good things happen when you talk emt en español - vkc...

Good things happen when you talk

EMT en Español: A Cultural and Linguistic Adaptation of Caregiver-Implemented Language

Intervention

Tatiana N. Peredo, PhD & Ann P. Kaiser, PhD

Vanderbilt University

ASHA Conference

November 12, 2015


Disclosures

Financial –

• We have no relevant financial or nonfinancial relationship(s) within the products or services described, reviewed, evaluated or compared in this presentation.

Nonfinancial –

• Dr. Kaiser's research is supported by the following grants: ACE Grant 1R01HD073975, HRSA Grant R40MC27707, IES Grant R324A090181, NIH Grant HD073975, and a Merck grant.

• Dr. Peredo's position is supported by the following grants: ACE Grant 1R01HD073975, HRSA Grant R40MC27707, a Merck grant, and a Vanderbilt Peabody College Small Grant.


What is EMT (Enhanced Milieu Teaching)?

• EMT is a naturalistic, conversation-based intervention that uses child interests and initiations as opportunities to model and prompt language in everyday contexts.

• EMT can be used throughout the day as part of the everyday interactions.

• EMT is an evidence-based intervention with 20 years of research.

• EMT is an effective intervention.Selected citations: Kaiser et al, l993; Scherer & Kaiser, 2010; Wright et al, 2013; Roberts & Kaiser, 2012; Kaiser & Roberts,

2012; Roberts & Kaiser, 2015


Why Spanish-speaking families?

• In 2011, 21% of people over age 5 spoke a language other than English at home (U.S.

Census, 2011).

• 62% spoke Spanish

• Hispanics are a young and growing population.

• ~25% of children under 5 (Federal Interagency

Forum on Child and Family Statistics, 2014)


Hispanic Children…

• comprise 24% of population in 2013, projected to 35% by 2050

• comprise over half of the population in some states

(Federal Interagency Forum on Child and Family Statistics, 2014; U.S. Census, 2011)


EMT en Español


EMT en Español: Steps to Adapting the Intervention

1. Review of relevant literature

2. Interviews/surveys of Spanish-speaking parents and EI providers

3. Proposed adaptations of intervention strategies and caregiver training method

4. Practice using intervention strategies with Spanish-speaking children

5. Practice teaching Spanish-speaking caregivers how to use strategies

6. Single case study to measure effectiveness of caregiver implemented intervention


What We Learned

Relationship

building Words matter:

disability

stigma

Including all

caregiversLocation for

training


Why Teach Home Language


Teaching Home Language: Family and Cultural Connections

By learning their home language, children can:

• Maintain culture

• Maintain family connections

• Have healthier social-emotional development

• Generalize learned communication skills with family members

(Kohnert & Derr, 2012)


Teaching Home Language: Acquisition of English

Children can make greater and faster gains in English with strong foundation in their first language.

• Spanish oral language skills were associated with literacy outcomes in English (Miller et al., 2006).

• Spanish vocabulary may support English vocabulary (Snow & Kim, 2007).

• Use of Spanish at home does not interfere with growth in English vocabulary (Mancilla-Martinez & Lesaux, 2011).


Teaching Home Language: Linguistic Models

• Caregivers can model more complex and rich language in their native language (Hammer, Davison, Lawrence, & Miccio, 2009).

• Native speakers can provide linguistic models that aid in children’s language development (Hoff et al., 2014).


EMT Strategies & Adaptations for EMT en Español


EMT Strategies: Setting a Context for Communication

• Sit on the floor

• Play together with toys

• Limit questions and directions to the child

• Follow the child’s lead

Definition/Behaviors

• Play on the floor or at the table

• Playfully use familiar materials/ engage playfully in familiar routines

• Notice child’s interest

Adaptations


EMT Strategies: Responsive Interactions

• Mirror and map

• Notice and respond to all child communication


• Use family dialect/words

• Ask caregivers every session

Considerations


Responsive Interactions: Examples


EMT Strategy: Model Target Language

• Choose language targets based on child’s current communication

• Use target level language 50% of the time

• Use slightly above target level language 50% of the time


• Use more verbs, model first person singular, first person plural, and third person singular inflection of verbs (Jackson-Maldonado, 2012)

