2. The Effectiveness of LENA Technology for Changing Parent Behavior and Accelerating Child Language Development Jill Gilkerson, Jeffrey A. Richards, Dongxin Xu Copyright © 2013 LENA Research Foundation, a not-for-profit 501(c)3 charitable organization. All Rights Reserved

3. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Disclosures Jill Gilkerson, Jeffrey A. Richards and Dongxin Xu are FT employees of LENA Research Foundation. LENA Research Foundation is a not-for- profit 501(c)3 charitable organization.

4. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Inspiration, History, and Mission LENA LENA: Language ENvironment Analysis Meaningful Differences Hart & Risley (1995) – 42 families, 1,300 recorded hours, 7 years – Correlation between early language exposure and later academic success, IQ

5. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Presentation Outline LENA technology overview Online parent program Experimental study design Study results Q&A

6. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved 3 Easy Steps Place the DLP in the custom LENA Clothing pocket Record as you go about your day—up to 16 hours At the end of the day connect the DLP to your PC and transfer data Leave to process Review the software- generated data Copyright © 2010, LENA Foundation, a not-for-profit organization. All Rights Reserved

7. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Key Child Male Adult Female Adult Other Child Overlap Noise TV/Electronic LENA System Algorithms Silence

8. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Where it all Starts: an Audio File

9. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Where it all Starts: an Audio File MANMale Adult Near & Clear (3) CHNKey Child Near & Clear (4) OLNOverlap Near & Strong (2) SILSilence (1)

10. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Where it all Starts: an Audio File Human SpeechNon-human KEY CHILDNoise ADULT MALESilence ADULT FEMALETV/electronic media Other Child Overlap

11. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved 1.Adult Word Count Adult words spoken to and near child 2.Child Vocalizations Frequency count of child vocalizations 3.Conversational Turns Adult-child interactions 4.TV/electronic sounds Amount of TV/electronic sounds exposure Key Child Adult Female Key Child Adult + Adult Male TV/Electronic +

12. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved LENA Home Reports

13. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Reports Time Resolutions Monthly Daily Hourly 5-Minute

14. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Reports Time Resolutions Monthly Daily Hourly 5-Minute

15. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Presentation Outline LENA technology overview Online parent program Experimental study design Study results Q&A

16. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved

17. 12-Week Online Intervention Basic steps – Parent receives LENA Home and website login – Parent installs LENA – Parent records, processes data, views reports – Parent accesses internet to pass summary information – Phone meeting with LENA coach to set goals – Parent visits program website weekly to view resources and participate in various activities

18. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Parent Resources Website Talking Tips Book Lists Videos Webinars Parent Forums Live Chat

19. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved

24. Coaching Full time research assistant is coach – Provides language enrichment strategies and encouragement for parents Phone meeting once per month – To interpret results and set monthly goals Private live chat – To answer questions on the spot

25. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Pass data via internet

26. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Presentation Outline LENA technology overview Online parent program Experimental study design Study results Q&A

27. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved LENA Online Study N = 82; <24 months Random assignment to Treatment and Control groups – Treatment: Begin using LENA Home immediately, SHBO website – Control: Record with LENA but no feedback (Control becomes “delayed treatment” after 3 months) Treatment Phase Recordings – Month 1-2: Once per week – Month 3: Every other week Follow-up Phase Recordings – Month 4-6: Every other week – Months 7-12: Once per month LENA Developmental Snapshot, MacArthur and CDI – At baseline, post treatment, 3, 6, 9 and 12 month follow-up

28. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved MonthDateTreatment Recordings Control Recordings Assessments 1June, 201241Snapshot, CDI, MacArthur 2July, 201241 3August, 201221Snapshot, CDI, MacArthur 4Sept, 201224 5Oct, 201224 6Nov, 201222Snapshot, CDI, MacArthur 7Dec, 201212 8Jan, 201312 9Feb, 201312Snapshot, CDI, MacArthur 10March, 201311 11April, 201311 12May, 201311Snapshot, CDI, MacArthur

29. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Recruitment Babycenter.com Required computer, internet connection 9-22 months of age Demographic questionnaire LENA Developmental Snapshot

30. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Participant Selection Within normal limits on Snapshot (1.5 SD of mean) Screened: delay diagnosis, sibling with delay, caregiver native language English Even age range 9-22 months

31. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Participant Demographics N=82 (34 Female, 48 Male) Age Mean = 9-22 mo. (mean 14 mo.) Mother’s Education – 80% College and beyond – 11% Some college – 9% High school diploma, GED – 0% <High school diploma Baseline Snapshot scores – Mean = 98.9

32. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Completer Demographics N=44 (20 Female, 24 Male) Age Mean = 13.8 months (SD=3.2) Mother’s Education – 91% College and beyond – 4.5% Some college – 4.5% High school diploma, GED – 0% <High school diploma Baseline Snapshot scores – Mean = 99.4

33. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Presentation Outline LENA technology overview Online parent program Experimental study design Study results Q&A

34. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Were there differences between the Treatment and Control groups at 12 weeks?

35. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Changes in Parent Behavior During Intervention

36. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Changes in Snapshot During Intervention

37. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Do program participants show significant increases in talk and interaction? Do these changes hold over time?

38. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Behavior Trends: AWC & Turns Time AWC Count Percentile Baseline13,81861 Month 315,138 * 72 * Month 615,053 * 72 * Month 915,228 * 74 * Month 1214,20366 Time Turns Count Percentile Baseline42861 Month 3511 † 67 † Month 6578 * 70 * Month 9631 † 72 † Month 1261163 *p ≤.05; † p=.08

39. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Behavior Trends: Language Scores

40. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Behavior Trends: Lower 50%

41. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Behavior Trends: Lower 50%

42. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Program Components Please rank the following components in the order that they influenced behavioral change for you: – Automated Reports – Coaching Sessions – Webinars – Videos – Parent Forum – Written website information

43. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Program Components Please rank the following components in the order that they influenced behavioral change for you: (% Ranked #1) – Automated Reports –76% – Videos -10% – Coaching Sessions - 8% – Webinars - 3% – Written website info - 3% – Parent Forum - 0%

44. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Is there a relationship between enhanced language environment and child language skills?

45. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Behavior Trends: Change from Baseline to Month 12

46. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Summary Significant elevations in adult talk and interaction after online intervention – Elevations held longitudinally for parents who we below 50 th percentile at baseline Child language skills are accelerated 9 months after online intervention Relationship between increased parent- child interaction and child language skills

47. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Limitations High SES sample TD children Limited age range (all under 2 at start) Large attrition rate

48. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Thank You! Terry and Judi Paul, Founders Scientific advisory board members LENA children and parents LRF employees past and present

49. Copyright © 2013 LENA Research Foundation, a not-for-profit organization. All Rights Reserved Q&A Jill Gilkerson, Ph.D. jillgilkerson@lenafoundation.org Jeffrey A Richards, M.A. jeffrichards@lenafoundation.org Dongxin Xu, Ph.D. dongxinxu@lenafoundation.org