Language Disorders Exam 4

family-centered practice (FCP)

services that incorporate families into the assessment and treatment process; this construct is designed to recognize the importance of connections with family members in communication development

federal policies for FCP (ex. Public Law 99-457)

created discretionary programs to help states set up early identification and intevrvention services for infants, toddlers, and their families

service plans mandated by IDEA 2004

Individual Family Service Plan (IFSP) - birth to 3

Individual Education Program (IEP) - school aged

Individuals with Disabilities Education Act (IDEA)

Provides a free appropriate public education for students with disabilities

goals of FCP

-maximize the child's development

-optimize family's capacity to address the child's needs

-help caregivers feel confident and competent

what are some challenges in providing family-centered care for prelinguistic infants?

-NICU stress

-medical fragility

Individual Family Service Plan (IFSP)

a plan designed for children ages 3 and younger that addresses the child's strengths and weaknesses as well as the family's needs; includes developmental goals

IFSP involves...

-present level of performance

-family's resources, priorities, and concerns

-major outcomes/criteria to measure progress

-early intervention and other services

-dates for initiation of services

-contact info for service coordinator

-transition plan to preschool services

4 risk factors for communication disorders

1. prenatal factors

2. prematurity and low birth weight

3. genetic and congenital disorders

4. post-newborn risks (ex. hearing impairment, nonspecific intellectual disability, etc.)

role of SLP with high-risk infants in the NICU

Perform a bedside feeding evaluation to determine if feeding is safe/what needs to be addressed

Provide questionnaires/checklists for parents for assessment

feeding/oral-motor development signs to look for in NICU infants

-suckling

-sucking

-rooting

-phasic bite reflex

Common Concern: gastoesophageal reflux

phasic bite reflex

an involuntary primitive reflex in infants where rhythmic up-and-down jaw opening and closing is triggered by pressure on the gums

gastroesophageal reflex

another name for heart burn

feeding management in the NICU

-can involve tube feeding or oral feeding

-provide support for mothers during non-oral feeding

-promotion of breastfeeding for premature infants

assessment/management goals of behavior and development (NICU)

-focus on strengths and physiological organization

-provide specialized newborn questionnaires

-promote a "healing environment"

-support interactions between the parents and infant

assessment of parent-child communication (NICU)

-readiness for communication

-3 stages of behavioral organization in high-risk newborns (determines when infant is ready for communicative interactions)

-parent communication and family functioning

3 stages of behavioral organization in high-risk newborns

1. turning in

2. coming out

3. reciprocity

turning in

before an infant can really participate in reciprocal interactions (when they are ill)

coming out

when the infant is responsive to the environment and they are no longer ill

reciprocity

when the infant can respond to parental interactions in predictable ways; failure to achieve this stage indicates that developmental deficits may persist

parent-child communication management options (NICU)

-kangaroo care

-helping parents identify infant states and respond

kangaroo care

Treatment for preterm infants that involves skin-to-skin contact

age: 0-4 months

food: liquids

oral-motor skill: suckle on nipple

developmental skill: head control

age: 4-6 months

food: purees

oral-motor skill: suckle off spoon, progression to sucking

developmental skill: sitting, hands to midline

age: 6-9 months

food: soft chewable foods

oral-motor skill: vertical munching, "sippy" cup drinking, limited lateral tongue movements

developmental skill: hand-to-mouth reach, grasp, finger-feeding, assistance w/ spoon

age: 9-12 months

food: lumpy textures

oral-motor skill: independent "sippy" cup drinking

developmental skill: pincer grasp, grasps spoon

age: 12-18 months

food: all textures

oral-motor skill: lateral tongue action, straw drinking

developmental skill: scoops food to mouth, increased independence w/ feeding

age: 18-24 months

food: more chewable food

oral-motor skill: rotary chewing

developmental skill: independent walking, can obtain food/nonfood objects on own

age: 24 months

food: tougher solid

oral-motor skill: mature chewing

developmental skill: total self-feeding, use of forks, open cup

preintentional infants (1-8 months)

-do not yet have cognitive skills to form intentions

-adults attribute intentions to their behaviors

-use specialized assessments for feeding and oral development (e.g. videofluoroscopy)

preintentional infants (1-8 months): vocal assessment

-rate of vocalization

-multisyllabic babbling

preintentional infants (1-8 months): managing feeding and vocal development

feeding:

-oral stimulation, introduction of solids

-sequential oral sensory (SOS) strategies

vocal development:

-encourage back-and-forth babbling, reward vocalizations

preintentional infants age

1-8 months

prelinguistic infants age

9-18 months

prelinguistic infants (9-18 months): illocutionary stage

expressing intentions through gestures, gaze, vocalization

prelinguistic infants (9-18 months): assessment

-cognitive testing

-observation of play

-parent reports

prelinguistic infants (9-18 months): management

-interactive book reading

-prelinguistic milieu teaching

older prelinguistic clients w/ profound autism: assessment

-feeding/oral-motor behavior

-unconventional communication (e.g., echolalia, body orientation)

older prelinguistic clients w/ profound autism: management

increase frequency and range of intentions (joint attention, social interaction)

intervention w/ AAC for older prelinguistic clients (key principles)

-all children need to communicate regardless of cognitive level

-core vocab, easy-to-use formats (e.g. iPad, smartphone)

-engage parents and teachers in using AAC

early signs of ASD in infants and toddlers

-limited response to name

-interest in objects over people

-resistance to change

ASD in infants and toddlers: intervention

-AAC can be a first mode of communication

-programs like prelinguistic Milieu teaching, Early Start Denver Model

stage 1: vocalization types (birth to 2 months)

-crying with pitch changes, extremely high pitch

-fussing or discomfort

-vegetative sounds (burps, sounds accompanying feeding)

-neutral sounds (grunts, sighs)

-vowel-like sounds

stage 2: vocalization types (2 to 4 months)

-predominantly vowel sounds, some emerging consonants

-marked decrease in crying (after 12 weeks)

-begins using CV (coo, goo)

-begins producing pleasure sounds (mmmm)

satge 3: vocalization types (4 to 6 months)

-consistent CV combinations

-imitation of sounds in back-and-forth babbling games

-more vowel variation

-front stops and nasals emerge

-laughter (16 weeks)

-"raspberries", bilabial trills, lip smacks

-variaiton of pitch contours

-extreme pitch glides (yells, squeals, low-pitched growls)

stage 4: vocalization types (6 to 10 months)

-canonical, repetitive, or reduplicated babbling (CV or CVCV structure)

-consistent variation of intonational contours

-early non-reduplicated CV sentences appear

-parents report first-words around 10 months

-full-stop consonants are used

-short exclamations (ahh!)

stage 5: vocalization types (10 to 12 months)

-variegated babbling

-variety of CV and CVC combos w/ sentence-like intonation

-syllables other than CVs are used

-jargon, protowords, or phonetically consistent forms emerge

-increased development of prosodic contours to match intonation

-approximations of meaningful single words (possible phonological processes)

upping the ante

upping the ante

A scaffolding technique in prelinguistic and early language intervention where the clinician or caregiver systematically raises communication demands ane elciti a higher level of response from a child:

• Once a child consistently produces a basic communicative act within an established routine (e.g., reaching or simple gaze), the adult pauses and withholds the desired item or action

• The child is required to produce a more advanced, mature, or intentional communicative form (e.g., combining gaze with a vocalization, pointing, or using a word approximation) to achieve the goal

• Used to shape and transition prelinguistic behaviors into intentional, conventional communication

assessment, evaluation, and programming system for infants and children (Bricker 2002).

criterion-referenced assessment, evaluation, and family participation components

measure abilities in the following areas: fine and gross motor skills, adaptive, cognitive and social communication development

includes a Family Report MEasure for parents to asses their children

birth to three assessment and intervention system (ammer and briggs 2021)

comprehensive program that allows examiners to identify, measure, and addresses developmental delays

includes norm-referenced screening test and a criterion-referenced checklist

measures receptive and expressive langauge, avenues for learning, social-emotional development and motor abilityco

communication and symbolic behavior scale CSBS (wetherby and prizant 2003)

used to provide early identification of children at risk for having or developing communication impairment

examines and measures communication, social-affective, and symbolic abilities

results are used to monitor changes in behavior and plan treatment

mac-arthur-bates communicative development inventories (fenson et al. 2007)

parent-report instruments used to determine child’s comprehension and production vocabularies for children using words and gestures, and vocabulary for children using these word combinations

assessment of early child language from first nonverbal gestural signals through expansion of early vocabulary and the beginning of grammar

receptive-expressive emergent language scale (reel-3_ (bzoch, league, and brown 2003)

designed to identify major receptive and expressive language problems in infants and toddlers

rossetti infant-toddler language scale (rosetti 2006)

developed for birth to 3 year olds

included parent questionnaire and test protocol to gather observed, elicited, and parent-report info

areas assessed include play, interaction-attachment, gesture, pragmatics, language comprehension and expression

includes questionnaire and addresses parental concerns regarding interaction and communication development