question

What age are typically developing children in the DL stage?

answer

between 2/3 and 5 years of age

question

What Brown's stages correspond to the DL stage?

answer

2 - 5 (II - V)

question

How big is the MLU of children in the MLU stage?

answer

2 - 5 morphemes

question

Characteristics of the DL stage:

answer

-between 2/3 and 5 years of age -Brown's stages II - V -MLU between 2 and 5 -Explosive stage of language development -Move from telegraphic utterances (semantic relations) to mastery of basic sentence structures

question

Older children in the DL stage

answer

-children with a language delay may begin this stage older than 2 and be well into school age when they complete it -any child (of any age) who falls into Brown's stages II - V and has an MLU between 2 and 5.

question

IEP

answer

-individualized educational program -provides skeleton of intervention program -guide overall programming direction -focuses more on the child than the family (as compared to IFSP), but the family is still considered central members of the IEP team

question

Under the IEP, families:

answer

-must be notified of IEP meetings -have the right to accept or reject IEP and request modifications -must approve any plan before initiation -meetings must be at a convenient time for parents and staff

question

Intervention settings in the DL stage

answer

-children "start school" at age 3 and no longer receive services at home

question

Family-centered practice:

answer

-have meaningful and serious discussions about diagnostic findings -discuss strengths and weaknesses -respect family's wishes about the extent they want to be involved -respect family's preferences about intervention goals and methods

question

(Goals for children in the DL stage) In general, you want to achieve 3 things:

answer

-help the child acquire intelligible, grammatical, flexible forms of expression -give the child tools to make communication effective, efficient, and rewarding -provide the oral language basis for success in literacy

question

Phonology goals:

answer

-at this stage, we care less about individual sounds/processes and focus on how well the child is able to communicate -many problems will resolve on their own -treat only if seriously unintelligible -assess syntactic and semantic skills to avoid missing deficits masked by their unintelligible speech -phonological awareness (PA) may prevent literacy difficulties

question

Long-term goal for phonology:

answer

-increase overall intelligibility -ensure generalization

question

During the DL stage and according to phonology, when is treatment warranted?

answer

-if seriously unintelligible, treatment is warranted -so much phonological growth occurs in the DL period, intervention for particular sounds can be deferred until school age since many speech sound problems resolve on their own by then

question

(T/F) Target phonological and syntactic/semantic skills separately.

answer

-True -not within the same activity, one thing at a time

question

(T/F) Children with language disorders acquire words and comprehension much like typical children.

answer

-True -using fast-mapping and repeated exposure

question

(Semantic goals) Children with DLD:

answer

-may need to hear a new word twice as many times before comprehending and producing it -have particular difficulty with words to talk about cognitive states, verb vocabulary, use of verb particles -less able to identify semantic features -broader difficulties with receptive vocabulary than simply a reduced ability to acquire labels -may benefit from enriched input (repeated opportunities to see connections between words and their referents) -expose children to rare words -help them broaden the range of ideas they can talk about

question

(T/F) In practice, it is easy to separate syntax from semantics.

answer

-False -it is hard to separate syntax from semantics -one thing at a time -be sure new complex syntax uses a meaning the child has already expressed in a simpler way -when expressing new meaning, control syntactic complexity

question

Syntax & Morphology goals

answer

-virtually always appropriate for this period -most obvious goals for the DL period -should be measured in real communication contexts (conversation or narration) -likely need support in other areas like preliteracy, pragmatic skills, and vocabulary -use guided play, mediated conversation, and storybook sharing -select goals that trigger change within and outside the therapy context -look for ways to change patterns of language -base goals on functional readiness (forms they use correctly occasionally and which are obligatory)

question

What should you focus on in Syntax/Morphology?

answer

-typical grammatical deficits: -bound morphemes -auxiliary verbs -articles -pronouns -verb marking (auxiliaries and inflections) -complex sentence production

question

(T/F) Grammar is usually the only aspect of language that needs to be targeted.

