Chapter 7 Assessment & Intervention for Emerging Language"

What is the frequency of communication that a SLP looks for in a 15 minute toddler observation?

- 12 months: 1 intentional act/minute - 18 months: 2 intentional acts/minute - 24 months: more than 5 intentional acts/minute

How could you define toddlers?

- 18 and 36 months of age -Begin speaking - Producing single words - Combining words into two word utterances may even produce simple sentences ***Problems with developing language become evident in this stage.

What goals should be addressed in a toddler with ASD?

- Address both expressive and receptive language goals; toddlers with ASD often have receptive scales at or below expressive level.

What are some Predictors and Risk Factors for Language Growth in Toddlers mentioned in Box 7-1

- Language production - Small vocabulary for age - Language comprehension - Presence of 6-month delay - Phonology - Few pre-linguistic vocalizations, limited number of consonants, limited variety of babbling, fewer than 50% of consonants correct - Nonlanguage - Little symbolic play - Few communicative gestures - Reduced rate of communication - Reduced range of expression - Behavioral problems

At 18 - 36 months when a child is developing their phonological skills what should the focus be?

- As the child is developing her phonological skills you want to focus on expanding the repertoire of sounds and syllable shapes rather than correcting errors in the child's speech. - Shape the child's speech production by rewarding any conventional word approximations rather than correcting. DO NOT correct at this 18-36 month stage!!!!!

At the toddler stage few standardized tests are sufficient to assess comprehension, what is an assessment tactic?

- Assessment tactic: identify level of linguistic comprehension and strategy use for - Single nouns, verbs - Agent-action instructions - Agent-action-object combinations

Steps in assessing speech-motor development includes:

- Attempt standard speech-motor assessment 1) Oral Motor Assessment - Be aware of cognitive and imitative difficulties that are common at this developmental level. - Be conservative about diagnosis of childhood apraxia of speech before continuous, multiword speech is acquired. -In the emerging language stage, we want to be careful of making a diagnosis of apraxia. - Use vocal assessment to complement speech-motor and feeding evaluation.

Communication skills in typically developing toddlers that are 18-24 months old would include what?

- Average expressive vocabulary size at 18 months is 100 words - Multiword utterances increase in frequency - New communicative intentions emerge related to discourse level functions a) Answering questions, acknowledging or requesting information - Understanding of sentences is not far ahead of production - Repertoire of speech sounds increases - CVC and multisyllabic words increase, though many are still single syllable - Average child is 50% intelligible at 24 months -Unfamiliar listener would be able to understand about ½ of what child says.

Once an eligibility decision has been made and it has been determined that a child can benefit from intervention. The next step is to decide WHAT to work on.

- Based on assessment data, we must make decisions about what to focus on in intervention. a) Want to look at each child's strengths and needs as we prioritize what would be the best to help the child communicate in their environment.

Potential goals for this Emerging Language Period include:

- Develop play and gestural production - Increase frequency of intentional and communicative behavior (both preverbal and verbal) - Develop receptive language - Increasing vocal and phonological production repertoire (sounds and syllables) - Increase vocabulary production, based on phonological and syllable repertoire - Once expressive vocabulary reaches about 50 words, begin encouraging production of word combinations.

Other communication skills in a typically developing toddlers 18-24 months old are.

- Early two-word utterances express small range of meanings (doggy eat, mommy hat, baby here) - Agent, action, object combinations - Possession - Location - Attributes - Meanings related to object permanence - hear babies talking about things not immediately present. - Word order is consistent within these combinations - usually NOUN FIRST!

What are some things the SLP can learn from the family during the emerging language stage regarding intervention?

- Learn from the family: - Vision for the child - Expectations - Opinions about the child's ability (family's assessment)

List some reasons that Indirect Language Stimulation is important.

- Extremely important for children in the 18-36 month development range - Gives child an opportunity to observe how language works - Builds comprehension strategies - Develops expectations about conversational situations Examples that we are talking about include: Self-talk, parallel-talk, imitations, expansions, descriptions, recasts, etc.

Give an example of a Representational Gesture.

