Early Communication Intervention Flashcards
(41 cards)
Early Communication Intervention (Owens, 2014)
◉ Developmental Disability (DD)
Developmental Disability (DD)
○ Severe, chronic disability that
■ Manifested before 22 years old
■ Likely to continue indefinitely
■ Attributed to mental/physical impairments or combination
■ Substantial limitations in 3 or more areas of activity
● Receptive/expressive language
● Self-care
● Mobility
● Self direction
● Independent learning capacity
● Economic self sufficiency
■ Need supports/services–individual→ lifelong
1986: Early Intervention (EI)/Early Communication Intervention (ECI)
1986: Early Intervention (EI)/Early Communication Intervention (ECI)
○ Legal Basis: Public Law PL 99-457 ‘Education of the Handicapped Act
Amendments’
■ Comprehensive service infants/toddlers with DD
■ Multidisciplinary team assess/intervene as necessary
■ Assess child/family’s strengths/weaknesses
■ EI services appropriate for family
○ Educational approach for young children, birth→3
○ Remediation/prevention of difficulties
○ Focus on child AND family
○ ECI: primary focus on speech, language, or feeding
1990: Individuals with Disabilities Education Act (IDEA) passed by Congress
1990: Individuals with Disabilities Education Act (IDEA) passed by Congress
○ “Free and appropriate public education” for children with DD
◉ 1997: PL 105-17 Reauthorized IDEA: services within family context
◉ 2004: IDEA reauthorized: ‘Individuals with Disabilities Education Improvement
Act (IDEIA)
○ Individualized programs in natural environment
○ ‘Least restrictive environment’ (LRE)
◉ Some principles of intervention (see p. 67 for more)
○ Individualized–child/family
○ Family-centered, including culture, values, language, priorities etc.
○ Developmentally appropriate/goal of participation functionally, naturalistic
environment; highest quality intervention
○ Comprehensive, coordinated, team-based to optimize participation
Various Team Approaches
Multidisciplinary
Multidisciplinary:
a. Separate evaluations–different professionals
b. Information gathered; little coordination overall
c. Families may not be full members–overwhelmed by variety of
professionals
d. Problems: gaps in services, overlap
Various Team Approaches
Interdisciplinary
Interdisciplinary:
a. More cohesive team; family included as a member
b. Constant lines of communication between professionals
c. Assessed separately; cohesive report
d. Serviced separately, but plan together, coordinate services
Various Team Approaches & Families
Transdisciplinary
Transdisciplinary:
a. More cohesive team; family and professionals fully integrated
b. Parents/professionals join to create plans/interventions
c. Assessment: ‘Arena assessment’; team members observe child
interacting with family/natural environment
d. Integrated service plan –consensus/collaboration with family
Various Team Approaches & Families
Transdisciplinary
Transdisciplinary:
a. More cohesive team; family and professionals fully integrated
b. Parents/professionals join to create plans/interventions
c. Assessment: ‘Arena assessment’; team members observe child
interacting with family/natural environment
d. Integrated service plan –consensus/collaboration with family
◉ EI: Family-centered!
○
◉ EI: Family-centered!
○ Parent as partner
○ Positive effects for physical, emotional, cognitive, and language skills
○ Quality relationships/goals
○ Family histories/rationales/circumstances
○ Research shows greater gains in studies with parent participation
Families and Cultural Differences
Successful early intervention depends on quality relationships between all
parties, children, parents, and intervention facilitators. These relationships have a
direct impact on the parent-child relationship” (Owens, 2014, 68).
◉ EI: respect for culture, diversity, individuality
○ Materials in native language
○ Procedures-nondiscriminatory
○ Multiple methods of assessment
○ Understanding ethnic and cultural groups
○ SLP: understand/respect cultural beliefs/values to increase ECI
participation, collaboration, service delivery
Child & Parents/Caregivers
Child & Parents/Caregivers (Owens, 2014)
◉ Dyad interaction: context for ECI
○ Beginning earlier, often less intervention needed (Jacoby, Lee, & Kummer,
2002)
◉ Individualized!
