Children with Down syndrome present with an array of physical and cognitive sequelae that can hinder speech and language development. These individuals can constitute a considerable portion of a speech-language pathologist’s caseload. Based on the principles of best evidence, clinicians are ethically responsible for providing the most effective treatment for their clients. The available literature focuses mainly on describing the linguistic characteristics in this population, while relatively less focus is placed on effective intervention programs. This paper investigates the available evidence regarding speech and language interventions for children with Down syndrome who are in the mild to moderate range of linguistic functioning, and provides an outlook for future research based on best evidence. / text

Prelinguistic Milieu Teaching (PMT) is an intervention designed to teach young children to initiate nonverbal communication using vocalizations, gestures, and eye-gaze. Children are taught through social routines in their natural environment. Techniques include contriving an environment in which the children will be motivated to communicate and using a hierarchy of prompting and modeling to evoke the desired communicative behaviors, such as requesting and commenting. PMT has been previously studied in young children (ages 1-5) with developmental delays. In this study, it is implemented with six school-age children with Autism (ages 5-8). A multiple baseline design across participants was used to evaluate the effects of the intervention on the variables of frequency, clarity, and maintenance of the participants’ communication. All six participants showed increases in the targeted prelinguistic communication skills during treatment and maintained the increases during follow-up. Analysis of individual behavioral profiles was helpful for disambiguating individual differences in response to intervention across the three variables. Future research should target generalization of learned behaviors across implementers and settings. / text

Abstract: Identification of, and responsiveness to, the communicative attempts of children with developmental delays’ is essential to developing intentional, symbolic communication. The current study was a replication of Keen, Sigafoos, and Woodyatt’s 2005 study titled Teacher Responses to the Communicative Attempts of Children With Autism, with modifications to the participants used in the study. The Inventory of Potential Communicative Acts (IPCA; Sigafoos et al, 2000) was used with three teachers of three children with deafblindness to determine if teachers were able to identify potential communicative acts (PCAs) of their students using the IPCA during an interview session. Additionally, analysis of teacher responsiveness to student PCAs took place during a 30-minute classroom observation session. All three teachers identified a wide range of student PCAs during the IPCA interview and showed high levels of responsiveness to those PCAs during the naturalistic, classroom observation. Low interobserver agreement, clinical implications, and directions for future research are discussed. / text

Thesis advisor: Susan Bruce / The prevalence of children with severe and multiple disabilities who come from culturally and linguistically diverse backgrounds increased considerably with the rise of immigration to the U.S. However, there is very little research about the way that children with disabilities who come from a culturally and linguistically diverse background communicate and develop communication skills (Mueller, Singer, & Carranza, 2006). Furthermore, there is no established term for describing this group of children. That is why this study uses the term Prelinguistic bilinguals to define individuals who use one or more languages at a nonverbal level in their everyday lives. This definition of prelinguistic bilinguals was built upon Grosjean’s (2010) definition of bilingualism. Knowing how prelinguistic bilingual children communicate and develop communication skills is fundamental for their educational team in order to effectively interact and support the children’s communication, which in turn would have a positive effect on their learning outcomes. The main goals of this study were to describe the communication of prelinguistic bilingual children and to learn more about what teachers, teacher assistants, speech language pathologists, and parents do to support their communication in English and Spanish. This qualitative study uses a constructivist theory approach to make in-case and across-case analyses of three case studies. Findings for the study indicated that prelinguistic bilingual children were not only aware of a difference between the two languages, but could also express a preference for one of their languages. Most of the communication supports that the participating adults provided for prelinguistic bilingual children were the same communication supports used for monolingual children developing language, which did not consider the children’s bilingual needs. / Thesis (PhD) — Boston College, 2018. / Submitted to: Boston College. Lynch School of Education. / Discipline: Teacher Education, Special Education, Curriculum and Instruction.

Mands, of which requesting and rejecting responses are considered subclasses, are the first emerging communication functions that allow children to express their wants and needs. While typically developing children develop speech without specifically designed intervention, many children with autism and developmental disabilities are likely to rely on prelinguistic communication forms that are socially and developmentally inappropriate or unacceptable until symbolic forms of functional communication are taught. A review of the literature on teaching mands indicates that although there is an abundance of research addressing teaching communicative requesting behaviors, rarely have studies attempted to teach communicative rejecting. The purpose of this study was to create rejecting opportunities using the wrong-item format embedded into the missing item format, and to teach socially appropriate rejecting response using AAC for four children with autism and developmental disabilities. This study employed a multiple probe design across four participants to examine the effectiveness of the procedure. Results indicated that the wrong-item format embedded into the missing-item format was effective in teaching symbolic forms of rejecting responses using VOCAs and PECS. The results were generalized across two untrained activities and were maintained up to four weeks following the termination of generalization probes for three participants. The implications and limitations of this study, as well as potential topics for future research are also discussed. / text

Children with cerebral palsy that have severe motor impairments, and often co-occurring visual impairments, may often have an impaired ability in prelinguistic forms of communication. In order for children to establish intentional communication, research suggests that prelinguistic communicative competence must be in place. Access to alternative and augmentative communication (AAC) is not sufficient to enhance interaction if motivation to communicate intentionally does not exist. The purpose of this literature review is to discuss the important aspects of early assessment and intervention for children with cerebral palsy who have severe motor impairment. There is a wealth of information about the development, assessment, and intervention of prelinguistic communication in typically developing children and children with developmental delays; however, limited empirical research focuses on children with severe physical impairments. The aim of this project will be to draw conclusions from the available research in order to formulate a protocol for speech-language pathologists to use in assessment and intervention of prelinguistic communication in young children with cerebral palsy. / text

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Abstract The present longitudinal follow-up study had two main goals. Firstly, this study aimed to describe aspects of maternal interactive/communicative behaviour that could be considered constitutive in sensitive responsiveness. Secondly and most importantly, it aimed to find predictive relations between characteristics of mother-infant interaction around the onset of infant intentional communication and subsequent child communicative and linguistic development. The participants were 27 Finnish-speaking mothers and their healthy first-born infants. Analyses of the amount and types of maternal and infant communicative acts as well as maternal responses to infant signals were carried out from videotaped free-play samples at the infants' age of 10 months. In addition, the CARE-Index was used to rate maternal sensitivity and infant co-operativity. At 12 months, children's communicative and linguistic skills were assessed by using the MacArthur Communicative Development Inventories and the Communication and Symbolic Behaviour Scales. At 30 months, the Reynell Developmental Language Scales III was used to assess comprehensive and expressive language. The results suggest that maternal activity in eliciting interaction and conversational interchanges is characteristic of sensitive responsiveness around the onset of infant intentionality. However, very distinctive aspects of verbal behaviour that might be constitutive in sensitive responsiveness were not found — probably as a result of considerable individual variation in all aspects of maternal as well as infant interactive/communicative behaviour that were analysed. As predictors of communicative and linguistic skills at 12 months, both maternal and infant characteristics made a significant contribution. In general, the predictive relations found were quite specific. In turn, except for the predictive validity of maternal sensitivity for comprehensive language at 30 months, later language outcomes were predicted only by children's communicative and linguistic skills at 12 months, suggesting that over time, language development becomes increasingly child-driven. Individual differences in early communicative capacities may also to some extent mask the language-facilitating effects of parenting. On the other hand, some potentially facilitating effects of parental behaviour may be elicited by the infant's well-advanced communicative skills. The importance to acknowledge transactional processes in parent-child interaction is highlighted — both in future research and clinical applications.