Week 3 - 4

Question 1

What are some of the broad purposes of intervention (3-4 main purposes)?

Change or eliminate the underlying problem

Answer 1

Change or eliminate the underlying problem
-resulting in a normal language learner who won’t need any further intervention —>usually impossible but in some instances it is achievable (i.e. child with hearing loss that was treated early and cochlear implants were used to achieve normal/nearly normal hearing

Question 2

What are some of the broad purposes of intervention (3-4 main purposes)?

Changing the disorder

Answer 2

-attempt to improve child’s discrete aspects of language function by teaching specific behaviors
-makes child a better communicator but DOES NOT guarantee that they won’t need further help at a later time
-This purpose is most commonly invoked when working with children who have developmental language disorders

Question 3

What are some of the broad purposes of intervention (3-4 main purposes)?

Teach compensatory strategies, not specific language behaviors

Answer 3

Instead of trying to make the child’s language “normal” the clinician attempts to give them tools to function better with the deficits they have

Question 4

What are some of the broad purposes of intervention (3-4 main purposes)?

The goal of language development may be focused not on the child entirely but also on the child’s environment

Answer 4

-This option is often combined with one if the other three options

Question 5

Purpose of initial evaluation in early intervention

Answer 5

Primary purpose of initial evaluation is to “determine if a child is demonstrating a significant delay in development” OR if the delay is predicted based on known diagnoses or circumstances

Question 6

Know how to determine eligibility for early intervention services in Colorado

Answer 6

-In Colorado, a significant delay is defined as a 33% delay (was 25% pre-pandemic!)
-Diagnosed disorder at or after birth
(ASD, CP, Down Syndrome, FASD, chromosomal abnormality, conditions with high probability of causing significant delay)
-Accumulation of risk factors such as having parents with a disability, a sibling with ASD, family socioeconomic status
-Informed clinical opinion
Whether or not you can make that determination may depend on the types of assessment tools & procedures used
-What is “Informed Clinical Opinion”? – we can technically ‘override’ the 33% amount if we have serious concerns

Question 7

Know appropriate assessment procedures for prelinguistic period, including what is important for the case history or parent interview

Case History review

Answer 7

-Were there any complications with the birth?
-Medical diagnosis?
-Maternal health during pregnancy?
-Family history of impairments/syndrome?
-Exposure to toxins?
-How much did the baby weigh and gestational age?
-History of traumas (post-natal)
-Brain injury?

Question 8

Know appropriate assessment procedures for prelinguistic period, including what is important for the case history or parent interview

Caretaker Interview

Answer 8

-NOT a repetition of case study
-Follow up on important, unclear information
-Ask about interactions and function of current communication
-Family concerns and priorities
-Family strength and challenges
-Goal: a conversation with the caregiver that shows attitude of wanting to understand, respect
-Open-ended questions
-Focus on strengths and successes
-Encourage different views without judging

Question 9

Know appropriate assessment procedures for prelinguistic period, including what is important for the case history or parent interview

Caretaker-child interaction assessment

Answer 9

Observe the caregiver and child interaction for
—The manner and emotions of interactions - on both the part of the caregiver and child
—Caregiver’s age appropriate stimulation of child - do they engage with the child?
—Language stimulation; use of “parentese”, engage in back-and-forth and choral babble
—Quality AND quantity of interaction

Question 10

Know appropriate assessment procedures for prelinguistic period, including what is important for the case history or parent interview

Assessment of child development by caregivers and clinicians

Answer 10

-Assess general development (trans-disciplinary play-based assessment)
-Assess communication development
—May be formal, informal, direct or indirect

Question 11

Know appropriate assessment procedures for prelinguistic period, including what is important for the case history or parent interview

Evaluate Results

Answer 11

Compile results, interpret and make appropriate recommendations

Question 12

Describe skills developed in the prelinguistic period

Answer 12

1. Prelinguistic acts/functions (gestures)
2. Joint attention
3. Intentional communication (pointing)
4. More requesting
5. Vocalizations that are frequent and increasing in complexity with age
6. turn-taking
7. rejecting
   8.imitation
8. Following simple instructions
9. Social responsiveness

