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Speech, Language, Communication

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The Autistic Spectrum

Due to the many hits this site has received concerning speech and language, and the emails I've received, I'm dedicating a page to the subject. I will be adding to this regularly. If you don't find what you need, please let me know by clicking on on my email addy: christinag@mchsi.com or you can go to my guestbook and click on the link there. If you have links, info, etc. that you think would be of interest to others, please email me and I'll be happy to put your recommendation on the site. :)

QUESTIONS AND ANSWERS ABOUT CHILD LANGUAGE

What is language?

  • Language is a code that we learn to use in order to communicate ideas and express our wants and needs. Reading, writing, speaking, and some gesture systems are all forms of language.

What makes up this language code?

  • Language is made up of a series of rules for:

    • creating words or signs from smaller units like sounds, letters, or body movements
    • modifying the meaning of root words (e.g., girl + -s = girls, walk + -ed = walked, teach + -er = teacher, quick + ly = quickly, dis- + obey = disobey)
    • combining words together (the grammar of the language) attaching meaning to words
    • holding a conversation; telling a story; and using different forms of language for different listeners, purposes, and situations.

What is speech?

  • Speech is the spoken form of language.

How do children learn all these language rules?

  • Children learn language and speech by listening to the language around them and practicing what they hear. In this way, they figure out the rules of the language code. It is not learned all at once but in stages over time.

How can parents help a child learn to talk?

  • Talk to the child. Read to the child. Encourage the child to talk, but don't demand speech. Make talking fun.

How do you know that a child's language and speech are what they should be for a particular age?

  • There are expected language behaviors for different ages. For example, by 1 year of age a child should use one or two words, follow simple requests ("Come here"), and understand simple questions ("Where's your shoe?"). By 2 - 3 years of age, the child should be using two or three word sentences to talk about and ask for things and following two requests ("Get the ball and put it on the table"), Parents should also understand their child's speech most of the time.

  • Children are individuals and do develop at slower or faster rates than expected. What is most important is that the child shows continuous language growth.

When should I seek professional help?

  • When you become concerned. Don't delay. No child is too young to be helped. If there is a problem, early attention is important. If there is no problem, you will be relieved of worry.

Will hearing problems affect speech and language development?

  • Yes. The first years of life are particularly important for learning speech and language. Even mild hearing losses may cause children to miss much of the speech and language around them and result in critical developmental delays. Parents should make sure that their children receive a regular hearing evaluation from an audiologist certified by the American Speech-Language-Hearing Association (ASHA), particularly if there is a history of ear infections, frequent colds or other upper respiratory infections, or allergies.

Are there ever other physical causes of language disability?

  • There are, but most often language disability exists without any known physical cause.

How about other causes?

  • Sometimes children are not exposed to enough language to learn the rules. Sometimes the child has no need to talk because parents respond to pointing and gestures instead of speech. But most language disabilities occur without an identifiable cause.

What can be done about language disabilities?

  • A speech-language pathologist with experience in child development can evaluate the child's language development, design an organized plan of language learning, and carry out the plan in individual or small group sessions. Educated at the master's or doctoral level, certified by ASHA, and licensed in almost all states, this professional will also help you help your child.

Where can I find a speech-language pathologist?

  • Speech-language pathologists provide services in schools, colleges and universities, hospitals, clinics, private practices, and other settings. To find a speech-language pathologist near you, write or call ASHA (American Speech-Language-Hearing Assocation) at:

American Speech-Language-Hearing Association
10801 Rockville Pike
Rockville, MD 20852

  • Toll-free, voice or TTY:
    Professionals/Students: 1-800-498-2071
    Public: 1-800-638-8255
    Available 8:30 a.m. - 5:00 p.m. ET
  • E-mail:
  • Contact the ASHA Action Center for general questions and requests at actioncenter@asha.org 
  • For e-mail addresses broken down by department and topic, see the e-mail directory
  • All e-mail correspondence must include the following:
    1. Your name
    2. Your postal address
    3. Your phone number
    4. Your e-mail address
  • Please be as specific as possible in composing your question. Some queries may take several days to research, and material may not be available in electronic format.



DEFINITION OF SPEECH AND LANGUAGE DISORDERS
 
Speech and language disorders refer to problems in communication and related areas such as oral motor function. These delays and disorders range from simple sound substitutions to the inability to understand or use language or use the oral-motor mechanism for functional speech and feeding. Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical impairments such as cleft lip or palate, and vocal abuse or misuse. Frequently, however, the cause is unknown.
 
INCIDENCE
 
More than one million of the students served in the public schools' special education programs in the 1997-98 school year were categorized as having a speech or language impairment. This estimate does not include children who have speech/language problems secondary to other conditions such as deafness. Language disorders may be related to other disabilities such as mental retardation, autism, or cerebral palsy. It is estimated that communication disorders (including speech, language, and hearing disorders) affect one of every 10 people in the United States.
 
CHARACTERISTICS
 
A child's communication is considered delayed when the child is noticeably behind his or her peers in the acquisition of speech and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.
 
Speech disorders refer to difficulties producing speech sounds or problems with voice quality. They might be characterized by an interruption in the flow or rhythm of speech, such as stuttering, which is called dysfluency. Speech disorders may be problems with the way sounds are formed, called articulation or phonological disorders, or they may be difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with speech disorders have trouble using some speech sounds, which can also be a symptom of a delay. They may say "see" when they mean "ski" or they may have trouble using other sounds like "l" or "r". Listeners may have trouble understanding what someone with a speech disorder is trying to say. People with voice disorders may have trouble with the way their voices sound.
 
A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary and inability to follow directions. One or a combination of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate.
 
EDUCATIONAL IMPLICATIONS
 
Because all communication disorders carry the potential to isolate individuals from their social and educational surroundings, it is essential to find appropriate timely intervention. While many speech and language patterns can be called "baby talk" and are part of a young child's normal development, they can become problems if they are not outgrown as expected. In this way an initial delay in speech and language or an initial speech pattern can become a disorder which can cause difficulties in learning. Because of the way the brain develops, it is easier to learn language and communication skills before the age of 5. When children have muscular disorders, hearing problems or developmental delays, their acquisition of speech, language and related skills is often affected.
 
Speech-language pathologists assist children who have communication disorders in various ways. They provide individual therapy for the child; consult with the child's teacher about the most effective ways to facilitate the child's communication in the class setting; and work closely with the family to develop goals and techniques for effective therapy in class and at home. Technology can help children whose physical conditions make communication difficult. The use of electronic communication systems allow nonspeaking people and people with severe physical disabilities to engage in the give and take of shared thought.
 
Vocabulary and concept growth continues during the years children are in school. Reading and writing are taught and, as students get older, the understanding and use of language becomes more complex. Communication skills are at the heart of the education experience. Speech and/or language therapy may continue throughout a student's school year either in the form of direct therapy or on a consultant basis. The speech-language pathologist may assist vocational teachers and counselors in establishing communication goals related to the work experiences of students and suggest strategies that are effective for the important transition from school to employment and adult life.
 
Communication has many components. All serve to increase the way people learn about the world around them, utilize knowledge and skills, and interact with colleagues, family and friends.
 
RESOURCES
 
Berkowitz, S. (1994). The cleft palate story: A primer for parents of children with cleft lip and palate. Chicago, IL: Quintessence. (Telephone: 1-800-621-0387.)
 
Cleft Palate Foundation. (1997). For parents of newborn babies with cleft lip/cleft palate. Chapel Hill, NC: Author. (Telephone: 1-800-242-5338. Also available online at: www.cleft.com/cpf/cpffrm.html)
 
Eisenson, J. (1997). Is my child's speech normal? (2nd ed.). Austin TX: Pro-Ed. (Telephone: 1-800-897-3202.)
 
Hamaguchi, P. M. (1995). Childhood speech, language, & listening problems: What every parent should know. New York, NY: John Wiley & Sons, Inc. (Telephone: 1-800-225-5945.)
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ORGANIZATIONS
 
Alliance for Technology Access
2175 E. Francisco Boulevard, Suite L
San Rafael, CA 94901
(415) 455-4575; (800) 455-7970
E-Mail: atainfo@ataccess.org
Web: http://www.ataccess.org
 
American Speech-Language-Hearing Association (ASHA)
10801 Rockville Pike
Rockville, MD 20852
301-897-5700 (Voice or TT)
800-638-8255
E-mail: actioncenter@asha.org
Web: http://www.asha.org
 
Cleft Palate Foundation
104 South Estes Drive, Suite 204
Chapel Hill, NC 27514
(919) 933-9044
1-800-242-5338
E-mail: cleftline@aol.com
Web: http://www.cleft.com
 
Division for Children with Communication Disorders
c/o Council for Exceptional Children (CEC)
1920 Association Drive
Reston, VA 22091
703-620-3660
 
Easter Seals--National Office
230 West Monroe Street, Suite 1800
Chicago, IL 60606
312-726-6200
312-726-4258 (TDD)
800-221-6827 (For information about services for children and youth.)
E-mail: info@easter-seals.org
Web: http://www.easter-seals.org
 
Learning Disabilities Association of America (LDA)
4156 Library Road
Pittsburgh, PA 15234
412-341-1515; 412-341-8077; (888) 300-6710
E-Mail: ldanatl@usaor.net
Web: http://www.ldanatl.org
 
Scottish Rite Foundation
Southern Jurisdiction, U.S.A., Inc.
1733 Sixteenth Street, N.W.
Washington, DC 20009-3199
202-232-3579
 
Trace Research and Development Center
University of Wisconsin - Madison
S-151 Waisman Center
1500 Highland Avenue
Madison, WI 53705-2280
608-262-6966; 608-263-5408 (TTY)
E-mail: info@trace.wisc.edu
Web: http://trace.wisc.edu/
 
Source: National Information Center for Children and Youth with Disabilities 

Language-Based Learning Disabilities

Language-based learning disabilities interfere with age-appropriate reading, spelling, and/or writing. This disorder does not impair intelligence; in fact, most people diagnosed with learning disabilities possess average to superior intelligence. Learning disabilities are caused by a difference in brain structure that is present at birth, is often hereditary, and often related to specific language problems.

The term dyslexia has been used to refer to the specific learning problem of reading. Because of the increased recognition of the relationship between spoken and written language, and the frequent presence of spoken language problems in children with reading problems, the term language-based learning disabilities, or just learning disabilities, is more accurate.

