Communication in Young Children with Motor Impairments: Teaching Caregivers To Teach

Abstract

Communication between caregivers and children with moderate to severe motor impairments is a tremendous challenge, and one that deserves attention as a central component of early intervention programs. This article examines a caregiver-training program that explored key elements to creating strong communicative interactions between young children with moderate to severe motor impairments and their primary caregiver. Three caregiver-child dyads participated in a 3-week treatment program teaching caregivers how to provide communicative opportunities, wait for a clear communication signal from their children, recognize their children's signal, and finally, shape a more advanced communicative behavior. These adult behaviors were designed to increase the children's use of conventional engaging signals of communication. Results revealed that caregivers demonstrated success learning all behaviors except for shaping during the brief treatment period. Children's engaging communicative behaviors increased correspondingly with the caregivers' changes. These findings have positive implications for caregiver training. Implications for "best practice" are considered.

Triadic Gaze Intervention for Young Children With Physical Disabilities

“…Some behaviors and skills are notably harder to teach caregivers and may require the expertise of a trained professional. Olswang et al (2006), for example, demonstrated that scaffolding children’s performance to TG is difficult for caregivers to learn, even when given direct instruction. Because no single approach can serve all needs, birth-to-three providers must select the most appropriate treatment and service delivery model to match a child’s current and emerging developmental profile, as well as family needs and preferences (Brady, Warren, & Sterling, 2009; Prelock, 2013).…”

“…Another study suggested the value of teaching this same protocol to caregivers of three children with physical disabilities (Olswang, Pinder, Hanson, 2006). After six sessions, caregivers demonstrated the ability to provide opportunities for communication and recognize gaze attempts, although they were minimally able to shape TG.…”

“…Complicated developmental profiles can profoundly disrupt production of conventional gaze, gestures and vocalizations in the context of social interactions. This, in turn, interrupts critical teaching and learning opportunities during the first months of life (Halle, Brady, & Drasgow, 2004; Iacono, Carter, & Hook, 1998; Olswang, Pinder, & Hanson, 2006; Paparella & Kasari, 2004; Pinder & Olswang, 1995; Pinder, Olswang, & Coggins, 1993). Early intervention for this population is crucial to teach behaviors that facilitate social engagement and joint attention (Arens, Cress, & Marvin, 2005; Goossens’ & Crain, 1987; Paparella & Kasari, 2004; Pinder et al, 1993; Pinder & Olswang, 1995; Reinhartsen, 2000; Wetherby, Yonclas, & Bryan, 1989; Woods & Wetherby, 2003).…”

Validating Dynamic Assessment of Triadic Gaze for Young Children With Severe Disabilities

“…This suggests that SLPs need to clearly advise caregivers on appropriate behaviors to emphasize during interactions with their children. Further, results of earlier work by Olswang et al(2006) have shown that scaffolding children’s performances to TG is difficult for parents to learn, even when they are provided with direct instruction. This evidence suggests the importance of being able to clearly identify the behavioral objectives and the means by which to teach them.…”

“…For those children who have adequate vision but are constrained by motor and other sensory limitations, gaze is viewed as an important conventional signal of communication to target in treatment (Woods & Wetherby, 2003; Wetherby et al, 1989; Pinder, Olswang, & Coggins, 1993; Pinder & Olswang, 1995; Olswang, Pinder, & Hanson, 2006). This is particularly true for children who may later require augmentative and alternative communication strategies (Goossens’ & Crain, 1987).…”