DOCUMENT RESUME

ED 379 899 EC 303 774

AUTHOR Laurel, Marci; Westby, CarolTITLE Speech/Language Pathology Module. Teams in Early

Intervention.INSTITUTION New Mexico Univ., Albuquerque. School of Medicine.SPONS AGENCY Special Education Programs (ED/OSERS), Washington,

DC. Early Education Program for Children withDisabilities.

PUB DATE 93

CONTRACT H024P00049NOTE 61p.; For related documents, see EC 303 770-775. This

module was designed to be used in conjunction withthe introductory module, EC 303 770.

AVAILABLE FROM University of New Mexico/Training Unit/UAP, HealthSciences Center, Albuquerque, NM 87131-5020 ($10each, set of six $60).

PUB TYPE Guides Non-Classroom Use (055)

EDRS PRICE MF01/PC03 Plus Postage.DESCRIPTORS Ancillary School Services; *Disabilities; Early

Childhood Education; *Early Intervention; FamilyInvolvement; Health Personnel; Inservice Education;Interdisciplinary Approach; Occupational Therapy;Physical Therapy; *Professional Development; *SpeechLanguage Pathology; *Speech Therapy; *Teamwork;Therapists; Training

ABSTRACTProject TIE (Teams in Early Intervention) was

conceptualized to meet the need for: (1) involvement of formerly"ancillary" service professionals in early intervention for childrenwith disabilities, (2) high quality family-centered services, and (3)training in the team approach. The project provides training to fourgroups that might constitute an early interventionteam--speech/language pathologists, motor therapists, health careprofessionals, and family members. This training module onspeech/language pathology examines reasons for consulting withspeech/language pathologists; outlines a framework for effectivecommunication; reviews what can be expected from a speech/languagepathologist; and explores relationships with other expert groups(families, occupational/physical therapists, and health careprofessionals). A mechanism is presented for determining what otherteam members want from speech/language pathologists and for applyingthe expertise of speech/language pathologists to the PerformanceCompetence Model to understand how children interact with theirenvironment. Several overheads and handouts are appended. (JDD)

Reproductions supplied by EDRS are the best that can made

from the original document.***********************************************************************

TEAMS IN EARLYNTERVENTION

11111-_

,a0111111a:

U.S. DEPARTMENT OF EDUCATIONOffice of Educational Research and ImprovementEDUCATIONAL RESOURCES INFORMATION

CENTER (ERIC)CVhie document has been reproduced as

received from the parson or organizationoriginating itMinor change* have been made to improvereproduction qugitty

Points of view c; opinions stated in this docu-mont do not nacessarity represent ettocalOERI p011100 or poltCy

Speech/Language PathologyModule

Marci Laurel, M.A., CCC-SLP

Carol Westby, Ph.D., CCC-SLP

BEST COPY AVAILABLE

IPI..111..111..1111All

This document was produced under Grant No. H024P00049 from The U.S. Department of Education, Officeof Special Education and Rehabilitative Services, Early Education Programs for Children with Disabilities.The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department ofEducation, and no official endorsement by that Department should be inferred.

© 1993 Reprint permission must be obtained from the Training and Technical Assistance Unit at the NewMexico University Affiliated Program at the University of New Mexico School of Medicine, Albuquerque,New Mexico 87131-5020 505-272-3000.

gat

ISLP Module

TABLE OF CONTENTS

This module was designed to be used in conjunction with the INTRODUCTORY MODULEwhich includes the background and philosophical framework for the project as well as the essentialinformation needed to use this module effectively. Read the INTRODUCTORY MODULE before

using information in this module.

Pathways to Teaming 3-15

I. Reasons for Consulting with Speech/Language Pathologists (SLP) 3

A. Concerns/QuestionsB. What the SLP Will Assess

II. Frameworks for Effective Communication 8

A. Observational Lens Model

III. What Can Be Expected. From A SLP 10

A. DevelopmentB. Preverbal CommunicationC. How to Talk to Children

W. Relationships with Other Expert Groups 12

A. FamiliesB. OT/PTC. Health Care Professionals

A Framework for Early Intervention 16-19

I. Synopsis of Information Shared in Other Groups 16

A. Reasons for Consulting with SLPB. Framework for Understanding Effective CommunicationC. Information That Can Be Expected From SLP

II. What Do Other Team Members Want From SLPs? 17

A. OT/PTB. Health Care ProfessionalsC. FamiliesD. What Did the SLP Group Hear From Others During Pfl A II?

LP Module

III. Applications of SLP Expertise to Performance Competence Model 18

A. GivensB. Underlying Factors for Producing an Efficient Adaptive ResponseC. Developmental SequenceD. What We Think, Feel and DoE. Environment and Culture

IV. Case Study Applications to Performance Competence Model 20

A. Newborn - Child Prenatally Exposed to Drugs/AlcoholB. 1 year old - Child with Down Synth ameC. 2 year old - Child with Delayed Language Development

C1 LP ModulePart 2: Pathways to Teaming

L#1

I. REASONS FOR CONSULTING WITH SPEECHAND LANGUAGE PATHOLOGISTS (SLP)

CONTENT SUMMARY: There are a number of concernsthat families might express that would indicate the needfor involvement by an SLP. These might include concernsin the areas of oral-motor and feeding behaviors, speechsound development, language development, or possibleneed for an augmentative communication system.

GOAL: Participants will develop an awareness of thereasons an SLP might be accessed.

A. Concerns/Questions

1. Presenting concerns about oral-motor andfeeding behaviors can be reported in theareas of

a. What the family notices

1) problems sucking, chewing or choking

2) frequent gasping

3) excessive drooling

4) sloppy eating

5) aversion to having things in andaround mouth

What the SLP will assess

1) sensory awareness in and aroundmouth

2) structure and function of oral mecha-nism

3) suck-swallow-breathe synchrony

4) suck, bite, chew, swallow patterns

/11 All Ilk Alh ilk Al9-141 4 4 AIlig.Ita.ltd. 411/

LP Module

c. Problems in these areas

1) dysphasia

2) oral apraxia

3) oral-motor dysfunction

4) dysarthria

2. Examples of concerns in the area of speechsound development

a. My child is not...

1) babbling.

2) making sounds.

3) easy to understand.

b. My child is...

1) saying words differently each time.

2) mispronouncing sounds.

3) hard to understand.

c. The SLP will assess

1) oral-motor skills

2) respiratory patterns

3) types of sounds produced

4) phonological processes used

7

d. Problems in these areas

1) developmental apraxia of speech

2) speech delay/disorder

3) phonological disorder

3. A variety of concerns can be discussed in thearea of language development

a. My child is not...

1) talking.

2) communicating.

3) being social.

4) putting words together.

5) volunteering to talk.

6) understanding words or directions.

7) able to get a message across.

b. My child is...

1) quiet.

2) withdrawn.

3) shy.

4) only repeating what someone else says.

3

sLP Module

c. The SLP will assess

1) cognitive and social prerequisites forlanguage

2) auditory comprehension/processing

3) ways child is currently communicating

4) emerging forms of communication

d. Problems in these areas

1) language delay/disorder

2) cognitive delay

3) childhood aphasia

4) echolalia

5) elective mutism

6) autism

(NOTE: Hearing ability will be assessed when anycommunication prob?...nz is suspected.)

