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SMILE forYoung Children: A Bilingual
Program for Improving Communication Skills
Katherine Marting, M.A., CCC-SLP
Scott Pra...
Background
• Development:
▫ Bilingual SLPs
▫ Home-based ECI Services
▫ Need for family involvement
 When families are inv...
Learner Objectives
Participants will list, identify, describe…
1. the importance of family involvement
2. factors affectin...
Do you need Continuing Education or want 
to listen to this course live?
Click here to visit 
the online courses.
1. Importance of Family
Involvement
Research
a. Language enrichment
b. Empowerment
c. Self-Efficacy
d. Why family particip...
a. Language Enrichment
• Parents use of language-based strategies leads to
▫ Increased receptive language skills in the fi...
a. Language Enrichment (cont’d)
• Mother’s use of labeling and increased periods of
interaction lead to increases in recep...
b. Empowerment
• Empowering parents increases their likelihood
of accessing information pertaining to their
child’s develo...
c. Self-efficacy
• Empowerment leads to self efficacy or the belief
that they can make a difference in their child’s
devel...
d. Why family participation is critical
• Parents are the most consistent language models
in the child’s life
• When famil...
Family Involvement
• Why do we need family involvement?
▫ Social Learning Theories (Vygotsky, 1967)
▫ Family members are t...
Family Involvement
• Parents use of language-based strategies leads
to:
▫ Increased receptive language skills in the first...
Family Involvement
• Mother’s use of labeling and increased periods of
interaction lead to increases in receptive
vocabula...
Family Involvement
• Empowering parents increases their likelihood
of accessing information pertaining to their
child’s de...
All of the documents and charts in this presentation 
can be downloaded from our Free Resource Library.
Click here to visi...
Models of Service Delivery:
Find a balance
Consultative
Model
Child Focused
Model
Not on the same page
Different Perspectives
Family’s Perspective
The therapist
just plays with
my child.
They just sit
and talk with
me and do
nothing with
my child.T...
SLP’s Perspective
Families don’t
always follow
through with
my suggestions.
I can’t get
families to
incorporate
ideas into...
2. Understanding families
• Demographics
• Theoretical models of social systems
• Factors affecting family involvement
Demographics of Families
Enrolled in ECI in Texas
Research
a. Economics
b. Ethnicity
c. Language
d. Gender
e. Reason Eligi...
a. Economics
• Percentage of ECI children receiving Medicaid
▫ 2006: 61%
▫ 2008: 60.3%
• Families at 250% of the poverty l...
b. Ethnicity
Race/Ethnicity Percent
Hispanic/Latino 47
White 38
Black/African American 12
Asian/Pacific Islander 2
America...
c. Language
Primary Language Percent
English 81
Spanish 19
Other <1
d. Gender
Gender Percent
Males 63
Females 37
e. Reason Eligible
Reason Eligible Percent
Medical Diagnosis 11
Chromosomal Anomalies 35
Congenital Anomalies--Brain/Spina...
f. Services on IFSP
Percent of Children with Planned Service Types Percent
Service Coordination 100
Developmental Services...
Theoretical Models on Social
Systems
Research
a. Maslow’s Hierarchy of basic needs
b. Kubler-Ross’ 5 stages of grief
a. Maslow’s Hierarchy of basic needs
b. Kubler-Ross’ Five Stages of Grief
• Denial (this isn't happening to me!)

• Anger (why is this happening to me?)

• Bar...
Factors Affecting Family
Involvement
Research Findings Pertaining to
Family Factors
• Mothers with limited family support tend to
withdraw from programs early ...
Factors Affecting Family Involvement
• Family Factors
▫ over which we have minimal influence but need to
understand
▫ over...
Provider Factors Affecting
Parent Involvement
▫ Consistency and reliability
▫ Quantity (amount of
services)
▫ Recognizing ...
Research Findings Pertaining to Provider
Factors
• The more services a child/family receives, the more
progress the child ...
Case Study #1: Understanding Kubler-
Ross’ stages of grief
How would you work with a family that is in denial?
Example
Int...
Case Study #2:
A client has been diagnosed with a receptive
and expressive language disorder. How
would you explain the ra...
3. Connecting Therapy
to Reality
Applying research to our family sessions
How do we improve outcomes?
We know it’s important,
how do we do it?
• Provide specific instructions
• Provide a rationale...
Daily Routines
Daily Routines
• 12 daily routines
• Frequency and consistency
• More natural
• Extra time is not needed to implement stra...
