Optimizing Outcomes for Early Identified Children Through Inclusive Service Provision Sarah...

Optimizing Outcomes for Optimizing Outcomes for Early Identified Children Early Identified Children

Through Inclusive Through Inclusive Service ProvisionService Provision

Sarah Wainscott & Marion HelfrichSarah Wainscott & Marion Helfrich

The River SchoolThe River School

Washington, D.C.Washington, D.C.

Project Funded by Deafness Research Project Funded by Deafness Research FoundationFoundation

Project ObjectiveProject Objective

Assess inclusive model as a Assess inclusive model as a language learning language learning

environment for young deaf environment for young deaf childrenchildren

Site: The River SchoolSite: The River School

Priority:Priority:

Competence commensurate with Competence commensurate with typical hearing peers for skills in:typical hearing peers for skills in:

communication communication spoken language spoken language socializationsocialization

Goal is broad competency and generalized Goal is broad competency and generalized skillsskills

Timeliness of Inclusive Timeliness of Inclusive Approach:Approach:

Advent of universal newborn hearing Advent of universal newborn hearing screeningscreening

Earlier implantation & advancing technologyEarlier implantation & advancing technology Research related to incidental learning for Research related to incidental learning for

CI usersCI users IDEA policy regarding “least restrictive IDEA policy regarding “least restrictive

environment”environment” Narrow scope of traditional oral approachNarrow scope of traditional oral approach Best practices in early childhood educationBest practices in early childhood education

Inclusion Model of Inclusion Model of EducationEducation

Underlying PrinciplesUnderlying Principles MMultifaceted approach should be used to ultifaceted approach should be used to

support the development of communication, support the development of communication, spoken language, and social skills. spoken language, and social skills.

Intervention services should be imbedded Intervention services should be imbedded within a context of “developmentally within a context of “developmentally appropriate” early childhood curriculum, appropriate” early childhood curriculum, and alongside hearing peers.and alongside hearing peers. Potential benefit in more natural contextPotential benefit in more natural context

Components of River School Components of River School Model:Model:

Small groupings of predominately typical hearing Small groupings of predominately typical hearing peerspeers

Transdisciplinary team of Educator and SLP full-Transdisciplinary team of Educator and SLP full-dayday

Strong developmental frameworkStrong developmental framework Deliberate focus on spoken language and literacyDeliberate focus on spoken language and literacy Family-centered programmingFamily-centered programming

Result:Result: Intensive services in least restrictive environmentIntensive services in least restrictive environment

Is the “Model” working forIs the “Model” working for emerging emerging language users?language users?Longitudinal study: Deaf children Longitudinal study: Deaf children

transitioning from pre- to para-transitioning from pre- to para-linguistic to linguistic stages.linguistic to linguistic stages.


The Big Question:The Big Question:


MethodologyMethodology Sample: Sample: EmergingEmerging language users language users

with cochlear implants in River School with cochlear implants in River School programsprograms N=6; 4 females N=6; 4 females Ages: 14 mos to 3yr 2 mosAges: 14 mos to 3yr 2 mos

Age at Implantation: 11 mos – 26 mosAge at Implantation: 11 mos – 26 mos Length of CI Use: 1 mo – 1yr 4mosLength of CI Use: 1 mo – 1yr 4mos


MethodologyMethodology

Interval video analysis of children in Interval video analysis of children in select activitiesselect activities 6 month intervals6 month intervals Activities: Teacher-directed, Facilitated Activities: Teacher-directed, Facilitated

play, Free playplay, Free play Analysis: Independent review of video Analysis: Independent review of video

Coding system & pattern identificationCoding system & pattern identification


Measurement ConditionsMeasurement Conditions Three five-minute segments at six-Three five-minute segments at six-

month intervals for high, medium, & month intervals for high, medium, & low structure activities:low structure activities: Teacher-directed: Circle timeTeacher-directed: Circle time Facilitated play: Theme related Facilitated play: Theme related

dramatic playdramatic play Free play: PlaygroundFree play: Playground

Frequency of interactionsFrequency of interactions Communication partnersCommunication partners

Peer v. TeacherPeer v. Teacher Child’s roleChild’s role

Initiator v. ResponderInitiator v. Responder Nature of interactionsNature of interactions

Paralinguistic, paralinguistic & vocal, Paralinguistic, paralinguistic & vocal, linguisticlinguistic


Items MeasuredItems Measured

0

5

10

15

20

25

Videoanalysis Results Videoanalysis Results Frequency of interactions Frequency of interactions

(mean/5 min)(mean/5 min)

Teacher-Teacher-directeddirectedTeacher-Teacher-directeddirected

Facilitated playFacilitated playFacilitated playFacilitated play

Free playFree playFree playFree play

Videoanalysis Results Videoanalysis Results Communication vs. NRCommunication vs. NR

(mean/5 min)(mean/5 min)

0

5

10

15

20

25

No ResponseNo ResponseNo ResponseNo Response

Opportunity Opportunity TakenTakenOpportunity Opportunity TakenTaken

0

5

10

15

20

25

30

GK DJ IH CM MA

Videoanalysis Results Videoanalysis Results Frequency of interactions per 5 min.Frequency of interactions per 5 min.

(differences per child at 5 mos)(differences per child at 5 mos)

0

5

10

15

20

PeerTeacher

Videoanalysis Results Videoanalysis Results Communication partners across Communication partners across

activitiesactivities(mean interactions by partner per 5 min)(mean interactions by partner per 5 min)

Teacher-directedTeacher-directedTeacher-directedTeacher-directed

Facilitated playFacilitated playFacilitated playFacilitated play


Videoanalysis Results Videoanalysis Results Communication partners mean Communication partners mean

interactions per 5 min.interactions per 5 min.(differences per child at 5 mos)(differences per child at 5 mos)

0

5

10

15

20

GK1 DJ1 IH1 CM2 MA1PeerTeacher

Videoanalysis Results Videoanalysis Results Initiations versus responses by activityInitiations versus responses by activity

(mean rate per 5 min)(mean rate per 5 min)

0

2

4

6

8

10

12

Initiations

Responses

Teacher-directedTeacher-directedTeacher-directedTeacher-directed

Facilitated Facilitated playplayFacilitated Facilitated playplay


Videoanalysis Results Videoanalysis Results Initiations versus responses per 5 min.Initiations versus responses per 5 min.

(differences per child at 5 mos)(differences per child at 5 mos)

IH1 IH2 CM1CM2MA1MA2 JW1 JW2 JN1 JN20

2

4

6

8

10

12

14

InitiationsResponses

Is the “Model” working for emerging language Is the “Model” working for emerging language users, targeting users, targeting competence in communication, competence in communication, spoken language, and socializationspoken language, and socialization??

Preliminary data suggest that implanted deaf Preliminary data suggest that implanted deaf children educated in an inclusion model show children educated in an inclusion model show trends of:trends of: high frequency of interactionshigh frequency of interactions greater peer-driven communicationgreater peer-driven communication frequent initiation of communicationfrequent initiation of communication rapid progress toward linguistic communicationrapid progress toward linguistic communication


The BIG question...The BIG question...

Further longitudinal analysisFurther longitudinal analysis Longterm educational and placement Longterm educational and placement

outcomesoutcomes Assessment of CI users in other inclusion Assessment of CI users in other inclusion

programsprograms Qualitative analysisQualitative analysis

Teaching strategies in inclusion settingTeaching strategies in inclusion setting Role of typical peers as language modelsRole of typical peers as language models


Future directionsFuture directions

Optimizing Outcomes for Early Identified Children Through Inclusive Service Provision Sarah...

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