Communication and Emergent Literacy: Early Intervention Issues

1. Communication and Language Interventions Session 3 Early Intervention Training Center for Infants and Toddlers With Visual Impairments FPG Child Development Institute, 2005 Communication and Emergent Literacy: Early Intervention Issues

2. Objectives After completing this session, participants will • define communication form and function. • describe recommended practices for facilitating early communication and language development. • describe the relationship between secure attachment and early communication and strategies for facilitating attachment and early communication—contingent responsivity, turn taking, providing choices, following the child’s lead. 3A

3. Objectives After completing this session, participants will • discuss the importance of concept development for early communication of children with visual impairments and strategies for facilitating concept development in infants and toddlers with visual impairments. • describe evidence-based strategies for communication and language intervention. 3B

4. Objectives After completing this session, participants will • describe strategies for facilitating early communication and language development in infants and toddlers as they move through the seven levels of communicative competence and acquire symbolic communication. • explain why some children with visual impairments may develop atypical communication and describe strategies for facilitating communication and for addressing echolalia, pronoun confusion, overuse of questions, and perseveration. 3C

5. Objectives After completing this session, participants will • define augmentative and alternative communication (AAC) and assistive technology and describe strategies to facilitate communication in individuals who may benefit from AAC. • describe the relationship of communication and language to emergent literacy—that reading, writing, speaking (augmented communication), and listening develop concurrently and interrelatedly. 3D

6. Objectives After completing this session, participants will • describe strategies and interventions that promote communication, language, emergent literacy (narrative knowledge, vocabulary, listening comprehension), and metalinguistic development (phonological awareness, syntactic awareness). 3E

7. Communicative Form • Communication is any behavior that an onlooker interprets as an attempt by another to convey a message. • Consistent caregiver responses promote intentional communication in infants. Dunst, 1978 Prizant, Wetherby, & Roberts, 2000 3F

8. Communicative Function Communicative functions include • Behavior regulation – regulating another’s behavior (e.g., wiggling to protest being held) • Social interactions – actions that maintain another person’s attention (e.g., greetings, social routines) • Joint attention – directing another person’s attention to an object or experience (e.g., a boy looks at his grandma while pointing to a toy) Dunst, 1978 Prizant, Wetherby, & Roberts, 2000 3G

9. Communicative Forms and VI • Children with visual impairments may engage in communicative behaviors that are socially inappropriate. • Families and early interventionists provide intervention to change the form of inappropriate behaviors while promoting use of appropriate forms for particular functions. • For example, hair pulling (form) may be used to initiate social interaction (function). While the function may be appropriate, the form is inappropriate. Thus, the child should be encouraged to seek social interaction in more appropriate ways. Fazzi & Klein, 2002 3H

10. Steps for Intervention 1. Distinguish the behavior that needs to be changed (form) from the function that it serves. 2. Provide children with more appropriate forms that serve the same or similar functions. For example, in order to provide an alternative to hair pulling, the team provides the child with a Big Mack switch that plays a recorded greeting when activated. The family and early interventionist respond immediately and interactively each time the switch is activated. 3I

11. Family-centered practices Team collaboration Appropriate functional assessment Functional outcomes within daily routines and natural learning opportunities Recommended Practices 3J

12. Family-Centered Practices • Treating families with respect • Being responsive and flexible • Sharing information that facilitates informed decision making by families • Promoting family choice in program and intervention decisions • Collaborating with families • Mobilizing and providing family supports and resources Dunst, 2002 3K

13. Early interventionists should support families by addressing their concerns and priorities for their children within the context of daily routines and natural learning opportunities. Early interventionists can assist families by recognizing that caregiver-child interactions provide the foundation for language and communication, cognitive, and emergent literacy development. Dodici, Draper, & Peterson, 2002 Family-Centered Support 3L

14. TVIs assist families in understanding and interpreting children’s subtle communicative cues. In order to communicate about actions, objects, and people, young children with visual impairments and multiple disabilities may use facial expressions, gaze orientation, body posture and movements, changes in muscle tone, and/or gestures. Chen, 1995 Reading Subtle Cues 3M

15. Collaboration Communication interventions are most effective when a partnership exists between professionals and caregivers, and caregivers are the primary interventionists. Prizant, Wetherby, & Roberts, 2000 3N

