Comprehensive Guide to Developmental Disabilities, Laws, and Communication Strategies in Early Intervention

PL-99457

A Piece of legislation mandated that states establish comprehensive services for children with developmental disabilities and their families. First mandated in 1986.

Individuals with Disabilities Education Improvement Act (IDEA) (1990)

Clarified free, appropriate public education (FAPE) for children with disabilities.

Individuals with Disabilities Education Improvement Act (2004)

Federal law that addresses services for children with disabilities and significant developmental delays from birth to 2 years, with possible extension to age 6. The primary focus was supporting the family's developmental needs.

IEP

For children aged 3-21, focuses on their educational needs and provides specialized education and related services within a school setting.

Developmental Disability

A severe chronic disability of an individual 5 years of age or older that is attributable to mental or physical impairment or a combination of impairments; is manifested before the age of 22 years; is likely to continue indefinitely; results in substantial functional limitations in three or more areas of life activity; and reflects the individual's need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration.

Disability

An inability or lack of ability to perform tasks, functions, or skills.

Impairment

An abnormality in function or structure.

Handicap

Social consequences of disability or impairment that prevent an individual from realizing his or her potential.

Multidisciplinary Teams

Professionals from different disciplines work independently. Separate roles, minimal collaboration.

Interdisciplinary Teams

Professionals from different disciplines work together, share information, and coordinate services but keep their specific roles. Team meetings, some role coordination.

Transdisciplinary Teams

Professionals share roles and skills, often using arena assessment, with one primary provider and high role release. Maximum collaboration, flexible roles, and one main facilitator. Considered the best team format for EI.

Cultural Competence

Evolves over time and is the competence that comes with self-assessment and ongoing education to understand various cultures.

IFSP

An intervention plan that addresses both child (birth to age 2) and family needs that affect the child's development and includes the child and the family's status, the recommended services and expected outcomes, and a projection of the duration of service delivery.

Who is involved in the IFSP

The family, a multidisciplinary team (such as SLPs, OTs, PTs, and service coordinators) and other professionals work together with the family to develop and review the IFSP.

Evidence-Based Practice (EBP)

Means making clinical decisions using the best available research evidence, your professional expertise, and the client's/family's values and needs.

Communication Impairment

A significant disability in young children, characterized by difficulty receiving, sending, processing, and comprehending concepts of verbal and nonverbal communication.

Late Language Emergence (LLE)

A hallmark characteristic of children with LI and often the first diagnostic symptom of a larger language problem. Less than 50 words at 25 months?

Established Risk

Children with an established risk have a diagnosed medical condition or disability that is known to cause developmental delays.

At Risk

Children who are more likely than others to experience developmental delays due to various environmental, biological, or social factors, but who have not yet been formally diagnosed with a condition.

APGAR

A Newborn or neonatal Screening tool used to rapidly assess overall health.

Respiratory Distress Syndrome (RDS)

Lack of surfactant leads to air sacs collapsing and difficulty breathing.

Apnea

Baby stops breathing for more than 20 seconds due to an immature brainstem; more common in smaller/preterm babies.

Bronchopulmonary Dysplasia (BPD)

Chronic lung disease from lung scarring and inflammation; often follows RDS and oxygen treatment.

Intraventricular Hemorrhage (IVH)

Bleeding in the brain's ventricles, mostly within 3 days of life; can cause brain damage, CP, seizures.

Parent Ductus Arteriosus (PDA)

Heart defect where a fetal artery doesn't close, which leads to abnormal blood flow, extra work for the heart and lungs.

Retinopathy of Prematurity (ROP)

Affects eyes.

Anemia

Low red blood cells.

Jaundice

Yellow skin from immature liver.

Functional Communication

The use of symbols or actions to express basic wants and needs and to obtain a desired outcome.

Transactional Model of EI

A model of typical communication and language development where both the parent and child contribute.

Generalization

The ability for the child or person to use the responses they've learned in different settings.

Importance of Generalization

Generalization is the real life impact of speech therapy.

Responsive Interaction Strategies

Intervention by responding to what the child does without forcing a response.

Directive Interaction Strategies

Manipulate antecedents and consequences around a desired behavior.

Blended Strategies

A mix of behavioral and naturalistic methods designed to feel more like real-life interactions.

Interprofessional Education - IPE

A learning approach where students from different professional backgrounds learn with, from, and about each other.

Interprofessional Practice - IPP

When professionals from multiple disciplines work together in a coordinated way to deliver integrated care and service.

Cultural Humility

Understanding that you have to know your own culture and reflect on what you know and don't know.

Cultural Responsiveness

Involves understanding and responding to the combination of cultural variables and dimensions of diversity.

Evaluation

The formal diagnosis and eligibility.

Screening

A quick check for risk.

Assessment

A continuous testing process to guide services.

Transdisciplinary Assessment

A team approach where professionals from different disciplines, like SLPs, OT, etc, share roles and skills.

Benefits of Transdisciplinary Assessment

Provides a comprehensive understanding, leads to increased efficiency and better-informed planning, and improved outcomes for children.

Play-Based Assessment

Observing how a child communicates and interacts during play to assess development in a natural, comfortable way- ideal for infants and toddlers.

Informal Assessment

Using flexible, naturalistic ways to learn how a child communicates in real life instead of relying only on a standardized test.

Nonsymbolic Communication

Communication without using conventional symbols like words, signs, or picture symbols, using gestures, vocalizations, echolalia, or behaviors like crying or hitting.

Prelinguistic Communication

The child communicates intentionally but doesn't use real words yet, including vocalizations, babbling, gestures, joint attention, and imitation.

Symbolic Communication

When the child starts using symbols to represent ideas, such as spoken words, sign language, or picture symbols.