4. Finally, questions may arise about augmenta-tive communication when a nonvocal communi-cation system is being considered. These caninclude

a. "Will my child ever talk?"

b. "Is an augmentative system appropriatenow?"

c. an augmentative system keep mychild from learning to talk?"

d. "What are the types of systems?"

9

ISLP Module

5. The SLP, with consultation from other teammembers, will consider

a. Positioning for use of system

b. Degree and range of motor control

c. Responses to the environment

d. Cognitive and social prerequisites forcommunication

e. Potential communication systems

10

sLP Module

QIA

#2

II. FRAIVIEWORKS FOR EFFECTIVECOMMUNICATION

CONTENT SUMMARY: Effective communication takesplace in the context of an interaction between two peoplein a specific environment. An observational lens model isdescribed by Silliman and Wilkinson (1991).

GOAL: Participants will learn one framework for lookingat communication that highlights the many ways a child'scommunication can be viewed, as well as the need for theSLP to receive information from the other members of theteam.

A. Observational Lens Model

1. Describe model components

a. Wide Angle physical setting, partici-pants, communication roles

b. Regular Lens interactional system,e.g., physical aspects of the activity, cogni-tive components, how language is used,till social organization, and activities andtopics

c. Close-up Lens examines social circum-stances that facilitate more effectivecommunication

d. Micro Close-up Lens examines thecritical sources of communication break-down

2. Different disciplines tend to use different"lenses" when observing a child.*

a. Speech-language pathologists and diag-nosticians tend to use the micro close-up lens and look at breakdowns in spe-cific skills and processes.

sLP Module

b. In recent years, speech-language patholo-gists are increasingly using the close-uplens by considering the interactionschildren have with other children andadults. They recognize that how childrentalk and what they talk about is depen-dent on their interactions with others.

c. Occupational therapists tend to use aregular lens, looking at the particulartypes of activities that children performwell or perform with difficulty.

d. Families see their children through awide angle lens. They see how theirchild functions in a variety of environ-mental contexts.

*An ecologically valid assessment of a child requiresthat the child be seen through all of these lenses. Certain lenses,however, may be more important for some children than for others.For example, the breakdown level may be the most important for achild with an oral/verbal apraxia. This condition shows little vari-ability with persons, activities, or environments. Many languagelearning differences and disabilities, on the other hand, are affectedby the child's communication partners, because persons differ in thedegree of support they provide to facilitate a child's comprehensionand production. Current research in the area of intelligence proposesmultiple intelligences, rather than a single intelligence. This impliesthat a child may be quite skilled with one type of activity, yet findother activities difficult. For example, children who exhibit signifi-cant difficulties on tasks requiring language processing, such astelling stories, may perform quite well on activities that rely onvisual-perceptual skills, such as puzzles. Environmental contexts canaffect children in a variety of ways. Children with significant cogni-tive disabilities may be able to perform only in highly familiar con-texts. Children with attention disorders may perform well in environ-ments free of distractions, but not in noisy environments with manyother children.

12

1

Cl LP Module

L #3

tei

HL WHAT CAN BE EXPECTED FROM A SLP

CONTENT SUMMARY: The SLP can be a resource forthe team in many ways. These can include providinginformation about communication development, preverbalcommunication, ar...1 facilitation of communication.

GOAL: To provide participants with information aboutwhat the SLP can contribute to the team, and for partici-pants to acquire specific information about speech andlanguage development, and the facilitation of develop-ment.

A. Development

1. A framework for learning about communica-tion development is provided which includes:behaviors that are often observed, "risks" atvarious stages of development, conditionsthat are often associated with these riskfactors, and some possible therapyap proaches. Development is presented inthis way to provide an opportunity togenerate discussion about the implicationsof differences that might occur in the "mostlikely" developmental sequence.

2. Review stated aspects of development interms of

a. Behavior observed

b. Developmental risk

c. Associated conditions

d. Possible therapy approaches

A slide presentation could be developed for this section tohighlight developmental stages, developmental risks, andpossible therapy approaches. A few slides could be used todemonstrate behaviors at each developmental stage.

13

sLP Module ..,,......--.....

16# 4, 5

B. Preverbal Communication

1. Communication begins in infancy And ismanifested in caregiver-child interaction.

2. By 8-9 months of age, children intentionallycommunicate even though they are notproducing intelligible words.

3. Through gestures, directed eye ga%e, andfacial expressions, children can coraznanicatea variety of intentions.

a. They can seek attention to themselves,objects, and other people.

b. They can request objects, actions, or infor-mation.

c. They can greet, show and give objects,protest, respond, and acknowledge actionsor language directed to them.

Suggestion: A videotape may be used here toCiernonstrate

a variety of preverbal communication strategies.

C. How to Talk to Children

1. The SLP can provide informatiot about waysto talk to and interact with children that canhelp to facilitate good communication andimproved language skills.

2. Recommended strategies will vat" based onthe child's developmental level efici commu-nication style.

1.4

Ci LP Module

:11 #3

N. RELATIONSHIPS WITH OTHER EXPERTGROUPS

CONTENT SUMMARY: The SLP will need a great deal ofinformation from the family members to provide the bestpossible services. This can include specific informationabout the child's developmental history, family concerns,the child's communication skills, the family interactionstyle, and parenting strategies. Families may need tolearn ways to convey to these professionals how impor-tant this information is to evaluation and treatmentplanning when the SLP has not been trained to under-stand its significance.

GOAL To delineate specific information needed by SLPsfrom the other expert groups (identify group) and specificinformation the SLP wants the other expert groups toknow.

A. Families

1. Information needed from families related tocommunication

a. Situations/context that the child mustfunction in

b. Activities expected of the child throughoutthe day, e.g., what must the child be ableto communicate

c. Types of interaction experienced by thechild, i.e., Who interacts with the child;in what ways; where do interactions takeplace? How does the child respond?

d. What does the child do successfully interms of communication; when does he/she break down?

15

sLP Module .............

rip

+,46!

#4

2. What the SLP wants the family to know:

Trainer facilitates a discussion to generate ideas aboutsharing information with, and learning from, families.

B. OT/PT

1. The SLP will need ongoing interactions withthe motor therapists to consider all aspectsof a child's performance.

2. Specific areas of information to be shared

a. Oral-motor, sensory, and motor skill

b. Postural and respiratory support for com-munication

c. Arousal and attention.

3. Professionals need to develop a commonframework and vocabulary for communicat-ing effectively about children receiving ser-vices from the team.

4. Information needed from OP/PT related tocommunication

a. ContextJactivities that facilitate commu-nication interactions

b. Sensory and motor information that couldbe related to communication breakdowns

c. Ways to intervene wizen motor and/orsensory issues may be affecting interac-tion or communication

1G

sLP Module

#5

5. What the SLP wants the OT/PT to know

a. In addition to needing support and infor-mation from the motor therapists, thereare a number of areas that the SLP wouldlike to bring to the attention of the motortherapist.