- Form is used to stand for a referent Ex: A child who represents eating a cookie by holding his hand up to his mouth. A child who flaps his arms in the air to represent being a bird. a) To increase a child's play and gestures, we need to model what we want them to do. b) Intervention for this area will mostly include teaching the parent to model play and gesture for their child, a parent to reinforce child for those behaviors. c) - Model for child/teach parent to model.

What other forms of communication can a SLP look for when assessing intentional communication of toddlers?

- Gaze - Gesture - Vocalization - Speech, even if it is not in a conventional way.

Name 3 screeners used to help identify children without disorders?

- Language Development Survey (AKA Rescorla , 1989) - Communicative Development Inventory (Fenson et al., 2007) - Communication and Symbolic Behavior Scales Caregiver Questionnaire (Wetherby & Prizant, 2003)

During the emerging language period services and intervention are family centered how should the SLP work with the family?

- Make choices about intervention rather than just putting out plan for child. a) We want to get input about what kind of intervention they want to see. - Review progress with family - Involve family when finding out child's interests a) best to have child's buy in or engaged in therapy or intervention. - Enable parents to do what works for their family a) Requires conversation about what family dynamics are, who is able to help with intervention. b) Get as much info from parents so intervention runs as smoothly as possible.

What range of communicative functions should a SLP look for when assessing intentional communication within toddlers?

- Making Requests and protests/rejections (regulatory functions) (giving cup of milk and then throwing it on the ground) = rejection Other Communicative Functions: - Comments (joint attention functions), Is the child attempting to get the parent to attend to something that she is interested in. - Child using any Higher Level Discourse Functions like answering questions, acknowledging for requesting information.

Why is play assessment important, what comparison will a SLP be able to form after conducting a play assessment?

- Play assessment: gives us a nonlinguistic comparison to language performance: sample methods Ex: You may assess a child that doesn't verbalize at all but in a play assessment you can see without considering verbal output a child's ideas or capabilities.

Describe the communication skills in a typically developing toddler 8-18 months old.

- Preverbal intentional communication using gaze, gesture, and vocalization at 8-12 months - Expressive vocabulary starts slowly - 12 months: 1-3 words - 15 months: 10 words - 18 months (explosion): 50-100 words; first word combinations - First 50 words include proper and common nouns, adjectives, verbs, social terms - Receptive vocabulary is larger: 50 words at 15 months -child will understand more words than he says - Most words have CV shape, one syllable; some reduplicated words (/baba/, /mama/, /dada/); closed syllables emerge (CVC) = dog, mom, dad - Sounds used are same as those found in early babble

As we discussed earlier, because services for children birth to 5 are the responsibility of each state, you will need to:

- Refer to local and state eligibility guidelines in making eligibility determinations. - Use decision tree l in determining eligibility and in planning for intervention. - In general, for children with accumulation of risk factors for continued communicative delays, should be considered for speech and language intervention. - For children with circumscribed delay in expressive language only (means they would be age appropriate in receptive language abilities), consider just monitoring with periodic reevaluations. - Also follow the family-centered practice guidelines in making all eligibility decision.

As SLPs we are very reliant on parents as we are assessing the lexical production in the emerging language stage. What are a couple of tools highlighted within the text that can be used?

- Use parent report vocabulary checklists; e.g., LDS (Rescorla, 1989); CDI (Fenson et al., 2007) - Use parent report of general communication skill; e.g., Vineland Adaptive Communication Scale (Sparrow et al., 2005); it is the Language Use Inventory (O'Neill, 2007)

Early screening instruments focus on screening for what and help identify what type of child?

- Used to help identify children without disorders identified at birth, but who show signs of delays in development before 3 years of age - Screeners focused on communication

The best procedures for increasing early vocabulary would include what types of methods?

1) Clinician-directed 2) Child-centered 3) Hybrid

Give an example of a Hybrid Communication Temptation.

1) Create Communication temptations, these were presented in chapter 6, table 6.5 Ex: Open up a jar of bubbles. Blow the bubbles. Put the lid back on the jar. Hand the jar to the child. By doing this we are hoping that the child will make a request by handing the jar back to the adult or perhaps verbalizing or gesturing a desire for the adult to blow the bubbles again. - Hybrid approach

Describe 3 phases of the clinician directed "Environmental Learning Intervention Strategy .

