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Assessment and Intervention for Emerging Language

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What is emerging language stage (EL) ... Who might be at the EL stage? ... Forms of communication (e.g. gestural, vocal) Assessing Communicative Intent: Worksheet ... – PowerPoint PPT presentation

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Title: Assessment and Intervention for Emerging Language


1
Assessment and Intervention for Emerging Language
  • Paul R. (2001). Language Disorders from Infancy
    through adolescence. Chapter 8

2
What is emerging language stage (EL)?
  • For normally developing children, corresponds to
    toddler age range
  • Approx - 18 - 36 months

3
Who might be at the EL stage?
  • Children between 18-36 mos with no known risks
    but parents or others are concerned
  • Children between 18-36 mos with known risks
  • Older children with severe disabilities

4
To see them or not to see themthat is the
question.
  • Children under 3 with intact cognitive, preverbal
    communicative, and sensory capacities with no
    risk factors - low priority
  • Children with cognitive deficits, hearing
    impairment or chronic OM, preverbal communication
    problems, risks pre or perinatally - should be
    seen

5
But remember...
  • Therapy may facilitate development in normal
    slow talkers
  • Children with later language disabilities often
    have histories of delayed language development

6
Normal Development
7
Assessment of Communication in EL
  • Multidisciplinary and Transdisciplinary
    assessment
  • Play assessment
  • Communication assessment

8
Play Assessment
  • Want to ensure child is at a developmental level
    consistent with communication development
  • Relationships exist between play and language
    development
  • Provides a more holistic picture of the child

9
Assessing Play
  • Communication and Symbolic Behavior Scales
    (Wetherby Prizant, 1990)
  • Play Scale (Carpenter, 1987)
  • parent plays with the child
  • see Table 8-1, 8-2 p 251
  • McCune (1985)
  • child is given a set of toys and behaviours are
    analysed (see Table 8-2)
  • Symbolic Play Test (Lowe Costello, 76)

10
Communication Assessment
  • Rating Scales
  • see Table 8-3, p. 253-254
  • Communication and Symbolic Behavior Scales
    (Wetherby Prizant, 1990)
  • observe parent and child in various interactions
  • rates performance in five areas
  • Informal examination of communication functioning

11
Informal Examination of Communication Function
  • Assessing Communicative Intention
  • Assessing comprehension
  • Assessing Production

12
Assessing Communicative Intention
  • Range of communicative functions
  • Proto-imperatives
  • Requests for objects
  • Requests for actions
  • Rejections or protests
  • Proto-declaratives
  • Discourse functions
  • Requests for Information
  • Acknowledgements
  • Answers

13
Assessing Communicative Intention (contd)
  • Frequency of expression of intentions
  • Forms of communication (e.g. gestural, vocal)

14
Assessing Communicative Intent Worksheet
  • Table 8-4, page 256
  • Communicative Act
  • Must be directed at adult. Child must look at or
    address the adult directly in some way.
  • Must have an effect on influencing the adults
    behaviour/focus of attn or knowledge.
  • Child must be persistent in the attempt to convey
    the message if the adult does not respond

15
Assessing Comprehension
  • Standardized language tests/scales
  • PPVT-III, Sequenced Inventory of Communicative
    Development (SICD), Receptive Expressive Emergent
    Lang Scale (REEL).

16
Comprehension Activities Understanding Single
Words
  • A collection of six to eight items
  • Give me or Wheres
  • Can assess body parts
  • Assess verbs
  • Comprehension of single words is normal for 12-18
    mos.
  • What if they dont?

17
Comprehension activities Two word combs
(18-24m)
  • Action-object (use words understood at
    single-word stage)
  • choose unusual combinations such as kiss the
    apple hug the shoe

18
Comprehension Activities Beyond 2-words (24-36 m)
  • Agent-action-object instructions
  • Rely on probability
  • Start with vocabulary from earlier stages and
    then move on
  • see Table 8-6

19
Comprehension beyond 36 months
  • Can be tested using formal comprehension measures
    such as PPVT-III, TACL-R, Miller-Yoder Test of
    Grammatical Comprehension, CELF-P

20
Comprehension Findings What do they mean?
  • If comprehension is superior to production
  • better outcomes
  • If comprehension is poor
  • need to include comprehension component in
    therapy as well as expressive component

21
Assessing Espressive Language
  • Speech motor development
  • Speech sample/phonetic repertoire
  • Phonological skills
  • Lexical production/Vocabulary
  • Semantic-syntactic production

22
Vocabulary (Lexical Production)
  • Expect a child to have at least 50 words and some
    two-word combinations in the 24-36 month stage
  • Rating scales
  • MacArthur Communicative Development Inventories
    (Fenson et al., 1993)
  • Language Development Survey (Rescorla, 1989)

