Comparison Of Triadic And Provider-Led Intervention Practices In Early Intervention Home Visits

Despite calls for adoption and use of triadic early intervention practices, remarkably little research has prospectively compared this approach with traditional, provider-led service delivery. The aim of this study was to compare the actions of providers and caregivers within triadic and provider-led interactions with regard to the following: (1) Who was in the lead? (2) What intervention practices were used most often? and (3) Who did adults focus on? A diverse sample of 17 caregivers of infants/toddlers with identified disabilities and their early intervention providers (n = 6) participated in this study. Children were randomly assigned to either the triadic or provider-led condition. Videotape data were collected during regularly scheduled home visits over the course of 4 months. A total of 71 home visit sessions were analyzed using a 30-s interval coding procedure and a structured protocol that assessed 11 different variables. Within- and between-group differences were compared using paired and independent t tests, as well as effect size calculations. Results of analyses revealed significant differences between triadic and provider-led sessions. In triadic intervention sessions, caregivers were far more likely to act as session leader and engage in joint interaction with the provider and providers were far more likely to engage in direct teaching of the caregiver. Provider-led sessions were characterized by significantly more focus solely on the child, comparatively little attention to the caregiver, and significantly less use of joint interaction and child-focused discussion. Implications for research and practice are described.