Considerations

Good things happen when you talk English Verb Inflections: An Illustration

To talk

talk

talks

talking

talked


Spanish Verb Inflections: An Illustration

hablar

hablo

hablas

hablahablan

hablé

hablaste

habló

hablamoshablaron

hablaba

hablabas

hablábamos

hablaban

hablaría

hablarías

hablaríamos

hablarían

hablaré

hablarás

hablará hablaremos

hablarán


Choosing Targets for Early Language Learners

hablar

hablo

habla

hablamos


EMT Strategies: Expand Activities and Language

• Expand child’s engagement in play and activities by adding steps or modeling new ideas

• Expand child’s language by repeating child communication and adding a word


• Add words to make phrasegramatically correct

• Add verbs, nouns, ordescriptive words

Considerations


EMT Strategies: Time Delay and Prompting

Set up request

• Assistance

• Inadequate portions

• Pause in routine

• Choice

Time Delay

• Time delay

• Open question

• Choice question

• Say prompt

Prompting

• Teach procedures based on specific routines (e.g., give a choice in snack)

• Teach 1 procedure based on child current abilities (e.g., always start with open question)

Adaptations


Time Delays and Prompting Examples


Teaching Caregivers EMT enEspañol


Teach-Model-Coach-Review

Teach: explain strategies being used

Model: show caregiver how to implement strategy

Coach: use guided practice

Review: ask caregiver for feedback on session, reflect and problem-solve

(Roberts & Kaiser, 2012, 2015)


Assessments


Standardized Assessments Used in EMT enEspañol

• PLS-5 (Zimmerman, Steiner, & Pond, 2012)

• ROWPVT-SBE (Martin, 2012)

Measures

• Adapted for and normed onSpanish-speakers or bilingualspeakers residing in the U.S.

• Can be used with youngchildren

Reasons for Choosing


Examples of Standardized Measures


Other Assessments

• Inventarios MacArthur-Bates del Desarrollo de Habilidades Comunicativas (Jackson-Maldonado et al., 2003)

Measures

• Parent reported expressivelanguage

Reasons for Choosing

• Language Sampling• Interactions with caregivers

• Interaction with “language teacher”

• Naturalistic

• Provides rich linguisticinformation (Rojas & Iglesias, 2009)


Language Sampling Example


Questions & Discussion

Contact: [email protected]

Website: vkc.mc.vanderbilt.edu/kidtalk

Friend us on facebook @ Vanderbilt kidtalk

mailto:[email protected]


References

Agazzi, H., Salinas, A., Williams, J., Chiriboga, D., Ortiz, C., & Armstrong, K. (2010). Adaptation of a behavioral parent-training curriculum for Hispanic caregivers: HOT DOCS Español. Infant Mental Health Journal, 31(2), 182–200.

Calzada, E. (2010). Bringing Culture Into Parent Training With Latinos. Cognitive and Behavioral Practice, 17, 167–175.

Hammer, C. S., Davison, M. D., Lawrence, F. R., & Miccio, A. W. (2009). The Effect of Maternal Language on Bilingual Children’s Vocabulary and Emergent Literacy Development During Head Start and Kindergarten. Scientific Studies of Reading, 13(2), 99–121.

Jackson-Maldonado, D. (2012). Verb morphology and vocabulary in monolinguals, emerging bilinguals, and monolingual children with primary languageimpairment. In Bilingual Language Development and Disorders in Spanish-English Speakers, Second Edition (2nd ed., pp. 153–174). Baltimore, Md: Paul H. Brooks Publishing Co.

Kaiser, A. P., & Roberts, M. Y. (2013). Parent-Implemented Enhanced Milieu Teaching with Preschool Children Who Have Intellectual Disabilities. Journal of Speech, Language, and Hearing Research, (1), 295–309.

Kohnert, K., & Derr, A. (2012). Language Intervention with Bilingual Children. In Bilingual Language Development and Disorders in Spanish-English Speakers, Second Edition (2nd ed., pp. 337–356). Baltimore, Md: Paul H. Brooks Publishing Co.

Kaiser, A.P., & Roberts, M.Y. (2013). Parent-implemented enhanced milieu teaching with preschool children with intellectual disabilities. Journal of Speech, Language, and Hearing Research, 56, 295-309.