Question 13

Signs of the transition to intentionality

Answer 13

1. Achievement of 9-10 month level of cognitive testing
2. In play, using objects as intended
   —-child understands common objects and their use
3. Wants to initiate play with a familiar adult and ANY communicative gesture (gestural, verbal, or vocal)
4. Gestures are paired with joint attention with communication partner
5. Requests objects or actions (asking to be picked up)

Question 14

Know at least ONE formal assessment tool for prelinguistic/0-3 assessment of communication

Answer 14

CDI (McArthur Bates Communication Developmental Inventories
—8-18 months
—words and gestures
—early words (expressive and receptive
—actions and gestures

Question 15

Know at least ONE informal assessment procedure appropriate for a prelinguistic child

Answer 15

Gesture profiling
-Looking at the types of gestures the child uses and the function of how they use them

Question 16

Know at least ONE assessment tool for 0-3 assessment of general development

Answer 16

Trans-disciplinary Play-based assessment
-cognitive, social, emotional, communication and language development

Question 17

Know how to identify goal areas (generally)

Answer 17

1. What are their immediate needs?
2. What are the foundational skills that can be targeted to address those needs?
3. What is within the child’s zone of proximal development?

Question 18

Know KEY FEATURES of PMT

Goal

Answer 18

to increase the frequency, clarity, complexity of non-linguistic communicative acts (requests, comments, nonlinguistic vocalization, coordinated eye gaze, gestures)

Question 19

Know KEY FEATURES of PMT

How is it done?

Answer 19

-In PMT, we Introduce something new or a slightly altered routine to the child, then wait for the child to engage with it/react to it then incorporate time delay-verbal prompts-gaze intersection, and other techniques to encourage communication attempts
-Adults encourage spontaneous communication by refraining from prompting and using “expectant waiting” (use of gaze, posture, and facial expression to indicate the adult expects the child to do something)
-The child initiates teaching situation by gesturing or indicating interest in a desired object or activity, Teachers provide prompts and cues for expansion of the child’s initiation, Expanded child responses are rewarded with access to a desired object or activity

Question 20

Know KEY FEATURES of PMT

Where is it done?

Answer 20

PMT is in everyday environments (e.g., home or classroom) rather than a “therapy room.” Activities take place throughout the day, rather than only at “therapy time.”

Question 21

Know KEY FEATURES of PMT

What is used?

Answer 21

Preferred toys and activities are included in the environment so that participation in activities is self-reinforcing

Question 22

Risk factors and predictors for continued language delay, especially in children with delayed language identified in the emerging language stage

Answer 22

-Established Medical conditions
-Hearing impairment
ASD
-Lake talkers
—6+ month delay in comprehension & production
Limited response to name & language
—Few vocalizations & gestures
—Few consonants in babbling
—Few spontaneous imitations
—Lack of object use & symbolic play
—Lower rate of nonverbal communication
—Only requests
—Difficulty gaining peer interaction
—Prefers adults over peers
—Family history of language impairment

Question 23

Risk factors and predictors for continued language delay, especially in children with delayed language identified in the emerging language stage

Predictors for continued language delay (emerging language delay)

Answer 23

—Receptive language ability: early in year 2, inventory of conventional gestures
—Expressive language ability: early in year 2, acts for joint attention, late 2’s inventory constants (phonology, limited consonants, limited babbling/vocalizations, restricted syllable structure) symbolic play skills at 14 months of age of predictive of expressive language skills at 24 months and 42 months (few imitations, small vocab)

Question 24

Know what skill development occurs in the emerging language stage

Pre-symbolic play

Answer 24

-Thematically-related play
-Two toys acting together
-Conventional/appropriate object use
-Nesting and organizing toys
-Knowing what objects are used to but not engaging in pretend play yet

