CSD 440 - EXAM 2

Early warning signs

* Dislike for shared book reading, nursery rhymes, etc. * Difficulty following directions * Difficulty learning letter names * Inability to recognize or identify letters in the child's own name

Writing

* Need executive functioning skills * Story organizers * Intervention might focus on specific skills or metaskills

Improving reading fluency

* Practice with the same book * Track the words with your finger * Start with easy books

Late First Grade/2nd Grade - Reading

* Read and retell familiar stories * Sounds words out * Identifies some sight words

Recommendations to parents to aid reading skills

* Read books with your child * Talk to your child and name objects in their environment * Talk about what you are doing during daily routines * Point out print in your everyday environment * Sing and rhyme with your child * Encourage your child to draw, scribble, etc. * Take turns telling stories

Reading Fluency

* The ability to read text accurately, quickly and with proper expression * Bridge between word recognition and comprehension

SLI - Associated Problems

- reading skills (problems with detecting, segmenting, and blending) - problems learning to read - problems with nonword repetition tasks (nonsense words)

SLI - Pragmatics/Language Use

- use language for same purposes as typical children - less initiation, more replies - communication problems may have secondary impact on social skills

Late Talkers

- Delay in productive language abilities (18-23 months less than 10 words; 24 months less than 50 words; few two-word combos) -No signs of other developmental delays

Differing Pathways to Birth to Three Services

- Diagnosed Condition (ie Down syndrome) - Developmental Delay (ie Late talker) - Atypical Development (ie ASD)

IFSP Functional Outcomes in Intervention

- Identify opportunities for practice - Map onto routine or activity - Determine if there is a need to arrange and/or restructure environment? - Describe the antecedent event to elicit response - Describe those behaviors needed to meet outcome - Specify the consequences for child following behavior - Develop a schedule matrix with visual reminder of outcomes

SLI Intervention - Facilitation Around Books and Play

- comment about child's interests - ask questions related to child's interests - respond to child utterances by adding a little more info

IFSP Child Goals examples

- communication - motor - cognitive - behavior

SLI Intervention - Peer Mediated (Young Children)

- identify problem behavior - teach appropriate behavior - support practice

SLI Intervention - Sentence Combining

- improve ability to use complex grammar - shows how words can be put into varying patterns - school-age to college students - improves writing skills

SLI - Phonology

- intelligibility difficulties - interact with other aspects of language

IFSP Family Goals examples

- interaction with child - learning sign language - promoting a skill

IFSP routines and activities should be...

- interesting - comfortable for caregiver - quick to complete - joint attention - interesting materials - repetition opportunities

SLI - Semantics/Language Content

- late onset of early productive vocabulary - overuse certain verbs - same ORDER of development as TD children - restricted, concrete knowledge - overextend and underextend (generalization issues) - problems with naming pictures of common objects - problems with abstract concepts - restricted vocabulary

SLI Intervention - Hanen Early Language Parent Program

- milieu teaching and naturalistic language facilitation

SLI Intervention - Hanen Early Language Parent Program Results

- more frequent and longer parent-child interaction - parents: slowed rate, less complexity, and use of facilitation strategies, lowered stress - children: more joint attention and increases in vocab

SLI Biological Factors

- neurological - genetic

Prerequisites for reading

- print knowledge - phonological awareness - writing - oral language -emergent writing

Curriculum-based assessment

-Assesses language skills of the student as it considers academic content and social interaction demands of curriculum -Identify knowledge and language required to succeed academically -Identify instructional modifications to enhance success -Results in meaningful intervention goals -Requires close collaboration between the SLP and classroom teacher

Evaluation B-3: Communication Protocol

-Hearing ability and hearing history -History of speech-language development -Expressive and receptive language performance (syntax, morphology, semantics, pragmatics, phonology) -Speech -Oral-motor functioning and feeding history -Voice (quality, pitch and loudness) -Fluency

Principle 9

Avoid telegraphic speech, always present targets in well formed phrases and sentences; children may be extracting forms from what is heard and comprehension may exceed production

Principle 1

Basic goals of grammar treatment is to help the child achieve greater competence in a variety of functional settings and usages

Mid-Kindergarten/Mid-First Grade- Writing

Basic words can be read by others Writes names Writes basic sentences

Three basic processes of writing

1. planning what to say 2. translating into written form 3. reviewing and editing *requires metaskills and executive function skills

