Intervention Strategies for Children with Developmental

Children with specific language Impairment, pervasive developmental disorder, developmental praxis of speech, autism, Down syndrome, or other types of developmental capabilities may need to use SAC strategies to supplement or enhance their language development. These children offer challenges to professionals, especially during the early years of language development. In the very young child, it is often difficult to determine the nature and degree of language Impairment, to accurately diagnose the presence of other factors such as cognitive disabilities, and to predict the child’s future prognosis for language or speech development.

Common Congenital Etiologies: ; Moderate Mental Retardation ; Multiple Disabilities: Sensory/Cognitive/Motor ; Cerebral Palsy Autism/Pervasive Developmental Disorder ; Developmental Praxis Earlier Scenario: In the past, young children diagnosed with severe language and speech disorders would have received years of traditional speech therapy focused on developing only after traditional therapy techniques had failed. SAC NOW: Today, professionals realize that SAC strategies can provide children who have developmental delays: 1 .

With an immediate means of communication 2. Can facilitate expressive and receptive language development until other communication modalities improve (I. E. , speech) 3. Can serve as a bridge to future poke language development (Kansas & Lloyd, 1988; Silversmith’s). 4. SAC provides an expressive method of communication to facilitate language development in children who, in all likelihood, will eventually use speech to communicate. 5. SAC can be used as a method to enhance speech, as well as a method of augmenting communication. . SAC as a part of multimode communication system may be a short term strategy until speech reaches an acceptable level of intelligibility, or it may be a long term strategy to build and maintain effective communication. Strategies used by professionals for assessing children with language and immunization impairment, and for creating conditions for language learning are usually based on diagnostic categories and assumptions about how particular child characteristics influence development.

Martinets and Tetchier (1996) reported that in order to make intervention optimal, professionals should focus not only on the characteristics of the child but also on practical considerations such as feasibility of the teaching involved and the potential for creating adequate considerations for learning. It is further suggested that process of intervention planning may be acclimated by distinguishing three main functional groups in need for SAC. Pick] Three main functional groups in need for SAC Expressive Language Group Children and adults who belong to this group have large gap between their understanding of other people’s speech and their ability to express themselves through spoken language. Typical members of this group are children with Cerebral speech sounds intelligibly (anorthic). Their language comprehension may however be good. In addition, they often have motor impairments that affect all or most of their movements, making graphic sign systems the obvious choice.

For the expressive language group, the purpose of SAC is to provide them with a communication form which will become their permanent means of expression, I. E. To be used in all kinds of situation and for the rest of their lives. Comprehension is not usually a significant goal of intervention. However, intervention may include teaching comprehension of complex graphic signs (Bliss symbols) and traditional orthographic reading. Manual signing is used, unless the child is living in a signing environment (e. G deaf parents), sign comprehension is usually included in teaching.

The Supportive Language Group This group consists of children who are taught an alternative language form as a temporary intervention measure, and children who have learned to speak but who have difficulty in making themselves understood with the help of speech. The first subgroup comprises children who are expected to begin to speak but whose language development is delayed. Children with developmental dysphasia belong to this group. So do many children with Down syndrome (Launder, Tetchier, 1984). This group is similar to the alternative group except the fact that they do not need

SAC as a permanent tool. The SAC is a scaffold to the development of normal mastery of speech. Children in the other subgroup of the support group may be paralyzed or have spasms that make it difficult for them to control their articulation properly and make it difficult for people to understand what they are saying. The degree to which they are able to make themselves understood through speech varies how well people know them, topic of the situation, and the noise conditions. E. G. A child who is well understood in a small class may be nearly unintelligible in a train or busy street.

In such situations and with unfamiliar people these group people may need to produce manual signs or letters, or point at graphic signs, written words, or grapheme corresponding to the speech sounds that the communication partner has not understood. Alternative language group Children belonging to the alternate language group are characterized by little or no use of speech as means of communication. The alternative communication is both their main form of expressive communication and the language form they comprehend best. It is likely to be the language form they will depend on permanently.

Autistic and severely intellectually impaired children may belong to this group, as well as children with auditory signoras or language deafness who appear have special problems in interpreting sounds as meaningful elements (Arnold, 1965). Intervention will compromise both comprehension and production, and principal goal will be to establish conditions where the child may learn to understand and use alternative language form without needing a reference to spoken language, and an environment where alternative language form is truly functional.

A fairly large number of individuals with cerebral palsy need SAC ( Beckmann & Miranda, 1992; Reich, York & Seafood, 1991). Cerebral Palsy is a disability caused by damage to the brain before, during and shortly after birth. People with CAP usually have motor problems. They might have trouble walking, eating or speaking. There are different types of CAP and its severity varies enormously. Most of the people with CAP have speech, although sometimes their speech can be difficult to understand.

