Ann P. Kaiser

Behavior Problems of Preschool Children from Low-Income Families: Review of the Literature.

Research on the prevalence of behavior problems in preschool children from low-income families, and the risk factors associated with these behaviors, was reviewed. A systematic search of studies conducted between 1991 and 2002 yielded a total of 30 research reports that met all of the preestablished criteria. These studies yielded several findings. Children from low socioeconomic status (SES) backgrounds were found to have a higher incidence of behavior problems as compared to the general population. Behavior problems were associated with multiple risk factors found in these childrens lives related to child, parent, and socioeconomic characteristics. The results are discussed in terms of implications for early identification and intervention and directions for future research.

Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder

Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. “Naturalistic Developmental Behavioral Interventions (NDBI)” are implemented in natural settings, involve shared control between child and therapist, utilize natural contingencies, and use a variety of behavioral strategies to teach developmentally appropriate and prerequisite skills. We describe the development of NDBIs, their theoretical bases, empirical support, requisite characteristics, common features, and suggest future research needs. We wish to bring parsimony to a field that includes interventions with different names but common features thus improving understanding and choice-making among families, service providers and referring agencies.

Parent Education in Early Intervention A Call for a Renewed Focus

Parent education as a key component of early intervention has been greatly deemphasized during the past 15 years, we believe, because of the perceived inconsistencies between the purposes and goals of parent education and family-centered approaches to early intervention. We argue that research indicating that parent involvement is critical to early intervention effectiveness and that parents want information about specific ways they can help their childrens development supports the need for parent education in early intervention. We propose that the early intervention field address the concerns expressed about the lack of sensitivity in parent education approaches, develop strategies for parent education that are consistent with contemporary family service concepts, address the need for explicit instruction of service providers in parent education strategies, and conduct research on the immediate and long-term effects of parent education on children and families.

Teaching Parents New Skills to Support Their Young Children's Development

Teaching parents new skills to support the development of their young children with developmental disabilities has been controversial in the field of early intervention even though there is considerable empirical evidence supporting this approach. We propose that teaching parents to implement family-centered interventions can be highly effective by: (a) allowing parents to choose when to learn new skills; (b) teaching parents strategies that are empirically based, well-matched to their childs developmental needs, and intended to be implemented in naturally occurring interactions between parents and children; and (c) teaching parents in a skillful and individualized manner. We outline the skills that parent educators need in order to be effective, then, we discuss a model for preparing professionals to teach parents. Throughout this article, we draw on empirical data and anecdotal examples from our ongoing research on teaching parents naturalistic language intervention strategies.

Parent-Reported Behavioral Problems and Language Delays in Boys and Girls Enrolled in Head Start Classrooms

Early emergent patterns of behavioral problems, social skill deficits, and language delays were examined in 259 three-year-old children enrolled in Head Start classrooms. The Child Behavior Checklist for Children Ages 2 to 3 (CBCL/2–3) and the Social Skills Rating System (SSRS, Pre-School Version) were completed by the childrens primary caregivers. Language skills were assessed using the Preschool Language Scale (PLS)-3 and the Peabody Picture Vocabulary Test (PPVT)-III. Findings indicated that this population is at elevated risk for behavioral and language problems. Approximately 25% of both boys and girls showed clinical/subclinical levels of internalizing problem behavior on the CBCL. More than 20% of boys scored in the clinical range for externalizing problems. Children with behavioral problems were more likely to have low language scores than were their peers without behavioral problems. Nearly half of the children scored in the category “lower than average” for social skills on the SSRS. Children with low social skills were more likely to have low language scores than were their peers with average social skills. The need to screen for early emergent behavioral problems, the potential contribution of poor language skills to childrens problem behavior, and implications for early intervention are discussed.

The Effects of Trainer-Implemented Enhanced Milieu Teaching on the Social Communication of Children with Autism

This study examined the effects of Enhanced Milieu Teaching on the social communication skills of preschool children with autism when delivered by trained interventionists. A modified single-subject design across four children was used to assess the childrens acquisition, maintenance, and generalized use of language targets and social communication skills as a result of the intervention. Observational data indicated that all children showed positive increases for specific target language use at the end of 24 intervention sessions, and these results were maintained through the 6 month follow-up observations. There was also evidence of positive changes in the complexity and diversity of language for children on observational measures. Three of the four children also generalized these positive language effects to interactions with their mothers at home, with the greatest changes seen immediately after the intervention. Parent satisfaction with the intervention procedures and child outcomes were high.

