Week 1 (Ch. 1 &3) Flashcards

(176 cards)

1
Q

ASHA definition of language disorder

A

An impairment in the “comprehension and/or use of

a spoken, written and/or other symbol system.

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2
Q

3 things a disorder may involve in any combination

A

The form of language (phonology, morphology, syntax) The content of language (semantics) The function of language in communication (pragmatics)

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3
Q

Define: Naturalist perspective

A

Impairment is characterized as a deviation from the average

level of ability achieved by a similar group of people

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4
Q
Naturalist perspective (does, Does not) help the clinician decide what differences in language
behavior constitute an impairment or what level of impairment intervention is warranted
A

does not

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5
Q

Define: normative perspective

A

Considers impact of language impairment on the child’s

overall development and ability to function in everyday situations

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6
Q

Normative perspective States a language disorder exists when __________________

A

it interferes with the

child’s ability to meet societal expectations now or in the future

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7
Q

Deficits (do, do not) always occur together, although

impairments in one area may influence development in another

A

do not

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8
Q

Important to make a distinction between ______, _______, and _______ in order to highlight __________
order to

A

speech, language, and communication. The child’s most salient difficulty.

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9
Q

Very often impairments occur in the context of __________ with a _________

A

another developmental disorder, recognized label (ASD, Down’s).

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10
Q

Some of the other names for language problems

A

Specific language impairment, language delay, language disability,
language disorder, or developmental language disorder

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11
Q

Bloom and Lahey (1978) and Lahey (1988)- 2 major findings

A

Provided the framework for examining language
competencies
Suggested that language is comprised of three major
aspects: form, content and use

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12
Q

(All, Not all) of these features will be present in all children
with a diagnosis of DLD and the features that characterize a child at one age (may, may not) be very different to the features that stand out as the child gets older

A

Not all, may

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13
Q

Bloom and Lahey’s taxonomy of language: 3 major aspects

A

Form, content, use

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14
Q

3 key linguistic characteristics of disorders in form

A

Errors in speech production and poor phonological
awareness
Errors in marking grammatical tense
Simplified grammatical structures and errors in
complex grammar

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15
Q

3 key linguistic characteristics of disorders of content

A

Delayed acquisition of first words and phrases
Restricted vocabulary
problems finding the right word for known objects

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16
Q

3 key linguistic characteristics of disorders of use

A

Difficulties understanding complex language and
long stretches of discourse
Difficulties telling a coherent narrative
Difficulties understanding abstract and ambiguous
language

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17
Q

Mental age is an index of __________.

A

Developmental age

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18
Q

One way to describe children with developmental disability is
to say that ____________.

A

their developmental level is significantly lower than their chronological age

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19
Q

ASHA (2000) argued against cognitive referencing in making

decisions about eligibility of services. Why? Define cognitive referencing?

A

Comparing oral language skills to IQ to determine if language
intervention would benefit a student – make student eligible for
services in public schools
Sometimes language functioning can surpass cognitive levels

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20
Q

A Full Scale IQ score is comprised of what 2 things?

A

Verbal IQ and non-verbal IQ

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21
Q

Define: verbal IQ

A

measure of oral language skill

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22
Q

Define: non-verbal IQ

A

measure of the ability to carry out motor tasks

or analyze and solve problems using visual reasoning

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23
Q

When measuring IQ in children with language

impairments, best to use _______________.

A

cognitive tests that do not involve the production or comprehension of language

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24
Q

Nonverbal IQ is used as a measure of __________.