1) Imitation: Linguistic and nonlinguistic stimulus are paired. Child told to imitate clinician. Adult pets stuffed animal and says, "Pet the bunny." and asks client to repeat. If child repeats they receive a token. If child doesn't repeat the clinician looks away for 3 seconds and repeats. 2) Conservation: Nonlinguistic stimuli are the same as the imitation phrase. Linguistic stimulus is a ?, "What am I doing?" Correct response is same as #1. If child fails to respond an imitative prompt is given followed by a repetition of linguistic stimulus, say "Pet the bunny." then "What am I doing?" 3) Play: While child is playing with materials used in nonlinguistic stimulation imitation & conversation phases, adult asks for conversational response. What are you doing? or pick something the bunny up saying, "What shall I do?" If child's response is incorrect 3 second delay occurs followed by a request for imitation or target utterance.

What are some of the risk factors for language delay shown in Box 7-1?

1) Males more vulnerable to delay than females. 2) Otitis Media, prolonged untreated OM. 3) Family Hx: Members w/ language, reading & learning problems. 4) Parent characteristics: Low maternal education, low SES, more directive than responsive interactive style, high parental concern.

Once a toddler has been screened and milestones have not been met assessment is next. What are the two primary assessment styles for population?

1) Multidisciplinary Approach: Each professional does independent assessment 2) Transdisciplinary: Child interacts with one adult: team members suggest assessment activities and observe assessment.

There is criteria that a child's behavior must satisfy to qualify as a communicative act, what is it?

1) Must be directed primarily by means of gaze to the adult. -The child must look at, refer to, or address the adult directly in some way as part of the act. 2) It must have effect or at least obvious intended effect of influencing the adult's behavior, focus of attention, or state of knowledge. - The child must obviously be trying to get a message across to someone. 3) The child must be consistent in attempt to convey a message if the adult fails to respond or responds in a way that the child has not intended.

Increasing vocabulary production is a common goal for children in the Emerging Language Stage. As we are developing a first lexicon we want to choose words based on the child's.....

1) Select Words (first lexicon) based on phonological and syllable repertoire Ex: If child cannot say the /k/ sound you will want to avoid first words containing /k/ especially in the beginning of the word. 2) Include labels or nouns, verbs, relational words (more, all gone), as well as social interactional words (hi, night-night) 3) Teach words that help the child express a variety of communicative functions rather than simply naming or labeling 4) All the intervention models (CC, Hybrid, CD) can be applied in therapy for increasing vocabulary Ex: Child centered, hybrid, and Clinician directed approaches.

There were 5 play scale items listed on Table 7.1, what were they?

1) Semi-appropriate toy use: objects used in appropriate but fleeting way. @ 12 months touches comb to hair with tines up, blanket over doll's face. 2) Nesting: Objects placed or stuffed into container. @ 15 months crams all toys into crib or tosses trucks into hat. 3) Multiple play episodes with different actions: 2 or more appropriate or semi appropriate toy uses. @18 months, pushes truck, loads blocks in truck, feeds doll w/ spoon. 4) Multiple play episode with same action: 2 or more appropriate or semi-appropriate toy uses thematically related. @ 21 months, feeds doll w/ spoon, feeds self, pushes truck. 5) Extended multiple play episode: 3 or more appropriate or semi-appropriate toy uses thematically related. @ 24 months, dials telephone, put phone to ear & talks, hangs up.

When using Increasing Frequency and Intentional Communication what would a SLP look for?

1) That means we want to see the child producing more requests, protests, rejections, etc. 2) We want the child to initiate communication.

When a child does reach the agent/action/object combination level at 18-24 months what should this be an indicator of?

An indicator that they are ready to have a standardized test like the Peabody Picture Vocabulary Test or the test of Auditory Comprehension.

Table 7.3 reviews Gestures and Gestural Development in the Prelinguistic and Emerging Language Stages, what are they?