◉ SLP→ Parent
○ Child’s current speech/language skills
○ Rationale for intervention
○ Role of SLP and other providers
○ SLP helping child to interact with family
○ Time/effort needed for success
○ Family: carryover and generalize
◉ SLP: Assisting parent as communication partner
○ Competent, confident in partnership
○ Integrate knowledge of child’s skills with adult education→guide
caregivers
IFSP: Child & Parents/Caregivers
IFSP: Individualized Family Service Plan (IFSP): Based on IEP
school-age
○ Both child and family needs impact development of the child
◉ Needs to include:
○ Child and family’s current status
○ Recommended services/expected outcomes
○ Projection of duration of service delivery
ECI Programs: early communication
Early communication:
◉ TD children learn their behavior affects others in environment
○ Important connection for establishing communication intent
○ LT: language delays can affect social development
■ More withdrawn, limited social-emotional skills (Irwin, Carter,
& Briggs-Gowan, 2002)
■ Preschool: Language problems associated with
behavioral/emotional problems later in life (Owens, 2014)
◉ LLE: Late Language Emergence: Possible Contributing Factors (Owens, 2014)
○ Low birth weight, premature birth
○ Family history of LLE
○ Early neuro-biological growth
○ Male Gender
LT: Outcomes
● ‘Watch and See’ (Paul, 1997, 1996)
● Early intervention assessment:
○ Training/modeling for parent not receiving services
○ Follow-up for services
● LT—> SLI? (Rescorla, 2009; Leonard, 2000)
● Late talkers: Risk for Specific Language Impairment (SLI; DLD)
○ “Greater risk than children who hit the early milestones of language
development on schedule” (Leonard, 2000, 183, emphasis added)
ECI Programs: Different Groups of Children
◉ 2 broad categories of children serviced:
○ Established risk
○ At risk
◉ ‘Established risk’: “strong relationship between the condition and developmental
difficulties” (Owens, 2014, 72)
○ Early intervention programs: very beneficial
○ Easier to identify
○ Strong link with developmental disabilities
◉ ‘At risk’: “potential to interfere with a child’s ability to interact in a typical way
with the environment and to develop typically” (Owens, 2014, 72)
○ Early intervention programs: very beneficial
○ Biological/Environmental in nature
Children: Established risk
○ CP: Cerebral Palsy
Established risk’ “strong relationship between the condition and developmental
difficulties” (Owens, 2014, 72)
○ ID: Intellectual disability
○ ASD: Autism Spectrum Disorder
○ CP: Cerebral Palsy
■ Group of chronic brain disorders–neurological damage
■ Affects movement, muscle tone/coordination
■ Risk factors: low birth weight, preterm birth, rubella and other maternal
infections during pregnancy, prolonged loss of oxygen, bleeding in brain
etc.
■ Different types: (can have mixed)
● Spastic: rigidity, jerky, labored movements
● Athetoid: slow, uncoordinated movements; difficulty with control
● Ataxic: uncoordinated, poor balance/walking
● Hypotonic (‘floppy’): poor muscle tone, floppy posture
Children: Established Risk (cont.) (Owens, 2014)
◉ Sensory Impairments:
Sensory Impairments: *Impacting child AND family
○ Deafness: hearing impairment (HI)
○ Severity of HI measured by intensity level; degree of loudness, measured
in decibels (dB)
○ *Spoken language acquisition—depends on hearing auditory input
○ Access to spoken communication from birth and onward
○ Identifying younger is so important!
■ Six months or less→greater chance of better language dev.
■ All infants in U.S. –hearing screening
○ Total Blindness:Complete lack of form/visual light perception
○ ‘Light perception’ can tell difference dark/light
○ ‘Legal blindness’-visual acuity with best possible correction of 20/200
(where 20/20 is typical vision)
Children ‘At Risk
At risk’ “potential to interfere with a child’s ability to interact in a typical way with
the environment and to develop typically” (Owens, 2014, 72)
○ International Adoptions & language acquisition
■ Language/culture differences
■ First weeks, months etc. of life–institution
■ Possible delays in growth/overall development
○ Socioeconomic Status (SES)–Risk factors may/may not be associated
■ Economic deprivation–lack of nutrition, medicine…
■ Birth complications
■ Physical/mental health problems
■ Neglect/abuse
○ Maltreatment/Neglect
○ Preterm/Low Birth Weight
■ Preterm (22-27 weeks): possible continual health problems
Importance of ECI Assessment
Different kind of assessment
○ Cooperation?
