Early Communication Intervention Research Articles

Early communication development and intervention for children with autism

Autism is a neurodevelopmental disorder defined by impairments in social and communication development, accompanied by stereotyped patterns of behavior and interest. The focus of this paper is on the early development of communication in autism, and early intervention for impairments in communication associated with this disorder. An overview of components of communication is provided. Communication characteristics that are diagnostic of autism are summarized, with consideration of the overlap between social and communication impairment, particularly for children with autism functioning at the prelinguistic level. Early communication development and predictors of communication functioning in autism are examined, based on a review of prospective and retrospective studies. The focus of the discussion then turns to intervention. Consideration is given to the rationale for beginning intervention as early in life as possible for children with autism. Implications of motor, imitation, and play deficits for communication-based intervention are examined. Finally, issues related to the design and delivery of intervention for young children with autism are presented, along with a review of the major early intervention approaches for autism.

Communication development of a young child with Foetal Renoid syndrome: A seven-year follow-up study

The aim of the article is to describe the communication development of a child with Fetal Retinoid syndrome (FRS) from six months to seven years of age. Little is known about this rare acquired syndrome and its long-term implications, especially on a child's communication development. A descriptive, ex post facto research design was used to study the participant's communication development from 1996 when the family enrolled in an early communication intervention programme. Annual serial assessments of the participant and her family were conducted and the data were stored in a research database after each assessment. The results are described according to a 4-level assessment framework and indicated consistent, but moderate to minor delays in the participant's communication development with a mild hearing loss in the right ear, associated with ear anomalies. Although prenatal exposure to isotretinoin may have serious effects on the unborn fetus and even cause death, the participant did not display all the symptoms of FRS described in the literature. The favorable family circumstances, early commencement of intervention, and supporting early educational environments were protecting factors that could have contributed positively to the participant's communication development. The importance of knowledge accumulation about rare syndromes such as FRS in Communication Pathology and Audiology is discussed and guidelines for early identification, assessment and treatment applicable to the case are proposed as an intervention option.

The Basic Structure of Community Early Intervention Programs for Children with Autism: Provider Descriptions

Autism researchers have identified a set of common effective practice elements for early intervention (EI) (e.g., intensive programming). The current study examined the reported use of common elements of effective interventions in community EI settings. Eighty EI providers reported about their programs. The majority of participants reported using common effective elements, however, the depth and quality of the use of these elements was highly variable. Taking community program structure into account in future research will facilitate the development of methodologies, which immediately fit into the context of community programming rather than requiring program adaptation for use in the real world. Recommendations for using current community program structure to improve use of evidence-based practices are discussed.

The need for collaboration in early communication intervention: whom do parents consult regarding the prevention of communication disorders?

The purpose of this article is to report findings regarding the needs of parents for information on communication development, to review the range of professionals whom parents frequently consult regarding communication development, to discuss the frequency with which professionals provide information on communication development to parents and to call early interventionists to action regarding involvement in transdisciplinary teams for the prevention of communication disorders. Two parallel surveys, one with parents (n = 184) and one with professionals (n = 83), as well as focus group discussions were utilised to reflect the perspectives of a variety of early intervention professionals and parents. Results indicated that parents desire more information on infant communication development and regularly consult a range of professionals in order to obtain information on the stimulation of communication skills and the prevention of early communication disorders. This has implications regarding the need for access to consistent, accurate information and the involvement of all early intervention professionals in the prevention of communication disorders.

A single case study of the communication development of a high-risk neonate, from birth to discharge from a Neonatal Intensive Care Unit (NICU)

Since preterm and low birth weight infants display a high-risk for communication disorders or delays, the Neonatal Intensive Care Unit (NICU) provides the earliest opportunity where family-centered early communication intervention (ECI) services can be initiated. Extensive knowledge about high-risk neonates exists, but there appears to be limited knowledge about the emergence of early communication skills in these neonates. The aim of the study was to provide a systematic description of the successive communication developmental steps of a high-risk neonate on a weekly basis, from birth to discharge from a NICU, in order to guide further research on a larger scale. An A-type single case study design was used to collect prospective data over 14 sessions during the participant's 51-day stay in the NICU. Using a comprehensive data-collection protocol, rich data sets were gleaned over time. The results are described as a chronology of events contributing to the participant's risk status and influencing his early communication development. The successive emergence of the different components of language skills in the participant provided new insights into the communication development of a preterm neonate and should be further investigated. An ECI programme and guidelines for implementation in the NICU are discussed as a treatment option.

