abc of imp - fcei 2012 of imp.pdf · the relationship between obligatory cortical auditory evoked...
TRANSCRIPT
The ABC of IMP: IMPlementing the
Infant Monitor of vocal Production . . FCEI 2012, Bad Ischl, Austria
Robyn Cantle Moore, PhD.
The Impetus
An obligation
� A family-centred approach imperative.� Parent knowledge & autonomy the focus.� Distinct strategies needed:
(a) to guide professionals(b) to support parent understanding &
expand skills.� Ensure benefits of earlier identification
do not dissipate.
Précis
Infant Monitor of vocal Production (IMP)Cantle Moore (2004, 2006, 2008).
� AAAAuthentic assessment procedure.
� BBBBasic (foundational) evaluation instrument.
� CCCCriterion referenced clinical tool.
AAAAuthentic assessment
� A systematic process of observation.
� An account of naturally occurring behaviours.
� An evaluation derived from the informed
opinion of a familiar observer / parent.
Advantages of authentic assessment
� More thorough & extensive sampling of
behaviour than ‘one-off’ / direct elicitation.
� Evaluates levels of functional ability.
� Consistent with family-centred practice and
upholds parent autonomy.
What? Why? When?
Pitfalls of authentic assessment
� Accuracy of parent perception is variable.
� “Informed opinion” can be reliable and valid if structured by procedure (Bagnato et al., 2008)
e.g., using face-to-face interview /probe question technique (Ching & Hill, 2007; Sparrow et al.,
1984; Robbins et al., 1991).
� Process guides parent to reflect and evaluate, thus enhancing informed opinion.
Expectations and challenges
� PROMPT INFORMATIONVisually literate
Experiential learners – “do something / discover”Feedback – “how’s it going? / Why?”
Make own decisions – “I think / believe..”(McQueen, 2010; Oblinger & Oblinger, 2005; Ryan, 2009).
Gen X Gen Y have different experience / different expectations.
The IMPreport
for parents
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BBBBasic evaluation instrument
(Kuhl, 2004).
PerceptionPerception
ProductionProduction
1 2 3 4 5 6 7 8 9 10 11 12
Universal speech production
Language specific speech production
First words
Non-speech sounds
Vowel-like sounds
‘Canonical babbling’
MONTHSMONTHS
Universal speech perception
Language specific speech perceptionPhonetic contrasts all languages
Language specific vowels
Language specific sound combinations
Native language consonants
Typical infant vocal development (Birth – 12 months)
Adapted from: Oller (2000) Nathani, Ertmer, & Stark (2006)
“Pre-Linguistic”
INTEGRATIVE BABBLE
LEVEL 5
Advanced Forms
“Pre-Lexical”
CANONICAL BABBLE
LEVEL 4
Basic Canonical Syllables “emergence is striking”
LEVEL 3
Expansion
LEVEL 2
Control of Phonation
EXPANSION
“Gooing”
PRIMITIVE
ARTICULATION
12
11
10
9
8
7
6
5
4
3
2
1
0
Months of Age
LEVEL 1
Reflexive
PHONATION
Vowel-like sounds
Non-speech sounds
‘Canonical babbling’
Language specific speech production
First words
Kuhl (2004)
Stages of infant vocal production
An educational strategy
� To engage parents in the nature and pace of
>12mth auditory-vocal development .
� To give value to parent observations of a
baby’s vocal ability.
� To encourage parents to descriptively report,
reflect on, and evaluate baby’s vocalizations.
A clinical tool
� To document hierarchical changes. (Nathani, Ertmer, & Stark, 2006; Oller, 2000).
� To demonstrate transition / / or lack of timely transition, to an Audition-Production Loop.
(Koopsman-Van Beinum et al., 2001; Mayne et al., 1998; O’Donoghue et al., 1999; Oller et al., 1985; Stoel-Gammon, 1989)
� To illustrate steady/accelerating/slowing rate of vocal progress >12mth HAge.
IMP examines the emergent relationship
SPEECH
AUDITORY PERCEPTION
RECEPTION
ORO-MOTOR ORGANIZATION
EXPRESSION
AUDITORYPROCESSINGCAPACITY
A diagnostic aid
� Impact of ANSD on auditory processing. (Rance & Barker , 2008; Sirimanna , 2010)
� Environmental inconsistency / opportunity. (Hart & Risley, 1995; Huttenlocher ,1998; Moeller et al., 2009)
� Oro-motor challenges to speech production. (Davis & Velleman, 2000; Evans Morris 1982; Maassen, 2002)
� Developmental – not related to hearing loss. (Riou et al., 2009)
CCCCriterion referenced clinical tool.
