Pediatric Language Intervention Flashcards
What is the continuum of naturalness?
The extent to which the settings and activities in intervention resemble “real life” or the world outside the clinic room
What are the three basic approaches according to Fey
Clinician directed approach
Hybrid
Child-centered
Clinicians specify all aspects of intervention, AKA drill or DTI or discrete trial intervention, increase relevant linguistic stimuli/reduce irrelevant stimuli. This is also less naturalistic as the the clinician controls the environment
Clinician directed approach
Provide an example of clinician-directed approach
“Say “what’s in the picture after me”
The clinician presents picture stimuli and asks, “What is this?”
What are the advantages of a clinician directed approach?
- Maximizes opportunities for the child to produce higher number of target responses
- Effective in eliciting a wide variety of new language forms
This is more of a drill-type and structured approach. What approach is this?
Clinician directed
What is drill play
It has subsequent antecedent
What is modeling?
The child is not expected to imitate immediately
What is the child-centered approach?
Child is in the driver’s seat
Clinician chooses the materials, child directs the activity
“Following the child’s lead”
What is the goal of a child-centered approach?
The goal is to respond to the behavior in a way that models communicative language use
Not trying to elicit specific reaction
We react to the child’s behavior
What are language stimulation techniques?
- Indirect ways to facilitate language growth
- “Tempt” the child to talk more
- Good for younger clients
- High levels of intensity of input
- 1 consequating remark/minute
What kind of LST is this: “Wow. I’m building with blocks and legos. I’m putting one lego here on top!”
Self talk - describing our own actions as we engage in parallel play with the child
What kind of LST is this: “Wow! You’re building a block!”
Parallel talk
What kind of LST is this:
Child: Eat apple
Clinician: The girl is eating the apple
Expansion - take what the child said and add the grammatical markers and semantic details
Sometimes called recasts
What is an extension?
- AKA expatiations
- Add some semantic information
- Child: Doggy house
- Clinician: Doggy went inside or Yes, he got cold.
- Adult extensions → significant increase in children’s sentence length
The clinician not only expands the child’s utterance by making it grammatically correct but also adds new semantic information that wasn’t part of the child’s original sentence.
Extension AKA expatiations
What are consequating behaviors?
- Imitation, expansion, extension
- Decrease amount of info the child has to process
- Applies ZPD
- Gives children more mature linguistic forms for their ideas
What LST is this? Break into several phrase-seized pieces that overlap in content
Build ups and breakdowns
Hybrid approaches
- Target one or a small set of specific language goals
- Maintains a lot of control but does so in a way to tempt the child to make spontaneous use of targets
- Clinician uses linguistic stimuli not just to respond to the child’s communication but to model and highlight targeted forms
What is focused stimulation?
- Carefully arranges the context of interaction so child is tempted to produce utterances
- Clinician provides very high-density models of the target forms in a meaningful communicative context
- Only tempted but not required to say. Respond contingently
- Effective for improving comprehension of a form, and production
What hybrid approach is this:
The clinician repeatedly models a target structure to stimulate the child to use it. This is usually done during a play activity that the clinician designs to focus on a particular language structure (e.g., the plural morpheme -s). The clinician uses various stimulus materials, talks about them, and repeatedly models the plural constructions “Look, here are two pigs. I see two pigs here.” The clinician does not correct the child’s incorrect responses but instead models the correct target.
Focused stimulation
This is a form of expansion used like focused stimulation to highlight target structure but it is less naturalistic than standard LSTs/LFTs, it is a specific nonlinguistic stimulus, and targets a particular form. It is also a naturalistic response from the clinician not requiring imitation. Target is early developing language forms. Child’s incomplete utterance → contingent question
Vertical structuring
A speech-language pathologist is working with a 3-year-old child with a language delay. The child says, “Dog eat.” The clinician uses vertical structuring to facilitate language development. Describe how the clinician might use this technique in this context and evaluate the effectiveness of vertical structuring for promoting the development of early language forms compared to other intervention strategies such as focused stimulation or recasting. In your response, discuss the potential advantages and limitations of vertical structuring in fostering syntactic and grammatical development in young children.
A. The clinician asks a contingent question like, “What is the dog eating?” and after the child’s response, expands on the child’s utterance by saying, “Yes, the dog is eating food.” This method is effective because it encourages imitation of complex sentences, which makes it more beneficial than recasting for promoting sentence complexity in natural conversations. However, vertical structuring may be less engaging for young children because it relies heavily on structured prompts.