Who Is At Risk

Children at risk for dyslexia and other learning disabilities may have several of the following characteristics:

  • A family history of delayed speech-language development or literacy problems
  • Difficulty processing sounds in words
  • Difficulty finding the words needed to express basic thoughts/ideas and more complex explanations/descriptions
  • Difficulty with the comprehension of spoken and/or written language, including, for older children, classroom handouts and textbooks
  • Delayed vocabulary development
  • Problems with the understanding and use of grammar in sentences
  • Difficulty remembering numbers and letters in sequence, questions, and directions
  • Difficulty with organization and planning, including, for older students, the drafting of school papers and longer-term school projects.

Other Language Problems

The child with dyslexia has trouble almost exclusively with the written (or printed) word. The child who has dyslexia as part of a larger language learning disability has trouble with both the spoken and the written word. These problems may include:

  • Expressing ideas coherently, as if the words needed are on the tip of the tongue but won't come out Consequently, utterances can be vague and difficult to understand (e.g., using unspecific vocabulary, such as "thing" or "stuff" to replace words that cannot be remembered). Filler words like "um" may be used to take up time while a word is being retrieved from memory
  • Learning new vocabulary that the child hears (e.g., taught in lectures/lessons) and/or sees (e.g., in books)
  • Understanding questions and following directions that are heard and/or read
  • Recalling numbers in sequence, e.g., telephone numbers and addresses
  • Understanding and retaining the details of a story's plot or a classroom lecture
  • Slow reading and reduced comprehension of the material
  • Learning words to songs and rhymes
  • Telling left from right, making it hard to read and write since both skills require this directionality
  • Letters and numbers
  • Learning the alphabet
  • Identifying the sounds that correspond to letters, making learning to read a formidable task
  • While writing, mixing up the order of letters in words
  • Mixing up the order of numbers that are a part of math calculations
  • Poor spelling
  • Memorizing the times tables
  • Telling time

    Other Possible Problem Areas

    • Inattention and distractibility [Irrelevant thoughts, ambient noise, and/or excessive visual stimulation "get in the way" of paying attention to incoming information]
    • Organizational skills [These children lose track of possessions, and have trouble completing tasks efficiently and thoroughly. Planning and organizing for writing letters and papers is also affected, resulting in a lack a focus or an unorganized sequence of ideas/thoughts]
    • Motor coordination [Some children are delayed in learning how to tie their shoes or may appear clumsy on the playground.]

Speech-Language Pathologist

As part of a collaborative team consisting of the parents and educational professionals (i.e., teacher(s), special educators, psychologist), the speech-language pathologist has several responsibilities.

He or she:

  • informs teachers and other school professionals as to how to identify children who are at risk for developing problems before they experience failure in the classroom.
  • works with professionals to help prevent problems before they occur by promoting opportunities for success with spoken and written language at home and school.
  • performs assessments of spoken (speaking and listening) and written (reading and writing) language for children who have been identified by their teachers and parents as having difficulty
  • provides treatment for those children who have language problems contributing to difficulties with reading and writing

Prevention

The speech-language pathologist consults with both educators and parents to teach and model language activities that promote success. He or she may:

  • explain the importance of joint book reading and provides demonstration lessons. For example, The speech-language pathologist may illustrate how to improve students vocabulary skills by having children name items in story pictures and describe the action(s) in these pictures.
  • model how to sharpen comprehension skills by asking questions related to a story plot and having the child predict what may happen next in the story.
  • have the child retell a story in their own words or act out the story.
  • teach how to increase the child's awareness of print in their environment (e.g., recognition of frequently encountered signs and logos) and the conventions of print (e.g., how to hold a book or that reading and writing are done from left to right)
  • demonstrate strategies to teach letters and their corresponding sounds
  • show ways that teachers and parents can model literacy activities (e.g., by reading newspapers and magazines, by writing notes and letters, by making writing materials available for everybody' s use).

Speech and Language Assessment

  • The clinician begins by interviewing the parents and teacher(s) regarding academic concerns and the child's performance in the classroom.

For preschool students, the speech-language pathologist gathers information about literacy experiences in the home. For example, are there books and other types of reading material around the home? How frequently does the child see family members writing letters, notes, lists, etc.? How often do family members read stories to the child?

  • The speech-language pathologist observes the child during classroom activities. He or she evaluates the child's ability to understand verbal and written directions and to attend to written information on the blackboard, daily plans, etc.

When evaluating a preschool child, the speech-language pathologist looks for awareness of print. Can the child recognize familiar signs and logos, hold a book correctly and turn the pages, recognize and/or write his or her name, demonstrate pretend writing (writing that resembles letters and numbers), and recognize and/or write letters. For the older child, the clinician observes whether he or she can read and understand information on handouts and in textbooks.

  • The speech-language pathologist assesses the student's phonological awareness skills (ability to hear and "play with" the sounds in words.

When evaluating a preschool student, the speech-language pathologist may have the child tap or clap out the different syllables in words. He or she may have the child state whether or not two words rhyme or give a list of words that rhyme with a specified word.

When evaluating an older student, the speech-language pathologist may have him or her put together syllables and sounds to make a word. He or she may have the child break up a word into its syllables and/or sounds (e.g., "cat" has one syllable but three sounds c-a-t). The speech-language pathologist assesses the older child's phonological memory by having him or her repeat strings of words, numbers, letters, and sounds of increasing length.

  • Spelling, writing, and reading are assessed with older students. In some settings, the speech-language pathologist completes these assessments as part of a team while in other settings he or she helps the educational team interpret the results of reading and writing assessments completed by other evaluators. The reading evaluation focuses on the student's ability to decode (sound out) words, read irregular spelling patterns, read fluently, comprehend texts that differ in length and complexity, and comprehend different types of material (e.g., stories versus non-fiction texts).

The writing evaluation focuses on the student's ability to spell and write longer texts. Does spelling show that the child understands the sounds that different letters make? Does he or she correctly use irregular spelling patterns? Do writing samples show evidence of planning? Are they organized, sequential, and coherent? Are correct grammar and vocabulary used?

  • The speech-language pathologist completes a formal evaluation of speech and language skills . Speech articulation (pronunciation and clarity of speech) is assessed. Understanding and use of grammar ( syntax ), understanding and use of vocabulary ( semantics ), and the client's ability to provide an extended narrative ( language sample ) are evaluated. Can the child explain something or retell a story, centering on a topic and chaining a sequence of events together? Does the narrative make sense or is it difficult to follow? Can the child describe the "plot" in an action picture?
  • Executive functioning is evaluated. The speech-language pathologist assesses the child's ability to plan, organize, and attend to details (e.g., does he or she plan/organize his or her writing? is he or she able to keep track of assignments and school materials). The speech-language pathologist may read an incomplete story and ask the child to provide a logical beginning, middle, or conclusion. The child is also asked to provide solutions to problems ( reasoning and problem solving ). For example, what would you do if you locked your keys in your car? How can this problem be avoided in the future?).

Treatment

The goals of speech and language treatment for the child with a reading problem target the specific aspects of reading and writing that the student is missing. For example, if the student is able to decode text but is unable to understand the details of what has been read, comprehension is addressed. If a younger student has difficulty distinguishing the different sounds that make up words, treatment will focus on activities that support growth in this skill area (rhyming, tapping out syllables, etc.).

Individualized programs always relate to the curriculum. Therefore, materials for treatment are taken from or are directly related to curricular content (e.g., textbooks for reading activities, assigned papers for writing activities, practice of oral reports for English class). The student is taught to apply newly learned language strategies to classroom activities and assignments. To assist the child best, the speech-language pathologist may work side-by-side with the child in his or her classroom(s).

Intervention with spoken language (speaking and listening) can also be designed to support the development of written language . For example, after listening to a story, the student may be asked to state and write answers to questions. He or she may be asked to give a verbal and then a written summary of the story.

Articulation (pronunciation) needs are also treated in a way that supports written language. For example, if the child is practicing saying words to improve pronunciation of a certain sound, he or she may be asked to read these words from a printed list.

The speech-language pathologist consults and collaborates with teachers to develop the use of strategies and techniques in the classroom . For example, he or she may help the teacher modify how new material is presented in lessons to accommodate the child's comprehension needs. He or she may also demonstrate what planning strategies the student uses to organize and focus written assignments.

Learning problems should be addressed as early as possible. Many children with learning disabilities that are treated later, when language demands are greater, experience lowered self-esteem due to their previous academic frustrations and failures. Learning problems that go untreated can lead to a significant decrease in confidence, school phobia (e.g., not wanting to go to school, not wanting to do homework), and depression.

For a speech-language pathologist near you, use  Find a Professional .

Links

Characteristics of Adolescent Language Disorder
 
Introduction
 
Brian is a 14-year-old who is repeating the seventh grade. Art is his favorite and best subject. In other subjects, he struggles to maintain a C average. His teachers comment about his lack of organization, his difficulty following directions, and his 'class clown' behavior. He never seems to quite fit in with the crowd. His level of frustration is rising along with his truancy rate. Many things may be contributing to Brian's difficulties, including a possible language disorder.
 
Language Skills
 
The ability to read and write is strongly influenced by the ability to understand and use language. Students who are good listeners and speakers tend to become strong readers and writers. Language has a major role in all subjects including reading, math, history, geography, and even art. The early school years emphasize language development, sociaI-emotional growth and readiness skills. The middle grades emphasize specific subjects. Mastery of language is assumed. Emphasis is placed on written skills. The later grades involve more complex use of language by students, including an increased vocabulary, more advanced sentence structure, and different kinds of language for different situations.
 
The importance of early identification and remediation of language delays or disorders in young children is well known. Less commonly known is the importance of identifying and remediating language disorders in the adolescent. Such disorders may lead to feelings of failure, low self-esteem, poor academic and social success, and a high drop out rate.

Language Disorders
 
Language disorder refers to any impairment in
  • form including phonology, morphology, and syntax, for example, misuse or misunderstanding of the information provided by word endings: "The boy eat his dinner."
  • semantics (meaning), for example, difficulty understanding idioms: "It's raining cats and dogs."
  • pragmatics (function), for example, using language for different purposes (promising, requesting), changing language for listener needs (peer vs.teacher), or following the rules of conversation (turn taking, introducing topics of conversation, and staying on the topic).

Adolescents With Language Disorder

Adolescents identified with language disorders include:
  • those initially identified through early intervention programs. Although they have received treatment and treatment may have reduced the severity of the problem, some language difficulties persist;
  • those who received no intervention;
  • those who had normal language development but experienced a disruption because of some physical, emotional, or traumatic event; and
  • those who have been identified as having a learning disability.
Evaluation
 
A student's understanding and use of language, hearing, thinking abilities, emotional and social skills, desire to interact and communicate with others, central and peripheral nervous system functioning, and type of language models are assessed in order to identify exactly any kind of language disorder that exists and to rule out other causes of the behaviors. The speech-language pathologist works closely with other professionals, such as the school psychologist, to make these decisions.

