Module 3
Using focused stimulation to address language form
e.g. when working on ing the clinician would manipulate the environment to that the child would have access to props and materials that would lend themselves to parallel talk ( adult talk about what child is doing) that included the present progress form. e.g. a jump rope
Who is the It takes two to talk program primarily for?
toddlers and preschoolers who are late talkers and have cognitive delays
Who is the primary client population for Focused Stimulation Approach to Language Intervention
toddlers through early elementary aged school children. Late talking toddlers , children with SLI, and children with mental retardation.
Give an example of focused stimulation to model target vocabulary
"Let's make something in the sand. Look at this sand. Do you like to play with sand? I like to dig in the sand. I can dig with my shovel."
What is MT
(mileu teaching) parent teaches functional languge in context of natural conversation. Prompts are used in conjunction with functional consequences. Used sparingly and based on child's interests.
what is RI
(responsive interaction) Parent models developmentally appropriate langauge in conversational interactions. Models, meaningful recasts, and expansions are contingent on child communication. Promotes balanced communication. Sets social context for language, just as environment sets physical context.
experiments done on it takes two to talk
-found that child in experiemental group acquired more target words but had same vocab size than control group. -experimental group showed greater use of gesture -follow up experimental group showed greater use of target words in play and larger lexicon. -positive results on children with down syndrome -need research on typical developing children for efficacy
What are ways to deliberately manipulate linguistic targets to increase the saliency of the input in focused stimulation?
-multiple repetitions -placing stress on target word
how do you teach proto- imperatives
-stop social routine and with hold item (ball) until the child requests it
What three things should be considered when using EMT for culturally diverse linguistic groups
1. EMT strategies: consider the cultures beliefs towards responsiveness including eye contact, touch and physical closeness. 2.EMT outcomes: adults must be competant in language the teach children so that they can model it. 3. venue: select culturally appropriate toys and materials
What are the three principal procedures for achieving the overall goal of teaching intentional communication in RE/PMT
1. Prompts: time delay, nonverbal prompts (holding out an upturned palm), and verbal prompts (asking open-ended question) 2. models: verbal (car goes beep beep) and gestural (pointing at an airplane) 3. providing natural consequences
What are 10 reasons why services should be integrated?
1. So that children learn the skills they need in the place they need to use them. 2.so that children have increased practice techniques 3. so that child's social relationships are fostered 4. so that child does not miss out on any classroom activities 5. so that teachers can see what therapists do to help kids and expand on their skills 6. so that therapist can see whether or not the strategies that they develop are feasible 7. so that teachers and therapists focus on skills that will be immediately useful 8. so that therapists can work with teachers to address problems as they arise 9. so that assessment can be done across a variety of routines 10. so that therapist becomes familiar with the curriculum and the expectations within the classroom.
What are three social theories that can be applied to the focused stimulus approach?
1. Social learning theory: human behaviors are learned through the observation of events concepts or activities modeled by others. Attention is a critical component of learning. 2. the social constructivist theory: emphasizes the adult's role in fostering the child's learning across a variety of developmental domains. 3.transational model of language development: reciprocle interactions between the caregiver and child are envisioned during participation in social discourse that provides natural and positive rewards for each member of the dyad.
name three key components for ensuring an optimal environment for highly responsive caregiving?
1. arrange the environment to increase opportunities of communication 2. follow the child's attentional lead 3. build social routines in which the child and adult play predictable roles
What are the three theoretical perspectives that EMT is based on?
1. behavioral perspective: the use of communication forms will occur in specific contexts when use results in desired positive consequences. Modeling, imitation and prompted practice are key to the behavioral model, reinforcing and shaping new models. 2. Social interactionist perspective: children learn language through meaningful interactions with caregivers. Modeling language in child's focus is significant for mapping underlying knowledge and social intention with spoken language 3. emphasis as parents as language teachers: supported by behavioral and social interactionist model
What are parents taught to use?
1. child-centered strategies 2. interaction promoting strategies 3. language model strategies
What are three characteristics of children who are most likely to show progress with emt?
1. children who are verbally imitative 2. children who hvae at least 10 productive words 3. children with MLU's between 1 and 3.5
What should children minimally demonstrate in order to use focused stimulation?
1. communicative attent 2. ability to participate in joint attention
What 3 components is EMT based on
1. environmental arrangement 2. responsive interaction 3.mileu teaching
What are five intermediate goals of PMT?
1. establish routines to serve as the context for communicative acts 2. increase frequency of nonverbal vocalizations 3. increase the frequency and sponnateity of coordinated eye gaze 4. increase the frequency and range of conventional and non conventional gestures 5. combine components of communication acts.