B. The clinician uses a more naturalistic approach by modeling the correct utterance, “The dog is eating,” without directly asking a question. Vertical structuring here is advantageous for fostering spontaneous language use, especially when compared to focused stimulation, but it may limit syntactic development because it doesn’t directly prompt the child for a response.
C. The clinician asks, “What is the dog doing?” to prompt the child to elaborate on the utterance. After receiving the child’s response, the clinician models a more complex sentence, such as, “Yes, the dog is eating food.” Vertical structuring is effective for building on incomplete utterances and promoting sentence expansion. However, it may not be as beneficial for encouraging the use of new vocabulary as focused stimulation, which targets specific forms repeatedly.
D. The clinician repeats the child’s utterance exactly, “Dog eat,” and waits for the child to self-correct. Vertical structuring relies on the child’s ability to recognize and self-correct errors. While this method can encourage critical thinking, it may be less effective for younger children who require more direct language input, unlike strategies like recasting or focused stimulation that offer immediate language models.
Answer: C. The clinician asks, “What is the dog doing?” to prompt the child to elaborate on the utterance. After receiving the child’s response, the clinician models a more complex sentence, such as, “Yes, the dog is eating food.” Vertical structuring is effective for building on incomplete utterances and promoting sentence expansion. However, it may not be as beneficial for encouraging the use of new vocabulary as focused stimulation, which targets specific forms repeatedly.
What type of hybrid approach is this:
Material: A picture of kids playing at the park
Clinician: Look at this. What do you see?
Client: Play
Clinician: Yes, there are kids playing. What are they playing?
Client: Tag
Clinician: Yes, they’re playing tag. The kids are playing tag.
Vertical structuring
What is milieu communication training?
- Uses child’s interest and initiation
- Use imitative cues and extrinsic reinforcement
What are the three major concepts of milieu communication training?
- Environmental arrangement
- Responsive interaction
- Conversation-based contexts
→ Implements incidental training: things the client wants or needs to complete a project are visible but out of reach
What is incidental training?
- Things the client wants or needs to complete a project are visible but out of reach
The child is points at the desired object. The clinician responds by focused attention–going to the child. When the child does not respond or say anything, the clinician will ask a question, “What is that?” If the question produces a target response, the clinician will provide a confirmation, which includes a model of the target form
Child: Want cookie
Clinician: Oh, you want the cookie. Here it is.
However, if the question fails to produce the target response a prompt is provided:
Clinician: Say, “I want a cookie” If not, one more attempt to prompt is made. If this fails, the child gets what they want. The clinician then tries again on the child’s next attempt at communication
Incidental teaching
This intervention technique is similar to incidental teaching but the difference is the clinician does not need for the child to initiate communication. The clinician, using attractive stimulus materials, designs a naturalistic interactive situation. The clinician will then say, “Tell me what you want.” If the child gives no or a very limited response, the clinician models the complete, correct response. If the child does not imitate the entire modeled sentence, the clinician prompts (e.g., “Tell me the whole sentence.”). The child is praised for imitating or for responding correctly without modeling and is given the item he or she wanted.
Mand-model
The child initiates the interaction, and the adult waits for this natural occurrence to prompt and expand the child’s language. The adult provides more indirect guidance, such as cues or questions.
Incidental teaching
The adult initiates the interaction and directly prompts the child to use language, often by asking a question. If the child doesn’t respond, the adult models the target language.
Mand-model
This is for children who are not yet using spoken language, developmentally 9-18 months old. The goal is to develop the basic intentional communication skills necessary for early language development by increasing the frequency, maturity, and complexity of nonverbal communicative acts
Prelinguistic milieu teaching
Goals for prelinguistic milieu teaching
- Establish interactive routines to serve as contexts for communication
- Increase frequency of vocalizations
- Increase frequency and spontaneity of coordinated gaze
True or False. Enhanced milieu teaching is effective for children who meet the following criteria:
(1) Produce some verbal imitation
(2) Have at least 10 productive words
(3) Are in the early stages of language development, with MLUs from 1 to 3.5 \
True
Activities used in enhanced milieu teaching
Choose materials of interest to child; arrange environment
Use environmental arrangement to elicit child initiations
Mirror child actions to take a nonverbal turn; pause and wait to give child a chance to take a turn
Recognize and respond to what child communicates verbally or nonverbally
Expand child utterances to those at child’s current zone of proximal development
Use models following child requests to elaborate child form
Use request or questions that give child a limited choice for responses
Use time delay/expectant waiting to elicit child speech
