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 362-377

hybrid approaches to intervention for the child with developing language

hybrid approaches in phonology

focused stimulation

focuses on specific forms and uses multiple models with a variety of forms of clinician feedback to stimilate language goals.

demonstrating  use of targets(targets are moved to sentence initial or final position,where they are most salient.

expansion(errors in the child's utterance are corrected)

recast(keep child's meaning but changes the form of the sentence)

buildups and break-downs(demonstrate how to manipulate the elements in a sentence)

false assertions(clinician makes a false remark as a prompt for the client to deny it )

feigned misuunderstandings(clinician pretends not to get the message sent by the client)

forced choices(provide a model of correct use of the target)

other contingent queries(omitting or incorrectly performing a step in an established routine to encourage the child to comment)

withholding objects and turns(used to encourage requests)

violating object function(used to encourage use of negative forms)

"syntax stories"(clinician and parents create stories,similar to "dad's bad joke" that give multiple examplars of target forms)

script therapy

reduce cognitive load of language training by embedding it in the context of a fimiliar routine.

event structures

literature-based scripts

both book reading and recitation of story passage provide ideal opportunities for practicing and stabilizing specific language skill.

joint book reading

by the use of carefully planned,scaffolded language input,for example,if spatial terms are a vocabulary category to be targeted,we would choose books that provide many examples of these terms,such as inside,outside,upside down,reading the book repeatedly,using emphatic stress on the spatial terms,and asking the child to comment or answer questions after hearing each page(where is the bear now?he's...),eventually,cloze techniques can be used to "up the ante"on the child's contribution.

by the selection of books that provide opportunities for the client to practice forms and meanings being targeted in the intervention,for example,if we are working on auxiliary verbs,we can select a book such as green eggs and ham and after several rereading,ask the child to play the role of sam-i-am

by using these carefully selected books as an opportunity for language production practice, using spatial vocabulary as our example again,we can,after several readings using questions and cloze techniques,ask the chlid to "read" inside,outside,upside down to the clinician and to several puppets,so the child must show each page to each"listener"and read the page over again to each.

multiple reading of the same book can be useful opportunities to focus children's attention on different aspects of the book,some relating to print awareness,others to vocabulary and language structure,and still others to literal and inferential comprehension.

activities for enhancing interactions with preschool storybooks(p.366)

questions(看完一個故事後，提問一些和此故事有關的問題）

joint story retell（看完故事後，以填空的方式回顧故事內容 小女孩坐在____,她看見____...）

expectancy violation detection（覆述故事，故意講錯讓孩子發現問題並糾正，如果孩子沒意發現錯誤，引導孩子，這說的對嗎？）

picture walk:閱讀書本前，把書給孩子，讓他瀏覽一邊內容，讓孩子說說看到什麼，這個一個關於什麼的故事

print referencing activities：call attention to print during reading by focusing on:

print organization

page order

page organization

title

print direction

print meaning

print function

environment print

concepts of print

letters

upper and lower case

letter names

concept of letters

words

word identification

short versus long words

letters versus words

concept of word

suggestions for using joint book reading in language intervention

step 1:read the book to the client several times over the course of a few sessions,use prosodic cues to segment and highlight target semantic and syntactic patterns.

step 2:after adequate expousure to the text,pause at points containing the target forms, creating a cloze condition,let the client produce the next word,phrase,or line (in choral fashion or groups of clients),insert pauses in linguistically specific ways to mark and select the portion of the text the client will produce,this facilitates the client's segmentation of the linguistic material for analysis.

step 3:read the book often enough that the client memorizes it,at each reading,segment the text in variable but explicit ways to facilitate linguistic analysis

step 4:segment the text so that the client must produce increasingly long portions,until eventually the client can recites the whole book.

step 5:once clients have memorized the text,have them take turns "reading" it and having the clinician or clients fill in parts left out by the "reader"

step 6:make up a new book using a similar linguistic pattern to encourage the child to use the learned forms in new ways,write down each client's version,and let the clients illustrate

theri "books"to take home to read to family members.

examples of songs.rhymes,and finger play routines for targeting language forms(368)

subject-verb-object sentences

prepositions

copula

(be)(verb)ing

modal auxiliary

third-person singular

past tense

questions

have auxiliary

relative clauses

conjuntions

structured play

using conversation and narrative in hybrid intervention

conversation

assertive and responsive skills

children with poor assertive skills are quiet in conversation.they take their conversational turns reluctantly or not at all and rarely initiate topics.

