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ECU Language Disorders > Week 6: Assessment and Intervention in the Prelinguistic Period (ch.6) > Flashcards

Week 6: Assessment and Intervention in the Prelinguistic Period (ch.6) Flashcards

1
Q

What is the core of SLP Practice with Infants?

A

It is family-centered

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2
Q

What document is used for SLP Practice with Infants?

A

Individual Family Service Plan (IFSP)

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3
Q

What is mandated in an IFSP?

7

A

Child’s level of performance (physical, cognitive, communicative)

Family resources (priorities and concerns related to development)

Major outcomes and criteria to determine progress

Early intervention services needed (Speech, OT, PT, Respiratory), Frequency, Location, Payments

Other services (Medical, funding, transportation)

Projected initiation date and anticipated duration

Name of service coordinator

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4
Q

_____ of newborns are considered high-risk. (March of Dimes)

A

12%

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5
Q

What are PRENATAL Factors that may put a child at risk for Communicative Disorders in Infants?

(3)

A

Prematurity and low birth weight

Mom’s age + health (also toxins, alcohol, drugs)

Genetic and congenital disorders (Down syndrome, William’s, Klinefelter’s, Fragile X)

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6
Q

What are POSTNATAL Factors that may put a child at risk for Communicative Disorders in Infants?

(5)

A

Hearing Impairment (See Audiology)

Nonspecific ID

ASD (DSM-V)

Language delay

Abuse or neglect

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7
Q

What tests can be used to test language delay in infants?

4

A

REEL-3

Rosetti

Boehm

PLS-5

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8
Q

How might an infant be referred for a Communication Disorder?

(2)

A

Physician referral

Child Find

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9
Q

What do we assess in the NICU?

2

A

Feeding

Oral Motor Development

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10
Q

How do we assess Feeding and Oral Motor Development in the NICU?

(2)

A

Chart review (gestational age, complications, concerns, etc.)

Bedside evaluation

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11
Q

What are we looking for in a Chart Review when performing assessment of Feeding and Oral Motor Development in the NICU?

(3)

A

Gestational age

Complications

Other concerns

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12
Q

What are we looking for in a Bedside Review when performing assessment of Feeding and Oral Motor Development in the NICU?

(4)

A

Suckling

Sucking

Rooting

Phasic Bite Reflex

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13
Q

What is Suckling?

3

A

Just the motion

Tongue extension and retraction,

Jaw and lip closure

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14
Q

What is Sucking?

3

A

Change in intraoral pressure

Rhythmic pattern of suck

Swallow + breathe

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15
Q

What is Rooting?

A

When baby turns to side when check or lip is rubbed (searching for food)

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16
Q

What is Phasic Bite Reflex?

A

When gums are touched, baby bites then releases

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17
Q

How do SLPs help manage feeding and oral motor development in the NICU?

(7)

A

Helping families understand why non-oral feeding is needed and its consequences

Providing support to mothers

Assessing infant communication readiness

Assess parent communication and family functioning

Kangaroo care

Help parents observe and identify infant states and emotion

Encourage parents and staff to allow parents to help participate in care (and improve observational skills)

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18
Q

What are three ways of non-oral feeding?

A

Nasogastric (tube through nose )

Orogastric (tube through mouth)

Gavage

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19
Q

When do SLPs provide support to mothers in NICU?

2

A

While NON-oral feeding is employed

Once oral feeding begins

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20
Q

What support does an SLP provide mothers in the NICU while NON-oral feeding is employed?

A

Provide child with opportunities for non-nutritive sucking (pacifier during tube feeding)

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21
Q

What support do SLP provide mothers in the NICU once oral feeding begins?

(4)

A

Suggestions for interactions and communication with baby

Advise on types of nipples, bottles

Working on feeding pacing

Look for signs of distress

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22
Q

How do SLPs assist in hearing conservation and aural habilitation in NICUs?

(2)

A

Newborn hearing screenings

Monitor hearing and noise levels in NICU

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23
Q

How do SLPs assess child behavior and development in the NICU?

(3)

A

Focus on current strengths and needs - not future ones

Evaluate physiological organization and homeostasis

Use specialized newborn questionnaires and checklists

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24
Q

What is the NICU goal for child behavior and development?

A

Achieve stabilization and homeostasis of physiology and behavior

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25
Q

How do SLPs Provide developmentally supportive care in the NICU?

(6)

A

Monitoring noise levels

Give child quiet time

Advocate for non-nutritive sucking and oral stimulation

Provide information about early intervention services

Encourage parental interaction with baby (talking to baby, rocking, loving touch, etc.)

Help parents recognize and respond appropriately to infant distress signals (cold/hot, hungry, diaper changes, etc.)

