Midterm Study Guide 2 hour exam

Total Points:94

Total Questions: 38 First 7 are short answer - define and describe, etc. One sentence long is okay

31 multiple choice questions @ 2pts each some based on case study scenario, ask to respond according to the info given. Critical thinking used to apply knowledge learned. Learn terms and examples of when they would be used in therapy sessions, and for which disorders.

What intervention environments can we explore for the best outcome of the child? What is the role of the parents?

“Children and families are typically better served in their homes, daycare centers, or play groups than they are in clinical or segregated disability-focused facilities” pg15

Parents’ role is to implement ECI methods for including individualized communication activities throughout the day. Pg 15

Pg. 13 “to help parents see the world from their child’s perspective…understand the development of their own individual child…to become more sensitive and responsive to their child’s behavior needs”

From break out groups:

What are examples of at risk and established risk?

• At risk: children that are at-risk for developing a speech-language disorder due to environmental factors: Preterm labor, low socioeconomic status, neglect

• Established risk: children that are born with congenital disorders that may lead to a speech-language delay or disorder. Cerebral palsy, ASD, down syndrome, etc.

Define and give an example of self talk and parallel talk

• Self talk: An adult describes his or her actions while engaging in play with the child

  • EXAMPLE: I’m putting the baby in the bathtub. My baby is splashing. I’m washing the baby. Washing.)

• Parallel talk: The adult provides a model of self-talk for the child’s actions, providing a description of what the child is doing.

  • EXAMPLE: If the child is playing with a toy horse, adult will say “the horse is running.”

Why is intervention in a natural environment important?

• Natural environment extends beyond the physical environment to include intervention embedded within daily routines enabling a focus on increased participation by the child in daily life.

• The context of a family’s daily routines and activities offers an opportunity for a child to learn and develop within events occurring naturally in their natural environments.

• Intervention becomes centered on the authentic interactions of everyday activities and meaningful experiences that a child has with his or her family and caregivers.

What are types of gestures and why is gesturing important?

• Deictic (Behavior regulation): pointing and symbolic (Interaction): waving

• Serve purposes of joint attention, behavioral regulation, and interaction

• Enable a child to request and comment, two basic communicative functions

• Express semantic knowledge

• Provides a way for the child to request and interact before verbal communication

• Transition step for intentional communication

What is dynamic assessment and why is it important?

• Mediated assessment (mediated learning)

• Assessment that allows the clinician to teach and give feedback during the test. This is important because it determines the child’s baseline of communication while also determining how the child learns best with the amount and type of assistance given.

Pre-symbolic (pre linguistic) joint eye gaze, cooing, babbling

Questions to ask:

• Do we need to know different Acts? Ie: IDEA, IDEIA

• If there's info in the book that isn't in the powerpoint should we know it for the exam?

Topics of questions:

• Behavioral observations ???? you mean behavior markers for ASD?

• Bilingual children (Ch. 1, p. 12)

  • TD monolingual and bilingual children are similar in the sequence, rate, and quality of their linguistic development.

  • They demonstrate advantages in certain areas of metacognition and metalinguistics.

  • Bilingual children with LI use skills developed in one language to facilitate learning in another

  • As SLPs, and as recommended by ASHA, parents should use both languages with their children to support language development

  • The home language provides a means of communication while the child learns English
    

• Communication temptations (Ch. 5, p. 163-164)

  • Minor challenges to the expected occurrence of events in familiar situations

    • Ie: SLP might eat and comment on a delicious cookie but offer none to the child

      • Stimulates child to vocalize or reach out in order to obtain some

      • Once the behavior is emitted the SLP attempts to shape the response into a more mature communication form

        • (MORE EXAMPLES OF COMMUNICATION TEMPTATIONS)

SLP:

Eating a desirable food item and not offering any

Activating a wind-up or remotely operated toy, letting it deactivate , and handing it to the child

Looking through a picture book and modeling naming the pictures

Initiating a pleasurable social activity with the child, then stopping and waiting

• SLP waits for a short time for child to initiate communication

  • If no response occurs, SLP prompts response

  • Important not to heap too many communication temptations upon a child because potential exists to frustrate the child

  • Purpose is to explore more effective ways to communicate for both the child and caregivers
    

• Context manipulation (Ch. 5, p. 163-164)

