Kathy Supple

ball and looks at the
adult and the adult
says, ball. Or child
reaches for the ball
and looks at the adult
and the adult says,
you want the ball?)
*Adults specific
acknowledgment
childs act (child looks
at adult and reaches
and the adult says,
you looked at me!)
*Adults talk to the
child (adult says, you
are playing with the
doll! what do you
want? or you looked
at me. For examples).