A

general intelligence in

individuals with language impairment

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25
Nonverbal IQ is sometimes used to qualify or deny | services in individuals with ID. Why?
The assumption is that language skills cannot improve beyond | one’s language ability
26
In many states, SLPs cannot provide services to a student | when his/her________ and ________ are equivalent
nonverbal IQ and language ability
27
Longitudinal studies of children with language disorders | have reported a (drop, increase) in (verbal, nonverbal) IQ over time
drop, nonverbal
28
Degree of discrepancy between verbal and nonverbal | abilities does not necessarily predict a child’s __________
responsiveness to intervention
29
Denial of services to children because of depressed | (verbal, nonverbal) IQ scores (is not, is) consistent with the tenet of IDEA
nonverbal, is not
30
Standardized scores give us some useful information | about ______________, but sometimes we need more information to determine if speech-language services are needed
a child's abilities relative to their peers
31
Tests with adequate psychometric data are (always, not always) available for all age levels, for all _________, __________, or _________.
not always; age levels, language communities, or aspects of language/communication
32
The __________ stresses that a language | disorder must be big enough to be noticed by ordinary people
Normative position
33
Some problems are more readily apparent to non-specialists, | while others are more ______ and _________.
Subtle and easily missed
34
(A, no) single cause of DLD.
No
35
4 risk factors that co-occur to give rise to diagnosable conditions
Biological, cognitive, behavioral, environmental
36
Define: biological factors
Biological factors Differences in genetic risk and neurological structure and function
37
Define: cognitive factors
Cognitive factors Differences in perception and information processing
38
Define: behavioral factors
Behavioral features Overt differences in behavior
39
Define: environmental factors
Environmental factors External experiences that either increase risk of disorder or that are protective in the face of biological risk
40
4 genetic factors of DLD
Primary DLD tends to run in families, suggesting that genes may influence susceptibility to disorder Cannot be sure of this because families also share environments Genes that have been implicated in DLD have also been implicated in a host of other neurodevelopmental disorders, including Tourette syndrome, ADHD, dyslexia, ASD, epilepsy and ID Partially overlapping etiologies may help to explain the high rates of co-morbidity seen in developmental disorders
41
Human brain starts developing ______ and | continues to grow and develop throughout adolescence
in utero
42
Current neurobiological theory of DLD
Initially regional differences in the brain favor different types of input for processing and computations Smaller regions within these areas become more specialized through activity-dependent processes that respond to environmental input
43
Increased cortical specialization and learning require | _________________ in order for effective communication within the brai
changes in the number and strength of connections between neurons
44
__________ eliminates weak or underused | connections and helps strengthen remaining connections
Synaptic pruning
45
Results in _____________ – specialized | neural networks that are more finely tuned to process particular inputs
functional specialization
46
Language in the adult brain is a great example of ________ and ___________.
Localization and functional specialization
47
In most individuals, language processing occurs in | the (right, left) hemisphere…this is called _____________.
left, left lateralized
48
As a result cortical structures that process language | tend to be larger in the (left, right) hemisphere than in (right, left) homologous structures
left, right
49
2 critical cortical areas for language
Frontal lobe and temporal lobe
50
Frontal lobe language functions
Inferior frontal gyrus includes pars opercularis and pars triangularis…together they form Broca’s area Important for speech motor planning needed for spoken language
51
Temporal lobe language functions
Includes Heschl’s gyrus, superior temporal gyrus and the planum temporale Important for auditory processing and language comprehension
52
5 things MRI studies of DLD find
as a group individuals with DLD show atypical patterns of asymmetry of the language cortex (Leonard and Gauger studies) Abnormalities in white matter volume Cortical dysplasia Additional gyri in frontal and temporal regions Unusual proportions of anatomical structures implicated in language processing
53
3 fMRI findings of brain function in DLD
Hugdahl et al. (2004) studied language processing in 5 Finnish family members with DLD and 6 age-matched peers. The family members with DLD showed bilateral activation in the temporal lobes which was much weaker and more focal than activations in the comparison group Weismer et al. (2005) studied working memory abilities in 8 teenagers with primary DLD and 8 individuals with NL. The individuals with DLD exhibited hypoactivation in frontal and parietal regions and inferior temporal gyrus Whitehouse and Bishop (2008) found that adults with DLD showed reduced blood flow to the left hemisphere when engaged in language tasks
54
Language learning is remarkably robust in the face of _________________
impoverished language input
55
___________ factors alone cannot account for the | deficits that characterize DLD
environmental
56
Environmental factors can have an important role in | mediating _________ and ____________
the developmental course of the disorder, impact of the disorder on the child's adaptation and wellbeing
57
