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The child is provided with concentrated exposures of specific linguistic forms / functions / uses within naturalistic communicative contexts
Appropriate for:
•Language Form
–Syntactic & morphological markers (-ing, is)
–Phonological (cup for tup)
•Language Content
–Vocabulary targets
•Language Use
–Greeting,requests, comments
Focused Language Stimulation
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•The manipulation of the input provided to
the child is in the form of multiple repetitions of preselected language targets presented in an unambiguous context
–Manipulate
multiple word language models to place stress on target word
• Intonation
• Placement– beginning or end of carrier phrase
•Natural reinforcers “Yes that is a funny dog”
•No requirement for child to produce
Key components of focused language stimulation
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•Children should minimally demonstrate
communicative intent and the ability to attend in joint attending
–Besides that; appropriate for multiple developmental levels
•Facilitator (parent or trained
caregiver), child, context
•Variation permitted
Requirements of Focused Language Stimulation
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•Children with developmental language
delays & disorders
–Have difficulty pulling language out from the natural context
•“unable to extract & process information from the natural social context”
•Need more focused, concentrated learning experiences
Target population for focused language stimulation
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–Bidirectional interactions between the unique cognitive characteristics of the learner, the environment, and the people
•Increases speed & durability of learning
Social Theories for Focused Language Stimulation
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–Difficulties in the way that the brain attends to, organizes and stores information
•Pathways traversed
Information Processing Models for Focused Language Stimulation
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–When an interaction exceeds the child’s resources in working memory breakdowns in language learning
–Weakly represented linguistic forms most susceptible
•Lessmcomplex, more salient, more frequent input of linguistic forms helps to build representation & store in working/long term memory
•Limited Capacity Model for Focused Language Stimulation
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•gains seen under ideal, controlled conditions & focus on specific, short-term language outcomes
Efficacy of Focused Language Stimulation
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usefulness of treatment under the conditions of everyday practice and usually identifies broader measures of language gains and functional outcome measures in related areas such as social skills, school readiness, perceptions of quality of life
Effectiveness of Focused Language Stimulation
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•Periodic informal probes of the target constructions following treatment sessions
•Comparison of target form usage to that of untreated control forms
•Language sample analysis to evaluate use of treatment targets as well as to assess cascading effects of intervention and development on other aspects of language development
•Parental report measures such as the CDI or LDS to assess early lexical and grammatical abilities
•Use of parent logs to document the child’s productions of target words or grammatical structures at home
•Completion of parent or teacher surveys to compile perceptions of the child’s linguistic skills as well as perceptions of broader domains relating to social skills and academic readiness or performance
Focused Language Stimulation Assessment Methods
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Child centered strategies for focused language stimulation
•Follow Child’s Lead
•Wait For Child To Initiate
•Face-to-Face Proximity
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Interaction Promoting Strategies for focused language stimulation
•Take One Turn At A Time
•Wait With Anticipation
•Ask Questions That Encourage Turns On Topic
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Language Modeling Strategies for focused language stimulation
•Interpret Child’s Message
•Self Talk & Parallel Talk
•Responsive Labeling
•Expand Child’s Utterances
•Extend Child’s Topic
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Setting up the environment with items that will stimulate the child to communicate what you want them to say. This can be done by keeping desired items out of sight (somewhere where your child will not find them) or keeping them out of reach.
Arrange Environment for Communication Opportunities
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A set of behaviors (e.g., following the child’s
lead, responding to the child’s verbal and nonverbal initiations, providing meaningful semantic feedback, expanding the child’s utterances) that keep the child’s attention in the conversation and provide models slightly in advance of the child’s current language.
Responsive Interactions
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When playing with a child, you allow them to lead you to what they are interested in.
Follow Child's attentional lead
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A way to introduce the child to conversation and
the practice of taking turns. A routine has the following features: the same steps are used each time, always following the same order ,it begins and ends the same way each time, it can be repeated several times each day, different people in the routine have different roles
Build & Use Social Routines
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describe your own actions as you play with the child
self talk
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you talk about what the child is doing
parallel talk
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The process in which a child's knowledge is gained from interactions with the environment. This learning process lacks a formal structure.
incidental learning
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Demonstrating to the child what is expected of them. An example is a child saying ‘We getted to the movies last year’. What he may mean is ‘We went to the movies last week’. So when he has finished his sentence I would re-model the correct sentence ie. “Yes that’s right we went to the movies yesterday.”
models
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used to encourage a specific behavior
ex: say "ball"
cueing/prompting
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Take what the child said and add the correct
grammar and semantic details that would make it an acceptable adult utterance (ie: The child puts a toy dog in a dollhouse and says “doggy house.” to “the doggy is in the house.”)
expansion
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Comments that add some information to a comment
made by the child (ie. “doggy house”, “He went inside.”)