Daily Routines
•Each routine includes:
• Speech/language focus
• Examples of each strategy
• Suggested target vocabulary a...
Strategies:
Speech
Language
Language Development
• Improved communication and bonding (Goodwyn,
Acredolo, & Brown, 2000; Tompson et al., 2007)
• Children stop using sign w...
• Frequency and consistency
• The more a child hears a phrase the more likely
they are to use it
• Use phrases that the ch...
• Imitation is vital for speech and language
development (Rogers & Williams, 2006)
• Teach the child how to imitate, by im...
• Each routine focuses on different vocabulary
• Multisensory learning for language targets
• Label objects, actions and d...
• Expand the child's utterances by adding
semantic information or syntactic complexity
can help their language grow.
• It ...
Speech Development
• Visual, tactile and motor cues
• Examples:
▫ Clap out syllables in words
▫ Put hand in front of mouth to feel air on plo...
• Auditory cues
▫ Emphasize specific sounds in words
▫ Melodic cues
• Model appropriate speech production
▫ Break consonan...
• Imitate sounds in the environment
• Repeat an incorrect production correctly,
repeating the correct production several t...
• Have a scavenger hunt
• Label objects that begin with the same sound to
increase phonological awareness
Speech Developme...
• Follow the hierarchy of speech production
• Help parents measure small successes
Speech Development
Example by Brianne Ruhnke on www.speakingofspeech.com
Speech Development
Sample session
Important Words
Practiquen estas palabras importantes y agreguen más:
Data Collection Sheet
Data Collection
• What words or gestures does your child use?
▫ Greetings/Saludos:
 Cuando saluda mueve la mano.
 Transl...
Data Collection
• What words or gestures does your child
understand?
▫ Greetings/Saludos:
 Sí entiende pero no puede pron...
Data Collection
• What words or gestures does your child use?
▫ Toys and Playtime/Jugando:
 Sí juega con niños de su edad...
Data Collection
• What words or gestures does your child
understand?
▫ Toys and Playtime/Jugando:
 Para salir a jugar, di...
Homework
Homework
Homework
Homework
Homework
Activity page
Homework
Session Record Form
Click to visit www.bilinguistics.com
Difference or Disorder? 
Understanding Speech and Language 
Patterns in Culturally and Linguistically 
Diverse Students
Ra...
References
• Goodwyn, Acredolo, & Brown (2000). Impact of symbolic gesturing on early language
development. Journal of Non...
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SMILE for Young Children: A Bilingual Program for Improving Communicaiton Skills

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This presentation discusses the importance of family involvement in their child's speech therapy, as well as factors that may affect their participation. It reviews theoretical models of social systems which help us understand how to get the parent 'buy-in' to follow through with therapy techniques. Finally we review the SMILE for Young Children therapy program, which incorporates all of the necessary components for effective collaboration between the SLP and caregiver of the child.

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SMILE for Young Children: A Bilingual Program for Improving Communicaiton Skills

  1. 1. SMILE forYoung Children: A Bilingual Program for Improving Communication Skills Katherine Marting, M.A., CCC-SLP Scott Prath, M.S., CCC-SLP Beat the Heat Conference July 24, 2012 Austin,TX Region 13 Education Service Center
  2. 2. Background • Development: ▫ Bilingual SLPs ▫ Home-based ECI Services ▫ Need for family involvement  When families are involved in the intervention process, language enrichment is ongoing rather than during “therapy” only (Rosetti, 2001)  Without family involvement, intervention is unlikely to be successful (Bronfenbrebrenner, 1974)
  3. 3. Learner Objectives Participants will list, identify, describe… 1. the importance of family involvement 2. factors affecting parent involvement 3. theoretical models of social systems 4. strategies to increase family involvement in intervention
  4. 4. Do you need Continuing Education or want  to listen to this course live? Click here to visit  the online courses.