Children from families with ________ have (slower, faster) | rates of language development relative to peers from __________ environments
low SES, slower, affluent
58
Relationship between ___ and _______ | not straight forward
SES, language impairment
59
DLD in the context of _______ should alert clinicians | and educators to the need for ________ and ____________
Low SES, careful monitoring and language support
60
3 cognitive models of DLD
auditory processing, limited processing capacity, procedural deficits
61
Auditory processing model of DLD
Auditory deficits have been shown to be neither necessary nor sufficient to cause DLD
62
Limited processing capacity model of DLD
Evidence for limited capacity system stems from poor | performance on tasks of working memory and phonological short term memory
63
Procedural deficits model of DLD
Children with DLD are impaired on measures of learning that tap into procedural memory systems (important for rule based learning such as grammar)
64
Children with Autism and DLD share ________________ (including _____ and ______)
language problems, vocabulary and grammar
65
Children with autism typically demonstrate 6 deviant features that would not be regarded as typical at any age
Repetitive use of stereotyped phrases Unusual and exaggerated intonation Pronoun reversal Idiosyncratic words Echoing the speech of others Pragmatic skills
66
Skilled reading requires ______ and ______ …_______-based skills
reading accuracy and | reading comprehension; language
67
Individuals with ________ also have some oral | language difficulties
dyslexia
68
``` Poor comprehenders (good decoding, poor reading comprehension) have oral language weaknesses in _____, ______, and __________ ```
vocabulary, grammar, verbal working memory
69
Many children with DLD end up having _____________
reading difficulties
70
4 purposes of intervention
1). Change or eliminate the underlying problem Rendering the child a normal language learner 2). Change the disorder Improve specific aspects of language behaviors by teaching specific behaviors 3). Teach compensatory strategies Rather than trying to make their language normal, the clinician attempts to give them tools to function better with the deficits they have 4). Change the child’s environment Try to influence the context in which a child must function
71
Identification of the basic purposes of intervention are based on what 5 things?
Age Intervention history of the client Nature of the disorder Way the environment interacts with the child’s communication function Data collected from the evaluation
72
3 interventions to change the disorder
facilitation, maintenance, induction
73
Define: facilitation
Helps children achieve language milestones sooner than they would have if left alone, but it does not mean that they ultimately achieve higher levels of language function than they would have without intervention
74
Define: maintenance
To preserve a behavior that would otherwise decrease or disappear
75
Define: induction
Intervention completely determines whether some endpoint will be reached
76
Define: evidence-based practice
“the conscientious, explicit, and unbiased use of current best research results in making decisions about the care of individual clients” by integrating clinical expertise with the best available external clinical evidence from systematic research (Sackett et al. 2000)
77
Evidence-based practice includes what?
Includes evaluating internal evidence…from characteristics of the client and family, their willingness to participate in a treatment approach, and their preferences as well as our own clinical preferences, professional competencies and values (Fey & Justice, 2007)
78
3 aspects of evaluating external evidence
Opinions of experts should be viewed with skepticism All research is not created equal. Some studies are better, and therefore better suited to inform clinical decisions, than others Clinicians must be critical about the quality of evidence they use to guide clinical decision-making
79
Step 1 in incorporating EBP
Formulate your clinical question
80
4 steps to formulating your clinical questions
P – Patient or Problem I – Intervention being considered C – Comparison treatment (can be no treatment) O – desired Outcome
81
Step 2 in incorporating EBP
Use internal evidence, such as clinical experience and family preferences to determine what your typical “first stab” approach would be
82
Step 3 in incorporating EBP
Find the external research evidence base
83
3 considerations in finding the external research evidence base
Use the ASHA database Databases such as MEDLINE or PsychInfo Start by reading the most recent review articles
84
Step 4 in incorporating EBP
Grading studies
85
3 things you grade studies for
Relevance to the clinical question Level of evidence provided by the study based on its design and quality The direction, strength, and consistency of the observed outcomes
86
Step 5 in incorporating EBP
5. Integrate internal and external evidence
87
Step 6 in incorporating EBP
6. Evaluate the decision by documenting outcomes
88
3 aspects of the intervention plan
Intended objectives of the intervention processes used to achieve these objectives Contexts, or environments, in which the intervention takes place
89
3 levels of goals
Basic goals – correspond to long-term objective (e.g., new grammatical forms) Intermediate goals (e.g., auxiliaries, articles, pronouns) Specific goals (e.g., is are; a, the; he, she)
90
In setting goals, you should target the _____
ZPD
91
Define: ZPD
the distance between a child’s current level of | independent functioning and potential level of performance
92
Don't want to select goals _______ or ______ the ZPD
below or beyond
93
May need to use ___________________ to | establish ZPD
dynamic assessment techniques
94
4 other factors to consider when setting goals
