KidTalk Tactics Offers Model for Early Language Intervention

topics: Special Education

Kurt Brobeck

Life with toddlers can be stressful, all the more so for parents of young children with disabilities. For parents of infants with Down Syndrome, a chronic health condition, or another significant impairment, among the many questions that arise is, "Is my child going to talk?" For these parents, Vanderbilt Peabody professor Ann Kaiser has some reassuring words: "We assume that every child is going to communicate in ways that other people can understand them. It may be speaking, it may be signing, or it might be using an augmentative communication device. We're going to stay with that child and that family until we are sure the child is on track for being able to communicate with others."

Kaiser, who holds the Susan Gray Chair in Education and Human Development, is in the first year of a four-year project to develop and demonstrate a model naturalistic language intervention for children who are identified with needs very early in their lives. Her KidTalk-Tactics Project (KTTP) is funded by the U.S. Department of Education's Office of Special Education Programs. Terry Hancock, research assistant professor of special education and Juliann Woods, chair of the Department of Communication Disorders at Florida State University, are co-investigators. KTTP is one of three centers nationally charged with developing model programs for naturalistic communication interventions for children ages birth to five and -their families, caregivers, and teachers. Other centers are located at the University of Kansas and the Orelena Hawks Puckett Institute in Morganton, North Carolina.

"These centers represent the next step in translating research into practice," said Kaiser. "It is important to have gotten to the point where you are taking a well researched intervention out into the community." In fact, Kaiser and her colleagues have been working on naturalistic communication intervention with young children for many years and have published about 40 papers related to this intervention. "This project represents where we are as a field with naturalistic communication intervention," she said.

KidTalk-Tactics provides continuous communication intervention for children from infancy until age five. Most of the children who participate enroll between 12 and 18 months of age. In all, forty children and their families in the Nashville area will receive the intervention. An additional 30 children and families at the Florida site complement the Nashville group.

Kaiser's team focuses on the home as the most logical environment for supporting communication with such young children. She and her staff of early childhood special educators begin by visiting the home to teach parents strategies that have been core to her research on Enhanced Milieu Teaching. Parents are taught to use these techniques during the course of what would be routine activities in any child's life: during meals, while playing, during bath time, when reading stories and getting ready for bed. "We give parents strategies to use in routines that they are already doing with their kids. We're not asking them to do things they don't already do, however, we do teach them ways to incorporate teaching their children to communicate during these daily events," Kaiser said.

This principle of "teach it where children will use it" is central to naturalistic language intervention, according to Kaiser. The idea is that it is easier and more effective to teach communication skills around situations that are typical in the context of a child's life, for example to teach the word "more" when a child is asking for a cookie. Parents are trained to take advantage of informal activities when children are interested by modeling language and being responsive to child communication attempts. For some parents, focusing on these activities helps them see the ways their children already communicate. "A lot of what we help parents do is to see that children are communicating even when they don't have language yet. We are so happy to jump start that communication," she said.

Over the course of four to five months, 24 sessions are held in the home. Sessions are videotaped and coded so that each child's progress may be monitored. Video captured at the FSU site is uploaded to Vanderbilt and coded as well. Over time, the pooled data will create an important resource for training special educators, teachers, and parents, as well. Because it provides actual samples of saying, signing, gesturing, or play, video also has become an important tool for assessing a child's progress.

KidTalk-Tactics is unique in that it spans two different legally mandated service delivery systems. Under the Individuals with Disabilities Education Act, children from birth to age two receive what are known as Part C early intervention services. When the children turn three, they transition to Part B, with services typically provided by the local school system. As Kaiser notes, because children are reassessed at the time of transition, and may move to new school or preschool settings, service delivery is often slowed, to the detriment of the child. "Our goals are to teach parents strategies to support communication and to help families ensure continuity in their children's communication intervention as they age and move through the Part C to Part B transition," Kaiser said.

Outside the home, Kaiser's team works with the caregivers, teachers, and therapists in a child's life to ensure that the intervention is seamlessly applied. "The idea is that within the first six or eight months, we've trained many of the significant adults in that child's life to do similar things to support the child's communications development," Kaiser said. She and her colleagues currently are training staff at Peabody's Susan Gray School, an inclusive early childhood program, and at High Hopes, an inclusive preschool in Nashville's suburban Williamson County.

"If we provide continuous communication intervention in these early years, we can get kids to someplace they wouldn't get in typical interventions," said Kaiser. "Typical early childhood intervention can be fragmented. Kids move from one teacher to another or to different therapists each year. Every time children make a transition, you tend to do more assessments. Continuity of intervention can be optimized in places like Susan Gray and High Hopes where staff know their kids and their communication needs. When children go from the two-year-old classroom to the three-year-old classroom, teachers talk about child communication and there is less disruption of intervention."

When children move from the two early childhood programs into school-based settings, Kaiser plans to be ready. "We'll be part of the transition planning, and we'll set up from the beginning to be a consultant to that teacher and the therapists in that setting," she said.

In the near term, Kaiser and her team remain committed to the parents and children enrolled in KidTalk-Tactic's first cohort. She notes, "These families are very stressed. They've just had a baby who happens to have a disability. They don't know yet what the future looks like for that baby. These young kids are usually in multiple therapies. There is a lot going on for these families, and the parents are trying to figure out the service delivery system. In addition to teaching parents how to support communication, a lot of what our communication coaches do is reassure parents, empower them, and help them work their way through the feelings about what is going on in their lives. One of our biggest tasks with parents is to show them that everyday interactions with their children can still be fun even when children have disabilities."