10-12 Months: Deictic gestures emerge. Pointing predicts first word use. 12-13 months: a) Symbolic play schemes emerge, gestures first, self-directed symbolic play. Ex. Feeding self from empty spoon. b) Representational gestures emerge, puts hand to mouth to indicate desired bite of brownie. 15-16 months: a) Deictic- Gestures complement spoken forms. Children show preference for gestural or vocal expression. Symbolic = pretends to feed doll. Representational - show preference for gestural or vocal expression. 18-20 months: Deictic - Increased pointing combined with spoken words. Symbolic - Play schemes w/o object. Ex. Holding hand to ear instead of toy phone. Multischeme symbolic play = stirring & then feeding. Representational - Gesture + spoken word combinations emerge. Increase in word use. Prefers words over gestures.

What are the Comprension Abilities of Children up to 3 Years Old? Table 7-5

8-12 mo. Understands a few single words in routine contests. (Looks at same objects as mom, act on noticed objects, imitate ongoing action) 12-18 mo. Understands single words outside routine, still requires contextual support (Attend to object mentioned, gives evidence of notice, Do what usually do) 18-24 mo. Understands words for absent ojects, some 2-term combos (Locate mentioned objects, puts objects in containers, acts on objects = child as ajent) 24-36 mo. Comprehends 3-term sentences but context of past experience determines meaning; little understanding of word order (Probable location or even, supply missing information)

Give an example of how you would find the linguistic level that a child should be comprehending and use appropriate strategies for assessing comprehension at the 12-18 month range.

A child who is 12-18 months should be able to identify an object out of a collection of objects. 1) You would give a child 6-7 different objects and without looking at the object ask child, "Hand me the pencil." "Hand me the ball."

Once a toddler is diagnosed with Autism intervention needs to begin____________

ASAP.

When is a transition plan necessary?

Any plan written for a child in the emerging language stage needs to include a transition plan. - Plans for transition from 0-3 to preschool services are mandated a) IFSP for 0-3 years (Individual Family Service Plan) b) IEP 3 years and up child (Individual Education Plan)

Assessing play skills in a child within the emerging language stage is important because it.

Assessing play skills helps give us a picture of the child's cognitive skills and can give us insight about his conceptual and imaginative abilities. -Play assessment will also give us an idea about what the child is interested in so we can plan therapy around the child likes to play and what the child likes to play with. - Certain gestural and play skills appear to be related to the development of intentions, first words, and word combinations.

Following the Child's Attentional Lead includes:

Attend to and talk about toys selected by the child from an array. Reduce adult behavior to child's rate of initiation, even if this means long periods of silence. Use contingent motor imitation - an exact, reduced, or slightly expanded imitation of child's motor act immediately after the child's production to establish early turn-taking. Use contingent vocal imitation - following a child's vocalization with a partial, exact, or modified adult vocal production (child says "aah & adult says aah")

What are the communication skills typically seen in developing toddlers 24-36 months?

Average expressive vocabulary size at 24 months is 300 words (+/-150); word classes include, a lot of variation - Object, action words - Kinship terms - Spatial terms - Question words - Color, shape words - Grammatical morphemes (ing, ed with overgeneralization), verb phrase marking emerges; some overgeneralization - Grammatical forms for sentences such as questions, negatives are learned - Sentence length is 3-5 words - Intelligibility increases from 50% to 70%

Natural Consequences Include:

Be sure the child achieves any intent expressed. If the child expresses a protest, honor it by ceasing the protested action. Provide any object the child requests and attend to anything on which the child is seeking joint attention. Provide acknowledgement of communication. Smile, look at, or comment on any intentional behavior of the child Make sure the child knows the message was received. Provide linguistic mapping. Use simple language to "translate" a child's nonverbal intention to words. If the child holds up a cup, respond, "It's a cup! I'm glad you showed me!"

The transdisciplinary assessment approach would include.

Child interacts with one adult: team members suggest assessment activities and observe assessment a. One adult acts as a facilitator while the other professionals observe & take notes. b. Model used initially to decide if client is eligible for services c. Once eligibility is determined the professionals, like SLP, would do more in depth assessments to plan for intervention.

Words chosen on the basis of a child's current knowledge are included in the context of play where opportunities are given for child to incorporate and imitate words. Child is not required to imitate adult model but if they do generous praise occurs. This is an example of what method?

Child-centered.

What assessment is needed when children are identified later or during the emerging language period?

Children identified later or during the emerging language period will require assessment to determine current strengths and needs a) Assessment is needed with children identified later. i. See if they are eligible ii. Determine strengths and needs

Using drill, drill play or clinician directed modeling where a child repeats back what is said is an example of what type of method?

