Language Disorders:from Infancy through Adolescence:

Listening, Speaking, Reading, Writing, and Communicating

Rhea Paul, PhD, CCC-SLPProfessor, Yale Child Study Center

New Haven, Connecticut

Courtenay F. Norbury, PhD

Senior Research Fellow Department of Psychology Royal Holloway University of London London,England

pages 520-530

service delivery models

inclusion should be about restructuring classrooms and schools to support and provide for the special needs of children with disabilities,not just having them passively "sit in".

the RTI model

the SLP has an important role to play in RTI classrooms:

consulting with classroom teachers on providing the highest quality,scientifically based instruction in language and literacy for all students,at tier I

participating in assessment and progress monitoring of student in tier I to determine need for additonal support 

developing and monitoring intensive small group instruction programs to be delivered by paraprofessionals,volunteers,or peers for children requiring tier II instruction

monitoring progress in tier II to identify when student no longer ruquire additional help,or show needs for tier III instruction or special education

participating in evaluations to determine the need for individualized insturction at tier III, or special education placement

designing and delivering tier III and special educational support in language and literacy

the clinical model

the traditional clinical,or "pull-out",model of intervention,part of the client's intervention time is spent in a clinical setting and part is spent in the classroom with participant observation-based intervention or with the clinician doing a collaborative lesson with the whole group.

the language-based model

these classrooms will be designed to serve more severely impaired students with communia-tion deficits that would make it difficult for them to particitpate in the mainstream.

often resource rooms focus on content mastery;helping sutdents to succed in the curriculum being taught in the regular classroom.

consultation and collaboration

consultation

consultation in an RTI format involves helping teachers select programs and instructional strategies for providing tier I lessons in literacy.

phonemic awareness

phonics

vocabulary

fluency

comprehension

to support comprehension,SLPs can work with teachers to implement the seven evidence-based strategies 

comprehension monitoring,where readers learn how to be aware of their understanding of the material

cooperative learning,where students learn reading strategies together

use of graphic and semantic organizers(including story maps),where readers make graphic representations of the material to assist comprehension

question answering,where readers answer questions posed by the teacher both before and after reading

question generation,where readers ask themselves questions about various aspects of the story

stroy structure,where students are taught to use the structure of the story as a means of helping them recall story content in order to answer questions about what they have read.

summarization,where readers are taught to integrate ideas and generalize from the text information to produce a brief synopsis of the material they read

consultation to support students on IEPs

recopying tests with larger print and fewer questions per page or arranging for a volunteer to audio record classroom readings for the student to use.

in the demonstration format,specialists from several disciplines can demonstate materials, methods,or activities that could be used in the classroom to foster success for clients as well as mainstream students.

the case-study method provides an opportunity for specialists and regular educators to discuss a particular case in depth,so that priciples and problems can be seen from a variety of points of views.

a literature session allows professionals to get together to talk about some readings they have selectied.

in-service training for teachers and SLPs who are collaborating to provide services to children with communication disabilities in the regular classroom(p.523)

training course outline

session I:language in the classroom:getting perspective on collaborating,sharing roles,and teaming

objectives:

1.to share the perspectives of participants involved in collaborative service delivery on meeting the needs of at-risk students with communication disorders in the regular classroom.

2.to recognize those roles shared by teachers and speech-language pathologists as they assess and interview with students.

3.to understand a transdisciplinary philosophy for teaming,including role exchange,role release,and support.

activity

video viewing of collaborative planning meetings,classroom activities,and follow-up.

session II:normal communication development and communication disorders in the classroom 

objectives

1.to understand normal communication and language development in school-age children.

2.to recognize communication disorders common to the classroom 

3.to understand the perasive nature of language deficits in children with disabilities.

activity

role playing an intial collaborative meeting

session III:identifying and managing classroom language demands:what are the scripts?

objectives

1.to gain a broader understanding of the impact traditional classroom methods have on the student with communication disorders.

2.to identify scripts in the classroom 

3.to explain a process-based approach for managing classroom language demands.

activity

developing and implementing a communication skills "script" in the classroom

session IV:assessing communication problems in the classroom :a collaborative approach

objectives

1.to understand curriculum-based language assessment

2.to provide a famework for collaborative assessment using language-based curriculum analysis,checklists,and observation logs.

3.to suggest ways to establishing collaborative data collection practices during classroom activities.

activity

practicing team assessment

session V:strategies for managing the language of math

objectives

1.to recognize the language complexity in the math curriculum and in text materials

2.to gain skills in adapting curriculum materials for elementary students with communication disorders

3.to learn strategies for collaborating with students to enhance their performance in math application,computation,and problem solving.

activity

explaining math problems in third grade

session IV:using literature in the classroom

objective

1.to examine the development of oral and written language

2.to learn strategies for implementing leterature use in the elementary classrooms

3.to recognize and manage the reading difficulties of at-risk students with communication disorders

activity

sharing a writing project

session VII:issues in collaborative service delivery:scheduling,IEP development,and conflict resolution

objectives

1.to explain a process for determining the types of service delivery a student with communication disorders should receive

