Intervention Flashcards
How do you prioritise goal setting?
Highest priority: forms and functions child uses in 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: forms and functions used in 50 –90% of required contexts. Forms that the client does not use at all and does not demonstrate understanding of in receptive task formats.
Important to also choose goals that will be efficient in increasing child’s ability to communicate.
How does the ZDP relate to goal-setting?
ZPD “fits” within the Social Interaction Theory of language development: “adult mediation plays a role in helping children construct knowledge of language and the world”.
The ZPD is the distance between a child’s current level of independent functioning and potential level of performance.
Goal is to provide examples language forms and functions that are slightly advanced of the child’s current capabilities. (Goals that are within reach with some help).
What will you consider in selecting goals?
Developmental –order of typical acquisition of skills
The degree to which the targeted behaviours will increase the child’s ability to communicate
The areas of most concern to the child, parents/SOs, ECEs
The frequency with which the behaviours naturally occur in everyday activities in which the child is involved.
What is a clinician-directed approach?
SLP specifies:
•the materials to be used
•how the client will use the materials
•the type and frequency of reinforcement
•the form of responses to be accepted as correct
•the order of the activities
• all aspects of the intervention
Example of training protocol:
- SLP gives instruction e.g., “Say …. after me.”
- SLP presents stimulus
- SLP waits for child to respond –gives sufficient time
- SLP presents reinforcement and/or feedback
Three major types of clinician-directed activities:
- drill
- drill play
- CD modelling
What are the advantages and disadvantages of clinic-directed interventions?
Advantages:
- Maximises opportunities for child to practise new forms.
- some children may respond better to clinician directed (e.g., children with ASD) –clear instruction and criteria
- large literature of research studies supporting effectiveness in eliciting a wide variety of new language forms
Disadvantages:
- “unnatural” – dissimilar to the contexts in which language is used in everyday conversation
- targets may not spontaneously be incorporated into everyday language use (even when reached criterion levels
What is child-centred intervention approach?
Opposite end of the continuum from CD approaches in terms of naturalness, degree of SLP control, use of external reinforcement •SLP arranges an activity so that opportunities for language occur as a natural part of play and interaction
•No tangible reinforcers
•No requirement that the child provides a particular response to the SLP’s language
•Child is in the driver’s seat
SLP selects materials, but does not direct activity
•SLP follows child’s lead: →does what child does →talks about what child is doing / talking about
•SLP has to learn to wait and respond to child
•Waiting for child to talk and/or express communication intent (sometimes SLP has to interpret)
•Responds to behaviour in a way that models communicative language use that is within the child’s ZPD
SLP reacts to child’s behaviour, placing it in a communicative context and giving it a linguistic mapping •SLP does mapping using a variety of indirect language stimulation techniques: 1.self-talk 2.parallel-talk 3.imitations 4.expansions 5.extensions 6.build-ups and breakdowns 7.recasts
Examples:
- Indirect language stimulation
- Hanen program
What are the advantages and disadvantages of child-centred approaches?
Advantages:
May be good approach for children who have behaviour problems May be good approach for passive children
May be a good introduction to intervention / may be a good adjunct Natural and enjoyable play -fun
Significant others see how actions & objects are mapped onto words in familiar contexts
May be good starting approach for child with minimal language
Disadvantages:
Some SLPs do not like approach relinquishing control
High level of intensity i.e., one remark per minute
What are hybrid approaches?
- Unlike CC approaches (which focus on general communication) hybrid approaches target one or a small set of specific language goals.
- The SLP maintains most of the control in selecting the activities and materials, but does in a way that tempts the child to make spontaneous use of utterances being targeted.
- The SLP uses linguistic stimuli not only to respond, but to model and highlight the forms being targeted
Examples:
- Milieu therapy
- Focused stimulation
- Script therapy
What is family centred pracitce?
Families involved in intervention provision and planning.
Primary decision maker and client - family.
Questions like:
If you could focus your energies on one thing for your child right now what would it be?
What would you like the accomplish in 6 weeks/6 months?
How will you know your child has made progress in the way you describe?
What is the descriptive-developmental model?
Also known as “Communication-Language Approach”
•Describes child’s current level of language functioning in terms of: →meanings expressed, and appropriate language in context →use of syntactic rules and morphological markers →pronunciation of sounds, and knowledge of phonological rules →appropriate use of language in social contexts
i.e., content, form and use
What are the benefits of family centred service?
- Increased knowledge about development
- Increased participation in therapy home program
- Better psychological well-being
- Feeling competent as a parent
- Enhanced self-efficacy and sense of control
- Individualised family outcomes
What are the service delivery options?
Direct individual intervention
Indirect intervention (i.e. agents of therapy →parent administered interventions)
Group therapy
Intensive intervention
Consultation and education –parents; early childhood educators; child health nurses; GPs
Home visits
Kindergarten/childcare visits
What are some important points about early social interaction?
Sustained mutual eye gaze is an important sign of positive interaction.
Interventions involve exploring variations of timing, positioning, and comforting.
Watch for symptoms of hypersensitivity to tactile and other sensory stimuli.
Desensitization techniques: controlled exposure to touch / noise to reduce sensitivity over time.
Discuss reciprocal dialogues and imitation in early intervention.
Engaging in mutual attention through facial expression and imitation.
Technique: encourage parents to put into words what they think their child would say if they could (interpreting).
Technique: observe-and-match technique help parents learn to match their child’s actions and interests
What stage of development do cause and effect toys relate to?
Piaget’s sensorimotor stage (birth - 2 years).