A typical IMP presentation takes 15 minutes:1 2 3 4 5 6 7 8 9 10 11 12BaselineBaseline
AGE IN MONTHS
“Pre-Linguistic”
INTEGRATIVE BABBLE
LEVEL 5
Advanced Forms
“Pre-Lexical”
CANONICAL BABBLE
LEVEL 4
Basic Canonical Syllables “emergence is striking”
LEVEL 3
Expansion
LEVEL 2
Control of Phonation
EXPANSION
“Gooing”
PRIMITIVE
ARTICULATION
12
11
10
9
8
7
6
5
4
3
2
1
0
Mont hs of Age
LEVEL 1
Reflexive
PHONATION
Adapted from: Oller (2000) Nathani, Ertmer & Stark (2006)
Stages: IMP Baseline
� Physical / “anatomical drivers”(Ingram, 1989; Oller, 2000; Vihman, 1996).
and maturation of the vocal system.
(Koopsman-van Beinum et al., 2001).
� Consistencies across languages (MacNeilage et al., 2000).
and in the presence of hearing loss. (Moore et al., 2007).
IMP: Question 3
Playful “cooing” (Ingram, 1989) and the emergence of
throaty consonantal sounds – [g] or [k] – (Roug, Landberg &
Lundberg, 1989) may give the impression of primitive syllables (Koopmans-van Beinum & Van der Stelt, 1986).
Video: Baseline parent interview
Integrity of the Audition-Production Loop
Beginnings of the Audition-Production Loop
BASELINEPhysiological Control
“Pre-Linguistic”
INTEGRATIVE BABBLE
LEVEL 5
Advanced Forms
“Pre-Lexical”
CANONICAL BABBLE
LEVEL 4
Basic Canonical Syllables “emergence is striking”
LEVEL 3
Expansion
LEVEL 2
Control of Phonation
EXPANSION
“Gooing”
PRIMITIVE
ARTICULATION
12
11
10
9 8 7 6 5 4 3 2 1 0
Months of Age
LEVEL 1
Reflexive
PHONATION
Adapted from: Oller (2000) Nathani, Ertmer & Stark (2006)
IMP Question 13
IMP Question 16
IMP Question 10
IMP Question 7
Transition to the Audition-Production Loop
Video: Transition stage, generic example
http://www.youtube.com/watch?v=ytWPh6oNthM&feature=related
IMP: Question 10
The first consonant + vowel (CV) combinations around 6
months of age may be a ‘by-product’ of motor practice (Oller,
2000). Early CV often accompany more frequent production of
labial consonants [b], [m] in sound play (Ingram,1989).
Video: Transition to A-P Loop interview
Integrity of the Audition-Production Loop
Beginnings of the Audition-Production Loop
BASELINEPhysiological Control
“Pre-Linguistic”
INTEGRATIVE BABBLE
LEVEL 5
Advanced Forms
“Pre-Lexical”
CANONICAL BABBLE
LEVEL 4
Basic Canonical Syllables “emergence is striking”
LEVEL 3
Expansion
LEVEL 2
Control of Phonation
EXPANSION
“Gooing”
PRIMITIVE
ARTICULATION
12
11
10
9 8 7 6 5 4 3 2 1 0
Months of Age
LEVEL 1
Reflexive
PHONATION
Adapted from: Oller (2000) Nathani, Ertmer & Stark (2006)
IMP Question 13
IMP Question 16
IMP Question 10
IMP Question 7
Integrity of the Audition-Production Loop
What do you hear?
LISTEN…
Can you describe it?
� Did the infant seem to ‘talk’ to himself
while playing alone? What did he do?
IMP: Question 13
Pre-lexical babble has rhythmic timing and is voluble (Oller et
al., 1985; Stoel-Gammon, 1989). Babble variety & complexity reflects
biomechanical “frame” theory (Davis et al., 2005).
Documenting CV babble variety
Interpreting the IMP
TYPICALTYPICAL
Interpreting sequential IMP results
Sequential scoring graphic: Case Study 53
“Sam”
1 1
13
Innate Transition to A-P Integrity of A-P Loop Loop
Sequential ranking graphic: Case Study 53
“Sam”
“Sam”
1 1
13
Sequential scoring graphic: Case Study 4
“Larry”
1 1
13 21
ANSD /Change in hearing?
Oro-motor challenges?
Other developmental concerns?
Environmental inconsistency?
