Results

1
Effects of a Naturalistic Sign Intervention on
Expressive Language of Toddlers with Down
Syndrome
Courtney Wright, Ann Kaiser, Dawn Reikowsky,
Megan Roberts Department of Special Education,
Vanderbilt University, Nashville, TN

• Procedures
• Baseline
• Adult directed play with toys.
• Moderately responsive
• No EMT/JASPER strategies used
• No signs modeled
• Intervention
• 20 sessions, 20-30 minutes
• Child directed play with toys
• Fully responsive
• All EMT/JASPER strategies used
• Signs modeled with gt90 of spoken words
• Generalization
• 10 minutes of standardized set of toys and books
• Conducted every 5 sessions
• At home with untrained parent

• Introduction
• Children with DS have specific phenotypic
  strengths and weaknesses based on their diagnosis
  (Chapman Hesketh, 2000 Kumin, 1996 Roberts,
  Price, Malkin, 2007 Stoel-Gammon, 2001).
• Two appropriate interventions
• Naturalistic interventions target strengths in
  social engagement (Adamson, Bakeman, Deckner,
  Romski, 2009) and weaknesses in requesting
  (Mundy, Sigman, Kasari, Yirmiya, 1988),
  persistence (Kasari Freeman, 2001), and object
  play (Adamson, et al., 2009).
• Sign language interventions target strengths in
  gesturing (Caselli et al., 1998 Franco
  Wishart, 1995) and weaknesses infusing symbols
  into joint engagement (Adamson et al., 2009).
• Purpose
• Does EMT/JASPER Words Signs increase use of
  expressive signs and spoken communication in
  young children with DS?
• Do children generalize newly learned words and
  signs to use with their parents at home?
• Participants

EMT and JASPER Intervention Components EMT and JASPER Intervention Components EMT and JASPER Intervention Components
Component Specific Strategies Examples
Setting a context for communication Sit face to face with the child Follow the childs lead Respond to all child communication Imitate the childs non-verbal actions (mirror) and map (model) language Adult reorients in front of the child when the child when the child moves from blocks to cars Child vocalizes while playing with the baby and the adult responds by saying baby Child rolls ball, adult rolls ball and says ball
Modeling and expanding play Choose interesting and engaging toys Teach target level play actions and sequences Choosing toys according to play level Modeling stacking the blocks
Modeling and expanding communication Model target signs or words Expanding child communication Pointing to the apple and saying apple Child signs baby and the adult signs/says, baby eats.
Modeling joint attention skills Model point, show and give gestures in conjunction with target language Points to car rolling down track and says down the slide Shows baby bottle and says and signs bottle
Time delay strategies Assistance Choices Waiting with routine/cue Inadequate portions Adult gives the child a juice box, waits for the child to ask for help, and expands communication Adult holds up two choices, waits for the child to indicate a choice., and expands communication
Prompting strategies Open questions Choice questions Say prompt Child reaches for the ball and the adult says say ball, Adult holds up juice and milk and says juice or milk?

• Results

• Discussion
• New application of EMT to sign mode
• Children still use words when learning to sign
• Children learned between 10 and 21 signs and
  generalized their use to untrained partner at
  home
• Future research
• Replicate findings in group and single subject
  designs
• Expand target words, environments partners
• Explore EMT/JASPER with other AAC modes
• Continue developing interventions targeting
  strengths and weaknesses of young children with
  DS

Ryan Ryan Erin Erin Jay Jay Gretchen Gretchen
Age at entry (months) 29 29 25 25 23 23 23 23
Gender Male Male Female Female Male Male Female Female
Ethnicity Caucasian Caucasian Caucasian Caucasian Caucasian Caucasian Caucasian Caucasian

Screening Screening Screening Screening Screening Screening Screening Screening Screening
Mullen SS 58 58 69 69 77 77 72 72
Imitation 80 80 80 80 40 40 0 0

Testing Pre Post Pre Post Pre Post Pre Post
PLS AC SS 61 57 67 71 74 75 67 61
PLS EC SS 73 72 73 83 73 75 81 89
MCDI of signs produced 0 27 1 30 0 21 0 7
MCDI of words produced 11 33 7 33 10 43 2 26
During baseline, all children used fewer than
five signs. Upon introducing the intervention,
use of signs increased to varying degrees ranging
from 0-78 signs. Spontaneous number of different
words increased for 3 of the 4 participants. Child
ren generalized their skills to untrained
parents. Three of the four participants used
zero words during baseline sessions. Erin said
five (three unique) words. After the introduction
of the intervention, each participant
demonstrated different patterns of word usage.
Participants used between zero and 32 total words
during intervention sessions. A word or sign
was included when the child used it spontaneously
during a single session. Participants used few
spontaneous words or signs during baseline. All
children acquired words and signs throughout
intervention, although at different rates.
Children learned more signs than words.