Clinician directed.

What does current research suggest about the diagnosis of Autism or Autism Spectrum Disorder?

Current research however suggests that a diagnosis of Autism or Autism Spectrum Disorder can be made by a team of highly qualified professionals that are specifically trained in assessment of Autism during a child's second year.

If a toddler is suspected of having Autism he will almost always display deficits in communication. What are some of the deficits you may see?

Delayed acquisition of spoken language Depressed rate of verbal communicative acts Delayed development of pointing gestures Restricted range of communicative behaviors Deficits in pretend and imaginative play

An example of representational gestures are:

Do not manipulate objects; a form is used to stand for a referent. Ex. Flapping arms to represent a bird.

The multidisciplinary assessment approach would include.

Each professional does independent assessment a. Team come together and discuss findings and plan interventions with parents.

Why does variability to obtain services for 0-3 year children old exist between states?

Eligibility determined by states a) Variability between states exists because individual states determine qualification for services. Children identified later will assessment to determine current strengths and needs.

Once expressive vocabulary reaches approximately 50 words, what should be encouraged?

Encourage word combinations.

Building Social Routines includes:

Engage the child in repetitive, predictable games, such as "patty-cake" or "Peek-a-boo"; encourage parents to play the game at least once a day with the child. Vary the game slightly with corresponding change in the pace of the song.

Give an example of a comprehension strategy masking deficits in receptive language.

Ex: A mother and a child are on a walk. The mother sees a horse in the pasture and stops to point it out to the child. The mother then says, "Look at the horse." The child looks in the direction the mother is pointing. The mother infers that the child understood the direction. Then say they see a dandelion in the road and the mom stops to pick it up and blows the seeds into the air. Then the mother turns to the child holds the dandelion in front of the child and says, "Your turn, you blow." The child follows the direction. The parent is giving a lot of contextual cues that she may not be considering. The child is able to use many comprehension strategies in order to follow the direction.

T/F All children are able to function at the communication level that is related to the chronological age?

False, some children function at this level and there chronological age is greater but functioning at the Emerging Language Level.

T/F Autism has always been diagnosed before age 3.

False, until recently Autism was diagnosed before age 3.

Table 7.4 listed Important Gestural Behaviors in the Identification of Developmental Disorders what were they?

Frequency Type: Disabled toddlers use fewer gestures than typical peers. Onset of pointing predicts language development. ASD & Downs late to acquire pointing. Communicative Function: Ltd. variety of gestures (esp. for purpose of joint attention & social functions) Toddlers 18-24 months associated w/ later autism diagnosis or other disabilities. Coordination of gesture w/ gaze & vocalization: By 15 months typical children combine gestures with gaze & vocalization. Lack of gaze w/ vocalization = developmental delay and or ASD. Transition from contact to distal gestures: Failure to acquire gestures to indicate objects at a distance associated with dev. disorders. Transition to words: by 16 months typical toddler use words & gestures to name objects, 20 months words & names predominate. Children who continue using gestures to label objects after 20 months may have language delay.

If a child fails an autism screen what should be the next step?

Further testing is needed.

Why are gestures an important part in early childhood development?

Gestures have been shown to be highly related to language in early development. -Most children rely on gestures before their verbal abilities develop. In this regard, gestures can be an important prognostic indicator for children with delayed language.

_______________ the most common form of communication from about 8-12 months of age.

Gestures. By 12-18 months gestures are combined with word like vocalizations. By 18-24 months you'll see conventional words or word combinations beginning to be used.

Organizing environment so that objects and activites are requested or commented on would be an example of a Milieu teaching approach used in what method?

Hybrid

An example of how you would find the linguistic level that a child should be comprehending and use appropriate strategies for assessing comprehension at the 18-24 month range.

In the 18-24 month stage you would expect a child to be able to follow agent/action instructions. You could have the same group of items and say, "Kiss the apple." In this example you are using an unexpected combination and that would be better than saying, "Hug the bear." Or "throw the ball."

When an adult engages a child in a play situation and a child gives a one word utterance that is expanded upon by clinician into a 2-word phrase. Example "eat", "Yes, the doll eats." This is an example of

Indirect Language Stimulation used to develop word combinations, a child centered (CC) approach.