Intervention techniques may focus on working to improve pragmatic skills and thinking skills. The student will be taught strategies for learning new information and skills.
 
What Can You Do?
 
If you recognize the characteristic behaviors of language disorders in an adolescent or if you have concerns, consult a speech- language pathologist. If you need a referral, call the toll-free HELPLINE (1-800-638-8255) or write to:

Consumer Affairs Division,
American Speech-Language-Hearing Association,
10801 Rockville Pike,
Rockville, MD 20852.

Characteristics of Adolescent Language Disorder
  1. failure to understand or pay attention to rules of conversation, for example, turn taking, introducing topics of conversation, and staying on the topic
  2. difficulty using different language for different needs of the listener or situation
    incorrect use of grammar
  3. poor or limited vocabulary
  4. difficulty requesting further information to aid understanding
  5. tendency to ask questions that are too general ("Are you going out tonight?" when what is really meant is "Where are you going tonight?"')
  6. tendency to agree rather than to voice opposition
  7. indirect requests and ambiguous statements
  8. class clown behavior
  9. extreme forgetfulness
  10. withdrawal or exclusion from group activities
  11. difficulty with
  12. understanding non-verbal behaviors, such as body language
    1. finding words
    2. puns, idioms, riddles, jokes, sarcasm and slang
    3. instructions, especially those that are long or grammatically complex
    4. words with multiple meanings (bear versus bare)
    5. sequencing
    6. expressing thoughts
    7. organizing information. 

Source: American Speech- Language- Hearing Association

 

Speech & Language Milestone Chart

. By Age One

Milestones

  • Recognizes name
  • Says 2-3 words besides "mama" and "dada"
  • Imitates familiar words
  • Understands simple instructions
  • Recognizes words as symbols for objects: Car - points to garage, cat - meows

Activities to Encourage your Child's Language

  • Respond to your child's coos, gurgles, and babbling
  • Talk to your child as you care for him or her throughout the day
  • Read colorful books to your child every day
  • Tell nursery rhymes and sing songs
  • Teach your child the names of everyday items and familiar people
  • Take your child with you to new places and situations
  • Play simple games with your child such as "peek-a-boo" and "pat-a-cake"

. Between One and Two

Milestones

  • Understands "no"
  • Uses 10 to 20 words, including names
  • Combines two words such as "daddy bye-bye"
  • Waves good-bye and plays pat-a-cake
  • Makes the "sounds" of familiar animals
  • Gives a toy when asked
  • Uses words such as "more" to make wants known
  • Points to his or her toes, eyes, and nose
  • Brings object from another room when asked

Activities to Encourage your Child's Language

  • Reward and encourage early efforts at saying new words
  • Talk to your baby about everything you're doing while you're with him
  • Talk simply, clearly, and slowly to your child
  • Talk about new situations before you go, while you're there, and again when you are home
  • Look at your child when he or she talks to you
  • Describe what your child is doing, feeling, hearing
  • Let your child listen to children's records and tapes
  • Praise your child's efforts to communicate

. Between Two and Three

Milestones

  • Identifies body parts
  • Carries on 'conversation' with self and dolls
  • Asks "what's that?" And "where's my?"
  • Uses 2-word negative phrases such as "no want".
  • Forms some plurals by adding "s"; book, books
  • Has a 450 word vocabulary
  • Gives first name, holds up fingers to tell age
  • Combines nouns and verbs "mommy go"
  • Understands simple time concepts: "last night", "tomorrow"
  • Refers to self as "me" rather than by name
  • Tries to get adult attention: "watch me"
  • Likes to hear same story repeated
  • May say "no" when means "yes"
  • Talks to other children as well as adults
  • Solves problems by talking instead of hitting or crying
  • Answers "where" questions
  • Names common pictures and things
  • Uses short sentences like "me want more" or "me want cookie"
  • Matches 3-4 colors, knows big and little

Activities to Encourage your Child's Language

  • Repeat new words over and over
  • Help your child listen and follow instructions by playing games: "pick up theball, " "Touch Daddy's s nose"
  • Take your child on trips and talk about what you see before, during and after the trip
  • Let your child tell you answers to simple questions
  • Read books every day, perhaps as part of the bedtime routine
  • Listen attentively as your child talks to you
  • Describe what you are doing, planning, thinking
  • Have the child deliver simple messages for you (Mommy needs you, Daddy )
  • Carry on conversations with the child, preferably when the two of you have some quiet time together
  • Ask questions to get your child to think and talk
  • Show the child you understand what he or she says by answering, smiling, and nodding your head
  • Expand what the; child says. If he or she says, "more juice", You say, "Adam wants more juice."

. Between Three and Four

Milestones

  • Can tell a story
  • Has a sentence length of 4-5 words
  • Has a vocabulary of nearly 1000 words
  • Names at least one color
  • Understands "yesterday," "summer", "lunchtime", "tonight", "little-big"
  • Begins to obey requests like "put the block under the chair"
  • Knows his or her last name, name of street on which he/she lives and several nursery rhymes

Activities to Encourage your Child's Language

  • Talk about how objects are the same or different
  • Help your child to tell stories using books and pictures
  • Let your child play with other children
  • Read longer stories to your child
  • Pay attention to your child when he's talking
  • Talk about places you've been or will be going

. Between Four and Five

Milestones

  • Has sentence length of 4-5 words
  • Uses past tense correctly
  • Has a vocabulary of nearly 1500 words
  • Points to colors red, blue, yellow and green
  • Identifies triangles, circles and squares
  • Understands "In the morning" , "next", "noontime"
  • Can speak of imaginary conditions such as "I hope"
  • Asks many questions, asks "who?" And "why?"

Activities to Encourage your Child's Language

  • Help your child sort objects and things (ex. things you eat, animals. . )
  • Teach your child how to use the telephone
  • Let your child help you plan activities such as what you will make for Thanksgiving dinner
  • Continue talking with him about his interests
  • Read longer stories to him
  • Let her tell and make up stories for you
  • Show your pleasure when she comes to talk with you

. Between Five and Six

Milestones

  • Has a sentence length of 5-6 words
  • Has a vocabulary of around 2000 words
  • Defines objects by their use (you eat with a fork) and can tell what objects are made of
  • Knows spatial relations like "on top", "behind", "far" and "near"
  • Knows her address
  • Identifies a penny, nickel and dime
  • Knows common opposites like "big/little"
  • Understands "same" and "different"
  • Counts ten objects
  • Asks questions for information
  • Distinguished left and right hand in herself
  • Uses all types of sentences, for example "let's go to the store after we eat"

Activities to Encourage your Child's Language

  • Praise your child when she talks about her feelings, thoughts, hopes and fears
  • Comment on what you did or how you think your child feels
  • Sing songs, rhymes with your child
  • Continue to read longer stories
  • Talk with him as you would an adult
  • Look at family photos and talk to him about your family history
  • Listen to her when she talks to you

Source: LEARNING DISABILITIES ASSOCIATION OF AMERICA

 

A Parent's Guide to Accessing Programs for Infants, Toddlers, and Preschoolers with Disabilities

Definition of Learning Disabilities

The regulations for Public Law (P.L.) 101-476, the Individuals with Disabilities Education Act (IDEA), formerly P.L. 94-142, the Education of the Handicapped Act (EHA), define a learning disability as a "disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations."
 
The Federal definition further states that learning disabilities include "such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia." According to the law, learning disabilities do not include learning problems that are primarily the result of visual, hearing, or motor disabilities; mental retardation; or environmental,cultural, or economic disadvantage. Definitions of learning disabilities also vary among states.
 
Having a single term to describe this category of children with disabilities reduces some of the confusion, but there are many conflicting theories about what causes learning disabilities and how many there are. The label "learning disabilities" is all-embracing; it describes a syndrome, not a specific child with specific problems. The definition assists in classifying children, not teaching them. Parents and teachers need to concentrate on the individual child. They need to observe both how and how well the child performs, to assess strengths and weaknesses, and develop ways to help each child learn. It is important to remember that there is a high degree of interrelationship and overlapping among the areas of learning. Therefore,children with learning disabilities may exhibit a combination of characteristics.
 
These problems may mildly, moderately, or severely impair the learning process.
 
Incidence

Many different estimates of the number of children with learning disabilities have appeared in the literature (ranging from 1% to 30% of the general population). In 1987, the Interagency Committee on Learning Disabilities concluded that 5% to 10% is a reasonable estimate of the percentage of persons affected by learning disabilities. The U.S. Department of Education (1994) reported that more than 4% of all school aged children received special education services for learning disabilities and that in the 1992-93 school year over 2 million children with learning disabilities were served. Differences in estimates perhaps reflect variations in the definition.
 
Characteristics

Learning disabilities are characterized by a significant difference in the child's achievement in some areas, as compared to his or her overall intelligence.
 
Students who have learning disabilities may exhibit a wide range of traits, including problems with reading comprehension, spoken language, writing, or reasoning ability. Hyperactivity, inattention, and perceptual coordination problems may also be associated with learning disabilities. Other traits that may be present include a variety of symptoms, such as uneven and unpredictable test performance, perceptual impairments, motor disorders, and behaviors such as impulsiveness, low tolerance for frustration, and problems in handling day-to-day social interactions and situations.
 
Learning disabilities may occur in the following academic areas:
  • Spoken language: Delays, disorders, or discrepancies in listening and speaking
  • Written language: Difficulties with reading, writing, and spelling
  • Arithmetic: Difficulty in performing arithmetic functions or in comprehending basic concepts
  • Reasoning: Difficulty in organizing and integrating thoughts
  • Organization skills: Difficulty in organizing all facets of learning
Educational Implications

Because learning disabilities are manifested in a variety of behavior patterns, the Individual Education Program (IEP) must be designed carefully. A team approach is important for educating the child with a learning disability, beginning with the assessment process and continuing through the development of the IEP. Close collaboration among special class teachers, parents, resource room teachers, regular class teachers, and others will facilitate the overall development of a child with learning disabilities.
 
Some teachers report that the following strategies have been effective with some students who have learning disabilities:
  • Capitalize on the student's strengths
  • Provide high structure and clear expectations
  • Use short sentences and a simple vocabulary
  • Provide opportunities for success in a supportive atmosphere to help build self-esteem
  • Allow flexibility in classroom procedures (e.g., allowing the use of tape recorders for note-taking and test-taking when students have trouble with written language)
  • Make use of self-correcting materials, which provide immediate feedback without embarrassment
  • Use computers for drill and practice and teaching word processing
  • Provide positive reinforcement of appropriate social skills at school and home
  • Recognize that students with learning disabilities can greatly benefit from the gift of time to grow and mature
Resources

Cronin, E.M. (1994). Helping your dyslexic child: A step-by-step program for helping your child improve reading, writing, spelling, comprehension, and self-esteem. Rocklin, CA: Prima. (Telephone: (916) 786-0426.)
 
