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Sunday, October 29, 2017

Why Routines Work for Building Language (no matter what mode of communication is used)

We often talk about using routine activities to build language skills.  There is a good reason for this; routines are predictable and…. well, routine.

As far back as the 1960’s and 1970’s, Hart & Risely were using routine activities of daily living (ADLs) to increase language skills.  

In 1995 they published the results of a study that found that 4-year-olds from working-class families and families on welfare had considerably smaller vocabularies than their agemates from professional families. This difference has been called the “30-Million-Word Gap” and “The Great Catastrophe.” 

The biggest predictor of a child’s success in school is his vocabulary.  Some parents just have a better idea of what to say and do, especially when reading to their children. They know their child needs to hear words repeated over and over again in meaningful sentences and questions.  Sociologists Farkas and Beron studied the research on 6,800 children from ages 3 to 12, and found that children from the lower SES were far more likely to arrive at school with smaller vocabularies (12-14 months behind) and they seldom made up the loss as they grew older.

Hart & Risely’s key findings: 
1. The variation in children’s IQs and language abilities is relative to the amount parents speak to their children.
2. Children’s academic successes at ages nine and ten are attributable to the amount of talk they hear from birth to age three.
3. Parents of advanced children talk significantly more to their children than parents of children who are not as advanced.

So, what’s so key about routines?
Well, these are often the times when parents speak most to their children.  And what they say is often repeated over and over again, using the same words and in the same order every time.  This repetition and predictability help their children build their vocabulary and their schema for how their life is organized.

Hart & Risley spearheaded other research, as well, about how to teach language skills.  They used incidental teaching - modified - to teach language skills in context. 
In their 1975 study, where they used “incidental teaching” of compound sentences, “increases in unprompted use of compound sentences were seen for all the children, first directed to teachers, and then to children, in accordance with who attended to the children's requests for play materials. The incidental teaching procedure also stimulated spontaneous variety in speech, and appears to have general applicability to child learning settings.” (Hart & Risely, 1975, JABA)

The premise of Incidental Teaching is that all interactions must be child-led.  This can be problematic with children who do not initiate interactions, but if teachers take advantage of “teachable moments,” they can overcome this ‘barrier’ by taking note of what motivates the child, what his interests are, what he engages with when left alone and then “sabotaging” the environment so that these things are just out of reach.  This provides those teachable moments by creating needs for him to communicate.

Hart and Risely also contributed greatly to the research on use of time delay and “expectant pause.”  Their research can be directly applied to AAC (although the technology was not yet available and AAC was in its very infancy) by looking at their levels of prompting in incidental teaching.  They wrote specifically about asking the child, “What do you want?” and waiting with an expectant pause.  Their next level of prompt was to ask, “What is this?” and pausing again.  At the level of most prompting, the partner models the response for the child, “Red ball.” 

This research was applied later by Gail McGee and her colleagues at the Amherst integrated preschool program in the 1980’s.  Her group, along with several other researchers studied not just incidental teaching, but also the impact of the environment on language development. (author’s observation of that program)

Children with disabilities, who are known to be vulnerable to environmental conditions, can have specific impacts of environment on development.  Caregivers have considerable impact; with studies showing that the quality of their interactions has specific impact on children’s development of language skills.  

Additionally, the quality of interactions within more educated families provided more complex language, resulting in preschoolers with greater vocabulary; an indicator of literacy development.
Importantly, incidental teaching, “must not request skills that are presently beyond his or her reach.”

Incidental teaching can play a large part in extending the language within daily routines.  Parents and others engage often in routines with children that demonstrate how the world is organized, what words people use in those organized routines, what people’s roles are in routines (who says what when) and how to interact with others in these routines; even before they can participate in the conversation.

So, let’s go back to our use of modeling in AAC - or in language development more generally.  Does that last statement ring any bells?  Does it sound a lot like how we provide Aided Language Stimulation?  At or 1 step beyond the child’s current level of language use?

Typical children learn the meanings of words by having caregivers say the words within routines over and over and over again.   By having those caregivers respond when he begins to communicate (which may begin simply as pointing), he learns an appropriate way to ask for something rather than screaming or crying.
But when we want children to move beyond pointing, and they do not have verbal words to use, we must present an alternative mode of communicating.

By providing pictures for communication for the child, we put ourselves in a position of having to model that “different” language system, just as we modeled use of speech for our neurotypical children. 

For our atypical children learning language takes a similar path, but a slower one that requires some modification of our planning interactions and modification of their expressive mode.

For example, break routines down into smaller component steps.  Help to ensure that the child understands the sequence of the routine.  And say the same things every time at every step.  In this way, the child becomes familiar with the words you use.

Be flexible. Follow the child’s lead, but rather than denying him some off-topic or off-sequence behavior, make it a contingency that he do what is involved in the routine in order to gain access to what he wanted to do.
Make sure to use appropriate language to label or describe what catches the child’s interest, as well as what is involved in the routine.  By naming and describing what caught the child’s interest, you provide input of vocabulary that is motivating.

Think outside the box.  While we want the child to learn the structure and attending language of the routine, we also want to take advantage of those moments when the child’s interest is piqued by something else in the environment.

Also consider that a routine can be made out of any repeated activity.  Think about the things that the child and caregiver do together.  No matter how small or extended, a routine can be a pivotal part of the child’s language intervention.

So, if you’re looking for ways to implement core vocabulary with your AAC user, you need look no further than the everyday routines.

If you’re looking for ways to implement the 200 opportunities per day that are the minimum needed for your AAC user to become competent, look no further than the routines in his or her life.

McGee, G. G., Morrier, M. J. & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. JASH , 24(3), 133-146.
Risley, B. M. & Risley, T. R. (1978). Promoting productive language through incidental teaching. Education and Urban Society , 10, 407-429.

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