Comparative Outcomes of Teacher Coaching Versus Parent‐Implemented Intervention for Preschoolers at Risk of Developmental Delay in Thailand

TL;DR

This study compares two methods to help preschoolers at risk of developmental delays in Thailand: teacher coaching and parent-led interventions, finding both improve outcomes.

Contribution

The study evaluates the feasibility and effectiveness of two implementation models for developmental promotion in community daycare settings in Thailand.

Findings

Both teacher coaching and parent-implemented interventions improved developmental-promotion practices and child outcomes.

Teacher knowledge improved more in the parent-implemented model compared to teacher coaching.

Short-term reductions in developmental delays were observed in both models.

Abstract

Early childhood developmental delays are a major concern in low‐ and middle‐income countries (LMICs), where gaps often exist between developmental surveillance and follow‐up support. In Thailand, the Developmental Surveillance and Promotion Manual (DSPM) provides a national framework for screening and promotion; however, practical models for integrating DSPM guidance into daily classroom and home routines in community daycare settings remain limited.

To compare two brief nurse‐facilitated implementation models—teacher coaching using practice‐based coaching (PBC) and a parent‐implemented intervention (PII)—and examine their effects on adult practices and short‐term developmental outcomes in preschool children at risk of delay.

A quasi‐experimental, two‐group pretest–posttest study was conducted in two community daycare centers. Forty‐nine at‐risk children and primary caregivers were enrolled (PBC: 26 dyads; PII: 23 dyads), along with 17 teachers (PBC: 8; PII: 9). Each center implemented one model over a 4‐week intervention period with follow‐up assessment approximately 4 weeks later. Outcomes included teacher developmental knowledge, teacher and caregiver developmental‐promotion behaviors, and child pass/fail status across five DSPM domains. Continuous outcomes were analyzed using 2 × 2 mixed‐design repeated‐measures ANOVA; within‐center domain changes used exact McNemar’s tests.

Teacher knowledge improved over time, and the magnitude of improvement differed between models (group‐by‐time interaction), with larger gains in the PII center than the PBC center. Teacher and caregiver developmental‐promotion behaviors improved significantly from pre to post (main effects of time), while group‐by‐time interactions were not significant, indicating comparable behavioral gains across pathways. Within‐center DSPM analyses suggested short‐term reductions in delayed status in selected domains in both centers.

Both PBC and PII were feasible in community daycare settings and associated with meaningful short‐term improvements in adult developmental‐promotion practices and selected DSPM domains. Child domain patterns should be interpreted descriptively because DSPM changes were analyzed within centers rather than as between‐model contrasts to inform service planning and scale‐up.

Trial Registration: Thai Clinical Trials Registry (TCTR): TCTR20250106003