1) normal development of communication

2) how to talk to children

3) issues regarding augmentative commu-nication

4) prelanguage issues

5) social and emotional development

6) play

C. Health Care Professionals

1. The SLP will want to have specific informa-tion regarding medical concerns, impres-sions, diagnosis, and treatment.

2. Communication should take place in thecontext of a mutually supportive and re-spectful professional relationship.

3. Information needed from the HCP related tocommunication.

Facilitate discussion about the relationship between SLPsand HCPs.

a. Be alert to the "most likely outcome" interms of communication development(examples to include Down Syndromevs. Fragile X Syndrome)

17

sLP Module

b. Provide prognosis and direction for treat-ment and predict patterns that mayemerge in later development

c. Learn about the relationships betweenmedical conditions and communicationdisorders

d. Be alerted to issues regarding medicationmanagement

e. Generate appropriate referrals

4. What SLP would like the HCP to know: inaddition to needing support and information,there are a number of areas that the SLPwould like to bring to the attention of theHCP.

a. Normal communication development

b. Therapy approaches

c. Philosophy of treatment

d. What therapy can do/can't do

e. Evaluation procedures and implications

f. Relationships between early medical condi-tions and communication development

g. Information regarding appropriatereferrals

Is

ISLP Module

Part 3 A Framework for EL Intervention

#1, 2, 3, 4, 5

I. SYNOPSIS OF INFORMATION SHARED INOTHER GROUPS

CONTENT SUMMARY: A condensed version of the majorpoints covered in the Family content for the other threeareas (OT/PT, SLP and HCP) will be discussed.

GOAL: SLPs will learn the information that was sharedby SLP lectures with each of the groups of professionalsand families.

NOTE: Give out same hand-outs which were distributed toother discipline groups.

A. Reasons for Consulting With SLP

B. Framework for Understanding EffectiveCommunication

C. Information That Can Be Expected From SLP

LP Module

H. WHAT DO OTHER TEAM MEMBERS WANTFROM SLPs?

CONTENT SUMMARY: Content will depend upon thediscussion with each of the groups. Fill in outline belowwith notes from disucssion.

GOAL: SLPs will understand and discuss what otherteam members need from them to develop a teattk-works efectively with young children and their families.

Use chart pages that were posted in each discipline group.

A. OT/PT

B. Heath Care Professionals

C. Fsmilies

D. What Did the SLP Group Hear From OthersDuring Part II? (Fill in discussion above.)

20

SLP Module

# 6, 7

1111# 7, 8, 9, 10, 11

L# 12, 13, 14, 15

III. APPLICATIONS OF SLP EXPERTISE TOPERFORMANCE COMPETENCE MODEL

CONTENT SUMMARY: The Performance ConpetenceModel provides windows to understand how childreninteract with their environment. It can be viewed inrelationship to development as a whole with specificemphasis on the development of communication skills.

GOAL: SLPs will be given the same framework as allother team members for asking questions about how tosupport a child's performance. The model will be relatedspecifically to the early development of communicationskills.

A. Givens

1. Predispositions

2. Basic biological drives

B. Underlying Factors for Producing an EfficientAdaptive Response

1. Internal self-regulatory functions

2. Purposive system

3. Ability to achieve, change, and maintain stateof arousal

4. Freedom and control of movement

5. Orientation to stimulus

6. Discrimination

7. Attention (or selective attention)

21

LP Module

C. Developmental Sequence

1. Comfort/safety

2. Confidence

3. Risk-taking

4. Competence

D. What We Think, Feel, and Do

1. Spiritual

2. Emotional

3. Intellectual

4. Physical

E. Environment and Culture

1. Quality of life

2. Membership

3. Personal sense of competence

22

sLP Module _

101:1

N. CASE STUDY APPLICATION TOPERFORMANCE COMPEl `;;NCE MODEL

CONTENT SUMMARY: Participants will discuss specificaspects of thre different children's performance in rela-tion to the Performance Competence Model. (See gamecards in Introductory Module.)

GOAL: SLPs will use mini-case studies to practice apply-ing the model to gain information about the performanceof young children.

A. NewbornChild Prenatally Exposed to Drugs/Alcohol

B. 1 year oldChild with Down Syndrome

C. 2 year oldChild with Delayed LanguageDevelopment

23

OVERHEADS

&

HANDOUTS

24

SLP

WHAT FAMILY

NOTICES

Problems with suck

Problems chewing

Choking (gagging)

Gasping

Doesn't like

things in mouth

Excessive drooling

Picky eater

Sloppy eater

THINGS SLP

LOOKS FOR

Sensory awareness in and

around mouth

Status of oral mechanism

Suck-swallow-breathe

synchrony

Suck, bite, chew, swallow

pattern

WHAT SLP MIGHT

CALL IT

Dysphagia

Oral apraxia

Oral-motor dysfunction

Dysarthria

Not babbling

Not making sounds

Saying words

differently each time

Mispronouncing words

Hard to understand

25

Oral motor skills

Respiratory patterns

Types of sounds produced

Phonological processes

used

Westhy &Orel, 1992, Training Unit, UAP/UNM

Developmental apraxia

Speech delay/disorder

Phonological disorder 26

WHAT FAMILY

NOTICES

Not talking

Not "trying" to

communicate

Not social

Not putting words

together

Doesn't "volunteer" to

talk

Doesn't understand words

or directions

Selective listening

Repeats what other

people say

Not able to get a

message across

2(

THINGS SLP

LOOKS FOR

Cognitive & social

prerequisites for

language

Auditory comprehension/

processing

Ways child is

communicating

Emerging forms of

communication

Westby liorrel, 1992, Training Unit, UAP/UNM

WHAT SLP MIGHT

CALL IT

Language delay/disorder

(expressive or

receptive)

Cognitive delay

Childhood aphasia

Echolalia

Elective mutism

(Autism)

23

FAMILY QUESTIONS

Concerns regarding a possible

augmentative system:

Will child ever talk?

Is augmentative system

appropriate or when will it be

appropriate?

Will it keep child from learning

to talk?

What are the different kinds?

29

Westby &4110rel, 1992, Training Unit, UAP/UNM

THINGS SLP LOOKS FOR

Positioning

Degree and range of motor control

Responses to environment

Social & cognitive prerequisites for

communication

Possible means of communication

30

SLP

SObservational Lens Model

CONTEXT

ACTIVITY STRUCTURE

INTERACTIONAL PATTERNS

BREAKDOWNSOURCES

Microclose-up Lens

Close-up lens

Regular lens .

Wide-angle lens

Wide angle lens - wide angle view of situations, activities, and conversationalpartners that lead to judgment about personal attributes, sources of failure, and sourcesof success.

Regular lens a description of the interactional system underlying the particularevent.

Close-up lens - gives observer finer detail regarding a specific layer of classroomdiscourse and its effects on a group as a whole or an individual.

Micro close-up lens observations of interactional patterns are sifted into a finerlayer for the purpose of examing critical sources of communicative breakdowns.

Reprinted from Communicating for Learning: Classroom Observation andCollaboration by E.R. Silliman and L.C. Wilkinson, p. 9, with permission of AspenPublishers, Inc., 1991.

31

Information Needed from FAMILIESRelated to COMMUNICATION

* What situations/context must the childfunction in?

* What activities are expected of the childthroughout the day?

* What types of interactions are experienced bythe child?

* When does the child communicateeffectively....when does he/she break down?

