Child maltreatment is a serious and pervasive public health problem in the United States. In 2008, there were 772,000 children who were substantiated victims of maltreatment and 1,740 children died as a result of maltreatment. Approximately 33 percent of maltreatment victims were under the age of four. Among numerous other negative sequelae, children who have been maltreated have an elevated incidence of language delay and poor cognitive functioning, both strong predictors of literacy skills and later academic achievement. Further, maternal language input is critical to a child’s cognitive development and language acquisition. Maltreating mothers provide their children with far less verbal stimulation and are less likely to engage their children in learning opportunities. Home visiting programs are effective means of preventing child maltreatment or further maltreatment by parents and may be better utilized to improve language of children. SafeCare® represents one such program. It is an evidence-based program for the treatment and prevention of child maltreatment, consisting of four modules: Parent- Infant Interaction (PII), Parent-Child Interaction (PCI), Health and Safety. The purpose of the proposed research is to determine whether PII or a language-enhanced version of the module is effective in increasing the number of maternal utterances with her infant and the frequency of incidental teaching. The enhanced PII segment was created, not only to be an effective tool for promoting language, but also to be succinct enough to imbed into the extant protocols so as not to add a cumbersome burden to SafeCare home visitors or parents participating in the program.

A leitura compartilhada de livros para crianças é uma atividade que tem sido estudada como forma de ensino incidental de vocabulário, que envolve, dentre outros processos, o responder por exclusão. O objetivo do presente trabalho foi investigar a ocorrência de aprendizagem de relações entre estímulos visuais (figuras) com seus respectivos estímulos auditivos (palavras) a partir de diferentes condições de leitura compartilhada de livros para crianças com Síndrome de Down (SD) e com desenvolvimento típico (DT). Para a pesquisa foram desenvolvidos dois estudos. No Estudo 1, participaram seis crianças com SD com seis a sete anos, e seis crianças com DT com três a quatro anos (amostras pareadas em função do nível de vocabulário). Foi utilizado um livro de história produzido pela pesquisadora, no qual havia dois substantivos e dois adjetivos desconhecidos (estímulos visuais S1, S2, A1, A2), apresentados uma única vez na história. Esse livro foi lido para cada criança duas vezes em sequência por sessão e em cada sessão foi realizada uma condição de leitura diferente. Foram apresentadas três condições de leitura e cada criança passou por todas, mas em diferentes ordens (contrabalanceamento). Na Condição 1, o livro foi lido para a criança sem intervenções. Na Condição 2, o livro foi lido para a criança e ela tinha que repetir o nome dos estímulos desconhecidos. Na Condição 3, o livro foi lido e foram realizadas perguntas relacionadas aos estímulos-alvo. Ao final de cada sessão foram realizadas sondas de aprendizagem (sondas de emparelhamento ao modelo e nomeação), e após uma semana da última sessão foi aplicada uma sonda de manutenção e uma de generalização. As crianças com DT apresentaram maior número de acertos que as com SD, e os acertos foram mais relacionados ao estímulo S1. As crianças não aprenderam a relação nome-cor. A análise dos resultados sugeriu que o número de estímulos-alvo era excessivo e com apresentações insuficientes no livro. No Estudo 2 participaram seis crianças com DT de 3 a 4 anos e seis crianças com SD, de 5 a 8 anos. O procedimento utilizado no Estudo 2 foi semelhante ao primeiro com as seguintes alterações no livro: utilização de apenas duas relações-alvo (um substantivo-alvo e um adjetivo-alvo - S2 e A3), cada uma sendo apresentada três vezes ao longo da história, em figuras que possibilitavam o responder por exclusão. Também foi acrescentada uma tentativa de exclusão nas sondas de aprendizagem. Nesse estudo, todas as crianças com DT conseguiram selecionar e nomear estímulo S2 e duas mostraram indícios de aprendizagem do estímulo A3. As crianças com SD apresentaram um menor número de acertos nas sondas de emparelhamento, mas apresentaram algumas nomeações corretas, o que não foi observado no Estudo 1. Os dados sugerem que as mudanças realizadas no livro melhoram o desempenho das crianças com DT, mas não o das crianças com SD. Não foram encontradas diferenças entre as condições de leituras nos dois estudos. No entanto, são necessários estudos adicionais para avaliar essas diferentes condições e as variáveis envolvidas na aprendizagem de palavras a partir da leitura compartilhada de livro. / Shared book reading for children is an activity that has been studied as an incidental vocabulary teaching that involves, among other processes, exclusion responding. The aim of this research was to investigate the occurrence of learning of the relation between visual stimuli (figures) with their respective auditory stimuli (words) in different shared book reading conditions to Down syndrome (DS) and typical development (TD) children. This research was performed in two studies. In Study 1, participated six DS children from six to seven years old and six TD children from three to four years old (paired samples based on vocabulary level). In this study, the conductor of the experiment used a storybook produced for this research. The book contained two nouns and two unknown adjectives (visual stimuli S1, S2, A1, and A2), presented one time in the story. The conductor of the experiment read the book to every child two times in sequence for each session. In each session, the conductor of the experiment applied a different reading condition. Three reading conditions were presented in various orders (counterbalance) for each child. In Condition 1, the book was read to the child without interventions. In Condition 2, the book was read to the child, and the unknown stimuli names were asked to be repeated. In Condition 3, the book was read to the child, and questions related to the target stimuli were made. At the end of each session, learning probes (matching-to-sample and naming probes) were made. After one week of the last session, maintenance and generalization probes were applied. TD children showed more correct answers than DS children. The right answers were mostly related to S1 stimuli. No child learned name-color relations. Result analysis suggested that the target stimuli was excessive and with insufficient presentations in the book. In Study 2, participated six TD children from three to four years old and six DS children from five to eight years old. The procedure of Study 2 was similar to Study 1, except for some alterations in the book: there were only two target-relations (one target-noun and one target-adjective S2 and A3), each being presented three times along the story, in figures that allowed the exclusion responding. It was also included an attempt of exclusion in learning probes. In this Study, all TD children could select and name S2 stimuli and two children showed indications of learning of A3 stimuli. DS children showed a smaller number of correct answers in matching probes but showed some correct nominations, which were not observed in Study 1. The data suggest that the changes in the book improved the TD children performance, but not to DS children. The results showed no difference between reading conditions in both studies. However, additional studies that evaluate different conditions and variables related to word learning in shared book reading are necessary.

