Pediatric Language Intervention

Question 1

What is the continuum of naturalness?

Answer 1

The extent to which the settings and activities in intervention resemble “real life” or the world outside the clinic room

Question 2

What are the three basic approaches according to Fey

Answer 2

Clinician directed approach
Hybrid
Child-centered

Question 3

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

Answer 3

Clinician directed approach

Question 4

Provide an example of clinician-directed approach

Answer 4

“Say “what’s in the picture after me”
The clinician presents picture stimuli and asks, “What is this?”

Question 5

What are the advantages of a clinician directed approach?

Answer 5

• Maximizes opportunities for the child to produce higher number of target responses
• Effective in eliciting a wide variety of new language forms

Question 6

This is more of a drill-type and structured approach. What approach is this?

Answer 6

Clinician directed

Question 7

What is drill play

Answer 7

It has subsequent antecedent

Question 8

What is modeling?

Answer 8

The child is not expected to imitate immediately

Question 9

What is the child-centered approach?

Answer 9

Child is in the driver’s seat
Clinician chooses the materials, child directs the activity
“Following the child’s lead”

Question 10

What is the goal of a child-centered approach?

Answer 10

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

Question 11

What are language stimulation techniques?

Answer 11

• 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

Question 12

What kind of LST is this: “Wow. I’m building with blocks and legos. I’m putting one lego here on top!”

Answer 12

Self talk - describing our own actions as we engage in parallel play with the child

Question 13

What kind of LST is this: “Wow! You’re building a block!”

Answer 13

Parallel talk

Question 14

What kind of LST is this:
Child: Eat apple
Clinician: The girl is eating the apple

Answer 14

Expansion - take what the child said and add the grammatical markers and semantic details
Sometimes called recasts

Question 15

What is an extension?

Answer 15

• 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

Question 16

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.

Answer 16

Extension AKA expatiations

Question 17

What are consequating behaviors?

Answer 17

• Imitation, expansion, extension
• Decrease amount of info the child has to process
• Applies ZPD
• Gives children more mature linguistic forms for their ideas

Question 18

What LST is this? Break into several phrase-seized pieces that overlap in content

Answer 18

Build ups and breakdowns

Question 19

Hybrid approaches

Answer 19

• 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

Question 20

What is focused stimulation?

Answer 20

• 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

Question 21

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.

Answer 21

Focused stimulation

Question 22

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

Answer 22

Vertical structuring

Question 23

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 23

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.

Question 24

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.

Answer 24

Vertical structuring

Question 25

What is milieu communication training?

Answer 25

- Uses child’s interest and initiation - Use imitative cues and extrinsic reinforcement

Question 26

What are the three major concepts of milieu communication training?

Answer 26

- 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

Question 27

What is incidental training?

Answer 27

- Things the client wants or needs to complete a project are visible but out of reach

Question 28

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

Answer 28

Incidental teaching

Question 29

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.

Answer 29

Mand-model

Question 30

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.

Answer 30

Incidental teaching

Question 31

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.

Answer 31

Mand-model

Question 32

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

Answer 32

Prelinguistic milieu teaching

Question 33

Goals for prelinguistic milieu teaching

Answer 33

- Establish interactive routines to serve as contexts for communication - Increase frequency of vocalizations - Increase frequency and spontaneity of coordinated gaze

Question 34

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 \

Answer 34

True

Question 35

Activities used in enhanced milieu teaching

Answer 35

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

Question 36

Advantages of milieu teaching

Answer 36

- Lead to better generalization - Increase children’s frequency of talking both to the teacher and each other - Broad range of expressive communication targets - Long term gains - Useful for small-group or classroom setting

Question 37

What is script therapy?

Answer 37

- A way to reduce cognitive load of language training by embedding it in the context of a familiar routine - Develops some routines or scripts with the child in the intervention context

Question 38

A clinician is working with parents on home language-stimulation activities for their 3-year-old daughter Hannah, who is language delayed. Among other things, Hannah needs to increase her expressive language skills to a level more commensurate with her chronological age. Her mean length of utterance is restricted and her utterances are more typical of a young 2-year-old child. The clinician has recommended that at home, the parents use a technique in which they play with Hannah and describe and comment upon what she is doing and the objects she is interested in. For example, the parents might say, “You are making the car go fast,” or “That pig is pink.” The parents are using the technique of: Self-talk Expansion Expatiation Parallel talk Joint reference

Answer 38

Answer: D. Parallel Talk

Question 39

Maximal prompting: clinician is teaching

Answer 39

- Cues are frequent (80% to 100% of trials) support is full - Complete imitative model or explicit verbal instruction - Hand-over-hand or full physical guidance - Point or show correct target location - Provide direct, explicit instruction or metalinguistic instruction

Question 40

Moderate prompting: Client is ___________

Answer 40

- Client is practicing - Cues are intermittent (25% to 75% of trials) Support is partial - Provide: a closed set or multiple choice, a category for response, a semantic cue, cloze cues with expectant waiting, phonological cues, point or look in the general area of a correct response

Question 41

Minimal prompting: client shows use of the skill; may self monitor; clinician is coaching

Answer 41

- Cues are occasional (5% to 20% trials) support is subtle - Provide a light touch or tap to direct attention or remind - Provide verbal reminders - Provide a visual cue (picture schedule)

Question 42

What are baselines?

