lang dis.: overview of tx & infants Flashcards
the continuum of naturalness
-organizes therapy based on similarity to real life
-critical to meeting the needs of client
most natural
child-centered
-indirect language stimulation
-daily activities
-facilitated play
in the middle
hybrid
-milieu therapy
-focused stimulation
script therapy
-interactive book reading
*more structured or scripted
least natural
clinician directed
-drill
-drill play
-modeling
direct teaching
-discrete trial training
*good for school-age that need that structure
follow the child’s lead
CCT
the child decides what to play with and how
wait & respond
CCT
use cues from the child to initiate an exercise or model a form -> interpret an action as an intention to communicate
self talk and parallell talk
cct
self -> we describe our own actions
parallel -> we give play by play of childs actions
*neither require child to talk
imitation
cct
imitate what the child says
expansions
cct
add grammatical markers to make an acceptable adult utterance.
*client is missing grammar, you fill it in adding the grammar
semantic elaborations
cct
add semantic info to a child’s remark.
*ex. child says doggy house, you say “the dog is in the house! he goes in abd out!”
buildups and breakdowns
cct
focus on syntax by saying things in different ways
recasts
cct
pragmatically appropriate response to child that models a grammatically correct utterance. recasts are like expansions but add the requirement that you naturally pass the conversational turn
*adds grammar but more naturalistic, like in conversation
verbal reflective question
cct
-recasts that repeat part of the child’s utterance but pass the conversational turn.
*doggy house is responses to with “the doggy is in the house isnt he?”
vertical structuring
cct
clinician uses incomplete child utterances to build complete, grammatical utterances
*would want to use with client that has 2-word utterances
3 characteristics of hybrid therapy
- target one or a small set of specific language goals that are identified, perhaps through criterion-referenced procedures
- clinician retains control materials necessaru to create or intorudce language goals
- prepared lingustic stimuli are used to respond to child’s communication and to model and highlight the forms being targeted
focused stimulation
ht
tempt child to use target forms; use a high number of models, more than is natural in typical conversation (pushing the good models)
milieu therapy
ht
3 components
1. environmental arrangement aka communicative temptations (taking a toy, handing it to the client, and waiting)
2. responsive intervention
3. conversation based contexts
incidental teaching
ht
arrange the environments with things the client needs but that are out of reach. the clinician uses focused attention, making eye contact and waiting
*tell me what you want
mand-model
ht
a mand is a request from the clinician for an utterance
*something they can say
script therapy
ht
common routines the child is familiar with. for example, passing out nametags or getting ready for story time. 2 options: introduce cloze procedure or disrupt the routine
interactive book reading
ht
reader uses 1) commenting, 2 asking questions, 3 responding by adding a little more, and 4 giving time to respond o enhance language input, structure is provided by the book
clinican directed therapy
the clinician specifies the materials, how the client will use them, the type and frequency of reinforcement
-appropriate when intellectual deficits may impede incidental or more natural learning
discrete trial training
cdt
heavily structured events or trials that are rpeated frequently
-salient targets and no distractors
explicit instructions
telling then what you want them to do
-clients often benefit from this early in therapy (beginning a newactivity or working on a new target)
modeling
cdt
show what must be done. parents and caregivers can be allies
direct teaching
cdt
typically best for school-age children and older. quickly wears down a client’s attentional capacity
extrinsic reinforcement
reinforcement comes from outside client
intrinsic reinforcement
reinforcement comes from the client itself
prenatal risk factors for communication disorders
-fetal alcohol
-low or very low birth weight
-family hist of developmental delays
-facial abnormalities
-in utero exposure to toxins
-infection while in utero
-bicornuate uterus
genetic/congenital risk factors
-genetic disorders (williams, down syndrome, cri du chat)
-sex chromosome disorders (turners, fragile x, klinefelter’s syndrome)
nicu related birth factors
estimates place risk of developmental delays near 50% for all infants born prematurely
low birth weight
-prematurity highly correlated with small size
-small babies more likely to need intubation, ventilation, and feeding tubes
gestational age
age calculated from the first day of the pregnant person’s last menstural period to the present day
chronological age
age from birth
15-18 weeks
swallow (amniotic fluid)
27-28 weeks
weak, disorganized sucking pattern
32 weeks
stronger sucking pattern noted
34 weeks
more stable rhythm/pattern
suckling
primitive form of sucking
sucking
more mature pattern
rooting
turn head towards stimulation
phasic bite
stimulation of teeth/gums
NG tube
through the nose, down the esophagues and into the stomach
-used for short term feeding
NJ tube
through the nose, down the esophagus, through the stomach and into the small intenstine
-when feeding into stomach isnt tolerated
PEG tube
directly into stomach through a small incision in the abdomens skin
-for long term use
JEJ tube
through the stomach and into the small intense or directlly into the small intenstine
-for long term use
posturing
use an infant pillow
specalized equipment
selecting an appropriate nipple for bottles
sensory stimulation
modify tmperature and consistency
oral stimulation for feeding and outside of feeding
toothettes
-stroking side of face and cheeks, squeezing cheeks, stroking ridge of nose
environmental modifications
may need to increase/descrease stimulation
communication
eye contact
cue based care
infant cues are indicators of whether the activity ‘works’ for the infant or not. Cue based care requires caregiver to observe, interpret, and then respond
signs of physiologic instability
drooling, gulpting, nasal flaring
signs of disengagement
infant pushes nipple out of mouth
signs of co-regulated feeding
caregiver gives time for breathing
non-nutritive sucking
-not related to nutrition
-pacifier use during tube feeding; thumbs
goal is to link non-nutritive sucking to feedings (before or after) so that a baby makes a connection between sucking and the reinforcement of nourishment
kangaroo care (skin-to-skin)
-decreased length of hospital stay
-shorter ventiliation periods
-increased alertness
-enhanced sense of parent nurturance
individual family service plan IFSP
-required for children from birth to 3
-serves the purpose of maximizing child development and optimizing familys capacity to address needs
-no offical format
-must include 5 levels of functioning: physical, cognitive, social, emotional, communicative, and adaptive
