Language Intervention Techniques

Focused Stimulation

• Naturalistic approach involving repeated exposure to a target during play or routines.
• Immediate production of the target is not required.
• Used for ASD, DLD, and language delay.
• Targets expressive vocabulary, two-word combinations, grammatical morphemes, and functional language use.

Hanen Program

• Family-centered program.
• "Takes two to talk" facilitates reciprocal interactions.
• Encourages responsive language, using Focused Stimulation to teach specific goals.
• Used for late talkers and those with expressive/receptive language disorders.
• Designed to improve two-way interactions.
• Enhances communication skills in various social settings.
• Improves understanding of language.
• Used for ASD population.

Prelinguistic Milieu Training (PMT)

• Clinician-directed, targeting gestures, vocalizations, and eye gaze.
• Appropriate for children with less than 10 words and developmental delays, aged 12-54 months.
• Prompt hierarchies and environmental arrangements are involved.
• Goals are to teach clear intentional communication acts.
• All social interactions are treated as transactional, involving give-and-take.
• Implementation involves following the child's lead, modeling, and celebrating communication attempts.

Shared Book Reading

• Goal is to improve language, literacy, and cognitive development.
• Targets phonological awareness, oral language, vocabulary, comprehension, and print knowledge.
• Involves using print referencing to draw attention to print and pictures in the book.
• Letters and sounds are discussed.
• Used for preschool-aged children at risk for delays.

Enhanced Milieu Training

• For minimally verbal children using single words or short phrases.
• Used for ASD, cognitive delays, language impairments, and Down Syndrome.
• Targets communication frequency, enhancing vocabulary, and generalized language use.
• Follows the child's lead, uses environmental arrangement, and prompts; models and expands on the child's speech.

Phonological Awareness

• For 4-5 year olds with significant speech or language difficulties.
• Goals focus on word awareness (counting and identifying words in sentences).
• Includes syllable awareness (segmenting and blending syllables in words).
• Rhyme awareness (identifying and producing rhymes) is included.
• Phonemic awareness (isolating, segmenting, blending, and manipulating individual phonemes/letters) is the most advanced goal.

Purposes of Intervention

• Interventions aim to change or eliminate the underlying issue.
• They can change the trajectory of a disorder.
• Teaching compensatory strategies is a key purpose.
• Optimizing the environment is also crucial.

Features of Clinician-Directed Treatments

• Lots of learning episodes with low generalization.
• Reinforcers are often needed.
• Therapy progresses slowly with drill play and explicit instructions.

Features of Hybrid Treatments

• Combines production drills with a play-based approach.

Features of Child-Centered Treatments

• Play-based and intrinsically motivated.
• Facilitated play involves indirect language sampling without external reinforcers.

Treatment Approaches

• Naturalistic approaches are embedded in everyday interactions.
• Contrived approaches are structured.
• Focus on generalizable skills applicable to real-world situations.
• High dosage (lots of trials) versus low dosage (fewer trials but more engagement).
• Explicit instruction with clear expectations.
• Implicit learning through natural interaction.
• Internal motivation through social engagement.
• External reinforcers such as tangible rewards should be provided.

Input Modification and Behavioral Techniques

• Indirect language stimulation enhances language input naturally without direct prompting.
• Self-talk involves narrating one's own actions.
• Parallel talk describes what the child is doing.
• Recasting expands or corrects a child's utterance.
• Focused stimulation repeats a target word or grammatical structure.
• Toy talk labels and describes objects in play to promote syntactic development.
• Prelinguistic Milieu Training (PMT) is used for children with limited intentional communication.
• PMT aims to increase gestures, vocalization, and eye contact.

Characteristics of Developmental Profiles

• Late talking includes delayed expressive language with typical development in other areas.
• Characterized by less than 50 words by age 2.
• Limited or no 2-word utterances by age 2.
• Normal hearing, cognitive, and social skills.
• Children usually catch up by age 4-5, but may develop persistent language disorder.
• Global developmental delay involves delays in multiple developmental domains.
• Delayed milestones are observed.
• Diagnosed in children under 5 when an ID cannot yet be confirmed.
• Possible underlying medical conditions may be present.

Autism

• Autism involves difficulties with social communication and restricted, repetitive behaviors.
• Limited eye contact and facial expressions are common.
• Delayed and atypical language development.
• Specific interests and sensory issues.

Milestones: 0-8 Months

• The pre-linguistic and perlocutionary stage.
• Unintentional communication.
• Social communication includes laughing, smiling, shared gaze, and gestures.
• Reflexive behaviors like crying, burping, cooing, and babbling.
• Canonical babble, like "mamama".
• Variegated babble, like "mabapala".

Milestones: 8-12 Months

• Pre-linguistic and illocutionary stage with more communicative function.
• Verbal imitation of sounds and early words.
• Expanding phonological repertoire of speech sounds.
• Gestures include clapping, waving, and pointing.
• Distal pointing is pointing at something further away.
• Proximal pointing is pointing within reach.
• Social bids include showing a toy.
• Language development includes one word by 12 months.
• Comprehension ranges from 20-100 words.

Milestones: 12-30 Months

• Emerging language and locutionary stage.
• 18-24 months: 2-word utterances and semantic relations.
• Zero words at 24 months can be a red flag for language delay.
• At 24 months, 50 spoken words with 50% intelligibility.
• The earliest morphemes emerge at age 3, including plural "-s" and present progressive “-ing”.

Milestones: 30-60 Months

• A period of developing language with longer conversations.
• Improved turn-taking skills.
• Comprehension of multi-step directions.
• The use of full sentences.
• Joint attention is evident, like a baby bringing a toy to show their mom.
• Eye contact is established.
• Parallel play and symbolic play are observed.

Language Development

• Children should be 100% intelligible by 4 years old.
• Pre-literacy skills emerge involving phonemic awareness.
• Vocabulary expands.
• Starting to decontextualize speech.
• All Brown's morphemes are mastered by age 4.

Pre-Intentional vs. Intentional Communicators

• Pre-intentional communicators do not intentionally communicate with a purpose.
• Intentional communicators deliberately convey messages to influence others or meet their needs.

Babbling and Language

• 0-3 months: vegetative sounds.
• 3-6 months: cooing.
• 6-8 months: canonical babbling with CV sounds.
• No canonical babble by 10 months is a red flag.
• 8-10 months: variegated babbling with varied syllables.
• 10+ months: jargon babble.
• First word at 12 months, usually a noun.
• Word combinations emerge at 18-24 months.
• Earliest bound morphemes to emerge are plural -s and present progressive -ing.
• All Brown's morphemes are mastered by age 4.