Communicative effectiveness Choose objective not only on developmental grounds, but also on the grounds of how efficient the targeted behaviors will be in increasing a child’s ability to communicate Require child to do only one new thing at a time Use new form to serve a communicative function that has already been expressed or new function with a form already used by client Phonological abilities Teachability Teach easier forms and functions before harder ones
95
Teachable forms include what 3 things?
Those that are easily demonstrated in pictures Taught through stimulus materials that are easily accessed and organized Used frequently in naturally occurring, everyday activities in which the child is engaged
96
3 intervention approaches
``` Clinician-directed approaches (CD approaches) Child-centered approaches (CC approaches) Hybrid approaches ```
97
________- centered is the most natural on the continuum, and includes what 2 things?
child; daily activities and facilitated play
98
________ is the "middle" natural on the continuum, and includes what 3 things?
hybrid; Milieu therapy, focused stimulation, script therapy
99
________-directed is the least natural on the continuum, and includes what 3 things?
drill, drill play, CD modeling
100
During clinician-directed approach, the clinician specifies all the aspects of intervention including what 4 things?
 materials to be used and how the client will use them  the type and frequency of reinforcement  the form of the responses to be accepted as correct  the order of activities
101
Clinician-directed approaches are also referred to as ________ or ________.
drill, discrete trial intervention
102
4 things clinician-directed approaches attempt to do
make the relevant linguistic stimuli highly salient  Reduce or eliminate irrelevant stimuli  Provide clear reinforcement to increase frequency of desired language behaviors  Control the clinical environment
103
4 advantages of CD approaches
Allows the clinician to maximize the opportunities for a child to produce a new form, producing a higher number of target responses per unit time than other approaches Unnaturalness of approach Research finds that these approaches are consistently effective with various disorders Research finds that individuals with lower IQs or more severe disabilities perform better with CD approaches
104
2 disadvantages of CD approaches
Not good at getting the client to generalize new skills into real communication outside clinical setting Research finds that using more naturalistic methods can provide a more efficient means of addressing language targets
105
3 types of CD activities- name and define
Drill Most highly structured activity Clinician instructs the client on what is expected and provides a training stimulus Drill Play Like Drill, but provides some motivation into the drill structure Modeling Child’s job is to listen as the clinician provides numerous examples of the structure being taught
106
Child-centered approaches also called what 3 things?
Also called indirect language stimulation, | facilitative play, pragmaticism and developmental or developmental/pragmatic approaches
107
What does the clinician do, and what is the clinician not allowed to do, during child-centered approach
Clinician arranges an activity so that opportunities for the client to provide target responses occur as a natural part of play and interaction No tangible reinforcers, no requirement that the child provide a response to the clinician’s language and no prompts or shaping or incorrect response
108
2 keys to the child-centered approach
Key to this approach is to respond to the client with one of several specific verbal techniques Our responses model communicative language use
109
Unlike in CD approaches, we are not trying to | __________________…instead we _____________________
elicit specific structures from the client. react to the child’s behavior, placing it in communicative context and giving it a linguistic mapping
110
6 verbal response techniques
``` Self-talk and parallel talk Imitations Expansions Extensions Buildups and breakdowns Recast sentences ```
111
Define and explain: self-talk
We describe our own actions as we engage in parallel play with the child Provides a clear and simple match between actions and words By using the child’s actions and matching our own words and actions to them, we model how to comment on our actions with language
112
Define and explain: parallel talk
Provide self-talk for the child Talk about the client’s actions, providing a running commentary
113
Define: imitation
Imitating what the child says
114
Research has showed that adults often ____________ and that when they do, there is a substantial probability that the child will ___________
repeat what normal toddlers say, imitate the imitation
115
Research shows that children who imitate show | advances in ____________
language development
116
The more the child says, the more the opportunities | exist for practice of _____, ______, and ____ forms and the more opportunities there are for _________
phonological, lexical, and syntactic forms; feedback
117
Define: extensions
Comments that add some semantic information to a remark made by the child We take what the child says and add the grammatical markers and semantic details that would make it an acceptable adult utterance
118
Expansions have been shown to increase the | probability that a child will ____________________
spontaneously imitate at least part of the expansion
119
Expansions have been shown to increase | _______________ for a number of structures in a number of diagnostic group
grammatical development
120
Buildup and Breakdown: explain, purpose
Build up and breakdown a child’s utterance to show them how sentences get put together Start by expanding the child’s utterance to a fully grammatical form (build up) Then break it down into smaller, phrase-sized pieces