answer

-False -grammar is RARELY the only aspect of language that needs to be targeted -don't ignore other areas of concern; also look for mall vocabularies, social problems, and reading disorders

question

Comprehension vs. Production goals:

answer

-guided production activities facilitate both comprehensio nand production of new meanings and forms -production training should be a high priority for forms and meanings the child already shows comprehension -for forms/meanings the child does not yet show comprehension: auditory bombardment, syntax stories, focused stimulation, ILS, etc.

question

Pragmatic goals:

answer

-how we get things done in the real world; how language is used during conversation -provide real communicative contexts (based on the problem areas) -incorporate pragmatic contexts into intervention plan for every objective, but not for every activity (only those that are in real communicative contexts)

question

2 ways to add pragmatics to practice:

answer

-generate a set of pragmatic targets for intervention OR -incorporate pragmatics in the intervention program (i.e. emphasize turn-taking while working on the morpheme -ing)

question

What are the cons of generating a set of pragmatic targets for intervention?

answer

-not as effective or realistic -can't isolate pragmatic skills from syntax and semantics

question

Children with language problems often have problems in _______ play.

answer

symbolic.

question

Play & Thinking goals

answer

-encourage child to use new language to structure pretend play, solve problems, and explore new ideas -play in context which problem solving and exploration take place -new language can be put in service of more mature and imaginative play -use play contexts for practicing new forms and meanings -generalize intervention targets -move child into the zone of proximal development -use language to achieve new levels of symbolic and conceptual development with models and support

question

Indicators of literary success in school:

answer

-strong oral language -phonological awareness -understanding of print -alphabetical knowledge -invented spelling -rapid naming -ability to write name prior to kindergarten

question

Many preschoolers with _____ _____ develop problems in learning to read and write.

answer

language delays

question

Increasingly, who is expected to address preliteracy development?

answer

-SLPs -have deep knowledge about phonological awareness and the connection between oral language and reading

question

The most effective intervention for literacy include a focus on:

answer

-oral language -phonemic awareness -letter-sound relationships -vocabulary and language comprehension

question

Domains for preliteracy intervention: (4)

answer

-phonological awareness -print concepts -alphabet knowledge -narrative and literate language

question

Examples of the 4 domains for preliteracy intervention: (phonological awareness, print concepts, alphabet knowledge, narrative and literate language)

answer

-phonological awareness (count syllables and sounds, identify rhymes and words that start with the same sounds, manipulate sounds in words -print concepts (how books work, turning pages, reading left to right, etc.) -alphabet knowledge (how print represents speech through written language units -narrative and literate language (exposure to stories, poems, plays, etc.)

question

3 major methods of intervention:

answer

-Clinician-directed (CD) -Child-centered (CC) -Hybrid

question

The goal of intervention is to have a ______ of ______ available.

answer

-repertoire of methods -match to the needs of the client/goals being addressed -maximize efficiency -greatest chance of generalization

question

Clinician-directed methods (CD)

answer

-highly effective in eliciting forms in production (great for getting a child to produce a form for the first time) -often fail to generalize to real communication

question

2 ways to increase generalization of CD methods:

answer

-increase naturalness of CD activities -supplement CD approaches with hybrid and CC approaches

question

CD approaches for phonology:

answer

-discrimination (use only for sounds child shows difficulty differentiating) -contrastive drills (minimal pairs, maximal opposition) -drill-play (preferred form of CD intervention) -computer-assisted drill

question

What is the preferred form of CD intervention at the DL stage?

answer

-DRILL-PLAY -good for phonological awareness (games w/ rhyming, syllable counting) -strong relationships between lexical and phonological development

question

(T/F) Computer-assisted drill is neither more or less effective.

answer

-TRUE -it can be motivating and fun for the child, but doesn't prove to be more effective than traditional approaches -use it later on in therapy once the child can use the target -clinician and client should work on the computer programs together

question

CD approaches for semantics:

answer

-many commercial programs available to work on concepts and vocabulary (i.e. Super Duper flashcards) -computer software for semantics

question

Computer software for semantics:

answer

-typically use a drill or drill play format -positive effects on word learning -no dramatically different results from traditional intervention -good contexts for teaching verbs (animation showing action) -do not appear to be a replacement for an interactive environment with a responsive adult

question

CD approaches for Syntax & Morphology

answer

-used extensively since the '70s -some are in commercial format -supplement more naturalistic methods with drill and drill-play activities that elicit imitation of target forms (alternative to operant conditioning)

question

Vast majority of computer software only targets _______ syntax and morphology.

