Area of Investigation

The study investigated whether:

1. Malaysian parents who attend a More Than Words Program:
   • Can successfully implement the program strategies
   • Are satisfied with the program
2. Malaysian children receiving a More Than Words Program improve their language and social skills

Research Design and Subjects

A quasi-experimental design was used to compare the parent and child outcomes of families who completed a More Than Words Program with a control group receiving traditional speech and language therapy. 

Subjects: 31 children with a diagnosis of ASD who have been receiving traditional speech and language therapy at least three times a month prior to enrolling in the study. 

Intervention group: 16 children and their families were assigned to one of the two More Than Words Programs offered as a part of the study.

Control group: The remaining 15 children continued with the traditional, one-to-one speech and language therapy that they were already receiving.  

Data for both the intervention group and the control group were gathered during the three study phases including:

• Baseline – prior to the start of the intervention
• Intervention – following the intervention
• Generalization – 5 months post-intervention

Intervention

A More Than Words Program that included a pre-program consultation, 8 parent training sessions and 3 individual video feedback sessions.

Results

Parent results

Increase parental use of strategies

The quality of parents’ interactions was analyzed at baseline and following intervention for both the intervention and control groups. The Joy and Fun Assessment was employed to code video of parent-child interactions during song, book and toy activities for both groups. The Joy and Fun Assessment (JAFA) is an observational checklist, which assesses parental use of nine interaction strategies learned in More Than Words. These include use of fun words (such as “whee!”), simplified language, expansions, fun physical contact, pretend games, turn-taking routines, imitations and expansions. Scores significantly increased from baseline to post-intervention for the parents who attended the More Than Words Program and these gains were maintained five-months post-intervention. This significant increase was not found for parents of children in the control group. 

The Parent Self-Evaluation Questionnaire was completed by parents who attended More Than Words before and after intervention to rate their own use of the strategies learned. A significant increase in scores was found from baseline to post-intervention. 

Increase in parent satisfaction 

The Satisfaction Survey (SS) was used to determine parents’ overall  impressions of and their perceptions of the value of the More Than Words Program. Parents who attended the program all agreed that their expectations were met and reported being very satisfied or satisfied with the intervention.

Child Results

Increase in communication, socialization, receptive and expressive language

Specific domains of The Vineland Adaptive Behavior Scales (VABS-II) and the MacArthur-Bates Communicative Development Inventory were administered at baseline and post-intervention for both the More Than Words group and the control group. The children in the More Than Words group were found to have a significant increase in receptive and expressive language as indicated via parent report on the CDI, as well as a significant increase in communication and socialization domains noted on the VABS-II. Video analyses demonstrated an increase in spoken words and gestures for the children in the More Than Words group from pre-to post-intervention; however there was not a significant increase in vocalizations. For the children in the control group, a significant increase in the social domain of the VABS-II was found, however no significant increases in communication, receptive and expressive language were found. There was also no significant difference noted in spoken words, gestures or vocalizations from baseline to post-intervention in the control group.