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 357-362

intervention procedures for children with developing language

clinician-directed methods

the weakness of clinician-directed approaches is their failure to generalize to real communi-cation and their tendency to place the child in a passive respondent role.

phonology 

speech sounds

drill play

hide and seek.the clinician hides the cards in obvious places around the room;the client says each word as he or she finds the cards.

safari.each card is clipped to a picture of an animal.the client uses binoculars(which may be made from two toilet-paper tubes taped together)to find each animal and says each word on the card attached to it.

sack ball.large,open shopping bags,each with one of the client's cards taped to it,are placed around the room,the client throws a softball into a bag and then names the cards on that bag.the game is continued until the client has throw at least once into each bag.

buried.the client's cards are buried in sand or foam peanuts.the client names each card as it is unearthed.

phonological awareness(PA)

phonological awareness is a curcial element in children's development of reading,writing,and spelling skill;and instruction in phonological awareness significantly improve achievement in children at risk for reading problems and those with reading disorders.

example drill play phonological awareness activities(p.359)

semantics

many children enjoy pushing the buttons and seeing the pictures and animations on the computer screen,and so computer-assisted intervention is often successful in motivating clients to persist with the drills the software programs contain.

computers may be particularly good contexts for teaching action verbs,because computer animations can display action more compellingly than a static picture,they may be particularly facilitative for these forms.while computer-based language programs can offer an addtional tool and provide motivating contexts for language activities,they do not appear to be a replacement for an interactive environment with a responsive adult.

syntax and morphology

training procedures for teaching the syntactic rule"NP is (verb)-ing"through contrasts

materials:20 pictures of assorted agents doing various actions

step 1:what is the NP doing?

        say,"NP is (verb)-ing."

step 2:NP is (verb)-ing.now the NP is done.what did the NP done?

        (show picture,then take it away).say,"NP (verb)-ed."

step 3:what is the NP doing? 

        (show picture.)

step 4:NP is (verb)-ing.now the NP is done,what did the NP do?

        (show picture,then take it away.)

step 5:what is the NP doing?(show picture)

        what did the NP do?(take it away)

generalization training:repeat step 5 with different pictures,clinicians,and environ-ments.

naturalistic modifications 

1.use a cohesive text.instead of a series of unrelated pictures,use a picture book or set of sequence pictures that depicts a series of related actions,such as those involved in dressing or in preparing food.go through all the steps procedure in exactly the same way,using these pictures that form a cohesive unit as the stimuli.

2.make the contribution informative,using either unrelated picture cards or pictures that form a cohesive unit as suggested in 1,sit with the client and the pictures at a table.place a favorite doll,action figure,or photo of someone the client knows across the table from the two of you,with its back toward you so it cannot"see"the pictures.tell the client the doll wants to know what's going on in the pictures,so the client must "tell" the doll waht's going on by answering you question,both to increase the communicative aspect of the activity and to provide distractor items,occasionally have the doll respond to the client's utterance by talking for it in a funny voice.express surprise or interset in what the client is saying,and make a comment not directly related to the picture descriptions.then tell the client the doll is so interested it wants to know more,and resume the activity.

3.increase motivation to communicate.use a cohesive set of pictures,and audio record each of the client's responses to the imitative set of items in step 1.tell the client he or she can take the audio home and play the "story" for his or her parents,so the parents can hear how well the child tells the story,

child-centered approaches to intervention for the child with developing language

indirect language stimulation

contingent feedback(saying something that relates to what the child said/did;e.g.,child picks up toy car,clinician remarks,"oh,nice car!you have the car!")

balanced turn-taking(letting the child lead and the responding,rather than using extensive questions and initiations to get to child to talk;e.g.,child is playing silently,clinician plays silently alongside,when child turns toward clinician,she remarks"oh, i see what you have!you have the blue car;i have the red one!")

extension of the child's topic(saying something that gives more information about what the child just said/did;e.g.,child holds up car for clinician to see,clinician remarks,"you have the blue car!that's neat! you blue car has big,black wheels!")

focus on specific language facilitation strategies(e.g.,modeling,expandsion,recasts,imitation, responsive feedback)

using multiple instructional methods(e.g.,demonstration,coaching,role plays,mediated parent-child interactions,video recorded examples,written materials,and specific instructive feedback.)

teaching a progression of skills and strategies embedded in specific activities

facilitated play

using child-centered play context to develop a variety  of language skills

enhancing narrative ability by engaging the child in direct metalinguistic planning of the roles,plans,attempts,and outcomes to be acted out in the play.

facilitating turn-taking by contriving reasons to communicate within the play.the clinician can require the child to communicate to multiple characters,if birthday party play is going on,the clinician can have the client tell each stuffed animal "guest"what to bring to the party.

increasing opportunities for decontextualized language.the clinician can use increasingly abstract props in the play,starting with real objects and moving to replicas,constructions, toys,and finally to imaginary props.the clinician also can include some discussion of events remote in space and time within the context of the play.

enhancing the expression of communicative intentions.the clinician can structure opportunities within the play for the child to negotiate roles and plans;project events;state rules and goals;and express the feeling;intentions,and desires of characters.the clinician can begin by modeling these functions and move to asking the child to express the functions following the model.

increasing vocabulary.words specific to particular scripts can be used by the clinician multiple times within a play episode,if a shopping script is being used,the words cashier, customer,groceries,and cart might be used,generic words important for play negotiation and enactment also can be modeled,such as cooperate,prepare,and character.

developing emergent literacy.play provides many opportunities for children to pretend to write and read and to see why written forms are used,the clinician can encourage clients to make real or pretend lists,signs,and labels and to write or pretend to write notes and instructions to others characters within the play.

language elicitation techniques(p.362)

violate routines（during snack,neglect to give client a cup and begin to pour juice.）

violate expectations（clinician:這是你的🥪。child：裡面啥都沒有。clinician：那我要怎麼做？）

withhold objects or turns（give each other child a turn to operate a toy and skip client when moving to next child）

misuse objects（use a hairbrush to brush teeth）

misname objects【clinician:你覺得我的新帽子怎樣？好看不？（手指著鞋子）】

misplace object(put paper plate on head)

provide inappropriate objects for activity(provide noodles and cheese when activity is making a sandwich)

"pass it on"(clinician:你知道果汁放在哪嗎？child：不知道。clinician：去問問Jamie知道不？child：Jamie，你知道果汁放在哪不？）

“strong，silent type”（clinician：placing interesting object before client：this is neat

child：what is it ? clinician:a  barometer(say nothing else until child asks for more information

"guess what" 猜猜我昨天幹啥了

expansion invitation(我想要蠟筆。你要吃臘筆嗎？不，要塗顏色。啥？我想用蠟筆塗顏色）

guidelines for modeling pretend play(p.363)

themes and events to use as play contexts in language intervention

getting ready for school(get dressed,brush teeth,pack lunch,do chores ,eat breakfast,get on bus)

going on a trip(plan and pack,load car,leave,drive to destination,arrive at hotel,go to pool)

taking care of sick baby(take temperature,rock baby,call doctor,take in car to doctor, doctor gives baby medicine,take baby home,give juice,put to bed)