What gains has research shown children to make when using LIK?
1. gains in MLU 2. improvements in receptive and expressive langugae 3. increase in frequency of utterance production
What are two types of information processing that can be applied to focused stimulation
1. parallel distributing processes: as links between information storing nodes strengthen individual can access information more quickly and efficiently. The more often a link between nodes is activated the stronger it becomes. In this way, even higher level linguistic input can be learned more quickly when related rules have already been processed through the system. 2. limited capacity model: All individuals are able to process and store information in their working memory. Because of limited capacity, information in working memory does not last unless it is continually activated through an internal or external method. Therefore, success is comprehending and producing langauge is dependent on the process to maintain and integrate information from the working memory
Name two things that adult learning is linked to
1. positive examples 2. coaching and feedback
What are three things that mothers are asked to do in the focused stimulation approach of it takes two to talk?
1. reduce mlu 2. use focused stimulation 3. be less directive
What are three ways to ensure ample opportunity to practice?
1.find out child's daily routines and use those routines as goals. 2.incorporate consultation into therapy time 3. provide therapy within the classroom
What are three techniques that lIK recommends that caregivers and professionals use when reading books and engaging in play?
1.make comments about the child's interests 2.asking questions related to the child's interests. 3. responding to the child's utterances by adding additional information.
What are eight steps to colloborative consultation?
1.starting conversation and building a relationship 2. ask teacher how things are going in the classroom and how things are going with the focal child 3. determine which goals will be the focus for the next few weeks 4. review progress on goals 5. develop strategies to address goals during classroom activities. 6. determine roles and responsibilities of each team member 7. determine when next meeting will occur and how members will keep in touch 8. anticipate obsticles
According to culutally consistent treatment for late talkers what percentage of monolingual english speakers are late talkers?
10-15%
How long does it take for parent to learn emt?
24-36 sessions 3-5 months twice a week. Each session is 45min. to 1 hour
group pullout
A group of one to six peers work outside the classroom. Direct focus on functioning on special skills. Teachers provide information before and after therapy and decide schedule and what children should participate.
What are two aspects of intervention that are important to consider when working with cultrually diverse people?
A. the nature and context of social interactions in terms of partners, settings, or activities, b. the language goals and language facilitative techniques
group activity
Context is the same as the rest of the class. Emphasis is on the children in the group and social interactions, and meeting special needs. When it is a small group do things with the other children. If possible watch or participate in therapist group. When the group is large watch/participate and participate in planning.
Describe the general characteristics of RE/PMT
Combined use of clinician-implemented intervention and parent training in techniques designed to facilitate nonverbal intentional communication development, the foundation for later language development
How does the article define culture?
Culture refers to the shared accumulated and integrated set of learned beliefs, values, habits, attitudes and behaviors of a group of people.
What are the general characteristics of the Focused Stimulation Approach to Language Intervention?
Exposure of the child to multiple specific linguistic forms, content, use, within meaningful contents, followed by optional elicitation of spontaneous speech of the targeted form within the context of a contexutualy based service delivery model.
consultation.
Focus is on teaching the teacher to help the focal child. Can vary from collegial to expert. Share information, help plan future therapy sessions, foster relationship with slp
Theoretical foundation of it takes two to talk
I takes two to talk adheres to the social interactionist perspective of language acquisition, which maintian that the simplified language input provided by caregivers helps children make comparisons between the nonlinguistic and linguistic contexts and induce the relationship between objects, actions, external events and words
using picture books and play with children with disabilities and esl
If there is not an option for bilingual learning in the school LIK model can enhance the english only model through the use of play and picture books. Strategies are cheap and easy to learn and give parents tools to use in typical family contexts. Literacy is not a prerequisite.
How is PMT similar and different from Milieu teaching?
In PMT the target is nonverbal acts in MT the clinician will only prompt and provide desired response for verbal acts.
one-on-one in classroom
In classroom but working on separate skills from the rest of the class and not in the same classroom context as the rest of the class. Teacher's role is to work with the rest of the class. Rarely observes therapy session. Provides information before and after.
What are the nature of the goals for it takes two to talk?
Increase parents use of general interaction strategies taught within the program as a means of facilitating the child's communication
RE/PMT nature of sessions
Individual
Nature of sessions in focused stimulation approach
Individual clinician-directed sessions supplemented by parent application within the home
What is enhanced Milieu teaching (EMT)?