Journal of Learning Disabilities. (Available from Pro-Ed, 8700 Shoal Creek Boulevard, Austin, TX 78758. Telephone: (512) 451-3246.)
 
Kratoville, B.L. (Ed.). (1996). Directory of facilities and services for the learning disabled (16th ed.). Novato, CA: Academic Therapy Publications. [Telephone: 1-800-422-7249 (outside CA); (415) 883-3314).]
 
Lab School of Washington. (1993). Issues of parenting children with learning disabilities (audiotape series of 12 lectures). Washington, DC: Author. [Telephone: (202) 965-6600.]
 
Silver, L. (1991). The misunderstood child: A guide for parents of children with learning disabilities (2nd ed.). New York, NY: McGraw Hill. (Available from McGraw Hill Retail, 860 Taylor Station Road, Blacklick, OH 43004. Telephone: 1-800-262-4729.)
 
Smith, S. (1995). No easy answers (Rev. ed.). New York, NY: Bantam Books. (Available from Bantam, 2451 South Wolf Rd., Des Plaines, IL 60018. Telephone: 1-800-323-9872.)
 
Organizations

Council for Learning Disabilities (CLD)
P.O. Box 40303
Overland Park, KS 66204
(913) 492-8755
 
Division of Learning Disabilities
Council for Exceptional Children
1920 Association Dr.
Reston, VA 22091-1589
(703) 620-3660
Web address: http://www.cec.sped.org
 
Learning Disabilities Assn. of America (LDA)
4156 Library Road
Pittsburgh, PA 15234
(412) 341-1515; (412) 341-8077
E-mail: ldanatl@usaor.net
Web address: http://www.ldanatl.org
 

National Center for Learning Disabilities
381 Park Avenue South, Suite 1401
New York, NY 10016
(212) 545-7510
(800) 575-7373
Web address: http://www.ncld.org

Orton Dyslexia Society
Chester Building, Suite 382
8600 LaSalle Road
Baltimore, MD 21286-2044
(410) 296-0232
(800) 222-3123 (Toll Free)
E-mail: info@ods.org
Web address: http://www.ods.org
 

Source:National Information Center for Children and Youth with Disabilities

LINKS TO PUBLISHERS OF SPEECH/LANGUAGE MATERIALS 
In addition to materials, you may find forums, newsletters, and lesson ideas!!

Academic Communication Associates

American Guidance Service
Shop their online catalog, find out about workshops and conferences, and read their informative newletters.

Augmentative Resources
Resources to enhance communication and language skills.

Cognitive Concepts, Inc
The makers of the popular Earobics educational software program for teaching the auditory and phonological awareness skills critical for reading and language development.

Communication Skill Builders

DataMorphosis
WordWeaver Report Writing Software

Edmark
Check out their educational software including the Speech Viewer III which creates entertaining, interactive displays of speech, as clients focus on a single speech dimension such as pitch, or on complex speech patterns in running speech. So, clients can actually "see" what they say.

Great Ideas for Teaching, Inc
Request one of their catalogs online. They look great! Delightfully illustrated materials.

Gus Communications, Inc
Speech output and computer access software

The Hanen Centre
Resources for language development, birth through 6 years

Kay Elemetrics Corp. 

Learning Fundamentals

 Lindamood-Bell Homepage

Linguisystems
Excellent tests and companion remedial programs.

Phonics Game

Playful Puppets
These puppets are just too cute! They even have articulable tongues and teeth!
Pro-Ed 

Remedia Publications 

Sonida, Inc - Software for Speech, Language, and Auditory Processing Therapy

Speech and Language Video Company
Videos for home practice 

Speech Bin

Speech Dynamics, Inc.

Super Duper Publications

TheraDat
Data collection tablets for articulation.

Thinking Publications

Students with Autism Spectrum Disorders and lots of other students with behavior or communication challenges tend to be visual learners. They understand what they see better than what they hear. Therefore, they benefit significantly from the use of Visual Strategies. Visual Strategies ~ Deciding when and how to use pictures and other visual supports is the key...Learn lots of great ideas here...

The Core Features of Autism: Communication
 
Communication problems are present in all children with autism. It is one of the core symptoms that must be present if a child is given the diagnosis of autism.
 
The DSM – IV criteria for communication impairment in autism are:

 
Qualitative impairments in communication as manifested by at least one of the following:
 
a) Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime);
b) In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others;
c) Stereotyped and repetitive use of language or idiosyncratic language;
d) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.(American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000)
 
Communication problems in children with autism present in a number of different ways with different outcomes according to the problem type and severity. Some children have severe communication problems and do not speak at all. Other children have very delayed and unusual speech that makes it difficult for them to make themselves understood. A smaller group of
children have superficially better speech but they still have problems knowing how to use language to communicate well with other people.
 
Recently, more attention has been paid to the effects of communication problems on children’s behaviour. It is important that parents and professionals understand the type and severity of the communication problems a child has, in order to work out more effective ways of communicating together and also finding possible explanations of behavioural problems that may be linked with communication problems.
 
Verbal Children
 
Some young children with autism will acquire functional speech. Typically, they will begin to speak later than is normal and will acquire speech more slowly and unevenly. A distinction is made between the ability to speak and ‘functional speech’ because some children use words but the words are not used to communicate effectively and therefore are not seen as being
functional.
 
Expressive language problems

(i) Development of speech may occur very slowly and some previously learned words may disappear once learned.
(ii) Speech may come in chunks or complete sentences may be spoken out of the blue.
(iii) Echolalia, the repeating of words and phrases, may be present in a number of forms. For example, the child may immediately repeat what you have just said to him/her. Echolalia may also be delayed, with the child repeating a word or phrase heard previously. Echolalia may also be mitigated, with the child using some repeated words but adding some of his/her own to get his/her message across.
(iv) The same word or sound may be repeated over and over.
(v) A word may be used out of context or a made up word used for a particular object.
(vi) Pronouns are often reversed and confused.
(vii) Tone, pitch and modulation may be unusual. The child’s voice may sound flat, may have an unusual accent or may be too loud or too soft.
Receptive language or comprehension problems
(i) Difficulty understanding the meaning of what others say.
(ii) Difficulty understanding a sequence of instructions.
(iii) Lack of understanding of metaphor, e.g. “shake a leg”.
(iv) Literal use of language and interpretation of what others say, e.g. “pull your socks up”.
 
There is also a range of difficulties that verbal children have with conversation. Children with autism usually have difficulty attending to other people. Conversation relies on two people listening to each other and taking turns to speak. For children with autism, this is a particular problem. Although they may have a lot of useful speech, they do not speak conversationally. The child with autism is more likely to talk at you rather than with you. Initiating and sustaining a conversation are also areas of difficulty. Some verbal children may have special topics they
want to talk about to the exclusion of all else, or may bombard you with questions that no answer you give seems to satisfy.
 
Non-verbal Children
 
Some children with autism do not acquire functional speech. It is still not clear why this is so. Some argue that it is because children with autism have such strong underlying social deficits and problems with joint attention. Others argue that it is because in autism there is a basic lack of understanding that people have thoughts and feelings that can be related to in the first place. Whatever the cause, children who are non-verbal must be able to convey their needs and desires to others in some way other than speech. It is important to assess how the non-verbal child expresses his/her needs and gets his/her message across to others.
 
Improving Non-verbal Communication using Augmentative systems.
 
Follow up studies have shown that for most children with autism who do not have useful speech by about the age of 7 years, it is likely that their ability to communicate verbally will remain severely impaired. It is important for these children to have some form of augmentative communication system.
Augmentative communication helps children who don’t have speech to communicate by using other systems. These systems are called “augmentative” because they augment or increase the strength of the child’s power to communicate. Simple pictures and line drawings such as CompicŪ or PCS/BoardmakerŪ, signing systems such as Makaton and also photographs are often used to augment communication for children with autism.
 
1. Signing
 
Signing was probably the first alternate system used with non-verbal children with autism. At first, the signing systems used by the deaf were taught, but these are complex systems that require finger spelling of words and use abstract concepts. In the early 1980’s, a simpler system called Makaton was devised to use with children with intellectual disability. This system has
varying degrees of difficulty, but at its earliest level, signs are simple, concrete and do not require difficult finger spelling. Many of the first signs use only one hand. For example, the sign for ‘drink’ uses one hand in the shape of a cup that is lifted to the mouth and tilted as if the child were having a drink. One advantage of signs is that they are very portable and do not require the child to carry around equipment. Another advantage of establishing a signing system is that it has been found to encourage speech in children contrasting to what some parents fear, that signing might reduce the chance of their child talking. However, signing is not widely understood in the community and the child may not always be well understood outside the circle of those who can sign with him/her. Signing also requires that the child attends to the person teaching the signs and is able to imitate an action.
 
2. Pictographs (line drawings)
 
There are a range of computer generated pictographs that are available and in use in Victoria, including CompicŪ and PCS/BoardmakerŪ. These pictures consist of simple and clear line drawings that represent a wide range of objects, actions and feelings. They can be used initially at a very simple, but practical level with young children who learn to point at the picture or show the picture to indicate their needs. When children are familiar with a number of these pictures, they can be put into a wallet/book of pictures that the child carries with him/her and uses to indicate his/her needs. The child gradually builds up a vocabulary of pictures to meet his/her own special needs.
Pictographs are widely available in both computer software and loose-leaf book formats. Pictographs are easily understood by everyone and do not require the child to learn and remember complex actions, as does signing. Children who have low cognitive skills can generally use a picture system in a simple way to communicate more effectively.
 
3. Photographs and Objects
 
Photographs of objects, activities and people in the child’s world can also be used effectively with low functioning children who cannot master the use of symbols or line drawings. Use of photographs usually requires that the child first learns to match an actual object with an exact photograph of the object. The child learns that the photograph represents the object. The
photograph must be simple, clear and uncluttered. After the child has learnt to match photographs and objects, the more complex concept of matching photograph and activity or action can be taught. 
Once the child is able to recognise a number of photographs, a photo vocabulary can be built up in the same way as a pictograph vocabulary. Photographs can be used to help the child understand timetables or the steps involved in completing an activity. For example, the playroom may have photographs of the day’s activities pinned to the wall. When each activity finishes, the child may put away that photograph. Similarly, when the child is required to get dressed, the steps involved may be pinned to his/her bedroom door in the correct sequence and easily followed.
 