answer

-RECEPTIVE -must be supplemented; child and clinician should participate together

question

Major characteristics of ILS (CC Approach)

answer

-contingent feedback -balanced turn-taking -extension of child's topic

question

Contingent feedback

answer

-ILS; CC approach -saying something that relates to what the child said/did

question

Balanced turn-taking

answer

-ILS; CC approach -letting the child lead, then responding rather than using questioning or initiation to get the child to talk

question

Extension of child's topic

answer

-saying something that gives more information about what the child just said

question

Modified ILS:

answer

-ILS at the developing language stage -child-centered play contexts (play, role-play, cooking, cleaning, crafts, shared book reading) -less parallel talk and self-talk, more recasting -more contrived (deliberately created; selected materials and activities to make targets highly probably) -provide multiple meaningful models of target forms -if the child begins to model clinician's narration, using the target form (correctly or incorrectly), incorporate expansion, extension, recast sentences, and build-up and break down forms of ILS

question

Recasts (CC Approach)

answer

-immediately recasting the child's utterance into a different syntactic form that retains the child's meaning -correct the form or expand on what the child said -helps children see how language rules work to provide several different ways of expressing similar semantic relations -works best when children are already producing a few of the target forms in their own speech

question

Language elicitation techniques (CC Approach)

answer

-violate routines/expectations -withhold objects or turns -misuse/misname/misplace objects -provide inappropriate objects for activity -"pass it on" -"strong, silent type" -"guess what"

question

Parent training (CC Approach)

answer

-focus on specific language facilitation strategies (modeling, expansion, recast, imitation, etc.) -use multiple instructional methods (coaching, demonstrating, role-play, mediating, video-recorded examples) -teach a progression of skills and strategies embedded in specific activities -use of questions in interactions (open-ended questions, questions followed by a pause)

question

Facilitated play (CC Approach)

answer

-highly motivating -permits integration of content, form, and use -encourages child to use everyday scripts to support new language use -play enhances narrative ability, turn-taking, decontextualized language use, communicative intentions, vocabulary development, emergent literacy

question

Play enhances:

answer

-narrative ability -turn-taking -decontextualized language use -communicative intentions -vocabulary development -emergent literacy

question

Child-Centered Approaches for DL stage:

answer

-ILS/modified ILS -Recasts -Language elicitation techniques -Parent training -facilitated play

question

Hybrid approaches in DL stage:

answer

-combination of CC and CD -more naturalistic and child-centered than CD -more structured, sequences and clinician-controlled than CC (ILS or facilitated play) -incidental and milieu teaching

question

Incidental and Milieu teaching for addressing _____ and _____ goals during the DL period.

answer

-semantic and syntax

question

3 main priniciples of Milieu teaching

answer

-environmental arrangement (set up by clinician to make communication likely) -responsive interaction (clinician responds to verbal and nonverbal communication attempts) -conversation-based contexts (based on child's interest and topics he initates

question

Incidental Training

answer

-objects the child wants are out of reach and require communication attempts to obtain -child selects topic of conversation by making some kind of request (verbally, gesturing, gaze) -focused attention/question when child initiates communication -prompt once or twice (if needed); ranging from general to specific -child receives desired object

question

Hybrid Approaches for Phonology: CYCLING

answer

-some parts are structured, others are not -review targets -auditory bombardment -practice production (small number of words) -identifying new words for the next session -repeating auditory bombardment -giving parents a list of the words for auditory bombardment at home

question

Focused Stimulation (Hybrid Approach)

answer

-Weismer and Robertson (2006) -facilitate grammar acquisition in preschoolers -focuses on specific forms and uses multiple models with a variety of forms of clinician feedback to stimulate goals -context of natural conversation between the client and adult -target forms used by the child < 50% of the time in obligatory contexts

question

Example procedures for focused stimulation:

answer

-demonstrating use of target in initial or final position (most salient) -expansion -recast -buildups and break-downs -false assertions -feigned misunderstandings -forced choices -violating routines -withhold objects and turns -violating object function -syntax stories

