assessment of communication...
TRANSCRIPT
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Assessment of
Communication Skills
Jessica Folk-Farber M.SLP RSLP
Kate Wishart M.Sc RSLP
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Learning Objectives
Participants will understand
The ICF Framework as it relates to
assessment of children’s communication
skills
That assessment involves a focus
beyond the child performance in
structured tasks including evaluation in
real life situations
And of communication partners
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What is Language?
Language is not a single entity
Form = grammar/structure
Content = words
Function = use of language in
appropriate context
Without all three, there is no shared
communication
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Language is more…
…than just words and sentences
Most of us communicate through speech
Some communicate through sign
We all use
Body language
Gestures
Facial expression
Tone (prosody)
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Communication is
both use of
language and
comprehension of
language
Talking AND
listening
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What is language?
Form
Sounds and grammar
Content
Words
Use
Language Functions
Appropriateness of Language
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Communication in Context
Bloom & Tinker (2001) add effort –
cognitive development – and
engagement – social & emotional
development – as a broader framework
for considering language development
Language-learning occurs within the
context of the child’s abilities
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The Intentionality Model – Bloom and
Tinker (2001)
FORM
USE
CONTENT
EFFORT:
Cognitive Development
ENGAGEMENT:
Social & Emotional
Development
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Learning Language is Interactive
Content: children must be repeatedly exposed
to new words in context in order to map them
into their lexicon
Form: children must be repeatedly exposed to
grammatical structures to map the rules of
their native language
Function: children must have opportunities to
try, succeed, and fail at communication
attempts in order to learn what is appropriate
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Learning Spoken Words
The child must connect the sound
sequences he/she hears with the object
or idea – the meaning
Child’s system of sound production develops to match adult system
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Delay vs. Disorder
Delay
Child’s language or speech sound system is developing in the expected sequence, but is behind that of his or her peers
Child’s language or speech reflects that of the chronologically younger child
Disorder
Child’s language or
speech sound
system is not
developing in the
expected sequence
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The Child’s Needs
Physical
Hearing
Structure of oral-motor mechanisms
Breath support, lung capacity
Muscle tone
Cognitive
Social-Emotional
Models
Partners
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Input: From Adults
Language-learning occurs in context
Caregivers:
structure the environment to facilitate
language development
model language and pair verbal input with
visual cues to help child make connections
between words and objects/events
create opportunities throughout the day
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Input: From Peers
Language-learning occurs in context
Peers:
Model language at a level similar to where
children are speaking now
Engage each other in social interactions
and pretend-play sequences
Frequently refuse or ignore others’ attempts
at communication and joining in play
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Communication Partners
Two roles: as receiver and as sender of
messages
Always within context of the environment
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The Communication Model
Activity and Participation
Communication
Environment
Sender Receiver
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Scene 1: Child & Teacher A
Teacher: What do you have?
Child: Car
Teacher: What colour is it?
Child: Blue
Teacher: Did you get it at the store?
Child: No mummy
Teacher: Mummy gave it to you?
Child: Yes
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Scene 2: Child & Teacher B
Teacher: What do you have?
Child: Car
Teacher: Oh, it’s a blue car!
Child: Blue car. Fast!
Teacher: A fast blue car! A racecar.
Child: Racecar. Blue racecar.
Teacher: Can you show me how it races?
Child: Races fast. Vroom.
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Scene 3: Child & Child B
Child: Car
Child B: My car!
Child: Car
Child B: My car!
… and so on!!!
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Importance of Interaction
Dickinson (2002) showed that improved
interactions between teachers and
preschool students leads to greater
academic success in the later years,
including in literacy
Hart & Risley: The Early Catastrophe
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The Speech Chain
Denes & Pinson, p.5
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International Classification of Functioning,
Disability & Health (ICF)
A model that helps bridge the worlds of
funders, families and clinicians to explain our
assessment, intervention goals and outcomes
Common language for all
Health-based
inclusive of all of us,
not just those with ‘disabilities’
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Child Abilities & Communication
Environments
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ICF
To improve child functioning:
a disability model emphasizes changing
or mitigating individuals’ deficits as a
way of improving their functioning
a health and social model which
emphasizes changing the environment
around the individual, to support their
improved functioning and participation
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ICF
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ICF
Health Condition
(disorder/disease)
Body function
and structure
(Impairment)
Activities
(Limitation)
Participation
(Restriction)
Environmental
Factors
Personal
Factors
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The Speech ChainICF Body/Structure Function Level
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Body Functions (Impairment)
Improving oral motor control
Producing new sounds
Improving eye gaze
Improving pointing
Jenny will identify objects by colour and size
Joseph will use grammatical markers
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Body structure?
