TOOLS FOR TALKING:A COLLABORATIVE APPROACH TO PARENT TRAINING FOR PROMOTING LANGUAGE DEVELOPMENT IN INFANTS AND TODDLERS

Kittie Butcher, MSU Extension, Clinton County

Katie Strong, MSU, Communication Sciences and Disorders

Outcomes of today’s presentation 1. Identify roles of speech-language pathologist,

parent educators, and other team members in training parents on language promotion strategies

2. Identify available tools for establishing program on promoting language development

3. Understand the value of collaborating with university level students, early childhood partners, and parent leaders in the training process to promote an interactive team in support of children’s outcomes

Traditional Model of Training of Students in Speech-Language Pathology Conflicts with Early Intervention Philosophy and Expectations

Disorder focused Clinical setting

preferred Clinician driven

therapy Treatment directly

focused on ‘patient’ or ‘client’

Skill set is kept within specialist and shared only with ‘patient’ or ‘client’

Focus on family support

Natural environments Cross disciplinary

models of service delivery

Service coordination Development of IFSPs

Traditional Medical ModelFamily Centered PracticeBruder & Dunst (2005)

Role of SLP in Early Intervention(ASHA 2008)

Impact of IDEA Part C Broader focus on children's successful participation in the activities and

routines that they engage in at home and in community settings

SLP in variety of roles Direct service provider, consultant, service coordinator, resource locator,

advocate, insurance liaison, administrator, policy maker

Federal mandates and general practice patterns support the goal of enhancing developmental outcomes for the targeted population of infants and toddlers. Practices featuring family-centered, culturally sensitive, developmentally

appropriate, and collaborative components have been deemed desirable

There is no one model or precise set of therapeutic approaches that can guide all early intervention services.

Guiding principles for services to infants and toddlers with disabilities (ASHA 2008)

Family centered and culturally and linguistically responsive

Developmentally supportive and promote children's participation in their natural environments

Comprehensive, coordinated, and team based

Based on the highest quality evidence available

WKAR Talaris

Early Head Start, MSU Extension, Clinton and Eaton Counties & Eaton County Early Childhood Connections

Goal - present parent training to families enrolled in programs Exploring Communication Stress Emotion Coaching

“Train the trainer" format to expand outreach efforts

Training materials Videos Handouts Website Research Spotlights

Food Book for each

family to practice with at training and then take home

Parenting Counts Grant Supports from Grant

Functions of the SLP in Infant/Toddler and Family Services (ASHA 2008)

The SLP is qualified to provide services to Families and their children

who are at risk for developing, or who already demonstrate, delays or disabilities in language-related play and symbolic behaviors, communication, language, speech, and/or swallowing and feeding.

In providing these services, the SLP may participate in the following primary functions Prevention Screening Evaluation and assessment Planning, implementing,

and monitoring intervention Consultation with and

education for team members, including families and other professionals

Service coordination Transition planning Advocacy Advancing the knowledge

base in early intervention.

Strategies for supporting and enhancing early child communication (ASHA 2008)

Adult structures interactions by selecting ways to elicit a particular communicative act, expecting and supporting the child in the interaction to gain the desired response and often providing a tangible reward for correct performance.

Encourage the child's engagement and interaction, to provide opportunities for child-initiated behavior, and for reciprocity and balanced turn taking with communication partners.

Directive Interaction Strategies

Responsive Interaction Strategies

Strategies for supporting and enhancing early child communication (ASHA 2008)

Continuum of service delivery models may include combinations of clinician-delivered and parent-implemented interventions that are individually designed in conjunction with the family for their infant/toddler. In some instances, it may be determined that the

best approach is for the SLP to provide services directly to the child in a one-on-one format

With others, it may be best for the SLP to teach caregivers and/or other team members providing direct services to implement communication and language-enhancing strategies

In yet other cases a combination of these two approaches may be warranted.

Irrespective of the approach, however, it is essential that the SLP and family collaboratively determine what is best given the child's needs and family priorities.

Collaborative partnership with the family and other team members (ASHA 2008)

Engages

Implements

Joins

Embeds

Consults

Monitors

The SLP selects among the available approaches and strategies, provides direct implementation of intervention, shares information and resources, offers information to family members to enhance informed decision making, and implements practices that enhance family confidence and competence.

Talk Tools Workshop

Goals of Talk Tools WorkshopParent Participants

Increase knowledge and value of daily interactions with their child and the impact on language development; language is a turn taking activity that can be embedded in daily routines.

Increase understanding of expressive language and receptive language skills.

Practice language support tools modeled by video clips and hands-on activities with feedback from language coaches.

