Promoting Communication Development in Young Children

Promoting Communication Development in Young Children with or at Risk for Disabilities

Importance of Communication Skills

• Communication skills in young children directly influence:

  • Opportunities to interact with others

  • Access to items and preferred activities

• Meaningful communication of wants and interests stems from children's initial understanding of how their behaviors affect their environment.

  • Example: An infant crying due to hunger will prompt parents to respond (feeding, soothing) reinforcing the child's understanding of behavior-environment contingencies (McCathren, Yoder, & Warren, 1999; Prizant & Wetherby, 1987).

• Early reciprocal interactions form the foundation for more sophisticated communication (Bruinsma, Koegel, & Koegel, 2004).

Development of Meaningful Communication

• Meaningful communication is dynamic, social, and involves multiple persons and settings (DEC, 2014; Hancock & Kaiser, 2006).

• Key participants in a child's communication development include parents, siblings, and community members, who provide opportunities and feedback.

  • Example: A child using pointing and vowel-consonant combinations (like /ca/ for car) to request toys, with adults reinforcing this behavior by providing items and modeling corrections.

• Interaction flexibility and fluency are crucial for successful communication across diverse contexts.

Adult Support in Communication Development

• Children with typical development may naturally progress in communication skills without extensive adult mediation.

• Children at risk or with disabilities may need more intensive adult support for meaningful communication acquisition.

• The chapter discusses the current evidence base for enhancing communication skills in at-risk children and describes key terminology and development sequences in forthcoming sections (Crais & Roberts, 2004).

Defining Communication and Related Terms

• Communication: Exchange of information between two or more individuals through a shared system to deliver a message.

  • Children communicate their needs, wants, interests, and feelings (Kaiser & Grimm, 2005).

• Form: The behavior used by a child to express internal states; includes words, gestures, signs, written text, and vocal devices (McCauley & Fey, 2006).

• Function: The purpose of a child's communication, such as requesting information or items, making comments, or protesting (Cooper, Heron, & Heward, 2007; Crais & Roberts, 2004).

  • Common categories of communication functions include:

  • Access items or social interactions

  • Escape non-preferred situations (Halle, Ostrosky, & Hemmeter, 2006).

• Bruner's (1981) categorization of communication purposes includes:

  1. Behavioral Regulation: Requesting objects/actions, protesting.

  2. Social Interaction: Attention-seeking, greetings.

  3. Joint Attention: Requesting information, commenting.

Understanding vs. Expression

• Differentiating intervention focus on understanding (comprehension) versus expression (producing communication behaviors) (Paul & Norbury, 2012).

• **Common Terms in Language Development: ** Includes:

  • Speech: Verbalizations for communication.

  • Language: Rule-governed symbol system for concept representation (Owens, 2012).

  • Key aspects of language:

  • Phonology: Speech sound production.

  • Morphology: Meaning understanding.

  • Syntax: Word order comprehension.

  • Semantics: Clear communication relative to meanings (Turnbull & Justice, 2012).

  • Pragmatics: Appropriate use in social contexts.

Typical Communication Development Stages

1. Preintentional Stage: Infants move from crying and reflexive sounds to babbling without specific intentions.

2. Early Intentional Communication: Gestures are added as infants develop joint attention.

3. Symbolic Communication: Development from pre-symbolic (contextual) to symbolic (decontextualized language which stands independently of the immediate context).

   • Example of Intentional Communication: A child saying "bottle" signifies a request regardless of the actual presence of the bottle.

Joint Attention and Gestures

• Joint Attention: Engaging with people and objects around them; critical for communication foundations (Adamson et al., 2014; Watt et al., 2006).

  • Emergence: Starts within 6 months, shifting attention between people and objects.

• Gestures: First intentional communication means associated with joint attention;

  • Contact Gestures: 7-9 months (e.g., giving, pushing away).

  • Distal Gestures: 10-12 months (e.g., pointing).

  • Representational Gestures: Used in familiar social routines by 12 months (Iverson & Thai, 1998).

Sounds and Vocalizations

• Infants discern sounds long before producing speech, segmenting speech streams into meaningful intervals (Saffran et al., 1996).

• Prelinguistic vocalizations categorized into levels:

  1. Reflexive Sounds: Crying, fussing (0-2 months).

  2. Control of Phonation: Vowel-like sounds (1-4 months).

  3. Vocal Expansion: Isolated vowels and babbling (3-8 months).

  4. Canonical Babbling: Using consonant-vowel combinations (5-10 months).

  5. Advanced Forms: Multisyllabic strings and jargon (9-18 months).

• Children with disabilities may have challenges producing sounds (Crais & Roberts, 2004).