Objects can be used in a similar way to photographs with children who have difficulty understanding photographs. Object time-tables are useful. Objects that represent activities can be laid out or stuck on the wall to show the child what happens next. For example, a crayon means work at the table, and the next object is a juice box straw to indicate that snack time comes after work.
 
A great advantage of photographs and objects is that the child can attend to them for as long as he/she needs to, and also return to them to refresh his/her memory. This is not possible with a hand sign which is gone once it has been demonstrated.
 
4. Picture Exchange Communication System (PECS)
 
The Picture Exchange Communication System (PECS) (Frost and Bondy, 1994) is another augmentative communication system. Developed in the early 1990s, PECS is widely used in early intervention and school programmes to teach children how to initiate communication. An advantage of this system is that it does not require complex or expensive materials and can be used in a variety of settings by parents, carers and teachers. PECS begins with teaching a student to exchange a picture of a desired item with a teacher who immediately honors the request. Verbal prompts are not used. Once this step is mastered, the system goes on to teach discrimination of symbols and later simple 'sentences' are made from stringing together these symbols. Children can also learn to comment and answer direct questions using the Compic system symbols.
 
Each child must be carefully assessed to determine which system will suit best. The majority of children with autism have delayed imitation skills but better developed visual recognition skills. Therefore a picture based system may be more suitable than a signing system. Ultimately, the choice of system to help improve the child’s communication will depend upon his/her level of cognitive and language ability and developmental profile of strengths and weaknesses.
 

 
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Autism: Communication and Behavior Links

By Linda Fielding


At this time it is believed that autism is a developmental disability with multiple causes (Batshaw & Perret, 1992). As there are no specific assessments for autism, the diagnosis of this disorder is usually based on characteristics which are exhibited by the individual (in relation to their developmental level). The most common characteristics displayed by individuals with autism may include any or all of the following: a lack of social-communicative skills, engagement in repetitive behaviors, the demand for sameness, abnormal preoccupation with specific objects, self injurious and/or aggressive behaviors, and language delays. While an individual may exhibit a combination of these characteristics, a number of authors support the idea that core underlying problems with communication are the primary disability of individuals with autism and other behavioral problems are secondary symptoms (Koegel & Koegel, 1995).

Both the expressive and receptive communication impairments exhibited by individuals with autism can be severe. About half of this population never gain useful speech (Schopler, 1978), and those children who do develop speech tend not to use their language in a communicative way (Donnellan, 1985). This inability to effectively use communication can lead to challenging behaviors. Recent literature substantiates the premise that a relationship exists between communicative intent and the function of the behavior. The function of a challenging behavior can usually be determined to be related to one or more of four specific communicative purposes: 1) to obtain attention; 2) to escape or avoid a request, activity, or person; 3) to procure an object (or tangible); and/or 4) to receive sensory feedback (Durand, 1990).

Programming practices for students with autism have also begun to reflect this linkage. Less emphasis is being placed on developing strategies to "manage" behavior while more attention is focusing on interpreting the purpose of the behavior and providing students with additional opportunities to enhance their communicative abilities. It is important to consider that no matter what the age of the individual with autism, teachers can actively plan programs (and offer parents suggestions) which will encourage communication, and perhaps, decrease the occurrence of inappropriate behaviors.

Koegel and Koegel (1995) have suggested four strategies that can be implemented throughout the school day to assist with the development of communication in individuals with autism. The remainder of this article profiles these strategies and provides illustrations of each.

1. Increase awareness of and respond to all communication attempts. In order to accomplish this, teachers must begin to interpret all student actions (and behaviors) as having communicative intent. For example, Sam (a student in your classroom) is sitting on the floor. You ask Sam to go get his coat so the class can go outside. Sam grabs his knees and begins to rock. As opposed to labeling Sam as "noncompliant", perhaps we need to consider that Sam may be telling us that he does not want to go outside today.

2. Teach students with autism that their actions have distinct consequences associated with them. No second guessing the individual! He or she must learn that communication can be used to influence the environment. Kate is moving through the lunch line in the school cafeteria. The vegetable choices for the day are green beans (which she hates) or french fries (her favorite food!). Kate selects the green beans. Instead of being prompted to again choose which vegetable she wants, Kate should be given the green beans. If she screams or pushes them away she has communicated that she does not want them and should then be given an opportunity to choose another item.

3. Provide positive supports and learning opportunities. Identify and arrange communication opportunities in natural contexts throughout the school day. Sabotage the environment! Create circumstances which stimulate communication. For example, hide Sarah's favorite drum in the closet, "forget" to pour Justin's juice at snack time, "lose" Tommy's knapsack before it's time to go home, or give Ashley the incorrect amount of change needed to purchase a soda from a vending machine.

4. Encourage interactions by providing individuals with autism the opportunity to socialize in environments with age-appropriate peers. The experience of participating in a social group is essential to developing social-communicative skills. Exposing children with autism to situations in which good communication and social skills are modeled may assist with developing more appropriate interactive behaviors. Engaging in communicative interactions helps to teach students that positive outcomes can occur through communication.

By employing these communication strategies, will all challenging behaviors in individuals with autism be eliminated? Probably not. But by increasing a student's understanding and use of communication, we can reduce his/her use of challenging behaviors to "get their message across".


References

Batshaw, M. L., & Perret, Y. M. (1992). Children with disabilities: A medical primer. Baltimore: Paul H. Brookes.

Donnellan, A. (Ed.). (1985). Classic readings in autism. New York: Teachers College Press.

Durand, V. M. (1990). Severe behavior problems: A functional communication training approach. New York: The Guilford Press.

Koegel, R., & Koegel, L. (1995). Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities. Baltimore: Paul H. Brookes.

Schopler, E. (1978). On confusion in the diagnosis of autism. Journal of Autism and Childhood Schizophrenia, 8, 137-161.

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MUSIC THERAPY AND LANGUAGE
FOR THE AUTISTIC CHILD
Written by Myra J. Staum, Ph.D., RMT-BC
Director and Professor of Music Therapy
Willamette University, Salem, Oregon
 
Music Therapy is the unique application of music to enhance personal lives by creating positive changes in human behavior. It is an allied health profession utilizing music as a tool to encourage development in social/ emotional, cognitive/learning, and perceptual-motor areas. Music Therapy has a wide variety of functions with the exceptional child, adolescent and adult in medical, institutional and educational settings. Music is effective because it is a nonverbal form of communication, it is a natural reinforcer, it is immediate in time and provides motivation for practicing nonmusical skills. Most importantly, it is a successful medium because almost everyone responds positively to at least some kind of music.
 
The training of a music therapist involves a full curriculum of music classes, along with selected courses in psychology, special education, and anatomy with specific core courses and field experiences in music therapy. Following coursework, students complete a six-month full time clinical internship and a written board certification exam. Registered, board certified professionals must then maintain continuing education credits or retake the exam to remain current in their practice.
 
Music Therapy is particularly useful with autistic children owing in part to the nonverbal, non threatening nature of the medium. Parallel music activities are designed to support the objectives of the child as observed by the therapist or as indicated by a parent, teacher or other professional. A music therapist might observe, for instance, the child's need to socially interact with others. Musical games like passing a ball back and forth to music or playing sticks and cymbals with another person might be used to foster this interaction. Eye contact might be encouraged with imitative clapping games near the eyes or with activities which focus attention on an instrument played near the face. Preferred music may be used contingently for a wide variety of cooperative social behaviors like sitting in a chair or staying with a group of other children in a circle.
 
Music Therapy is particularly effective in the development and remediation of speech. The severe deficit in communication observed among autistic children includes expressive speech which may be nonexistent or impersonal. Speech can range from complete mutism to grunts, cries, explosive shrieks, guttural sounds, and humming. There may be musically intoned vocalizations with some consonant-vowel combinations, a sophisticated babbling interspersed with vaguely recognizable word-like sounds, or a seemingly foreign sounding jargon.
 
Higher level autistic speech may involve echolalia, delayed echolalia or pronominal reversal, while some children may progress to appropriate phrases, sentences, and longer sentences with non expressive or monotonic speech. Since autistic children are often mainstreamed into music classes in the public schools, a music teacher may experience the rewards of having an autistic child involved in music activities while assisting with language.
 
It has been noted time and again that autistic children evidence unusual sensitivities to music. Some have perfect pitch, while many have been noted to play instruments with exceptional musicality. Music therapists traditionally work with autistic children because of this unusual responsiveness which is adaptable to non-music goals Some children have unusual sensitivities only to certain sounds. One boy, after playing a xylophone bar, would spontaneously sing up the harmonic series from the fundamental pitch. Through careful structuring, syllable sounds were paired with his singing of the harmonics and the boy began incorporating consonant-vowel sounds into his vocal play. Soon simple 2-3 note tunes were played on the xylophone by the therapist who modeled more complex verbalizations, and the child gradually began imitating them.
 
Since autistic children sometimes sing when they may not speak, music therapists and music educators can work systematically on speech through vocal music activities. In the music classroom, songs with simple words, repetitive phrases, and even repetitive nonsense syllables can assist the autistic child's language. Meaningful word phrases and songs presented with visual and tactile cues can facilitate this process even further. One six-year old echolalic child was taught speech by having the therapist/teacher sing simple question/answer phrases set to a familiar melody with full rhythmic and harmonic accompaniment The child held the objects while singing:
 
Do you eat an apple? Yes, yes.
Do you eat an apple? Yes, yes.
Do you eat an apple? Yes, yes.
Yes, yes, yes.
and
Do you eat a pencil? No, no.
Do you eat a pencil? No, no.
Do you eat a pencil? No, no.
No, no, no.
 
Another autistic child learned noun and action verb phrases . A large doll was manipulated by the therapist/teacher and a song presented:
 
This is a doll.
This is a doll.
The doll is jumping.
The doll is jumping.
This is a doll.
This is a doll.
 
Later, words were substituted for walking, sitting, sleeping, etc. In these songs, the bold words were faded out gradually by the therapist/teacher. Since each phrase was repeated, the child could use his echolalic imitation to respond accurately. When the music was eliminated completely, the child was able to verbalize the entire sentence in response to the questions, "What is this?" and "What is the doll doing?"
 
Other autistic children have learned entire meaningful responses when both questions and answers were incorporated into a song. The following phrases were sung with one child to the approximate tune of Twinkle, Twinkle, Little Star and words were faded out gradually in backward progression. While attention to environmental sounds was the primary focus for this child, the song structure assisted her in responding in a full, grammatically correct sentence:
 
Listen, listen, what do you hear? (sound played on tape)
I hear an ambulance.
(I hear a baby cry.)
(I hear my mother calling, etc.)
 