○ Indicative of child’s true language skills?
○ Unreliable responding
◉ **Compare child’s current skills across different developmental domains
○ Identify child’s strengths/challenges
○ Foundation of prelinguisitic skills
■ Vocalic play
■ Vocalizations
■ Gesture use
■ Symbolic play
■ Initiating/responding to joint attention
■ Parental interactions–input
■ Family History of language/learning impairments etc.
ECI Assessment
Two step assessment:
◉ Evaluation: Must be conducted to determine child’s eligibility for services
○ Evaluations: structured, formal, standardized testing (norms)
○ 1) Global evaluation: overall skills
○ 2) Specific evaluation: i.e. communication
◉ Assessment:
○ Assessment: “Ongoing process of identifying a child’s unique needs; the
family’s priorities, concerns, and resources, and the nature and extent of
the EI services needed by both” (Owens, 2014, 79)
○ Less formal
○ Use multiple tools/methods to assess
○ Cooperation with family, other professionals
○ Not just identifying challenges, but identifying what can be done to
help–Step 1 of intervention!!
ECI Assessment (cont.) (Owens, 2014)
◉ Arena Assessment
Arena Assessment: Transdisciplinary team
○ Common sample of child’s behavior, language etc. collected
○ All observe process for assessment
○ Not observed separately by different professionals
○ **Family-centered assessment; parent collaboration is key!
■ Priorities, resources, concerns, supports
○ Play based assessment:
■ Naturalistic
■ Context based
■ Child centered
■ **Not a free-for-all! Structured play!
■ “Process of interaction takes precedence over the product or result”
(Owens, 2014, 79)
Informal Communication Assessment
Early Communication Development—Child behaviors earlier have important impact on later
communication
1. DESCRIPTION OF COMMUNICATION: (use by child/interpreted by caregiver)
a. Descriptive forms/means of communication: Intentional and unintentional
behaviors performed by a child in front of caregiver
i. Physical (non-vocal): eye contact, facial expressions,
communication distance, gestures, body contact/movements,
aggression to self/others
ii. Vocal: sounds, crying, screaming
**Important to include all observed, as early behaviors are
connected to later language disorder diagnoses
b. **Communication Success:
i. Communication goal obtained?
ii. Environment–response to child is important
Informal Communication Assessment (cont.) (Owens, 2014)
2. CAREGIVER-CHILD INTERACTIONS:
CAREGIVER-CHILD INTERACTIONS:
◉ Sensitivity, responsiveness, and interpretation of intent by caregivers
◉ Responses by caregivers encourage/discourage behaviors (Owens, 2014, 81)
○ Relatedness of the response to child’s behavior
○ Consistency of adult response
○ Timeliness (how quickly) adult responds
Informal Communication Assessment (cont.) (Owens, 2014)
3. PRESYMBOLIC BEHAVIORS:
- PRESYMBOLIC BEHAVIORS:
◉ Joint attention/attention following (gazing/pointing)
◉ Variety/complexity in symbolic play
◉ Gestures and vocalizations: intentional communication
○ Gestures correlate with later receptive language skills AND can serve as a bridge
to language expression, from language comprehension
◉ Complexity of presymbolic vocalizations (various consonant, syllable structures)
◉ Motor Imitation
◉ Receptive language/comprehension of words
○ Significant predictor of language expression at later stage
*Communicative intent: Observe child: - Performing a signal/behavior
- Signal/behavior directed at/toward another person
- Appears to indicate communicative function (hard to identify)
Informal Communication Assessment (cont.) (Owens, 2014)
4.. SYMBOLIC ASSESSMENT:
SYMBOLIC ASSESSMENT:
◉ Words, signs, AAC communication
◉ Produced for purpose of communicating a message
◉ Functional: frequent, flexible, purposeful
◉ SLP must observe/report:
○ Phonotactic abilities: production sounds, sound combinations, syllable
structures
○ Imitation abilities
○ Expressive vocabulary
○ Multi-word combinations
○ Pragmatic functions:
