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Enhanced Milieu Teaching in resource-constrained settings: Stakeholder-informed adaptation guidelines.

Chevonne D Du Plessis1, Lauren H Hampton, Michal Harty

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Summary

Stakeholders find Enhanced Milieu Teaching (EMT) suitable for South African children with developmental disabilities. Adaptations are suggested for resource-constrained settings to improve intervention fit.

Keywords:
Enhanced Milieu Teachingadaptationscontextual fitdevelopmental disabilitiesimplementation sciencenaturalistic developmental behavioural interventionsresource-constrained settingsstakeholder perceptions

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Area of Science:

  • Developmental Psychology
  • Applied Behavior Analysis

Background:

  • Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioral intervention (NDBI).
  • Limited understanding exists regarding EMT's applicability and necessary adaptations in resource-constrained environments.
  • This study addresses the need to evaluate EMT's contextual fit in such settings.

Purpose of the Study:

  • To investigate stakeholders' perceptions of EMT's contextual fit for young children with developmental disabilities in a resource-limited South African context.
  • To identify specific adaptations required to enhance EMT's applicability and effectiveness in this setting.

Main Methods:

  • A descriptive qualitative study was employed, utilizing semi-structured interviews and focus groups.
  • Participants included 5 speech and language therapists and 11 caregivers of children with developmental disabilities.
  • Thematic analysis was used to code data, which were then categorized using the Adaptome framework.

Main Results:

  • Stakeholders generally perceive EMT as an appropriate intervention within the South African context.
  • Adaptations to intervention materials and activities are recommended to align with families' resources, routines, and priorities.
  • Guidelines for improving EMT's contextual fit in South Africa were developed based on these findings.

Conclusions:

  • Enhanced Milieu Teaching is a viable intervention for the South African context, with potential for enhanced fit through specific adaptations.
  • Engaging stakeholders is crucial for assessing and refining the implementation of NDBIs like EMT in new cultural and resource settings.
  • The study provides stakeholder-informed guidelines for adapting EMT in resource-constrained environments, emphasizing cultural and practical considerations.