2.to recognize the role of regular and special education teachers,parents,and students in developing IEPs for students with communication disorders

3.to discuss barriers to effective communication when working with a team

activity

conflict resolution through role-play

collaboration

building administrative support,developing relationships with teachers,and creating effective collaborative lessons and curriculum units.

building administrative support

need to do some groundwork with school administrators to convince them to provide the coordination time necessary

developing collaborative relations

building relationships with teachers is the next step in sucessful collaboration.

models of collaborative teaching(p.524)

one teach,one support

station teaching

parallel teaching 

alternative teaching 

team teaching 

effective lesson planning

a framework for collaborative classroom lesson plans(p.525)

creat an anticipatory set

focus students' attention on the topic to be discussed.(today we'll talk about how characters in a story make plans to solve their problems)

state the objective

tell the students what you expect them to learn as a result of the lesson(we'll learn to look for ways charaters plan their actions in a story)

give the purpose of the lesson

tell the students how the learning will benefit them(it helps us understand stories better if we look for the ways characters make and carry out their plan)

provide an input model

tell the students what to look for;provide an example,check for understanding,monitor and adjust the instruction if necessary.

provide guide practice

have the students complete an activity under adult supervision and scaffolding

close the lesson

review the objective and purpose and ask students to tell what they learned

provide distributive practice

leave follow-up activities for the teacher to do so students can review and practice in a different setting what they learned in the lesson.

collaborative curriculum planning

finding ways to work with classroom teachers to design and modify the curriculum and provide appropriate accommodations so that our students learn what the other students in the class do.

considerations for the older clients with moderate to severe disabilities and those with ASD

older students with moderate to severe disabilities who function at the language for learning level

for adolescents and yound adults functioning at elementary grade levels of language and literacy,the main goal of intervention is to foster independence in vocational and living situations to as great  an extent as possible.having fuctional social discourse skills is very important in making this transition,as is having some functional literacy.

we should relate targets to the major domains in which the student must function,these domains would include domestic,recreational,and vocational settings.ecological inventories can be used to assess what communication skills are needed,this often involves making contact with community settings to which the student will eventually transition and beginning to set up links before the student leaves school,intervention can focus on providing the skills needed for these most crucial environments.

be used to express basic wants and needs,and enable the speaker to obtain desired outcomes through the mediation of a listener.

components of precision reading 

format texts:make materials more accessible by increasing prints size,adding additional spacing for lines and paragraphs,simplifying sentence structure but not vocabulary

use repeated readings with corrective feedback to increase speed,soomthness and word recognition:students reads same passage each day for 10 days;readings last only one minute, over the ten days,the amount the student can read in one minute increase.

teacher identifies misread words,which are presented to students on cards for additonal practice.

support vocabulary:once words originally misread are fluently,teachers work on meaning of these words through elaborated exposure techniques

teach comprehension:teach retelling,QART,reciprocal teaching,and other evidence-based comprehension strategies to enhance understanding

use complementary strategies:supplement instruction with sustained silent reading,choral reading,buddy reading,and home-based reading.

did i pay attention to the problem?

what do i know?how do i know it?

did i pay attention to what others saw,heard,and thought?

what does everyone else know about the problem?how do they know it?

do i know what i need to do?what is my best choice?why?

using peer models

examples of evidence-based,peer-mediated social interaction programs for students with ASD(p.528)

evidence-based pragmatic programs for students with ASD

peer group entry

student with ASD is taught to:

walk over to your friend

watch your friend

get a toy like your friend is using

do the same thing as your friend

tell an idea

peers are coached to welcome and facilitate group entry

special interest game group 

students with ASD is encouraged to develop a board game based on special/obsessive interest

game time with small group of peers is arranged(e.g.,lunch bunch)

target student teaches game to peers

group takes turns choosing games to play during interactive game time(target student must play games of others' choice as well as his own)

peer support networks

popular peers chosen based on teachers' recommendation.

peers receive four training sessions:

introduce the nondisabled peers to the characteristics of students with ASD

following three sessions include the student with ASD

social interactions are observed in conversation;taking turns,and sharing are modeled and practiced

peers assigned to buddy target child for specific periods;each responsible for coaching/ mentoring the student with ASD for one period of time(e.g.,lunch,Phys,Ed.)

pivotal response training

peers given 7 training sessions and taught to:

gain attention:say the target student's name and then give the prompts "look" and "listen" while making eye contact.

vary activities:offer target student different play options using cue cards or by verbally giving choices of preferred activities.

narrate play:comment and narrate their own play;provide examples of appropriate play with play material,describe what he or she is doing with material(e.g., let's bounce the ball)

reinforce attempts:praise the target student for any attempt at functional play

take turns:offer turns or demonstrate sharing

evidence-based pragmatic programs for students with ASD

script-fading(p.528)

video modeling

generalization and maintenance are increased when children watch the video interaction, then rehearse it verbally before re-enacting the scenario.re-enactments occur first with the clinician,later with other adults,and finally with peers,new,inexpensive methods of videorecording on computers,cameras,and smart phones make this method now very accessible.