Innate Transition to A-P Integrity of A-P Loop Loop
Sequential scoring graphic: Case Study 4
“Larry”
“Larry”
1 1
13 21
Scatter plot of scores: Normal Hearing
100
80
60
40
20
0
MONTHS HEARING AGE
3 4 5 6 7 8 9 10 11 12 13
IMP
%Q
.Ceiling &
Ranking
Vocal Proficiency
Ranking > 80%
Ranking 50-80%
Ranking < 50%
NORMAL HEARING (n=14)(R2 = 0.710)
Transition to A-P Integrity of A-PLoop Loop
Scatter plot of scores: Hearing Aided
100
80
60
40
20
0
MONTHS CHRONOLOGICAL AGE
3 4 5 6 7 8 9 10 11 12 13
IMP
%Q
.Ceiling &
Ranking
Vocal Proficiency
Ranking > 80%
Ranking 50-80%
Ranking < 50%
BILATERAL HEARING AIDED (n=41)(R2 = 0.207)
Transition to A-P Integrity of A-PLoop Loop
Scatter plot of scores: C-Implanted
100
80
60
40
20
0
MONTHS CHRONOLOGICAL AGE
3 4 5 6 7 8 9 10 11 12 13
IMP
%Q
.Ceiling &
Ranking Vocal Proficiency
Ranking > 80%
Ranking 50-80%
Ranking < 50%
COCHLEAR IMPLANTED (n=12)(R2 = 0.427)
Transition to A-P Integrity of A-PLoop Loop
Transition to A-P Loop
100
80
60
40
20
0
3 4 5 6 7 8 9 10 11 12
Normal hearing
Hearing aided
Cochlear implanted
MONTHS HEARING AGE
TREND OF SCORES AT EQUIVALENT HEARING AGE
Normal hearing (n=14) : Bilateral hearing aided (n=41) : Cochlear implanted (n=12)
Transition to A-P Integrity of A-PLoop Loop
IMP
%Q
.Ce
iling & R
ankin
g
Thankyou for listening
Online IMP training is free of charge, however you are required to register before you can access the training modules . We also ask that you share data collected using the IMP via the online form, available within the training website.
Go to http://www.ridbcrenwickcentre.com/imp to register. Once registered, you will receive an email containing your login credentials.
Questions?
Contact:
Dr Robyn Cantle MooreRIDBC Renwick [email protected]
RIDBC Renwick Centre for Research and Professional EducationAdministered by the Royal Institute for Deaf and Blind Childrenin affiliation with The University of Newcastle, Australiawww.ridbcrenwickcentre.com/imp/
ReferencesBagnato, S.J., McKeating-Esterle, E., Fevola, A.F., & Bartolomasi, P. (2008). Valid use of clinical judgement (informed opinion) for early intervention eligibility.
Infants &Young Children, 20(1), 35-48.Camaioni, L., Caselli, M.C., Longobardi, E., & Volterra, V. (1991). A parent report instrument for early language assessment. First Language 11, 345-359.Ching, T.Y.C., Hil,l M. (2007). The Parents’ Evaluation of Aural/oral performance of Children (PEACH) scale: normative data. Journal American Academy of
Audiology, 18(3), 221-237.Dale, P.S., Bates, E., Reznick, J.S., & Morisset, C. (1989). The validity of a parent report instrument of child language at twenty months. Journal of Child Language,
16, 239-249.Davis, B.L., & Velleman, S.L., (2000). Differential diagnosis and treatment of developmental apraxia of speech in infants and toddlers. Infant-Toddler
Intervention, 10, 177–192.Evans Morris, S. (1982) Pre-speech Assessment Scale. New Jersey: J.A. Preston Corporation.Golding, M., Pearce, W., Seymour, J., Cooper, A., Ching, T., & Dillon, H. (2007). The relationship between obligatory cortical auditory evoked potentials (CAEPs) and
functional measures in young infants. Journal of the American Academy of Audiology, 18, 117-125.Hart, B., & Risley, T. (1995). Meaningful differences in the everyday experience of young American children. Baltimore: Brookes.Huttenlocher, J. (1998). Language input and language growth. Preventive Medicine 27,195-199. Ingram, D. (1989). Phonological disability in children (2nd ed.). London: Cole and Whurr Ltd. Koopmans-van Beinum, FJ. Clement, CJ. & van den Dikkenberg-Pot, I. (2001). Babbling and the lack of auditory speech perception: a matter of coordination?.
Developmental Science 4: 61-70.Kuhl, P.K., (2004). Early language acquisition: cracking the speech code. Nature Reviews Neuroscience, 5, 831-843.Lyytinen, P., Poikkeus, A-M., Leiwo, M., Ahonen, T., & Lyytinen, H. (1996). Parents as informants of their child's vocal and early language development. Early Child
Development & Care 126: 15-25.MacNeilage, P.F., Davis, B.L., Kinney, A., & Matyear, C.L. (2000). The motor core of speech: A comparison of serial organization patterns in infants and languages.