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26
Q

How can SLPs foster staff awareness in the NICU?

4

A

Ototoxicity

Laryngeal effects of endotracheal tubes

That oral stimulation is reduced with non-oral feeding

Sensory overstimulation and low interactive stimulation

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27
Q

How do SLPs help assess Parent-Child Communication?

2

A

Infant readiness for communication

Parent communication and family functioning

28
Q

How do SLPs assess infant readiness for communication?

1+3

A

By looking at Stages of Readiness

  • Turning in
  • Coming out
  • Reciprocity
29
Q

What is Turning In?

3

A

Infant is unavailable for communication due to medical needs (Remember baby is very sick)

Work on maintaining homeostasis

Interaction between baby and parents (talking to baby, holding baby, etc.)

30
Q

What is Coming Out?

2

A

Infant begins to respond to environment

Important parents interact during feeding, diaper change, general time, singing, rocking, etc.

31
Q

What is Reciprocity?

A

Baby will reciprocate with parents

(if not a development delay - vision, feeding, sensory issues,
hearing)

32
Q

How do SLPs assess parent communication and family functioning?

(5)

A

Assessment (adjust for age)

Consider parents (feelings, coping strategies)

Develop development activities (face to face interactions, etc.)

Provide educational information

Make appropriate referrals (if you see a danger, counseling needs, food supply, etc.)

33
Q

What is Kangaroo Care?

A

Skin-to-skin contact between mother and child

34
Q

What do SLPs try to help parents learn to observe in their baby?

(1+4)

A

Stress Signals

  • Gaze aversion
  • Turning away
  • Spreading fingers
  • Arching back
35
Q

Do we need to allow babies time to relax?

How?

A

Yes

Rock them gently, talk/sing quietly, swaddle, lower the lights, decrease number of people/sounds

36
Q

Are parents part of the NICU team?

A

Yes

37
Q

How do we assess feeding in Pre-Intentional Infants?

3

A

Assessment instruments

Informal assessments

Identification of developmental feeding patterns

38
Q

What are specialized assessments for children with neurological involvement or tracheostomy?

(9)

A

***Cervical auscultation

***Videofluoroscopic studies

Ultrasound studies

Endoscopy

Upper GI study

Milk scan

Radionuclide imaging

pH Probe

Methylene blue screening

39
Q

What should we be looking for in Observational Recordings of Pre-Intentional Infants?

(4)

A

Rate of vocalization (pausing, delays, etc.)

Proportion of consonants (initial bilabials should increase to coordinated sounds 4-6 months)

Multisyllabic babbling (6-10 months)

All should increase over first year

40
Q

Is development highly variable?

A

Yes

41
Q

When should canonical babbling occur?

A

Around 10 months

42
Q

What should performance be assessed relatively to?

A

Gestational age

43
Q

What are the three stages of Pre-Intentional Infant Feeding?

3

A

Provide oral stimulation (non-nutritive sucking: pacifier, nuk brush)

Slowly introduce solid foods around 6 months (depends on previous test results - pureed dissolvable starts, puffs)

Teach strategies for improving feeding skills

44
Q

How should SLPs assess and manage Hearing Conservation and Aural Habilitation in Pre-intentional Infants?

(3)

A

Continue to monitor hearing; audiological assessments every 3 to 6 months

Alert parents to signs of otitis media - encourage treatment

Provide amplication/CIs for children with hearing impairments (8-12 months)

45
Q

How should SLPs assess and manage Child Behavior and Development in Pre-intentional Infants?

(2)

A

Ongoing monitoring of cognitive, motor, and communicative development

Management by multidisciplinary team (often home-based, often transdisciplinary model where SLP consults with other professionals to design plan but not deliver services directly)


46
Q

How does an SLP assess Parent-Child Communication in Pre-intentional Infants?

(2)

A

Formal assessments

Informal assessments

47
Q

How does an SLP INFORMALLY assess Parent-Child Communication in Pre-intentional Infants?

(7)

A

Pleasure/positive affect

Acceptance of baby’s temperament

Reciprocity and mutuality (how ‘in tune’ are parent and infant)

Appropriateness of objects and activities

Language stimulation (use of ‘baby talk,’ engage in back-and-forth and “choral” babble)

Establishment of joint attention (scaffolding the baby’s participation)

Singing with modeled movements (Itsy Bitsy Spider)

48
Q

How does an SLP help parents increase Parent-Child Communication in Pre-intentional Infants?

(3)

A

Teach normal infant communicative patterns

Model interactive behaviors

Develop self-monitoring skills

49
Q

How can an SLP help make parents aware of normal communicative patterns?