Linguistic Communication

True language use where the child uses words and grammar rules to create new phrases or sentences.

Functional Equivalence

When two behaviors have the same effect on the environment, and a child picks a method that has the best results.

Joint Attention

The ability to coordinate attention between people and objects for social purposes, usually developing through the first 18 months.

Motor Imitation

When a child copies an action done by someone else, like clapping hands or waving.

Functional Use

When a child uses an object or toy in the way it's meant to be used in daily life.

Intentional Communication

A child's gesture or sound meant to send a message by getting someone's attention and sharing focus on an object or event.

Caregiver-Child Interactions

Observing how the child and caregiver share attention, play, and communicate.

Contingent Response

Checking if caregivers respond immediately and appropriately to the child's signals.

Parental Responsiveness

Noting how sensitive and tuned-in the caregiver is to the child's needs, interests, and attempts to communicate.

Means-Ends (Pre-intentional)

Baby Problem-Solving where the child gets what they want by doing something simple, like pulling a string or pushing a button.

Requesting (Intentional)

Asking for something where the child tries to get what they want on purpose, by reaching, looking at you, or making a sound.

Protesting (Intentional)

Saying "no!"- the child shows they don't want something by pushing it away, turning away, or shaking their head.

Signaling notice/ Pointing (Intentional)

Pointing at something interesting- the child notices something new and points to show you.

Dynamic Assessment

An approach where the SLP changes or adjusts help (support, prompts, teaching) during the assessment based on how the child responds in real time.

Zone of Proximal Development

Where you scaffold learning, can't do alone yet, but can do with help. Developed by Lev Vygotsky.

Scaffolding

The use of both verbal and nonverbal prompts to frame a behavior.

Mediated assistance

Guidance in which the amount and type of assistance are individualized to suit the learner and task and are slightly different from what the child can do presently.

Communication temptations

Planned situations that create a need or motivation for the child to communicate.

Context Manipulation

Purposefully changing the routine or environment to prompt the child to communicate or respond differently.

Dynamic Supports

Flexible help or prompts given during assessment or therapy, adjusted in real time to match the child's needs abilities.

Communication Breakdowns

Happen when a child's attempt to communicate is not understood by the listener, or when the child can't express what they want to say.

Preterm

Birth before 37 weeks.

Very Preterm

28-31 weeks.

Extremely preterm

Less than 28 weeks.

Low Birth Weight (LBW)

Less than 2,500 grams (5.5lbs).

Very Low Birth Weight (VLBW)

Less than 1,500 grams (3.3lbs).

Extremely Low Birth Weight (ELBW)

Less than 500 grams (1.1lb).

Patent Ductus Arteriosus (PDA)

A heart condition that occurs when the ductus arteriosus does not close after birth.

Respiratory Distress signs

Bluish skin, struggle to breathe, and apnea episodes.

Presymbolic Behaviors

Behaviors that include Attention, Joint Attention, Motor Imitation, Functional Use, and Intentional Communication.

Areas of Assessment

Includes Oral Motor Abilities, Vocalizations, Level of Play, Hearing, Motor and Cognitive Skills.

Assessment Process

Includes Preplanning and preliminary data gathering, Interactional Observation, based interactional assessment, Sampling, Analysis of data, and Decision-making and recommendations.

Play Based Assessment Components

Includes Means-Ends (Pre-Intentional), Requesting (Intentional), Protesting (Intentional), and Signaling notice/Pointing (Intentional).

Language Sample Analysis Programs

Includes Communication Matrix, a parent questionnaire used by a clinician for children 0 to 24 months of age or early stages of language development.

Preschool Language Scale 5 (PLS-5)

Auditory Comprehension/Expressive Communication; Birth to 7;11; Norm-referenced; Level B (Credentials Required)

MacArthur-Bates Communicative Development Inventories (CDI)

Assess words/gestures; Words in sentence form; 0;7 to 3;1; Norm-referenced (20 to 40 minutes); Level A; Parent Administered

Rossetti Infant Toddler Scale (RITLS)

Assesses interaction attachment, pragmatics, gesture, play, language comprehension, and expression; Birth to 3;0; Criterion referenced (time varies by individual); Level B (Credentials required)

Receptive Expressive Emergent Language -4 (REEL)

Assesses language composite (receptive/expressive language) and vocabulary (nouns/expanded); Birth to 3;0; Norm referenced (20 minutes); Level B (Credentials Required)

Ages and Stages Questionnaire (ASQ-3)

Assesses communication, gross motor, fine motor, problem solving, and personal-social skills; 0;1 to 5;5; Norm referenced (10 to 15 minutes); Level A; Parent Administered

Deictic Gestures

Establish a reference to the here and now; Two main types: Contact (developed earlier) and Distal (developed later)

Contact Gestures

Developed earlier; Examples include giving or pushing an adult's hand to an object

Distal Gestures

Developed later; Examples include pointing or reaching without contact

Conventional Gestures

Culturally learned social gestures such as waving, nodding, shaking head, and clapping

Representational or Symbolic Gestures

Gestures that stand for a reference/action without it being present, such as miming drinking or flapping for a bird or airplane

Frequent Gesture and Vocal Combinations

Occurs between 8-13 months

Distal Pointing

Typically appears between 10-12 months

Complimentary/Reinforcing Gestures

Gestures that duplicate word meaning; Example: saying 'dog' and pointing to a dog

Supplementary Gestures

Gestures that add new information beyond the word used and come before multi-word speech; Example: saying 'juice' and pointing to the fridge

Families in Early Intervention (EI)

Central team members who share concerns, priorities, and daily routines that support life

Cultural Considerations for EI

Includes respecting family beliefs and values, individualizing services, and empowering family choices

Bilingualism in Development

Bilingualism is NOT a disorder; Assess and support both languages