question

Script-Therapy Event Structures (Hybrid Approach)

answer

-reduces the cognitive load of language training by embedding it in the context of a familiar routine -choose event structures from the real world that are well-known to the child as contexts to develop verbal routines (i.e. ordering food at a restaurant, grocery shopping, etc.) -play provides background, but focus is on using target language

question

Conducting script-therapy event structures:

answer

-client and clinician use props to act out, with clinician first modeling entire verbal script -cloze procedures to elicit increasingly large parts of verbal scripts -clients act out and recite entire even structure -repeat enactment, but trade roles -add variations to event structure -clinician plays a role and violates expected events in script

question

Scripts serve as a framework for developing _______ and ________.

answer

-vocabulary and morphosyntax

question

Child-centered play vs. script therapy event structures:

answer

-CC play is more open ended -Script therapy: clinician takes on a stronger leadership role by modeling, requesting target forms, and is more structured/contrived

question

Script Therapy Literature-Based Scripts:

answer

-picture books are of interest to children -natural, familiar format for adult-child interactions -receptive language closely tied to pictures -adults scaffold child's reading contribution -establish joint attention -practice and stabilize language skills -also songs, rhymes, and finger plays -ideal homework activity for families -adds to children's cultural literacy

question

MUST structure the joint book reading experience (literature-based scripts):

answer

-select books that provide opportunities for the target -multiple readings of the same book -questions, joint retell, retell the story with errors, picture walk, print referencing activities, etc.

question

(T/F) Joint book reading is an ideal context for language learning.

answer

-TRUE -promotes vocabulary acquisition, grammatical development, social communication, and preliteracy

question

Structured-Play - Conversation (Hybrid approaches)

answer

-guided conversation supports skills being targeted -suggested techniques for children with poor assertive skills and trouble with responsiveness -teach preschoolers to use interesting props in order to gain entry into peer group play activities

question

Brinton and Fijuki: 2 types of conversational behaviors:

answer

-Assertiveness -Responsiveness

question

Children w/ poor assertive skills:

answer

-quiet in conversation, take their turns reluctantly or not at all, rarely initiate topics -engage child in entertaining activity, child's contribution is minimal -"Go Fish" child must initiate play; demands on the child are increased -Later, make format less structured; peer conversations

question

Children who have trouble with responsiveness:

answer

-peers and adults find conversations with such children difficult and unrewarding -use interactive games that help the child become sensitive to signals in conversation that a turn is available -set up turn exchanges (walkie talkies, "over") -move to more collaborative games in which the child needs to obtain and attend to info provided by the partner

question

Structured play - Narrative (Hybrid approach)

answer

-story reenactments -children listen to simple stories (provide preparatory set, first to focus attention on basic elements) -If FAMILIAR story, have them recall setting, characters, basic problem, consequences, plans and goals -If NEW story, have children listen for certain elements so they can answer questions later -after reading/telling, ask questions (repeated answering of these types of questions helps children learn story grammar) -assume roles and act out story

question

If familiar story...

answer

-have them recall setting, characters, basic problem, consequences, plans and goals -(structured play - narrative; hybrid approach)

question

If new story...

answer

-have children listen for certain elements so they can answer questions later -(structured play - narrative; hybrid approach)

question

(T/F) Narrative skills are not correlated with success in literacy.

answer

-FALSE -Narrative skills are HIGHLY correlated with success in literacy -children w/ language disorders in the DL period are less skilled at producing narratives than typical peers

question

2 questions to ask for intervention in the DL stage:

answer

-Who should deliver the intervention? -What service delivery model will be used?

