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Research Summary for It Takes Two to Talk®

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It Takes Two to Talk® — The Hanen Program® for Parents of Children with Language Delays is a well-known model of family-focused early language intervention for young children with expressive and/or receptive language disorders. The goal of It Takes Two to Talk is to increase parents’ capacity to support their child’s communication and language development, thereby maximizing the child’s opportunities for communication development in everyday situations. It Takes Two to Talk is offered to children with receptive and expressive language delays under the age of five, who may or may not have other developmental concerns (Weitzman, Girolametto & Drake, 2017).


The It Takes Two to Talk Program has the following features:

  • It is led by a Hanen Certified speech-language pathologist (SLP), who has received specialized training at a Hanen certification workshop
  • It is offered to groups of parents (up to eight families per program)
  • It has three major components:
    • An initial assessment of the child’s communication skills and baseline video recordings of the parent-child interaction. 
    • Eight group sessions for parents only (20 hours), where parents learn and practice responsive communication strategies that support their child’s goals.
    • Three Individual video feedback sessions for each parent attending the program. The parent-child interaction is video-recorded and reviewed together with the SLP.
  • It is supported by a user-friendly parent guidebook and a detailed leaders guide for use by the SLP

It Takes Two to Talk has three objectives:

  • Parent education — parents learn some essential, basic concepts about communication and language — e.g., the development of communication; differences between expressive and receptive language; the importance of the child’s active participation in frequent, extended turn-taking episodes. This knowledge helps parents better understand their child’s stage of communication development and facilitates the setting of realistic communication goals. It also enhances parents’ responsiveness to their children’s communicative attempts.
  • Early language intervention— parents learn to apply responsive interaction strategies flexibly across contexts so intervention becomes a natural part of parent-child interactions. Strategies highlighted by the SLP for individual parents are tied to their child’s communication goals, which are developed collaboratively and modified over the course of the program. Since effective and consistent strategy use by parents is critical to the child’s progress, video feedback sessions play a major role in helping parents modify their interactive behaviour. The focus of these sessions is on:
    • The SLP coaching the parent, as needed, to help them apply strategies successfully during interactions with the child; and
    • The shared viewing of the video-recorded interaction, with the SLP guiding the discussion to increase the parent’s awareness of their own interactive behaviour and its effect on their child, with the goal of facilitating consistent strategy use.
  • Social support — this has been shown to have a positive impact on the well-being of the child and family when the child has a disability (Shilling et al. 2013). In It Takes Two to Talk, parents gain both formal and informal social support. The SLP, whose multi-faceted role includes that of group leader, interventionist, coach and counsellor provides more formal support. The parent group itself provides informal support through the sharing of experiences with individuals in similar situations, who can genuinely empathize. This constitutes a vitally important component of the program. The results of a study of consumer satisfaction by Girolametto, Tannock & Siegal (1993) confirmed the value parents place on the support they experience during It Takes Two to Talk.

Philosophical Foundation
It Takes Two to Talk reflects a family-centered model of intervention, recognizing the child as part of a dynamic social system and the family as the most important element in a child’s life. This philosophical orientation recognizes the interrelatedness of the family system in that any action or event affecting one member of the family unit affects them all (Rouse, 2012). The family is the client in an It Takes Two to Talk Program since it is widely recognized that without family involvement, intervention is unlikely to be successful and any short-term positive effects erode quite rapidly (Bronfenbrenner, 1974). In the It Takes Two to Talk Program, a collaborative, respectful partnership is built with parents, who are acknowledged as knowing their child best. Empowerment of parents involves supporting and strengthening their capacity to access knowledge and gain practical skills, which in turn, bolsters their sense of self-efficacy in relation to fostering their child’s development (McCarthy & Guerin, 2022). This is the focus of It Takes Two to Talk.

In addition to having a family-centered focus, It Takes Two to Talk provides a naturalistic approach to intervention, which draws upon “strategies that identify and use opportunities for learning that occur throughout the child’s natural activities, routines, and interactions; follow the child’s lead; and use natural consequences” (Shelden & Rush, 2001, p. 2). By learning to communicate in real-life situations, a child is better able to generalize newly learned communication skills to other situations. In contrast to direct intervention with a clinician, which is time limited and time specific, It Takes Two to Talk enables parents to make intervention a continual and ongoing process (Rossetti, 2001).

