Hanen & Parent Coaching in Early Intervention

In early intervention, the SLP is rarely the person who produces the change. The caregiver is. A toddler sees a clinician for perhaps an hour a week and a parent for eighty. That arithmetic is why naturalistic, caregiver-implemented intervention — Hanen programs, Enhanced Milieu Teaching, JASPER, and coaching models generally — outperforms clinician-led pull-out drill for young children with language delays.

The Hanen programs

• It Takes Two to Talk: for parents of children under five with expressive and receptive language delays. Group sessions plus individual video-feedback visits.
• More Than Words: for parents of autistic children and children with social communication differences.
• Target Word: for late talkers.
• Learning Language and Loving It / Teacher Talk: the same principles translated for early childhood educators.

Programs require clinician certification and follow a consistent structure: group parent education, individual video review, and coached practice at home.

The core strategies

Hanen packages its strategies in memorable acronyms, which is exactly how exam items reference them:

• OWL — Observe, Wait, Listen. The single highest-yield habit. Adults fill silence; children need it to initiate.
• ROCK (More Than Words) — Repeat, Offer opportunities, Cue, Keep it fun, keep it going.
• Follow the child's lead — join the activity the child already chose rather than redirecting to the clinician's materials.
• Face to face, at the child's level — position drives joint attention.
• Say less, stress, go slow, show — simplified, emphasized, slowed, multimodal input.
• People games and routines — predictable, repeatable interactions (peekaboo, tickle, songs) that create expectation and a slot for the child to fill.

Techniques shared across naturalistic models

• Self-talk and parallel talk: narrating your own actions and the child's actions with no demand for a response.
• Expansion and extension: "doggie" → "big doggie" (expansion) → "the doggie is running" (extension).
• Recast: reformulating the child's utterance correctly without correction — "him goed" → "yes, he went!"
• Modeling with mand-model and time delay: the milieu-teaching sequence — model, then prompt, then wait expectantly with an anticipatory pause.
• Communication temptations: the sabotage family — a favorite item in a clear sealed container, missing pieces, violating a routine, offering a nonpreferred item — all of which create a genuine reason to communicate.
• Environmental arrangement: in-view/out-of-reach placement, small portions, choice offers.

Related evidence-based models

• Enhanced Milieu Teaching (EMT): environmental arrangement + responsive interaction + milieu prompting episodes embedded in play, with strong caregiver-implemented evidence.
• JASPER: Joint Attention, Symbolic Play, Engagement and Regulation — targets the prelinguistic foundations rather than word count, with good evidence for autistic toddlers.
• PMI (Parent-Mediated Intervention) / PACT: video-feedback-based coaching on parental synchrony.
• Focused stimulation: dense, non-obligatory modeling of a small target set (10 to 20 words) many times within meaningful activities.

What coaching actually looks like

Caregiver coaching is not "teach the parent a strategy and leave." The evidence-based coaching cycle is: joint planning, observation, modeling with explanation, caregiver practice during the visit while the clinician is present, specific feedback, reflection, and a plan for the week. The clinician's hands stay off the toys more than feels natural at first. Video review — the mechanism inside Hanen and PACT — accelerates reflection more than verbal feedback alone.

Natural environment, routines, and IFSP fit

Part C early intervention requires services in natural environments with family-centered outcomes on the IFSP, so goals should be written around routines the family already has: mealtime, bath, book sharing, car rides, grocery store. "Child will produce 20 words" is weaker than "During mealtime, Maya will request three preferred foods using a word or sign across three consecutive days." Cultural humility matters here: interaction styles, expectations about child-directed speech, and play norms vary, and coaching should fit the family rather than replace their practices. For multilingual families, advise maintaining the home language — switching to English does not accelerate language and costs the child family connection.

What the exam asks

Typical keys: recommend caregiver-implemented, routines-based intervention in the natural environment; choose "wait expectantly and follow the child's lead" over "ask the child to imitate"; recognize expansion versus extension versus recast; and support home-language maintenance for bilingual toddlers. Distractors usually offer clinician-directed drill, pull-out therapy for an 18-month-old, or advising a family to stop speaking their language.