(2)

A

Print, video, and spoken instruction models

Adapt to infant’s immaturity (start small and build on foundation)

50
Q

How can an SLP help model interactive behaviors, including?

4

A

Turn-take with vocalization

Imitate see if child imitates

Establish joint attention (focus on objects, people)

Develop anticipatory sets (peek-a-boo, pop-up, bubbles)

51
Q

How can an SLP help develop self-monitoring skill?

A

Review video recordings of baby and parent interactions

52
Q

How can an SLP help assess the transition to intentionality in Prelinguistic Infants?

(4)

A

Needs achievement of 9- to 10-month level on cognitive testing)

Observation of play, using play scales

Parent report measures

Informal observation of presence and frequency of intentional communication (child vocalizes to gain attention, react to others, imitate looks and vocalizes - may point too)

53
Q

What are strategies an SLP can use for at-risk children with age-appropriate communicave developement?

(12)

A

Encourage parents to scaffold and support communication attempts (respond to vocalizations)

Help parents learn to ‘up the ante’ to more sophisticated forms of communication (add more pauses, require vocalizations)

Prelinguistic milieu teaching has evidence base for this developmental level

Interactive book reading provides contexts for
communication (start with simple books, point out important pictures/people)

Communication temptations can be used to increase frequency of communication

Included activities to develop comprehension

Provide intensified ‘motherese’ input (not baby talk)

Focus on fostering comprehension skills

Encourage vocalization

Make adult communication contingent on what child does/looks at/is interested in

Offer interactive story reading if child is interested

Encourage vocal and motor imitation—by imitating child at first

54
Q

How do SLPs assess Feeding and Oral Motor Development in Older Prelinguistic Clients?

(11)

A

Review medical and feeding history

Thorough physical exam

Assess posture, position, oral-motor structure and function

Observe chewing, biting, swallowing

Assess food preferences

Use instrumental study if necessary

Include social and communicative aspects of feeding

Maintain pleasant, positive environment allow for breaks

Provide social opportunities with feeding pause and talk with child
words (more, yummy, yucky -encourage turn taking)

Develop feeding skills as a foundation for speech (be aware feeding is necessary but not sufficient for speech development)

Always address vocal development specifically

55
Q

How do SLPs assess Hearing Conservation and Aural Habilitation in Older Prelinguistic Clients?

(5)

A

Continue to assess hearing regularly and communicate with audiology

Treat otitis media aggressively

Provide early identification and amplification of hearing loss

Even children with severe intellectual and motor impairments benefit from amplification

Help parents and teachers manage hearing aids

56
Q

How do SLPs assess Child Behavior and Development in Older Prelinguistic Clients?

(2)

A

Consider communicative function of challenging behaviors

Provide ongoing assessment of cognitive development to determine when new cognitive skills can support new communication behaviors

57
Q

How can we consider communicative function of challenging behaviors in Older Prelinguistic Clients?

(3)

A

Use Functional Behavior Analysis to identify functions

Teach adaptive strategies for expressing functions

Consider differential reinforcement of other behavior

58
Q

How do SLPs assess Intentionality and Communication in Older Prelinguistic Clients?

(4)

A

Identify unconventional forms of communication

Work to increase the frequency of communication

Increase the range of intentions expressed to include
joint attention and social interaction

Use ‘prompt-free’ techniques for children with no intentional communication


59
Q

What are some examples of Unconventional Forms of Communication?

(5)

A

Echolalia has communicative value (may be a sign of frustration, lack of understanding)

Aggression or self-abuse try to decrease by giving a break

Body orientation

Touch

Generalized movements or changes in muscle tone

60
Q

How can SLPs use Augmentative and Alternative Communication in Older Prelinguistic Clients?

(5)

A

All children need to communicate regardless of cognitive level

Provide core vocabulary (more, all done, stop, wait, important people)

Choose among pictures, symbols, written words to represent concepts, based on client characteristics

Use easy to transport formats, including smart phones and notepad

Develop transactional support within communicative environment

61
Q

How does ASD affect communication at the Prelinguistic Level?

(2)

A

Almost all delayed in communication

Restricted range of communicative intentions

62
Q

How can SLPs assist with Autism Spectrum Disorders in Older Prelinguistic Clients?

A

Evidence base for eliciting first communicative behaviors

63
Q

What are some evidence-based strategies for eliciting first communicative behaviors?

(4)

A

Prelinguistic milieu teaching

Picture Exchange Communication System

Applied Behavioral Analysis

Parent responsiveness training

64
Q

What is Low Tech AAC?

A

Pictures, symbols, written words to represent concepts, based on client charateristics

65
Q

What is High Tech AAC?

A

Easy to use technology (smart phones and notepad computers)

ECU Language Disorders (12 decks)

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