Jennifer R. Frey

The Use of Play Expansions to Increase the Diversity and Complexity of Object Play in Young Children With Disabilities

The purpose of this study was to determine if an intervention consisting of contingently imitating play, modeling expansions of play actions, and describing play actions increased the diversity of object play in young children with disabilities. The multicomponent intervention was introduced in a multiple-probe design across three young children in their classrooms. Generalization probe sessions, using an untrained toy set, were conducted throughout baseline and intervention. Follow-up sessions were conducted approximately 1 month after completion of the intervention. All participants increased their performance of different actions and the complexity of their play with toys; however, the magnitude of effects varied across participants. In addition, all participants spoke more and used more different words at the end of intervention when compared to the end of baseline. Performance during generalization and maintenance assessments was variable. Implications for future research and practice are discussed.

Older Siblings' Use of Responsive Interaction Strategies and Effects on Their Younger Siblings with Down Syndrome:

The effects of an intervention designed to facilitate interactions between older typically developing siblings and their younger siblings with Down syndrome were investigated. Older siblings were taught to use two responsive interaction strategies through the use of written materials, modeling, role play, and oral feedback. Following training, older siblings increased their use of mirroring and verbal responding. Intentional communicative behaviors increased among their younger siblings. One-month follow-up observations indicated that older siblings maintained their use of the responsive interaction strategies, but the effects of the intervention did not appear to generalize to an untrained setting. In an assessment of social validity, blind observers found sibling interactions to appear more positive and reciprocal following intervention than during baseline.

Social skills intervention planning for preschoolers: using the SSiS-Rating scales to identify target behaviors valued by parents and teachers

Teachers’ and parents’ importance ratings of social behaviors for 95 preschoolers were examined using the Social Skills Improvement System–Rating Scales (Gresham & Elliott, 2008). Multivariate analyses were used to examine parents’ and teachers’ importance ratings at the item and subscale levels. Overall, parents assigned significantly higher importance ratings than teachers assigned on each of the seven assessed social skills domains: communication, cooperation, assertion, responsibility, empathy, engagement, and self-control. Parents and teachers rated responsibility and cooperation as the most critical skill domains for preschoolers. At the item level, parents and teachers agreed on 4 of their top 10 critical items. The potential value of including parent and teacher importance ratings in planning interventions across home and school is discussed.

The Effects of Enhanced Milieu Teaching With Phonological Emphasis on the Speech and Language Skills of Young Children With Cleft Palate: A Pilot Study

Purpose The purpose of this pilot study was to investigate the extent to which a naturalistic communication intervention, enhanced milieu teaching with phonological emphasis (EMT+ PE), improved the language and speech outcomes of toddlers with cleft lip and/or palate (CL/P). Method Nineteen children between 15 and 36 months (M = 25 months) with nonsyndromic CL/P and typical cognitive development were randomly assigned to a treatment (EMT+PE) or nontreatment, business-as-usual (BAU), experimental condition. Participants in the treatment group received forty-eight 30-min sessions, biweekly during a 6-month period. Treatment was delivered in a university clinic by trained speech language pathologists; fidelity of treatment was high across participants. Results Children in the treatment group had significantly better receptive language scores and a larger percentage of consonants correct than children in the BAU group at the end of intervention. Children in the treatment group made greater gains than children in the BAU group on most language measures; however, only receptive language, expressive vocabulary (per parent report), and consonants correct were significant. Conclusions The results of this preliminary study indicate that EMT+PE is a promising early intervention for young children with CL/P. Replication with a larger sample and long-term follow-up measures are needed.

Longitudinal Comparison of the Speech and Language Performance of United States–Born and Internationally Adopted Toddlers With Cleft Lip and Palate: A Pilot Study

Objective: This study compares the early speech and language development of children with cleft palate with or without cleft lip who were adopted internationally with children born in the United States. Design: Prospective longitudinal description of early speech and language development between 18 and 36 months of age. Participants: This study compares four children (age range = 19 to 38 months) with cleft palate with or without cleft lip who were adopted internationally with four children (age range = 19 to 38 months) with cleft palate with or without cleft lip who were born in the United States, matched for age, gender, and cleft type across three time points over 10 to 12 months. Main Outcome Measures: Childrens speech-language skills were analyzed using standardized tests, parent surveys, language samples, and single-word phonological assessments to determine differences between the groups. Results: The mean scores for the children in the internationally adopted group were lower than the group born in the United States at all three time points for expressive language and speech sound production measures. Examination of matched pairs demonstrated observable differences for two of the four pairs. No differences were observed in cognitive performance and receptive language measures. Conclusions: The results suggest a cumulative effect of later palate repair and/or a variety of health and environmental factors associated with their early circumstances that persist to age 3 years. Early intervention to address the trajectory of speech and language is warranted. Given the findings from this small pilot study, a larger study of the long-term speech and language development of children who are internationally adopted and have cleft palate with or without cleft lip is recommended.

