1. Results Effects of a Naturalistic Sign Intervention on Expressive Language of Toddlers with Down Syndrome Introduction Children with DS have specific phenotypic strengths and weaknesses based on their diagnosis (Chapman & Hesketh, 2000; Kumin, 1996; Roberts, Price, & Malkin, 2007; Stoel-Gammon, 2001). Two appropriate interventions: Naturalistic interventions target strengths in social engagement (Adamson, Bakeman, Deckner, & Romski, 2009) and weaknesses in requesting (Mundy, Sigman, Kasari, & Yirmiya, 1988), persistence (Kasari & Freeman, 2001), and object play (Adamson, et al., 2009). Sign language interventions target strengths in gesturing (Caselli et al., 1998; Franco & Wishart, 1995) and weaknesses infusing symbols into joint engagement (Adamson et al., 2009). Purpose 1.Does EMT/JASPER Words + Signs increase use of expressive signs and spoken communication in young children with DS? 2.Do children generalize newly learned words and signs to use with their parents at home? Participants Observational Measures Twenty minutes video recorded and coded Spontaneous, imitated, and prompted If a child used a sign and a word simultaneously, both the word and sign were tallied. Reliability was coded for 30% of sessions and averaged 91% (SD=.19, range=0-100, 87% sessions over 80%) During baseline, all children used fewer than five signs. Upon introducing the intervention, use of signs increased to varying degrees ranging from 0-78 signs. Spontaneous number of different words increased for 3 of the 4 participants. Children generalized their skills to untrained parents. Three of the four participants used zero words during baseline sessions. Erin said five (three unique) words. After the introduction of the intervention, each participant demonstrated different patterns of word usage. Participants used between zero and 32 total words during intervention sessions. A word or sign was included when the child used it spontaneously during a single session. Participants used few spontaneous words or signs during baseline. All children acquired words and signs throughout intervention, although at different rates. Children learned more signs than words. Discussion  New application of EMT to sign mode  Children still use words when learning to sign  Children learned between 10 and 21 signs and generalized their use to untrained partner at home Future research  Replicate findings in group and single subject designs  Expand target words, environments partners  Explore EMT/JASPER with other AAC modes  Continue developing interventions targeting strengths and weaknesses of young children with DS Courtney Wright, Ann Kaiser, Dawn Reikowsky, Megan Roberts Department of Special Education, Vanderbilt University, Nashville, TN Procedures Baseline: Adult directed play with toys. Moderately responsive No EMT/JASPER strategies used No signs modeled Intervention: 20 sessions, 20-30 minutes Child directed play with toys Fully responsive All EMT/JASPER strategies used Signs modeled with >90% of spoken words Generalization: 10 minutes of standardized set of toys and books Conducted every 5 sessions At home with untrained parent EMT and JASPER Intervention Components ComponentSpecific StrategiesExamples Setting a context for communication  Sit face to face with the child  Follow the child’s lead  Respond to all child communication  Imitate the child’s non-verbal actions (mirror) and map (model) language  Adult reorients in front of the child when the child when the child moves from blocks to cars  Child vocalizes while playing with the baby and the adult responds by saying “baby”  Child rolls ball, adult rolls ball and says “ball” Modeling and expanding play  Choose interesting and engaging toys  Teach target level play actions and sequences  Choosing toys according to play level  Modeling stacking the blocks Modeling and expanding communication  Model target signs or words  Expanding child communication  Pointing to the apple and saying “apple”  Child signs “baby” and the adult signs/says, “baby eats.” Modeling joint attention skills  Model point, show and give gestures in conjunction with target language  Points to car rolling down track and says “down the slide”  Shows baby bottle and says and signs “bottle” Time delay strategies  Assistance  Choices  Waiting with routine/cue  Inadequate portions  Adult gives the child a juice box, waits for the child to ask for help, and expands communication  Adult holds up two choices, waits for the child to indicate a choice., and expands communication Prompting strategies  Open questions  Choice questions  “Say” prompt  Child reaches for the ball and the adult says “say: ‘ball,”  Adult holds up “juice” and “milk” and says “juice or milk?” RyanErinJayGretchen Age at entry (months)292523 GenderMaleFemaleMaleFemale EthnicityCaucasian Screening Mullen SS58697772 Imitation80% 40%0% TestingPrePostPrePostPrePostPrePost PLS AC SS6157677174756761 PLS EC SS7372738373758189 MCDI # of signs produced 02713002107 MCDI # of words produced 11337 1043226 Frequency of Total Signs and Spontaneous Novel SignsFrequency of Total Words and Spontaneous Novel WordsCumulative Words & Signs Used Spontaneously