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BACKGROUND: Many families of children who are deaf or hard of hearing (DHH) pursue the development of spoken language through the use of advanced hearing technology and intensive, specialized listening and spoken language (LSL) intervention services. LSL practitioners utilize caregiver coaching to transfer knowledge and skills to parents, equipping them to effectively support their child's listening and language development. Caregiver coaching builds parents' capacity to implement intervention strategies within daily routines to maximize learning opportunities to reach this goal. While caregiver coaching is a hallmark of LSL practice, there is a lack of consensus and paucity of evidence to support its use with children who are DHH learning to listen and talk. The purpose of this research was therefore to gain a greater understanding of caregiver coaching practices in LSL services for families of children ages birth-3 who are DHH. OBJECTIVES: 1) to provide a synthesis of the literature and identify gaps in the existing knowledge base regarding coaching in LSL services, 2) to gain insight into practitioners' and caregivers' experiences with coaching in LSL services, and 3) to gain a better understanding of coaching practices in LSL services with families of children who are DHH. METHODOLOGY: The first objective was addressed by performing a scoping review of the literature to synthesize the relevant research and professional practice recommendations and identify gaps in the knowledge base regarding coaching caregivers in LSL practice. The remaining objectives were addressed through qualitative, semi-structured interviews and video observation discussions with LSL practitioners and caregivers to gain insight into caregivers' perspectives and practitioners' perspectives and practices. Interviews were conducted with 14 practitioners and 13 caregivers at three intervention sites in the US and Canada. These sites represent three different service delivery models of LSL intervention for families of children who are DHH. RESULTS: The scoping review findings revealed a lack of consensus in the literature regarding the principles and practices of caregiver coaching in LSL services. We presented the following topics found in the literature: coaching practices, training for coaching, the effectiveness of coaching, and recommendations for coaching. Caregivers reported coaching as a positive experience; however, coaching practices differed among sites and between practitioners, supporting the results of the scoping review. The caregivers indicated factors that contribute to a positive coaching relationship, including practitioner characteristics, establishing explicit expectations, and adapting to caregivers' changing needs over time. The practitioner interviews also supported a lack of consistency in coaching practices between sites and indicated that underlying beliefs impact how practitioners coach and engage caregivers. CONCLUSION: The findings from this dissertation provide practical, actionable steps that LSL practitioners can implement to develop and support the caregiver coaching relationship. These findings have the potential to inform professional preparation and development activities to better equip practitioners to engage caregivers in the intervention process, and ultimately, positively impact the listening and spoken language outcomes of the children they serve.

Practitioners utilize caregiver coaching in early intervention services, but coaching principles and practices are not well understood in the context of listening and spoken language (LSL) services with families of children who are deaf or hard of hearing. The purpose of this study was to examine practitioners’ experiences with coaching, including definitions, training, and practices they utilize in their work with families. Using semi-structured, qualitative interviews and video observation discussions, this study examined the perspectives of 14 practitioners providing LSL services to families at three intervention sites in the US and Canada. Results indicate that practitioners’ underlying beliefs about their coaching proficiency and caregivers’ capacity impact their coaching practices and how they engage with caregivers. Results highlight practices such as mentoring and accountability that supported practitioners’ coaching skills. This study contributes to the understanding of caregiver coaching in LSL practice and has implications for practitioners working to improve their coaching skills, which may improve LSL services and optimize child outcomes.

Caregiver coaching is utilized in early intervention services with families of children who are deaf or hard of hearing to increase caregivers’ skills and confidence in supporting their child’s language development, but few studies have examined coaching from the perspective of the caregivers. The purpose of this study was to increase understanding of caregivers’ experiences of coaching in the context of listening and spoken language intervention services. Using semi-structured, qualitative interviews, this study examined 13 caregivers’ perspectives at three intervention sites in the US and Canada. Results indicate that caregivers perceive that practitioner characteristics, expectations, and the evolution of the coaching relationship over time contribute to a positive caregiver coaching relationship. This study contributes to the understanding of the caregiver coaching experience and has implications for new and experienced practitioners working to improve their practice by establishing and strengthening collaborative caregiver coaching relationships with the families they serve.

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