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.

KEYWORDS

Motor impairment - caregiver training

REFERENCES

• 1 Bates E, Camaioni L, Volterra V. The acquisition of performatives prior to speech. In: Ochs E, Schieffelin B Developmental Pragmatics. New York; Academic 1979: 111-129
• 2 Trevarthen C, Hubley P. Secondary intersubjectivity: confidence, confiding and acts of meaning in the first year. In: Lock A Action, Gesture and Symbol: The Emergence of Language. New York; Academic 1978: 183-229
• 3 Trevarthen C. The concept and foundations of infant intersubjectivity. In: Bråten S Intersubjective Communication and Emotion in Early Ontogeny. Cambridge, United Kingdom; Cambridge University 1998: 15-46
• 4 Tomasello M. Joint attention as social cognition. In: Moore C, Dunham PJ Joint Attention: Its Origins and Role in Development. Hillsdale, NJ; Lawrence Erlbaum 1995: 103-130
• 5 Tomasello M. Reference: intending that others jointly attend.  Pragmatics Cognit. 1998;  6 229-243
• 6 Trevarthen C, Aitken K J. Infant intersubjectivity: research, theory, and clinical applications.  J Child Psychol Psychiatry. 2001;  42 3-48
• 7 Dunst C J. Social-emotional consequences of response-contingent learning opportunities. Bridges.  Practice-Based Research Syntheses. 2003;  1 1-17
• 8 Dunst C J, Lowe L W, Bartholomew P C. Contingent social responsiveness, family ecology, and infant communication competence.  National Student Speech-Language-Hearing Association Journal. 1990;  17 39-49
• 9 Iacono T, Carter M, Hook J. Identification of intentional communication in students with severe multiple disabilities.  Augmentative and Alternative Commun. 1998;  14 102-114
• 10 Pinder G L, Olswang L B, Coggins T E. The development of communicative intent in a physically disabled child.  Infant-Toddler Interv. 1993;  3 1-17
• 11 Yoder P J, Warren S F. Intentional communication elicits language-facilitating maternal responses in dyads with children who have developmental disabilities.  Am J Ment Retard. 2001;  106 327-335
• 12 Hutto M D. Latency to learn in contingency studies of young children with disabilities or developmental delays. Bridges.  Practice-Based Research Syntheses. 2003;  1 1-16
• 13 Cress P J, Spellman C R, DeBriere T J, Sizemore A C, Northam J K, Johnson J L. Vision screening for persons with severe handicaps.  J Assoc Pers Sev Handicaps. 1981;  6 41-49
• 14 Dowden P A, Cook A M. Selection techniques for individuals with motor impairments. In: Reichle J, Beukelman D, Light J Implementing an Augmentative Communication System: Exemplary Strategies for Beginning Communicators. Baltimore, MD; Brookes 2002: 395-432
• 15 Brooks-Gunn J, Lewis M. Maternal responsivity in interactions with handicapped infants.  Child Dev. 1984;  55 782-793
• 16 Pennington L, McConachie H. Mother-child interaction revisited: communication with non-speaking physically disabled children.  Int J Lang Commun Disord. 1999;  34 391-416
• 17 Yoder P J, Warren S F. Maternal responsivity predicts the prelinguistic communication intervention that facilitates generalized intentional communication.  J Speech Lang Hear Res. 1998;  41 1207-1219
• 18 Yoder P J, Warren S F. Relative treatment effects of two prelinguistic communication interventions on language development in toddlers with developmental delays vary by maternal characteristics.  J Speech Lang Hear Res. 2001;  44 224-237
• 19 Pepper J, Weitzman E. It Takes Two To Talk: A Practical Guide for Parents of Children with Language Delays. Toronto, Canada; Hanen Centre 2004
• 20 Yoder P J, Warren S F. Effects of prelinguistic milieu teaching and parent responsivity education on dyads involving children with intellectual disabilities.  J Speech Lang Hear Res. 2002;  45 1158-1174
• 21 Pennington L, Goldbart J, Marshall J. Interaction training for conversational partners of children with cerebral palsy: a systematic review.  Int J Lang Commun Disord. 2004;  39 151-170
• 22 Pinder G L, Olswang L B. Development of communicative intent in young children with cerebral palsy: a treatment efficacy study.  Infant Toddler Intervention. 1995;  5 51-70
• 23 Olswang L B, Pinder G L, Braverman J. Communication in infants with physical disabilities: teaching parents to teach. Presented at: The American Speech-Language-Hearing Association Annual Convention November 1999 San Francisco, CA;
• 24 Billingsley F, White O R, Munson R. Procedural reliability: a rationale and an example.  Behav Assess. 1980;  2 229-241
• 25 Cohen J. A coefficient of agreement for nominal scales.  Educ Psychol Meas. 1960;  20 37-46
• 26 Cicchetti D, Sparrow S. Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior.  Am J Ment Defic. 1981;  86 127-137
• 27 Dunst C J, Kassow D Z. Characteristics of interventions promoting parental sensitivity to child behavior. Bridges.  Practice-Based Research Syntheses. 2004;  3 1-17