Prevalence of Late Talkers

13.4-19% Predictive Factors: suggests neurobiological & genetic mechanisms that operate across maternal and family characteristics (not yet possible to use as screening factors)

Parent-child interaction assessment

Aligned with social interaction theory Children use complex language in familiar routines Identifies parent's scaffolding strategies Child's play may reveal level of cognitive development Documents target behaviors and the antecedent events and reinforcement

Principle 1 usages

Conversational speech, telling a story (oral or written)

Evaluation vs Assessment for B-3

Evaluation: determine eligibility based on developmental status: cognition, communication, physical, adaptive/self-help, or social-emotional Assessment: follows determination of eligibility; determine child and family's needs, strengths and early intervention services

Morphological Awareness Approach

Explicitly teach part of words (prefix, suffix, root) Important for reading fluency, comprehension and spelling

Intervention for older children

Help the child be successful in classes Work on literacy through a variety of subjects Push in and pull out

Principle 1 settings

Home, school

Assessment for children with SLI

In depth LSA Norm-referenced Criterion-referenced/naturalistic assessments (ie parent-child interaction assessment and curriculum-based assessment)

Enhancing Language & Communication in Infants and Toddlers

Family-centered care Parental Partnerships Individual Family Service Plan Evidence-based practice

Methods to achieve functional outcomes

Direct: professional as an agent for change Indirect: professional assists others to be agents of change

Intelligibility Issues

Lack of normative data Variability in performance Multiple influencing factors Separating speech from language Oral motor work and affect on speech

Principle 7

Manipulate discourse so that targets are more salient in appropriate contexts; salient or word final position

Principle 5

Manipulate social, physical, and linguistic context to create frequent opportunities for a grammatical target

Principle 4 focus

Partially mastered forms first and then proceed to unused forms; only target forms if cognitively and functionally ready for use

National Reading Panel Domains

Phonological Awareness Fluency Reading Comprehension

Spelling skills needed

Phonological awareness Morphological awareness Visual storage Orthographic knowledge

Early Intervention targets for reading

Phonological awareness Print concepts Alphabetic awareness Oral Language skills

Preschool reading

Print carries meaning Pretend to read books Actively participate in shared book reading routines Handle books appropriately

SLI associated problems

Problems with interactive communication Phonological impairment Processing Difficulty- Memory (STM) 59% also diagnosed with ADHD 80% have reading problems Writing and spelling also poses challenges

SLI social communication: 3 treatment paradigms

Social interaction with peers Peer confederate training Sociodramatic play

Late PK/ Mid K reading

Recognizes names Can name many letters Know some letter sounds Can identify where to start reading and in which direction to read

Principle 3

Select intermediate goals to stimulate child's language acquisition process and not to teach all specific language forms; select goals for a system-wide change

SLI Definition

Significant language learning difficulties - no impairment of: nonverbal cognition, social-emotional development, hearing, neurological or oral structure, or oral motor abnormalities

Collaboration with parents

Increase caregiver's awareness of the child's communication acts (ie behavior regulation, joint attention, social interaction) Encourage appropriate responses to communication behaviors (select appropriate targets, set up hierarchies)

Three components of a narrative

Initiating event- problem that sets story in motion Attempt- action undertaken by a character to solve problem Consequence- what happened?

Principle 6

Use different genres and written modality to develop appropriate contexts for specific treatment targets; the transfer from conversation to other forms is not automatic, obligatory context is not always the easiest in conversations (more past tense in stories)

Principle 10

Use elicited imitation to make target more salient and to give child practice with targets that are difficult to produce; use functional context; make the child repeat you of what you want to happen, make it happen, make child repeat you saying what happened

Principle 4

Specific goals should be based on the child's readiness and need for form

Explicit approach

Structured Adult-directed Specific targets (may include letter identification, sound blending, story maps)

Principle 3 focus

Subject-verb agreement could lead to the addition of other required markings

Generally, treatment should focus on...

direct work on the language elements (no evidence to focus on potential "underlying" causes)

Facilitate Functional Outcomes (where)

natural environment during child-initiated actions, routines, and planned activities

Narrative microstructure

necessary syntax and internal linguistic features

Narrative macrostructure

overall story organization

Surface theory/ missing feature hypothesis

children don't perceive the morphological features produced with less stress and lower intensity

