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Preschool Language > Intervention > Flashcards

Intervention Flashcards

1
Q

Goal of intervention

A

1) The ultimate goal of intervention is to make the child a better communicator
2) ASHA requires that SLPs must be able to show that the change a child makes is due to intervention
3) We must establish goals carefully to make certain we are targeting what requires intervention

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2
Q

Purposes of Intervention

A

1) Change or eliminate the underlying problem
2) Change (modify) the disorder
3) Teach compensatory strategies

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3
Q

Intervention: Changing Behavior

A
  • Facilitation
  • Maintenance
  • Induction
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4
Q

Evidence Based Practice

A

“the conscientious, explicit, and unbiased use of current best research results in making decisions about the care of individual clients”

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5
Q

Internal Evidence

A
  • The characteristics of the client and family
  • Willingness to participate in a given approach
  • Family preferences
  • Our preferences
  • Our professional competencies
  • Family values
  • Our values
  • The values of the institution in which we work
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6
Q

How to approach using EBP in intervention

A
  • Formulate clinical questions
  • Use internal evidence
  • Find the external research evidence base (ASHA, Medline, Psychinfo, etc.)
  • Grade studies
  • Integrate internal and external evidence
  • Evaluate the decision made by documenting outcomes
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7
Q

Aspects of an intervention plan

A
  • The objectives
  • Processes used to achieve the objectives
  • Environments in which the intervention takes place
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8
Q

Levels of Intervention

A
  • Basic
  • Intermediate
  • Specific
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9
Q

Priorities for setting goals

A
  • Highest Priority – forms and functions child uses 10-50% of required contexts
  • High Priority – forms and functions used in 1-10% of required contexts, but understood in receptive task formats
  • Lower Priority – a. forms and functions used in 50-90% of required contexts, b. forms the client does not use at all and does not demonstrate understanding of in receptive tasks
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10
Q

Zone of Proximal Development

A

Distance between child’s current level of independent functioning and potential level of performance (what the child is ready to learn with assistance)

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11
Q

Considerations for setting long and short term goals

A
  • Communicative Effectiveness
  • New forms express old functions / new functions are expressed by old forms
  • Client phonological abilities
  • Teachability
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12
Q

Continuum of Naturalness

A
  1. Child-centered (Ex. Facilitated play, daily activities)
  2. Hybrid (Ex. Milieu Therapy, Focused stimulation, Script therapy)
  3. Clinician – directed (Ex. Drill, Drill play,
    Modeling)
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13
Q

Clinician-directed approach

A
  • Drill
  • Drill play
  • Modeling
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14
Q

Drill

A
  • SLP instructs the child concerning the response he/she should give
  • Provides a training stimulus (word or phrase to be repeated)
  • Stimuli are planned and controlled by the SLP
  • Often involves prompts which are faded
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15
Q

Drill Play

A
  • Differs from drill in that it attempts to provide some motivation into the drill structure
  • The motivating event occurs during the original training stimulus vs. after
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16
Q

Modeling

A
  • Highly structured format
  • Formal interactive context
  • Child’s job is listen as SLP models
    numerous examples of structure being taught
  • Through listening child is expected to “induce” and later produce the target
17
Q

Child-centered

A
  • May be better for children who refuse clinician-directed treatment
  • May be better for unassertive children who respond but rarely initiate communication
  • SLP organizes activities to provide child with an opportunity to provide the target response with a natural play context
  • No tangible reinforces are used
  • No requirements exist and no prompts used
  • Child directs the activity (though the SLP chooses therapy material initially)
  • SLP makes a consistent and salient match between what child is doing and the language used to talk about it
18
Q

Child-centered Approach: The keys… (4)

A
  • The SLP must learn to wait
  • The SLP may have to interpret a child’s actions as if they are attempts at communication (and reinforce with child)
  • The SLP then must respond to the child’s behavior in a way that models communicative language use
  • The SLP is not attempting to elicit specific structures but is reacting to the child’s behavior and placing it in communicative context (giving it linguistic mapping)
19
Q

Child Centered Approaches

A
  • Self-talk and parallel talk
  • Imitations
  • Expansions
  • Extensions
  • Build ups and breakdowns
  • Recast sentences
20
Q