16. Potential Roles of Early Intervention Team Members • Families identify their concerns and priorities. • TVIs can assess the impact of visual impairments on communication, language, and emergent literacy development. 3O

17. Potential Roles of Early Intervention Team Members • Speech-language pathologists can offer information about early communication and assist in assessment and intervention planning. • Audiologists are helpful in assuring that young children have normal hearing or are identified as having a hearing loss. 3P

18. Functional Assessment • Routines-based assessments (RBAs) provide insight into families’ concerns and priorities for children’s communication and language development and guide functional interventions. • Families will be more motivated to implement interventions in their daily routines if the interventions address their concerns and priorities and make it easier for the family to function. 3Q

19. Developing Functional Goals • Break large goals that the family and other members of the early intervention team identify as priorities into smaller, functional objectives. • Children learn naturally from their caregivers within naturally occurring learning opportunities. • Communication and language interventions should be embedded in routines. 3R

20. Realistic Outcomes • Families sometimes identify abstract communication goals such as, “I want her to be able to describe what’s wrong when she cries.” • The early intervention team can assist the parent by breaking this large goal into small, achievable steps based on the child’s current level of functioning. 3S

21. Functional Communication and Language Outcomes Functional communication and language outcomes • promote and facilitate social interactions, • promote the child’s active engagement and learning, and • promote the child’s ability to function as independently as possible. 3T

22. Facilitating Communication in Routines To be effective, communication and language intervention for infants and toddlers should occur within social contexts in naturally occurring social routines and events. 3U

23. Attachment and Communication • Attachment is the formation of significant and stable emotional connections between individuals, such as an infant and mother. • The attachment process begins in early infancy as the child bonds with one or more primary caregivers. 3V

24. Secure Attachment Behaviors • Crying when separated from parents • Staying close by parents • Expressing joy upon reunion with parents • Social referencing or “checking in” • Reacting to strangers 3W

25. Attachment and Early Communication Children who are securely attached are more likely to • cooperate with their parents, • actively explore their environment, • build stronger relationships with others, and • be involved in communication and emergent literacy events. Dodici, Draper, & Peterson, 2003 3X

26. Contingent Responsivity The development of attachment is related to caregivers’ ability to perceive infants’ cues and to respond quickly and appropriately (contingently) to those cues. Fazzi & Klein, 2002 Warren & Hatton, 2003 3Y

27. Nonverbal Communicationand Attachment Early in the process of language development, children’s communication may be subtle and expressed through • facial expressions, • eye gaze, • body posture and movements, • changes in muscle tone, and • gestures. Chen, 1995 3Z

28. Attentive Stillness • Attentive stillness, an act of staying motionless to better attend to a situation, is a subtle nonvisual communicative behavior observed in some children with visual impairments. • If the parent recognizes that the child is staying still to better attend, the parent is more likely to continue the interaction. 3AA

29. Understanding Nonverbal Cues Learning to interpret and respond immediately and appropriately to children’s subtle behavioral and nonverbal cues (contingent responsivity) facilitates attachment and communication. 3BB

30. Facilitating Secure Attachment • Touch and hold the child. • Respond to the child’s physical and emotional needs promptly and appropriately. • Follow the child’s lead. • Consider the child’s interests and abilities. • Provide the child with choices. • Play turn-taking games. • Establish and maintain consistent routines. 3CC

31. Insecure Attachment • Insecure attachment can occur for a variety of reasons other than visual impairment. • Parents and caregivers may have to examine their own parenting behaviors and attitudes, often rooted in childhood experiences. 3DD

32. Concept Development and Communication As infants grow and are exposed to new experiences, they develop more concepts about themselves, their world, and other people that provide them with topics about which to communicate. 3EE

33. Concept Development and Visual Impairments Visual impairments may affect what concepts a child develops as well as how the concepts are developed. Most children acquire many concepts incidentally through vision. Even when children use other senses to develop concepts, vision is the unifying sense that integrates information from the other senses. 3FF

34. Promoting Concept Development To develop the concepts that are necessary for communication, children with visual impairments must • actively engage in a variety of activities with people and objects, • learn through naturally occurring events and functional tasks in the home and in the community (e.g., baking cookies, physically exploring a fire truck at the local fire station), and • have opportunities to play. Fazzi & Klein, 2002 Ferrell, 1996 3GG