The present dissertation on autism spectrum disorders (ASD) addressed several questions. First, the behavioral symptoms of speaking and mute individuals with ASD were compared on the Autism Behavior Checklist (ABC), a commonly used diagnostic instrument. In addition, questions about the construction of the ABC were investigated. In Study I it was found that although the two groups did not significantly differ on the total ABC score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores to speaking, rather than mute, individuals with ASD was called into question. In addition, it was speculated that the expressive language items are weighted too heavily, on both the Language subscale and the total score. Second, because the 57 items of the ABC were categorized into 5 subscales on a subjective basis, an empirical investigation of the factor structure of the ABC was performed. In Study II, a 5-factor model that contained 39 of the items accounted for 80% of the total variance in the checklist. No support was found for classifying the 57 items into the existing 5 subscales. Finally, the two most common forms of instruction to teach children with ASD, discrete-trial teaching and incidental teaching, were assessed. In Study III it was ascertained that discrete-trial teaching was more efficient and produced faster acquisition and initially, greater generalization. However, by follow-up, the incidental teaching methods resulted in equal retention, greater generalization, and equal or greater spontaneous usage. The findings indicate that although it takes a longer time for children with autism to learn with incidental teaching procedures, once they have acquired an ability, it may be more permanent.

A leitura compartilhada de livros para crianças é uma atividade que tem sido estudada como forma de ensino incidental de vocabulário, que envolve, dentre outros processos, o responder por exclusão. O objetivo do presente trabalho foi investigar a ocorrência de aprendizagem de relações entre estímulos visuais (figuras) com seus respectivos estímulos auditivos (palavras) a partir de diferentes condições de leitura compartilhada de livros para crianças com Síndrome de Down (SD) e com desenvolvimento típico (DT). Para a pesquisa foram desenvolvidos dois estudos. No Estudo 1, participaram seis crianças com SD com seis a sete anos, e seis crianças com DT com três a quatro anos (amostras pareadas em função do nível de vocabulário). Foi utilizado um livro de história produzido pela pesquisadora, no qual havia dois substantivos e dois adjetivos desconhecidos (estímulos visuais S1, S2, A1, A2), apresentados uma única vez na história. Esse livro foi lido para cada criança duas vezes em sequência por sessão e em cada sessão foi realizada uma condição de leitura diferente. Foram apresentadas três condições de leitura e cada criança passou por todas, mas em diferentes ordens (contrabalanceamento). Na Condição 1, o livro foi lido para a criança sem intervenções. Na Condição 2, o livro foi lido para a criança e ela tinha que repetir o nome dos estímulos desconhecidos. Na Condição 3, o livro foi lido e foram realizadas perguntas relacionadas aos estímulos-alvo. Ao final de cada sessão foram realizadas sondas de aprendizagem (sondas de emparelhamento ao modelo e nomeação), e após uma semana da última sessão foi aplicada uma sonda de manutenção e uma de generalização. As crianças com DT apresentaram maior número de acertos que as com SD, e os acertos foram mais relacionados ao estímulo S1. As crianças não aprenderam a relação nome-cor. A análise dos resultados sugeriu que o número de estímulos-alvo era excessivo e com apresentações insuficientes no livro. No Estudo 2 participaram seis crianças com DT de 3 a 4 anos e seis crianças com SD, de 5 a 8 anos. O procedimento utilizado no Estudo 2 foi semelhante ao primeiro com as seguintes alterações no livro: utilização de apenas duas relações-alvo (um substantivo-alvo e um adjetivo-alvo - S2 e A3), cada uma sendo apresentada três vezes ao longo da história, em figuras que possibilitavam o responder por exclusão. Também foi acrescentada uma tentativa de exclusão nas sondas de aprendizagem. Nesse estudo, todas as crianças com DT conseguiram selecionar e nomear estímulo S2 e duas mostraram indícios de aprendizagem do estímulo A3. As crianças com SD apresentaram um menor número de acertos nas sondas de emparelhamento, mas apresentaram algumas nomeações corretas, o que não foi observado no Estudo 1. Os dados sugerem que as mudanças realizadas no livro melhoram o desempenho das crianças com DT, mas não o das crianças com SD. Não foram encontradas diferenças entre as condições de leituras nos dois estudos. No entanto, são necessários estudos adicionais para avaliar essas diferentes condições e as variáveis envolvidas na aprendizagem de palavras a partir da leitura compartilhada de livro. / Shared book reading for children is an activity that has been studied as an incidental vocabulary teaching that involves, among other processes, exclusion responding. The aim of this research was to investigate the occurrence of learning of the relation between visual stimuli (figures) with their respective auditory stimuli (words) in different shared book reading conditions to Down syndrome (DS) and typical development (TD) children. This research was performed in two studies. In Study 1, participated six DS children