Implementation of "Parler-Bambin" preventive program in the multilingual and multicultural context of nurseries/daycares in Lebanon

This project is targeting prevention programs for language and communication difficulties in nurseries in Lebanon. More specifically, it will explore the implementation of a preventive program to enhance language skills in early childhood, and to specify the role of the Speech and Language Therapist (SLT) in this implementation. There is a growing consensus among researchers and clinicians that abilities acquired at an early age, especially in oral language, are predictive of children's academic performance and future social integration (Zorman, 2011). Preventive actions are increasingly recognized as a priority to improve public health worldwide (Law et al., 2013). In Lebanon, an ongoing national program (MHPSS 2015-2021 - MHPSS, Preventive and Curative, Ministry of Public Health, 2015) is taking part of this kind of healthcare development. Aims: Thus, taking into account some variables that affect the implementation process (environment communities, providers, prevention delivery system and the prevention support system), the aims of this project are 1) to study the feasibility of a preventive program model, that partners Speech and Language Therapist and educators or caregivers in daycare and nurseries, to facilitate language and communication in Lebanese toddlers (under 3 years old), 2) determine the success factors of the implementation. It will be based on a French program “Parler Bambin”, which is currently widely developed in France. Method: The first study will focus on the factors of engagement of different stakeholders in a prevention program: firstly, by identifying the professionals involved in nurseries in Lebanon and then identifying the characteristics of these stakeholders in diverse childcares. Data will be gathered through a questionnaire constructed or adapted from existing questionnaires for this purpose (eg, Preschool Teacher Literacy Beliefs Questionnaire [TBQ], Hindman and Wasik, 2008). Similarly, the questionnaires will address SLT’s representations about their role in supporting language in nurseries. Nominal groups or focus groups (Baribeau and Germain, 2010) and questionnaires will be also carried out to identify the facilitators of this kind of preventive actions and the specific needs of SLTs in preventive settings. A second phase will target the implementation process itself: adapting and implementing a preventive intervention, while taking into consideration implementation aspects. We will find out major variables that are worthy for the program’s implementation, by measuring its fidelity (dosage, quantity, intervention strength, quality, participant responsiveness, program differentiation, etc.), also using videos and direct coaching sessions. Pre and posttest measures will be applied on children (MCDI -The MacArthur communicative development inventories, Fenson et al., 1996; Questionnaire for parents of bilingual children LITMUS-PABIQ, COST IS0804, validation in Lebanon, Tuller 2015). Finally, following the pilot study, the implementation of the adapted program will be proposed according to different execution modalities to support its implementation: with a direct or indirect involvement of an SLT. It will be tested more widely, with particular focus on the role of the speech therapist. Evaluation measures similar to those presented in Phase 2 will be carried out. Expected results: This project will highlight the added value of speech therapy in setting up a prevention program. It also participates in the elaboration of a national strategic framework for the Speech and Language Therapy