Goals of Talk Tools WorkshopStudent Participants

Expanding experience in sharing information in language intervention

Learning to value of partnering with parents and increasing comfort level with parents

Using parent as a partner model in speech intervention

Increasing knowledge and skills in language intervention

Developing value for collaboration with interdisciplinary providers

Begin exposure to service delivery that differs from traditional medical model

Looking for where language can fit into daily tasks, developing props for parents to practice these skills

Selection of Language Coaches Student volunteers from MSU CSD473

Childhood Phonological Disorders Class 1 Student Leader - Honors Option

Assisted in organization of materials, pre-workshop trainings, communication with other Language Coaches, wrap-up session

6 additional students 1-2nd year MA student 3-1st year MA students 2-Undergradaute seniors

Language Coach Training

Review of language development for 2-3 year olds

Provide additional reading resources Talaris materials ASHA supplements

Practiced modeling language for output

Brainstormed on ideas for activities to use during Talk Tools training

Homework Reading material Developing scenarios and

equipment for hands on practice with parents

Discussion and Q/A on What types of children may

attend Disorders What intervention already

done Assembled practice kits for

hands on activities with parents

Practiced with at least 2 different kits Language modeling strategies Providing feedback to parents Explaining concepts to parents

Initial 60-minute training Second 60-minute training

Strategies Taught for Modeling Language

Repetition

Exaggerated Phrasing

Slow Rate

Anticipatory Pauses

Expanding Language

Labeling actions & objects

Now…It’s your turn to get in the kitchenShare your ideas with someone sitting next to you.

Take 5 minutes for this task.

List 5 daily activities that you could model with a family you are currently working with.

Expand one of the activities on your list What materials are needed? What are the target words or

sounds? How would this interaction with

the parent look?

Language Activities

Car ride Snack time Taking a bath Getting dressed in

the morning Getting ready for

bed Making and eating

dinner

Laundry Grocery shopping Changing a diaper Watching sports/tv McDonalds Reading a book Playtime Cleaning

Look Who’s Talking – Helpful Parenting Tips(Talaris 2008)

Talk to your little one early, & talk to her often. Get up close so she can see how your lips move. Babies are wonderful copycats.

Use “parentese." It’s a way of drawing out your vowels and changing the tone of your voice from high to low, like “hello baaaabeeeee!”

Don’t be afraid to repeat yourself, over and over again. Favorite songs, nursery rhymes, and the words to favorite books give children lots of practice hearing the sounds of the language.

When she babbles, don’t be embarrassed to babble right back. Babies learn early to take turns with you in making sounds. Think of these as conversations!

What a Chatterbox! – Helpful Parenting Tips (Talaris 2008) Remember that young

children recognize & understand many more words than they can say.

Talk to your child often. Point out the cats, balls, & other objects in her life. Talk about what you’re doing throughout the day. Follow her lead and describe the things she points to.

As children learn new words, they may not say them quite right at first. Rather than correcting them, help them by repeating the word after they say it, so that they can hear it again.

Help build a child’s vocabulary by adding details to the objects and events of the day. For example, if she says “ball” you could add, “Yes, that’s right, it’s a ball. It’s a red ball that bounces.” Use a rich vocabulary when you talk about things.

Tired of talking? Try reading. It can be a fun way to be close to your child!

Talking on the Go: Everyday Activities to Enhance Speech and Language Development(Dougherty & Paul 2007) Loaded with everyday

activities to enhance speech and language development in four major areas: building vocabulary listening and speech

production reading and writing readiness participation in conversations

Offers simple and fun suggestions for parents and caregivers to use in a variety of settings. Activities are geared for children from birth through age five.

CD included in the book for easy access in printing handouts for parents and caregivers

Ongoing Debate… What does evidence say on modeling language (van Kleeck et. al in press)

(Susan is/I’m) feeding the baby

(The baby is) drinking milk (from the bottle)

(This is/Here is) my baby

(Mommy) feed(ing) (baby)

(Baby) drink(ing) (milk) (from) (bottle)

This (is) my baby

Dad: Bucket (picks up bucket)

Child: BucketDad: Bury the bucket

(digs hole) Daddy’s going to bury the bucket. (buries in sand) Where’s the bucket?

Child: Where?Dad: Where? Where’s

the bucket?

Telegraphic Input Grammatical Input

Language Modeling (van Kleeck et. al in press)

Bottom Line:

Ongoing support from consultants is vital in helping parents shift their skills based on their child’s needs at the time of intervention.

Child: BallAdult: Say, throw the ball.Child: Throw ball.Adult: Okay, I’ll throw the ball.

Lexically and relationally simple, but grammatically well-formed utterances that are highly redundant in structure and content, characteristic of 2-year old language production

Talk Tools TrainingNuts and bolts of planning

Participant identification Language delayed children currently in Early On

Home visit recruiting identified by Early On Consultant Invitations at initial evaluations for Early On eligibility

Language delayed children, who at the time were not receiving special education services

Flyers sent to Head Start, Great Parents Great Start, Community Play Groups

Advantages Typical language learners – strategies appropriate

for these groups Parents self identified as wanting support for their

child’s language development Disadvantages

Some parents with children whose needs were more complex that the content of this training (e.g., ASD)

36 participants – including student language coaches

Agenda for “Tools for Talking” Seminar2-hour seminar Dinner (not included in 2-hour time frame) Welcome, explanation of grant and community

partners (15 minutes) Introduction of presenters Instructions for completion of necessary paperwork Introduction of parents and student participants, each

individual will introduce self and share their (child’s) favorite book or toy.