It is a naturalistic, conversation-based strategy for teaching language and communication skills to children in early stages of language development. It combines RI strategies (contingent semantic feedback, modeling language targets in descriptive talk, expansions, balanced turn taking.) and MT procedures to prompt language production (elicitive models, mands time delays, incidental teaching)
What must a child have to use emt.
MLU between 1-3.5 10 plus words verbally imatative
what should you consider when designing an environment for focused stimulation?
Make sure that the environment provides opportunities for joint attention to selected stimuli that support the use of the linguistic target
theoretical basis of RE/PMT
Model presumes that early social communication development are facilitated by bidirectional, reciprocal interactions between the child and their environment. e.g. the onselt of intentional communication may trigger change in social environment by encouraging parents to repeat and expand on their communication using words. this is called linguistic mapping.
give an example of focused stimulation to model locative forms
Nemo looks for his dad beside the cave. Look, he's beside the cave. Now he looks in front of the rock. Look he's swimming in front of the rock.
Is imitation used in the focused stimulation approach?
No. Instead an attempt is made to elicit spontaneous productions of the target by taking advantage of naturalistic conversational contexts that promote the use of the target.
What is the general characterization of the Takes two to talk methods?
Parent training in methods designed to facilitate communication development in natural contexts with special attention paid to goals identified for individual children.
What is blended EMT and behavior intervention?
Parent uses the EMT approach and also postively supports the child's behavior. Combines behavior support techniques.
How does EMT combine MT and RI
Parent's use of mileu teaching prompt strategies is embedded in responsive conversational interactions with child.
describe the responsive interation training component
Parents should recieve 8-10 sessions of training over 6 months. Conducted in parents home. Establish trusts, direct teaching on following child's lead and providing time to communicate. Sessions are video-taped and reviewed with parent.
what are benifits of facilitating the child's heritage language at home in addition to english at school?
Research since the early1980's suggests that strengthening a child's heritage language will also support their development of English and help ensure that child's acquisition of academic content and skills does not suffer.
what is meant by the focused stimulation model in it takes two to talk?
SLP and parents create communication goals and parents use focused repetition to make these goals salient during naturalistic interactions. General: no specific language goals, involves following child's lead, joint attention
What three federal laws require inclusion?
Section 504 of the rehabilitation act Americans with disabilities act IDEA individuals with disabilities education act state that treatment should be provided in the most inclusive and least restrictive natural environement.
What are the theoretical foundations of using play to facilitate language and literacy?
Studies have found strong correlation between play and language development, especially for children with disabilities. Language use of parents with children during play is a strong predictor of later langauge development.
What does individual pullout entail?
Taking a child out of the classroom to work on directly on child functioning. Peers are not present. Teachers provide Information before therapy and after.
What language does LIK encourage that parents practice with their children?
The language they are most comfortable with, while teachers and professionals teach english at school
Why are children with delays and sensory imput problems at particular risk?
They display low rates of initiation and responsisveness. Because of this they may experience low rates of imput compared to typically developing children despite caregivers best efforts.
Individual during routine
This is the best one that you should aim for. The context is the same as the class. Focus is on the child but is not exclusive. Peers are usually present. The teacher plans and conducts the activity and observes therapists actions with the focal child. Exchange information before and after.
What are some general characteristics of LIK?
Use of teaching others about common language facilitation techniques that can be implemented within contexts such as play and book reading (open-ended quesetions, expansion of children's utterances
What is a rule that tells when a child is done with RE/PMT, and who it is not appropriate for?
When child produces 1-2 spontaneous, intentional communication acts per minute in social play with an adult.
Does EMT have research to back it up?
Yes more than 50 empirical studies have provided evidence for effectiveness of EMT for children with asd, significant cognitive language delays, and children from high-risk low income families.
evidence to support focused stimulation?
Yes! studies done on lexical learning, as well as vocabulary and grammatical goals suggest that focused stimulation is effective in facilitating vocabulary skills when incorporated within treatment. Foscused stimulation involving clear modeling of target words constriubtions was reported to result in more imporvement than other approaches such as imitation, direct questioning or expansion.
does focused stimulation work for children from diverse backgrounds?
Yes, because of it's flexibility.
What is the transactional model of adult-child interaction?
a mechanism by which enhanced prelinguistic development can serve as scaffold for communication
what do all the language treatments for late talkers have in common?
all have common roots in social interactive or social constructivist theories of language development.
Who is the target group for language is key? (LIK)
children who are functioning below approximately the 4-year level and have unmet communication needs, and children with limited english proficiency
What client age is most appropriate for Re/PMT
children who are functioning developmentally between 9 and 15 months. Often 2-3 chronological age. The treatment takes several months
What is the primary client population for RE/PMT
children who are not using gestures and vocalizations at frequency and in a manner consistent with the onset of language use
Intervention agents in RE/PMT
clinician and parents
why is verbal imitation a prerequisite?
core MT techniques rely on adult modeling and child imitation to practice the response in a functional context.
