Increasing Caregivers’ Adherence to an Early-Literacy Intervention Improves the Print Knowledge of Children with Language Impairment

This study investigated the effects of four behavior-change techniques for caregivers implementing a 15-week literacy intervention with their children with language impairment. Techniques include modeling, encouragement, feedback, and rewards. Random assignment within a factorial experimental design was used to determine which behavior-change technique(s) each of the 128 caregivers would receive. Caregivers’ adherence was assessed for frequency and dosage of intervention based on submission of logs and tape recordings. Children’s print knowledge was assessed at pre- and posttest to assess literacy skills. Results showed that children whose caregivers were rewarded 50 cents per session to implement the intervention made significantly greater gains in print knowledge over the treatment period. Further, these effects were fully mediated by effects of the behavior-change technique on caregivers’ adherence to the intervention.