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KANSAS CITY, Kan. — Early Head Start children showed significant improvement in language skills when they received therapy guided by a new computer system designed at the University of Kansas, a study conducted by KU researchers showed.

The results of the study were published in the National Head Start Association's August publication, “NHSA Dialog: A Research-to-Practice Journal for the Early Childhood Field.”

KU research professor Jay Buzhardt — one of the co-authors of the study and creators of the Making Online Decisions (MOD) computer system — said the web-based interface assists in the diagnosis and treatment of language deficiencies.

"There are a lot of things that can cause a temporary shutdown in communication," Buzhardt said.

"MOD tries to determine why the child is performing low on an assessment. There might be a medical issue like an ear infection and the child can't hear what's being said to him," he said. "Or maybe there was a recent divorce or some other change in the family dynamic that results in the child not communicating as much, or a change in the school environment."

Buzhardt said many Early Head Start children are at increased risk of developing language deficiencies.

"We know from research, the more you talk to your children the more they're going to talk and develop. We also know in low-income families there is much less talk that happens in the natural environment, particularly directed toward the child," he said.

Making Online Decisions

Use of the MOD starts with the Early Head Start home visitors. Every few months, as part of their visit to a family, they give the child a standardized language assessment.

If a child performs at a certain level below normal, home visitors work with parents to start some level of therapy, ranging from language exercises such as counting fingers and toes to starting work with a speech pathologist.

The therapy level is determined by the home visitor who often refers to a guide developed by another KU professor and co-author of the recent study, Dale Walker. Her 2003 "Strategies for Promoting Communication and Language of Infants and Toddlers" recommends research-driven therapies for various symptoms of language deficiencies.

"The idea is to use those strategies in the field," Walker said. The MOD facilitates doing so and ties given symptoms to specific research-proven therapies.

For the study, half of the children received the existing treatment: The home visitor decided what treatment was needed based on the assessment. The other half received the experimental treatment: The home visitor did the assessment, then plugged the results into the MOD, which determined the treatment.

All treatments recommended came from the same source, but those recommended by the computer showed significantly better results during the 18 months of the study.

"Essentially they all made some progress," Buzhardt said. "The average rate of improvement on the (assessment)" was much higher when the MOD was employed.

“These results are particularly promising in light of earlier research suggesting that children with early language delays often show similar deficits later in life related to reading and general school readiness,” he said.

He said the MOD incorporates years and volumes of data and delivers recommendations customized to a specific child.

"It gives parents very specific strategies," Buzhardt said. "If a child is doing fine with gestures and their non-word vocalizations are fine but their single words are low, it will recommend specific strategies to improve that. It's very individualized to a child's performance on the assessment."

The randomized trial was performed between 2008 and 2010 and involved 124 children in five Early Head Start programs in Wyandotte County, Manhattan, Clay Center, Hays and Dodge City.

It was funded by a three-year, $900,000 grant from the U.S. Office of Special Education Programs' Steppingstones of Technology Innovation program. The study's third co-author was Charles R. Greenwood, KU senior scientist, professor of applied behavioral science and director of the Juniper Gardens Children’s Project in the Children’s Campus of Kansas City.