question

Agents of intervention for Children in DL stage:

answer

-SLPs -Paraprofessionals -Parents -Peers

question

SLPs

answer

-responsible for intervention program -design detailed lesson plans using linguistic stimuli, materials, language targets, reinforcement/corrective feedback -evaluate and adjust the program (ongoing) -train and supervise paraprofessionals according to ASHA guidlenes

question

Paraprofessionals

answer

-deliver services to children and their families under the supervision of a professional who is ultimately responsible for the intervention program -generally provide one-on-one instruction using methods and procedures developed by the supervising clinician

question

ASHA Guidelines for PARAPROFESSIONALS working with the DL period

answer

-trained to use ILS in the classroom setting -supply intensive one-on-one language stimulation in the classroom-based intervention setting (modeling appropriate language for child to use with peers; coaching the child in social settings) -provide structured CD or hybrid intervention in small group (under the close supervision of the SLP) -may be assigned to one child with severe disabilities to help that child function in the classroom

question

Parents

answer

-child is with their parent more than anyone else, so they can be a great tool in therapy -caution: sensitive to parent-child relationship (child may need acceptance and uncritical approval of parents) -use parents to encourage generalization and provide opportunities to use learned forms

question

Peers

answer

-best for practice and generalization -typically developing peers can be models -select for normal language competence, interest in peers with disabilities, willingness to play for extended periods, responsiveness to conversation -teach peers to provide good models and opportunities for the client

question

Service delivery models

answer

-clinician / "pull-out" model -language-based classrooms -consultant model -collaborative model

question

Clinician model

answer

-aka "pull-out" model -children are seen in a one-on-one or small group setting

question

PROS of clinician-model

answer

-more individualized attention -many opportunities for child to practice target forms -helpful for children with attention problems, hearing impairments, behavioral problems

question

CONS of clinician-model

answer

-high cost, labor intensive, may be less effective at achieving generalization -clinic room is not like the real room

question

Language-based classroom

answer

-popular for preschool age -extended periods of intervention time -teaming with classroom teacher -combines a variety of approaches and intervention contexts (routine activities, theme-based units) -allows for a variety of individual goals to be targeted for the different needs of children in the classroom -emergent literacy skills

question

Consultant model

answer

-SLP takes on a consultant role -supply specific suggestions for activities that parents and teachers can use to engage the client -provide training in specific techniques (ILS, joint book reading) -ongoing assessment and evaluation of the client's program -helping teachers understand and manage challenging behaviors

question

2 types collaborative model

answer

-demonstration model -team-teaching

question

Demonstration teaching (collaborative model)

answer

-SLP acts as a "guest teacher" -providing targeted intervention in a main-stream classroom setting

question

Team-teaching (collaborative model)

answer

-SLP participates in a lesson designed in collaboratio nwith the teacher -SLP may work with a group of students who need specific help in language -Similar to the RTI model (Response-to-Intervention; 3 tiers); continuous progress monitoring, collaborative problem solving

question

5 factors for successful collaboration efforts:

answer

-be ready to learn from others -take responsibility for the student as a team -have a system in place for making decisions -clarify the roles of the team members -support families and regular education teachers

question

3 tiers of the RTI model

answer

-Tier 1: evidence-based instruction for all students -Tier 2: more intensive instruction for children who need additional support -Tier 3: additional support, more intense and individualized

question

Principles of intervention for older, severely impaired clients at the DL level:

answer

-help students achieve functional abilities for being as independent as possible -focus on function rather than developmental sequence -use activities and materials that are appropriate and functional -develop early literacy skills -develop opportunities to participate independently in social contexts

question

Echolalia

answer

-echo/repetition of what he/she has heard -not universal or unique to ASD -in 40% of children with ASD, it is a first step toward language acquisition; decreases as spontaneous language grows

question

2 types of intervention for echolalia

answer

-response interruption and redirection -mitigated echolalia: more naturalistic, imitating the echo, but changing it into something more natural/appropriate for the conversation

question

Form & ASD

answer

-limited spoken abilities throughout preschool -show both autistic communication difficulties and problems acquiring form similar to other children with DLD -have difficulty when imitation and joint attention - may not respond to the child-centered and hybrid approaches -best to use clinician-directed, behavioral approaches like discrete trial training (these have the strongest evidence base for this population)

question

Content & ASD

answer

-use few words that refer to mental states (think, remember, know) -have trouble with deictic uses of words (i/you, here/there, come/go, give/take) that shift meaning depending on the point of view

question

Use & ASD

answer

-pragmatics are the area in which all children with ASD will require assistance -using pragmatic contexts as generalizing opportunities makes sense for children with ASD -need help to use their language effectively with peers -visual schedules help (provide predictability)

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