32Westby & Laurei, 1992, Training Unit, UAP/UNM

ILP

Information Needed from OT/PTRelated to COMMUNICATION

* What sensory and motor context/activitiesappear to facilitate communication?

* What sensory and motor information could berelated to communication breakdown?

* How can the SLP intervene in interaction whenmotor and/or sensory issues may be affectinginteraction or communication?

Westby & Laurel, 1992, Training Unit, UAP/UNM

33

1LP

Specific medical information canhelp the SLP:

* Be alerted to the most likely outcome interms of communication development

* Provide prognosis and direction for treatmentand predict patterns that may emerge in laterdevelopment

* Learn about the relationships between medicalconditions and communication disorders

* Be alerted to issues regarding medicationmanagement

* Generate appropriate referrals

Westby & Laurel, 1992, Training Unit, UAP/UNM

34

What Family Notices Things SLP Looks For What SLP Might Call tt

-Problems with suck -Sensory awareness in and around Dysphagia

-Problems chewing mouth Oral apraxia

-Choking (gagging) -Status of oral mechanism Oral-motor dysfunction

-Gasping -Suck-swallow-breathe synchrony Dysarthria

-Doesn't like things in mouth -Suck, bite, chew, swallow patterns

-Excessive drooling-Picky eater-Sloppy eater

-Not babbling -Oral motor skills Developmental apraxia

-Not making sounds -Respiratory patterns Speech delay/disorder

-Says words differently each time -Types of sounds produced Phonological disorder

-Mispronounces sounds -Phonological processes used-Hard to understand

-Not talking -Cognitive & social pre-requisites for Language delay/disorder

-Not *trying' to communicate language (expressive and/or receptive)

-Not social -Auditory comprehension/processing Cognitive delay

-Not putting words together -Ways child is currently communicating Childhood aphasia

-Doesn't "volunteer" to talk -Emerging forms of communication Echolalia

-Doesn't understand words or directions Elective mutism

-Selective listening" (Autism)

-Repeats what other people say-Not able to get a message across

-Concerns regarding a possible -Positioningaugmentative system: -Degree and range of motor cont ol

Will child ever talk? -Responses to environmentIs augm. sys. appropriate or when will -Cognitive & sock -.1 prerequisites for

it be appropriate? communicationWill it keep chile from learning to talk? -Possible means of communicationWhat are the different kinds?. systems

(adapted from Chris Brown, 1991).

35

Westby & Laure ,Training & Technical Assistance Unit, NM UAP/UNM

ILISIP

0Observational Lens Model

CONTEXT

ACTIVITY STRUCTURE

INTERACTIONAL PATTERNS

BREAKDOWNSOURCES

Microclose-up Lens

Close-up lens

Regular lens

Wide-angle lens

Wide angle lens - wide angle view of situations, activities, and conversationalpartners that lead to judgment about personal attributes, sources of failure and sourcesof success.

Regular lens a description of the interactional system underlying the particularevent.

Close-up lens - gives observer finer detail regarding a specific layer of classroomdiscourse and its effects on a group as a whole or an individual.

Micro close-up lens observations of interactional patterns are sifted into a finerlayer for the purpose of examing critical sources of communicative breakdowns.

Reprinted from Communicating for Learning: Classroom Observation andCollaboration by E.R. Silliman and L.C. Wilkinson, p. 9, with permission of AspenPublishers, Inc., 1991.

36

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and

mot

orde

velo

pmen

t for

faci

litat

ing

stro

nger

sig

nalli

ng c

ues

4 -

8 m

onth

sT

hrou

gh g

ener

aliz

ed m

ovem

ents

,in

dica

tes

desi

re fo

r re

petit

ion

ofac

tivity

Rea

ches

tow

ard

or m

oves

tow

ard

desi

red

obje

ctT

urns

to m

othe

r's v

oice

Laug

h tr

igge

red

by to

uch

Bab

blin

g/vo

cal p

lay

(incr

ease

dva

riety

of s

ound

s-in

fluen

ced

bybo

dy p

ostu

re)

Var

iety

of f

acia

l, ge

stur

alex

pres

sion

sIn

tere

st/e

xplo

ratio

n of

obj

ects

Min

imal

/unc

oord

inat

ed m

ovem

ent

Not

ach

ievi

ng m

otor

mile

ston

esB

aby

.vol

ds o

r do

esn'

t res

pond

to to

uch

Lack

of/l

imite

d so

und

play

Min

imal

exp

ress

ion

of e

mot

ion

Dec

reas

ed e

xplo

ratio

n

As

abov

eB

egin

dia

gnos

ing

spec

ific

mot

or d

isor

ders

Par

ents

beg

in to

sus

pect

a p

robl

emO

titis

med

ia

As

abov

eC

areg

iver

beg

ins

to fo

llow

child

's le

adM

odul

ate

nonv

erba

lex

pres

sion

s an

d vo

caliz

atio

ns(r

educ

e or

inte

nsify

)

8 -

12 m

onth

s

37

Spe

cific

mea

ns to

ach

ieve

goa

lsV

arie

ty o

f act

ions

on

obje

cts

/exp

lora

tion

Join

t atte

ntio

nC

ompr

ehen

sion

of "

no"

