the late talker strategies for effective communication 90...

The Late Talker 1/30/2018

Ashley S. Fairleigh, M.S., CCC-SLP 1

The Late Talker: Strategies for Improving Communication in the

Classroom Ashley S. Fairleigh, M.S., CCC-SLP

[email protected]

Biography

17 years SLP

2 years Peace Corps

Specialty is pediatrics

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Fill in the blank spaces with the appropriate words. The first letter of the missing words are given to suggest the right ones.

The problems which confront p______________ in raising ch______________ from in_________________ to adult life are not easy to s________________. Both fa_________________ and m________________ meet with many d_____________ in their concern for satisfactory pro___________________ from the e______________ stage to later life. It is important that young ch_______________ should have plenty of s_______________ and good f________________ for healthy growth. B___________ and g______________ should not occupy the same b__________ or sleep in the same r_____________. They are often afraid of d______. Bad ha___________ can be avoided by intelligent ca_____________. We must ask ourselves set good e_____________ if we expect to get satisfactory results later on. Free access to m_____________ and w_______________ in their immediate neighborhood will help young p_______________ to solve the problem ofad__________. It has been well said that the proper study of m___________ is m______________.

Why am I here?

• Understand the milestones for speech and language development for 0-5 years old

• Understand the foundations of functional and interactive communication

• Identify target activities and strategies for eliciting active participation by student(s)

• Select communication opportunities that are natural and appropriate

• Arrange the environment to promote communication

Everyone communicates

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crying

words

Falling asleep pointing

sounds



Everyone Communicates

screaming Pushing Eye

contact

Biting Grunting Signing

Pinching IgnoringSilence

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Communication Purposes

• Expressing Wants and Needs

• Social Interactions including Social Etiquette

.

• Exchanging Information: joint attention then topic specific

Communication Stages

Adjusts over time 11

Infancy Stage

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Social @50%

Wants & needs @ 49%

Info Sharing

@1%

Elementary Stage

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Social @ 60%

Sharing Info @

20%

Wants & needs @

20%

Secondary Stage

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Social @ 60%

Sharing Info

@40%

Wants & needs @

10%



Deviations from Normal Development

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Why are there delays?

• Check hearing levels (have a hearing test)• Not Neurotypical • Undiagnosed Disorder (too young)• Lack of Exposure • Unknown

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Think about YOUR students who are struggling to communicate

effectively…What are some

characteristics of their communication?

More Engaged Parents Less Engaged Parents

Words heard per hour 2,168 616

Words known by age 3 1,116 525

Words heard by age 4 45 million 13 million

Letters of alphabet by 5 22 letters 9 letters

Parents read every day 59% 36%

Sources: Hart and Risley, 1995; Worden and Boettcher, 1990; Ehri and Roberts, 2006; National Survey of Children’s Health, 2003; Neuman and Dickinson, 2006; IEA Reading Literacy Study, 1996

Importance of Early Engagement

School Success Largely Determined by Age 3

• Basic language and communication skills are formed during a child’s first three years

• Language experience before age 3 is an excellent predictor of reading ability in third grade

• After 3 years of age, it is increasingly difficult to make up for differences in earlier experiences

Communication Disorder Characteristics

• Children with communication disorders may display the following characteristics in multiple environments:– Use of limited number of words– Difficulty understanding concepts– Problems following directions– Displaying frustration when trying to communicate



Strategies that Facilitate Improved Communication Skills

• Read a child’s body language• Provide a child with choices• Provide picture schedules to help

a child move easily between activities

• Segment multiple-step directions• Provide cues to help child better

understand expectations• Model appropriate

communication language

Communicative Milestones

• Universal Communication Milestones 1. infancy2. toddlerhood3. preschool-age4. school-age

.