The Influences of Child Intelligibility and Rate on Caregiver Responses to Toddlers With and Without Cleft Palate

Objective: The purpose of this study was to investigate the influences of child speech intelligibility and rate on caregivers’ linguistic responses. Design: This study compared the language use of children with cleft palate with or without cleft lip (CP±L) and their caregivers’ responses. Descriptive analyses of children’s language and caregivers’ responses and a multilevel analysis of caregiver responsivity were conducted to determine whether there were differences in children’s productive language and caregivers’ responses to different types of child utterances. Setting: Play-based caregiver-child interactions were video recorded in a clinic setting. Participants: Thirty-eight children (19 toddlers with nonsyndromic repaired CP±L and 19 toddlers with typical language development) between 17 and 37 months old and their primary caregivers participated. Main Outcome Measures: Child and caregiver measures were obtained from transcribed and coded video recordings and included the rate, total number of words, and number of different words spoken by children and their caregivers, intelligibility of child utterances, and form of caregiver responses. Results: Findings from this study suggest caregivers are highly responsive to toddlers’ communication attempts, regardless of the intelligibility of those utterances. However, opportunities to respond were fewer for children with CP±L. Significant differences were observed in children’s intelligibility and productive language and in caregivers’ use of questions in response to unintelligible utterances of children with and without CP±L. Conclusions: This study provides information about differences in children with CP±L’s language use and caregivers’ responses to spoken language of toddlers with and without CP±L.

Language Disorders and Problem Behaviors: A Meta-analysis

We meta-analyzed 47 studies in which authors investigated the association between language disorders and problem behaviors and found a moderate effect size that changes over development. CONTEXT: A large number of studies have shown a relationship between language disorders and problem behaviors; however, methodological differences have made it difficult to draw conclusions from this literature. OBJECTIVE: To determine the overall impact of language disorders on problem behaviors in children and adolescents between the ages of birth and 18 years and to investigate the role of informant type, age, and type of problem behavior on this relationship. DATA SOURCES: We searched PubMed, EBSCO, and ProQuest. STUDY SELECTION: Studies were included when a group of children with language disorders was compared with a group of typically developing children by using at least 1 measure of problem behavior. DATA EXTRACTION: Effect sizes were derived from all included measures of problem behaviors from each study. RESULTS: We included 47 articles (63 153 participants). Meta-analysis of these studies revealed a difference in ratings of problem behaviors between children with language disorders and typically developing children of moderate size (g = 0.43; 95% confidence interval 0.34 to 0.53; P < .001). Age was entered as a moderator variable, and results showed that the difference in problem behavior ratings increases with child age (increase in g for each additional year in age = 0.06; 95% confidence interval 0.02 to 0.11; P = .004). LIMITATIONS: There was considerable heterogeneity in the measures of problem behaviors used across studies. CONCLUSIONS: Children with language disorders display greater rates of problem behaviors compared with their typically developing peers, and this difference is more pronounced in older children.

The Accessibility Needs of Students with Disabilities: Special Considerations for Instruction and Assessment

In this chapter, we will discuss the distinct needs of students with learning differences and strategies to truly increase their access to effective instruction and testing. Over 6 million American students between the ages of 3 and 21 years receive special education services (National Center for Education Statistics [NCES]. Alternate assessments for students with disabilities. Retrieved from https://nceo.info/Resources/publications/TopicAreas/AlternateAssessments/altAssessFA Q.htm, 2016). Each of these students is entitled to a free and appropriate public education in the least restrictive environment (Individuals with Disabilities Education Improvement Act [IDEA], 20 U.S.C. § 1400, 2004), which means, to the extent possible, students with disabilities should be educated in general education classrooms with peers who do not have disabilities. These students present a unique set of considerations for ensuring access to high-quality instruction and assessing their learning and growth.