Final (Weeks 1 - 3) Flashcards
an umbrella term that includes intellectual disabilities and physical disabilities
developmental disabilities
intellectual disabilities limits:
cognitive (IQ) and adaptive functioning (social and practical skills)
*implications for daily life experiences
intellectual disabilities are determined by…
psychometric testing by clinical psychologist
what percentage of those with an intellectual disability are in the mild range of severity?
90%
dual diagnosis includes the co-occurance of….
both psychiatric disorder AND behaviour disturbance in addition to intellectual disability
most common diagnoses that co-occur with intellectual disability include….
ADHD
anxiety, bipolar and eating disorders
depression
schizophrenia
complete the sentence:
“it can be very hard to diagnose ______ _______ problems in those who cannot explain their own experience”
mental health
what are the dangers in diagnosing mental health problems in those who cannot explain their own experience?
danger of:
-inappropriate medication
- not recognizing a treatable problem
can lead to: isolation and withdrawal
in relation to language and cognition in intellectual disorders, what percentage of these individuals have difficulties?
50%
- 25% receptive language skills below cognition
- 25% expressive language below cognition
language in children with intellectual disabilities can be…
impaired but it varies.
follows the typical development but at a slower rate
pragmatic language patterns in children with intellectual disability include:
development slower of intentionality, intention of reading, presupposition (knowing what others know)
semantic language patterns in children with intellectual disability include:
slow rate of vocab acquisition, it is more concrete
syntax & morphology language patterns in children with intellectual disability include:
- follows same patterns with grammar, markers, less complex
- narrative skills related to receptive vocab & knowledge
receptive language language patterns in children with intellectual disability include:
- uses context to understand (context reliance)
- sentence recall impaired
expressive language language patterns in children with intellectual disability include:
perseveration (single focus on a specific topic)
attention in intellectual disabilities and the impact on language:
difficulties with:
- scanning array of stimuli
- selecting stimuli to focus on
discrimination in intellectual disabilities and the impact on language:
difficulties with:
-knowing which aspects of stimuli are important
-relevant/ irrelevant info
simple vs. conditional discrimination
organization in intellectual disabilities and the impact on language:
difficulties with:
- forming association between words to recall another word
- items that go together
memory in intellectual disabilities and the impact on language:
difficulties with:
- retrieving info from long term memory
- short term memory
- inefficient rehearsal of info
- language related info harder than non-linguistic
generalization in intellectual disabilities and the impact on language:
difficulties with:
-transfer of learned skills to new context (needs to be exclusively taught)
DSM V - ASD
intro persistent deficits in:
-social communications and social interactions across contexts
DSM V - ASD
three main points of persistent deficits
- nonverbal communication
- social and emotional cooperation
- developing and maintaining relationships appropriate to development level
DSM V - ASD
fill in the blanks:
“________ or _____ patterns of behaviour, interests and activities”
restrictive / repetitive
DSM V - ASD
two of the following patterns of behav/interests:
- stereotyped/ repetitive speech, motor movements
- excessive adherence to routines, ritualized patterns of verbal/nonverbal behaviour, excessive resistance to change
- high restricted/ fixated interests; abnormal intensity or focus
- hyper/hypo reactivity to sensory input
DSM V - Social Communication Disorder
includes difficulties with:
- social use of verbal and nonverbal communication diffs:
- appropriate manner for context
- changing communication to match context of listener
- following rules for convo and story telling
ASD prevalence
1 in 68
more common in males
common co-morbid conditions with ASD
anxiety disorders, mood disorders, OCD, tourette, fragile x, ADHD
language profiles in ASD can be highly ______
variable
75% of those with ASD have some type of _____ delay
language
commonalities with ASD and language related to communicative functions:
restricted communicative functions (most commonly used is requesting)
problem behavs often linked to limited language ability
unconventional verbal behaviour related to ASD:
- echolalia (immediate or delayed)
- perseverant utterances (incessant questioning)
- stereotypical speech, scripting, idiosyncratic
other language behaviours related to ASD
- grammatical errors (pronoun reversal)
- poor comprehension (semantic relations not understood, abstract concepts, sarcasm etc.)
