Optimizing Outcomes for Early Identified Children Through Inclusive Service Provision Sarah Wainscott & Marion Helfrich The River School Washington, D.C. Project Funded by Deafness Research Foundation

Project Objective Assess inclusive model as a language learning environment for young deaf children Site: The River School

Priority: Competence commensurate with typical hearing peers for skills in: communication communication spoken language spoken language socialization socialization Goal is broad competency and generalized skills Goal is broad competency and generalized skills

Timeliness of Inclusive Approach: Advent of universal newborn hearing screening Advent of universal newborn hearing screening Earlier implantation & advancing technology Earlier implantation & advancing technology Research related to incidental learning for CI users Research related to incidental learning for CI users IDEA policy regarding least restrictive environment IDEA policy regarding least restrictive environment Narrow scope of traditional oral approach Narrow scope of traditional oral approach Best practices in early childhood education Best practices in early childhood education

Inclusion Model of Education Underlying Principles M ultifaceted approach should be used to support the development of communication, spoken language, and social skills. M ultifaceted approach should be used to support the development of communication, spoken language, and social skills. Intervention services should be imbedded within a context of developmentally appropriate early childhood curriculum, and alongside hearing peers. Intervention services should be imbedded within a context of developmentally appropriate early childhood curriculum, and alongside hearing peers. Potential benefit in more natural context Potential benefit in more natural context

Components of River School Model: Small groupings of predominately typical hearing peers Small groupings of predominately typical hearing peers Transdisciplinary team of Educator and SLP full-day Transdisciplinary team of Educator and SLP full-day Strong developmental framework Strong developmental framework Deliberate focus on spoken language and literacy Deliberate focus on spoken language and literacy Family-centered programming Family-centered programmingResult: Intensive services in least restrictive environment Intensive services in least restrictive environment

Is the Model working for emerging language users? Is the Model working for emerging language users? Longitudinal study: Deaf children transitioning from pre- to para-linguistic to linguistic stages. Longitudinal study: Deaf children transitioning from pre- to para-linguistic to linguistic stages. Inclusion Model of Education The Big Question:

Inclusion Model of Education Methodology Sample: Emerging language users with cochlear implants in River School programs Sample: Emerging language users with cochlear implants in River School programs N=6; 4 females N=6; 4 females Ages: 14 mos to 3yr 2 mos Ages: 14 mos to 3yr 2 mos Age at Implantation: 11 mos – 26 mos Age at Implantation: 11 mos – 26 mos Length of CI Use: 1 mo – 1yr 4mos Length of CI Use: 1 mo – 1yr 4mos

Inclusion Model of Education Methodology Interval video analysis of children in select activities Interval video analysis of children in select activities 6 month intervals 6 month intervals Activities: Teacher-directed, Facilitated play, Free play Activities: Teacher-directed, Facilitated play, Free play Analysis: Independent review of video Analysis: Independent review of video Coding system & pattern identification Coding system & pattern identification

Inclusion Model of Education Measurement Conditions Three five-minute segments at six-month intervals for high, medium, & low structure activities: Three five-minute segments at six-month intervals for high, medium, & low structure activities: Teacher-directed: Circle time Teacher-directed: Circle time Facilitated play: Theme related dramatic play Facilitated play: Theme related dramatic play Free play: Playground Free play: Playground

Frequency of interactions Frequency of interactions Communication partners Communication partners Peer v. Teacher Peer v. Teacher Childs role Childs role Initiator v. Responder Initiator v. Responder Nature of interactions Nature of interactions Paralinguistic, paralinguistic & vocal, linguistic Paralinguistic, paralinguistic & vocal, linguistic Inclusion Model of Education Items Measured

Videoanalysis Results Frequency of interactions (mean/5 min) Teacher-directed Facilitated play Free play

Videoanalysis Results Communication vs. NR (mean/5 min) No Response Opportunity Taken

Videoanalysis Results Frequency of interactions per 5 min. (differences per child at 5 mos)

Videoanalysis Results Communication partners across activities (mean interactions by partner per 5 min) Teacher-directed Facilitated play Free play

Videoanalysis Results Communication partners mean interactions per 5 min. (differences per child at 5 mos)

Videoanalysis Results Initiations versus responses by activity (mean rate per 5 min) Teacher-directed Facilitated play Free play

Videoanalysis Results Initiations versus responses per 5 min. (differences per child at 5 mos)

Is the Model working for emerging language users, targeting competence in communication, spoken language, and socialization? Is the Model working for emerging language users, targeting competence in communication, spoken language, and socialization? Preliminary data suggest that implanted deaf children educated in an inclusion model show trends of: Preliminary data suggest that implanted deaf children educated in an inclusion model show trends of: high frequency of interactions high frequency of interactions greater peer-driven communication greater peer-driven communication frequent initiation of communication frequent initiation of communication rapid progress toward linguistic communication rapid progress toward linguistic communication Inclusion Model of Education The BIG question...

Further longitudinal analysis Further longitudinal analysis Longterm educational and placement outcomes Longterm educational and placement outcomes Assessment of CI users in other inclusion programs Assessment of CI users in other inclusion programs Qualitative analysis Qualitative analysis Teaching strategies in inclusion setting Teaching strategies in inclusion setting Role of typical peers as language models Role of typical peers as language models Inclusion Model of Education Future directions