Milestones in Infancy

• Stages of Vocal Development:-Phonation (0-1 month)-Gooing and Cooing (2-3 months)-Expansion Stage (4-6 months)-Canonical Babbling (6-8 months)-Variegated Babbling (8+ months)


Emergence of Intentionality:• All infants are pre-intentional (0-6 months)• Intentional communication Emerges (7-12

months)– Gestures– Pointing– Eye Contact


• Transition to Symbolic Representation• Words are arbitrary symbols that represent

concepts in the world• Mental dictionaries develop with lexical entries• ~ 12 months, infants begin using symbols,

including words and referential gestures (gesture carrying a fixed meaning)


• The First Word:-first “true” word occurs around 12 months, on average

True words are ALL 3: 1. clear intention and purpose2. recognizable pronunciation3. consistent use and extends beyond original

context



Toddler Language • Achievements in Form:

-grammatical morphemes-transition to multi-word utterances-distinct grammar that governs word order-Mean Length of Utterance (MLU)-basic mastery of three sentence forms:

-yes/no questions-wh-questions-negatives

Grammatical MorphemesToddler Language

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Toddler Language

• Achievements in Content:-vocabulary spurt (“naming explosion”)-Understand more than they say -underextensions used (dog vs their dog)-overextension used

-categorical (dogs vs. horse )-analogical (hot = all things you can’t touch)-relational (all older ladies are grandmas)

Milestones in Toddlerhood

• Achievements in Use-use a variety of language functions:instrumental, regulatory, personal interactional, heuristic (problem solving) , imaginative, and informative-not highly skilled in conversation (topic maintenance or language beyond the here and now)

Milestones in Toddlerhood• Achievements in Speech (how they say it):

-2-year olds correctly produce about 70% of sounds used -Attainment of specific phonemes(Norm references: customary age of production vs. mastery)

-Phonological processes:-articulatory adjustments that occur during speech

-final consonant deletion, fronting, backing, consonant harmony, weak syllable deletion, cluster reduction, liquid gliding

Milestones in Preschool

• “Small word” stage-articles, verb morphology-prefixes, suffixes-sentence complexity



Milestones in Preschool

Decontextualized language-events and concepts beyond the here and now-necessary for academic success

Turn Taking Emerges

Narrative Discourse (Does a story they tell make sense?)

.

Creating a Communication Environment

• Requires changes to:

• Activities– Environment– Facilitator

Language • Every Day Routines

• Brief

• Repetitive

• Process Oriented (not product oriented)

Activity represents a class of activities: Art activities, cooking, reading books, snack, Variation in content from episode to episode, but same “core” vocabulary

Selecting a Target Activity to Elicit Communication

Should be brief in nature, but occur 3-4 times per week Requires communication (initiations) by the studentActivity should be process - not product orientedChoices are offered during the activity

COMMUNICATION and FUNctional are the goals of the Target Activity!

Selecting Target Activities• Identify an activity

– Motivating– Successful – FUNctional– Interactive– Broad to include all developmental levels

Describe your Target Activity on the Target Activity Form

Motivate to Communicate

Cumley, J & Pallaske, M. 2002

Target Activity Description Communication Turns Communication Considerations Prompt Hierarchy What does student have to say to begin the activity? Environmental Cue… Open Questions… What does student have to say to continue the activity? Prompt or Request Communication… Environmental Modifications

Full Model What does student have to say to end the activity?

Descriptive Feedback

Come up with an example of an activity that you might do in your classroom for the preschool aged population 0-3 .

How is vocabulary represented:

Activity Vocabulary:

Wants/Needs:

Social Interactions & Etiquette:

Sharing Information:



Does your Target Activity have at least THREE opportunities for the student to initiate?

• What does the student have to say to BEGIN the activity?

• What does the student to have to say to CONTINUE the activity?

• What does the student have to say to END the activity?

If you can’t think of 3 statements the child needs to say to be engaged in the activity….pick a different activity!

Communication Turns-example

Routine Play Beginning: Student asks for bubbles.“I want….” “Can I have ….” “bubbles”, etc.

Middle: Student asks for “more”, “help”, makes social, informational or etiquette comments to peers and adults“I want more ….”, “more ….”, “good …..” “I like …” “You want…”

End: Student indicates when finished“all done”, “clean up”, “no more”, “bye-bye”

Group Practice Printed Form (reproducible)

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Communication Considerations

How will the vocabulary be represented (e.g., objects, tangible symbols, photos, symbols, etc.) List the vocabulary that must be available. Try to

have vocabulary that represents• Wants/Needs• Social Interactions & Social Etiquette• Sharing Information

Addressing Communication Challenges AND Creating a Communication Environment…

Requires changes in: – Activities

–Environment– Partner

Structure the Environment for Success

• Common Strategies….