Parental experiences of feeding problems in their infants with Down syndrome.

Although feeding difficulties in infants with Down syndrome are described in the literature, the experiences of parents regarding the feeding problems of their infants are largely omitted. In order to promote closer collaboration with families and speech-language therapists in early communication intervention, the study investigated some experiences of a group of parents concerning the feeding problems of their infants with Down syndrome. A descriptive survey approach was implemented to collect quantitative data. The results revealed the type of feeding problems and associated conditions occurring in the infants of the twenty participants; the type of feeding methods used; the assistance received during the feeding problems; the emotions experienced in relation to the feeding problems in their infants as well as suggestions made by the participants regarding the management of early feeding problems. Numerous feeding problems occurred in the infants and the variety of emotions experienced by the participants indicated that feeding therapy and counseling were required. As a result of the different conditions underlying the feeding problems of the participants' infants, a comprehensive approach, which included therapeutic and medical intervention, was necessary. In order to provide effective early communication intervention services from birth, the results indicated that the knowledge, skills and sensitivity of speech language therapists to identify caregiver needs, to provide appropriate family-focused intervention and to make recommendations regarding the management of feeding problems in infants with Down syndrome is of great importance.

Clinical training of undergraduate communication pathology students in the neonatal assessment and neonate-caregiver interaction in South Africa

Developing an undergraduate clinical training module in Early Communication Intervention (ECI) that provides sufficient opportunity for students' learning experiences, and that allows contextually relevant and ethically accountable services to clients, as well as the dissemination of the latest scientific findings to both students and clients, poses a significant challenge. The article describes the development of a clinical training block and the development of an appropriate instrument for the assessment of neonatal communication skills that was used in this student practical. A qualitative research approach, employing a series of formative assessments, was used to refine the instrument. The results indicated changes in the content and use of the neonatal assessment instrument regarding the approach to infant and caregiver risk assessment; caregiver beliefs about neonatal capabilities; newborn state observation; caregiver training; language, cultural and age barriers; collaboration with nurses; kangaroo mother care; involvement of caregivers during the assessment; and adolescent mothers. The results confirmed the need for the ongoing refinement of an instrument to ensure quality training of students in the difficult field of neonatal assessments and neonate-caregiver interaction. The results also highlighted to the importance of initiating ECI services before birth in communities at risk for infant neglect and abuse, and the close relationship between ECI service delivery and student training.

Early Intervention Practices and Communication Intervention Strategies for Young Males With Fragile X Syndrome.

This study describes speech-language pathologists' impressions of the communication difficulties of young males with fragile X syndrome (FXS) and the need for both syndrome-specific and individualized interventions. The findings of a regional study that identified speech-language pathologists' impressions of the speech, language, and behavioral difficulties experienced by males with FXS and an array of interventions used by speech-language pathologists to improve communication skills for these children are reported. Fifty-one speech-language pathologists providing intervention for males with FXS ranging in age from 2 to 9 years (mean age=6;3 [years;months]) were interviewed. The majority of the speech-language pathologists reported that boys with FXS exhibit a visually based, experiential or wholistic learning preference. They emphasized the necessity of making environmental accommodations for limited attention span, difficulties with topic and activity transitions, sensory deficits, and low threshold for anxiety. They reported that speech goals focused on slowing rate and increasing precision for verbal children and both low and high levels of assistive technology for nonverbal or minimally verbal children. Language goals focused on listening, auditory comprehension, and narrative/conversation skills. Pragmatic goals emphasized social dialogue, role playing, and topic maintenance. This study suggests that young males with FXS present the clinician with a constellation of behaviors and communication impairments that are both syndrome specific and symptom familiar. The specific communication strengths and deficits described by clinicians working with these children are common to many children with speech and language impairments compounded by cognitive deficits. Intervention programs for young boys with FXS should also attend closely to the specific behavioral (e.g., increased anxiety, attention deficits) and sensory "overload" problems they often exhibit before designing a tailored intervention program.