Autistic children have also made enormous strides in eliminating their monotonic speech by singing songs composed to match the rhythm, stress, flow and inflection of the sentence followed by a gradual fading of the musical cues. Parents and teachers alike can assist the child in remembering these prosodic features of speech by prompting the child with the song.
 
While composing specialized songs is time consuming for the teacher with a classroom full of other children, it should be remembered that the repertoire of elementary songs are generally repetitive in nature. Even in higher level elementary vocal method books, repetition of simple phrases is common. While the words in such books may not seem critical for the autistic child's survival at the moment, simply increasing the capacity to put words together is a vitally important beginning for these children.
 
For those teachers whose time is limited to large groups, almost all singing experiences are invaluable to the autistic child when songs are presented slowly, clearly, and with careful focusing of the child's attention to the ongoing activity. To hear an autistic child leave a class quietly singing a song with all the words is a pleasant occurrence. To hear the same child attempt to use these words in conversation outside of the music class is to have made a very special contribution to the language potential of this child.
 
For more information about music therapy, contact 
 
National Association for Music Therapy
8455 Colesville Road, Suite 930
Silver Spring, MD 20910
 
 
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Signed Speech or Simultaneous Communication
Written by Stephen M. Edelson, Ph.D.
Center for the Study of Autism, Salem, Oregon
 
Sign language was first developed as a means of communication for hearing-impaired individuals. Sign language has also been used to teach people with developmental disabilities who have little or no communication skills. Teaching autistic children how to use sign language is not as common a practice today as in previous years, possibly due to an increase in the use of computerized com-munication systems. However, research suggests that teaching sign language along with speech will likely accelerate a person’s ability to speak (Creedon, 1976; Kopchick, Rombach, & Smilovitz, 1975; Larson, 1971; Miller & Miller, 1973). Teaching sign language and speech at the same time is often referred to as Signed Speech, Simultaneous Communication, or Total Communication.
 
Sign language is useful for those individuals who have little or no verbal abilities or communication skills. It is not recommended for those who have a relatively large vocabulary. Furthermore, persons with a variety of functioning levels can be taught to use sign language. Many aberrant behaviors associated with autism and other developmental disabilities, such as aggression, tantrumming, self-injury, anxiety, and depression, are often attributed to an inability to communicate to others. Signed Speech may, at the very least, allow the person to communicate using signs and may stimulate verbal language skills. When teaching a person to use sign language, another possible benefit may be the facilitation of their attentiveness to social gestures of others as well as of themselves.
 
There are several different forms of sign language; and when implementing Signed Speech, it is best to use the ‘Signing Exact English’ or “Signed English" method. This form of sign language uses the same syntax as spoken language, and this method will help facilitate the use of syntactic rules of spoken language. For example, a statement using both Signed English and speech would be: "Look at the table." In contrast, the syntax of American Sign Language would be: ‘Table look.’ Since the majority people do not understand sign language, it may be ideal to use some form of picture system or computerized communication device in addition to Signed Speech to enable communication with those who do not understand the signs.
 
When beginning a sign language program, it is best to start with signs expressing basic needs, such as the need to eat, drink, and use the toilet. In this way, the person will be motivated to use the signs to communicate needs. In addition, it may take anywhere from a few minutes to a few months to teach the first sign; but as the person acquires more and more signs, they will be much easier and faster to learn.
 
As mentioned above, learning to speak is usually accelerated by teaching sign language and speech at the same time. One possible reason is that both forms of communication stimulate the same area of the brain. PET Scans, which measure the amount of activity occurring in the brain at a given time, indicate that the same area of the brain is activated when a person talks or when a person uses signs (Poizner, Klima, & Bellugi, 1990). Thus, when utilizing the Signed Speech method, the area of the brain involved in speech production is receiving stimulation from two sources (signing and speaking) rather than stimulation from one source (signing or speaking).
 
In conclusion, teaching sign language to people with autism and other developmental disabilities does not interfere with learning to talk; and there is research evidence indicating that teaching sign language along with speech will actually accelerate verbal communication.
 
Benson Schaeffer, Ph.D., has written an excellent book on Signed Speech. You can write to him to learn more about his book. Dr. Schaeffer’s address is: Emanuel Medical Office Bldg., 501 N. Graham; Suite 365, Portland, OR 97227.
 
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PECS

 

Communicate with your Child using Photographic Communication Cards

http://www.squarepics.com/

 

Pyramid Educational Products, Inc., is the premier source for products for the Picture Exchange Communication System (PECS).

http://www.pyramidproducts.com/

 

Games, songs, communication cards and more

http://www.dotolearn.com/

 

Visually Cued Instruction

http://www.talklc.com/handout/Outline.html

 

Software:

http://angelspeaks.tripod.com/index.htm

 

Visual Supports: Helping Your Child Understand and Communicate

http://card.ufl.edu/visual.html

 

Quality software and related products for the visual learner

http://www.silverliningmm.com/products.htm

 

Internet Picture Dictionary

http://pdictionary.com/

 

 

Realistic images that are more abstract than photographs & can be used with any therapeutic method: ABA, Discrete Trial, TEACCH, PECS, FloorTime, etc.; comes in all shapes, sizes & combinations.

http://www.kidaccess.com/html/products/main.html

 

Products to Help you Teach Children to Understand Language and Communicate

http://www.talkingwords.com/

 

Visual schedule systems are an easy way to provide students with consistent cues about their daily activities.

http://www.setbc.org/projects/vss/

 

ASL

 

About ASL (American Sign Language)

http://www.deaflibrary.org/asl.html

 

ASL Browser

http://commtechlab.msu.edu/sites/aslweb/browser.htm

 

ASL Fonts

http://babel.uoregon.edu/yamada/fonts/asl.html

 

Sign Languages, Visual Culture and Arts

http://www.handspeak.com/

 

ASL Lesson Tutor

http://www.lessontutor.com/ASLgenhome.html

 

ASL Videos

http://www.aslaccess.org/

 

This website focuses on ASL, Interpreting and deaf related information

http://www.aslinfo.com/

 

ASL University is an online curriculum resource for American Sign Language students, instructors, interpreters, and parents.

http://www.lifeprint.com/

 

Teaching Students with Autistic Spectrum Disorders to Read

http://journals.sped.org/EC/Archive_Articles/VOL.36NO.4MarApr2004_TEC_Braun36-4.pdf

 

 

Vision Therapy and the Autistic Child
http://www.visionhelp.com/autism.htm

 

Son-Rise and the Autism Treatment Center
 
 The Son-Rise Program teaches a specific and comprehensive system of treatment and education designed to help families and caregivers enable their children to dramatically improve in all areas of learning, development, communication and skill acquisition. It offers highly effective educational techniques, strategies and principles for designing, implementing and maintaining a stimulating, high-energy, one-on-one, home-based, child-centered program.
 
The principles of the Son-Rise Program:
 
    *  Your child's potential is limitless.
    * Autism is not a behavioral disorder: it is a relational, interactional disorder.
    * Motivation, not repetition, holds the key to all learning.
    * Your child's "stimming" behaviors have important meaning and value.
    * The parent is the child's best resource. 
    * Your child can progress in the right environment.
    * Parents and professionals are most effective when they feel comfortable with their child, optimistic about their child's capabilities and hopeful about their child's future.
     * The Son-Rise Program can be combined effectively with other complimentary therapies such as biomedical interventions, sensory integration therapy, dietary changes (gluten/casein-free), Auditory Integration therapy and others.
 
For more information, go to:
 
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Autism Quotes:

*Michael Maloney (Teach Your Children Well) refers to the public schools' failure at teaching our children well as "academic child abuse."

*Unless school districts and other providers of early intervention 'get on the bandwagon' and start OFFERING effective early intervention (which has been known for years now) rather than forcing parents to FIGHT for effective intervention(s) one at a time, greater awareness will not lead to "more effective early intervention and improved outcomes."

*Mainstreaming is like visiting. Inclusion is belonging.

*Stanley Greenspan, MD, believes that two major mistakes are frequently made in early intervention:

1. taking a mininmalist approach which does not provide the family enough team support; and

2. overlooking family dynamics to such a degree that early intervention becomes, not a support to the family, but another source of familial stress. Intervention must consider the well-being of the family as paramount, and avoid the tempation of viewing the child as if he or she existed in isolation.






Childhood Apraxia of Speech

Childhood apraxia of speech is a disorder of the nervous system that affects the ability to sequence and say sounds, syllables, and words. It is not due to muscular weakness or paralysis. The problem is in the brain's planning to move the body parts needed for speech (e.g., lips, jaw, tongue). The child knows what he or she wants to say, but the brain is not sending the correct instructions to move the body parts of speech the way they need to be moved.

Signs of Childhood Apraxia of Speech

In Very Young Children

The child:

  • does not coo or babble as an infant
  • produces first words after some delay, but these words are missing sounds
  • produces only a few different consonant sounds
  • is unsuccessful at combining sounds
  • simplifies words by replacing difficult sounds with easier ones or by deleting difficult sounds (Although all children do this, the child with developmental apraxia of speech does so more often).
  • may have feeding problems.

In Older Children

The child:

  • makes inconsistent sound errors that are not the result of immaturity
  • can understand language much better than he or she can produce it
  • has difficulty imitating speech
  • may appear to be groping when attempting to produce sounds or to coordinate the lips, tongue, and jaw for purposeful movement
  • has more difficulty saying longer phrases than shorter ones
  • appears to be worse when he or she is anxious
  • is hard for listeners to understand.

Some children may have other problems as well. These problems can include weakness of the lips, jaw, or tongue; delayed language development; other expressive language problems; difficulties with fine motor movement; and problems with oral-sensory perception (identifying an object in the mouth through the sense of touch).

Assessment

In order to rule out hearing loss as a possible cause of the child's speech production difficulties, an audiologist certified by the American Speech-Language-Hearing Association (ASHA) should perform a hearing evaluation.  Use our Find a Professional service to help locate an audiologist near you).

An ASHA-certified speech-language pathologist (Use our Find a Professional service to help locate a provider near you) should examine the child's speech mechanism. He or she assesses the muscle development of his lips, jaw, and tongue, checking for signs of weakness. He or she evaluates the coordination of the speech mechanism for purposeful movement by having the client imitate non-speech actions (e.g., moving the tongue from side to side, smiling, frowning, puckering the lips, etc.). The speech-language pathologist will also evaluate the coordination and sequencing of muscle movements for speaking by having the child repeat strings of sounds (e.g., puh-tuh-kuh) as fast as possible.

The coordination of breathing with speaking, another skill that requires planning and sequencing of muscle movements, is evaluated too.

Can the child take in a breath and then effectively use this air to produce a phrase or sentence?