children who have trouble with responsiveness in conversation are less likely to find conversational partners responsive to them

narrative skill (敘事能力）

narrative is highly correlated with success in literacy

read stories,then asked to retell them with pictures and verbal scaffolding

interaction contexts for children with developing language

agents of intervention for children with developing language

paraprofessionals

paraprofessionals are individuals who deliver services to children and their families but serve under the supervision of a professional who is ultimately responsible for the intervention program.

parents(家長的職責和參與程度)

有些家長對孩子在學業上的要求不高，吃飽穿暖就行，不關注細節（有時覺得我活得夠粗糙的了，這孩子比我活得還糙，勤洗澡、勤換衣、勤洗頭這些都是基本要求啊）

有些家長雖然關心自己孩子的發展，但總想走捷徑，死活不肯腳踏實地一步一個腳印手把手去教自己的孩子，除了看書識字，事事包辦，生生把自己的孩子養成又殘又廢（碰到這種家長最鬧心，我自動屏蔽）

有些家長關心自己孩子的發展，自己想不出好的方法，會主動跟老師溝通交流如何做更合適

還有些家長很少和老師交流，但是老師佈置的作業會認真教孩子完成

peers

normally speaking peers provide models that are slightly above the language of the client but not too far above,because of the typical peer's own still-developing stage.conversation with a peer will be more natural and engaging to a developmentally yound child than will interaction with an adult,since topics of conversation and activities of interest are more likely to be shared between two speakers of similar developmental level.the typically developing peer is likely to provide models of appropriate behavior and speech that can be imitated by the child with language impariment.

not all preschoolers are equally willing or able to interact with disabled peers.

邀請一些小朋友去參觀，選擇那些有責任心的作為語言障礙小朋友在班級裡的communication models

peers must be supported and encouraged to provide appropriate models and opportunities for the client.

peer-mediated interventions involve teaching peers to use strategies to faciliate interaction with developmental disabilities.

buddy time

the rules for buddy time

week 1:stay with your buddy;maintain physical proximity to assigned partner.

week 2:play with your buddy;maintain proximity while continuing to play with your partner(partners are offered a choice of one activity each from a visual "choice board "then instructed to play with each partner's choice for half the buddy period session, usually 10-20mins

week 3:talk with your buddy;say you partner's name to establish joint attention,make suggestions for playing together,talk about the play,respond to what your partner says by repeating,saying more about it,or asking a questions.

service delivery models for children with developing language

clinical model

the clinical model is very useful for children with attentional problems,it provides a helpful quiet environment for children with hearing impairments or others who have difficulty screening out background noise.it can provide a safe and comforting place for children with behavioral or emotional problems who need the nurturing qualities of a ont-to-one attachment to an adult.

the major shortcoming of the clinical model,is that it may be less effective at achieving generalization to the natural communicative environment.

using multiple exemplars,involving multiple communication partners,carrying on the intervention in different places,using naturalistic reinforcers,using distracter items and intermittent reinforcement,providing coaching in peer interactions,and encouraging self-monitoring.

language-based classroom

reverse mainstream(typical peers invited to join a special education preschool)

each client's language goals can be integrated in the language used in the routines.

theme-based units are another feature of language-based classroom.

classroom-based intervention provides ample opportunity for development not only of communicative skills but of emergent literacy.

literacy centers

theme-based opportunities for seeing print in labels and captions for pictures;playing with literacy artifacts such as menus,newspapers,grocery lists,and product labels drawn from classroom themes.