Lonigan, C. J., Farver, J. M., Nakamoto, J., & Eppe, S. (2013). Developmental trajectories of preschool early literacy skills: A comparison of language-minority and monolingual-English children. Developmental Psychology, 49(10), 1943–1957.

Mancilla-Martinez, J., & Lesaux, N. K. (2011). Early home language use and later vocabulary development. Journal of Educational Psychology, 103(3), 535–546.


References (Continued)

Miller, J. F., Heilmann, J., Nockerts, A., Iglesias, A., Fabiano, L., & Francis, D. J. (2006). Oral Language and Reading in Bilingual Children. Learning Disabilities Research & Practice, 21(1), 30–43.

Miller, J., & Iglesias, A. (2012). Systematic Analysis of Language Transcripts. Madison, WI: SALT Software, LLC.

Roberts, M. Y., & Kaiser, A. P. (2012). Assessing the effects of a parent-implemented language intervention for children with language impairments using empirical benchmarks: a pilot study (Report). Journal of Speech, Language, and Hearing Research, 55(6), 1655.

Roberts, M. Y., & Kaiser, A. P. (2015). Early Intervention for Toddlers With Language Delays: A Randomized Controlled Trial. Pediatrics, peds.2014–2134.

Scherer, N., and Kaiser, A.P. (2010). Enhanced milieu teaching with phonological emphasis: Application for children with CLP in treatment of sound disorders in children. Chapter to appear in Williams, L., McLeod, S., & McCauley, R. (Eds.), Intervenmore: Brookes Publishing.

Snow, C. E., & Kim, Y.-S. (2007). Large problem spaces: The challenge of vocabulary for English language learners. In Vocabulary Aquisition: Implications for Reading Comprehension (pp. 123–139).

U.S. Census Bureau. (2014, June 20). The Hispanic Population in the United States: 2012 (Table 1). Retrieved from http://www.census.gov/population/hispanic/data/2012.html

Wright, C.A., Kaiser, A.P., Reikowsky, D.I., & Roberts, M.Y. (2013). Effects of naturalistic sign intervention on expressive language of toddlers with Down Syndrome. Journal of Speech, Language, and Hearing Research, 56, 994-1008.

Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (2012). Preschool Language Scales, Fifth Edition Spanish (PLS-5 Spanish). Pearson.

http://www.census.gov/population/hispanic/data/2012.html

EMT en Español: Frequently Asked Questions

1. Why should we support home language?

Preservation of home language helps maintain culture and family connections needed for children’s healthy

social-emotional development (Kohnert & Derr, 2012).

Children can make greater and faster gains in English to be successful in school when there is a stronger

foundation in their first language (Kohnert & Derr, 2012; Miller et al., 2006; Páez & Rinaldi, 2006; Snow &

Kim, 2007).

Children can generalize learned communication skills with family members (Kohnert & Derr, 2012).

Caregivers can model more complex and rich language in their native language (Hammer, Davison,

Lawrence, & Miccio, 2009).

When caregivers who are not native English-speakers model language in English, it does NOT help with

children’s language development in English and it hinders their children’s Spanish acquisition (Hoff,

Rumiche, Burridge, Ribot, & Welsh, 2014).

2. If a child speaks Spanish at home and English at school what language should I provide intervention in?

Both! Children need language to communicate with family members and to succeed in school.

Choose targets in home language that are appropriate for social communication with family members and

targets in English that are appropriate for school success (Kohnert & Derr, 2012).

3. Is it more “confusing” to children who demonstrate language delays to learn two languages?

This is a myth!

Research shows bilingualism does NOT delay or hinder language development (Kohnert & Medina, 2009).

There are social, cultural, and cognitive benefits to bilingualism that children miss out on when they lose their

home language (Barac & Bialystok, 2012; Barac, Bialystok, Castro, & Sanchez, 2014; Hoff et al., 2014;

Kohnert & Derr, 2012).

4. What can I do if I don’t speak Spanish?

Include caregivers in assessment and intervention planning (with an interpreter).

Conduct intervention in English for academic language, but teach parents strategies for them to support home

language at home.

Do NOT tell parents to speak English to their child if they are not native English speakers.

Explain the benefits of maintenance of home language and benefits of bilingualism.

Respect parents choices.