SAC can help these people to communicate effectively. The type of SAC they use will depend on their needs and abilities. SAC INTERVENTION FOR PERSONS WITH cap: I Aided communication – Tech communication Blink communication I Unaided communication I I No – Tech communication I Pointing to picture symbols or objects Sign Language I No I Eye I I Low-Tech I Auditory scanning I Sigh-Tech communication No – Tech communication I Gestures I Eye movement I Nodding and shaking head Smiling and Frowning 1.

Pointing to picture symbols or objects. Use of head pointers or chin sticks in case of decreased upper extremity range of motion and dexterity. Use of eye gaze or making communication partner point to each item (three or four options provided). 2. Auditory scanning- Communication partner asks a series of questions from neural to specific to narrow down the communication topic.

I Advantages I I Easy to use I I Can be used any time conversation I Disadvantages I Highly dependent on skill of partner I Less control over direction of I Requires no equipment I Eye-gaze boards/ “E-Trans” Mack by Babble I Clock Scanner I Big I I User fixes eye gaze on a symbol to communicate I Communication symbols are placed in a circular I Uses a large switch with built in digitized I Lethe choice and looks at the communication I pattern. Individual depresses a switch until I speech used with individual with gross I I partner for acknowledgement of the choice.

I dial is pointed to preferred symbol. Unilateral or bilateral arm movements. Advantages: ; Easy to use. ; Quick to program. ; Relatively inexpensive. High- Tech communication: Includes text to speech as well as picture based communication through: ; Liberator ; Delta-Talker. ; Dynamos. Which allow individual to spell out words and phrases. I alienates voice communication I Allows storage of large amounts of vocabulary I Expensive I Takes time to program I Often cumbersome I Gives individual more topics to communicate suitable for users who are not ambulatory or who use a wheelchair.

Together with the optional eye control module, the Tidbit Key, the CLC 5 is appropriate for users who have limited or no use of hands or other body parts such as: ; Users in the early and late phases of ALLS ; Individuals with Cerebral Palsy ; People who have suffered from stroke/aphasia With the Tidbit CLC 5 communication device, one can easily engage in daily communication via text or symbols that generate speech. One can also effortlessly connect with others using communication device through e-mail, text messaging and chat, or surf the web, play games and access regular computer applications.

The Tidbit CLC 5 communication device also offers environmental control (CEO) that allows one to control IR enabled equipment such as TV’s, DVD players, doors and light switches. ; Communicate easily via text or symbols that generate speech ; Effortlessly connect with others through email, phone, text messaging and chat, or through the Web ; Word and phrase prediction enhances rate of communication ; Offers environmental control of IR enabled equipment such as TV’s and DVD players Customizable design and function ; Wide range of input methods including eye control Supports many mounting options ; Easy to set up, easy to use.

For many years the primary strategies that have been used to control these behaviors n children with cognitive disabilities include institutionalizing, medication, and the use of aversive (punishment based) behavior modification techniques. Since the mid-1980, the emphasis has shifted to the use of proactive, ecological strategies to prevent behavioral problems, as well as numerous strategies for teaching functional communication skills as alternatives for challenging behavior ( Carr et al 1994; Duran, 1990, Goggle,1996). The intervention program for individuals with MR. includes: 1 .

Monoclinic/ Non Linguistic communication 2. Symbolic/ Linguistic Communication training. Non symbolic communication training: The term non symbolic means of communication includes use of gestures, visualization, eye-gaze and body language, objects, or three dimensional symbols, graphic symbols and manual signs. The term visualization refers to unintentional vocal utterances, such as expressions of discomfort or pleasure, as well as the use of vocal patterns that may be idiosyncratic but nevertheless recognizable in certain situations.

The term gesture broadly refers to unaided, non-linguistic communication including generalized body movement, facial expression, hand, limb or eye movement. It is known that during the first year of life communication is purely non symbolic in nature which includes pre- intentional reflexive behavior, pre- intentional anticipatory behavior and It has been documented that in individuals with developmental disabilities, these early behaviors may be weak, infrequent, or absent and thus may not elicit contingent caregiver responses.

Thus an early important link in the chain of events leading to communicative competence is missing and this in turn would hamper the linguistic symbolic communication. In non-symbolic communication training, sutures and visualization are gradually augmented in naturalistic contexts by new forms which in turn helps in building strong foundation for speech and language behavior, symbolic communication via SAC. Three essential building blocks of communication are signal for attention seeking, acceptance and rejection.

Even individuals who might have limited repertoire or gestures or vocal behaviors may be able to communicate these signals. ; Attention seeking signals are the signals individual uses primarily to initiate social interaction with others, such as crying, laughing or making eye contact. Acceptance signals are those used to communicate whatever is currently happening is tolerable, okay or enjoyable. ; Rejection signals are used to communicate that the individual finds his or her current status unacceptable not enjoyable, or intolerable for some reason.