Extensions
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Stress more than one word per utterance and use
exaggerated intonation contours.
Increase perceptual saliency through prosody and word order
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Use shorter more semantically simple sentences (shorter vocabulary).
Decreasecomplexity of language
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Providing clients with what they would normally
get from natural interactions, but increasing the occurrence of these.
provide repepition
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Every once in a while, take away a toy the child
is playing with so they have to request it to have it given back to them.
withholding
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For example, give your child a fork to eat his cereal with and see how he problem solves this "mistake."
sabatoge
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•Play-based interactions to enhance
language skills in young children
•3 Main Components:
–Environmental Arrangement (to support language learning and language teaching)
–Responsive Interaction
–(Limited) Milieu Teaching Episodes
Enhanced Milieu Teaching
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EMT is must successful with:
- –Kids with MLU of 1.0 – 3.5
- –Kids who are verbally imitative
- –Kids who have at least 10 productive words
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•Grounded in Behavioral Principles
–Antecedent-Behavior-Consequence
–Adultprompts child for language target -> children respond to prompt -> Adultreinforces child’s attempt
EMT theoretical basis
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•Emphasis:
–Development of a conversational style of interaction between parent and child that promotes:
•Balanced communication
•Appropriate language models
–Supportive,interactional social context for language
EMT responsive interactions
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•Prompting Procedure:
–Child’s interest in the environment is the basis for eliciting elaborated child communicative responses
•Core Techniques:
–Modeling
–Mand Modeling
–Time delay
–Incidental teaching
Milieu teaching
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EMT targets
- –Vocabulary
- –Semantic classes
- –Syntactic classes
- •Immediately functional in child’s environment
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•Acquisition
•Generalization
•Maintenance
EMT phases
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•Two Main Aspects:
1.Positive Examples of EMT Use
•In Vivo Models, Watching videos of parents demonstrating EMT techniques,
•Role Playing examples: parent plays role of therapist and child across several practice opport
–Good opportunity for SLP to teach parent
in safe environment
–Presents fresh perspective for parent
without pressure from child
2.Coaching and Feedback
teaching parents EMT
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•SLP models new skills for parent and
joins in parent – child interaction
–Must be sensitive and balanced when doing so; can be overwhelming for parent
•Coaching:
–Most effective when offered while parents are practicing with child
–Stay in background of parent-child interaction while providing guidance
•Give specific suggestions & differential feedback about parent’s use ofprocedures
–Must be precise, supportive and clear about critical behavior changes
In Vivo Modeling
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•Clinician Teaching Child
–Designed to increase the frequency and complexity of intentional NONVERBAL communicative acts to set the stage for later language learning
-for children with developmental age of 9-15 months, need to increase vocalizations
Prelinguistic Milieu Teaching
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•Clinician Teaching Parent
–How to be optimally responsive to their child
–Increase recoding of nonverbal acts
Responsivity Education
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Goals of PMT
- •Increase the frequency, clarity, &
- complexity of the child’s nonverbal communicative acts:
- –Vocalizations
- –Eye Gaze
- –Gestures
- –Combo
- of the three
- •IntentionalCommunication
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3 main purposes of intervention
- 1.Change or eliminate the underlying problem
- •Not usually possible
- –Usually don’t know cause or underlying problem cannot be eliminated
- 2.Change the disorder
- 3.Teach Compensatory Strategies
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•Rate of growth or learning is accelerated, but the final outcome is not changed
–Achieve milestones sooner, but does not mean higher overall language skills ultimately
–i.e. expressive language delay
facilitation
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•Preserves a behavior that would otherwise
decrease or disappear
–i.e. cleft palate toddler; therapy to continue babbling and vocalizations until surgery
maintenance
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•Imake that behavior happen
•Without therapy the behavior would not occur
–Most dramatic form of intervention
–i.e. teaching sign language to a deaf
child with hearing parents
Induction
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highest priority goals are from __% to __%
10-50%
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–Choose
objectives that increase child’s ability to communicate
communicative effectiveness
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–Stimulable for teaching the concept
teachability
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target selection based on..
- –Client needs
- –Generalization
- –Ease of mastery
- –Age appropriateness
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3 intervention approaches
- -clinician directed
- -child centered
- -hybrid
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use with child who has language
ABC
play-based
EMT
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