Lecture 1 Flashcards

1
Q

Successful Intervention

A

Occurs when the child is able to use the forms and functions that have been targeted to effect REAL communication

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2
Q

General Consideration About Goals

A

The ultimate goal of intervention is to make the child a better communicator

ASHA requires that SLPs must be able to show that the change a child makes is due to intervention

Must establish goals carefully to ensure we are targeting what requires intervention

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3
Q

3 Major Purposes of Intervention

A
  1. ) Change or eliminate underlying problem
  2. ) Change (modify) the disorder
  3. ) Teach compensatory strategies
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4
Q

How do we decide the purpose of our intervention?

A

Intervention history of the child

Nature of the disorder

The way the environment interacts with the child’s communication

Data collected from the communication appraisal

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5
Q

Changing Behavior

A

Facilitation
Maintenance
Induction

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6
Q

Evidence-Based Practice

A

•“the conscientious, explicit, and unbiased use of current best research results in making decisions about the care of individual clients”

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7
Q

Internal Evidence

A
  • The characteristics of the client and family
  • Willingness to participate in a given approach
  • Family preferences
  • Our preferences
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8
Q

Internal Evidence contd

A
  • Our professional competencies
  • Family values
  • Our values
  • The values of the institution in which we work
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9
Q

How do we evaluate external evidence

A

•View the opinions of experts with skepticism
•Realize that some studies are structured better than others
•Be critical of the quality of
evidence we use

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10
Q

How to approach using EBP in intervention

A

•Formulate clinical questions
•Use internal evidence
•Find the external research evidence base (ASHA, Medline, Psychinfo, etc.)
•Grade studies
•Integrate internal and external evidence
•Evaluate the decision made
by documenting outcomes

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11
Q

Aspects of an intervention plan

A
  • The objectives
  • Processes used to achieve the objectives
  • Environments in which the intervention takes place
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12
Q

Levels of Intervention goals

A
  • Basic
  • Intermediate
  • Specific
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13
Q

Priorities for Setting Goals

Highest Priority

A

forms and functions child uses 10-50% of required contexts

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14
Q

•High Priority

A

forms and functions used in 1-10% of required contexts, but understood in receptive task formats

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15
Q

Lower Priority

A

a. forms and functions used in 50-90% of required contexts, b. forms the client does not use at all and does not demonstrate understanding of in receptive tasks

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16
Q

Zone of Proximal Development

A

Distance between child’s current level of independent functioning and potential level of performance (what the child is ready to learn with assistance)

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17
Q

Considerations for setting long and short term goals

A
  • Communicative Effectiveness
  • New forms express old functions / new functions are expressed by old forms
  • Client phonological abilities
  • Teachability
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18
Q

Continuum of Naturalness

A

Child-centered (Ex. Facilitated play, daily activities)
Hybrid (Ex. Milieu Therapy, Focused stimulation, Script therapy)
Clinician – directed (Ex. Drill, Drill play,
Modeling)

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19
Q

Clinician-directed Approach

A
  • Drill
  • Drill play
  • Modeling
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20
Q

DRILL

A
  • SLP instructs the child concerning the response he/she should give
  • Provides a training stimulus (word or phrase to be repeated)
  • Stimuli are planned and controlled by the SLP
  • Often involves prompts which are faded
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21
Q

Drill Play

A
  • Differs from drill in that it attempts to provide some motivation into the drill structure
  • The motivating event occurs during the original training stimulus vs. after
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22
Q

MODELING

A
  • Highly structured format
  • Formal interactive context
  • Child’s job is listen as SLP models numerous examples of structure being taught
  • Through listening child is expected to “induce” and later produce the target
23
Q

Child-centered Approach

A
  • May be better for children who refuse clinician-directed treatment
  • May be better for unassertive children who respond but rarely initiate communication
  • SLP organizes activities to provide child with an opportunity to provide the target response with a natural play context
24
Q

Child-centered Approach cont.

A
  • No tangible reinforces are used
  • No requirements exist and no prompts used
  • Child directs the activity (though the SLP chooses therapy material initially)
  • SLP makes a consistent and salient match between what child is doing and the language used to talk about it
25
Q

Child-centered Approach: The keys…

A
  • The SLP must learn to wait
  • The SLP may have to interpret a child’s actions as if they are attempts at communication (and reinforce with child)
  • The SLP then must respond to the child’s behavior in a way that models communicative language use
  • The SLP is not attempting to elicit specific structures but is reacting to the child’s behavior and placing it in communicative context (giving it linguistic mapping)
26
Q

Child Centered: Approaches

A
  • Self-talk and parallel talk
  • Imitations
  • Expansions
  • Extensions
  • Build ups and breakdowns
  • Recast sentences
27
Q

Child Centered: Self talk

A
  • SLP describes his/her own actions during parallel play
  • Ex. If child is putting balls in a bucket, SLP mirrors the action
  • While partipating the SLP says “I’m dropping balls. I’m dropping balls in my bucket. See the balls? See the bucket?, etc.
  • Provides a clear and simple match between actions and words
28
Q

Child Centered: Parallel talk

A
  • We provide “self-talk” for the child
  • We give a running commentary
  • We mirror the child’s actions and “speak” for them
  • Ex. “You are dropping balls. You are dropping balls in the bucket. You see the balls. You seen the bucket
29
Q