Theoretical Foundation 
It Takes Two to Talk is based on a social-interactionist perspective of language acquisition, which views the development of communicative competence within a framework of early parent-child interactions (McCarthy & Guerin, 2022). This perspective views language acquisition as an interactive process in which the communicative behaviour of the parent influences the behaviour of the child and vice versa (Sameroff & Fiese, 1990). This interactive system may either encourage or inhibit the child’s communication development, depending on many factors, including the child’s ability to provide clear behavioural cues and the responsiveness of the parent to the child’s cues (Barnard, 1997; Stock, 2002).

The approach parents learn in an It Takes Two to Talk Program is based on the responsivity hypothesis. This hypothesis maintains that responsive language input which is contingent on the child’s focus of interest and/or communicative behaviour, is simplified and has exaggerated prosody, is more easily processed, thereby permitting the child to redirect more cognitive resources to language learning (Tamis-LeMonda et al., 2014; Weitzman, Girolametto & Drake, 2017). In addition, the adults’ use of responsive language may promote the child’s intrinsic motivation to interact and learn to communicate because responsiveness fosters a child’s experience of autonomy, competence, and relatedness — psychological needs that fuel intrinsic motivation (Grolnick, Deci & Ryan, 1997; Ryan & Deci, 2000; Weitzman, Girolametto & Greenberg, 2006).

Responsiveness, which is reflected in the caregivers’ prompt, positive and sensitive input that is contingent on the child’s interest, has been associated with optimal child outcomes (Stock, 2002; Lloyd & Masur, 2014; Golinkoff et al., 2015). Responsiveness has been associated with increased cognitive growth (Landry et al., 2001), attachment security (Bakermans-Kranenburg, van IJzendoorn & Juffer, 2003) and better language development (Masek et al., 2021).

There are three clusters of Responsive Interaction Strategies that are associated with the social interactive model of language intervention and which parents learn in It Takes Two to Talk:

Child-oriented behaviors are designed to encourage the child to initiate interaction, thereby fostering frequent episodes of joint interaction around the child’s interests.

Strategies:

  • Get Face to Face
  • Observe, Wait and Listen™ (OWL™)
  • Follow the Child’s Lead by Joining In, Imitating, Interpreting and Commenting

Interaction-promoting strategies are designed to foster balanced turn-taking between caregivers and children.

Strategies:

  • Match Your Turns to Your Child’s Turns

  • Cue your Child to Take a Turn
  • Ask Questions that Keep the Conversation Going
  • Use Routines to SPARK an Interaction

Language-modeling strategies are designed to expand children’s receptive and expressive language skills. 

Strategies:

  • Comment

  • Interpret

  • Match What you Say to What’s Happening at the Moment

  • Repeat Important Words

  • Use a Variety of Words; Highlight Your Language

  • Expand your Child’s Message

(Weitzman, 2017)

Summary of Empirical Research

Studies #1 and #2

Two studies on the efficacy of It Takes Two to Talk 
(Girolametto, 1988; Tannock, Girolametto & Siegel, 1992)

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Study #3

Study on the efficacy of an updated version of It Takes Two to Talk
(Girolametto, Pearce & Weitzman, 1996a; 1996b)

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Study #4

Study on the efficacy of It Takes Two to Talk, incorporating focused stimulation, for children with Down Syndrome (Girolametto, Weitzman & Clements- Baartman, 1998)

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Study #5

Study on the effectiveness of It Takes Two to Talk within a linguistically and demographically diverse community sample of children with language delays (Kidd et al., 2024)

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Study #6

Study comparing the outcomes of It Takes Two to Talk with clinician-directed therapy (Senent-Capuz et al., 2021)

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Study #7

Study assessing the effects of It Takes Two to Talk on the communication development of young children with cochlear implants (Nicastri et al., 2020)

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Study #8

Study on the effect of It Takes Two to Talk on child behaviour and social-emotional functioning (Rose et al., 2019)