  5. 5. 1. Importance of Family Involvement Research a. Language enrichment b. Empowerment c. Self-Efficacy d. Why family participation is critical
  6. 6. a. Language Enrichment • Parents use of language-based strategies leads to ▫ Increased receptive language skills in the first year (Baumwell, Tamis-LeMonda & Bornstein, 1997) ▫ Increased receptive and expressive language skills in the second and third years of life (Olson, Bates & Bayles, 1986) ▫ Greater receptive vocabulary at 12 years of age (Beckwith & Cohen, 1989)
  7. 7. a. Language Enrichment (cont’d) • Mother’s use of labeling and increased periods of interaction lead to increases in receptive vocabulary and greater expansion of expression in older children (Tomasello & Farrar, 1986) • Participation by fathers in early childhood programs has been shown to be beneficial to the child, father and other family members (Frey, Fewell, & Vadasy, 1989; Krauss, 1993)
  8. 8. b. Empowerment • Empowering parents increases their likelihood of accessing information pertaining to their child’s development
  9. 9. c. Self-efficacy • Empowerment leads to self efficacy or the belief that they can make a difference in their child’s development (Dempsey & Dunst, 2004)
  10. 10. d. Why family participation is critical • Parents are the most consistent language models in the child’s life • When families are involved in the intervention process, language enrichment is ongoing rather than during “therapy” only (Rosetti, 2001) • Without family involvement, intervention is unlikely to be successful (Bronfenbrebrenner, 1974)
  11. 11. Family Involvement • Why do we need family involvement? ▫ Social Learning Theories (Vygotsky, 1967) ▫ Family members are the guides and the child is the apprentice who learns from adult models (Rogoff, 1990) ▫ Parents are the most consistent language models in their children’s lives and their first teachers
  12. 12. Family Involvement • Parents use of language-based strategies leads to: ▫ Increased receptive language skills in the first year (Baumwell, Tamis-LeMonda & Bornstein, 1997) ▫ Increased receptive and expressive language skills in the second and third years of life (Olson, Bates & Bayles, 1986) ▫ Greater receptive vocabulary at 12 years of age (Beckwith & Cohen, 1989) ▫ 30 Million Word Gap by age 3 (Hart & Risley, 1995)
  13. 13. Family Involvement • Mother’s use of labeling and increased periods of interaction lead to increases in receptive vocabulary and greater expansion of expression in older children (Tomasello & Farrar, 1986) • Participation by fathers in early childhood programs has been shown to be beneficial to the child, father and other family members (Frey, Fewell, & Vadasy, 1989; Krauss, 1993)
  14. 14. Family Involvement • Empowering parents increases their likelihood of accessing information pertaining to their child’s development • Empowerment leads to self-efficacy or the belief that they can make a difference in their child’s development (Dempsey & Dunst, 2004)
  15. 15. All of the documents and charts in this presentation  can be downloaded from our Free Resource Library. Click here to visit the Resource Library
  16. 16. Models of Service Delivery: Find a balance Consultative Model Child Focused Model
  17. 17. Not on the same page Different Perspectives
  18. 18. Family’s Perspective The therapist just plays with my child. They just sit and talk with me and do nothing with my child.This is all too overwhelming. I forget what to do after the therapist leaves. I don’t have time in my day to do this.
  19. 19. SLP’s Perspective Families don’t always follow through with my suggestions. I can’t get families to incorporate ideas into daily routines. I don’t have easily accessible resources to share with families. Many times families don’t keep appointments.
  20. 20. 2. Understanding families • Demographics • Theoretical models of social systems • Factors affecting family involvement
  21. 21. Demographics of Families Enrolled in ECI in Texas Research a. Economics b. Ethnicity c. Language d. Gender e. Reason Eligible f. Services on IFSP
  22. 22. a. Economics • Percentage of ECI children receiving Medicaid ▫ 2006: 61% ▫ 2008: 60.3% • Families at 250% of the poverty level or lower ▫ Approximately 84%
  23. 23. b. Ethnicity Race/Ethnicity Percent Hispanic/Latino 47 White 38 Black/African American 12 Asian/Pacific Islander 2 American Indian/Alaskan <1
  24. 24. c. Language Primary Language Percent English 81 Spanish 19 Other <1
  25. 25. d. Gender Gender Percent Males 63 Females 37
  26. 26. e. Reason Eligible Reason Eligible Percent Medical Diagnosis 11 Chromosomal Anomalies 35 Congenital Anomalies--Brain/Spinal Cord 16 Symptoms and Ill-Defined Conditions 14 Disorders of the Nervous System 12 Congenital Anomalies--Facial Clefts 9 Conditions Originating in Perinatal Period 7 Congenital Anomalies--Musculoskeletal 7 Developmental Delay 71 Atypical Development 18 Areas of Delay/Atypical Development Speech/Communication 67 Physical/Motor 43 Cognitive 26 Adaptive/Self-Help 21 Social/Emotional 16 Vision 2 Hearing 2 Children with more than one qualifying diagnosis 22 Children with more than one area of delay 37
  27. 27. f. Services on IFSP Percent of Children with Planned Service Types Percent Service Coordination 100 Developmental Services 78 Speech Language Therapy 58 Occupational Therapy 32 Physical Therapy 25 Nutrition 12 Family Training/Counseling 5 Vision 3 Audiology 3 Psychological/Social Work 3 Medical/Nursing 1
  28. 28. Theoretical Models on Social Systems Research a. Maslow’s Hierarchy of basic needs b. Kubler-Ross’ 5 stages of grief
  29. 29. a. Maslow’s Hierarchy of basic needs
  30. 30. b. Kubler-Ross’ Five Stages of Grief • Denial (this isn't happening to me!)