Does the child begin speaking before he or she has inhaled sufficiently?

Does the child seem to "run out of air" in the middle of utterances?

The speech-language pathologist checks to see whether or not the child uses breathing efficiently to change the intonation of speech. For example, when asking a question, does the child have enough air to raise the pitch of the voice at the end of the question?

Speech articulation (pronunciation of sounds in words) is evaluated. Along with pronunciation of individual sounds and combined sounds, overall intelligibility of the child's speech is assessed, in single words as well as in conversation.

The speech-language pathologist evaluates expressive and receptive language skills to determine if speech difficulties are part of a larger language problem. The speech-language pathologist evaluates:

  • the child's understanding and use of vocabulary as well as the ability to understand and answer questions, follow directions, and comprehend verbal passages of increasing length and complexity;
  • the child's ability to use age-appropriate grammatical constructions in sentences and in the context of longer utterances (e.g., when explaining how to perform a task or when retelling the plot of a favorite movie or book);
  • whether or not the child has age-appropriate understanding and use of word forms (e.g., using -ed at the end of words to indicate that something has already happened);
  • social communication skills paying particular attention to whether or not the child has modified the communication because of any speech disability. For example, does the child refuse to participate in classroom discussions because he or she is ashamed of and/or frustrated by his or her speech?

Based on these findings, an appropriate plan for treatment is developed.

Treatment

Intervention for the child diagnosed with apraxia of speech often focuses on improving the planning, sequencing, and coordination of motor movements for speech production. The child is taught exercises that strengthen the muscles of the lips, jaw and tongue as well as those that improve the coordination of the speech mechanism. For example, the speech-language pathologist uses tactile (e.g., pushing the tongue against a tongue depressor), auditory (e.g., listening to his or her own speech on a tape recorder) and visual (e.g., "watching" a picture of his or her speech on a computer screen) feedback to help the brain tell the speech muscles what to do. With this feedback, the child repeats syllables, words, sentences and longer utterances to improve muscle coordination and sequencing for speech. If assessment reveals expressive and/or receptive language deficits, treatment will include improving these skill areas as well.

Some clients may be taught to use an augmentative or alternative communication system (e.g., a portable computer that writes and produces speech) if the apraxia significantly hinders speech production. This communication system provides them with a means to communicate their ideas when communication through speaking is not a viable option. Once speech production is more effective, the system is used less often or withdrawn completely. Our site has more information on augmentative and alternative communication.

The client and his family are provided with home assignments to accelerate progress and to facilitate carryover of newly learned strategies outside of the treatment room.

One of the most important things for the family to remember is that treatment of apraxia of speech takes time, commitment, and a supportive environment that helps the child feel successful with communication. Without this, the disorder can persist into adulthood with years of speech-related anxiety and frustration.

Links

Apraxia-Kids information site
Site of the Childhood Apraxia of Speech Association

Tice Technology Service, Inc.
Motor speech disorders information page.

National Center for Voice and Speech


 
Sites:
 
 
 

Treatments For Communication Therapy
 
Discrete Trial Training/Direct Instruction

This technique is a specific methodology used to maximize learning. Discrete trial is a behavioral approach that breaks learning down into small steps that build toward functional and academic skills. In discrete trial training small bits of information are presented systematically. Each step is taught by presenting a specific cue or instruction. Appropriate responses are reinforced immediately. As soon as a student has mastered a skill, that skill is practiced in a variety of settings.
  • Skills or routines are task analyzed and broken down into individual steps;
  • Individual steps or skills are taught one step at a time, or directly using a number of trials;
  • Prompting is used to get a child started or gently guide appropriate responses;
  • Prompts are faded quickly to promote independence;
  • Each skill or step is required to be mastered before additional information is presented;
  • Ongoing data collection is used to determine if a child has reached criteria or if they are experiencing learning problems. Data provides an objective overall picture of progress.
Pivotal Response Training (PRT)

Pivotal response training is a naturalistic behavioral intervention used to improve specific skills in the areas of language, play and social skills. PRT teaches "pivotal" skills that have a broad effect by increasing motivation and the ability to respond to many cues. The basic structure of a PRT session involves:
  • Provision of motivating materials based on a child's preferences;
  • The student indicates what materials he/she would like to work for;
  • The adult uses any child-initiated communication as an opportunity to prompt for more elaborate communication;
  • The child is presented with the desired item after the response.
Functional Routines

Many daily activities and targeted skills are taught within routines. When skills are incorporated within routine activities they can be systematically practiced throughout the day in a functional manner. Using the targeted skills within the context of performing the routine enables the child to eventually rely on natural cues to maintain their behavior. Functional routines within Bridges include:
  • Arrival and Departure;
  • Transition;
  • Snack/ lunch;
  • Hygiene;
  • School jobs
Structured Teaching

Structured teaching provides visual frameworks or systems that help children to function more independently. Structured teaching provides concrete and visual ways of presenting information, modifying and structuring the environment. The components of structured teaching include:
  • Physical structure, setting up the environment;
  • Daily Schedule;
  • Work Systems;
  • Visual Structure
Augmentative Communication

Augmentative communications systems and assistive technology are used to provide a means of expressive communication while verbal language is developing. The Picture Exchange Communication System, picture choice boards as well as dedicated voice activated devices are used throughout the school environment to augment expressive communication.
 
The Picture Exchange Communication System (PECS)

The Picture Exchange Communication System is an augmentative communication picture /symbol system. PECS program focuses on teaching child-initiated communication. The pragmatic communication skills taught using this approach are requesting and commenting.
  • The student approaches a communication partner;
  • The student gives or exchanges a picture of a desired item with his or her communication partner;
  • The communication partner gives the student the item he/she requested.
Inclusion

Students are included with their typical peers in the regular classroom setting or in planned social experiences. Students participate in the areas of the regular curriculum that they can be most successful. As students gain more skills and are successful in the classroom, participation is gradually increased.
 

General Information about Traumatic Brain Injury
 
Definition of Traumatic Brain Injury

The regulations for Public Law 101-476, the Individuals with Disabilities Education Act (IDEA), formerly the Education of the Handicapped Act, now include Traumatic Brain Injury (TBI) as a separate disability category. While children with TBI have always been eligible for special education and related services, it should be easier for them under this new category to receive the services to which they are entitled.
 
Traumatic Brain Injury (TBI) is defined within the IDEA as an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. The term applies to open and closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgement; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or brain injuries induced by birth trauma. [(Code of Federal Regulations, Title 34, Section 300.7(b)(12)]
 
Incidence

TBI is the leading cause of death and disability in children and adolescents in the United States. The most frequent causes of TBI are related to motor vehicle crashes, falls, sports, and abuse/assault. More than one million children sustain head injuries annually; approximately 165,000 require hospitalization. However, many students with mild brain injury may never see a health care professional at the time of the accident.
 
Characteristics

The Brain Injury Association (formerly the National Head Injury Foundation) calls TBI "the silent epidemic," because many children have no visible impairments after a head injury. Symptoms can vary greatly depending upon the extent and location of the brain injury. However, impairments in one or more areas (such as cognitive functioning, physical abilities, communication, or social/behavioral disruption) are common. These impairments may be either temporary or permanent in nature and may cause partial or total functional disability as well as psychosocial maladjustment.
 
Children who sustain TBI may experience a complex array of problems, including the following:
  • Physical impairments - speech, vision, hearing and other sensory impairment, headaches, lack of fine motor coordination, spasticity of muscles, paresis or paralysis of one or both sides and seizure disorders,balance, and other gait impairments.
  • Cognitive impairments - short- and long-term memory deficits, impaired concentration, slowness of thinking, and limited attention span, as well as impairments of perception, communication, reading and writing skills, planning, sequencing, and judgement.
  • Psychosocial-behavioral-emotional impairments - fatigue, mood swings, denial, self-centeredness,anxiety, depression, lowered self-esteem, sexual dysfunction, restlessness, lack of motivation, inability to self-monitor, difficulty with emotional control, inability to cope, agitation, excessive laughing or crying, and difficulty relating to others.

Any or all of the above impairments may occur to different degrees. The nature of the injury and its attendant problems can range from mild to severe, and the course of recovery is very difficult to predict for any given student. It is important to note that, with early and ongoing therapeutic intervention, the severity of these symptoms may decrease, but in varying degrees.

Educational Implications

Despite its high incidence, many medical and education professionals are unaware of the consequences of childhood head injury. Students with TBI are too often inappropriately classified as having learning disabilities, emotional disturbance, or mental retardation. As a result, the needed educational and related services may not be provided within the special education program. The designation of TBI as a separate category of disability signals that schools should provide children and youth with access to and funding for neuropsychological, speech and language, educational, and other evaluations necessary to provide the information needed for the development of an appropriate individualized educational program (IEP).
 
While the majority of children with TBI return to school, their educational and emotional needs are likely to be very different from they were prior to the injury. Although children with TBI may seem to function much like children born with other handicapping conditions, it is important to recognize that the sudden onset of a severe disability resulting from trauma is very different. Children with brain injuries can often remember how they were before the trauma, which can result in a constellation of emotional and psychosocial problems not usually present in children with congenital disabilities. Further, the trauma impacts family, friends, and professionals who recall what the child was like prior to injury and who have difficulty in shifting and adjusting goals and expectations.
 
Therefore, careful planning for school re-entry (including establishing linkages between the trauma center/rehabilitation hospital and the special education team at the school) is extremely important in meeting the needs of the child. It will be important to determine whether the child needs to relearn material previously known. Supervision may be needed (i.e. between the classroom and restroom) as the child may have difficulty with orientation. Teachers should also be aware that, because the child's short-term memory may be impaired, what appears to have been learned may be forgotten later in the day. To work constructively with students with TBI, educators may need to:
  • Provide repetition and consistency;
  • Demonstrate new tasks, state instructions, and provide examples to illustrate ideas and concepts;
  • Avoid figurative language;
  • Reinforce lengthening periods of attention to appropriate tasks;
  • Probe skill acquisition frequently and provide repeated practice;
  • Teach compensatory strategies for increasing memory;
  • Be prepared for students' reduced stamina and increased fatigue and provide rest breaks as needed; and
  • Keep the environment as distraction-free as possible.
Initially, it may be important for teachers to gauge whether the child can follow one-step instructions well before challenging the child with a sequence of two or more directions. Often attention is focused on the child's disabilities after the injury, which reduces self-esteem; therefore, it is important to build opportunities for success and to maximize the child's strengths.
 
Resources:

DeBoskey, D.S. (Ed.). (1996). Coming home: A discharge manual for families of persons with a brain injury. Houston, TX: HDI Publishers. (Telephone: (713) 682-8700.)
 