Child Development ,71(1), 153-163.McQueen, M. (2010). The new rules of engagement: A guide to understanding and connecting with Generation Y. Morgan James Publishing.Maassen, B. (2002) ‘Issues contrasting adult acquired versus developmental apraxia of speech’, Seminars in Speech and Language 23: 257–266.Mayne, A.M., Yoshinaga-Itano, C., Sedey, A.L., et al. Expressive vocabulary development of infants and toddlers who are deaf or hard of hearing. Volta Review
1998; 100:1–28.Moeller, M.P., Hoover, B., Putman, C., Arbataitis, K., Bohnenkamp, G., Peterson, B., Wood, S.L., Lewis, D.E., Pittman, A.L. & Stelmachowicz, P.G. (2007).
Vocalizations of infants with hearing loss compared to infants with normal hearing: Part I - Phonetic development. Ear & Hearing. 28, 605-627.
Moeller, M.P,. Hoover, B., Peterson, B., & Stelmachowicz, P. (2009). Consistency of hearing aid use in infants with early-identified hearing loss. American Journal of Audiology, 18(1),14–23
Moore, J.A., Prath, S., & Arrieta, A. (2007). Early Spanish speech acquisition following cochlear implantation. The Volta Review, 106(3), 321-341.Nathani, S., Ertmer, D.J., & Stark, R.E. (2006). Assessing vocal development in infants and toddlers. Clinical Linguistics & Phonetics 20(5): 351-369.O’Donoghue, G., Nikolopoulos, T., Archbold, S., & Tait, M.(1999). Cochlear implants in young children: The relationship between speech perception and speech
intelligibility. Ear & Hearing, 20, 419–425.Oblinger, D.G., & Oblinger, J.L. (Eds.) (2005). Educating the Net Generation. Available on-line: http://www.educause.eduOller, DK. (2000) The emergence of the speech capacity. Mawah, NJ: Erlbaum Associates Publishers.Oller, D K. (2006) 'Vocal language development in deaf infants: new challenges', in P. Spencer and M. Marschark (Eds.) The Spoken Language Development of
Deaf and Hard-of-Hearing Children, pp. 22-44. Oxford: Oxford University Press.Oller, D.K., Eilers, R.E., Bull, D.H. & Carney, A.E. (1985): “Prespeech vocalizations of a deaf infant: a comparison with normal metaphonological development”,
Journal of Speech and Hearing Research, 28: 47-63.Pierce, W., Golding, M., & Dillon, H. (2007). Cortical evoked potentials in the assessment of auditory neuropathy: Two case studies. Journal of the American
Academy of Audiology, 18, 380-390.Rance, G., & Barker, E.J., (2008). Speech perception in children with auditory neuropathy/dyssynchrony managed with either hearing aids or cochlear implants.
Otology & Neurotology, 29, 179-182.Riou, E., Gosh, S., Francoeur, E., & Shevell, M. (2009). Global developmental delay and its relationship to cognitive skills. Developmental Medicine & Child
Neurology, 51, 600-606.Robbins A.M., Renshaw J.J., & Berry S.W. (1991). Evaluating meaningful auditory integration in profoundly hearing-impaired children. American Journal of
Otololaryngology, 12(Suppl), 144150.Ryan, K. (2009). Meet the Gen Y parents. Landor. Available on-line: http://www.landor.com/index.cfm?do=thinking.article&storyid=709Sirimanna, T. (May, 2010). Auditory neuropathy spectrum disorder (ANSD) in children: Aetiology, risk factors, categorization and outcome predictors'. Paper
presented at the 10th PAIG Conference, Reading, UK.Sparrow, S.S., Balla, D.A., & Cicchetti, D.V. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service. Stoel-Gammon, C. (1989). Prespeech and early speech development of two late talkers. First Language, 9,207–24.Thal, D., O’Hanlon, L., Clemmons, M., & Fralen, L. (1999). Validity of a parent report measure of vocabulary and syntax for preschool children with language
impairment. Journal of Speech, Language, and Hearing Research, 42, 482–496.Thal, D., DesJardin, J. L., & Eisenberg, L. S. (2007). Validity of the MacArthur-Bates Communicative Development Inventories for measuring language abilities in
children with cochlear implants. American Journal of Speech-Language Pathology, 16, 54–64.Vihman, MM. (1996) Phonological Development: The Origins of Language in the Child. Oxford: Blackwell.