A Transdisciplinary Conceptual Framework for the Early Identification of Risks for Communication Disorders in Young Children

The early identification of infants with communication disorders or at risk for communication delays is still one of the biggest challenges of early communication intervention (ECI) and threatens to compromise its efficacy. Current approaches to the early identification of young children at risk for communication disorders involve strategies aimed at the identification of general developmental delays and may not be sufficiently sensitive and specific enough to detect the early stages of communication disorders. The risks for mortality and health are often identified early in life, but the concomitant risks for communication disorders in the same young children are frequently not identified at that opportune time. The current study involved a descriptive survey, describing the identification of communication disorders in 153 subjects, whose data was stored in and retrieved from a customized ECI database system. The findings revealed that the subjects were assessed at the average age of 18 months, but that identifications of risk conditions occurred prenatally, at birth, after the perinatal period and later in life. The time of identification related to the different communication disorders identified in the subjects and caregivers played a major role in detecting the first signs of communication disorders in their children. In order to provide a guideline for clinical practice, a transdisciplinary conceptual framework towards a coordinated effort for the early identification of risks for communication disorders in young children is proposed.

Early identification of at-risk infants and toddlers: A transdisciplinary model of service delivery

Traditional models of service delivery prevent speech-language therapists and audiologists from identifying and implementing early communication intervention (ECI) in South Africa. This study utilized the framework of the transdisciplinary team approach to develop a collaborative partnership between community nurses and speech-language therapists and audiologists. An interdisciplinary in-service training programme was implemented with 24 community nurses employed at family health clinics in Kwa-Zulu Natal; with the aim of enhancing their knowledge and attitudes toward the early identification and referral of at-risk children to speech-language therapists and audiologists. Three questionnaires were used to evaluate the nurses' knowledge and attitudes. Results indicated that the training programme significantly improved the nurses' knowledge regarding ECI but not their attitudes. Implications of these findings are discussed in terms of service delivery for ECI, and the education and training of early interventionists in the South African context.

The Future of Early Communication and Language Intervention

This article presents a vision of the future of early communication and language intervention efforts. In this vision, all young children experience highly responsive environments for as much of the time as possible from infancy onward, communication and language delays and disorders are routinely identified as close to their genesis as possible, and optimal intervention strategies are implemented as early as possible. To realize this vision, we must achieve the following on a broad scale: (a) increase support for responsive interaction styles among all parents, childcare workers, teachers, and early interventionists; (b) expand efforts to identify communication delays and disorders as early as possible; (c) move forward with the development of truly effective communication and language intervention approaches; and (d) transform research findings into day-to-day practice. The realization of this vision will necessitate a truly transdisciplinary approach to both research and practice.

Early Communication Intervention within a Community-based Intervention Model in South Africa

Infants and toddlers with special needs within the developing context in South Africa are not currently receiving adequate early communication intervention services. The development of a model for service delivery to this population is imperative for the successful implementation of early communication intervention in the developing context in South Africa. The basic model of early intervention service delivery provides a theoretical basis for early intervention service delivery but has certain limitations when applied to the developing context in South Africa. Community-based intervention is proposed as an avenue for the delivery of health care services within primary health care although constraints in the application of community-based intervention exist. An integrated model of early communication intervention service delivery within community-based intervention is proposed and illustrated by presenting a case example.

Early Communication Intervention with Young Children with Pierre Robin Sequence

Young children with Pierre Robin sequence are at considerable risk to develop delayed or disordered communication development. This study investigated the effectiveness of early communication intervention with four young children with Pierre Robin sequence, aged 5 to 28 months. The Proportional Change Index (Wolery, 1983) was used to determine the amount of child progress that took place during the intervention period. The results indicated that regular early communication intervention sessions over an extended period of time produced positive results, especially for expressive language abilities. The presence of a slight hearing loss due to otitis media, seemed to have influenced the effectiveness of early communication intervention. One subject displayed an associated disorder and evidenced the slowest rate of development for receptive and expressive language abilities as well as a limited phonetic repertoire for consonants. All but one subject had limited phonetic repertoires possibly due to velopharyngeal incompetence. Early communication intervention services should be delivered regularly over an extended period of time and the hearing abilities and speech production skills of young children with Pierre Robin sequence should be followed closely during early communication intervention.

Attitudes and perceptions of nurses regarding early communication intervention

Although nurses play a vital role during Early Communication Intervention with infants and toddlers 0-2 years, limited research has been conducted regarding this role. OpsommingAlhoewel verpleegkundiges 'n belangrike rol speel in Vroee Kommunikasie Intervensie met hoerisiko-babas en kleuters van 0-2jaar, is beperkte navorsing egter uitgevoer oor hierdie rol.
 