and

fam

iliar

wor

dsin

tent

iona

l com

mun

icat

ion

for

varie

ty o

f pur

pose

sB

egin

ning

adu

lt-lik

e In

tona

tion

Imita

tes

new

sou

nds

that

are

sim

ian

to th

ose

alre

ady

prod

uced

Tur

n-ta

king

rou

tines

(ver

bel(n

onve

rbal

)S

ome

Imita

tion

of fa

mili

ar fa

cial

expr

essi

on

Um

ited

expl

orat

ion

of to

ysU

mite

d in

tent

iona

l com

mun

icat

ion/

few

purp

oses

for

com

mun

icat

ion

Lack

of i

nter

est i

n pe

ople

or

obje

cts

Dec

reas

e in

sou

nd p

rodu

ctio

n/im

itatio

n of

new

sou

nds

Not

ed la

ck o

f affe

ct

As

abov

eD

eafn

ess

Blin

dnes

sS

peci

fic c

omm

unic

atio

n im

pairm

ent

Que

stio

ns o

f pos

sibl

e au

tistic

-lik

e be

havi

orm

ight

aris

e

As

abov

eC

areg

iver

follo

ws

child

's le

adT

urn-

taki

ng r

outin

esV

erba

lly c

ode

child

'sin

tent

ions

Use

of s

impl

e fa

mili

arla

ngua

ge (

imita

tion/

expa

nsio

n)S

impl

e or

al a

ctiv

ities

Pos

ition

ing

for

play

and

voc

alIn

tera

ctio

n

Westby & Laurel, 1992, Training Unit, UAP/UNM

BE

ST

CO

PY

AV

AIL

AB

LE

38

Ago

Ran

geB

ehav

ior

Dev

elop

men

tal R

isks

: Wha

t Can

Go

Wro

ngA

ssoc

. Con

ditio

nsP

ossi

ble

The

rapy

' App

roac

hes

1217

mon

ths

Ref

ine

and

Inte

grat

e 8-

12 m

onth

activ

ities

(Con

tinuo

Issu

es o

f 8-1

2 m

onth

s)S

ame

as a

bove

Sam

e as

abo

ve

Dire

cted

pro

test

s/ta

ntru

ms

Fre

quen

t Int

ense

, len

gthy

tant

rum

sP

oint

s to

des

ired

obje

ct(e

scal

atio

n of

tant

rum

s)S

tart

s to

use

wor

ds to

com

mun

icat

e/in

crea

se o

fco

mm

unic

ativ

e fu

nctio

nsJa

rgon

ing

Ove

rly c

ompl

iant

as

com

pare

d to

oth

ers

in th

e cu

lture

Fai

lure

to fo

llow

dire

ctio

ns/ f

ailu

re to

unde

rsta

nd n

ames

May

sho

w p

refe

renc

e fo

r w

ords

that

have

cer

tain

sou

nds

Diff

eren

t qua

lity

of In

tera

ctio

ns

Fun

ctio

nal u

se o

f obj

ects

Initi

ates

rou

tines

Mor

e so

phis

ticat

ed u

se o

f obj

ects

toge

t atte

ntio

n an

d In

tera

ct

1724

mon

ths

Sym

bolic

beh

avio

r (p

lay

and

Ref

inin

g or

al m

otor

ski

llsS

peci

fic la

ngua

ge d

isor

der

Can

con

tinue

ear

lier

stra

tegi

esla

nzua

ge)

Can

't ge

t mes

sage

acr

oss

Dys

prax

iaM

ore

stru

ctur

ed a

ctiv

ities

Mar

kel I

ncre

ase

of v

ocab

ular

yU

nint

ellig

ible

to p

aren

tsM

otor

spe

ech

diso

rder

desi

gned

to m

eet g

oals

(In

Sta

bilit

y If

voca

bula

ryE

asily

frus

trat

ed in

com

mun

icat

ive

atte

mpt

sS

peec

h so

und

diso

rder

/ pho

nolo

gica

lco

ntex

t of p

lay)

; cre

ate

Exp

ress

ion

of s

eman

tic r

elat

ions

hips

Use

of u

nusu

al o

r ov

erly

freq

uent

use

of

proc

ess

diso

rder

oppo

rtun

ity to

use

targ

eted

Res

pond

s to

spe

ech

with

spe

ech

Con

vent

iona

lized

form

s of

beh

avio

rsp

eech

sim

plifi

catio

n st

rate

gies

(i.e

.,de

letio

n of

Initi

al c

onso

nant

s, v

owel

lang

uage

and

spe

ech

soun

dsS

peci

fic la

ngua

ge te

achi

ngto

ref

erU

se o

f alte

rnat

ive

stra

tegi

es to

achi

eve

goal

s

dist

ortio

n, g

lotta

l rep

lace

men

t, ba

ckin

g)In

cons

iste

ncy

In a

rtic

ulat

ory

prod

uctio

nLi

mite

d vo

cabu

lary

stra

tegi

es (

imita

tion,

expa

nsio

n, p

aral

lel,

talk

,w

eltin

g, m

odel

ing)

Com

preh

ensi

on o

f wor

ds w

hen

Slo

w s

peed

in le

arni

ng v

ocab

ular

yN

eed

dire

ct In

volv

emen

t of

refe

rent

not

pre

sent

Not

usi

ng a

var

iety

of s

eman

tic r

elat

ions

hips

spee

ch p

atho

logi

stC

hild

can

get

mos

t mes

sage

sac

ross

Doe

sn't

follo

w d

irect

ions

Ext

rem

e ''s

hyne

ss*

Pos

sibi

lity

of jo

int t

reat

men

t

Spe

ech

sim

plifi

catio

n st

rate

gies

(i.e.

, fin

al c

onso

nant

del

etio

n,sy

llabl

e re

duct

ion,

con

sona

ntcl

uste

r re

duct

ion,

pre

voca

licvo

icin

g, c

onso

nant

har

mon

y)S

ubst

antia

l inc

reas

e In

Imita

tion

offa

cial

exp

ress

ion

3J40

Westbyrel,

1992, Training Unit, UAP/UNM

S&

P

Age

Ran

geB

ehav

ior

Dev

elop

men

tal R

isks

: Wha

t Can

Go

Wro

ngA

ssoc

. Con

ditio

nsP

ossi

ble

The

rapy

App

roac

hes

2 -

3 ye

ars

Beg

inni

ng r

efer

ence

to p

ast a

ndD

oesn

't pl

ay li

ke o

ther

chi

ldre

nS

ame

as a

bove

Sam

e as

abo

ve

imm

edia

te fu

ture

Doe

sn't

inte

ract

with

oth

er c

hild

ren

Aut

istic

/Aut

istic

-like

"

Dev

elop

men

t of p

lay

even

ts th

at a

reof

less

freq

uent

exp

erie

nces

or

inw

hich

chi

ld w

as n

ot a

n ac

tive

part

icip

ant

Mai

ntai

ns "

baby

-tal

k"D

oesn

't un

ders

tand

que

stio

nsU

nint

ellig

ible

Dev

elop

men

t of p

lay

sequ

ence

sIn

crea

sing

sen

tenc

e le

ngth

Ask

s an

d an

swer

s w

hat,

whe

re,

who

...do

ing

ques

tions

Use

of m

orph

olog

ical

mar

kers

and

auxi

liary

ver

bsA

dult

spee

ch c

an in

hibi

t chi

ld's

actio

nB

egin

ning

ass

ocia

tive

play

Sou

rces

Coh

en &

Don

ne li

on, 1

987

Dun

st. 1

980

Gre

ensp

an &

Gre

ensp

an, 1

985

Kha

n &

Lew

is, 1

986

Pat

ters

on &

Wes

tby,

in p

ress

Sch

lefe

lbus

ch, 1

980

Wes

tby,

in p

ress

11.e

stby

& L

aure

l. 19

92 T

rain

ing

UA

P/U

NM 41

rort

,*ro

tr.,4

1p{1

11,1

11 1

1101

0d3.

5,94

16SLP

LANGUAGE FACILITATING STRATEGIES: BABIES

* Answer your baby

* Use a special voice

* Imitate

* Respond from a distance

* Be sensitive to cues

* Repeat key words

* Pause often

* Follow baby's lead

Adapted from: "Talking to Babies; Mother-Infant CommunicationProject"

LANGUAGE FACILITATING STRATEGIES: TODDLERS

* Repeat words

* Encourage conversation

* Ask questions and give time to respond

* Expansion

* Say the names of things

* Answer and explain in a simple way

Adapted from: "Talking to Toddlers; Mother-Infant CommunicationProject"

4 ,3

1116SIP

Adult Strategies

Upping the Ante - adult requires progressively higher levels of communication from the childby using a contingent nonlinguistic or linguistic request

C: (points to cookies and vocalizes)A: What did you say?C: Cookies.

C: (reaches for toy on shelf)A: (looks at child and shrugs shoulders)C: Ball.

References: Bruner.1977; MacDonald, 1982

Encoding - an utterance by the adult which codes meaning expressed nonlinguistically by thechild.

C: (points to car)A: Yeah, that's a big car.

C: (looking in book and laughs)A: Yeah, that's a funny picture.