Some predictors and risk factors for language growth in toddlers that need intervention from Box 7-1 include:

Language Production: small vocab for age, few verbs, lots of general verbs (make, go, get & do) Language Comprehension: presence of 6-month language delay, comprehension deficit w/ large comprehension gap. Phonology: few prelinguistic vocalizations, ltd. number of consonants, ltd. variety of babbling & reduced babbling. fewer than 50% consonants correct. Imitation: Few spontaneous imitations, reliance on direct modeling Nonlangauge Play: Primarily manipulating & grouping, little symbolic play. Gestures: few communicative gestures or symbolic gestural sequences. Social Skills: Reduced rate of communication, behavior problems, interacts more with adults than peers.

Bishop made recommendations for multidisciplinary diagnostic assessment of ASD in toddlers. What were some of his recommendations?

Medical Examination: Rule out hearing loss, family hx, genetic testing, & neurological exam. Parent Report: Thorough developmental Hx, Structured interview gathering info on social, communicative, play, adaptive skills, as well as restricted & repetitive behaviors. Child Observation: Observe social, communicative, play and repetitive behaviors in the context of play. Then confirm that findings are typical behavior with parent or caregiver. Language & Developmental Testing: Assess expressive vocab & any word combinations present, Assess response to name, assess receptive vocab & understanding of simple word combos, evaluate find & gross motor skills, evaluate adaptive behavior.q

What are some the Screening Instruments for ASD in Toddlers listed in Box 7-7

Modified checklist for Autism in Toddlers Early Screening for Autism Traits Pervasive Developmental Disorders Screening Test - II Screening Test for Autism in 2-year-olds Stone

Arranging the Environment Teaching Method includes:

Place desired material in view but out of reach. Place materials where adult assistance is necessary to get them Violate the expected order of events.

An evaluation from a child in the emerging language stage will include assessments on.

Play and gesture Intentional communication Language Comprehension Speech-Motor Development Phonological Skills Lexical Production Semantic-Syntactic Production

An example of symbolic gestures are

Play schemes, actions carried out on an object to depict the object & its function. Ex. Holding a toy phone to ear.

What is one of the easiest interventions to teach parents in the preliteracy stage?

Provide preliteracy opportunities. Begin this intervention by: - Provide families access to books: Many early intervention programs have lending libraries - Encourage families to select books that are developmentally appropriate and attractive to toddlers - Teach parents routine interactive reading strategies Ex: Pointing out picture to print connection (If there is a picture of a bear on the page and the word says "Bear" this is bear and point to the word. Using cloze procedure: Ex: After a book has been read a couple of times or if there is a predictive element in the book the parent waits for the child to finish part of the sentence. a) Book Brown Bear, Brown Bear = Can use a Cloze procedure by saying, "Brown Bear, Brown Bear what did you see? I see a red bird looking at _____. Child says, "me." - Encourage parents to use exaggerated intonation and stress during reading to highlight important elements in the text - Help parents develop play activities around the themes from storybooks read in the home. - Help parents begin to expose older toddlers to decontextualized talk relating the stories they have heard.

Use Specific Consequences includes:

Provide the following specific consequences in teaching episodes that are brief, positive, and embedded within the ongoing interaction.

What is the name of the assessment tood designed to probe for Autism specific behaviors?

Results from tests such as the ADOS (Autism Diagnostic Observation Schedule) or the Autism Diagnostic Interview will provide information that may lead to a diagnosis of Autism. ****Specific training on these tests must be given before a professional can make the diagnosis of Autism. ***

A clinician teaches a finger play like "Where is Thumbkin?" After singing the song many times the lyrics are altered to "What is Thumbkin?" and delaying production of the song. If child corrects clinician saying, "No! Were pinky?" lavish praise is given. This is what type of therapy method?

Script therapy, Hybrid approach

When examining range of semantic relations expressed in multiword utterances use the Semantic Relational Categories Used by Brown (1973) to Account for the Majority of the Word Combinations in Toddlers' Spontaneous Speech give examples of Table 7.7

Semantic Relation Example - Attribute-entity: Big shoe - Posessor-possession: Mommy nose - Agent-action: Daddy hit - Action-object: Hit ball - Agent-object: Daddy ball - Demonstrative-entity: This ball - Entity-locative: Daddy chair - Action-locative: Throw chair - Recurrence: More milk -Nonexistence, denial: No cookie -Disappearance: All gone cookie

Who mandates services to children 0-3?