  • Consists of environmental arrangements

  • (EXAMPLES):

    • Pausing in the middle of a favorite activity, such as listening to music

    • Pausing before completing an act, such as holding the spoon just in front of the child’s face

    • Violating a routine, such as missing a child at snack time

    • Violating an object function, such as wearing gloves on your feet

    • Offering choices either visually or verbally

    • Not having enough items to complete a task, such as no plastic knives for cutting fruit for fruit salad or missing puzzle pieces

    • Giving small portions of a favorite food or drink

    • Withholding needed assistance such as help getting coats and boots on

    • Sabotaging activities so children must ask for assistance , such as putting a small hole in a child’s cup

  • SLP waits for a short time for child to initiate communication

    • If no response occurs, SLP prompts response

  • Important not to heap too many communication temptations upon a child because potential exists to frustrate the child

  • Purpose is to explore more effective ways to communicate for both the child and caregivers
    

• Contingent-caregiver responses (Ch. 1, p. 110)

  • Based on the perceived INTENT of the child, so that the response is related to the child’s behavior

  • EXAMPLE: child struggles to reach for his toy. The CCR would be for the mother to say “You want train? Mommy help,” as she hands the toy to the child.

  • Such a response provides labels for the object and the child’s behavior, while handing the toy to the child strengthens the reaching behavior as a signal of desire.
    

• Diagnosis of developmental disability (Ch. 1, p. 4)

  • A severe, chronic disability of an individual that:

    • Is attributable to mental or physical impairment or a combination of impairments

    • If manifested before the age of 22 years old

    • Is likely to continue indefinitely

    • Results in substantial functional limitation in 3 or more areas of life activity such as self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent learning, and economic self-sufficiency; 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 and are individually planned and coordinated.

  • Children with DD generally share the common characteristic of severely impaired speech and language development

  • The Education of the Handicapped Act Amendments, mandated that states establish comprehensive service for infants and toddlers with DD and for their families

  • The term DD refers to a number of specific condition such as:

    • Intellectual Disability

    • Autism Spectrum Disorder

    • Cerebral Palsy

  • PL 99-457 requires that qualified professionals complete an assessment of each child and that both assessment and intervention be provided by a multidisciplinary team

  • The purpose of the assessment is to confirm the presence and extent of disability and to identify:

    • A child’s unique needs, accomplishments, and strengths

    • A family’s strengths and needs as they relate to the child’s development

    • The nature and extent of early intervention services appropriate to the child and family

  • Evaluation must describe a child’s functioning in the areas of cognitive, physical, speech and language, and psychosocial development and in self-help skills
    

• Disability definition (Ch. 1, p. 3)

  • Implies an inability or lack of ability to perform particular tasks, functions, or skills

• Dynamic assessment (Ch. 5 p. 161-162)

  • Describes a child’s optimal level of functioning

  • Can help identify a child’s potential and the amount of external support needed

  • Teaching and adult assistance play a significant role

  • Has a correlation to zone of proximal development

    • Flows from the notion that we all learn best things that differ only slightly from what we already know

      • Reason why adults offer assistance at a level just above a child’s current functioning

  • All assessment of child’s communication skills should attempt to accomplish two things:

    • To determine the child’s current level of communication

    • Assess the child’s ability to learn behaviors slightly advanced from the current level

  • Utilizes dynamic test: test-teach-test paradigm

    • Examines “teachability” of a behavior

    • Tested for baseline performance to establish a level of performance

    • Taught the new or modified skill

    • Retested to determine if learning has occurred

      • Important to utilize because young children with severe disabilities who look similar on static assessment actually may be very different when dynamic assessment techniques are used

  • Dynamic assessment rests on the concept that a child learns best when adults provide 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 at present

    • Assistance might include:

      • Varying rate of presentation

      • Repeating cues

      • Supplementing with nonverbal cues such as pointing or gesturing

      • Using more and varied verbal cues such as touch the X, Show me X, or Where’s X?

