We had our big meeting last month with Kat and all of Carver's therapists. We have an action plan in place now to begin working on Carver's Communication and Language Development.
Kat compiled all of the feedback from everyone at the meeting and provided the following initial goals/action plan:
Auditory Perception & Aural Receptive Communication & Language
1. Specific responses to sound play in a social & play interaction
2. Response to environmental sounds in the home
3. Increased vocalizations
4. Increased action on sound-toys
Receptive Communication & Language Targets
1. Use of touch cues/tactile gestures for “names,” directions, choice, greetings
2. Use of objects to “announce” different activities/locations/people
3. Identification of objects that are motivational, used frequently and part of routines.
4. Response to one-concept directions (up, down, bite, bath)
Expressive Communication & Language Targets
1. Increased use of prelinguistic forms and rate of communication ( specifically, extending hand to request object/toy; tapping person to request more interaction, extending object for interaction). Carver currently vocalizes and moves his body to request more. We need to up-the ante so that he is oriented to the other person who is interacting with him and using gestures.
2. Increase rate and type of vocalizations
3. Later – Selecting objects to communicate, paired with vocalizations if possible.
4. Use of communication intents/functions: request more; request, make choices, greetings, offer.
Sensorimotor Targets to Support Communication and Language
1. Use of different objects (washcloth, spoon to mouth, Kleenex) to represent function.
2. Play with objects demonstrating different relations (dumping, putting in, taking out).
3. Continued movement of actions leading to imitation.
4. Partial participation to wipe mouth, throw away, take off.
How will we teach?
1. Follow child’s lead
2. Be responsive to vocalizations & movements
3. The A-B-C’s of teaching…know exactly the behavior being targeted (B) and how much help the child needs under what conditions (A); and provide timely consequences (C) that include the name of the object, activity or person…always lead with the auditory and support with an touch, object, tactile gesture cues, say the name again.
4. Use social interactions that include (a) turn-taking (b) joint activities, and (c) joint attention
5. Use shaping and fading so that you shape a child’s behavior (use a reach for toy to an “extend hand” response and gradually “fade” your support to encourage initiations.
6. Use a “finished box” so Carver will know when activities are finished; let him know that you are removing toys…try to do it within his line of best vision if possible…and gradually fade the sound of the toy so he begins to understand sounds at a distance.