Communication in young children with motor impairments: teaching caregivers to teach.

Communication between caregivers and children with moderate to severe motor impairments is a tremendous challenge, and one that deserves attention as a central component of early intervention programs. This article examines a caregiver-training program that explored key elements to creating strong communicative interactions between young children with moderate to severe motor impairments and their primary caregiver. Three caregiver-child dyads participated in a 3-week treatment program teaching caregivers how to provide communicative opportunities, wait for a clear communication signal from their children, recognize their children's signal, and finally, shape a more advanced communicative behavior. These adult behaviors were designed to increase the children's use of conventional engaging signals of communication. Results revealed that caregivers demonstrated success learning all behaviors except for shaping during the brief treatment period. Children's engaging communicative behaviors increased correspondingly with the caregivers' changes. These findings have positive implications for caregiver training. Implications for "best practice" are considered.