social communication and ASD commonalities:
- limited responding to nonverbal messages (gestures, nuances, hidden meaning)
- not turn taking typically
- not initiating interactions
- not following typical conversational rules: off topic, interrupting, focus on fav topic, not asking Qs
Examples of restricted, repetitive patterns in ASD
- more interest in object than person
- adherence to routines (can lead to OCD)
- coping with change difficult
- rituals
- singular interests
- rote learning
- stereotypical behavs (self-stimulatory)
what ability is a predictor of language outcomes?
in preschool where can these abilities be observed?
cognitive ability
- object play skills
- imitation
- joint attention, gaze following, gesture (social-cog.)
what is theory of mind?
name some early pre-cursors of TOM
TOM: knowing that another person has other thoughts that are different than your own. early pre-cursors: - looking at others - imitating other's actions -recognizing other's emotions/reason -pretending skills, socio-dramatic play
what is the theory of executive dysfunction related to ASD?
difficulty managing deviations from routines, difficulty with emotional regulation, lack of awareness of self and others, difficulty in free play
theory of weak central coherence in relation to ASD
difficulty understanding the “whole picture” – related to information integration
mind and context blindness
difficulty understanding what others think and understanding how context in social situations may guide other’s thoughts
tools that can be used to help those with ASD maneuver mind and context blindness
social stories, reading emotions
what is overselectivity?
a type of ‘tunnel vision’
singular focus on one aspect of a stimulus, while unaware of the other stimuli
what is a real life example of overselectivity with a client?
a client only being focused on the spinning wheels of a toy car
interfering behaviours; we see problem behaviours. why are these likely happening? what should we look at to determine this?
we need to look at the functions of behaviour:
- the client may have limited verbal skills and the behaviour is their only way of communicating.
- may be due to attention, denial/ removal of reinforcer, or demands placed on child
- learned behaviour
problem behaviours due to escape/ avoidance:
we see: compliance issues, poor instructional control
why are they happening?
- learned behaviour
- reinforcement at delay/ removal of activity
- compounded by: limited language skills, obsession with reinforcer
limited requesting skills:
we see: child not ‘using their words’, negative behavs in place of a verbal request
why are they happening?
- child may be able to ask for things only when they are in sight
- child may have a defective mand repertoire (history of R+ after negative behaviours can result in use of behavs)
explain why a child may not be ‘using his words’?
good receptive vocab
good expressive vocab for labeling
not being able to use words when it comes to requesting items
limited labeling skills:
what we see: limited ability to label nouns/verbs, limited ability or errors with advanced labels (concepts, prepositions, adjectives)
why is this happening?
rote or gestalt learning has occurred in the past
give a client example of rote or gestalt learning with labeling
a client learned ‘bed’ and ‘sleep’ and now they say sleep every time they see a bed.
limited motor imitation
what we see in session:
- lack of/limited spontaneous imitation of movement related to comms.
- imitation of non salient stimulus
- not visually attending to model stimulus
- prompt dependent (verbal/ physical)
receptive language issues
what we would see in session:
- limited attending to speaker
- visual scanning and discrimination issues
- limited comprehension of spoken utterances at phrase level: 1 step or multi step instructions
- limited comprehension of utterances requiring conditional discriminations
receptive language issue behaviours:
why are they occurring?
- involve multiple tasks (visual, auditory, motor)
- may need to be specifically and explicitly taught
difficulty responding to questions that do not include visual stimuli:
what do we see in session?
- limited responding ability to wh-questions
- rote responding (ex/ any Q about a dog includes the response ‘bark’)
difficulty responding to questions that do not include visual stimuli:
why are we seeing these behaviours?
- this is the most complex verbal skill to learn
- Qs involve different antecedent stimuli and change frequently (vs. pics and objects)
prompt dependency:
what do we see? when can this be seen, what settings?
- child does not respond unless clinician prompts
- can be evident in speech, language, social play, academic skills and functional activities
scrolling:
what do we see in session?
- guessing
- usually going from one previously learned response to the next etc.
- may occur with expressive and receptive tasks
scrolling:
why is this happening?
- guessed responses have been reinforced in the past
- could have been assumed ‘self corrections’ in past
difficulty generalizing:
what does this present as in session?
why is this occuring?