5. What assessments are appropriate for young Spanish-speaking or Spanish/English bilingual children?

Standardized Measures (selected) Other Measures (selected)

Preschool Language Scale 5th Edition Spanish (PLS-

5;Zimmerman, Steiner, & Pond, 2012)

Inventarios MacArthur-Bates del Desarrollo de Habilidades

Comunicativas (Jackson-Maldonado, 2012)

Receptive One Word Picture Vocabulary Test- Spanish

Bilingual Edition (ROWPVT-SBE) and Expressive One Word

Picture Vocabulary Test-Spanish Bilingual Edition (EOWPVT-

SBE; Martin, 2012)

IGDI-ECI (www.igdi.ku.edu)

Bilingual English Spanish Assessment (BESA; Peña,

Gutiérrez-Clellen, Iglesias, Goldstein, & Bedore, 2014.)

Language sampling/transcribing

SALT (J. Miller & Iglesias, 2012)

http://www.igdi.ku.edu/

References

Barac, R., & Bialystok, E. (2012). Bilingual Effects on Cognitive and Linguistic Development: Role of Language,

Cultural Background, and Education. Child Development, (2), 413–422. http://doi.org/10.1111/j.1467-

8624.2011.01707.x

Barac, R., Bialystok, E., Castro, D. C., & Sanchez, M. (2014). The cognitive development of young dual language

learners: A critical review. Early Childhood Research Quarterly, 29(4), 699–714.

http://doi.org/10.1016/j.ecresq.2014.02.003

Hammer, C. S., Davison, M. D., Lawrence, F. R., & Miccio, A. W. (2009). The Effect of Maternal Language on Bilingual

Children’s Vocabulary and Emergent Literacy Development During Head Start and Kindergarten. Scientific

Studies of Reading, 13(2), 99–121. http://doi.org/10.1080/10888430902769541

Hoff, E., Rumiche, R., Burridge, A., Ribot, K. M., & Welsh, S. N. (2014). Expressive vocabulary development in children

from bilingual and monolingual homes: A longitudinal study from two to four years. Early Childhood Research

Quarterly, 29(4), 433–444. http://doi.org/10.1016/j.ecresq.2014.04.012

Jackcson-Maldonado, D. (2012). Verb morphology and vocabulary in monolinguals, emerging bilinguals, and

monolingual children with primary language impairement. In Bilingual Language Development and Disorders in

Spanish-English Speakers, Second Edition (2nd ed., pp. 153–174). Baltimore, Md: Paul H. Brooks Publishing Co.

Kohnert, K., & Derr, A. (2012). Language Intervention with Bilingual Children. In Bilingual Language Development and

Disorders in Spanish-English Speakers, Second Edition (2nd ed., pp. 337–356). Baltimore, Md: Paul H. Brooks

Publishing Co.

Kohnert, K., & Medina, A. (2009). Bilingual Children and Communication Disorders: A 30-Year Research Retrospective.

Seminars In Speech And Language, 30(04), 219–233. http://doi.org/10.1055/s-0029-1241721

Miller, J. F., Heilmann, J., Nockerts, A., Iglesias, A., Fabiano, L., & Francis, D. J. (2006). Oral Language and Reading in

Bilingual Children. Learning Disabilities Research & Practice, 21(1), 30–43. http://doi.org/10.1111/j.1540-

5826.2006.00205.x

Miller, J., & Iglesias, A. (2012). Systematic Analysis of Language Transcripts. Madison, WI: SALT Software, LLC.

Páez, Mariela, M., & Rinaldi, Claudia. (2006). Predicting English Word Reading Skills for Spanish-speaking Students in

First Grade. Topics in Language Disorders, 26(4), 338–350.

Peña, E., Gutiérrez-Clellen, V., Iglesias, A., Goldstein, B. A., & Bedore, L. M. (n.d.). Bilingual English Spanish

Assessment. Retrieved November 10, 2015, from http://ar-clinicalpubl.com/home.html

Snow, C. E., & Kim, Y.-S. (2007). Large problem spaces: The challenge of vocabulary for English language learners. In

Vocabulary Aquisition: Implications for Reading Comprehension (pp. 123–139).

Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (2012). Preschool Language Scales, Fifth Edition Spanish (PLS-5

Spanish). Pearson.

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