61518016 Westby 1980 Assessment of Cognitive and Language Abilities Through Play
ED 379 899 AUTHOR Laurel, Marci; Westby, Carol · LP Module. c. Problems in these areas. 1)...
Transcript of ED 379 899 AUTHOR Laurel, Marci; Westby, Carol · LP Module. c. Problems in these areas. 1)...
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.
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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?"
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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
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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.
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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.
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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.)
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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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sory
/mot
or In
tegr
atio
nD
evel
opm
enta
l del
ayF
ailu
re to
thriv
eA
buse
and
neg
lect
Con
tinue
abo
veH
ealth
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
CO
PY
AV
AIL
AB
LE11
1056
n.
GE
NE
RIC
SK
ILL
S A
SSE
SSM
EN
T I
NV
EN
TO
RY
CO
NT
EN
T S
UM
MA
RY
App
rox.
ale
DIL
LE
Siiii
i-pe
ople
Skill
sA
nnah
leL
eara
ins
sir
&te
st le
s
LE
VE
LO
BJE
CT
Com
preh
ensi
onR
EL
AT
ION
SHIP
SR
EPR
ESE
NT
AT
ION
DY
AD
IC I
NT
ER
AC
TIO
NE
XPR
ESS
IVE
& I
mita
tion
Com
mun
ical
ion
A.
Orie
nts
A.
Tol
erat
esA
.R
eact
ive
A.
Res
pond
s to
13.
Atte
nds
Pro
xim
ityC
omm
unic
ativ
eIn
tona
tion
0.4
C.
Tra
cks
R.
Ret
urns
beha
vior
Gaz
eB
.C
omm
unic
ativ
eF
unct
ions
I.P
leas
ure
2.D
ispl
easu
re3.
Oth
er11
A.
Alte
rnat
esA
. Loc
ates
obj
ect t
oA
. Atte
nds
toA
.P
roac
tive
A.
Ant
icip
ates
atte
ntio
nau
dito
ry c
ueS
peak
erC
omm
unic
ativ
eR
outin
eB
.R
each
es A
B.
Loca
tes
visi
bly
13.
Rel
ease
s/A
ccep
tsB
ehav
ior
Eve
nt4.
8ca
ptur
eshi
dden
obj
ects
obje
ctB
.C
omm
unic
ativ
eB
.C
ontin
ue m
otio
nC
.C
aptu
res
&C
.P
layf
ulF
unct
ions
mov
emen
tM
anip
ulat
esIn
tera
ctio
nI.
Req
uest
C.
Res
pond
s to
2.P
rote
stR
itual
ized
3.In
tere
stU
ttera
nces
4.A
ttent
ion
to s
elf
5.O
ther
IIIA
.D
iffer
entia
lA
.Lo
cate
s in
visi
bly
A.
Evo
kes
Atte
ntio
n1
A.
Prim
itive
A.
Res
pond
s to
Act
ion
Sch
emas
Hid
den
Obj
ects
for
com
mun
icat
ion
Inte
ntio
nal
Con
vent
iona
lB
.C
ombi
nato
rial
13.
Iden
tify
Mat
ch:
13.
Mai
ntai
ns J
oint
focu
sC
omm
unic
atio
nG
estu
res
8 -1
8A
ctio
n on
Obj
ects
Obj
ects
C.
Wai
ls tu
rnB
.C
omm
unic
ativ
e13
.Im
itate
s A
ctio
nC
.D
irect
mea
ns io
D.
Fill
s tu
rnIn
tent
son
Obj
ects
ends
E.
Est
ablis
h Jo
int F
ocus
1.R
eque
stC
.R
espo
nds
toD
.In
dire
ct M
eans
to2.
Pro
test
Act
ion
ends
3.A
ttent
ion
to S
elf
Ges
ture
sB
.P
rimiti
ve to
olus
e4.
Atte
ntio
n to
Ref
eren
tD
.E
.Im
itate
s M
otio
nC
ompr
ehen
dsF
.F
unct
iona
l Use
5.O
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
Thi
neSk
ills
peop
leSk
ills
Ava
ilabl
eL
earn
ing
Stra
tegi
es
OB
JEC
TC
ompr
ehen
sion
RE
LA
TIO
NSH
IPS
RE
PRE
SEN
TA
TIO
ND
YA
DIC
IN
TE
RA
CT
ION
EX
PRE
SSIV
E&
Im
itatio
nC
omm
unic
atio
n
IV
A.
Con
vent
iona
lT
ool u
seA
,B
.P
hoto
-toO
bjec
t Mat
chA
ctio
n-to
-Obj
ect m
atch
A.
Est
ablis
hes
Join
tR
efer
ent
A.
Con
vent
iona
lIn
tent
iona
l
A. C
ompr
ehen
dsLa
bels
of a
bsen
t
B.
Com
plex
C.
Per
cept
ual C
lass
B.
Ans
wer
Sim
ple
Com
mun
icat
ion
Obj
ect/A
ctio
ns
Com
bina
toria
lco
ncep
tsQ
uest
ions
B.
Com
mun
icat
ive
BC
ompr
ehen
d T
wo
.
18+
actio
nD
.P
eer
Inte
ract
ion
C.
Mai
ntai
n Jo
int R
efer
ent/
Inte
nts
orin
Utt
mor
e
Top
ic1.
Req
uest
a n
erat
erm
snc
e
.P
eer
Inte
ract
ion
2.P
rote
st3.
Atte
ntio
n4.
Atte
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.]