Gerring, J.P., & Carney, J.M. (1992). Head trauma: Strategies for educational reintegration. San Diego, CA: Singular Publishing Group, Inc. (Telephone: 1-800-521-8545.)
 
Hughes, B.K. (1990). Parenting a child with traumatic brain injury. Springfield, IL: Charles C. Thomas. (Telephone: 1-800-258-8980.)
 
National Rehabilitation Information Center. (1994). Traumatic brain injury: A NARIC resource guide for people with TBI and their families. Silver Spring, MD: Author. (Telephone: 1-800-227-0216.)
 
Orto, A.D., & Power, P. (1994). Head injury and the family: A life and living perspective. Delray Beach, FL: St. Lucie Press. (Telephone: 407-274-9906.)
 
Savage, R. (1995). An educator's manual: What educators need to know about students with TBI. Washington, DC: Brain Injury Association. (See address below.)
 
Tucker, B.F., & Colson, S.E. (1992). Traumatic brain injury: An overview of school re-entry. Intervention in School and Clinic, 27(4), 198-206.
 
Organizations:

Brain Injury Association (formerly the National Head Injury Foundation)
1776 Massachusetts Avenue, NW
Suite 1000
Washington, DC 20036
800-444-6443 (Family Helpline)
202-296-6443
Web Address: http://www.biausa.org
 
Epilepsy Foundation of America
4351 Garden City Drive, Suite 406
Landover, MD 20785
301-459-3700
(800)332-1000; (800) 332-2070 (TTY)
E-Mail: postmaster@efa.org
Web Address: http://www.efa.org
 
THINK FIRST Foundation
22 South Washington Street
Park Ridge, IL 60068
708/692-2740
 
Source: National Information Center for Children and Youth with Disabilities

LINKS

 
 
Difficulties in Word Finding
 
Beginning Reading And Phonological Awareness For Students With Learning Disabilities
 
Stuttering
 
 
Speech Therapy
 
Speech therapy activities
 
A wonderful resource for parents of children with speech or language delays.
 
Special Education Page
 
Special Educator's Web Page
 
Internet Special Education Resources (ISER) is a nationwide directory of professionals who serve the learning disabilities and special education communities. They help parents and caregivers find local special education professionals to help with learning disabilities and attention deficit disorder assessment, therapy, advocacy, and other special needs.
 

PICTURE EXCHANGE COMMUNICATION SYSTEM

Make your own!

Use any clipart software you have or go to Google or Altavista and click on "Images" and type in what you're looking for. Save to your hard drive as a JPEG, they are easier to work with.  (Make a folder for PECS and store them in there).  Then if you have Microsoft Word or Works you can copy them with several pictures to a document, add in your text and print them out!  You can buy laminating sheets anywhere. Cut them down to size, holepunch in the upper lefthand corner and put on a ring (you can buy metal rings at office supply stores) or you can put them in a book in clear sheet protectors.

(Click on the underlined links down below to access the site.)

Do To Learn A web site for those with special learning needs. This site provides information and special learning tools for anyone having difficulty understanding, ordering and functioning in our world. We have planned our activities to help children and adults with diagnosed disorders such as autism, LD or ADD. This website has software for making pecs pictures. They offer 1,000 different pictures and schedule forms for $29.95 per year. That's much cheaper than the boardmaker software.

Free Worksheets:Handwriting Zaner Bloser (these are new free printable worksheets that have been added. There are worksheets for lower and upper case alphabets for 5-6 year olds. Under miscellaneous there is lined paper you can print out has small, medium or large lines. These worksheets uses School House Fonts from Signature Software and are patterned after the Zaner-Bloser method of handwriting.

Free Worksheets: Reading : Sight Words Free printable worksheets for the Dolch words

KidsAccess Eye-cons Catalog Main Page

Internet Picture Dictionary

Picture Symbol Dictionary

Pictures and Graphics available at Use Visual Strategies ( Click on each picture to see it larger, then save them to your hard drive to add to your collection.)

The Portacom System

Pyramid Educational Products (Pyramid Educational Products is dedicated to providing educational materials to ensure that families, educators and students have the materials needed to use communication skills in their everyday  schedules and lives.

See it, Say it, Write it

Talk, Learn and Communicate Visually Cued Instruction

Visual Strategies (need acrobat reader )

Visual Supports from CARD in Gainsville,Fla.  Visual communication tools such as objects, photographs, picture symbols, daily schedules, calendars and choice boards can provide the support necessary to greatly improve a child's understanding and ability to communicate.

Welcome to Kids Fonts! We are a new site dedicated to bringing do-it-yourself supplies to teachers of toddler-Kindergarten age children. Whether you're homeschooling, or are just tired of the prepackaged worksheets available to early-childhood educators, Kids Fonts is here to help!

Workstation Photos

http://www.speechfun.com/ (main page)

http://www.speechfun.com/SignandPict.htm (pictures to use for PECS)

http://www.tacanow.com/pecs.htm

http://www.setbc.org/projects/vss/

Visual Schedule System

http://www.talkingwords.com/

Products to help you teach children with autism to understand language and communicate

http://www.talklc.com/handout/Outline.html

Talk, learn and communicate

 

PIVOTAL RESPONSE TRAINING
 
What is Pivotal Response Training?

Pivotal response training (PRT) is a behavioral treatment intervention based on the principles of applied behavior analysis (ABA) and derived from the work of Koegel, Schreibman, Dunlap, Homer, and other researchers. It is a composite of the research on task interspersal, direct reinforcement, and role of choice. Key pivotal behaviors have been identified for children with autism: motivation and responsivity to multiple cues (Koegel & Koegel). PRT has demonstrated positive changes in these "pivotal behaviors" exhibiting widespread effects on many other behaviors associated with language and social interaction. Pivotal Response Training (PRT) provides a guideline for teaching skills and has been most successful for language, play and social interaction skills in children with autism.

The main components of PRT:
  • Choice (shared control to increase motivation)
  • Clear and uninterrupted instructions or opportunities (make sure child is attending)
  • Reinforcement of approximations! attempts
  • Reinforcement has a specific relationship to dIe desired behavior natural reinforcement ("ball" gets ball, not pmise. Child chooses object for instruction and that object is used. This is done to increase motivation)
  • Multiple examples or multiple components presented (e.g., use two different objects but same verb such as "roll car" and then "roll ball" then "throw ball." Multiple components also means using "new pants" or "red suite" versus just "pants" or "suit." This is done to increase responsiveness to multiple cues. (http://www.spectrumcenter.org/autismplanning.html)
Pivotal Response Training and Social Skills

Social skills deficits are a hallmark feature of children with autism, particularly in areas of shared engagement with peers. Learning the rules for engagement for successful interaction with children of their own age is extremely difficult for children with autism. "The rules of engagement; of knowing how to enter a group of children; how to join in with their activities; and how to talk to them, are all highly complex:, unwritten, and generally poorly understood' (Howlin, 1998). PRT is also an intervention that typically developing children can use to assist their peers with autism to attend to and maintain effective social interactions.

Pivotal Response Training (PRT) involves teaching typical peers to use strategies to:
  • Gain attention
  • Give choices to maintain motivation
  • Vary toys
  • Model social behavior
  • Reinforce attempts
  • Encourage conversation
  • Extend conversation
  • Take turns
  • Narrate play (reaching Students with Autism: A Guide for Educators)
Generalization to new toys and new adults as well as the maintenance of improved play behaviors has also been seen in children who have participated in PRT (Schreibman, Stahmer, & Pierce, 1996).
For More Information, please visit one of the following websites:
 
 

Hyperbaric Oxygen Therapy (HBOT)
 
Hyperbaric medicine is an accepted medical practice for the treatment of numerous physical and neurological injuries and dysfunctions. It was originally developed by the diving industry and advanced by the military for dealing with complications encountered by naval divers.
 
"Hyper" means increased and "baric" relates to pressure. Hyperbaric oxygen therapy (HBOT) refers to intermittent treatment of the entire body with 100-percent oxygen at greater than normal atmospheric pressures. The earth's atmosphere normally exerts 14.7 pounds per square inch of pressure at sea level. That pressure is defined as one atmosphere absolute (abbreviated as 1 ATA). In the ambient atmosphere we normally breathe approximately 20 percent oxygen and 80 percent nitrogen. While undergoing HBOT, pressure is increased up to two times (2 ATA) in 100% oxygen. The entire body is totally immersed in 100-percent oxygen. There is no need to wear a mask or hood. This increased pressure, combined with an increase in oxygen to 100 percent, dissolves oxygen in to the blood and in all body tissues and fluids at up to 20 times normal concentrationhigh enough to sustain life with no blood at all. 

While some of the mechanisms of action of HBOT, as they apply to healing and reversal of symptoms, are yet to be discovered, it is known that HBOT: 
  • greatly increases oxygen concentration in all body tissues, even with reduced or blocked blood flow; 
  • stimulates the growth of new blood vessels to locations with reduced circulation, improving blood flow to areas with arterial blockage; 
  • causes a rebound arterial dilation after HBOT, resulting in an increased blood vessel diameter greater than when therapy began, improving blood flow to compromised organs; 
  • stimulates an adaptive increase in superoxide dismutase (SOD), one of the body's principal, internally produced antioxidants and free radical scavengers; and  greatly aids the treatment of infection by enhancing white blood cell action and potentiating germ-killing antibiotics.
While not new, HBOT has only lately begun to gain recognition for treatment of chronic degenerative health problems related to atherosclerosis, stroke, peripheral vascular disease, diabetic ulcers, wound healing, cerebral palsy, brain injury, multiple sclerosis, macular degeneration, and many other disorders. Wherever blood flow and oxygen delivery to vital organs is reduced, function and healing can potentially be aided with HBOT.
Adequate oxygen has been recognized as essential to good healing since we first gained an appreciation of the way our bodies functioned. The lack of oxygen (hypoxia) causes damage and prevents the repair of tissue. Hyperbaric oxygen therapy (HBOT) has been demonstrated to address these issues through hundreds of studies done for many different indications. The first thing a paramedic gives a patient is oxygen to help prevent tissue and cell death through hypoxia. The brain is the most vulnerable organ and the control centre for all our bodily functions.

Links that may be of interest:

A new intervention tool helps children build key language skills.

Autism and pragmatics of language.

Bright Start Therapeutics. Special products for special kids.

Baby Bumblebee vocabulary builder CDs and videos.

Early Learning site.

Early pragmatic accomplishments and vocabulary development in preschool children with Autism

Lindamood-Bell Learning Processes.

Linguisystems, Inc.: speech, learning disabilities, languages, reading.

Running Ahead: Vocabulary earning in children with Autism.