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Study #9

Study investigating the effectiveness of It Takes Two to Talk in improving children’s language abilities and in equipping parents with the skills to teach their children 
(Fong et al., 2012)

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Study #10

Qualitative study on parent outcomes after attending the It Takes Two to Talk Program (Konza, Maloney & Grafton, 2010)

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Studies #11 and #12

Studies investigating the effectiveness and acceptability of It Takes Two to Talk for children with motor disorders and their parents (Pennington et al., 2009; Pennington & Noble, 2010)

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References

  1. Bakermans-Kranenburg, M. J., van IJzendoorn, M. H. & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129(2), 195-215.
  2. Barnard, K.E. (1997). Influencing parent-child interactions for children at risk. In M.J. Guralnick (Ed.). The effectiveness of early intervention (pp. 249-270). Baltimore: Paul H. Brookes.
  3. Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
  4. Fong, N. W., Ho, S. K., So, B. J., & Lian, W. B. (2012). Evaluation of the Hanen It Takes Two to Talk intervention programme. Proceedings of Singapore Healthcare, 21(4), 251–256. https://doi.org/10.1177/201010581202100406
  5. Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.
  6. Girolametto, L., Tannock, R. & Siegel, L. (1993). Consumer-oriented evaluation of interactive language intervention. American Journal of Speech-Language Pathology, 2, 41-51.
  7. Girolametto, L., Pearce, P. & Weitzman, E. (1996a). The effects of focused stimulation for promoting vocabulary in children with delays: A pilot study. Journal of Childhood Communication Development, 17, 39-49.
  8. Girolametto, L., Pearce, P. & Weitzman, E. (1996b). Interactive focused stimulation for toddlers with expressive vocabulary delays. Journal of Speech and Hearing Research, 39, 1274-1283.
  9. Girolametto, L., Weitzman, E., & Clements-Baartman, J. (1998). Vocabulary intervention for children with Down Syndrome: Parent training using focused stimulation. Infant-Toddler Intervention: A Transdisciplinary Journal, 8, (2), 109-126.
  10. Golinkoff, R. M., Can, D. D., Soderstrom, M., & Hirsh-Pasek, K. (2015). (Baby) talk to me: The social context of infant-directed speech and its effects on early language acquisition. Current Directions in Psychological Science, 24(5), 339-344.
  11. Grolnick, W., Deci, E. & Ryan, R. (1997). Internalization within the family: The self-determination theory perspective. In J. Grusec & L. Kuczynski (Eds.), Parenting and children’s internalization of values: A handbook of contemporary theory (pp. 135-161). New York: Wiley & Sons.
  12. Kidd, J. C., Short, K., Earley, J., Beckett, S., & Kleiman, C. (2024). Parent training of early language facilitation skills: Parent and child outcomes from a large-scale effectiveness study in a diverse clinical population. Speech, Language and Hearing, 1–10. https://doi.org/10.1080/2050571x.2024.2377906
  13. Konza, D., Maloney, C. & Grafton, P. (2010). It Takes Two to Talk: A focused intervention program for parents and children with language delays. The International Journal of Interdisciplinary Social Sciences: Annual Review, 5(6), 225–236. https://doi.org/10.18848/1833-1882/cgp/v05i06/59301
  14. Landry, S. H., Smith, K. E., Swank, P. R., Assel M. A. & Vellet, S. (2001). Does early responsive parenting have a special importance for children’s development or is consistency across early childhood necessary? Developmental Psychology, 37(3), 387-403.
  15. Lloyd, C. A. & Masur, E. F. (2014). Infant behaviors influence mothers’ provision of responsive and directive behaviors. Infant Behavior & Development, 37, 276-285.
  16. Masek, L. R., McMillan, B. T., Paterson, S. J., Tamis-LeMonda, C. S., Golinkoff, R. M., & Hirsh-Pasek, K. (2021). Where language meets attention: How contingent interactions promote learning. Developmental Review, 60, 100961.