Answer 42

Clinician-designed measures that provide multiple opportunities for a client to demonstrate a given communicative behavior 75% accuracy or higher - not in need of remediation Below 75% accuracy - potential intervention targets At least 50% accuracy - best potential for improvement

Question 43

Highest priority

Answer 43

Uses in 10% to 50% of required contexts

Question 44

High priority

Answer 44

Uses in 0% to 10% of required but understood in receptive tasks

Question 45

Low priority

Answer 45

Uses in 50% to 90% of required contexts Does not use at all and does not demonstrate understanding

Question 46

Number of therapy doses per week

Answer 46

Dose frequency

Question 47

Number of trials or learning instances provided during a therapy session

Answer 47

Therapy dosage

Question 48

True or False. Early intervention has a primary emphasis on family involvement and education

Answer 48

True

Question 49

What is the goal of early intervention?

Answer 49

The **development of basic skills** thought to be critical to successful speech, language, and communication learning

Question 50

Age of early intervention

Answer 50

0-3 years old

Question 51

What are the primary therapy strategies for infants?

Answer 51

- Authentic learning experiences in natural environments - Modeling/stimulation

Question 52

What is localization?

Answer 52

Infants ability to demonstrate awareness of sounds in their environment by turning toward and visually searching for the source of a sound Infants conceptual grasp of cause-effect relations

Question 53

What is joint/shared attention?

Answer 53

A shared focus underlies successful communication Relationship between the adult’s utterances and the objects, actions, or concepts they represent Joint visual attention → prerequisite for all subsequent communication

Question 54

The clinician placed an attractive or noisy object in front of the infant, looked at it, and commented on it

Answer 54

Joint/shared attention

Question 55

What is mutual gaze?

Answer 55

- The **infant and caregiver look at each other during social interactions** - Attachment/bonding between infant and caregiver - Later development of the important skill of turn-taking in conversation - Immediate parental response to the infant’s initiation of eye contact results in more frequent and varied interactions Adult eye contact is accompanied by smiling and other facial expressions, touching, and novel, or entertaining vocalizations

Question 56

What is joint action and routines

Answer 56

- Occurs in play sequences known as **sound-gesture games or routines** such as peekaboo - A routine is a prepackaged or **ritualized exchange** - Clear marked beginning, middle, and end - Clearly specified positions for vocalizations/verbalization - Encourages anticipation and predictability

Question 57

Vocalization

Answer 57

- Increasing the frequency, variety, or quality of the vocalizations produced by the infant - Singing, humming, cuddling, tickling, or playing sound-gesture games such as peekaboo - Clinicians may also imitate the infant’s vocalizations in a playful manner to initiate a repetitive imitative exchange

Question 58

What are communicative intentions?

Answer 58

The meaning that a speaker wishes a message to convey

Question 59

This is where the infant discovers intentional communication and begins to express their communicative intentions through gesture and vocalization.

Answer 59

9 months

Question 60

At around this age, infants begin to understand a few familiar words

Answer 60

6-8 months

Question 61

Production of first true words occurs around the _________________

Answer 61

First birthday

Question 62

Three main consideration in the selection of target vocabulary are:

Answer 62

(1) words that can be used in different contexts (2) words that are important to the child (3) words that represent dynamic rather than static states

Question 63

This period is characterized by rapid growth in vocabulary.

Answer 63

3-5 years old

Question 64

How is focused stimulation applied at this age?

Answer 64

Provides concentrated exposure to a target form in a variety of contexts Clinician preselects a linguistic target and produces it in high concentration throughout natural and meaningful adult-child interactions The child is not required to produce the linguistic form Wide variety of targets: vocabulary, grammatical morphemes, and syntax

Question 65

What is incidental teaching?

Answer 65

This is a naturalistic approach that encourages a child to initiate communication by arranging the environment to increase the likelihood that the child will produce a verbal or nonverbal intervention target The child’s successful communicative attempts are rewarded through natural consequences such as a requested object or event The clinician also responded to the child’s communicative attempts with requests for expansion of elaboration Variations of incidental teaching include milieu and time-delay

Question 66

Floortime/Developmental, individual difference, relationship-based

Answer 66

Building the foundations of social, emotional, and intellectual capacities in young children rather than targeting isolated behaviors or skills It encourages socially appropriate child-initiated interactions With emphasis on developmental milestones, individual differences, and the relationship between the child and others in the environment A critical component of this model if family engagement

Question 67

What is the family centered approach?