References: Lombardino & Mangan, 1983; MacDonald, 1982

Wait and Signal - adult waits with clear visible anticipation (e.g., mother pauses, raises hereyebrows and opens her mouth) while looking at the child with expectatio:f for the child to take

his/her turn.

A: What's this? (pauses and looks at child)A: Huh?

References: MacDonald, 1982

Parallel Talk - an utterance by the adult that relates the action of either the parent or child asthey are occurring during joint attention/action.

A: (changing child's diaper)You have a dirty diaper. Let's take it off. Change your diaper.

C: (playing with blocks)A: Play with blocks. Stack them up. Knock them down.

Reference: Muma. 1978; Russo & Owens, 1982

4 4

Referencing a non-verbal behavior that directs the child's attention to an object or event by useof a discrete, visible movement.

A: Let's play with the blocks. (shakes blocks in container)C: (looks)A: Blocks. (points to blocks)

References: Mahoney & Seely, 1977; McLean & Snyder-McLean, 1978

Modeling - adult requests a child behavior by demonstrating the desired motor, vocal or verbalbehavior.

A: (holds up cup) Say cup.

A: (bangs on xylophone) Do this.

Reference: Moerk, 1972, 1974

Imitation - adult utterance which repeats exactly or in part the child's preceding utterance.

C: (points to ball) Ball.A: Uh huh, ball.

References: Brown & Bellugi,.1964; Cross, 1977; Moerk, 1972, 1974

Expansion - adult utterance which extends the preceding child utterance to a more grammaticallycomplete one.

C: Baby. (picks up doll)A: That's a baby.

References: Brown & Bellugi, 1964; Cross, 1977; Moerk, 1972, 1974

Labeling - adult provides a word for an agent or object in the environment which is notcontingent upon a previously asked question or verbal cue.

A: This is a doll just like your doll at home.(takes doll out of toy box)

References: Broen, 1972; Bruner, 1978

Compiled by: Laurel & Lombardino, 1981

SLP

PERFORMANCE/COMPETENCE

PHYSIC AL

INTELLECTUAL

EMOTIONAL

SPIRITUAL

H QUALITY OF LIFE

H MEMBERSHIP

HPERSONAL SENSE

OF COMPETENCE

COMFORT/SAFETY

11 CONFIDENCE 1 RISKTAKING

11.1 COMPETENCE

EFFICIENT ADAPTIVE RESPONSE

Integration of multiple sensory input

Attention (or selective attention)

Discrimination

Orientation to stimulus

Freedom and control of movement

Ability to achieve, change and maintain state ofarousal

Purposive system (spark, curiosity, desire, persistence)

Internal self regulatory functions

Predispositions (temperament, culture, physiological status, genetics, styles)

Basic biological drives (Combine processes into an integratedsystem, Strive for equilibrium and, Fulfill developmental cycle)

Oetter & StevensDominguez, 1991, Training Unit, UAPNNM

INFANT-CAREGIVER

RECIPROCAL INTERACTION

Specific infant attributes contributing to interaction:

*responsiveness

*soothability

*curiosity

*signal intensity

*organizational ability

Adapted from Seligman. 1987

INFANT-CAREGIVER

RECIPROCAL INTERACTION

Specific adult attributes contributing to interaction:

*Playfulness

*Sensitivity

*Encouragement

*Contingent pacing

Adapted from Seligman. 1987

48

EARLY INFANT COMMUNICATION

Infants Use Their:

Gaze

Head Position

Body Position

In Order To:

Initiate

Maintain

Avoid

Terminate

4 9

* Marci Laurel, Training Unit, UAP/UNM

SU'

Ref

eren

ces

:

Greenspan & Greenspan,

Piaget, 1952

Schiefulbusch, 1980

Age

in M

onth

s

1985

Em

otio

nal

Cog

nitiv

eLa

ngua

ge

0 -

2R

egul

atio

n an

d In

tere

st in

Wor

ldR

efle

xive

(0-

1)P

rein

tent

iona

l(0

-8)

2 -

4F

allin

g in

Lov

eP

rimar

y C

ircul

ar R

eact

ions

(1-

4)

4 -

8P

urpo

sefu

l Com

mun

icat

ion

Sec

onda

ry C

ircul

ar R

eact

ions

(4-

8)

Coo

rdin

atio

n of

Sec

onda

ry S

chem

as(8

-12)

Inte

ntio

nal

4,(8

-12)

10 -

18

Em

ergi

ng C

ompl

ex S

ense

of S

elf

Ter

tiary

Circ

ular

Rea

ctio

ns (

12-1

8)F

irst P

erfo

rmat

ives

and

Wor

ds(1

2-18

)

18 -

20

Em

otio

nal I

deas

/Men

tal R

epre

sent

atio

n

Inve

ntio

n of

New

Sch

emas

Thr

ough

Rep

rese

ntat

iona

l Tho

ught

(18

-24)

Men

tal C

ombi

natio

n(1

8-24

)

20+

Org

aniz

atio

n of

Idea

s

50La

urel

, 198

7

16SLP

POTENTIAL MOTOR INFLUENCES ONEARLY COMMUNICATION

Motor Deficit Potential Communication Deficit

Abnormal Muscle Tone

Lack or Decreased Locomotion

Abnormal Oral-Motor/Feeding

visual attentionhead orientationjoint attentionvocalizationfunctional object useimitationrespiratory support for

vocalization and nonverbalcommunication

limited social/cognitiveexperiences

limited interaction withvariety of objects

vocalizationvocal turn takingpairing vocalizations and

gesturesfacial expression

Laurel, 1992Adapted from Chris Marvin, 1986

52

SLP

Development of Goal Directed Behaviors

Leve

lIn

tera

ctio

n T

ype

Goa

lD

escr

iptio

n of

Beh

avio

rsE

xam

ples

II III IV V VI In:

Atte

nt'_

.. I

nter

actio

nsN

o go

al a

war

enes

s

Con

tinge

ncy

Inte

ract

ions

Aw

aren

ess

of g

oa;