 • Anger (why is this happening to me?)
 • Bargaining (I promise I'll be a better person if...)
 • Depression (I don't care anymore)
 • Acceptance (I’m ready for whatever comes)
  31. 31. Factors Affecting Family Involvement
  32. 32. Research Findings Pertaining to Family Factors • Mothers with limited family support tend to withdraw from programs early (Luker & Chalmers, 1990) • Mothers engaged in family conflict show lower rates of involvement (Herzog, Cherniss, & Menzel, 1986) • Mothers engaged in substance abuse showed lower rates of involvement (Navaie-Waliser et al, 2000) • Mothers who are anticipating a change in residence also showed lower rates of participation (National Committee to Prevent Child Abuse, 1996)
  33. 33. Factors Affecting Family Involvement • Family Factors ▫ over which we have minimal influence but need to understand ▫ over which we have more influence • Minimal influence ▫ Social-emotional needs ▫ Economic needs ▫ Cultural parameters • More influence ▫ Education about disability ▫ Attendance ▫ Engagement in the intervention process
  34. 34. Provider Factors Affecting Parent Involvement ▫ Consistency and reliability ▫ Quantity (amount of services) ▫ Recognizing your assumptions ▫ Understanding family needs ▫ Engaging all family members ▫ Ability to adjust strategies to match family style ▫ Communicating rationale for intervention techniques ▫ Clearly specifying what families should do between intervention sessions ▫ Setting expectations ▫ Staff communication ▫ Staff education and training ▫ Staff turnover rates
  35. 35. Research Findings Pertaining to Provider Factors • The more services a child/family receives, the more progress the child makes • High staff turnover rates reduce family involvement ▫ Gomby (2007) • Quantity--There were some interesting studies that showed that white families received more services than others. Hispanics were rated as more engaged. African Americans received less child-focused activities. ▫ Wagner (2003)
  36. 36. Case Study #1: Understanding Kubler- Ross’ stages of grief How would you work with a family that is in denial? Example Interventionist: Lets work on the word “more”. Parent: She says that. Interventionist: Great, how about the words, mom or dad? Parent: She says that too. Interventionist: She only says twenty words and she is two years old Parent: We understand what she wants
  37. 37. Case Study #2: A client has been diagnosed with a receptive and expressive language disorder. How would you explain the rationale behind these suggestions and strategies? • Roll a ball back and forth with your child. • Add a word to what your child says and repeat the words back together. • Give your spouse more time to form a response.
  38. 38. 3. Connecting Therapy to Reality Applying research to our family sessions
  39. 39. How do we improve outcomes? We know it’s important, how do we do it? • Provide specific instructions • Provide a rationale • Keep it simple and consistent • Have it pertain to a family event or routine • Set expectations • Have something written • In their native language • Follow through • Make sure caregivers understand: ▫ WHAT? ▫ HOW? ▫ WHY? • Assess the caregivers • Give positive reinforcement • Take risks
  40. 40. Daily Routines
  41. 41. Daily Routines • 12 daily routines • Frequency and consistency • More natural • Extra time is not needed to implement strategies • Use objects in their environment as therapy materials
  42. 42. Daily Routines •Each routine includes: • Speech/language focus • Examples of each strategy • Suggested target vocabulary and 6 pictures of signs • Homework sheet • Activity sheet •The amount of time spent on each routine varies
  43. 43. Strategies: Speech Language
  44. 44. Language Development
  45. 45. • Improved communication and bonding (Goodwyn, Acredolo, & Brown, 2000; Tompson et al., 2007) • Children stop using sign when able to communicate orally (Pizer, Walters & Meier, 2007) • Provide visual support during language learning Language Development
  46. 46. • Frequency and consistency • The more a child hears a phrase the more likely they are to use it • Use phrases that the child is able to imitate Language Development
  47. 47. • Imitation is vital for speech and language development (Rogers & Williams, 2006) • Teach the child how to imitate, by imitating their sounds and movements Language Development
