Journal of Autism and Developmental Disorders

, Volume 48, Issue 12, pp 4179–4192 | Cite as

Increasing Caregivers’ Adherence to an Early-Literacy Intervention Improves the Print Knowledge of Children with Language Impairment

  • Laura M. JusticeEmail author
  • Jing Chen
  • Sherine Tambyraja
  • Jessica Logan
Original Paper


This study investigated the effects of four behavior-change techniques for caregivers implementing a 15-week literacy intervention with their children with language impairment. Techniques include modeling, encouragement, feedback, and rewards. Random assignment within a factorial experimental design was used to determine which behavior-change technique(s) each of the 128 caregivers would receive. Caregivers’ adherence was assessed for frequency and dosage of intervention based on submission of logs and tape recordings. Children’s print knowledge was assessed at pre- and posttest to assess literacy skills. Results showed that children whose caregivers were rewarded 50 cents per session to implement the intervention made significantly greater gains in print knowledge over the treatment period. Further, these effects were fully mediated by effects of the behavior-change technique on caregivers’ adherence to the intervention.


Language impairment Developmental disability Emergent literacy Parent-implemented interventions Home literacy Preschool 



This research was supported by a Grant from the National Institute of Health’s Institute on Deafness and Other Communication Disorders (NIDCD), Grant # 1R21DC013599. We are grateful to the families who participated in this work, and the collaboration with Nationwide Children’s Hospital for supporting implementation of this study.

Author Contributions

Each author contribute substantially to this work. LMJ and JL conceived of the study, participated in its design and coordination, and drafted parts of the manuscript; JC conducted key analyses and aided in interpretation of the data, and helped to draft the manuscript; ST participated in the design and coordination of the study, developed key measures, and helped to draft the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflicts of interest

The authors have no potential conflicts of interest to declare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Provision of caregiver consent was provided for all parents and children enrolled in this study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Laura M. Justice
    • 1
    • 2
    Email author
  • Jing Chen
    • 1
    • 2
  • Sherine Tambyraja
    • 1
  • Jessica Logan
    • 1
    • 3
  1. 1.Crane Center for Early Childhood Research and PolicyThe Ohio State UniversityColumbusUSA
  2. 2.Educational Psychology ProgramThe Ohio State UniversityColumbusUSA
  3. 3.Quantitative Research and Evaluation Methods ProgramThe Ohio State UniversityColumbusUSA

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