If clear and socially appropriate attention seeking acceptance and rejection signals are not a part of an individuals’ communication repertoire, initial intervention should include strategies for developing these behaviors. ; Attention getting signals: It is important that the facilitators should be attuned to attention seeking behaviors initiated by the individual. Initially, facilitators should respond to any kind of behaviors which are socially acceptable (vacationing loudly) but later the facilitators can limit their responses to the most desirable and frequent behaviors only.

A simple technology can serve to enhance the salience of attention getting behaviors, especially for learners whose behaviors are quite subtle and easily missed. Simple devices like call buzzers and a single message tape recording that said “come here, please” (Gee, Graham, 1991), hand tap or arm wave ( Alai et al, 1993), invitation books (Hunt et al, 1998) and electronic communication devices with the message I want to be with the group ( Duran, 1993). Teaching attention getting signals helps in reducing socially unacceptable behaviors such as screaming, hitting, throwing temper tantrums, performing self injurious behaviors etc.

Accept/ Reject Signals: These signals may be subtle, for example, an individual might not display distressed or uncomfortable. In other cases, a person might give more overt indicators such as limb movements, smiling or crying. Initially, it is necessary for oscillators to respond to and comply with any communicative behaviors that can be socially and culturally tolerated in order to strengthen the behaviors over time and teach the power of communication. Individuals with developmental disabilities may use unconventional gesture behaviors to signal acceptance or rejection.

It could be self stimulatory behaviors (egg. Spinning objects, gazing at a light) and aggressive behaviors (throwing tantrums, causing self injury) both can be interpreted as rejection messages for many individuals. Others may flap their hands, squeal repetitively, or become aggressive hen they are happy or excited, which are two clear means for sending acceptance messages. In these cases, functional communication training (FACT) can be taught. FACT involves a set of procedures designed to reduce challenging behavior by treating functionally equivalent communication skills.

Movement Based Approach: A more systematic method for facilitating the development of communicative signals and natural gestures is based on the work of Van Dick (1996). This can be used to enhance social and communicative abilities of young children with communication effects mainly dual sensory impairments (I. E. Deafness and blindness). This approach emphasizes on “learning through doing”. Thus these approaches emphasize movement as a ways for the individual to be actively involved in the ongoing activities of daily life.

This approach has six levels 1. Nurture 2. Resonance 3. Active Movement 4. Non representational reference 5. Deferred imitation 6. Natural gestures Nurture: The aim of nurture is to develop a warm, positive relationship between the individual with disabilities and the facilitator. Siegel – Causes and Guess 1989) suggested that nurture is provided when the facilitator gives support, comfort, affection, creates a positive setting for interaction and focuses on the individual’s interest. Towards the coat rack.

She holds his hand and as they walk, they swing their arms back and forth slightly. While smiling at Ken, Sarah’s voice is warm as she says to him, “It is almost time for recess now, what do you need to do? ” Ken returns the smile and looks delighted as he reaches for his coat. He obviously enjoys the attention Sarah pays him and uses non symbolic behaviors (reaching, smiling) to communicate with ere. Resonance: Activities related to resonance are designed to shift the individual’s attention from him or herself to the external world of people and objects.

This consists of rhythmic movements that the individual and the facilitator perform while in direct physical contact. For example, the facilitator might use a full hand on hand prompt to assist the individual to wipe tabletop with sponge. After several back and forth wiping movements, the facilitator pauses and waits for a signal that the movement should start again. Active movement: Active movement is an extension of resonance with the basic preference being the amount of physical distance between the facilitator and the individual with disabilities (Steal- Causes & Guess, 1988).

Here the learner and caregiver engage in activities to promote anticipatory behavior within predictable sequences, with increasing physical distance. The establishment of such predictable sequences facilitates communicative development by allowing the individual to anticipate and become actively involved in daily activities. The facilitator may use full body movements, limb or hand gestures (kicking a ball, waving good-bye) and tactile sues to help the individual initiate the active movement, with the goal of fading these cues.

Egg: Blowing soap bubbles with periodic pausing by the caregiver to wait for the learner to signal desire to resume/discontinue the activity. Non representational reference: Non representational reference involves teaching the individual to identify body parts on models that are initially three dimensional (e. G. , a doll, another person) and later two dimensional (line drawing). These activities develop body image, teach pointing, and encourage individual to be somewhat independent of the facilitator.

The facilitator should conduct these activities as much as possible during routine activities. Deferred Imitation: Deferred imitation teaches the individual to imitate movements after the facilitator has completed them, starting with full body movements (standing up, sitting down) and eventually proceeding to functional limb and hand movements. Deferred imitation is the direct result of further fading of the cues used during active movement. Natural gestures: The final component of the movement based approach involves encouraging the individual to produce communicative gestures that are self