名字的书写（婷婷、朗朗、雄哥和源仔要坚持每天练习）

strategies for activity-based language intervention

forgetfulness(forget to give out brushes during painting;children must do something to request needed supplies)

novelty(intorduces slightly new elements into known routine e.g.,play farmer in the dell wearing a big straw hat.let children who comment on the hat have a turn to wear it )

in sight but out of reach(put attractive or necessary objects where children can see them, but cannot get them without help.encourage them to communicate a request)

violate expectations(omit or change a step in a routine e.g.,give a child a dish of ice cream but no spoon)去肯德基吃🥣，把🥄藏起来，静静应该会说没有🥄

piece by piece(give items needed for an activity one at a time,so the clients need to communicate something to get each one.at snack time,give out one raisin at a time,or color by giving out one crayon at a time)柔柔喜欢🖨，说一次机我就打一张纸

assistance(put the child's snack in a clear glass jar that he or she cannot open without help, so the child needs to communicate a request to obtain an object or activity)给柔柔一个有包装袋的山楂条，让她自己撕开包装，她开不了，让她说帮，然后帮她撕开一点，剩下让她自己撕

sabotage(unplug the music player,then ask child to turn it on;hide children's coats when it is time to go outside.this forces the client to do something communicative to try to correct the situation.)回去我是不是该趁恒哥不注意的时候把他的饭盒或者书包藏起来？这个还没试过

delay(pause in the midst of an activity to get the child to communicate the need to continue e.g.,pause while zipping a coat before going outdoors)

昨天煲了糖水，有鸡蛋，桂圆，红枣，芝麻，她抓我的手让我勺某样东西起来给她吃，动作精准，不带差的，后来她用🥄勺了几次桂圆放我嘴里让我吃（那一刻觉得好贴心哦），自己又勺了一样东西放自己嘴里，最后连一点糖水都不放过，端起饭盒喝

facilitating emergent literacy in preschool classroom activities

circle time (look for name;tag read job list with students' names and pictures of each classroom job)

story time(point out when pages are turned;ask questions about story after reading;have children read parts of the book chorally)

center time(label favorite play equipment;post classroom rules for children to read)

snack time(label snack supplies)

outdoor time(use signs ,such as a stop sign,in games such as red light,green light;act out favorite stories in outside play)

consultant model

provide iep-based instruction that is embedded in everyday classroom routines,is the best practice.

children with disabilities sometimes turn to maladaptive  behaviors,such as aggression, because they do not have more conventional means available for expressing themselves.

positive behavior support

1.help the teacher to understand that these behaviors may be used to serve a communicative function

2.establish the function of the maladaptive behavior through functional behavior analysis

3.use visual schedules to aid comprehension and predict events

4.model dealing with the behavior within the classroom,work with the child in a situation likely to trigger the behavior,and model how to prevent it,by providing an appropriate communication strategy to the child when aggressive behavior seems imminent

5.suggest that the teacher model using language for emotions within classroom activities; show students how to talk(or communicate)about how they feel;and encourage peers to do the same.

6.help teachers involve families in carrying over strategies to the home setting

consultation suggestions for including phonological  targets within a classroom setting(p.375)

collaborative model

demostration teaching

using crown questions as a basis for discussion and modeling with teachers:

c=completion questions that focus on the linguistic structure(the cat was wearing a red and white___?[hat] are there any words that you heard that rhyme with hat?)

r=recall questions that focus on story content(where did the children's mother go?)

o=open-ended questions that focus on increasing amount of talk about the book(why do you think the fish was upset with the cat's ideas?)

w=wh- questions that focus on teaching new vocabulary(can anyone find the rake in this picture?what do you use a rake for ?)

d=distancing questions that focus on linking book events with one child's own experiences (how would you feel if you made a mess in your house while your mother was not around?)

team teaching 

a tiered framework of instruction,comprising

tier I :provision of evidence-based instruction for all students

tier II:more intensive instruction for children for whom progress monitoring indicates a need for additional support

tier III: additional support that is more intense and individualized

continuou progress monitoring 

collaborative problem solving 

embedded startegies seen in classrooms with literacy-rich environments(e.g., available books and writing materials,display of literacy artifacts,encouragement of interaction with books and print),as well as 

explicit,direct instruction that highlights aspects of print during storybook reading, introduces new vocabulary in conjunction with classroom themes ,and provides guided practice in letter and sound identification as well as phonological awareness.

collaborative intervention

be ready to learn from others

take responsibilty for the student as a team(the team should share their individual viewpoint on the student's needs ,find points of agreement,and cooperatively assume responsibility for his or her progress.

have a system in place for making decisions.(have established means of resolving conflicts and dealing with conflicting views)

clarify the roles of team members(decide who will do what when)

support families and regular education teacher(be aware that the child will spend more time in the home and classroom than in the therapy setting)