What are the dimensions of service delivery?
dimensions of service delivery include: presence of peers, context of intervention initiation functionality of skills amount and type of consultation.
What is the nature of the sessions in LIK?
direct individual session conducted by SLP or significant others who are trained in target facilitation techniques
Is there evidence to support this practice?
e.g. yonder and warren 2002 found a statistically significant increase in intentional communication relative to the community intervention
using focused stimulation to address language use
emphasis is placed on what is occuring in interaction to help the child focus on what is occuring in the interation.
What are two different styles of collaberation when working with teachers?
expert: independently evaluates, recommends strategies and says whether goals are met. collaborative:teacher specialist parent identify needs, make a plan, and evaluate progress together. more narturalistic
what are the nature of the goals in LIK?
facilitation of advances in form, content and use of early language.
Why is maintianing sustainable routines an important aspect of LIK?
for a language intervention method to work, it must not only be effect but must also get used.
What is necessary to ensure that the child's prelinguistic skills have maximal impact?
high degree of parent responsivity
Nature of goals in focused stimulation approach
improve vocabulary and early grammatical skills promote form content and use of language
What are general goals for late talkers?
increase production and comprehention of words and sentences and promote the use of newly acquired language within meaningful communicative interactions.
What are the nature of the RE/PMT goals?
increase the frequency, clarity and the complexity of intentional nonverbal communication as a precursor for language and increase the parent's ability to support this development
what type of delivery model is it takes two to talk
it is an indirect service delivery model that empowers parents to facilitate langauge development in naturalistic contexts
why is the component of environmental arrangement so important to EMt
it is designed to increase the child's engagement with the physical setting which then can provide more frequent opporutnities for parent to communicate with the child to elicit communicative responses, and respond contingently to verbal and nonverbal communication attempts
Why does RE/pMT consider prelinguistic skill to be so important
it is grounded in the assumption that prelinguistic skill form the foundation for later language skills.
how to teach proto-declaritives
modeling and providing situations likely to stimulate their use, or in some contenct by directly prompting with physical assistance
Who are the main intervention agents in It Takes Two to Talk?
parents slp
Who is involved in LIK?
professionals, paraprofessionals (child-care providers) and family members
What is the primary objective of it takes two to talk
promote adult behaviors that are thought to influence children's developmental progress in prelinguistic aspects of communication such as: vocabulary , early word combinations, and prelinguistic aspects of communication
What is the main focus of EMT?
promoting children's functional use of productive language skills in naturalistic interactions.
What are the theoretical foundations of using picture books to facilitate language and literacy
provide rich opportunity for young children to learn language and preliteracy skills. Books do not have to be read but can serve as a departure for talking and listening. Books are practical because they provide a specific shared context for interactions and the are often associated with undivided adult attention.
philosophical foundation of it takes two to talk
recognizes the family as a dynamic soical system in which individual family members are so interrelated that any action or experience affecting one member will affect the whole unit. The ultimate goal is to empower the family and enhance their sense of competence.
What are the two broad types of acts that PMT focuses on?
requests: child seeks action object comments: purely social
Is there evidence to support that LIK works?
research regarding specific methods of interaction around picture books by parents and teachers indicates both short and long term gains in language production and development for children who are delayed and developmentally typical. In addition the methods appear to be culturally appropriate for families who speak a language other than English at home. -The LIK play model has not yet been evaluated. However, play has traditionally been a medium for language facilitation.
What is the nature of an it takes two to talk session?
small group parent-training sessions, preceded by individual assessment sessions and followed by individual videotaped feedback sessions
What theoretical two theoretical viewpoints can support for the focused stimulation model be drawn from?
social theories as a rationale/foundation for focused stimulation: In contrast to behavioristic theories, in which all learning is viewed as the result of a conditioned response to a given stimulus. These models view individuals as cognitively active in the learning process and emphasize the importance of the social context to the speed and durability of the learning information processing models as a rationale/foundation for focused stimulation: information processing frameworks argue that all processing begins with input and ends with output. A variety of mental operations occur between input and output. All of these must work smoothly in order for learning to occur.
Using focused stimulation to address language content
target is modeled by clinician in presence of referent. Child's job is to interact with clinician and object as the clinician provides high density repetition of target word.
two key characteristics of application
the careful selection of the linguistic targets using normal dvelopment as a guide