View “Parentese” video clip (30 minutes) Group discussion of video Activity of using learned strategies with book (provided

by grant) for each parent/s to take home with them. MSU students to assist with small group facilitation.

View “Parentese” video clip again for further discussion

Break (5 minutes)

Agenda for “Tools for Talking” Seminar2 hour seminar(continued) Transition to application to daily life. (30 minutes)

Discussion of balance between “Parentese” - expressive activities and “Keep Talking” – Receptive activities. Practical strategies on how parents can put this into their daily routines with their children. Opportunities for modeling.

Information on speech sound development for parents with questions on articulation

Language modeling activity with MSU students and parents (20 minutes) Model language using props for daily activities (ideas to include: bath time,

meals, getting in car seat, getting dressed, folding laundry, putting away groceries)

View “Keep Talking” video clip – (30 minutes) Group discussion of video Language expansion activity with props again with MSU students as group

facilitators. Emphasizing level of child to engage in participation. View “Keep Talking” video clip again for further discussion

Conclusion (5 minutes) Final questions? Thank you for attending Completion of course evaluation 

What did parents think?

What did student “language coaches” think”?

Workshop Participant Feedback

“To take sentences (phrases) kids are saying and expand to add one or two words to it.”“That all along I was doing the right thing for my son, and that’s reassuring.”

What is the most important thing you learned from today’s workshop?

“To be more interactive during regular tasks around the house that will make my child feel more involved.”

“Slow down, talk directly to my child, and do not talk over their skill level.”

List one thing you will do as a result of this workshop

What did you like about the workshop? What would you add? “Being able to

communicate with others and connect, share ideas, relate, etc. It’s okay to be a little silly.”

“The students working with the parents was very good.”

“Having the students help reinforce the ideas being presented was beneficial.”

What did you like about the workshop? What would you add?

“The center around our relationships with our children.”

“The assistance from grad and undergrad students. It was helpful for me to practice out loud to others to see if what I am doing is correct.”

Feedback from colleague who attended workshop in response to “What is the most important think you learned from today’s workshop

“Parents want info - great turn out.”

What did students say?

Skills learned Improvising Just talking to parents Confidence boost

Reinforced that this is for all children

Liked the 2 trainings – and the recap, just enough information.

Our thoughts on this workshop

Collaborative effort Reinforcement of

information on home visits, play groups and home visits

Efficiency Home visits Consultation with SLP

Parent support and networking

Increased awareness and skills for students

Language coaches Parent leaders Other EO staff Day care providers

Increased partnerships Universities Other training centers Community agencies

Advantages Future thoughts and ideas

Before you leave….

Take out your postcard from your white envelope of handouts

Write your name and address on the label

Write out a few thoughts on your postcard regarding How you may use this information

in your own setting Identify potential collaborators

References & ResourcesApel, K. & Masterson, J.J. (2001). Beyond baby talk.

Roseville, CA: Prima Publishing.American Speech-Language-Hearing Association. (2008).

Roles and Responsibilities of Speech-Language Pathologists in Early Intervention: Technical Report [Technical Report]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association (2006). Speech, language, and hearing milestones. DVD

Bruder,M.B. & Dunst, C.J. (2005). Personnel preparation in recommended early intervention practices: Degree of emphasis across disciplines. Topics in Early Childhood Special Education, 25(1), 25-33.

Childress, D.C. (2004). Special instruction and natural environments. Infants and Young Children 17(2), 162-170.

Dougherty, D. & Paul, R. (2007). Talking on the go: Everyday activities to enhance speech and language development. American Speech-Language Hearing Association.

References & ResourcesTalaris Institute (2008). Look who’s talking! Babbling babies are

learning how to make sounds! Research Spotlight, Parenting Counts.

Talaris Institute (2008). Talking to baby: The magical sounds of “parentese” make it the preferred language for babies. Research Spotlight, Parenting Counts.

Talaris Institute (2008). What a chatterbox! Learning new words can happen quickly! Research Spotlight, Parenting Counts.

Talaris Research Institute (2005). It’s a wabbit! Rhymes and songs help children learn the sounds of words. Research Spotlight.

Talaris Research Institute (2005). Look who’s talking: Babbling babies are learning how to use their lips, tongues, mouths and jaws to make sounds before they make words. Research Spotlight.

Van Kleeck, A., Schwarz, A.L., Fey, M., Kaiser, A., Miller, J. & Weitzman, E. (in press). Should we use telegraphic or grammatical input with children in the early stages of language development who have language impairment? A meta-analysis of the research and expert opinion. Journal of Speech-Language Pathology.