CSD 462 Lecture 9: csd 462 lesson 9

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Communication Sciences and Disorders
CSD 462

CSD 462: Language Disorders in Children 1 Finke/Spring 2017 Handout 06.2 VII. PRINCIPLES OF INTERVENTION • When you are doing intervention, be thinking about working within the child's zone of proximal development (ZPD). F. A. Processes of Intervention • 3 Types of Intervention Approaches • Clinician-directed approaches • Child-centered approaches • Hybrid approaches • Approaches vary as to: • How functional they are • How much structure is provided Things to consider: • 1. The degree of naturalness of the intervention approach • 2. The reason (function) of the skill you are planning to teach • 3. The type of language user you are teaching • Behavior problems, passive communicators Ex: Let you come to them. YOU need to text THEM in order to have a conversation otherwise you’d never hear from them. They love you and all they just aren’t active communicators(Fey, 1986) • 4. The advantages and disadvantages of each intervention approach. Naturalness Continuum: 1. Clinician-directed- Drill play, Direct teaching LEAST NATURAL 2. Hybrid- Milieu teaching, scripting 3. Child-centered- Daily activities, Facilitate play MOST NATURAL 2 Clinician-directed Approaches • At the less natural end of the continuum- is highly structured • Clinician controls and chooses: • Basically, all aspects of the intervention. • Materials to be used and number of practice opportunities • Order and number of the activities • How the client uses the materials • Type of frequency of reinforcement (feedback) What responses are acceptable from the client ADVANTAGES: o You can plan in advance o You have a lot of control over your session o You can accomplish a lot o Makes data collection much easier o Lots of opportunities for reinforcement schedule o Predetermine how many opportunities (more practice; help with data collection) DISADVANTAGES: o Might not have the same language opportunities for natural language development o Might not lead to generalization o If the child isn’t interested in what you plan… could be in trouble Child-centered Approaches • Clinician arranges the activity so that the teaching opportunities are likely to occur naturally, as part of the ongoing interaction • Generally, clinician offers child choice of multiple items (child chooses activity) and follows child’s attentional lead, very unlike the clinician-directed • Clinician may accept approximations of the responses and then model them herself. • Setting can be anywhere ADVANTAGES o More flexibility especially if the child isn’t doing well with structure o Child has more freedom to play with the language o More potential for generalization o Comfortable for the child- does not feel like therapy o Natural CSD 462: Language Disorders in Children 3 Finke/Spring 2017 Handout 06.2 o Engaging o Fun DISADVANTAGES: o Could be slower o More challenging for data collection o If the child isn’t learning child naturally, how is doing more of the same language stimulation going to help? Child may go off on a tangent (efficiency) o Could be a challenge to redirect o Can be challenging for an observer to know what the targets are How do we choose? Hybrid Approaches: • In the hybrid approach, clinicians try to combine the best parts of both approaches in order to target specific language goals. • The interaction still feels very natural, like in child-centered therapy. • The clinician maintains control over the materials which allows her to create many opportunities to practice, like in clinician-directed. • The clinician prompts and reinforced correct productions, like in clinician-directed therapy • The clinician often uses communication temptations to elicit desired forms. • This is probably used more frequency Evidence-based Input Strategies • Evidence based input strategies are the foundation for child-centered approaches. So they are used throughout this particular approach. • However, they are also widely used in hybrid approaches, because they offer the benefits of the naturalistic communication setting and have been proven to be quite effective. • The difference is that in the hybrid approach, the opportunities for these things to happen have been directly built into the plan, and also the clinical can prompt the child to produce the target behavior. • Communication Temptations – provide natural opportunities for the child to communicate 4 • Initiate a social game (peek-a-boo) with the child until it is clear they are having fun, then stop the game and wait • Play with a desirable toy in front of the child without offering it to the child • Place a favorite item inside a clear (hard to open) container, and hand it to the child • Give the child a broken toy • Put something in a weird place, for example a plastic spider in the crayon box • Deliberately make a mistake • Put supplies for a craft activity in sight, but out of reach • Script Therapy - allows planned opportunities for the child to practice a skill over and over. • Acting out familiar stories • Role Playing • Social Stories/ Scripts – kid write a social story regarding playing • Focus Stimulation - using repeated modeling in order to encourage production of a particular form. • Example: My horse is jumpING, what’s your horse doING? Child says “He jump” SLP says “ooooh your horse is jumpING? Now my horse is walkING! And my pig is running and the goal is eatING” • Emphasizing the structure you want them to use • Elicited imitation (mand-model) – clinicians can use to help a student practice using the target form. • Example: My horse is jumpING, what’s your horse doING? Child says “He jump” Ohhh, your horse is jumpING too? Now you try. Tell me, “He’s jumpING” Then child says “He is jumpING” • Trying to elicit the target form • Self-talk (talking about what you're doing) is very useful, especially with children who are reluctant to engage. Often children can't resist if it seems like you're having more fun than they are! • Example: Oh my gosh, I love French fires. I’m going to put ketchup on my French fries yumm!!! Oh maybe ill have a hamburger with my French fries? Hmmmm I would love a milkshake… I wonder if they have them? • Parallel talk, where the clinician keeps up a running commentary on what the child is doing, can also help draw a reluctant child into interacting with the SLP. • Example: “OOOOH, you’re drawing a really cool picture. I see a big blue house, and you drew a huge green tree out front. And now you’re putting a swing hanging from the tree! I bet that swing is really fun! • Giving them the vocabulary to go along with the picture CSD 462: Language Disorders in Children 5 Finke/Spring 2017 Handout 06.2 • Clinicians often reformulate the child's incomplete utterances in order to model more complete forms. • Expansion: Expand a telegraphic utterance to be grammatically complete • Example: Child says “glasses for party.” You say “You have glasses for your party!” • Extension: Add new information as well as grammatical complexity • Example: Child says “glasses for party.” You say “You have two fancy blue glasses for the party!” • Recast: Change grammatical modality (Ex turn statement into a question) • Example: Child says “glasses for party.” You say “Are those glasses for your party?” Clinicians can also use direct instructional techniques to explicitly teach new skills or strategies • Modifying the Linguistic Input (5 areas to target/consider)
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