Services managed by individual Family Service Plan (IDEA) States provide from 0 - 3 services to this population.

What are the Guidelines for Play Assessment mentioned in table 7.2

Symbolic play Level 1) <18 mo. Presymbolic scheme: No pretending, serious rather than playful. Ex: Picks brush up, touches to hair, drops it. 2) 18-24 mo. Autosymbolic Scheme: Pretends, playful. Ex: swishes broom on floor. 3) 24-36 mo. Single-scheme symbolic games: Pretending at activities of other people objects such as dogs. Ex: Feeds doll, pretends to read a book. 4) 24-36 mo. Combinatorial symbolic games: Pretend is related to several people. Ex. Drinks from toy bottle & also feeds doll toy bottle. Also, multischeme combinations, holds telephone to ear & dials. 5) 24-36 mo. Hierarchical Pretend: Planned single-act & Multi-act symbolic games Ex. finds the iron, sets it down, searches for cloth, tosses aside objects, finds cloth & irons cloth.

For children with less than 50 words what is the first step in increasing phonological skills?

The first step in increasing phonological skills is to engage them in: a) back and forth babbling games b) Start by imitating what the child can say c) Slowly introducing consonants for the child to imitate

What are some examples of Prelinguistic Milieu Teaching Methods?

The prelinguistic Milieu Teaching Methods are also suggested for increasing the frequency of Intentional Communication. These involve: - Arranging environment Ex. Placing desired materials in view but out of reach - Following the child's lead Ex. Attend to and talk about toys selected by the child - Building social routines Ex. Patty-cake, peek-a-boo - Using specific consequences Ex. Providing acknowledgement of communication

When selecting consonants for a child to use what is important to keep in mind?

When selecting which consonants for the child to use you want to keep in mind the order of acquisition by normally developing children. ii. You will want to begin with sounds like nasals /m, n/ or stops like /b, p, d/

Prompts Include:

Time delay prompts: Nonverbal prompts that interrupt an ongoing turn-taking routine (While rolling a ball back and forth adult holds ball instead of rolling it back and waits with expectant look for the child to initiate a request.) Gaze Intersection: To establish eye contact, adult moves his head into the gaze of child. This is faded out as the child begins to engage in eye contact more regularly. Verbal Prompts: Attempts to elicit communication, such as open-ended question (what?) or directive statement (Look at me?)

When developing receptive language training parents to use what strategy is an important target for intervention?

Training parents to use Indirect Language Stimulation is a very common strategy to implement when the target for intervention is developing receptive language. Hopefully, you all recall the video Oh Say What They See from the last unit. This video represents the most common ILS or Indirect Language Stimulation techniques.

When a child is referred for assessment because they are not talking it is the SLPs job to consider other forms of communication the child might be using, T/F?

True, for children with little spoken language it is important to assess intentional communication. We want to first look at a range of communicative functions. Even if the child is not verbalizing in a conventional way. - Use primarily for children with little spoken language to assess communicative basis for speech.

T/F Assessment tools for toddlers in the prelinguistic age range are also appropriate for suspected toddlers having ASD?

True, the assessment tools that are used for other populations in this age range are also appropriate for the suspected population that has ASD.

T/F Even if a parent reports that a child understands everything that is said around them very well, it is important to assess receptive language skills or comprehension in the emerging language stage.

True.

Child says, "doggy" and clinician responds to incomplete utterance w/ a response like "Where is the doggy?" If child responds saying "bed" clinician would expand saying, "Yes, the doggy is in the bed." The child is not required to imitate the clinician. This is an example of...

Vertical structuring, hybrid approach.

Models include:

Vocal Models: Delayed imitations of sounds that the adult has heard the child use. If the child is heard saying "ba" for example the adult can use "ba" at another time to try to elicit vocalization from child. Gestural Models: Encourage the child to use presymbolic gesture by modeling them at appropriate times (if plane passes overhead, adult can point up to it, as a model of nonverbal commenting.)