Body function?
Activities?
Participation?
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Communicative Participation
Performance in actual life
situation
in contrast to
Capacity in controlled activities
such as clinic or therapy
WHO, 2007, pp. xvi, 12
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Activity
‘Capacity’ – optimal ability to perform a task
in a standard environment, such as the
speech clinic.
Increased vocabulary
Increased sentence length
Use of grammar in structured tasks
Increased fluency
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Participation
‘Performance’: what someone typically does in all of
their environments
More sociable
Starting to play with other children at child care setting
Talking more to other people in the stores or at family
gatherings
Taking more communication turns when playing at child
care
Following the teacher’s instructions at school
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Personal Factors
Biological preparation
for language.
perceptual,
attention,
memory
cognitive capacities
motivation
individual child traits
personality
Interests
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Environmental factors
Linguistic factors
Parental communication
style
Language input-quantity
-quality
Attitudes of family, peers, society beliefs
values
customs
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Community participation and life satisfaction of
individuals with disabilities
People with disabilities are just like everyone else."
"Remember the person is an individual first and disabled second."
"We are people. We have feelings, hopes, desires, and needs like everyone and what we need most is acceptance and support, financially and emotionally."
What Helps and Hinders People at Turning Points in Life? (1999) King, G., Cathers, T., MacKinnon, L., Havens, L., Smith, L., Brown, L.,
Specht, J., Miller Polgar, J., & Willoughby, C., CanChild Centre for Childhood Disability Research
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Standardized assessments:
where do they fit?
Communicative Capacity
Communication Performance
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CFCS
Communication Function Classification System for Individuals with Cerebral Palsy
Classifies the everyday communication performance of an individual with cerebral palsy into one of five levels
Focuses on activity and participation levels
http://www.cfcs.us/
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CFCS Level Identification Chart
Does the person consistently and
effectively alternate sender and receiver roles
with familiar partners
Does the person consistently and
effectively communicate with unfamiliar partners?
Is the person an effective sender AND/OR a
receiver at least some of the time?
Does the person usually maintain a comfortable
conversational pace with communication partners
Level IEffective Sender and
Receiver with unfamiliar and
familiar partners
Level IIEffective, but slower-paced Sender and/or
Receiver with unfamiliar and familiar partners
Level IIIEffective Sender AND
Effective Receiver with familiar partners
Level IVInconsistent Sender
and/or Receiver with familiar partners
Level VSeldom Effective
Sender and Receiver with familiar partners
NOYES
YES NO
YES NO
YES NO
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FOCUS
F ocus on the
O utcomes of
C ommunication
U nder
S ix
A new outcome measure for preschool children that identifies ‘real world’ changes associated with speech therapy.
http://www.bloorview.ca/research/scientistprofiles/thomasstonell.php
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FOCUS
Measures changes in ‘participation-level’ real-world communication skills
50 item questionnaire
Completed by clinician and parent
Takes 10 minutes to complete
* Thomas- Stonell, N, Oddson, B., Robertson B., Rosenbaum, P., (2009) Predicted and observed outcomes in preschool children following speech and language treatment. Journal of Communication Disorders, 42, 29-42
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Participation –every child’s goal
The child
The family
The environment
Law, M., & King, G. (2000), Participation! Every child's goal. Today's Kids in Motion, 1, 10-12
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Stumbling blocks: Speech/language delay
and participation in physical activities
Child
Understanding of
language – rules
Ability to express
ideas
Social communication
Processing
Environment
Noise level
Activity level
Needs of others in
environment
Abilities of others in
environment
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What does this mean for
intervention?
Consider:
Where we do treatment
How we do treatment
How we frame goals of treatment
Increased role of family and other
caregivers in treatment
Increased role of teachers
Increased role of peers
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