Evidence-based intervention enhancements to reduce language delays and disorders among children of parents with substance use disorders - 7. Project Summary/Abstract Children of parents with substance use disorders (SUD) are at greater risk for early language delays (LD) and subsequent developmental language disorder (DLD). Health disparities in DLD happen because families impacted by SUD are not able to access interventions to prevent and address DLD. To our knowledge, there are no national efforts focused on addressing disparities in LD among children of parents with SUD, despite a clear indicated need. Substance use disorder service providers are uniquely positioned to provide group-based intervention to families by offering opportunities to support access to early intervention, which is currently inadequate. Implementing group-based services in these existing settings is resource efficient, builds on trusted relationships with service providers and, as a result, improves the likelihood of earlier engagement with services for children to support early intervention efforts. Nesting services within group-based settings in partnership with culturally-responsive service providers reflects the intersections of SUD, rurality, and language minoritization. Although group-based PI-NCI improve language outcomes for children, it is unknown whether individual parent support modalities (e.g., parent coaching and individualized lessons) may confer additional effectiveness over group intervention alone. To our knowledge, this is the first project to evaluate PI-NCI to prevent and address LD for children of parents with SUD. The goal of our proposed work is to identify which intervention modalities work best, for whom, and how each could be practically implemented to promote adoption, sustainability, and dissemination. We will collaborate with a community impact board to accomplish the following specific aims: Aim 1: Evaluate the comparative effectiveness and implementation outcomes of different PI-NCI modalities for improving parent responsivity and child communication and language outcomes using a factorial experiment (N = 244 parents with SUD of children aged 18-42 months). All parents will receive a foundational group-based intervention and randomization to 1 of 4 modality conditions such that the parent coaching and individualized lesson plan modalities are either “off” or “on.” We will use Proctor’s taxonomy of implementation outcomes to characterize implementation and the likelihood of adoption to support the translation of research to practice. Aim 2: Identify PI-NCI mediators and moderators of the effectiveness of PI- NCI among sub-populations of parents with SUD and their children including parent knowledge and self- efficacy, parent functional impairment, parent psychopathology, and child prenatal exposure. Our work has high potential to transform the clinical landscape of early intervention for children of parents with SUD by identifying PI-NCI modalities to decrease the prevalence and severity of LD among children of parents with SUD.