  48. 48. • Each routine focuses on different vocabulary • Multisensory learning for language targets • Label objects, actions and descriptors • Repeat object labels – the more a child hears a word, the more likely they are to use it Language Development
  49. 49. • Expand the child's utterances by adding semantic information or syntactic complexity can help their language grow. • It is important to keep phrases simple enough that your child can repeat them. Language Development
  50. 50. Speech Development
  51. 51. • Visual, tactile and motor cues • Examples: ▫ Clap out syllables in words ▫ Put hand in front of mouth to feel air on plosives Speech Development
  52. 52. • Auditory cues ▫ Emphasize specific sounds in words ▫ Melodic cues • Model appropriate speech production ▫ Break consonant clusters apart ▫ Model target words slowly with emphasis Speech Development
  53. 53. • Imitate sounds in the environment • Repeat an incorrect production correctly, repeating the correct production several times Speech Development
  54. 54. • Have a scavenger hunt • Label objects that begin with the same sound to increase phonological awareness Speech Development
  55. 55. • Follow the hierarchy of speech production • Help parents measure small successes Speech Development
  56. 56. Example by Brianne Ruhnke on www.speakingofspeech.com Speech Development
  57. 57. Sample session
  58. 58. Important Words Practiquen estas palabras importantes y agreguen más:
  59. 59. Data Collection Sheet
  60. 60. Data Collection • What words or gestures does your child use? ▫ Greetings/Saludos:  Cuando saluda mueve la mano.  Translation: To give a greeting, he waves his hand. ▫ Getting Dressed/Vestirse:  Todavía no puede vestirse él solo. Le tengo que ayudar.  He still doesn’t get dressed on his own. I have to help him.
  61. 61. Data Collection • What words or gestures does your child understand? ▫ Greetings/Saludos:  Sí entiende pero no puede pronunciarlas.  Translation: He does understand, but he can’t pronounce them. ▫ Getting Dressed/Vestirse:  No response
  62. 62. Data Collection • What words or gestures does your child use? ▫ Toys and Playtime/Jugando:  Sí juega con niños de su edad.  Translation: He does play with children his age. ▫ Mealtime/Hora de Comer:  Se sienta a comer pero en ocasiones le tengo que dar en la boca.  He sits to eat but sometimes I have to put the food in his mouth.
  63. 63. Data Collection • What words or gestures does your child understand? ▫ Toys and Playtime/Jugando:  Para salir a jugar, dice “quiero jugar.”  Translation: When he wants to go out to play, he says, “I want to play.” ▫ Mealtime/Hora de Comer:  “Quiero comer.”  Translation: “I want to eat.”
  64. 64. Homework
  65. 65. Homework
  66. 66. Homework
  67. 67. Homework
  68. 68. Homework
  69. 69. Activity page
  70. 70. Homework
  71. 71. Session Record Form
  72. 72. Click to visit www.bilinguistics.com
  73. 73. Difference or Disorder?  Understanding Speech and Language  Patterns in Culturally and Linguistically  Diverse Students Rapidly identify speech‐language  patterns related to second language  acquisition to  distinguish difference from disorder.
  74. 74. References • Goodwyn, Acredolo, & Brown (2000). Impact of symbolic gesturing on early language development. Journal of Nonverbal Behavior, 24, 81-103. • Kummerer, B., Lopez-Reyna, N.A., & Hughes, M.T. (2007). Mexican Immigrant Mothers’ Perceptions of Their Children’s Communication Disabilities, Emergent Literacy Development, and Speech-Language Therapy Program. American Journal of Speech-Language Pathology, 16, 271-282. • McWilliams, R. (2007). Early Intervention in Natural Environments. Retrieved February 5, 2008 from http://naturalenvironments.blogspot.com/2007/10/toy-bags.html • Pizer, G., Walters, K., & Meier, R. P. (2007). Bringing up baby with baby signs: Language ideologies and socialization in hearing families. Sign Language Studies, 7 (4), 387-430. • Rogers, S. J., & Williams, J. H. G. (Eds.). (2006). Imitation and the Social Mind: Autism and Typical Development. New York: The Guliford Press. • Rogoff, B. (1990). Apprenticeship in Thinking. Oxford: Oxford University Press. • Thompson, R.H., Cotnoir-Bichelman, N.M., McKerchar, P.M., Tate, T.L., & Dancho, K.A. (2007). Enhancing early communication through infant sign training. Journal of Applied Behavior Analysis, 40, 15-23. • Vygotsky, L. S. (1967). Play and its role in the mental development of the child. Soviet Psychology, 5, 6-18.

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