Language Disorders Exam 3

Zone of Proximal Development (ZPD)

The gap between what a child can do independently and what they can do with support

Intervention for ZPD

we aim to work within the child's ZPD to maximize progress - by scaffolding support and gradually fading prompts as skills emerge

ex) if a child can name one item in a book with help but not alone, the clinician might model labeling and give cues until the child can do it independently

Continuum of naturalness - clinician directed

Most structured. The SLP controls all aspects; materials, responses, order

ex) flashcards, drills, phonological contrast tasks

-often used for very specific targets like articulation or syntax

Continuum of naturalness - hybrid

blends clinician structure with child-led interaction

ex) script therapy, focused stimulation, structured play

-often embedded in routines or familiar contexts

Continuum of naturalness - child centered

Most natural. The child leads; SLP follows and responds

ex) facilitated play, language facilitation strategies

-best for very young children or those with low MLU (<3.0)

Focused stimulation

Hybrid; clinician repeatedly models a target form (eg. verb endings) in meaningful contexts without requiring immediate imitation

Script therapy

embeds targets in familiar routines (bath time, snack) with opportunities for close procedures (now we brush our___)

Facilitated play

promotes narrative, turn taking, and vocabulary by involving the child in imaginative play

How do we modify the linguistic signal? Think Mr. Rodgers

slow rate, repetition, wait time, simplifying utterances, register variation

Token reinforcement

give stickers, tokens, or other motivators for correct responses - often paired with verbal praise

Natural consequences

access to desired activity when child uses language (eg. I want bubbles - gets them bubbles)

Feedback types

recast: He go - Yes, he goes

contingent feedback: child picks up toy car - oh nice car! You have the car

balanced turn taking: let the child lead, then respond

extension of child's topic: saying something that gives more info than the child, child holds up car - you have the blue car

EBP: NICU/Preterm

1. feeding and oral-motor development

2. hearing conservation

3. infant behavior development

4. parent/child communication

EBP: NICU - feeding and oral motor development

positioning for feeding, control milk flow, oral stimulation in feeding, nonfeeding oral stimulation

EBP: NICU - hearing conservation

developing staff awareness of ototoxic medications - antibiotics; monitoring noise level - below 45 dB

EBP: NICU - infant behavior development

goal - achieve stabilization and homeostasis of physiology and behavior

-provide a healing environment

-protect the skin - not over bathing, minimize use of adhesives

-touch times - minimize pain; sleep disruptions

EBP: NICU - parent/child communication

kangaroo care - skin to skin contact; 30 min/day

-decreases length of stay, increase periods of alertness, role of nurturer

EBP: Perlocutionary/preintentional

1-8 months

1. managing feeding

2. managing vocal development

3. communication management

EBP: Perlocutionary - managing feeding

provide oral stimulation; introduce solid foods at 6 months; improving feeding skills - sequential oral sensory (SOS) - avoidance behaviors intervention

EBP: Perlocutionary - managing vocal development

encourage vocalizations; baby talk; reward infant; use functional materials - items at home

EBP: Perlocutionary - communication management

TIPS

PMT - prelinguistic milieu teaching

-combination of gaze, gestures, vocalizations within interactive routines through imitation of child, turn taking, and repetition

1. arranging environment to show desired items, but do not allow access

2. follow child's lead -wait for any communication attempt for requesting item

3. reward immediately - allow access to item

TIPS

Turn taking - back and forth interactions: songs, peek a boo, toys

Imitate - mirror actions/vocals: monkey see monkey do

Point things out - joint attention - bring into view then move to eye gaze

Set the stage - repeat simple games/songs - pause often - wait for child to respond

EBP: Illocutionary/intentional

9-18 months

1. Communication management

EBP: Illocutionary - communication management

Increase frequency by:

-time delay: interrupting a turn taking activity/routine/withholding an object until they request

-verbal: open ended questions or directions

-gaze intersection - move into child's gaze

-modeling -producing sounds child has to produce

-natural consequences

EBP: Emerging

18-36 months

1. enhances milieu teaching (EMT

-choose materials of interest to the child, environmental arrangement, recognize and respond to child

-include goals to: develop play and gestural production; increase frequency; develop receptive language; increase vocabulary; encourage production of word combinations

Exploratory play

2-10 months

focuses on discovering and experiencing the sensory properties of objects and manipulating objects in simple ways. first type of play to emerge in babies

Relational play

10-18 months

involves taking objects apart and putting them back together. may involve 2 or more different objects, eg. staking blocks, puzzles, dumping

Functional play

12-18 months

simple kinds of pretend play, using realistic objects in the way they are used conventionally by other people eg. car on track,, brush own hair, feeding a doll

Symbolic play

18-30 months

complex pretend play that involves moving doll like figures as though they are alive, using one object to represent something else

PMT

-prelinguistic

-nonverbal/intentional communication

-create communication opportunities, model gestures/vocalizations

-parents trained to respond to prelinguistic signals

EMT

-emerging language

-verbal language development

-model and prompt language in natural routines

-parents help model and prompt words in daily interactions

Interactive book reading - CART

encourages engagement and language growth through shared reading:

-comment: look at the big dog

-ask questions: what is the dog doing

-respond by adding more: yes, he's barking. the dog is barking loudly

-time to respond: wait, make eye contact, lean in expectantly

Goals for the 5 areas of language

Phonology: produce multisyllabic words; minimal pairs; constant drills

Morphology: mark past tense, plural -s, possessives

Syntax: increase sentence length and complexity; vary sentence types

Semantics: use precise vocabulary; understand concepts (colors, sizes, emotions)

Pragmatics: initiate conversations, request help, maintain topics

Parallel talk

narrate what the child is doing - you're building a tower!

Self talk

narrate what you are doing - I'm putting the red block on top!

Gestalt Language Processing

children process and use chunks of language as a whole - often learned in routines or emotional situations

-often includes echolalia, which may seems scripted but can be communicative

ex) how very dare you - child repeats entire phrase from bluey when upset

-therapy: focus on modeling shorter, flexible chunks that can be broken down and recombined over time