 *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Emerging model of communication and language intervention

Research on methods to enhance and remediate the communication and language development of children with mental retardation and developmental disabilities has been ongoing since the early 1960s. Scores of studies have been conducted over this time period, the vast majority aimed at testing various procedures or intervention “packages” with relatively small numbers of children for very limited periods of time. This “technology building” period is gradually receding and the framework of a developmental model of early communication and language intervention is emerging. This model supports the use of different intervention approaches at different points in a child's development. The purpose of this paper is to describe the basic framework of this emerging model, to provide an overview of the research findings that support it, and to identify high priority areas for further investigation. MRDD Research Reviews 1997;3:358–362. © 1997 Wiley-Liss, Inc.

Early communication functioning of infants with cleft lip and palate

This study investigated the early communication functioning and hearing abilities of 44 infants with cleft lip and palate, ages 3 to 31 months old. The results revealed that 64% of the subjects had a history of recurrent otitis media with effusion and 33% displayed associated anomalies. 26% of the subjects had mild hearing losses and middle ear pathology at the time of data collection. The subjects as a group displayed average developmental levels for perceptual-cognitive, socio-personal and receptive language skills, but a limited phonetic repertoire and a statistically significant expressive language delay. The results indicated that the subjects experienced a motor developmental delay, but this was not statistically significant. The implications for early communication intervention are to conduct regular hearing measurements and to conduct regular parent-centered therapy with individualized home programmes. Efforts should be directed towards expanding early communication intervention services to include all infants with cleft lip and palate in South Africa.

Enhancing Communication and Language Development in Young Children With Developmental Delays and Disorders

In this article, we present an overview of past and present research on early communication and language intervention at the John F. Kennedy Center for Research on Human Development. First, we present three basic premises that inform most research on early communication and language intervention at the Kennedy Center. Second, we present brief summaries of seven lines of contemporary research by Kennedy Center investigators that have and continue to influence the development of effective communication and language intervention approaches. Several basic findings that have emerged from this

Communication skills of biologically at-risk neonates

Early communication intervention has advanced to include neonatal assessment and management. Currently, however, there are limited diagnostic tools developed from a speech-language pathology and audiology perspective. The purpose of the study was to design a comprehensive neonatal communication assessment protocol and use it to describe the communication skills of 50 biologically at-risk neonates (852 g-3060 g birthweight). The results indicated that the subjects' general development was within normal limits, but their communication abilities displayed a serious delay. A high risk register consisting of 13 factors predicting the subjects' communication abilities was compiled. The length of time before the subjects could successfully take bottle feeds was found to be the strongest predictor of their communication development. The study is of particular relevance to the present South African context which has an increased incidence of low birth weight, thus rendering an enlarged population of biologically at-risk neonates.

A Survey of Pediatricians on Early Identification and Early Intervention Services

In order for Public Law 99-457 (P.L. 99-457) Part H to be effective, it is crucial that pediatricians be aware of and participate in community early intervention systems. Three hundred and forty-two pediatricians responded to a questionnaire regarding screening practices, referral methods, and training needs. Nearly all (97%) indicated that they routinely performed some type of developmental screening. Most respondents recommended more training in developmental/behavioral pediatrics in residency programs. Less than half of the pediatricians surveyed were familiar with all of the provisions of P.L. 99-457, even though 83% said they were aware of the legislation. The most frequently requested area of continuing education was developmental screening (66%), followed by requests for more information regarding community resources in early intervention (51%). Regional and local seminars were chosen as the type of continuing education most likely to be used by pediatricians. Continuing education is needed to prepare pediatricians for the new roles and skills needed to fully participate in the early intervention system.

Validity of Curriculum-Based Scales With Young Neurodevelopmentally Disabled Children: Implications for Team Assessment

Recent surveys in early childhood special education and developmental school psychology reveal that criterion-referenced or curriculum-based developmental assessment (CBA) is the primary form of measurement employed by interdisciplinary early intervention teams. Despite their wide use, little technical adequacy data are available on the validity of CBA instruments with specific populations of handicapped preschoolers. This research analyzed the concurrent validity of two norm-based and six curriculum-based scales commonly used within community early intervention programs with a sample of 50 infants and preschool children having diverse neurodevelopmental and neurobehavioral deficits. Results supported the concur- rent validity of CBA measures despite some significant interscale differences. Based on these results, guidelines are offered regarding "best practices" in the use of CBA systems by early intervention teams.