Language Disorders:from Infancy through Adolescence:

Listening, Speaking, Reading, Writing, and Communicating

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

New Haven, Connecticut

pages 80-87

intervention activities

structuring intervention activities to maximize learning 

essential ingredients of successful therapy

principle:

intensity

active engagement(（sustaining a client's active involvement in intervention tasks by monitoring and guiding attention through preparatory,selective,and maintenance cueing,and choosing activities that are appealing enough to sustain client engagement.)

feedback(information about the accuracy of client response)

reinforcement(delivering a reward following a correct reponse that increases the rate or likelihood the appearance of the target behavior.)

repetition(providing many opportunities for clients to use or process a new target.)

use distributed practice(provide short,intense periods of practice for new forms,intersperse with practice on other forms or instruction in new target.)

 specificity(children learn what they are taught ;to teach a skill,provide instruction,and practice on that specific skill,not on skill thought to be prerequisite or related to it)

control complexity(teach in the zone of proximal development;provide activities the client can do with the clinician's support but cannot do without it.)

minimize error reponse(provide adequate cueing and scaffolding so child reponses are correct almost all the time)

work within schemas(embed practice of new forms and functions within familiar sequences of actions)

modifying the linguistic signal

rate

slowing the rate of speech improves both comprehension and production of new words by children with language impariments.

repetition

we should strive to say the sme thing the same way in the same context over and over and over.in this way we can maximize client's opportunity to add it to their repertoire.

increasing perceptual saliency through prosody and word order

controlling complexity

children exposed to more complex input show greater comprehension of complex sentences than children whose input contains fewer complex examples.semantically constrained ,well-formed，grammatically correct input just slightly morecomplex than the child's own does not hinder,but may help,language development.

obligating pragmatically appropriate responses

if we want a client to produce a whole sentence as a reponse,our linguistic stimulus should obligate that form and not provide a context for an elliptical sentence.

如果想让孩子说出“他在跑步”，我们不要问“孩子在干嘛”，孩子可能会直接说“跑步”，然后提醒孩子把句子说完整，这种方法不可取，如果想让孩子说出“他在跑步”，可以酱紫说“我们一起来看图片，小女孩在跑步，这里有一只小狗在跑步，那小男孩呢？”

let's look at these pictures.here，the girl is running.here the dogs is running.now you tell me what about the boy

省略句

careful selection of linguistic stimuli is one of the most important asopects of our clinician work.

determining dosage

how intense does intense need to be ?

it is likely that daily,intensive seesions involving distributed practice for a few weeks or months will be more effective than the current standard schedules of two to three 30 to 45 minute session per week for an academic year.

把任務嵌入每日的活動中，每天堅持一點點，更為有效

婷婷寫名字、認識詞彙都是每天花一點時間對她進行鞏固訓練，新舊知識交替

determining the intervention modality

how we will require the child to respond

comprehension versus production

for forms the child comprehends,production training should be a high priority.

augmentative and alternative modalities

for some children ,though ,speech is simply not a realistic option.

the process of choosing an AAC system has two componets:choice of the symbols to be used and choice of interface between communicator and the system,or how the child will access the symbols.

symbols can be either aided or unaided.unaided symbols include gestures,vocalizations,and body language.aided symbols include productions that require some of tool outside the client's own body.

aided systems include objects,pictures,graphic symbols,and alphabet letters.

communication boards containing words,letters,pictures,or symbols are sometimes used.

clients can indicate what they want to point out with a finger,head stick,headlight,or other device.

electronic systems with speech generation devices are availiable and often very useful,especially since it is know that voice output capacity not only increases vocalization and intelligibility,but also improves phonological awareness skills,which may help in the development of literacy.

interactive functions of communication partners that increase communication opportunities for clients using aac systems

use extended pause time and expectant waiting to increase opportunity for client to take a conversation ture.

respond to all user attempts to communicate,whether with the device,or by means of vocalization,gesture,or gaze;treat behaviors with the aac device as if they were commmunicative and respond even when user's intent is not entirely clear.

use open-ended questions to encourage more elaborated response from user.

model using the aac system to communicate;accompany speech with indicating symbols on the user's device to show that the device is a means anyone can use for communication.

consequating client language

強化

the intent of reinforcement is to increase the frequency of the behavior being reinforced.

反饋

its intent is to give the client information about the communicative value or linguistice accuracy of an utterance.

interactive language development teaching 

generalizing language gains

the goal of language intervention is not only to get the client to produce appropriate forms in response to our stimuli but also to get the child to use these forms in real interaction.

泛化

use many examplars of target forms and functions.

we need to work toward that generalization by providing many different examples of how the form can be used,when it can be used,and who can use it in real conversations.

sequential modification

in addition to providing multiple examplars of target forms,we should do so in multiple settings.包括家裡、戶外、教師、咖啡廳、餐館等

make the treatment material similar to things used in the natural environment

for example,using classroom textbooks rather than specially designed materials in intervention for school-age children or using the storybooks read in the preschool class instead of commercial"speech therapy"material.

intermittent or delayed reinforcement行為表現穩定後採用間歇或者延遲強化

introducing distracter items into the intervention stimuli

within a training sequence used to elicit particular language targets,the clinician should inject a relevant comment that will elicit a nontargeted response from the child.

practice makes perfect.

self-monitoring

encouraging children to take advantage of models in the environment.

by making imitation or use of a model in the intervention setting very rewarding.

providing the client with some very salient and appealing models.

generalization needs to be built consciously into our intervention programs.