from six to seven years old and six TD children from three to four years old (paired samples based on vocabulary level). In this study, the conductor of the experiment used a storybook produced for this research. The book contained two nouns and two unknown adjectives (visual stimuli S1, S2, A1, and A2), presented one time in the story. The conductor of the experiment read the book to every child two times in sequence for each session. In each session, the conductor of the experiment applied a different reading condition. Three reading conditions were presented in various orders (counterbalance) for each child. In Condition 1, the book was read to the child without interventions. In Condition 2, the book was read to the child, and the unknown stimuli names were asked to be repeated. In Condition 3, the book was read to the child, and questions related to the target stimuli were made. At the end of each session, learning probes (matching-to-sample and naming probes) were made. After one week of the last session, maintenance and generalization probes were applied. TD children showed more correct answers than DS children. The right answers were mostly related to S1 stimuli. No child learned name-color relations. Result analysis suggested that the target stimuli was excessive and with insufficient presentations in the book. In Study 2, participated six TD children from three to four years old and six DS children from five to eight years old. The procedure of Study 2 was similar to Study 1, except for some alterations in the book: there were only two target-relations (one target-noun and one target-adjective S2 and A3), each being presented three times along the story, in figures that allowed the exclusion responding. It was also included an attempt of exclusion in learning probes. In this Study, all TD children could select and name S2 stimuli and two children showed indications of learning of A3 stimuli. DS children showed a smaller number of correct answers in matching probes but showed some correct nominations, which were not observed in Study 1. The data suggest that the changes in the book improved the TD children performance, but not to DS children. The results showed no difference between reading conditions in both studies. However, additional studies that evaluate different conditions and variables related to word learning in shared book reading are necessary.

Manual signs are an augmentative and alternative communication mode which enables and facilitates communication for persons with impairments in speech, language and hearing. There are different ways of teaching signs to persons with intellectual disabilities. One of them is milieu teaching, which is a method where the teaching takes place in natural settings. This method has proven to give good results in generalization and maintenance. Teaching signs to staff in groups has been shown to be effective. The purpose of the present study was to investigate whether sign intervention affected the number of signs and the number of different signs, used by two persons with Down’s syndrome and eleven staff on a day center. The study was carried out as a single-subject design. A sign intervention was conducted at the day center with the two participants with Down’s syndrome. They were educated individually with a procedure inspired by milieu teaching. When the intervention with the two participants was terminated, the staff was educated in a group format. The number of signs and the number of different signs used by the two participants with Down’s syndrome and the staff were registered. The sign intervention with the two participants led to an increased use of signs for one of them and the sign intervention with the staff led to an increased use of signs for the staff together with one of the participants. The main reason for why the sign intervention was effective for one of the two participants with Down’s syndrome and for one group of staff, but not for the other participant or the other group of staff, seems to be that the participants use of signs had an impact on each other. One of the participants with Down’s syndrome and one group of staff seems to have had a positive impact on each others use of signs. The intervention also seems to have been too short and therefore has not given effect for all of the participants.

This thesis explores the applications of a drama-based intervention program for very young children with Autism Spectrum Disorder (ASD) and their parents. Drama-based pedagogy and practice is merged with behavioral principles from the world of Applied Behavior Analysis (ABA) to create an interdisciplinary program tailored specifically for the unique learning needs of children with ASD. This document offers a comprehensive overview of the history of diagnosis and treatment of ASD and the many factors that can influence relationships between children with ASD and their parents. A drama-based intervention program was designed specifically to address the communication and social skill deficits in children with ASD. In addition, the drama-based intervention program encouraged parents to use responsive teaching strategies to enhance and extend creative play with their child. The document concludes with recommendations for essential components of a drama-based intervention program for very young children with ASD and their parents. / text