Article  |   June 2013
Effects of a Naturalistic Sign Intervention on Expressive Language of Toddlers With Down Syndrome
Author Affiliations & Notes
  • Courtney A. Wright
    Vanderbilt University, Nashville, TN
  • Ann P. Kaiser
    Vanderbilt University, Nashville, TN
  • Dawn I. Reikowsky
    Vanderbilt University, Nashville, TN
  • Megan Y. Roberts
    Vanderbilt University, Nashville, TN
Article Information
Audiologic / Aural Rehabilitation / Augmentative & Alternative Communication / Special Populations / Genetic & Congenital Disorders / Language
Article   |   June 2013
Effects of a Naturalistic Sign Intervention on Expressive Language of Toddlers With Down Syndrome
Journal of Speech, Language, and Hearing Research, June 2013, Vol. 56, 994-1008. doi:10.1044/1092-4388(2012/12-0060)
History: Received February 17, 2012 , Revised July 7, 2012 , Accepted October 17, 2012
Journal of Speech, Language, and Hearing Research, June 2013, Vol. 56, 994-1008. doi:10.1044/1092-4388(2012/12-0060)
History: Received February 17, 2012; Revised July 7, 2012; Accepted October 17, 2012

Purpose: In this study, the authors evaluated the effects of Enhanced Milieu Teaching (EMT; Hancock & Kaiser, 2006) blended with Joint Attention, Symbolic Play, and Emotional Regulation (JASPER; Kasari, Freeman, & Paparella, 2006) to teach spoken words and manual signs (Words + Signs) to young children with Down syndrome (DS).

Method: Four toddlers (ages 23–29 months) with DS were enrolled in a study with a multiple-baseline, across-participants design. Following baseline, 20 play-based treatment sessions (20–30 min each) occurred twice weekly. Spoken words and manual signs were modeled and prompted by a therapist who used EMT/JASPER teaching strategies. The authors assessed generalization to interactions with parents at home.

Results: There was a functional relation between the therapist's implementation of EMT/JASPER Words + Signs and all 4 children's use of signs during the intervention. Gradual increases in children's use of spoken words occurred, but there was not a clear functional relation. All children generalized their use of signs to their parents at home.

Conclusions: The infusion of manual signs with verbal models within a framework of play, joint attention, and naturalistic language teaching appears to facilitate development of expressive sign and word communication in young children with DS.

Acknowledgments
This project was supported, in part, by Early Childhood Special Education Doctoral Leadership Training Grant H325D070075 and KIDTALK TACTICS Model Demonstration Center on Early Childhood Language Intervention Grant H326M070004.
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