121
This type of buildup and breakdown response has been associated with _________?
This type of response has been associated with | language development in typically developing children
122
Define: recast sentences
Like expansions, but instead expand the | child’s utterance into a different type or more elaborated sentence
123
3 characteristics of hybrid approaches
Target one or a small set of specific language goals Clinician maintains a good deal of control in selecting activities and materials but does so in a way that consciously tempts the child to make spontaneous use of utterances of the types being targeted Clinician uses linguistic stimuli not just to respond to the child’s communication but to model and highlight the forms being targeted
124
4 types of hybrid approaches
Focused stimulation, vertical structuring, milieu teaching and script therapy
125
Define: focused stimulation
Clinician arranges the context of interaction so that the child is tempted to produce utterances with obligatory contexts for the forms being targeted Clinician provides lots of models of the target form in meaningful context
126
Focused stimulation is effective for __________?
Effective for improving comprehension and | production of a form
127
During focused stimulation, a clinician gives ___________________
Clinician gives feedback similar to an expansion | when the child makes an unsuccessful attempt
128
Define: vertical structuring
Particular form of expansion used like focused | stimulation to highlight target structures
129
Why is vertical structuring Less naturalistic than standard ILS technique?
the clinician provides a specific nonlinguistic stimulus, but does use a naturalistic response
130
Vertical structuring is effective at targeting ___________?
early developing language forms
131
3 major components that characterize Milieu Communication Training
Environmental arrangement Responsive interaction Conversation-based contexts that use child interest and initiation as opportunities for modeling and prompting communication in everyday settings
132
4 main methods of Milieu Communication Training
Incidental teaching Mand-model Prelinguistic milieu teaching Enhanced milieu teaching
133
5 steps of incidental teaching
Clinician arranges the setting so that things the client wants or needs to complete a project are visible but out of reach Clinician first responds with focused attention If client does not respond as expected, clinician asks question to get child to use verbal request If response produces target response, clinician provides confirmation with a model of target form If response does not produce target response, a prompt is provided
134
Define: mand-model
Clinician observes child and when the child seems to | show some interest in some aspect of the environment, the clinician “mands” or requests an utterance with a stimulus
135
During mand-model, clinician is trying to elicit ____________ rather than __________.
Clinician is trying to elicit general one-word, two- | word or complete grammatical sentences, rather than specific form or meaning targets
136
Prelinguistic Milieu Teaching is designed for what age group?
Designed for nonverbal children between 9 – 18 | months of age developmentally
137
Goal of prelinguistic milieu training
Goal is to develop the basic intentional communication skills necessary for early language development by increasing the frequency, maturity, and complexity of nonverbal communicative acts
138
5 major goals of PMT
Establish interactive routines to serve as contexts for communication Increase frequency of vocalizations Increase frequency and spontaneity of coordinated gaze Increase use of nonconventional and conventional gestures Encourage combinations of gaze, vocalization and gesture
139
Enhanced Milieu Teaching is effective for children who meet what 3 criteria?
Produce some verbal imitation Have at least 10 productive words Are in the early stages of language development, with MLUs from 1 – 3.5
140
Enhanced milieu teaching incorporates methods of both _________ and _________.
incidental teaching and the mand-model approaches
141
Define and explain: script therapy
A way to reduce the cognitive load of language training by embedding it in the context of a familiar routine Clinician can develop some routines or scripts with the child in the intervention context or re-enact scripts the child already knows
142
In the intervention the known script is violated in | some way, this does what?
challenging the child to communicate to call attention to or repair the disruption
143
Script therapy includes what 2 things?
Includes literature-based scripts and interactive | book reading
144
Fey's 4 guidelines for increasing naturalness of CD activities
Make the language informative Increase the motivation to communicate with the task Use cohesive texts Move from “here and now” to “there and then”
145
10 essential ingredients of successful therapy
Intensity Active engagement Feedback Reinforcement Repetition Use distributed practice Specificity Control complexity Minimize error responses Work within schemas
146
Think carefully about the (output, input) you present to the | child in terms of both its _____________ and ______________.
input, meaning and its formal properties
147
5 ways Linguistic input can be manipulated many ways to | make it more effective
Rate Repetition Increasing perceptual saliency through prosody and word order Controlling complexity Obligating pragmatically appropriate response
148
(A lot of, Very little) empirical evidence exists to guide us in determining ____________ for the wide range of communication skills that SLPs address
very little, optimal intensity
149
Proctor & Williams (2007) found that _____________ appears to be more effective than ______________.