35. Naturalistic, Evidence-Based Practices for Communication and Language Dunst and Roper identified seven naturalistic evidence-based communication practices: • Increased opportunity • Child-directed activities • Adult responsiveness • Imitation • Modeling • Minimal prompting • Participation Dunst & Roper, 2003 3HH

36. Naturalistic intervention is used to help children generalize communication skills or to teach new skills. These strategies have been found to be effective with children with disabilities who engage in nonlinguistic communication as well as children who talk. Sapp, 2005 Naturalistic Intervention 3II

37. Though there are many specific kinds of naturalistic strategies, they all share the following characteristics: involve brief interactions between a child and an adult, occur in informal settings and activities, provide opportunities to learn new skills or practice skills, are based on children’s interests, have naturally occurring reinforcers, and do not affect the natural flow of the interaction. Sapp, 2005 Characteristics of Naturalistic Interventions 3JJ

38. Increased Opportunity • Children are given frequent and varied opportunities to communicate. • The experiences should provide children with opportunities to practice current communication abilities in meaningful and functional activities. Dunst & Roper, 2003 3KK

39. Child-Directed Activities • Child-directed activities involve following the child’s lead and modeling language. • Interviews with caregivers can be used to identify child interests to increase active engagement and facilitate communication. • Interactive matching requires adjusting pacing and communication to match the child’s communicative level as well as following the child’s lead. Dunst & Roper, 2003 3LL

40. Adult Responsiveness Responsiveness involves “paying attention to a child’s cues, no matter how subtle or unconventional, and responding contingently to the child’s attempts to interact with others as a means of increasing child production of the behavior.” Dunst & Roper, 2003, p. 221 3MM

41. Joint Attention Joint attention is a communicative act in which two or more individuals interactively attend to the same object, activity, or person. Episodes of joint attention increase children’s communication, as evidenced by behaviors such as meaningful words, pointing, shared looks with adults, and showing toys. Kasari, Freedman, & Paparella, 2001 Murphy & Abbeduto, 2005; Paparella & Kasari, 2004 3NN

42. Responsive Parenting Responsive parenting is linked to optimal outcomes in all areas of development, including communication and language development and emergent literacy. Dodici et al., 2003 Warren, 2000 3OO

43. Specific Interventions Based on Responsiveness Responsiveness is also incorporated in other more specific evidence-based interventions: • Prelinguistic milieu teaching (PMT) • Milieu language teaching techniques 3PP

44. Prelinguistic Milieu Teaching Prelinguistic milieu teaching is an adaptation of milieu language teaching for children in the prelinguistic period that also uses the following strategies: • Following the child’s lead • Facilitating learning during social routines • Arranging the environment • Targeting individual behaviors Warren & Yoder, 1998 Warren, Yoder, & Leew, 2002 3QQ

45. Prelinguistic Milieu Teaching Prelinguistic milieu strategies include: • Targeting individual behaviors • Using specific verbal and nonverbal prompts • Using vocal and gestural modeling • Providing specific praise • Linguistic mapping • Using natural consequences as reinforcers Warren & Yoder, 1998 Warren, Yoder, & Leew, 2002 3RR

46. Milieu Language Teaching Milieu language teaching procedures • can be used to implement individualized language goals for young children during naturally occurring learning opportunities, • involve observing a child or playing beside a child and making use of naturally occurring communication opportunities • use the mand-model and incidental teaching procedures. Warren & Kaiser, 1988 Warren, Yoder, & Leew, 2002 3SS

47. Imitation • Imitation enhances communicative competence. • Imitative social interactions establish the concept of turn-taking, which is the basis for effective communication. Dunst & Roper, 2003 3TT

48. Modeling • Dunst and Roper (2003) define modeling as “the provision of appropriate examples of target sounds, words, or phrases” (p. 222). • Imitation and modeling can be combined to further develop communication (Paparella & Kasari, 2004). 3UU

49. Mand-model intervention is beneficial for children who rarely initiate interactions and for children who need to expand their current communication skills. Incidental teaching can address a broad range of goals. When children frequently initiate interactions and are engaged in motivating activities, responsive caregivers scaffold the child’s experiences to help facilitate the development of new skills. Sapp, 2005 Mand-Model Intervention and Incidental Teaching 3VV

50. Mand-Model Procedure The adult asks the child a question that requires a response other than yes or no, and then waits expectantly for a response. When the child speaks, the adult expands slightly on the response and continues the interaction. Wolery, 1994 3WW