Levels of Evidence: 1a: 1b: a well conducted IIa: a systematic review of ? IIb: a high quality III: observational studies with IV: observational studies without V:
systematic meta-analysis of well conducted single randomized control trials
single randomized trial (RCT)
nonrandomized quasi-experimental or single subject studies
quasi-experimental, low quality RCT or single subject
controls
controls
expert opinion/theoretical knowledge
EBP principles do NOT:
they do requires us to examine ?
they do require us to be ?
-this is especially true when
this is most especially true when there is?
limit us to thee use of clin. practices that have been shown to be efective
our practices to determine what types and what amounts of evidence support
skeptical
- we do not have strong body of evidentiary support
- less support for our approach than for alt.
3 levels of goals:
basic goal: general goals selected for
-correspond to ?
example=
intermediate goal: greater
-there are ?
example=
specific goals: steps to
-based on child’s
-includes specific ?
example
importance for functionality or severity
-long-term obj.
acquiring new grammatical forms
- specification within basic goal
- several levels to intermediate goals
- euxilaries, articles, pronouns
basic goals
- functional readiness
- language form,content or use in intermediate goals
- is, are, the , he , she
Continuum of naturalness:
most to least
child centered: daily activities, facilitated play
hybrid: milieu therapy, focused stim., script therapy
clinician directed: drill, drill play,modeling
Purposes of intervention:
change or eliminate
-rarely possible to
-often difficult to
changing the?
- improve aspects of ?
- most common for
Teach ?
- not ? but ways to ?
- teaching a ?
influence the ?
- do not ?
- can be ?
underlying prob.
- fully remediate prob.
- identify specific prob.
disorder
- language function by teaching specific behavior
- developmental lang. disorders
compensatory strategies
- specific/accommodate
- strategy for word finding
environment:
intervene directly
combined with any of the three prior
How intervention changes behavior:
facilitation:
-does not ?
maintenance:
induction: without intervention
- difficult to ?
accelerate growth or learning
-age level lang. skills
preserves behaviors that are decreasing or disappearing
outcome will not be achieved
-decipher form facilitation
In the spirit of Universal design for learning : includes providing access to ?
multiple means of
multiple means of
multiple means of
wide range of tools along continuum of naturalness
rep.
expression
engagement
Clinician directed model:
… materials will be used
… materials will be used
the .. and .. of ?
acceptable ? highly? eliminates reinforcement may be maximized opp. to ?
what
how
type and freq./reinforcement
forms of responses
sturctured-often drill based
arbitrary
practice new skills
Child centered: facilitated? -clinician arranges the -opportunities to learn targeted skills -no? -no ? clinician ? good for ? must learn to?
play/indirect language stimulation
-environment/activities so that opp. to learn new skill arise naturally
-tangible reinforcers
-prompts or shaping of incorrect responses
-follows child’s lead
obstinate or unassertive clients
-wait (ascribe intentionally)
Child centered interventions: self-talk parallel talk: imitation: expansion: extension: build-up/breakdown: recast sentences: similar to expansions but clinician recasts into ?
clinician describes own actions
clinician describes child’ actions
clinician imitates child’s language
clinician takes utterance and adds grammatical/semantic details
clinician takes childs utterance and adds semantic info
clinician expands to full grammatical form then breaks down into phrase sized
diff. type of elaborated sentences
Hybrid approach: target?
clinician maintains most of the ? but choosing things that allow for?
clinician uses ?
one or small set of specific lang. goals
control in selection of activities and materials/ spontaneous comm. attempts for child
linguistic stimuli to both respond to and model forms targeted
Hybrid Approach:
focused stimulation: clinician carefully arranges ?
vertical structuring: Clinciian responds to a child’s incomplete utterance with?
Milieu teaching: focus on ?
-includes
Script therapy: embedding ?
-includes
context/environ. so child will more likely produce targets
-high density modeling
contingent question then expansion
environmental arrangement and convention based contexts around child interests
-mand model
targets within a script/routine
-shared interactive book reading
Essential ingredients for successful intervention: - -active - - - use ? - -control ? -minimize -work with
intensity active engagement feedback reinforcement repetition distributed practice specificity complexity (ZPD) error responses schemas
A note about generalization:
you need to ? think about how the skills you are targeting will be
-use exemplars of (how many)
sequential modification: when the intervention environment extends from
use treatment materials similar to ?
use ?
introduce ?
help your client learn how to
plan in advance; achievable in other settings outside therapy
target forms and situations (2-3)
one place to another until spontaneous gen. to a new environment occurs
materials in child’s natural environ.
intermittent or delayed reinforcement after targets stabilized
distractor items into your intervention stimuli
self-monitor
Multiple Baseline design: a way to demonstrate use assessment data to treat the ? gather ? continue
intervention was effective
design target, gen., and control goals
target goals but not others
baseline data on all 3 goal types
monitoring progress on target goals
Prevention of lang. disorders in children:
primary:
-proper
-educate
-genetic
-mass
-environmental
-governmental
-eliminate
reduces?
health and medical care public counseling screening and early detection quality control action poverty
incidence and prevalence
secondary and tertiary: minimizing early early research to identify newborn preschool and kindergarten tertiary prevention =
effects of lang. disorders identification intervention risk factors and preventative intervention methods screening mandates screening programs rehabilitation