– Use motivating materials and activities– Materials should be in view but out of reach– Activity needs assistance – Provide small or inadequate amounts of materials– Violate the Routine – Use visual tools



Addressing Communication Challenges AND Creating a Communication

Environment…• Requires changes in the…

– Activities– Environment

–Partner

Qualities of Communicative Partners

Less Language is More

Engage Meaningful

Communication Success

Avoid • Hyper-verbal:

Bombardment of Questions• Asking Rhetorical Questions• Asking Yes/No Questions • Doing everything for them

(anticipating their needs)• Use of the word “more” for

communication

Practice • Verbal Pauses • Ask Open Ended Questions• Wait• Provide an Expectant

Response• Gain Attention• Stay in Field of Vision• Placement of word in

phrase• Wait & Wait & Wait

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Worksheets

Think back to your childhood and tell me ONE thing you learned from a worksheet?

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Advocate: Invest Early• Students who don’t read proficiently by third grade are four times more likely to

leave high school without a diploma than proficient readers, according to a study over time of nearly 4,000 students nationally. (Hernandez, D. Double Jeopardy: How Poverty & Third-Grade Reading Skills Influence High School Graduation, 2011, Annie E. Casey Foundation)

• Children in whom speech and language impairments persist past five and a half years of age have an increased incidence of attention and social difficulties. Children with specific speech and language impairments at 7 ½ to 13 years of age have been shown to have impaired writing skills, with marked deficits in spelling and punctuation compared with children without speech and language impairments. (Snowling MJ, Bishop DV, Stothard SE, Chipchase B, Kaplan C., 2006).

• From conception to kindergarten, the rate of brain development is the fastest of any other period in a person’s life and highly influenced by the quality of early experiences and relationships with their parents. Yet the public investments are at their lowest point in the infant and toddler years – when brain growth is the most rapid. (J.S. Shonkoff & D. Phillips, Eds., From Neurons to Neighborhoods: The Science of Early Childhood Development (2000), Washington D.C.; National Research Council & The Institute of Medicine, National Academy Press.)

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You suspect delays: Now What?

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Caregiver Conversations

• Do not initiate at drop off or pick up• Arrange a 1:1 time where the caregiver is

focused• Avoid DIAGNOSING• State observations

– Remain Objective NOT Subjective

• Ask if observations at home are commensurate with observations at school

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Objective vs. Subjective

Objective Objective is a statement that is completely unbiased. It is not touched by the speaker’s previous experiences or tastes. It is verifiable by looking up facts.

Subjective Subjective is a statement that has been colored by character of the speaker. It often has a basis in reality, but reflects a perspective of the how the speaker perceives reality. It can not be verified by using concrete facts and figures.

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Suspect Delays: What to do?

Objective1. When your child appears

frustrated, he hits, bites and screams. This generally occurs when he wants another child’s toy.

2. I have noticed that your child lines up cars side by side and plays with them for long amounts of time.

Subjective1. Your child hits all of the time.

2. I think your child is autistic.

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Suspect Delays: What to do?

Objective3. When your child talks, his speech seems to come from the front of his mouth.

4. When I try to get your child’s attention, he responds better when I’m talking to him from the front (when he sees me).

Subjective3. Your child talks like a baby.

4. I don’t think your child can hear very well.

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Practice

Topics • Constant crying • Hits• Bites• No consistent words by 18

months.• Picky Eater• Excessing Drooling• Play skills• Not showing an interest in

communicating

Subjective and Objective

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Options for Intervention

Local Options • Early Childhood Intervention (ages 0-3)

– Easter Seals– Bluebonnet Trails– Any Baby Can, Inc.– Therapy Corps, PLLC

• Home Health (ages 0-21)– Therapy Corps, PLLC– RiverKids– Little Engines

• School System (ages 3-21)* in general

• PPCD classroom (ages 3+)• Private Practice

– Therapy Corps, PLLC– Little Tosoros– Various Independent Clinicians

Where to refer? PCP

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Ashley S. Fairleigh, M.S., [email protected]

the late talker strategies for effective communication 90...

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