SPED 537 ECSE Methods:Multiple Disabilities Chapter 9 Deborah Chen, Ph.D. California State University, Northridge May 1-2, 2006

Communication Modes Input: Receptive communication and language understanding Output: Expressive communication and language use

Input Considerations Use of available senses - vision, hearing, tactile, kinesthesia/movement Comprehensible input -figure/ground, signal/noise - matches child’s ability - meaningful

Output: Early Communication Development Preintentional communication Beginning intentional communication Intentional and symbolic communication

Output: Early Communication Functions Behavior regulation - refuse or request action or object Social interaction - greet, request social routine, comfort, or permission, show off Joint attention - comment or request information

Strategies that Support Interaction Responds contingently to child’s signals Varies prosodic features Encourages “conversation” Modifies own communicative behaviors in response to child’s signals Uses communication to teach language and concepts

PLAI: Background and Model Field tested in S.CA and Utah Children ages 8-48 months Multiple disabilities Preintentional level of communication English and Spanish speaking homes Diversity of home situations Variety of service providers

PLAI Modules 1. Understanding child’s cues 2. Identifying child’s preferences 3. Establishing predictable routines 4. Establishing turn-taking 5. Encouraging communicative initiations Klein, M.D., Chen, D., & Haney, M. (2006). Promoting learning through active interaction. A guide to early communication with young children who have multiple disabilities. Baltimore: Paul. H. Brookes.

Module 1: Understanding Child’s Cues Typical daily routines Behavioral states Antecedents, typical reactions, consequences Getting attention Expression of state and feelings

Typical Daily Activities TimeActivityLikes?Dislikes? How do you Know?

Behavioral States Active and alert Crying or agitated Dazed or tuned out Drowsy Repetitive or stereotypical behavior Fussy or irritable Quiet and alert

Situation: Bath time Antecedent M begins to wash J’s face and hair Behavior J screams Consequence M sings to him REVISED M puts shampoo bottle under J’s nose (cue) J becomes quiet and alert M talks to J

Situation: Snack time Antecedent Adult begins to feed child applesauce Behavior Child screams Consequence Adult removes bowl REVISED Adult helps child touch bowl (cue) Child quiets and alerts and sticks finger in bowl Adult offers child spoonful of applesauce

Module 2: Identifying Preferences Likes and dislikes Activities Persons Objects Reaction to presentation and removal Objects Persons Sensory events

Module 3: Establishing Predictable Routines Schedule of daily events Predictable sequence Predictable sequences within activities Subroutines Anticipatory cues Auditory Visual Tactile Olfactory Kinesthetic/movement

Home Sub-routine: Bath “ Time for bath”; Carries child to bathroom Turns on water Walks back to bedroom Pulls off shirt;tickles tummy “Tickle tummy!” Takes off diaper Picks up child Returns to bathroom Places child in tub “OK, in you go” Suggested revisions?

School Sub-routine: Snack “ Snack time”; pushes child in wheelchair to table Reaches for applesauce on table Puts applesauce in bowl and sets bowl on wheelchair tray Puts spoonful of applesauce up to child’s mouth “ You like applesauce” Suggested Revisions?

Module 4: Establishing Turn Taking Encourage the request for “more” Identify and extend turn taking Encourage new turn taking games Generalize turn taking games

Interrupted Routine Strategy Identify a favorite activity Engage child in activity Pause or interrupt the activity Wait for child’s response Interpret child’s request behavior and “speak for the child” Resume the activity

Module 5: Encouraging Communicative Initiation Encourage expression of rejection Use delay procedures Encourage initiation of games Encourage getting attention

Delay Procedure Set up the situation for a familiar and favorite activity Wait for the child to signal anticipation of the activity Interpret the child’s request behavior and “speak for the child” Begin the activity

Naturalistic Interventions Identification of child’s signals and arousal states Identification of preferences Use of anticipatory cues Use of “pause and wait” strategy to teach requests turn-taking Use of “delay” procedure to encourage initiation

Progressively Matched Turn- taking Child does not communicate intentionally- adult imitates sounds and actions Child uses gestures and sounds - adult imitates and provides words Child uses words – adult provides standard form and adds a bit more information