Answer 67

Trains parents and other caregivers to foster the development of language and communication in naturalistic contexts The SLP functions in an indirect or educational capacity with family members Improving the child’s communicative skills and/or improving the adult family members’ ability to engage in mutually reinforcing communicative interactions with their child

Question 68

What are the 5 main areas to increase child’s print knowledge

Answer 68

- Shared book-reading and sense of story - Phonological awareness - Promoting awareness of speech sounds - Alphabetic letter name and sound knowledge - Adult modeling of literacy activities - Experience with writing materials

Question 69

Shared book-reading and sense of story

Answer 69

Engage in dialogic reading Ask questions throughout the reading activity about what has been read and what might happen next Direct the child’s attention to the printed words rather than focusing solely on picture.

Question 70

Improve the child’s phonological awareness through

Answer 70

- Reciting fingerplays - Sing songs and chants - Engage in alliteration and rhyming - Point out words that begin with the same sound - Say simple words such as “cat”; have the child think of one or two words that start with the same initial sound - Encouraged the child to recount familiar experiences that occur routinely in daily life (e.g., scripts) such as grocery shopping or getting dressed - Encourage the child to recount personal event narratives, which are event sequences experienced by someone else (e.g., Daddy cooking dinner)

Question 71

Promoting awareness of speech sounds. What is this?

Answer 71

PASS is a structured early reading program designed for preschool children It follows a consistent lesson format This can be used with typically developing preschoolers and early elementary aged children with and without disabilities

Question 72

Three instructional units that are being used would be

Answer 72

rhyming Blending Segmentation

Question 73

True or False. The rhyming lesson demonstrates an expressive task at the level of saying the words.

Answer 73

False. The rhyming lesson demonstrates a receptive task at the level of matching and recognition Choosing two pictures that rhyme from a set of three

Question 74

The blending lesson utilizes what kind of task?

Answer 74

A yes/no judgment task A child is given a word phoneme by phoneme (e.g., b-a-t) and then a whole word The child is required to indicate whether the whole-word version is the same as or different from the unblended version

Question 75

What is segmentation?

Answer 75

The child is required to produce a word using its individual sounds Example: When given the word bat the correct response would be b-a-t

Question 76

What is alphabetic letter name and sound knowledge?

Answer 76

The following order: letters in which the sound represents the beginning of the letter name, end of the letter name and which the sound is not related to the letter name Call attention to the way letters are formed /w/ → round lips etc., Call attention to the sounds that each letter makes (e.g., letter m makes the /mmm/ sound)

Question 77

What is adult modeling of literacy activities?

Answer 77

Frequent opportunities for the child to observe adults engaged in reading and writing contexts Child as a “helper” in everyday activities Engage the child in interaction with various kinds of written materials

Question 78

This provide materials that permit children to write by themselves, facilitate all forms of writing, and encouraging the child to dictate a “story” given visual stimuli

Answer 78

Experience with writing materials

Question 79

What is language for learning (L4L)

Answer 79

It is a framework that emphasizes the role of language in supporting learning and academic success Understanding and using complex information in academic contexts

Question 80

What is inter-professional planning?

Answer 80

Therapists and teachers work together to design therapy program

Question 81

Principle 1: Use curriculum-based instruction.

Answer 81

The SLP must refrain from having their own independent intervention agenda Based on material drawn from the academic curriculum Purely developmental or specific deficit model - are less central to the needs Avoid working on isolated language skill We want to integrate our language intervention with the demands in the classroom everyday

Question 82

Principle 2: Integrate oral and written language

Answer 82

Provide both oral and written opportunities for students to practice forms and functions

Question 83

What is the principle 3?

Answer 83

Principle 3: Go Meta

Question 84

What are metas?

Answer 84

Activities that direct conscious attention to the language and cognitive skills a student uses in the curriculum

Question 85

What are the meta-skills

Answer 85

Talking and thinking about thinking

Question 86

Meta skills would include

Answer 86

Activities for language objective must be done at 2 levels: (1) Demonstrate through models and practice how particular forms and functions of language work (2) The client and clinician talk about the language forms and functions being used and state rules and principles explicitly, focusing attention on the structure of language The client and clinician → Language forms and functions → Rules and principles explicitly

Question 87

Principle 4: Collaborate to prevent school failure by participating in RTI

Answer 87

We can work on semantic and syntactic targets in curriculum-based activities Example: using language from the literacy materials for talking about the words and sentences in the material

Question 88

True or False. Pragmatic skills are crucial for effective communication and social interaction

Answer 88

True