{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:18:23Z","timestamp":1787843903990,"version":"build-2784847793"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coaching parents through parent\u2013child interaction therapy (PCIT) is a key aspect of early communication intervention for children with Down syndrome. However, the evidence for its effect on child language outcomes is limited. Some research has indicated that more intensive, individualised interventions yield better outcomes; however, in Ireland many children receive less than the optimal dosage of intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of the study was to investigate the effectiveness of an intensive PCIT intervention in a real\u2010world clinical context using a structured coaching protocol. We also aimed to explore SLT and parental views\/experiences of the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Procedures<\/jats:title>\n                    <jats:p>We piloted a PCIT intervention incorporating keyword signing (JEMT\u00a0+\u00a0Sign) with four parent\u2013child dyads. A multiple baseline, individual case series design was used to measure the intervention effects based on (1) accuracy of parental strategies; (2) frequency of parental strategies and (3) child communication acts. Four parent\u2013child dyads took part in a twice\u2010weekly intervention delivered by two trained specialist speech and language therapists over 11 weeks, via a hybrid in\u2010person and tele\u2010practice model. Parental coaching followed a \u2018teach\u2010model\u2010coach\u2010review\u2019 protocol. Researchers not involved in delivering the intervention coded parent behaviours and child communication acts at baseline, during the intervention and at follow\u2010up. In addition, interviews were conducted to gather parent and practitioner views on the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Results<\/jats:title>\n                    <jats:p>Using structured visual analysis supplemented with single\u2010case statistics, we found that the intervention resulted in an increase in parental accuracy and for some, increased frequency of JEMT\u00a0+\u00a0Sign strategy use, although with individual variation. The children's language and communication improvements were also variable. Clinicians noted that the intervention suited the families involved, but may not be feasible for all families and found the structured coaching protocol of this intervention to be particularly helpful and effective. Parents valued the more intensive and individualised intervention, although they recognised that their existing relationship with the clinician and the flexibility of delivery were beneficial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Implications<\/jats:title>\n                    <jats:p>It was possible to implement this intensive intervention for children with Down syndrome in this Irish clinical setting. Parents and SLTs found the intervention to be valuable and reported that the hybrid nature of the delivery and clear coaching methods were helpful. Further research is needed to determine the longer\u2010term effects and suitability of the intervention for a wider group of families and services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT THIS PAPER ADDS<\/jats:title>\n                    <jats:p>\n                      <jats:italic>What is already known about this subject<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Individualised and intensive intervention has been found to be more effective for children with Down syndrome than more diluted services but is rarely available. This is particularly true of the Irish context where SLT services are under\u2010resourced for children with disabilities. This study aimed to determine if it was possible to implement an intensive PCIT intervention for children with Down syndrome in Ireland and to determine whether it was effective and acceptable for the families and clinicians involved.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>What this study adds to the existing knowledge<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>JEMT + Sign has been shown to be effective for children with Down syndrome in the US when delivered under controlled research conditions, but has yet to be tested in \u2018real\u2010world\u2019 clinical contexts. This study examined whether it could be implemented by trained clinicians in an Irish context, measured the effectiveness for parents and children and gathered the views of those taking part.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>What are the potential or actual clinical implications of this work?<\/jats:italic>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Clinicians working in a specialised service for people with Down syndrome valued the intervention. They found it effective for families that they had an established and trusting relationship with and whom they knew had the capacity to engage with the demands required. They found the structured coaching protocol to be beneficial for wider aspects of their work. Parents learned the skills and could apply them to the required accuracy criteria. The children in general increased their language and\/or communication skills, although this cannot yet directly be attributed to the intervention. Further research is necessary to determine if JEMT\u00a0+\u00a0Sign can be delivered in other contexts, the long\u2010term effects of the intervention and whether it is effective for wider groups of families.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1460-6984.70233","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T04:59:16Z","timestamp":1774587556000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Customised, Intensive Parent\u2013Child Interaction Therapy for Children With Down Syndrome: Findings From a Real\u2010World Pilot Effectiveness Study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2225-420X","authenticated-orcid":false,"given":"Ciara","family":"O'Toole","sequence":"first","affiliation":[{"name":"Department of Speech and Hearing Sciences University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Moloney","sequence":"additional","affiliation":[{"name":"Department of Speech and Hearing Sciences University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Speech and Hearing Sciences University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Vousden","sequence":"additional","affiliation":[{"name":"Department of Speech and Hearing Sciences University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Department of Speech and Hearing Sciences University College Cork  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy Down Syndrome Ireland  Cork &amp; 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