Proctor & Williams (2007) found that distributed practice within sessions and throughout the treatment program appears to be more effective than massed practice involving long periods of repetitive practice
150
Daily, intensive practice sessions involving | distributed practice for a few weeks or months is (worse, better) than two to three sessions/wk for a year
better
151
Requiring the child to respond: comprehension vs. production
Not always necessary to train comprehension before having the child produce a target form For forms and functions that are comprehended but not produced, production training is indicated…think within the child’s ZPD For structures and meanings that are neither comprehended or produced… production in imitation should be first step
152
Requiring the child to respond: augmentative and alternative modalities
Beukelman & Mirenda (2005) advocate a “communication needs” model Children who need a means to communicate because of a lack of speech are provided with some communication system, regardless of whether they have identifiable barriers to vocal expression
153
2 types of consequences that can be provided to the client based on their production
Reinforcement or feedback
154
Define: reinforcement
The intent of reinforcement is to increase the frequency of the behavior being reinforced
155
Define: feedback
Not intended to increase the frequency of the client’s behavior Intent is to give the client information about the communicative value or linguistic accuracy of an utterance
156
The goal of language intervention is to?
The goal of language intervention is to get the client | to use appropriate forms in real interactions…this process is generalization
157
Generalizing language gains is thought to be the (first, last) step in intervention, but should really be incorporated into every session.
last
158
Research tells us that children (do not, do) always | generalize the forms learned in CD activities, or even naturalistic approaches, to spontaneous conversations
do not
159
____________ needs to be built consciously into our | intervention programs
Generalization
160
6 ways to increase generalization
Use many exemplars of target forms and functions Provide many exemplars of target form in multiple settings Make treatment material similar to things used in natural environment Intermittent or delayed reinforcement Use distractor items Teach self-monitoring
161
You choose non-linguistic stimuli based on what 2 things?
Types of stimuli  timing
162
3 intervention service delivery models
consultant model, language-based classroom model, collaborative models
163
Define: consultant model
SLP determines the intervention targets, procedures and context Meets with agent of intervention (parent, teacher, SLP aids, peers)
164
Define: language-based classroom model
SLP is classroom teacher for group of students with language disorders
165
Define: collaborative models
SLP works with one or more students with language disorder in the mainstream classroom in collaboration with classroom teacher
166
Define and explainThe: intervention termination criteria
One way to demonstrate accountability Level of use of a targeted structure that the client must achieve for the structure to be considered achieved Usually 80% to 90% correct usage in structured situations Better way…50% correct in spontaneous speech
167
Define and explain: determining responsiveness to intervention
Designed to overcome the problem of identifying children with language and learning disorders based on a discrepancy Using RTI children are exposed to a series of levels of instruction
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6 discharge criteria
1. Communication is now within normal limits 2. All goals and objectives of intervention have been met 3. The client's communication is comparable to those of others the same age, sex, and ethnic and cultural backgrounds 4. The individual's speech and language skills no longer adversely affect social, emotional, or educational status 5. The individual uses an AAC system and has achieved optimal communication across partners and settings 6. The client has attained the desired level of communication skills
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3 levels or RTI (Response to Intervention)
Tier, I, Tier II, Tier III
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Define: RTI Tier I
Classroom instruction for all children that is evidence-based
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Define: RTI Tier II
Targeted, short-term research-based instruction designed to address weaknesses in children who struggle with language and literacy Intervention delivered in small groups
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Define: RTI Tier III
Intensive, therapeutic intervention
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National trend away from exclusive attention to | __________ and toward ________.
rehabilitation, prevention
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Prevention before rehabilitation trend partially arises from
our knowledge of the enormous cost of rehabilitation and the burden it places on the economy CDC (2003) estimated that preventing one case of ID can result in long-term savings of $1 million
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US public health service has developed goals for what 4 things?
improving health, reducing risk factors, providing screening and early identification resources and increasing public awareness
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ASHA (2005) and Marge (1993) identified 6 | primary prevention strategies that can be applied to disabilities that lead to communication disorders. What are they?
Wellness promotion Proper health and medical care, including immunizations and prenatal care Public education Genetic counseling Mass screening and early identification Elimination of poverty