  17. McCarthy, E., & Guerin, S. (2022). Family‐centred care in early intervention: A systematic review of the processes and outcomes of family‐centred care and impacting factors. Child: Care, Health and Development, 48(1), 1-32.
  18. Nicastri, M., Giallini, I., Ruoppolo, G., Prosperini, L., de Vincentiis, M., Lauriello, M., Rea, M., Traisci, G., & Mancini, P. (2020). Parent training and communication empowerment of children with Cochlear Implant. Journal of Early Intervention, 43(2), 117–134. https://doi.org/10.1177/1053815120922908 
  19. Pennington, Lindsay, Thomson, K., James, P., Martin, L., & McNally, R. (2009). Effects of It Takes Two to Talk—The Hanen Program for parents of preschool children with cerebral palsy: Findings from an exploratory study. Journal of Speech, Language, and Hearing Research, 52(5), 1121–1138. https://doi.org/10.1044/1092-4388(2009/07-0187)
  20. Pennington, L., & Noble, E. (2010). Acceptability and usefulness of the group interaction training programme it takes two to talk to parents of pre‐school children with Motor Disorders. Child: Care, Health and Development, 36(2), 285–296. https://doi.org/10.1111/j.1365-2214.2009.01054.x
  21. Rose, T., Scarinci, N., Meyer, C., Harris, S., Forsingdal, S., Anger, N., & Webb, K. (2019). The It Takes Two to Talk® – The Hanen Program® for Parents: Impacts on child behaviour and social-emotional functioning. Speech, Language and Hearing, 23(3), 180–188. https://doi.org/10.1080/2050571x.2019.1622832
  22. Rossetti, L.M. (2001). Communication intervention: Birth to three. San Diego: Singular Publishing Group.
  23. Rouse, L. (2012). Family-Centred Practice: Empowerment, self-efficacy, and challenges for practitioners in early childhood education and care. Contemporary Issues in Early Childhood, 13(1), 17-26.
  24. Ryan, R. & Deci, E. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 25, 54-67.
  25. Sameroff, A. J. & Fiese, B.H. (1990). Transactional regulation and early intervention. In Meisels & Shonkoff (Eds.). Handbook of early childhood intervention (pp. 119-148). New York, NY: Cambridge University Press.
  26. Senent-Capuz, N., Baixauli-Fortea, I., & Moret-Tatay, C. (2021). Parent-implemented Hanen Program it takes Two to talk®: An exploratory study in Spain. International Journal of Environmental Research and Public Health, 18(15), 8214. https://doi.org/10.3390/ijerph18158214
  27. Shelden, M.L. & Rush, D.D. (2001). The ten myths about providing early intervention services in natural environments. Infants and Young Children, 14(1), 1-13.
  28. Shilling, V., Morris, C., Thompson-Coon, J., Ukoumunne, O., Rogers, M. & Logan, S. (2013). Peer support for parents of children with chronic disabling conditions: a systematic review of quantitative and qualitative studies. Developmental Medicine & Child Neurology. 602-609.
  29. Stock, C. D. (2002). The effects of responsive caregiver communication on the language development of at-risk preschoolers. Eugene, University of Oregon.
  30. Tamis-LeMonda, C. S., Kuchirko, Y., & Song, L. (2014). Why is infant language learning facilitated by parental responsiveness? Current Directions in Psychological Science, 23(2), 121–126
  31. Tannock, R., Girolametto, L. & Siegel, L. (1992). Language intervention with children who have developmental delays: Effects of an interactive approach. American Journal of Mental Retardation[sic], 97, 145-160.
  32. Weitzman, E. (2017). It Takes Two to Talk: A Practical Guide for Parents of Children with Language Delays, 5th ed. Toronto, Ontario: The Hanen Centre.
  33. Weitzman, E., Girolametto, L., & Drake, L. (2017). Hanen Programs® for Parents: Parent Implemented Early Language Intervention. In McCauley, R. J., Fey, M. E. & Gillam, R. B. (2ed ed.), Treatment of Language Disorders in Children (pp. 27-56). Baltimore, MA: Paul H. Brookes Publishing Co.
  34. Weitzman, E., Girolametto, L. & Greenberg, J. (2006). Adult responsiveness as a critical intervention mechanism for emergent literacy: Strategies for Early Childcare Educators. In L. Justice (Ed.), Clinical Approaches to Emergent Literacy Intervention. San Diego: Plural Publishing.
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