Early Intervention Approaches for Young Children with MR
…An ounce of prevention is better than a pound of cure…

Main Spe...
o
o

of communication
efficiency
Follows the child’s lead
Makes use of what is
available at the moment of
intervention

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...
Pre-requisites
in Language
Content

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Searching for
objects

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Peek-a-boo
Hide and seek
Tunnel games
Where’s the...
Pre-requisite
In Language
Form

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Imitating
gross motor
behavior

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Action songs and rhymes

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Imi...
Pre-requisite
skills in
Language
Use

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Gazing
interpersonal
ly

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(Incorporate goal with other
play activities)

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...
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Making
reference

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regulating
 Point
 Pull
 Push
 Tap
 Vocalize for
help

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Group games
(Incorporat...
Pre Speech
Skills

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Sucking

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Swallowing

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Chewing

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Smiling

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Blowing

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Lip clos...
My Personal Tools
My Language Parameters
Content/ Semantics
Form

Use/ Pragmatics/context/function

My Speech Parameters
P...
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MR Early Intervention Approcahes

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MR Early Intervention Approcahes

  1. 1. Early Intervention Approaches for Young Children with MR …An ounce of prevention is better than a pound of cure… Main Speech and Language Concerns of Young Children with MR Language/ Learning Domain General Language Skills Pre Requisite Skills Strategies PLAY PLAY PLAY!!!!! With manipulatives and with other children and adults too (For stimulation, sensory integration, to induce, facilitate, and maintain language-related behaviors) Free Play Structured Play Dyad Play Group Play Action Songs and Rhymes Indirect Language Stimulation (ILS) o Child-centered approaches o No specific objective but generally aims to facilitate language learning o No specific form as target but aims for a general level Guidelines    Incidental teaching (teach anywhere, anytime. Make every moment a teaching moment) Self talk (talk about your own actions as you play beside the child: “ilalagay ko ito sa taas…dadagdagan ko pa ng isa…ayan mataas na ang tower ko, isa pang kahon…” parallel talk/ information talk (talk about 1
  2. 2. o o of communication efficiency Follows the child’s lead Makes use of what is available at the moment of intervention      what the child is doing as she plays beside you: “tinutulak mo yung aso. Ay kinuha mo yung pusa. Binibigyan mo sila ng pagkain…” : talk about what the child is doing/seeing/feeling…) imitation (imitate what the child is saying/vocalizing) expansions (affirm what the child said and then add up to what the child said: “Dog. Yes, it’s a big dog.”) extensions (add up to the thought of what the child said, not necessarily using the same words) Recast (use the child’s own words in another sentence form) Peer-mediated learning (let the child learn with other kids who may serve as models for him to imitate) 2
  3. 3. Pre-requisites in Language Content  Searching for objects      Peek-a-boo Hide and seek Tunnel games Where’s the ____ games Toys which allow for dropping something at one end and expecting the same thing to come out on the other end           Hiding objects (as above)     Performing action on objects Use of manipulative table-top toys which allow for as many movements and manipulation as possible     Exhibiting object to object relations        Use manipulatives that allow for connecting, dismantling, cueing… Knots and bolts Screw tops Pounding toys Stacking Chaining /Clip-ons Puzzles and Beads     Ask “where” Point “There” Play with your voice Speak slow and clear Use short, adult-form sentences with simple words Use familiar/favorite toys of the child Repeat procedures in as many situations as possible Be creative Reward positive behaviors – even the smallest efforts Let the child be the one to hide the object/ self Gesture and say “No more”, “Its’ gone”, “wala na”… (as above) Do ILS as the child plays and as you play with the child Highlight the action done and the result of the action Use songs and rhymes to enhance the activity Consider age-appropriate toys Scaffold Couple with ILS and songs Use hand-over-hand as needed 3
  4. 4. Pre-requisite In Language Form  Imitating gross motor behavior  Action songs and rhymes           Imitating fine motor behavior Imitating vocalizations    Action songs and rhymes Action songs and rhymes story telling     Approximati ng adult linguistic form    Action songs and rhymes Story telling Phone play  Consider songs with big movements Modify movements for younger kids Use hand over hand Sing with other kids Do live singing or sing along with CDs and Tapes Reward/praise every effort Use pop hits if it is more familiar with the child Improvise actions but be consistent (as above but focus on fine movements) Let the children fill in the missing lyrics of a familiar songs Reward/praise every effort As above; give time and space for the child to answer) 4
  5. 5. Pre-requisite skills in Language Use  Gazing interpersonal ly  (Incorporate goal with other play activities)      Focusing using joint    Point to the ____ games Where is the ____ games (Incorporate goal with other play activities)     attention  (Incorporate goal with other play activities)     Taking turns    (Incorporate goal with other play activities) Peek-a-boo Ball games   Sit at eye-level of the child Call the child’s name whenever there is something you want to say to him directly Place favorite objects beside your face to draw the child’s gaze to you SMILE and do ILS Say, “Look at that” and point towards the direction Lead the child to look at the same object gently (try inclining the child’s body towards the direction first. If the child does not look gently lead his head to look towards the direction) Let the child follow the movement of the object from one place to another before pointing it out to him: “there it is!” Call the child’s name and wait for a response before presenting him with the favored toy Use colorful manipulatives which engage the child Use Audio-visual-kinesthetic-tactile materials Prompt the child: “____ turn first, Now ____/your turn”, “wait for your turn”, “good waiting”, May give auditory signals to help the child 5
  6. 6.   Making reference   regulating  Point  Pull  Push  Tap  Vocalize for help     Group games (Incorporate goal with other play activities) Pointing games (Incorporate goal with other play activities) Model the behavior Use manipulatives Incidental teaching      “wait” like counting 1-5 before next turn… Use hand over hand Scaffold reward Use ILS You may need to be a bit Over-Acting 6
  7. 7. Pre Speech Skills  Sucking      Swallowing    Chewing    Smiling    Blowing    Lip closure    Sensory Integration   Hyposensitiv e (hyperactive behaviors) Hypersensiti ve (hypoactive behaviors)      OPM Exercises Use of Cross-cut nipples Use of flavored pacifiers Use of straws with varying length and diameter OPM exercises Use of varying food textures OPM exercises Use of varying food textures OPM exercises Incorporate in other activities OPM Exercises Use of various blowing materials OPM Exercises Verbal reminders Visual reminders Swinging Spinning SI Massage Trampoline Desensitization  Consider the level; and preference of the child Consider proper sitting/positioning of the child Consult with SPLs (as above)  (as above)      Consider the level; and preference of the child Consider safe/non toxic materials Consult with SPLs  Consult with OTs  Consult with OTs 7
  8. 8. My Personal Tools My Language Parameters Content/ Semantics Form Use/ Pragmatics/context/function My Speech Parameters Pitch Volume Voice Quality Rate Fluency What to do? Use Simple, age-appropriate terms Modify, adapt, bend your style Speak with a clear diction Use the syntax/grammatical level similar to or at least one step ahead of the child you are helping (for imitations and expansions) Use short but correct grammar and syntax as often as possible when interacting with children Talk about what is here and now rather than there and then Supply speech teaching with experience Use terms, materials, and concepts familiar to the child Use pictures or real objects related to previous experience when talking about past events Make every moment a learning experience Be conscious of the child’s focus of attention What to do? Moderate to slightly low pitch generally relaxes High pitch generally excites Do not shout!! Modulated rather than throaty and shrill Slow rate to give accent to important words and allow each sound to be heard. Also facilitates processing for the child. Let your speech naturally flow while considering appropriate rate. 8

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