Area of Investigation

Study #1

This study examined caregivers’ perceptions about their children’s outcomes and their own outcomes following participation in a virtual 
More Than Words program

Study #2

This study identified possible facilitators and barriers that exist for caregivers participating in a virtual More Than Words program. 

Research Design and Subjects

Subjects: 

21 families who attended a virtual More Than Words Program. Of the 21 families, 14 had a child with an autism diagnosis and the rest had a child for whom they identified would benefit from social communication support. The children ranged in age from 18 to 54 months. 

Study #1

This study used a qualitative research design from the World Health Organization’s ICF guided analysis process to both categorize and describe the functional outcomes associated with the program, as reported by caregivers. The researchers conducted semi-structured interviews with caregivers, completed through zoom video conferencing,  after caregivers completed their virtual More Than Words program. The interviews included 19 open ended questions around the caregivers’ experiences with the virtual More Than Words program. 

Study #2

The researchers created a semi-structured interview that included open ended questions looking at caregivers’ experiences during the virtual More Than Words program.  The interviews were transcribed and analyzed in NVivo using a top-down deductive approach that referenced a modified Dynamic Knowledge Transfer Capacity model. Responses were categorized into themes that were likely to affect knowledge transfer.

Intervention

The caregivers who participated in the study attended a virtual More Than Words program. They either attended a full virtual More Than Words  program consisting of a preprogram consultation followed by 8  sessions and 3 video feedback sessions or an approved adapted program consisting of a preprogram consultation followed by  5 sessions and two video feedback sessions.

Results

Study #1:

Five themes were identified during thematic analysis that represented perceived child and caregiver outcomes following the virtual More Than Words program. 

Theme 1: Caregivers learned new strategies to facilitate their child’s development. 
Caregivers learned communication and engagement strategies and learned how to support their child’s play both with and without toys. 

Theme 2: Caregivers developed a new mindset. 
Participation in the program led to increased awareness that their behaviors could impact interactions with their child. Caregivers felt optimistic and reported they were excited and eager to continue to support their child. 

Theme 3: Children gained functional communication skills
Caregivers reported their child was using more spoken communication and reported their child engaged in more social interactions, turn-taking, joint attention, and showing. 

Theme 4: Improved caregiver-child relationship
Caregivers felt even more connected to their child and felt they understood their child even more. The strategies they learned could be embedded within daily activities and caregivers felt this created more opportunities for engagement. 

Theme 5: Caregivers gained a social and professional support network 
Many caregivers felt connected to the other caregivers in their group and developed a continued social network with them. Caregivers felt empowered by the SLPs to apply the strategies they learned and felt the SLPs truly listened to them. 

Study #2 

The research revealed six themes of perceived facilitators or perceived barriers for caregivers who participated in a virtual More Than Words program. 

Theme 1: Experiences Participating from Home
Caregivers identified convenience as facilitator and home distractions as a barrier. 

Theme 2: Access to the More Than Words® Program
Familiarity with the zoom platform both for caregivers and for SLPs was a facilitator, while there were no significant barriers. 

Theme 3: Delivery Methods and Program Materials (virtual components)
Caregiver-to caregiver connection was an important facilitator, while caregivers’ busy schedules presented barriers to completing outside of session readings and tasks.

Theme 4: The SLP-Caregiver Relationship
Caregivers felt connected to their SLPs, which was a facilitator, while some caregivers felt the virtual sessions made it more difficult for the SLP to get to know them and their child and this was interpreted as a barrier. 

Theme 5: New Skills Learned 
Caregivers successfully learned strategies to support their child’s social communication in everyday activities and this was a facilitator. Some program content was not relevant to every family, particularly if caregivers had a child at a different communication stage than the rest of the group, and researchers considered this a barrier.

Theme 6: Virtual Program Engagement 
Connecting with other caregivers who had similar experiences was a facilitator. However, some caregivers felt in-person sessions would have created even more opportunities to connect before and after the sessions and the researchers viewed this as a barrier.