The Ask Grandma app brings important teachings to life in short modules designed to support early communication and cultural connectedness in infants and toddlers. Each module in the app features real examples and video demonstrations of developmental strategies completed with Native children which make them useful for both caregivers, home visitors, and early interventionists who want to nurture language, learning, and identity in culturally meaningful ways.
The +LiM pilot study was designed for parents and caregivers of toddlers in the Shiprock area and delivered in five lessons by a community-based Diné Family Health Coach. Lessons emphasize responsive communication in daily routines, following the child’s lead, book reading, pretend play, and incorporating Diné language into everyday life.
“Families that have experienced significant trauma – especially when household members attended boarding school – often fall back on authoritarian language with young children,” Joshuaa explained. “We help caregivers shift from behavior management to language rich communication.”
Through the program, caregivers learn to label emotions, wait for a child’s response and model language. “It’s like we turn on these warm heart feelings that build pride in parenting. Often we’re touching on a soul wound that a caregiver has from childhood, and filling it with love and warmth. Researchers might call it building ‘parental self-efficacy’, I think of it as a lightening up of the soul – we see it with almost every family.”
ASCENDing Beyond Barriers
This study leverages the framework of the National Institutes of Health parent grant “Addressing Structural Disparities for Children with Early Communication Disorders (R01DC020402)” based at Oregon Health Sciences University to address persistent disparities in early intervention (EI) services for Native infant and toddlers with communication disorders (CDs). EI services, which include home-based speech/language/physical/occupational therapies and developmental support, are funded by the government and serve young children with CDs and other developmental delays. This initiative integrates quantitative analysis of EI data that states collect with qualitative insights from caregivers and EI providers. The study will specifically examine the unique successes and challenges faced by families living on and off tribal lands.
CDs encompass difficulties in producing or understanding speech and language, including conditions such as autism spectrum disorder, hearing impairment, and primary developmental speech and language disorders. These disorders are the most prevalent form of disability in early childhood, affecting approximately one in five children before the age of six. Effective communication skills are critical for academic achievement, social-emotional development, and overall health, meaning that early deficits can lead to longterm adverse impacts on children and their families. Moreover, those who have CDs may have difficulty absorbing their culture, native language, and communal mastery, further impeding their ability to fully engage with and contribute to their community. For Native children, particularly those on tribal lands, these challenges are compounded by structural disparities, historical trauma, and sociocultural obstacles in accessing timely and high-quality EI services.