Diff

eren

tiate

dIn

tera

ctio

ns

Enc

oded

Inte

ract

ions

Sym

bolic

Inte

ract

ions

Met

apra

gmat

IcIn

tera

ctio

ns

Sim

ple

plan

des

igne

d to

achi

eve

a go

al

Coo

rdin

ated

pla

n de

sign

edto

ach

ieve

a g

oal

Alte

rnat

ive

plan

s de

sign

ed to

achi

eve

a go

al

Men

tal a

war

enes

s of

pla

n to

achi

eve

goal

Atte

nds

to a

nd d

iscr

imin

ates

bet

wee

n st

imul

i;di

ffuse

fuss

or

mov

emen

t to

expr

ess

emot

ion

Und

iffer

entia

ted

form

s of

beh

avio

r to

Initi

ate

orco

ntin

ue a

stim

ulus

; man

ipul

ates

phy

sica

lpr

oper

ties

of o

bjec

t or

voca

lizes

tow

ard

pers

on o

rob

ject

Mod

ifies

and

adj

usts

beh

avio

r to

ach

ieve

goa

l;ad

apts

to e

nviro

nmen

tal d

eman

ds a

nd s

ocia

lex

pect

atio

ns; u

ses

mot

oric

or

voca

l act

s di

rect

edto

war

d pe

rson

Use

s co

nven

tiona

lized

form

s of

beh

avio

r th

at a

reco

ntox

t bou

nd a

nd d

epen

d on

con

cret

e re

fere

nts

to e

voke

beh

iwio

rs; u

ses

com

bina

tion

of m

otor

ican

d vo

cal a

cts

Gr

uses

inte

rmed

iary

obj

ect t

oga

in In

tera

ctio

n

Use

s co

nven

tiona

lized

form

s of

beh

avio

r(la

ngua

ge, p

rete

nd, s

ign,

dra

win

g) to

ref

er to

prev

ious

and

futu

re o

ccur

renc

es; m

odifi

es v

ocal

sign

al o

r us

es a

ltern

ativ

e st

rate

gy a

fter

unsu

cces

sful

atte

mpt

to a

chie

ve th

e go

al

Pla

ns o

ut a

head

of t

ime

stra

tegi

es to

use

toac

hiev

e go

al; r

efle

cts

on s

ucce

ss o

r la

ck o

fsu

cces

s

Tra

cks

obje

cts

mov

ing

In a

nd o

ut fi

eld

of v

isio

n;or

ient

s to

sou

nd; s

mile

s at

fam

iliar

face

Sw

ipes

a m

obile

; rea

ches

for

obje

ct, p

icks

It u

p,lo

oks

at It

, and

mou

ths

it; v

ocal

izes

to g

etat

tent

ion;

ant

icip

ates

eve

nts

such

as

feed

ing

whe

n se

es b

ottle

or

brea

st b

y sh

owin

gex

cite

men

t

Rai

ses

arm

s to

be

pick

ed u

p; s

how

s an

d gi

ves

obje

cts

to o

ther

s; p

ulls

str

ing

to g

et to

y; fo

llow

sad

ult's

vis

ual l

ine

of r

egar

d to

loca

te o

bjec

t;op

erat

es d

iffer

ent b

utto

ns o

r kn

obs

on b

usy

box;

antic

ipat

es s

ocia

l gam

es, e

.g.,

brin

gs h

ands

toge

ther

for

pat-

a-ca

ke; l

ooks

bet

wee

n ad

ult a

ndde

sire

d ob

ject

Poi

nts

to d

esire

d ob

ject

; say

s w

ords

for

obje

cts

he s

ees

on w

ants

In th

e en

viro

nmen

t; cl

imbs

on

chai

r to

get

som

ethi

ng o

ut o

f rea

ch; b

rings

an

obje

ct to

car

egiv

er a

s a

way

of g

ettin

g at

tent

ion

Use

s w

ords

to la

bel o

r re

ques

t, e.

g., W

hat's

that

?gi

mm

e co

okie

; pre

tend

s to

drin

k fr

om e

mpt

y cu

pan

d ea

t fro

m e

mpt

y pl

ate;

rep

eats

req

uest

loud

erIf

not a

ttend

ed to

on

first

try

Chi

ld c

an v

erba

lize

plan

: Mom

mig

ht g

ive

it to

you

if yo

u as

k re

al n

ice;

I'll

save

my

allo

wan

ce ti

llI h

ave

enou

gh fo

r th

e ga

me

Wes

tby,

C.E

. (In

pre

ss).

Soc

lo-c

omm

unic

ativ

e ba

ses

of la

ngua

ge d

evel

opm

ent.

In W

.O. H

ayne

s &

B.B

. Shu

lman

(E

ds.)

,C

omm

unic

atio

n D

evel

opm

ent:

Fou

ndat

ions

, Pro

cess

es

and

Clin

ical

App

licat

ions

. Eng

lew

ood

Clif

f, N

J: P

rent

ice-

Hal

l,

535

4

gm SLP

AG

EP

RO

PS

by 1

8 m

onth

sus

es o

ne r

ealis

tic o

bjec

t at a

time

by 2

2 m

onth

sus

es tw

o re

alis

tic o

bjec

ts a

t atim

e

24 m

onth

sus

es s

ever

al r

ealis

tic o

bjec

ts

by 3

41 m

onth

s

by 3

yea

rs

by 3

1/2

yea

rsm

inia

ture

pro

ps, s

mal

l fig

ures

,an

d ob

ject

sub

stitu

tions

by 4

yea

rs

by 6

yea

rs

imag

inar

y pr

ops

(lang

uage

and

gest

ure

help

set

the

scen

e)

lang

uage

and

ges

ture

can

car

ryth

e pl

ay w

ithou

t pro

ps

SUMMARY OF SYMBOLIC PLAY DEVELOPMENT

TH

EM

ES

fam

iliar

eve

ryda

y ac

tiviti

esin

whi

ch c

hild

is a

ctiv

e pa

rtic

ipan

t(e

.g.,

eatin

g, s

leep

ing)

fam

iliar

eve

ryda

y ac

tiviti

es th

atca

regi

vers

do(e

.g.,

cook

ing,

read

ing)

com

mon

but

less

freq

uent

lyex

perie

nced

ores

peci

ally

trau

mat

icex

perie

nces

(e.g

.,sh

oppi

ng, d

octo

r)

obse

rved

, but

not p

erso

nally

expe

rienc

edac

tiviti

es(e

.g,

polic

e, fi

refig

hter

)

fam

iliar

fant

asy

them

es (

e.g.

,B

atm

an,

Won

der

Wom

an,

Cin

dere

lla, e

tc.)

crea

te n

ovel

fant

asy

char

acte

rsan

d pl

ots

OR

GA

NIZ

AT

ION

shor

t, is

olat

ed p

rete

nd a

ctio

ns

com

bine

s tw

o re

late

d to

ys u

rpe

rfor

ms

actio

ns o

n tw

o pe

ople

(e.g

., us

es s

poon

to c

at fr

ompl

ate;

feed

s m

othe

r, th

en d

oll)

mul

tisch

eme

com

bina

tions

of

step

s(e

.g.,

put

doll

intu

b,ap

ply

soap

, tak

e do

ll ou

t and

dry)

sequ

ence

sof

mul

tisch

emc

even

ts (

e.g.

, pre

pare

food

, set

tabl

e,ca

tfo

od,

clea

rta

ble,

was

h di

shes

)

plan

ned

play

eve

nts

(e.g

., ch

ildde

cide

s to

pla

y a

birt

hday

par

tyan

dga

ther

s ne

cess

ary

prop

san

d as

sign

s ro

les)

mul

tiple

plan

ned

sequ

ence

s(p

lans

for

self

and

othe

rpl

ayer

s)

RO

LES

auto

sym

bolic

pret

end,

(e.g

.,ch

ildfe

eds

self

pret

end

food

child

act

s on

dol

ls a

nd o

ther

s (e

.g.,

feed

s do

ll or

car

egiv

er)

emer

ging

lim

ited

doll

actio

ns (

e.g.

,do

ll cr

ies)

child

talk

s to

dol

lin

res

pons

e to

doll'

s ac

tions

(e.

g., '

don'

t cry

now

,*I'l

l get

you

a c

ooki

e.")