Child Centered: Imitation

A
  • The SLP imitates the child
  • In typical development adults often imitate children and the child then imitates the imitation
  • Research supports that anything that increases the amount of child talk accelerates language development
  • The more the child says the more opportunity for practice of phonological, lexical, and syntactic forms
  • As the child repeats our imitation we have an opportunity to use some of the other forms of contingent responses available in indirect language stimulation (allows us to provide more focused and extensive feedback)
  • We can also use the child’s imitation to initiate a back and forth exchange that encourages turn taking
30
Q

Child Centered: Expansions

A
  • The SLP “expands” on the child’s utterance and adds grammatical markers and semantic details to make it more adult like
  • Expansions have been shown to increase the probability that a child will spontaneously imitate at least part of the “expansion”
  • May also be called “recasts”
31
Q

Child Centered: Extensions

A
  • Comments that add some semantic information to a remark made by a child
  • Research indicates that extensions are associated with significant increases in children’s sentence length
  • Also called “expatiations”
32
Q

Child Centered: Build Ups & Breakdowns

A
  • Step 1 – expand child’s utterance to a fully grammatical form
  • Step 2 – Break the larger phrase down into several phrase-sized pieces (sequential utterances that overlap content)
33
Q

Child Centered: Recast Sentences

A
  • We expand a child’s utterance into a grammatically correct version
  • Expand the child’s remarks into a different type or more elaborated sentence
34
Q

Hybrid Approaches: Characteristics

A
  • Target one or a small set of specific language goals
  • SLP maintains control in selecting activities but does so in a way that tempts the child to make use of utterances in relation to a target
  • SLP uses linguistic stimuli to respond to the child but also to model and highlight forms being targeted
35
Q

Hybrid: Focused Stimulation

A

•SLP arranges the context of interaction so the child is “tempted” to produce targets
•SLP provides multiple models
of the target forms in a meaningful
way (usually play)
•Helpful for improving comprehension of a form as well as production
•If target isn’t produced, SLP responds contingently and then presents other models

36
Q

Hybrid: Vertical Structuring

A
  • Step 1 – Child responds to child’s incomplete utterance with a contingent question
  • Step 2 - If / when child responds with another fragmented remark, SLP takes 2 pieces from child and expands into a more complete utterance
  • Less “natural”
37
Q

Intervention Activities: General Features

A
  • Rate – Reducing our rate of speech may help the child by reducing the number of units he/she needs to process over time
  • Repetition – Repeated exposure enhances the opportunity for a child with language disorders to acquire language forms
38
Q

Intervention Activities: General Features

A

•Increasing perceptual saliency through prosody
•Increasing perceptual saliency through word order
•Complexity – Our sentences should be slightly longer than the child’s and refer to concepts that are semantically accessible to him/her
•Obligating pragmatically appropriate responses
Generally be mindful to use linguistic stimuli that will yield the entire response you are looking for…

39
Q

Service Delivery Models

A
  • Consultative model – SLP determines targets, procedures, and contexts and trains parent/teacher/etc. to carryover
  • Language-based classroom model – SLP is the classroom teacher for a group of students with language disorders. SLP provides a continuous form of intervention embedded w/I context of daily activities
  • Collaborative - SLP works with one or more students with language disorders in the mainstream classroom in collaboration with the teacher.
  • May be a combination of pull out and sit in
40
Q

Termination Criteria

A
  • ASHA 2004 e
  • Communication is now WNL
  • All goals and objectives have been met
  • Client’s communication is comparable to others of the same age, sex, ethnic, and cultural backgrounds
  • The individual’s speech or language skills no longer adversely affect social, emotional, or educational status
  • The individual uses an AAC system and has achieved optimal communication across partners and settings
  • The client has attained the desired level of communication skills
41
Q

General Criteria

A
  • (Behaviorist criterion is usually 80-90 % accuracy in a structured intervention context)
  • Paul recommends 50% accuracy in a natural language sample
  • When accuracy in a natural context exceeds 50% direct therapy may be discontinued (with a periodic check…)
42
Q

Primary Prevention

A
  • ASHA identifies several primary prevention strategies…
  • Public education
  • Genetic counseling
  • Mass screenings and early identification
  • Proper health and medical care (including immunizations and prenatal care)
43
Q

SLP’s and Prevention

A
  • Promote wellness in family-centered early intervention programs
  • Provide education to parents of preemies
  • Encouraging pregnant women to avoid drug and alcohol use during pregancy
44
Q

•1. What are the 3 basic purposes of intervention?

A
  • Change or eliminate the underlying problem
  • Change (modify) the disorder
  • Teach compensatory strategies
45
Q

•2. Define the proximal zone of development.

A

Distance between child’s current level of independent functioning and potential level of performance (what the child is ready to learn with assistance)

46
Q

•3. Name the 3 basic approaches to intervention.

A

Child Centered
Hybrid
Clinician Directed

47
Q

Which of the three basic approaches to intervention is the most natural?

A

Child Center

48
Q

•5. What techniques are considered clinician-directed?

A

Drill
Drill Play
Modeling

49
Q

In the consultative model the SLP determines targets, procedures, and contexts and trains parents/teachers to carry over. T or F

A

True

50
Q

In the “extensions” technique the goal is impact pragmatics. T or F

A

False

51
Q

3.The “reward” is always given after the production in drill play. T or F

A

False

52
Q

1.The level of “basic” (goal) is usually specific and short-term. T or F

A

False

53
Q

2.Forms that don’t appear at all in a child’s repertoire should be addressed first. T or F

A

False