23
Semantic syntactic production
  • Children dont begin to combine words until
    vocabulary size is approx 50 words
  • To assess semantic-syntactic production
  • Determine the relative frequency of word
    combinations
  • Evaluate semantic relations expressed
  • Table 8-7 (Browns Semantic Relations)
  • Variety of relations
  • Advanced relations
  • Normal toddlers express 8-11 different semantic
    relations

24
Decision making based on assessment information
  • See Pauls decision tree on p. 253 (Fig. 8.2)

25
Intervention Goals, Procedures Context
  • Four main areas that may be targeted
  • Functional and symbolic play skills
  • Using intentional communication
  • Language comprehension
  • Production of sounds, words, and word combinations

26
Functional and Symbolic Play Skills
  • Step1 Establish reciprocal behaviour and
    anticipatory sets (e.g. peek-a-boo)
  • Step 2 Model early forms of symbolic play and
    encourage imitation
  • Step 3 Model play routines like pretending to
    give the doll a bath, meal time, store games

27
Developing Intentional Communicative Behaviours
  • Want children to initiate communication
  • 1 Communication temptations
  • can model first with the parents (e.g. hand Mum a
    container and she hands it back to therapist and
    indicates take the lid off or says help.
    Then hand container to the child)
  • 2 Milieu model
  • place things out of reach and get the child to
    ask for it or draw the childs attention to it
    and wait for a response

28
Developing Intentional Communication (contd)
  • 3 Use routines or script therapy and then
    violate the routines
  • 4 Respond as though the child is showing
    intent
  • 5 If range of intent is limited, increase use
    of proto-imperatives and declaratives
  • model the behaviour
  • pretend not to notice something that the child is
    interested in and wait for them to get your
    attention

29
Developing Intentional Communication (contd)
  • If child has adequate intentions but is only
    using gesture --gtincrease vocalising
  • Model the target response
  • Withold response or pretend not to notice until
    some vocal behaviour produced

30
Developing Intentional Communication (contd)
  • If the child is using maladaptive behaviour
  • immediately provide an alternative form of
    communication (e.g. I see you want it. Point to
    it and Ill give it to you.)
  • might need to actually take the childs hands and
    demonstrate the action

31
Developing Receptive Language
  • Indirect Language Stimulation (parent training)
  • self-talk/parallel talk
  • imitations
  • expansions
  • extentions
  • build-ups and breakdowns
  • recast sentences
  • labelling
  • see box 8-3

32
Developing sounds, words, and word combinations
  • Increasing phonological skills
  • expand the repertoire of sounds
  • use developmental information
  • Developing a first lexicon
  • choose words based on normative data
  • some words should be nouns for labeling
  • other words should be chosen for expressing other
    functions
  • see Table 8-10

33
Developing sounds, words, and word combos (contd)
  • Developing a first lexicon (contd)
  • MacDonald suggested choosing words that are
    within the childs interests
  • Consider the childs phonetic repertoire
  • choose words with sounds in the childs
    repertoire
  • early words may be limited to CV and CVC shapes

34
How should we teach first words?
  • Child centered approach
  • clinician provides many models
  • use play contexts and dont require response
  • Hybrid approach
  • milieu teaching
  • place objects out of childs reach
  • script therapy
  • engage in a verbal routine, once it is
    overlearned, either violate it or use a cloze
    technique

35
How should we teach first words?
  • Hybrid approaches
  • focussed stimulation
  • set up the situation so that you are modeling the
    specific vocabulary you want to teach
  • provide lots of opportunities for the child to
    produce it
  • use recasts, expansions, extensions, etc.
  • Clinician-directed
  • may be suitable for older children

36
Developing word combinations
  • Word combinations express semantic relationships
  • Client-centered
  • play situation-when the child produces a one-word
    utterance, the clinician expands it to a two-word
    phrase

37
Developing word combinations
  • Hybrid approaches
  • Schwartz et al.(85) - vertical structuring
  • Whitehurst et al.(91) - see box 8-5
  • milieu approaches
  • put something out of childs reach - get X
  • focussed stimulation
  • script therapy
  • perhaps use a book or song-play that has two words

38
Developing word combinations (contd)
  • Clinician-directed approaches
  • Leonard (75)
  • use a puppet and the puppet describes whats
    happening in the picture
  • get the child to tell the puppet whats
    happening and to talk like the puppet
  • MacDonald et al. (74) - Environmental Language
    Intervention (ELI)
  • parent works on goal for 5 min in 3 conditions
  • sessions are three times/week
  • see Box 8-6

39
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