Question 25

Know what skill development occurs in the emerging language stage

Answer 25

—Transition to Intentionality (9-12 months)
—Gestures
-Diectic (pointing, giving, showing
-symbolic and representational
-Combining gestures and vocalizations
—Understands some single words outside of routine but still needs overall contextual support
—Produced 2-5 communicative acts per minute
—Age range is 12-30 months
—Any language delays typically become known during this period
—begin speaking
—begin producing single words
—and begin to combine words into two-word utterances and simple sentences

Question 26

Know what foundational skills we expect to be mostly in place before a child begins using words

Answer 26

-at least at the developmental age of 12(-18) months
-gestures
-play skills
-social communication
-babbling and phonological development

Question 27

What question (broadly) does a screening tool answer?

Answer 27

—Is the child at risk and needs further assessment or not?
—Screening is the process of identifying children at risk for communication deficits so their eligibility for services can be evaluated.
—What developmental level is the child at, and whether they are ready for conventional, symbolic communication?

Question 28

Describe why play assessment and gesture assessment are important.

Play Assessment

Answer 28

Purpose: To get a full picture of the child’s skills that can be utilized in language learning

Play is a natural context for language learning: we can learn about the child’s motivations and interests
—Can also be used to assess cognitive skills

Play also allows us to gain insight into the child’s conceptual and imaginative abilities

Assessment
—thematically-related play with multiple objects and actions
—symbolic play
—two toys acting together
—nesting/organizing toys
—Appropriate toy use

Question 29

Describe why play assessment and gesture assessment are important.

Gesture Assessment

Answer 29

Gesture development is important because:
—Predictive of later spoken language usage
—communicative
—linked to cognition
—Indications of emerging symbolic language
—Suggests that language skills are within the child’s ZPD

Question 30

Describe why play assessment and gesture assessment are important.

Gesture Assessment

Answer 30

Assessment for gesture looks at
—Function
-Are gestures accompanied by appropriate communication
-In place of verbal communication
-In conjunction with verbal communication
-Are they representing concepts with a gesture?

—Type
-What are the categories of gestures used?
-Consider variety and complexity

—frequency
-How often

-Is the child using gestures (Can use MCDI or 16x16)
-Are gestures being presented to the child?
-Does the child imitate gestures?
-Are gestures typical? (if not, what might be the cause of this?)

Question 31

Functional Play

Answer 31

In this type of play, the child uses objects as they are/conventional use of object
I.e. drinking out of a cup

Question 32

Symbolic Play

Answer 32

When a child starts to use objects to represent other objects i.e. a banana as a phone

Question 33

Prelinguistic intentional (9-15 months)
Stages of Play

Answer 33

Functional Play
-putting telephone to ear, putting it aside

Question 34

Emerging Language Stage
Symbolic Play
<18 months

Answer 34

-Briefly sweeping floor
-Putting telephone to ear and then setting it aside

Question 35

Emerging Language Stage
Symbolic Play
18-24 months

Answer 35

-Pretends to drink from an empty toy teacup
-Eats from an empty spoon
-Closes eyes, puts hand by cheek and pretends to sleep

Question 36

Emerging Language stage
Symbolic Play
24-36 months

Answer 36

-Feeds doll
-Brushes doll’s hair
-Pretends to read a book
-Pretends to sweep the floor
-Moves a block or toy car with appropriate sounds of vehicle

Question 37

Emerging language stage
Symbolic Play
24-36 months part 2

Answer 37

-combs mother’s hair and then own hair
-Drinks from the toy bottle, then feeds bottle to doll
-Kisses doll, puts it to bed and puts a blanket over it
-Stirs the pot, feeds doll, then washes dishes

Question 38

Emerging Language Stage
Symbolic Play
24-36 years old Part 3

Answer 38

-Finds an iron, sets it down, searches for the cloth, tossing aside several objects. When cloth is found, irons it.