Alphabet Awareness

children's understanding of letter names

Most Deficient Area in SLI (Form, Content, OR Use?)

form

Extended optional infinitive theory

get "stuck" in a stage were tense is considered optional

Facilitate Functional Outcomes (how)

identify naturally occurring routines and preferred planned activities

Facilitate Functional Outcomes (when)

throughout the day as the child in involved with ongoing routines and activities

Print Concepts

understanding print carries meaning

Phonological Awareness

word and syllable awareness, rhyme, phonemic awareness

Intervention: Writing

• Targeting specific foundation skill: Spelling, punctuation and syntax • Targeting metaskills and executive function: Story organizers, evaluative rubrics

Intervention: Reading comprehension

• Teaching metaskills • Make predictions and form questions prior to reading • Answer the questions as they read • Look up words • Summarize paragraph by paragraph • Graphic organizers, visual diagrams

Late First Grade/2nd Grade - Writing

• Writes phrases that others can read • Uses the "writing process" • Uses punctuation • Monitors writing

Intelligibility rough guidelines

18 months- 25% 24 months- 50-75% 36 months- 75-100%

Birth to Three Program Steps

1. Referral 2. Evaluation by a team 3. Eligibility criteria 4. Assessment 5. IFSP 6. Transition

What age are SLI principles best used for?

3-8 years old

SLI prevalence

7% 3:1 ratio male to female

Oral Language Development

Narrative: monologue describing real or fictional event that has specific linguistic features Should have clear structure by age 6

Embedded Approach

Naturalistic Set up environment to promote literacy development (ie storybook reading, "sign in" at beginning of class

The fluency four

Punctuation Accuracy Right Rate Expression

Literacy and Hearing impairment

• 50% of deaf students graduate from high school with a 4th grade or lower reading level • 30% leave school functionally illiterate • Literacy can also be affected in children with less severe hearing loss

Intervention: Spelling

• Focus on student's deficits • PA, orthographic knowledge, morphological skills, visual storage • PA deficit = most common cause for poor spelling • Practice identifying incorrect and correctly spelled words • Word sorts

Literacy and Intellectual Disability

• It's a myth that children with ID will not be able to learn to read • Interventionists need to incorporate preliteracy into interventions • Skills may develop differently

RBI Disadvantages

- B-3 program level: reimbursement and time - conflicting expectations - geographic and scheduling barriers - distractions - clinician discomfort - unpredictability

SLI Environment Factors

- NOT THE CAUSE - require more intense and focused stimulation to become language proficient - parent-child communication patterns should be monitored and sometimes modified to foster language

SLI - Syntax and Morphology

- deficiencies in grammar - short, less syntactically complex utterances - errors and omissions - difficulty with verb inflections - look at differences between SAE and AAE - same ORDER of development as TD children

SLI Intervention - Peer Mediated (School-Age Students)

- encourage understanding of others emotions - practice established social routines - use and understand "hidden communication"

RBI Advantages

- frequent practice - natural consequences (NOT BAD) - parents are effective implementers - natural element - cultural responsiveness

IFSP General Information

-Develop goals and functional outcomes (child and family) - Determine strategies and who will implement them - Facilitate functional outcomes in natural environments

Evaluation B-3: Team's clinical opinion supported by:

-Review of records/existing data -Developmental history -Observations-natural settings -Administer norm or criterion-referenced instruments

SLP role in the NICU

Adapt environment Monitor infant behavior Encourage, inform & empower caregivers (ie non-nutritive sucking and feeding; reading signals-alertness, state)

Principle 2

Grammar should rarely be the only target of language treatment; children with SLI have multiple areas of concern that should be treated as well (phonology, vocabulary, social interaction)

Preschool writing

Start scribbling Use letter-like forms Control a writing tool

Reading Comprehension

Starts at 3rd grade Vocabulary development, narrative ability, use of metastrategies during the reading process Use graphic organizers and visual diagrams

Late PK/ Mid K writing

Syllabic writing Some conventional letters Chooses their own "words"

Principle 8

Systematically contrast forms used by child with adult forms by used recast

SLI - More Receptive or Expressive Problems?

expressive

Range of Language abilities

typical- late bloomer- late talker- SLI

Mid-Kindergarten/Mid-First Grade- Reading

• Recognizes all letter names and most letter sounds • Can identify where word begins and ends in a sentence • Knows capital from lowercase letters