Teacher-Reported Behavior Problems and Language Delays in Boys and Girls Enrolled in Head Start.

Behavior problems, social skill deficits, and language delays were examined in 332 three-year-old children enrolled in Head Start. Teachers completed the Caregiver Teacher Report Form/2-5 (CTRF/2-5) and the Social Skills Rating System (SSRS, Pre-School Version). Language skills were assessed using the Preschool Language Scale (PLS-3) and the Peabody Picture Vocabulary Test (PPVT-III). Findings indicated that this population is at elevated risk for behavioral, social, and language problems. Boys showed elevated levels of behavior problems across all measures. Both boys and girls displayed low language scores, with boys significantly lower than girls on both auditory and expressive skills. Boys with behavior problems were more likely to have low language skills than were their male peers without behavior problems; this pattern was not as clearly defined for girls. Teacher years of experience, child gender, and PLS-3 scores were significant predictors of CTRF scores. The results of the study are discussed in terms of strategies for identifying children at highest risk for persistent problem behavior.

Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial.

OBJECTIVE This study tested the effect of beginning treatment with a speech-generating device (SGD) in the context of a blended, adaptive treatment design for improving spontaneous, communicative utterances in school-aged, minimally verbal children with autism. METHOD A total of 61 minimally verbal children with autism, aged 5 to 8 years, were randomized to a blended developmental/behavioral intervention (JASP+EMT) with or without the augmentation of a SGD for 6 months with a 3-month follow-up. The intervention consisted of 2 stages. In stage 1, all children received 2 sessions per week for 3 months. Stage 2 intervention was adapted (by increased sessions or adding the SGD) based on the childs early response. The primary outcome was the total number of spontaneous communicative utterances; secondary measures were the total number of novel words and total comments from a natural language sample. RESULTS Primary aim results found improvements in spontaneous communicative utterances, novel words, and comments that all favored the blended behavioral intervention that began by including an SGD (JASP+EMT+SGD) as opposed to spoken words alone (JASP+EMT). Secondary aim results suggest that the adaptive intervention beginning with JASP+EMT+SGD and intensifying JASP+EMT+SGD for children who were slow responders led to better posttreatment outcomes. CONCLUSION Minimally verbal school-aged children can make significant and rapid gains in spoken spontaneous language with a novel, blended intervention that focuses on joint engagement and play skills and incorporates an SGD. Future studies should further explore the tailoring design used in this study to better understand childrens response to treatment. Clinical trial registration information-Developmental and Augmented Intervention for Facilitating Expressive Language (CCNIA); http://clinicaltrials.gov/; NCT01013545.

Language Characteristics of Children with ADHD.

Language characteristics of 11 children with attention-deficit/ hyperactivity disorder (ADHD) and 11 typically developing children ages 6 to 8 were compared in terms of semantic, syntactic, and pragmatic language skills. Children were tested on the Peabody Picture Vocabulary Test-Revised (PPVT-R), the Test of Language Development-2 Primary (TOLD-2), and the Test of Pragmatic Language (TOPL). Samples of childrens language were collected during free play with an adult conversational partner using the Pragmatic Protocol. Results indicated that there was no difference between the two groups on receptive vocabulary as measured by the PPVT-R. Children with ADHD performed worse than typically developing children on the sentence imitation, word articulation, speaking quotient, and overall speech and language quotient subtests of the TOLD-2 Primary. Children with ADHD produced more inappropriate pragmatic behaviors in conversational interactions, although their pragmatic knowledge as measured by the TOPL did not differ from that of the normally developing children. Results are discussed in terms of the relative strengths and weaknesses in the communication skills of children with ADHD.

Improving the Social Communication Skills of At-Risk Preschool Children in a Play Context

This study was designed to examine the effects of a three-component intervention on the social-communicative interactions of six preschool children at risk for language delays and behavior problems. In a multiple baseline design across three dyads, children were taught to (a) plan their play, (b) use conversational social interaction strategies, and (c) self-evaluate their play interactions. The number of social-communicative behaviors by each child increased following introduction of the intervention condition, as did their use of descriptive and request utterances during play sessions. Increases in linguistic complexity and diversity and play complexity also were associated with the intervention. This intervention holds promise for improving social, linguistic, and play behaviors in preschoolers at risk for language delays and behavior problems.