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A Customised, Intensive Parent-Child Interaction Therapy for Children with Down Syndrome: Findings from a Real-World Pilot Effectiveness Study

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Title: A Customised, Intensive Parent-Child Interaction Therapy for Children with Down Syndrome: Findings from a Real-World Pilot Effectiveness Study
Language: English
Authors: Ciara O'Toole (ORCID 0000-0002-2225-420X), Hannah Moloney, Chloe McCarthy, Sophie Vousden, Abby O'Sullivan, Deirdre Flynn, Susanna Stokes, Emily D. Quinn, Pauline Frizelle (ORCID 0000-0002-9715-3788)
Source: International Journal of Language & Communication Disorders. 2026 61(3).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 22
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Down Syndrome, Parent Child Relationship, Foreign Countries, Intervention, Communication Disorders, Speech Therapy, Program Effectiveness, Parent Attitudes, Specialists, Therapeutic Environment
Geographic Terms: Ireland
DOI: 10.1111/1460-6984.70233
ISSN: 1368-2822
1460-6984
Abstract: Background: Coaching parents through parent-child interaction therapy (PCIT) is a key aspect of early communication intervention for children with Down syndrome. However, the evidence for its effect on child language outcomes is limited. Some research has indicated that more intensive, individualised interventions yield better outcomes; however, in Ireland many children receive less than the optimal dosage of intervention. Aims: The aim of the study was to investigate the effectiveness of an intensive PCIT intervention in a real-world clinical context using a structured coaching protocol. We also aimed to explore SLT and parental views/experiences of the intervention. Methods and Procedures: We piloted a PCIT intervention incorporating keyword signing (JEMT + Sign) with four parent-child dyads. A multiple baseline, individual case series design was used to measure the intervention effects based on (1) accuracy of parental strategies; (2) frequency of parental strategies and (3) child communication acts. Four parent-child dyads took part in a twice-weekly intervention delivered by two trained specialist speech and language therapists over 11 weeks, via a hybrid in-person and tele-practice model. Parental coaching followed a 'teach-model-coach-review' protocol. Researchers not involved in delivering the intervention coded parent behaviours and child communication acts at baseline, during the intervention and at follow-up. In addition, interviews were conducted to gather parent and practitioner views on the intervention. Outcomes and Results: Using structured visual analysis supplemented with single-case statistics, we found that the intervention resulted in an increase in parental accuracy and for some, increased frequency of JEMT + Sign strategy use, although with individual variation. The children's language and communication improvements were also variable. Clinicians noted that the intervention suited the families involved, but may not be feasible for all families and found the structured coaching protocol of this intervention to be particularly helpful and effective. Parents valued the more intensive and individualised intervention, although they recognised that their existing relationship with the clinician and the flexibility of delivery were beneficial. Conclusions and Implications: It was possible to implement this intensive intervention for children with Down syndrome in this Irish clinical setting. Parents and SLTs found the intervention to be valuable and reported that the hybrid nature of the delivery and clear coaching methods were helpful. Further research is needed to determine the longer-term effects and suitability of the intervention for a wider group of families and services.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1506772
Database: ERIC
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  Data: A Customised, Intensive Parent-Child Interaction Therapy for Children with Down Syndrome: Findings from a Real-World Pilot Effectiveness Study
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  Data: <searchLink fieldCode="AR" term="%22Ciara+O'Toole%22">Ciara O'Toole</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2225-420X">0000-0002-2225-420X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Hannah+Moloney%22">Hannah Moloney</searchLink><br /><searchLink fieldCode="AR" term="%22Chloe+McCarthy%22">Chloe McCarthy</searchLink><br /><searchLink fieldCode="AR" term="%22Sophie+Vousden%22">Sophie Vousden</searchLink><br /><searchLink fieldCode="AR" term="%22Abby+O'Sullivan%22">Abby O'Sullivan</searchLink><br /><searchLink fieldCode="AR" term="%22Deirdre+Flynn%22">Deirdre Flynn</searchLink><br /><searchLink fieldCode="AR" term="%22Susanna+Stokes%22">Susanna Stokes</searchLink><br /><searchLink fieldCode="AR" term="%22Emily+D%2E+Quinn%22">Emily D. Quinn</searchLink><br /><searchLink fieldCode="AR" term="%22Pauline+Frizelle%22">Pauline Frizelle</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-9715-3788">0000-0002-9715-3788</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2026 61(3).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 2026
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  Data: <searchLink fieldCode="DE" term="%22Down+Syndrome%22">Down Syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Child+Relationship%22">Parent Child Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Communication+Disorders%22">Communication Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Therapy%22">Speech Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Parent+Attitudes%22">Parent Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Specialists%22">Specialists</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+Environment%22">Therapeutic Environment</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Ireland%22">Ireland</searchLink>
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  Data: 10.1111/1460-6984.70233
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  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
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  Data: Background: Coaching parents through parent-child interaction therapy (PCIT) is a key aspect of early communication intervention for children with Down syndrome. However, the evidence for its effect on child language outcomes is limited. Some research has indicated that more intensive, individualised interventions yield better outcomes; however, in Ireland many children receive less than the optimal dosage of intervention. Aims: The aim of the study was to investigate the effectiveness of an intensive PCIT intervention in a real-world clinical context using a structured coaching protocol. We also aimed to explore SLT and parental views/experiences of the intervention. Methods and Procedures: We piloted a PCIT intervention incorporating keyword signing (JEMT + Sign) with four parent-child dyads. A multiple baseline, individual case series design was used to measure the intervention effects based on (1) accuracy of parental strategies; (2) frequency of parental strategies and (3) child communication acts. Four parent-child dyads took part in a twice-weekly intervention delivered by two trained specialist speech and language therapists over 11 weeks, via a hybrid in-person and tele-practice model. Parental coaching followed a 'teach-model-coach-review' protocol. Researchers not involved in delivering the intervention coded parent behaviours and child communication acts at baseline, during the intervention and at follow-up. In addition, interviews were conducted to gather parent and practitioner views on the intervention. Outcomes and Results: Using structured visual analysis supplemented with single-case statistics, we found that the intervention resulted in an increase in parental accuracy and for some, increased frequency of JEMT + Sign strategy use, although with individual variation. The children's language and communication improvements were also variable. Clinicians noted that the intervention suited the families involved, but may not be feasible for all families and found the structured coaching protocol of this intervention to be particularly helpful and effective. Parents valued the more intensive and individualised intervention, although they recognised that their existing relationship with the clinician and the flexibility of delivery were beneficial. Conclusions and Implications: It was possible to implement this intensive intervention for children with Down syndrome in this Irish clinical setting. Parents and SLTs found the intervention to be valuable and reported that the hybrid nature of the delivery and clear coaching methods were helpful. Further research is needed to determine the longer-term effects and suitability of the intervention for a wider group of families and services.
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