By Jenna Somers
Ann Kaiser, Susan W. Gray Professor of Education and Human Development and director of the Vanderbilt KidTalk lab, is an early childhood language and intervention researcher. If someone had told her a year ago that she would be assessing the language development of toddlers over Zoom, she would have said, “Not a chance.” And yet, since the beginning of June, Kaiser and her team have been doing just that, discovering not only that virtual intervention works, but also that, in many ways, it may have unique benefits when compared to in-person intervention.
When Vanderbilt ramped-down in-person research activities in mid-March, the KidTalk team spent several months changing the protocol on two different studies that support toddlers with language delays. One of them is a large multi-site study that relies entirely on a remote protocol and the other involves working with low-income Spanish-speaking families whose toddlers are dual-language learners and language-delayed. That study transitioned to a hybrid approach of virtual and in-person visits because it was too difficult to assess bilingual skills in children virtually. Since children learn best from their parents, both studies focus on training parents over Zoom to conduct language interventions with their children.
Relatively soon after the COVID-19 pandemic began, Kaiser and her colleagues realized that for the multi-site study to continue, they needed to shift to exclusively virtual visits. The team reinvented their face-to-face child assessments to make them parent-supported and altered intervention materials to design a telecommunications-based intervention. That conceptual and technological seismic transformation posed the greatest challenge to Kaiser’s team during ramp-down, but such a change was not unprecedented.
“My field was already headed in this direction due to inefficiencies of having home visitors spend much of their time driving to and from appointments, and continuous underfunding of Part C intervention for families of young children with disabilities,” said Kaiser. “My lab had already researched telecommunication training with families, but the pandemic gave us the push to do it more quickly and systematically in our randomized trials.”
Remote intervention has reduced some burden for families in the studies. “Hearing the feedback from families about the virtual model has been a humbling experience for us as researchers,” Kaiser said. “I’ve become much more sensitive to everyone’s time. To load up a car, drive about 10 miles to campus and find parking is an hourlong process for families with little kids. We’ve become more conservative in what we ask of families. I wouldn’t have thought that was something I was going to learn when we switched to the virtual model.”
Some parents also feel empowered by receiving training through Zoom. During in-person visits at families’ homes, intervention researchers would manage the training, including the various household distractions, making it easier for parents to practice but less like their everyday home environment. Now some parents feel they have greater control over the training process and actually report feeling more empowered by the virtual training approach. “We’re now beginning to think about conducting research on telecommunications protocols that are most effective and acceptable to families,” Kaiser said. “It’s important to determine how to improve the effectiveness of virtual training processes and make them more responsive and individualized to families’ needs. The shift has really opened up a whole new venue of research.”
According to Kaiser, the KidTalk team has assessed around 20 children in the multi-site study since it restarted over the summer, and they have collected good reliability and validity data on a range of assessments while supporting families in a way that is best for them. Similarly, the research team takes a family-first approach in their bilingual study but determined that assessing and intervening with children in person while providing mostly virtual training for the parents was the best approach.
Since the bilingual study involves direct contact with children, the KidTalk team could not resume until after the university entered Phase II of Research Ramp-up. “We returned to in-person meetings as soon as we could, because we couldn’t properly support these kids otherwise,” Kaiser said. “The choice was either to stop the trial or go back to seeing families. My team was eager to return to visiting with families and the kids who need early language intervention.”
Parents collaborate in the Spanish assessments that involve caregiver-child interactions. KidTalk personnel visit families at home to do the bilingual portions of the assessment because the parents are not fluent in English. They also provide initial parent training in person, but subsequent trainings occur on Zoom.
When the team visits a home, they follow strict COVID-19 safety protocols. They call before each visit and verbally assess the health of everyone in the household. Everyone washes their hands before the visit, and the adults wear masks, face shields and gloves. The children, ages 24-36 months, also wear masks during the visit. The team sanitizes all toys and surfaces before and after each session and brings training materials for parents in clean bags. After leaving a home, they sanitize the toys they brought with them and put everything in clean bags or containers.
According to Kaiser, her team had to stop making visits to a home for a whole month because several members of one family developed COVID-19 symptoms. During that time, the team only met with the parent and child over Zoom, waiting two weeks from the final day of fever in the last person who was sick to return to the home. Working with these participants through this difficult time highlighted the value of the hybrid approach to the study. Remote connections with the family ensured continuity of research and critical intervention for the child until Kaiser’s team could resume in-person visits.
“As beneficial as remote trainings have been for our families, the hardest part for us is not being able to interact with the kids,” Kaiser said. “We’re applied researchers. It’s not the same if what you really love is seeing kids and families.”
She hopes that the pandemic does not foil her plans—beyond the changes she has already made—for KidTalk’s latest study that began in September. It is an Institute of Educational Sciences Goal 2: Development and Innovation study, meaning the intervention is built and tested sequentially. Before the pandemic began, Kaiser had planned to conduct measurements of children’s language development in toddler day care classrooms and case studies with teachers, but all classroom engagements are now postponed until next school year since only 50–60 percent of students are back in the collaborating child care centers, and conducting a study with so few students might yield atypical results.
Instead, Kaiser has moved up other tasks to this year that would have occurred in later years, such as literature reviews and materials development. Her team has plenty on its plate, but she worries what will happen to the study if they cannot return to full-capacity toddler classrooms next year.
Despite those worries, Kaiser remains optimistic because she believes in her team at the KidTalk lab. “It’s hard to convey how difficult it was to make all these changes,” said Kaiser, “but I work with amazing people who are incredibly committed to nurturing the development of children as well as conducting high-quality research. That’s why we do this work, and we will adapt, as needed, to continue doing it.”
This story is part of a series highlighting Vanderbilt University researchers who have returned to in-person research activities on or off campus. More than 3,000 Vanderbilt research personnel, including Ann Kaiser and her team, have returned to in-person research activities through the Research Ramp-up process spearheaded by the Ad-Hoc Research Ramp-up Working Group and the Office of the Vice Provost for Research.