Self Talk

A
  • SLP describes his/her own actions during parallel play
  • Ex. If child is putting balls in a bucket, SLP mirrors the action
  • While partipating the SLP says “I’m dropping balls. I’m dropping balls in my bucket. See the balls? See the bucket?, etc.
  • Provides a clear and simple match between actions and words
21
Q

Imitation

A

SLP imitates the child and kids will typically begin to imitate the imitation

22
Q

Child centered- expansions

A
  • The SLP “expands” on the child’s utterance and adds grammatical markers and semantic details to make it more adult like
  • Expansions have been shown to increase the probability that a child will spontaneously imitate at least part of the “expansion”
  • May also be called “recasts”
23
Q

Extensions

A
  • Comments that add some semantic information to a remark made by a child
  • Research indicates that extensions are associated with significant increases in children’s sentence length
  • Also called “expatiations”
24
Q

Build ups and Breakdowns

A
  • Step 1 – expand child’s utterance to a fully grammatical form
  • Step 2 – Break the larger phrase down into several phrase-sized pieces (sequential utterances that overlap content
25
Q

Recast sentences

A
  • We expand a child’s utterance into a grammatically correct version
  • Expand the child’s remarks into a different type or more elaborated sentence
26
Q

Hybrid Approaches

A
  • Target one or a small set of specific language goals
  • SLP maintains control in selecting activities but does so in a way that tempts the child to make use of utterances in relation to a target
  • SLP uses linguistic stimuli to respond to the child but also to model and highlight forms being targeted
27
Q

Focused Stimulation

A
  • Hybrid approach
  • SLP arranges the context of interaction so the child is “tempted” to produce targets
  • SLP provides multiple models
    of the target forms in a meaningful way (usually play)
  • Helpful for improving comprehension of a form as well as production
  • If target isn’t produced, SLP responds contingently and then presents other models
28
Q

Vertical Structuring - hybrid approach

A
  • Step 1 – SLP responds to child’s incomplete utterance with a contingent question
  • Step 2 - If / when child responds with another fragmented remark, SLP takes 2 pieces from child and expands into a more complete utterance
  • Less “natural”
29
Q

General features of intervention activities

A
  • Rate – Reducing our rate of speech may help the child by reducing the number of units he/she needs to process over time
  • Repetition – Repeated exposure enhances the opportunity for a child with language disorders to acquire language forms
  • Increasing perceptual saliency through prosody
  • Increasing perceptual saliency through word order
  • Complexity – Our sentences should be slightly longer than the child’s and refer to concepts that are semantically accessible to him/her
  • Obligating pragmatically appropriate responses

— Generally be mindful to use linguistic stimuli that will yield the entire response you are looking for

30
Q

Service delivery models

A
  • Consultative model – SLP determines targets, procedures, and contexts and trains parent/teacher/etc. to carryover
  • Language-based classroom model – SLP is the classroom teacher for a group of students with language disorders. SLP provides a continuous form of intervention embedded w/I context of daily activities
  • Collaborative - SLP works with one or more students with language disorders in the mainstream classroom in collaboration with the teacher.

—- May be a combination of pull out and sit in

31
Q

Termination Criteria

A

ASHA 2004-

  • Communication is now WNL
  • All goals and objectives have been met
  • Client’s communication is comparable to others of the same age, sex, ethnic, and cultural backgrounds
  • The individual’s speech or language skills no longer adversely affect social, emotional, or educational status
  • The individual uses an AAC system and has achieved optimal communication across partners and settings
  • The client has attained the desired level of communication skills
32
Q

General Criteria

A
  • (Behaviorist criterion is usually 80-90 % accuracy in a structured intervention context)
  • Paul recommends 50% accuracy in a natural language sample
  • When accuracy in a natural context exceeds 50% direct therapy may be discontinued (with a periodic check…)
33
Q

)Primary Prevention (7)

A
  • Public education
  • Genetic counseling
  • Mass screenings and early identification
  • Proper health and medical care (including immunizations and prenatal care)
  • Promote wellness in family-centered early intervention programs
  • Provide education to parents of preemies
  • Encouraging pregnant women to avoid drug and alcohol use during pregancy

Preschool Language (13 decks)

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