If it is Thursday, it is bound to rain. At least that is what it feels like to Amanda Squires and Vicki Wright. Each Thursday these two Speech Language Pathology students from McGill’s School of Communication Sciences and Disorders (SCSD) make the trek out to Beaconsfield’s Child and Family Services Center, a part of the West Montreal Readaptation Center, and so far it has rained on them each time. But it is there that they are a part of Stepping Stones, a preschool program for developmentally delayed preschool aged children. Stepping Stones aims to prepare the children to enter school along with their peers. The program is one of many offered by the West Montreal Readaptation Center (WMRC) which provides a wide range of services for intellectually disabled people and their families from birth until death, with a special interest in facilitating social integration.
Stepping Stones is an enhanced and highly structured preschool program. Each session begins with free play and integrates other preschool activities, such as circle time, gym and crafts. A special part of the program consists of what the children call their work. Work is specially assigned by the educator to focus on each child’s goals. Before McGill’s SCSD’s Head of Clinical Program, Jeanne Claessen, developed a clinical partnership with the Stepping Stones program, the children did not have access to speech and language intervention through the program. Ms. Claessen became aware of the need for speech and language intervention for these children almost simultaneously through contacts with Susan Rvachew, a professor in McGill’s SCSD SLP program, as well as Marie Flouriot, Ph. D., a communication specialist from the WMRC. In the fall of 2003 the first students, with Ms. Claessen as their supervisor, began their clinical experience with the Stepping Stones program. Since then ten students have had clinical experience within the program and just this year a separate supervisor, Anne Vogt SLP, was hired.
The SLP students work with their supervisor to set speech and language goals for the children. They work on these goals with each child in both the group and individual settings. Due to the large number of nonverbal children in the program, the goals for the children mostly involve developing precursors to language such as imitation, turn-taking and joint attention. Exercises to develop these skills are as simple as rolling a ball back and forth or taking turns putting toys or trinkets in a bucket to reinforce the concept of turn-taking, which can be done on a one-to-one basis. The students are also introducing a Picture Exchange Communication System to some of the children that helps them communicate their needs even if they cannot speak.
The services provided by the McGill students in the classroom allow the children to develop their communication skills in a variety of real-life situations. Anne Vogt, the students’ supervisor, points out that "one of the special things about the Stepping Stones Program was that in the mornings the Students were able to experience what it was like to help with more holistic Language Intervention in the context of the Pre-school group; that provided quite a lot of variation when contrasted with one-on-one Therapy that they provided later in the afternoon." One parent believes that "the speech language therapy offered by the McGill student has been a great learning experience for my daughter. It’s been fun and she has picked up words and increased her comprehension skills” and adds that she hopes “they come back again in January." Another parent feels the same way, believing that these services are essential to her son's language impairment and have benefited him on so many levels, not just language. She commented that “this hands on experience should be encouraged and continued. From my point of view as a mother, I felt a strong desire from the students to wanting to learn and succeed. I also noticed good results ... In all, our family is very grateful for the opportunity given to our son."
While the rain may dampen the trek to the center, nothing can dampen the experience for Amanda and Vicki, who report that they are having a lot of fun and learning a lot at the same time.
How to Help Your Child Learn to Communicate
Having a child who doesn’t communicate well can be a challenging and overwhelming experience for you as a parent. However, there are many things that you can do to help your child communicate better, even if he is not yet talking.
Play is a natural and positive occupation in every child’s life. It provides a privileged moment for you to interact with your child and stimulate her language. Let’s look at some concrete strategies based on this approach that you could use while interacting with your child during free play.
Follow your child’s lead: During free play, your child experiences a feeling of control as he can focus his attention on objects he enjoys. At this moment, you have a good opportunity to establish joint attention. Joint attention is viewed as a powerful channel for language development. Joint attention refers to the ability of two persons to share a common interest and focus on a same object or event. You can help by attending to and commenting on what your child is spontaneously paying attention to, instead of imposing or redirecting the child’s attention to new objects/games. In other words, when your child is playing, wait for him to initiate, and then follow his lead). With this type of undemanding and non-directive interaction, it is more likely that your child will learn from your speech, as it relates to something that motivates him and that he really enjoys.
Establish turn taking: The ability to take and wait for one’ s turn is an important skill for conversation. It is something you can stimulate during your interactions with your child. You can engage her in simple games that imply prolonged turn taking. For example, if she puts a block in a container, imitate her by putting another block in the container before encouraging her to take a turn with another block. Balls, bubbles, puzzles, dolls, and toy cars can also be used in turn-taking games.
Provide simple speech input: When playing with your child, talk to him using short sentences that are simple but grammatically correct. Adapt the complexity of your sentences to be just a little above your child’s level. For example, if your child points at the toy car, you could say ‘Car’. If he points and says ‘Car!’, you could say ‘You want the car.’ before giving it to him.
Repeat what you say frequently: Frequent repetition of the words that refer to objects that interest your child is another important strategy for helping your child to learn new words.
Where to start: Initially, focus should be given to words that refer to concrete and appealing objects in the child’s life. Remember that the child himself/herself will guide you by attending to specific objects during his play.
In summary, joint attention and turn taking are important skills related to language development. We wish you good luck and a lot of fun time interacting and playing with you child!
Further reading for professionals: These suggestions are based on an intervention approach called Interactive Focused Stimulation. Studies have shown that this approach can be successfully used by parents, child care workers, educators, and speech language pathologists.Girolametto, L., Pearce, P. S., Weitzman, E. (1996). Interactive Focused Stimulation for Toddlers with Expressive Vocabulary Delays. American Speech-Language-Hearing Association, 39, 1274-1283.
Girolametto, L., Weitzman, E., Greenberg, J. (2003). Training Day Care Staff to Facilitate Children’s Language. American Journal of Speech-Language Pathology, 12, 299-311.
Hoff, E.& Naigles, L.(2002).How Children Use Input to Acquire a Lexicon. Child Development, 73, 418-433.
Siller, M. & Sigman, M. (2002). The Behaviors of Parents of Children with Autism Predict the Subsequent Development of Their Children’s Communication. Journal of Autism and Developmental Disorders, 12, 77-89.