;

brie

f com

plem

enta

ry r

ole

play

with

peer

s (e

.g.,

mot

her

and

child

; doc

tor

and

patie

nt)

attr

ibut

es e

mot

ions

and

des

ires

todo

lls;

reci

proc

alro

leta

king

with

dolls

(ch

ild tr

eats

dol

l as

part

ner

talk

s fo

r do

ll an

d as

car

egiv

er)

child

or d

oll

has

mul

tiple

role

s(m

othe

r,w

ife,

doct

or,

firef

ight

er,

husb

and,

fath

er)

child

can

han

dle

two

or m

ore

dolls

inco

mpl

emen

tary

rol

ls (

dolls

arc

doc

tor

and

patie

nt)

attr

ibut

es th

ough

ts a

nd p

lans

to d

oll

mor

e th

an o

ne r

ole

per

doll

(dol

l is

mot

her,

wife

, doc

tor)

LAN

GU

AG

E U

SE

IN P

IAY

lang

uage

use

d to

get

and

mai

ntai

nto

ys a

nd s

eek

assi

stan

ce o

pera

ting

toys

(e.

g., '

baby

,' m

ine,

"hel

p*)

occa

sion

al c

omm

ent o

n to

y or

act

ion

talk

s to

dol

l brie

fly, d

escr

ibes

som

eof

the

doll'

sac

tions

(e.g

.,'b

aby

slee

ping

")

talk

sto

dol

l and

com

men

ting

ondo

ll's

actio

ns in

crea

se in

freq

uenc

y

child

ren

may

com

men

t on

wha

t the

yha

ve ju

st c

ompl

eted

or

wha

t the

y w

illdo

nex

t (e.

g., '

Dol

ly a

te th

e ca

ke.'

'I'm

gon

na w

ash

dish

es.')

child

ren

use

dial

ogue

for

dolls

and

met

alin

guis

ticm

arke

rs(e

.g.,

The

said

"); r

efer

to e

mot

ions

uses

lang

uage

to p

lan

and

narr

ate

the

stor

y lin

e

elab

orat

ion

of p

lann

ing

and

narr

ativ

est

ory

line

Pro

m. P

atte

rson

, 1. &

Wes

tby,

C. (

in p

ress

). T

he d

evel

opm

ent o

f pla

y. In

Shu

lman

, W. H

ayne

s &

B. S

hulm

an (

Eds

.). C

omm

unic

ativ

e D

evel

opm

ent:

Fou

ndat

ions

. Pro

cess

es, a

ndC

linic

al A

pplic

atio

n. E

ngle

woo

dC

liffs

, NJ:

Pre

ntic

eHal

l.

5 5

BE

ST

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PY

AV

AIL

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LE11

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n.

GE

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RIC

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ILL

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App

rox.

ale

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atte

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dito

ry c

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es A

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tes

visi

bly

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ease

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tsB

ehav

ior

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nt4.

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ptur

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ects

obje

ctB

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ativ

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ue m

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aptu

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tera

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pond

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rote

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itual

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iffer

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visi

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pond

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ion

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emas

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den

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ects

for

com

mun

icat

ion

Inte

ntio

nal

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vent

iona

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ombi

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13.

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tify

Mat

ch:

13.

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ntai

ns J

oint

focu

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omm

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atio

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ects

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int F

ocus

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eque

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nds

toD

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dire

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eans

to2.

Pro

test

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ion

ends

3.A

ttent

ion

to S

elf

Ges

ture

sB

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rimiti

ve to

olus

e4.

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ntio

n to

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eren

tD

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otio

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ompr

ehen

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unct

iona

l Use

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ther

labe

l of

Pre

sent

Ob'

ect

From The PREP Curriculum by Lee McLean, Ph.D.,

Sara H. Sack, Ph.D., & Barbara Solomonson,

CCC;

Paton's Regional Early InterventionProgram, 1992.

57B

ES

T C

OP

Y A

VA

ILA

BLE

58

SIP

App

rox.

aS

e

LE

VE

L

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neSk

ills

peop

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ills

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ilabl

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earn

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tegi

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ehen

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IN

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itatio

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omm

unic

atio

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hoto

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chA

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efer

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tent

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l

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ompr

ehen

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bels

of a

bsen

t

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plex

C.

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ual C

lass

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icat

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ect/A

ctio

ns

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bina

toria

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ompr

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wo

.

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actio

nD

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eer

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ract

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ntai

n Jo

int R

efer

ent/

Inte

nts

orin

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mor

e

Top

ic1.

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uest

a n

erat

erm

snc

e

.P

eer

Inte

ract

ion

2.P

rote

st3.

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ntio

n4.

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ntio

nto

ref

eren

t5.

Gre

etin

g6.

Ans

wer

7.In

form

atio

n8.

Oth

erC

.C

onve

ntio

nal

Sig

nals

Use

d

C.

Con

vent

iona

lS

igna

ls U

sed

I.P

oint

2.G

ive

3.S

how

4.R

eque

st5.

Wav

e6.

Hea

d N

od7.

Voc

aliz

atio

n8.

Oth

erC

.C

onve

ntio

nal

Sig

nals

Use

dD

.E

mer

ging

Ling

uist

icC

omm

unic

atio

nE

.Li

ngui

stic

Per

form

ativ

es1.

Req

uest

2.P

rote

st3.

Atte

ntio

n to

sel

f4.

Atte

ntio

n to

60

Ref

eren

t

55.

Gre

at6.

.A

nsw

er7.

Info

rmat

ion

8.O

ther

From

PREP Curriculum by Lee

McLean, Ph.D., Sara H.

SPh.D., &

Bar

bara

Sol

omon

son,

MA

, CC

C;

'Par

Reg

iona

l Ear

ly I

nter

vent

ion

Program, 1992.

SLP

FUNCTIONAL SIGNALS INTENTIONAL CONVENTIONAL-All produced with eve contact

Request,- gaze alternation between object and

person- reach toward object (palm down) with

eye contact- establish proximity- pull person to item desired- put person's hand on item desired- whole hand point

Request- one finger point- open palm request- one finger or whole hand beckon

Protest/rejection- place person's hand away

from self with eye contact- place object away from self

with eye contact

Protest/rejection- one hand up ("stop")- one/two hand(s) up

with palm(s) out and head averted ("no")- hand/arm sweep away from body with

palm down ("go away")Attention to self Attention to self- differentiated vocalizations with eye

contact- established proximity- tap hand(s) on surface/stamp foot on floor

with eye contact- tug on person's clothes with eve contact

- one finger or whole hand beckon- tap person's hand, arm, shoulder, etc.- point to/tap self ("me")

Attention to obiect or action Attention to object or action- whole hand point- gaze alternation between object and

person- gaze directing (looks intently at object

or action with occasional glance atperson)

- pull person to object or action- put person's hand on object

- one finger point- extend object (give)- hold object up (show)- tap seat of chair or place to sit

cztratingauting- wave handAnswer- one finger point- nod/shake head ("yes/no")- shrug shoulders ("don't know")Other- finger to lips ("be quiet")- hands over ears ("loud")- shoulders shrugged, elbows bent, palms

up and fingers spread (question)

From The PREP Curriculum by Lee McLean, Ph.D., Sara H. Sack, Ph.D., &Barbara Solomonson, MA, CCC; Paron's Regional Early Intervention Program,1992.

61[NOTE: This list is not exhaustive or in developmental order.]