Birth-3 Language Impairments

primary prevention

purpose is to reduce the incidence of disorder

secondary prevention

we can’t eliminate all disorders, but we can minimize the handicapping effects of the disorder if we identify them

tertiary prevention

re/habilitation to prevent further disability

risk factors

• prematurity

• genetic & congenital disorders

• other risks identified after birth

premature infants

post natal development; occurs outside the womb

• sulci & gyri aren’t developed, must develop outside the womb

• glia division & proliferation

• respiratory/cardiac/blood cell issues

• cellular migration

language skills

decreased receptive language, as temporal lobe & prefrontal cortex are developed asymmetrically

• pain & stress on infant

• nurture by reading to baby, talking, listen to music, improve social engagement

• encourage bond w parents; kangaroo care = increase in cognitive skills

• enhance sensory experiences - hearing, tactile visual, smell, movement

language intervention

increase attachment & interactions btwn infant-caretaker

• mothers respond more to babies who smile & vocalize than to sick babies who don’t

• promote communication; recognize when baby wants interaction/responses. get through trauma and create nurturing

qualifications

for children <6 yo, no diagnostic labels, but identify if child has developmental delay to get services

• for 0-3, 25% delay in any developmental area

• physical impairments alone do not qualify

family centered approach

family develops goals & is involved in every part of the process

baseline

identify current function of language skills, strengths, weaknesses

• skill abilities (cognitive, motor, behavioral, feeling)

• appropriate goals, treatment approaches for Tx

coaching method

adult learning strategy that is used to build the capacity of the parent to improve existing abilities, develop new skills, & gain understanding

joint planning

an agreement btwn coach & learner on the actions to be taken by coach and/or learning or opportunities to be practiced btwn coaching visits

observation

by parent or child, towards coach

action/practice

spontaneous or planned events that occur withing context of real life

reflection

provides parent with opportunity to analyze current strategies

feedback

information shared by coach

• informative, affirmative, evaluative, directive

clinician directed

drill, drill play, required imitation

client directed

indirect language stimulation, play based activities

hybrid

milieu teaching

• mand model, incidental teaching, script therapy

interactive behaviors

• turn taking: respond to child movement/vocalization & wait for child to respond

• imitation

• joint attention

• anticipatory sets: allow foundation for scripts of schemes by predicting what is going to happen next in a sequency in a game

communicative intent

• imitation: gestures, then words

• increased frequency of initiation thru facilitation approaches

  • time delay can be very long for delayed child to process

  • gaze interaction

  • verbal modeling

  • recasts

communication temptations

use highly motivated activities/objects that promote child’s desire to convey a message so adult needs to respond promptly

book reading

start as birth, as it promotes bonding

• imitation of patting book, turning pages

• joint attention or picture or picture sound

  • invite child to interact

• eventually, child imitates or names pictures & actions

play skills

lacking play skills & gestures = lacking communication skills

• give insight into linguistic, conceptual, & imaginative abilities of child

• play is most natural context for language learning

• play behaviors

  • semi-appropriate toy use

  • nesting

  • multiple play episodes, extended multiple play episodes

gestural skills

related to development of lang skills

• use of gestures w words facilitate 2-3 word language

• if words & gestures are paired early on, language performance is enhanced

comprehension

understand a few single words in routine contexts

• understand single words outside a routine

• words for objects not in sight

• 3-word semantic relations w context/recall

• delays here = more pervasive language disorder

phonological skills

limited phonemic inventories = risk for long-term speech delay in late talkers & reading delays

• small expressive vocabs usually have small phonemic inventories, lack syllables

indirect language stimulation

• descriptive talk: adult labels what child is seeing

• parallel talk: adult talks about what child is doing

• self talk: adult talks about objects & actions in immediate environment

• expansions: adult expands child’s utterance to an adult-like sentence

• expansion plus: adult expands child’s utterance to an adult-like sentence & adds another sentence

prelinguistic milieu teaching

used to increase intentional communication; arrange environment to elicit child comm. follow child’s lead

• place desired object in view & out of reach

• build social routines

• unexpected events or sabotage routine to elicit comments

• use specific consequences, eg.

  • prompt & reinforcement

  • provide long time for response, up to 15s

  • models

  • natural consequences

maladaptive behaviors

acknowledge they have something to say, and if you know what it is, model the language for them to imitate or request them to try to communicate