-diff. using target behaviour at different times, places etc.
- rote responding, and always responding in the same way (response generalization)
why? client is learning to only respond to certain stimulus conditions
issues with motivation:
what we see
- limited number of preferred items
- unusual or very strong preferred items, patterns
- stays with preferred item for short periods (fleeting MO)
- unconditional motivators may not be strong
- loss of interest of preferred item once task demanded
issues with motivation:
why are they occurring?
- linked to cognitive and sensory profile
- response effort may be too high
- reinforcement history of removal of demand when child shows lack of interest in preferred
issues with reinforcement:
what we see in session
- child may not work unless continually reinforced
- *child dependent on edible reinforcers not by social praise
issues with reinforcement:
why this happens?
- clinician may not be thinning reinforcement schedule
- clinician not specifically pairing edible and tangible reinforcement with social praise
strong obsessions:
what we see in session
- obsession with patterns or textures
- certain routines repeated
- during play child may line things up in a particular way
- may not tolerate disruption of materials
strong obsessions:
why are they happening?
- learned behaviours
- related to sensory preferences/ aversions
- may require behavioural assessment
self-stimulatory/ stereotypical behaviour:
what we see in session?
why is this happening?
-rocking, flicking hands, humming, flapping, spinning, picking etc.
why? automatic reinforcement, reinforcing value of these behaviours, may help person reduce anxiety
hyperactivity:
what we see in session?
why does this happen?
-constant movement, running, climbing, jumping, fidgeting, making noises, talking
why? ADHD common comorbidity, limited opportunity for movement
limited eye contact:
what do we see in session?
- child not looking at speaker, communication partner while making a request
- child not following eye gaze or initiating for joint attention
limited eye contact:
why is this happening?
- this is a core deficit in ASD
- may be tied to reinforcement
- eye contact may be highly aversive
sensory issues:
what we see in session?
- holding hands over ears (sound)
- not wanting to get hands wet, sticky etc.
- not eating certain foods
- running, jumping, smelling things, licking things
ABA stands for
Antecedent
Behaviour
Consequence
ABA does not mean
- drill work
- sitting at the table
- flashcards
naturalistic in session means
- daily life experiences
- variety of contexts, people, objects/ toys
- multitude of stimuli
pivotal response treatment
-environment and involvement includes:
teaching occurs in natural enviro
involvement of parents and collaboration btwn providers
pivotal response treatment
“pivotal skills lead to ____ _________ in other areas”
skill development
pivotal response treatment
pivotal skills taught:
motivation
responding to multiple cues
self-management
initiations (ultimately will lead to other comm. skills and functions)
pivotal response treatment is based on ______
ABA - ABC framework
pivotal response treatment: early language learner
- child choice
- natural reinforcers
- reinforce attempts
- intersperse maintenance (easy) tasks
- get child’s attention
- provide a clear opportunity – WAIT
early start denver model (ESDM) was developed for:
developed for intervention with young children with ASD, aged 1-3 years, up to age 5
(not meant for older children as play based)
early vocal production in ASD
- limited canonical babbling
- lower frequency of vocalization
list some developmental domains included with the early start denver model (ESDM):
receptive and expressive communication social, play skills cognitive skills fine motor and gross motor skills adaptive behaviour skills
after what age does speech development become unlikely? after what age is it very poor?
- age 5 (unlikely)
- age 13 (very poor)
speech production in individuals who have vocal phrase-level speech
unusual prosody (stress, pitch, intonation, rhythm, volume, rate of speech)
considerations for intervention that lead to functional speech:
- AAC
- vocal imitation
- sound repertoire
sound repetoire
take inventory of:
- individual sounds
- sound combinations
- prosody
early start denver model (ESDM) intervention includes ______ (number) short term objectives per domain. intervention takes place over _____ (number) weeks.