Single Words and Word Combinations

• Children begin using single words around their first birthday (10-15 months); a typical expressive vocabulary contains five words by 15 months.

  • Criteria for True Words: 1) Clear intention, 2) Adult-like pronunciation, 3) Consistent use applicable to instances beyond original context.

• As children approach 50 words between 18-24 months, they start combining them into two-word phrases, although understand may lack grammatical markers.

• Mapping connects word usage with referents, aided by social cues from adults (e.g., emphasis on relevant words during interactions).

Conversation Development in Preschool Years

• Communication leaps during preschool with advanced syntax, vocabulary expansion, and intelligible speech.

• Difficulty in initiating conversations is prevalent among young children with disabilities and limits interaction opportunities (Crais & Roberts, 2004).

Atypical Development

• Communication may deviate from the norm in rate or quality. Disorders can occur with or without other developmental issues.

• Language disorders impact future social interactions and are linked with written language and academic challenges (Johnson et al., 2010; Rescorla, 2002).

• Recognition of typical vs. atypical development supports identification and intervention of communication challenges.

History of Communication Interventions

• Past interventions were often controlled environments, yielding limited generalization outside of context.

• Research has emphasized natural settings, family involvement, and multiple communication forms.

• Modern recommendations seek to embed interventions in everyday experiences (LeBlanc et al., 2006; Schreibman et al., 2015).

Current Evidence Base for Communication Interventions

Environmental Arrangement

• Modifying the physical and social environment promotes communication opportunities (Halle, Baer, & Spradlin, 1981).

  • Example: During snack time, arranging materials to facilitate child engagement helps them communicate requests.

Milieu Teaching Methods

1. Modeling: Adult provides verbal models of targets upon communication opportunities.

2. Mand-Model: Adult interrupts ongoing activities with questions or directives, modeling responses as needed.

3. Time Delay: A preferred material is withheld before prompting responses for communication.

4. Incidental Teaching: Environmental strategies spur child initiation, expanding on communication attempts.

Contingent Imitation

• Involves imitating a child’s actions to promote communication and turn-taking (Dunst et al., 2010).

Expansion and Recast Strategies

• Expansion: Adding new information to child communication (e.g., from “go” to “go ball”).

• Recast: Correcting grammatical forms (e.g., from “Mommy walk fast” to “Mommy walked fast”).

Video Modeling

• Visual methods of demonstrating communication through videos have gained attention especially in ASD interventions, allowing repeated model observation.

Multicomponent Interventions

Early Start Denver Model (ESDM)

• Focus on behavioral strategies to improve communication, language, and play skills in children with ASD (Dawson et al., 2010).

Early Social Interaction (ESI)

• Family-centered intervention to enhance social communication in everyday routines for toddlers with ASD.

Enhanced Milieu Teaching (EMT)

• Combines behavioral and social interactionist approaches in child-directed intervention settings.

Hanen Programs

1. It Takes Two to Talk (ITTT): For young children with language delays.

2. More Than Words (MTW): For young children with ASD.

• Both involve parent training by certified speech-language pathologists.

Joint Attention Intervention (JAI)

• Focus on improving joint attention skills critical for language development in children with ASD.

Pivotal Response Training (PRT)

• Targets pivotal behaviors to influence broader social and communication skills.

Prelinguistic Milieu Teaching (PMT)

• Designed for intentional communication improvement in children with developmental delays.

Responsive Interaction Intervention (RII)

• Encourages positive play interactions without verbal prompts.

Summary of Interventions

Augmentative and Alternative Communication (AAC)

• AAC is an approach for children who may not achieve functional speech and includes:

  • Unaided AAC: Gestures, manual signs, ASL.

  • Aided AAC: Communication boards, computerized devices.

• Research indicates that using AAC does not inhibit oral language development; rather, it may enhance it (Romski & Sevcik, 2005) .

Sign Language and Visual Communication Systems

• Considerations for sign language use in young children include motor skills and partner understanding (Branson & Demchak, 2009).

• PECS (Picture Exchange Communication System) is a major intervention focusing on image exchange

1. Phases of PECS:

   • Basic exchange requests, persistence requests, discrimination, sentence strips, answering questions, commenting.

Conclusion: Understanding communication development and effective intervention strategies in early childhood are vital for supporting children at risk for disabilities in achieving meaningful interaction and speech.