When assessing semantic-syntactic production what should be assessed first?

We first want to assess the relative frequency of word combinations vs. single word productions. In other words, we want to see more word combinations than just single words as we are looking over the communication sample. Things we are looking for: - At 24 months, looking for half of the utterances to contain word combinations. - MLU of 1.5 or above ****If the above two are true then you can be confident that the child at 24 months is progressing appropriately.

If a child is NOT demonstrating age appropriate play and gesture skills what needs to be targeted?

We will want to target those in therapy. 1) We want to make sure that the child is demonstrating reciprocal behavior. This Includes: - Reciprocal Behavior - Turn-taking - Back and forth babble - Peek-a-boo games

Which Deictic Gestures are the first that SLPs want to see?

With regards to gestures, we first want to see deictic gestures such as showing or giving a parent a toy, or pointing/ reaching for a desired object that is out of the child's reach. - Showing, giving, pointing, reaching.

An example of how you would find the linguistic level that a child should be comprehending and use appropriate strategies for assessing comprehension at the 18-24 month range.

a) A child who is 18-24 months should be able to understand agent/action/object combination. You could say something like, "Have the bear kiss the mom." The child would need to grab the bear and have the bear kiss the mom.

What are the risk factors that are identified at birth that make children 0-3 years eligible for early intervention services?

a) Children born prematurely b) Born with a low birth weight c) Those with FAS, drug exposure d) Hearing Impairment e) Genetic disorders f) Cerebral Palsy

There is a strong correlation between phonology and lexical development, SLPs need to what sounds a child can produce to help them choose words a child can learn. Discuss how you would do this.

a) Collect consonant inventory from communication sample. This is especially important as we are establishing a first lexicon we want to pick words that contain consonants the child is able to produce so that the words are easy for the child to say. b) Analysis of phonological skills of child will tell us if the child has a severe speech delay which will impact how we attack therapy. - Use number of consonants in inventory to assess severity of speech delay - Want to know if child is producing an adequate number of syllables for his age. 1)) Referring to CV patterns discussed earlier, CVC... 2) Assess relational phonology (e.g., McIntosh & Dodd, 2008) this is comparing what the child produces with the adult form. Ex: A child at 24 months should be approximately 70% accurate in how they produce consonants in speech.

What are the risk factors that are identified at 18-36 months identified later through Child Find?

a) Include children with fetal alcohol effects and perhaps weren't identified at birth because symptoms not severe enough b) Fragile X syndrome, effects show up later c) Mild or unidentified hearing loss d) Autism spectrum disorders e) Those with delayed language development.

How can SLPs be effective members of a transition team during the emerging language period?

a) Provide families with information and support while in transition planning. b) Set aside time to work with team members both from early intervention and preschool service providers to prepare a timely transition plan c) Share information about adaptations, accommodation, resources, and developmentally appropriate activities with preschool staff. d) Important that we actively help preschool staff prepare necessary services and supports for successful preschool placement.

Assessment during the emerging language stage is very comprehensive, what needs to be evaluated and prioritized?

a) Want to evaluate all major aspects of communication to make sure we aren't missing anything. b) Early intervention has proven to be very effective. It is important that we assess across the board to detect delays in development. c) Want any areas of need to be prioritized and appropriately addressed in therapy.

Once a child is at this level we can begin working on conventional and symbolic play by:

a) We want to increase a child's ability to participate in play schemes. Ex: Pretending to prepare food in a play kitchen; pretending to drive a car around a city made of blocks. - Pretending/play schemes

When developing the first lexicon it is important that the first words are ________________ and fulfill a ______________ ________________ of communicative purposes.

functional, broad range

When using a worksheet to provide a summary of a child's performance in terms of intentional communication the most common mistakes made using a coding system is being too ________________ in attributing communicative intent.

generous

Name 3 play assessments highlighted within chapter 7.

i. CSBPS (Communication and Symbolic Play Scale) will get to know this test well as we'll be completing an assignment on for this unit. ii. Play Scale (1997) - Shown in part on Table 7.1 of text iii. McCune (1995) assessment Table 7.2

Examples of deictic gestures include:

showing, giving, pointing, ritualized requests such as reaching.