2-3 domains
12 weeks
early start denver model (ESDM) service delivery method includes:
intensive, in home
20 hours per week
parent delivered in home
early start denver model (ESDM) joint activity routines includes:
teaching opportunity every 10 seconds
object and sensory based activities
early start denver model (ESDM) borrows from ABA and PRT:
ABA: capturing child’s attention, prompting, shaping
PRT: child’s choice, reinforcing
verbal behaviour is reinforced through another ______
person —> interaction
verbal behaviour may include:
vocal speech AND non vocal means (exchanging pics, SGD, sign)
skinner’s conceptualization of a ‘word
Different functions
Defined by function not form
Functions are learned independent of each other
Speaker and listener behavior: two distinct processes
Verbal operants are functionally independent, i.e. context determines if/what verbal operant is expressed
linguistic conceptualization of a ‘word’
Once acquired person will “know” the word
In SLP -> Do they know it receptively, expressively, or both?
Syntax, morphology, phonology, semantics, pragmatics, communicative functions
Expressive and receptive related processes.
sound combinations:
- single syllables
- duplicated
- syllables with vowel/consonant change
- three syllables
stimulus-stimulus pairing
- pairing the reinforcing activity with specific sound
- inconsistent results, effects are only show to be temporary
describe the ABC’s of: mand
antecedent -desire or motivation behaviour -verbal behaviour consequences -SR+ specific to MO
ultimate goal of mand training
the child is able to request what he wants when he wants it, even if it’s not in sight
increasing the number of vocalizations and eliciting new sounds
- stimulus-stimulus pairing
- lag schedule of reinforcement
- rapid motor imitation
tasks analysis
- simple discriminations for early language learners
- SD: “give me”, “touch ___”, “point to___”, “show me.___” “where is _____”
- follow single step actions: gross motor (jump, clap, stand up, sit down, arms up, wave)
chaining
- forward chaining
- backward chaining
things to watch out for when modelling
- don’t add the schwa
- model sounds, NOT letters
- don’t repeat sounds
- do slow your speech rate but use the natural rhythm of speech
tacts for advanced learners
- ultimate goal is spontaneous labelling
- actions
- features (colours, shapes, sizes)
- function
- prepositional phrases
- class (categories)
listener responding
- following actions to do motor action:
- one component (e.g. stand up)
- two components (e.g. stand up slowly)
- two components with object (make the car go fast)
- conditional discriminations (e.g. find the red car)
in plain english, describe: tact
Saying “coffee” because you see, or smell coffee being brewed”
in plain english, describe: echoic
Saying “coffee” right after someone else has said coffee”
in plain english, describe: intraverbal
Saying “coffee” when someone asks what you like to drink in the morning”
describe the ABC’s of: mand
antecedent -desire or motivation behaviour -verbal behaviour consequences -SR+ specific to MO
setting up a manding session
- ensure you are paired
- identify reinforcers
- set up your therapy space
errorless teaching procedure for manding with children who have echoic responses
- select 4 or 5 of the most potent reinforcers and have them visible to child
- entice with one and give a small freebie
- as child is indicating he wants more of that item/activity offered…
- provide an echoic prompt (single word)
- if he repeats, give item right away and say word again
- if not, still give it.
- subsequent trials: fade the echoic prompt
- pivotal response teaching procedure for manding with children who have echoic responses
- select 4 or 5 of the most potent reinforcers and have them visible to child
- entice with one item or give a small freebie
- as child is indicating he wants more of that item/activity offered…
- wait for child to initiate request with some kind of vocalization - give item right away contingent on ANY attempt at the word and say the word
- subsequent trials: use of echoic prompt to differentially reinforce closer approximations
ultimate goal of mand training
the child is able to request what he wants when he wants it, even if it’s not in sight
describe the ABC’s of: echoic
antecedent -someone's verbal behaviour behaviour -verbal behaviour (matches) consequences -social
describe the ABC’s of: tact
antecedent -non verbal stimulus behaviour -verbal behaviour consequences -social
describe the ABC’s of: intraverbal
antecedent -someone's verbal behaviour behaviour -verbal behaviour (does not match) consequences - social
pre-requisite skills for receptive language
- orienting to speaker
- responds to name
- sustained attention to speaker
- visually attends to pictures/objects
- motor skills
tasks analysis
- simple discriminations for early language learners
- SD: “give me”, “touch ___”, “point to___”, “show me.___” “where is _____”
- follow single step actions: gross motor (jump, clap, stand up, sit down, arms up, wave)
what are the teaching considerations for receptive language?