      • Allowing more time for a response

      • Helping a child complete the task

      • Decreasing the communication distance from the child

      • Physically guiding a child such as hand-over-hand manipulation of a toy

      • Manipulating the environment such as placing objects closer to a child

  • In Dynamic Assessment, child is retested on either same or similar task to assess learning which allows SLPs to assess:

    • a child’s independent abilities

    • modifiability or reaction of the child to varying types of assistance

    • Possible intervention methods

  • Following a dynamic assessment, SLP and team will have:

    • New description of child’s communication behavior and potential

    • Identified ways in which communication is malleable (influenced)

    • Knowledge of how to modify their(caregiver) own behavior to promote communication

• Early communication intervention approaches ?? Chapter 6???

• Functional equivalence

  • Behaviors that have the same effect on the environment.

  • EXAMPLE: a child may either tap a potential listener on the back or scream to get attention

  • These behaviors are functionally equivalent if they produce the same outcome

• Gestational age (Ch. 2, p. 46) **Do we need to know about health risks associated with which level of prematurity, etc?”

  • Most pregnancies last 37-42 weeks

  • Preterm labor is birth before 37 weeks of gestation

  • Babies born between 28-31 weeks are labeled very preterm

  • Babies born before 28 weeks of gestation are labeled extremely premature

  • Babies born before 32 weeks of gestation face the highest risk for health problems

• Prematurity (Ch 2, p. 58) ADD MORE*

  • Accompanied by greater risk of neurological disabilities and cognitive dysfunction.

  • Although preterm and low birth weight children are at risk for more cognitive difficulties, such as learning disabilities and intellectual disability, they are not at an increased risk for specific language impairment (SLI)

• IDEA Part C (Ch. 1, p. 5)

  • Part C of this federal law addresses services for children with disabilities and significant development delays from birth through age 2 years with possible extension to age 6.

  • The primary focus of Part C is on supporting a family’s ability to meet the developmental needs of its infant or toddler.

  • This includes the right to an individualized program developed by IFSP or IEP teams and offered in the natural environment or the least restrictive environment (LRE)

• IFSP goals

  • Addressing both the child and family needs that affect a child’s development

  • At the very least an IFSP should include:

    • The child and family’s current status

    • The recommended services and expected outcomes

    • A projection of the duration of service delivery

  • The service coordinator, or primary service provider (PSP), is responsible for ensuring that:

    • The family’s priorities drive the service system

    • The collaborative intent of the legislation is realized between and among providers and the family

    • The early intervention experience is perceived positively by the family

• Incidental teaching

  • A naturalistic, child-directed intervention strategy used during unstructured activities.

  • Typically occurs when a child has shown an interest in something and an adult or peer mediates the situation

  • Adults can provide models of social behavior and encourage peers to model appropriate responses

  • Teachers and SLPs can systematically prompt social behavior to support peer interactions

  • Inc. teach. Is an opportunity to expand teaching in to functional and realistic social situations

• Joint attention

  • The ability to coordinate attention between people and objects

  • Includes both responding to and initiation of joint attention

  • Proto-declaratives means using gestures and vocal behaviors to initiate joint attention and is often delayed in children with severe communication disorders

  • Joint Attention in children with ASD:

    • JA is often deficient in children with ASD

    • Children with ASD orient to stimuli, particularly social stimuli less frequently than typically developing peers

    • Children with ASD shift attention less when a person is involved rather than two objects

    • Children with ASD display less auditory attention to the human voice than TD children

• Late language emergence

• Mediated learning

• Natural environments

• Reciprocity

• Requests and symbolism

• Supplemental combination

• Tenets of cultural competency

• Transdisciplinary team model

• Zone of proximal development

  • Vygotsky’s notion that recognizes that we all learn est things that differ only slightly from (are proximal, or close to) what we already know

    • Reason adults offer assistance at a level just above a child’s current functioning

Short Answer = 1 Question = 4 points

• Communication development: pre-symbolic communication, gestures, intentional communication, or vocalizations

• Assessment methods

  • PRE-SYMBOLIC COMMUNICATION

    • Largely discussed in Chapter 4 but some additional notes on measuring:

      • Joint attention/attention following

      • Motor imitation

      • Oral motor skills

      • Sound making

      • Functional Use

      • Level of Play

  • GESTURES

    • The function of gestures:

      • Serve purposes of joint attention, behavioral regulation, and interaction

      • Mark transition to intentional communication

      • Contact and distal gestures lead to the acquisition of symbolic gestures

      • Enable a child to request and comment, two basic communicative functions

      • Express semantic knowledge

    • Differences in gesture production:

      • Children between 9 and 12 months with ASD use about the same total amount of gestures as TD children but they are qualitatively different than both TD children and children with other developmental disabilities (DD)

      • Children with ASD use gestures to regulate behavior of others less frequently

      • Children with ASD use gestures to establish joint attention less frequently

      • Children 15-18 months with ASD use fewer gestures than TD children

      • Children with DD gesture development is slower that TD children

      • Children with Down syndrome more likely to demonstrate relative strength in use of gestures compared with language

      • Children with Cerebral Palsy may be limited in ability to gesture due to motor involvement

    • Types of gestures

      • Deictic gestures:

        • Early developing, used to call attention to or indicate an object or action

        • EXAMPLE: pointing or taking an adult’s hand

      • Symbolic or representational gestures

        • Later developing, used to establish a reference or indicate semantic contact (The meaning of how words connect or make sense in a sentence or conversation)

        • EXAMPLE: waving hand to say bye or gesturing hand motions to “Itsy Bitsy Spider”

    • Assessment:

      • Rossetti Infant-Toddler Language Scale and the Communicative and Symbolic Behavior Scales (CSBS) include gestures

      • Include information about the following:

        • Frequency of gesture use

        • Function of gestures

        • Pairing gestures with eye gaze and vocalizations

        • Transition from contact to distal gestures

        • Transition from gestures to vocalization

      • Repair strategies

• INTENTIONAL COMMUNICATION

  • VOCALIZATIONS

    • Diversity of sound and syllable shape important for later language development

    • Poor indicator of future development is if the child is limited to one consonant during vocalizations at 24 months

    • Children with A S D, speech sound vocalizations produced between 18-24 months correlated with expressive language outcomes at age three

    • During Vocalizations assessment, look for:

      • Sounds and syllable shapes produced independently

      • Imitation of adult vocalizations

      • Sounds/shapes important to family/caregiver

Case Study = 2 cases = 28 points

• Early intervention assessment approaches and techniques including caregiver interviews, observations, questionnaires, informal/authentic assessment methods, and play-based methods.

  • Caregiver interviews:

    • •Does not replace the questionnaire

    • •Best if you can record

    • •Conversational but not unstructured, sample in Figure 5-2

    • •Open Questions to address:

      • How they child communicates basic wants/needs

      • Family goals of the assessment process

      • Motivational methods for the child

      • History of intervention and assessment

      • Cultural and linguistic environment

  • Observation:

    • •Will include observing child’s communicative behaviors

    • •Caregiver interaction style and responsiveness

    • •Impact of the larger environment.

    • •Record, but halt if parents become concerned

    • Observation of Caregiver/child Interaction

      • •Collaborative with parents, but want to be representative - make sure to inquire about the reliability of the observations

        • Examine the child’s intentionality of communication and the child’s success with communication

        • Caregivers can be barriers to a child’s development based on interaction style and responsiveness

Difficult to discuss with caregivers but some suggested language would be “Did you notice…” states or “Is there another way…” or “how do you think….” -focused on empowerment not judgment

Description of caregiver interaction styles in Table 5.2

Look for presence of contingent responsiveness

• Questionnaires:

  • Informal/authentic assessment methods

  • Play-based methods

    • Offers the opportunity to test hypotheses and to gather more assessment information

    • Three Steps:

      • Build rapport through interacting with the child in preferred routines, following his/her lead, and being responsive to communication attempts - See Figure 5-6 for tips on building rapport

      • Assess through unstructured play by building in opportunities for a variety of intentional communication behaviors - optimal if caregiver can be involved with motivating materials

      • Structured opportunities to elicit behaviors not already reported/produced - several opportunities both with and without support

• Routines based intervention with application of how to integrate a goal into a daily routine.

• At-risk vs. established risk developmental disability categories

  • Established risk: ASD, cerebral palsy, Fragile X syndrome, etc.

  • At-risk: Preterm birth, caregiver alcohol or substance abuse, Low socioeconomic status, etc.

• Early indicators of autism spectrum disorder (ASD) and barriers to diagnosis under the age of three of ASD:

  • Early indicators: aversion to touch, fixation on objects, lack of facial expression, less eye contact, and less orientation when name is called

  • Some children may not display symptoms until later in early childhood