- choose lots of easy targets and intersperse few new targets
- teach errorlessly at first
- clear the array after each trial - - vary SD (i.e. don’t always say “show me” or “give me”)
- provide powerful reinforcer
- error correction if needed
- multiple exemplar teaching (generalization)
mands for advanced learners
- ultimate goal is MO only
- mands for missing items
- more specific mands containing verb, adjective, and prepositional phrases
- mands for information
- mands for stopping/removal of aversive activity
tacts for advanced learners
- ultimate goal is spontaneous labelling
- actions
- features (colours, shapes, sizes)
- function (what things are used for)
- prepositional phrases (e.g. the cookie is on the table)
- class (categories)
listener responding
- following actions to do motor action:
manding is a…..
the reinforcement is…
demand or request for something of value (a reinforcer)
reinforcement is receipt of this valuable item/ activity
motivating operation key points
- they are transient (come&go)
- they are the most important variable in language training
- mand must be under functional control of the MO
MO’s effect on value of reinforcer: two things
too much of item is….
too little of item is…
satiation = too much, do not want anymore = not effective deprivation = had too little, , want more, receiving item now has more value = effective
establishing operations
events or conditions that: alter the value of reinforcers
AND
increases the likelihood that the behaviour that has produced the reinforcer is more likely to occur
why is mandiing so important?
when young children have no or limited manding repertoire, problem behaviour will develop, which will serve the function of mands
things we can mand for include:
preferred items (objects in sight and not in sight)
preferred actions (provide certain action, removal of aversive)
information (“where is___”)
attention (could be problem behaviour)
an echoic involves steps:
verbal imitation
child repeats exactly what is heard
reinforcement is non-specific
intraverbals for advanced learners
- ultimate goal is to answer questions such as “tell me two things about dogs”
prerequisite skills for intraverbals
- child has ~ 50 mands and tacts
- tacts
- listener responding
- divergent and convergent stimulus control
divergent stimulus
a single stimulus evokes many different responses (e.g. name some furniture)
convergent stimulus
multiple stimuli converge to evoke a correct response (e.g. couch, chair, table are all furniture)
simple discriminations
- head and shoulders, knees and …
- what is your name?
- what are some animals? (divergent)
- what can fly? (divergent)
conditional discriminations
- tell me a fruit that is red
- name an animal that has whiskers
- where do you wash your hands?
- tell me something that is not food
teaching progressions for intraverbals
- fill-ins (i.e. songs, animal sounds, associated words)
- use reinforcers (mand targets) initially
- answering Wh-questions
- answering questions that involve use of features, function, class
use tacting to teach intraverbals
e. g. “tell me a red fruit”
- pictures: strawberry, banana, red car, yellow block
ultimate goal of mand training in ABA terms
child’s mands are in functional control of the MO (pure mands).
a tact involves:
naming/ labeling something or describing the property of something that is present in the environment that the speaker can conTACT
(eg/ nonverbal stimulus that can be seen, touched, heard, smelled)
a intraverbal involves:
a verbal behaviour that is emitted about something (item, person) or a property of something that is not present in the immediate environment in response to another person’s verbal behaviour
examples of types of intraverbals:
fill in the blanks/ sentence starter
word association
answering questions
conversations
errorless teaching
- prompt immediately after you provide your instruction for new targets
- fade prompts as soon as possible
- if child makes errors and you must use error correction on 2 trials, use most prompt for remainder of session
error correction procedure with example:
Tacting and Intraverbals
SD: “What’s this?” (picture of dog)
Child errors - says “cat”
Immediately re-issue SD + 0-delay echoic prompt (prompted trial)
SD: “What’s this?” “dog”
Child says “dog”
Present 1 to 3 mastered easy tasks (distractor trials)
Then clinician re-issues SD
SD: “What’s this?” (may need to give partial prompt)
errorless teaching
Prompt immediately after you provide your instruction for new targets
E.g. What’s this? “sock” – child says “sock”
Unless pretty certain child is able to do it without prompt, prompt! (most to least prompt hierarchy)
Then fade prompts as soon as possible
If child makes errors and you must use error correction on 2 trials, use most prompt for remainder of session
transfer control of the mand from echoic to MO
- start with item visible and echoic prompt
- then item visible and partial echoic prompt
- then item visible
