Designing a Shared Storybook Reading Intervention for Children With ASD

Transcription

1 Designing a Shared Storybook Reading Intervention for Children With ASD Dawn Vogler-Elias, Ph.D. CCC-SLP Nazareth College ASHA Convention 2011 San Diego, CA

2 Outline Rationale and overview Assessment Goal Development Intervention

3 Autism Spectrum Disorders (ASDs) Autism is a developmental disability affecting as many as 1 out of 110 children (Centers for Disease Control, 2009) Young children with autism demonstrate difficulties in the areas of: Language understanding and use Social interaction Play skills Behaviors that impact learning (American Psychological Association, 2000)

4 Effective Intervention for ASDs (Dawson & Osterling, 1997; Hurth et al., 1999) Earliest possible start Individualization Systematic teaching Specialized curriculum Programming for generalization Intensity of engagement Family involvement/parent-training

5 Parent-Implemented Interventions SLP facilitates and supports parent-child interaction Especially appealing for young children because: Family-centered Natural environment Least Restrictive Environment

6 Evidence-Base for Parent-Implemented Interventions Increases in children's social communication and language skills (McConachie & Diggle, 2007) Increase in quality of parent-child interaction (McConachie & Diggle., 2007) Reduced stress and increased happiness for the family when provided during naturalistic daily routines (Koegel et al., 1991; Kashinath et al., 2006)

7 Shared Storybook Reading (SSR) A naturalistic daily routine context Interactive involvement between a child and caregiver Provides an opportunity to decontextualize language Highlights oral and written language simultaneously (Ezell & Justice, 2005)

8 Quantity and Quality of SSR QUANTITY: Frequency between 1-3 years is positively associated with teacher ratings of oral language at 5 years (Wells, 1985) QUALITY: Responsive quality of interaction supports child engagement (Kaderavek & Sulzby, 1998) and is related to vocabulary development (Leseman & de Jong, 1998)

9 Adult Responsiveness During SSR Follow child s lead Promote interaction Provide language models Engage in scaffolding (Girolametto & Weitzman, 2002; Ezell & Justice, 2005)

10 Barriers to Literacy for children with ASD

11 Barriers to Literacy Children with disabilities have fewer early literacy experiences like shared storybook reading (Van Kleeck et al., 1997) Barriers to literacy may occur for several reasons, including: Nature of literacy Conventional literacy instructional practices Caregiver perceptions and practices

12 Interactive to Independent Model (Kaderavek & Rabidoux, 2004) A road map to literacy access

13 Interactive to Independent Model (Kaderavek & Rabidoux, 2004) Literacy is the product of supportive social interaction It is important to reduce barriers to literacy Literacy exposure should occur in natural contexts

14 5 Levels of Achievement (Kaderavek & Rabidoux, 2004) Levels I and II focus on social aspects of emergent literacy experiences (interactive) Levels III, IV, and V target conventional literacy skills

15 SSR Interventions SSR interventions have the potential to increase literacy opportunity for children with ASD SSR interventions support quantity and quality of SSR between a child and adult

16 Evidence-Base Studies focused on SSR interventions for children at risk for literacy difficulty have shown increase in: Adult strategy use (Crain-Thorenson & Dale, 1999; Crowe et al., 2000; Whitehurst et al., 1994) Parent-child social engagement and participation (Crain-Thorenson et al., 1999; Crowe et al., 2000) Child language complexity (Crain-Thorenson & Dale, 1999; Crowe et al., 2000) Child vocabulary (Whitehurst et al., 1994)

17 Assessment of Parent-Child Shared Storybook Reading

18 Assessment Components Participant Interview Observation and data collection

19 Participant Interview Ask caregiver about the various aspects of SSR Frequency Behaviors Barriers and Challenges Use open-ended questions Describe what happens when you read storybooks together. What types of books do you enjoy reading? How do you know that Billy wants you to read a book? How do you know when Joel is finished reading? What is challenging about reading books with Sarah?

20 Observation Overview Ask to observe a shared storybook reading session: If possible, observe 3-5 sessions across different days 1-2 books or 5-minute probes Video or audio record if possible Use a data collection sheet Allow parent/child to choose any book they like for baseline sessions

21 Observation Environmental factors: time of day, location, etc Storybook selection Parent responsiveness and use of scaffolding strategies: quality and frequency Parent-child engagement: turn-taking, quality of engagement Duration of shared storybook reading Child factors: MLU, responsiveness, initiations Resource for shared storybook reading observation: Kaderavek, J.N., & Sulzby, E. (1998). Parent-child joint book reading: An observational protocol for young children. American Journal of Speech-Language Pathology, 7,

22 Scaffolding Strategy Examples 1. Praise/encouragement Statements 2. Pauses 3. Attention-getters 4. Achievable Models 5. Recasts 6. Cloze Statements 7. WH Questions 8. Vocabulary Definitions

23 1. Praise/Encouragement Statements

24 2. Pauses

25 3. Attention-Getters

26 4. Achievable Models

27 5. Recasts

28 6. Cloze Statements

29 7. WH Questions

30 8. Vocabulary Definitions

31 Developing Meaningful Goals

32 Developing Goals Goals should: focus on bolstering the social and emotional context of parent-child shared storybook reading be family-centered and generated collaboratively with the parent promote strengths and encourage long-term growth of SSR as a socially rewarding context for both parent and child

33 Goal Examples Parent Goals: 1) The parent will make one comment per page followed by a long pause during a shared storybook reading experience. 2) The parent will initiate shared storybook reading twice daily by setting up the environment and asking child if she wants to read. Child Goals: 1) The child will initiate joint attention by pointing at a picture twice during a shared storybook reading experience. 2) The child will initiate a comment about two events within the story during a shared storybook reading experience. Parent-Child Goals: 1) The parent and child will read two books twice daily for 10 minutes. 2) The parent and child will engage in social-turn taking, as evidenced by physical (e.g., turning pages, touching, smiling) and verbal behaviors (e.g., asking/answering, commenting/responding) on 7 out of 10 pages of the storybook.

34 Intervention Strategies and Techniques

35 Parent Training Parent-training will be the core component of intervention SLP s role is to support the parent to facilitate the parent-child interaction Think of yourself as a coach instead of teacher or therapist

36 Parent Training Some parents may already be doing a few or many of the strategies -- Acknowledge and celebrate this! The goal may be to refine how or when they are using the strategies -- Focus on quality of parent-child interaction

37 Book Selection Length Overall length Words per page Interest Child interest Parent interest Type and complexity of story Narrative format preferred (usually)

38 Parent-Training Components Setting Up the Environment Direct instruction Models Practice with feedback and prompting Self-evaluation and reflection Ongoing support Home reading logs (Drew et al., 2002; Ingersoll & Dvortcsak, 2006; Koegel, Bimbela, & Schreibman, 1996; Moes & Frea, 2002)

39 Setting Up the Environment Seating Both parent and child can hold book and turn pages Side-by-side seating of having the child on the parent s lap is ideal Quiet location, free from distractions Sufficient lighting Time of Day This may be a challenge with therapy schedules and other outside variables

40 It is important to review these variables at the beginning of your intervention (even those that seem obvious)!

41 Direct Instruction Review of goals developed collaboratively Provide handout Goals clearly stated Other reminders (e.g., setting up the environment factors) Include parent as partner and collaborator

42 Models Utilize video models Demonstration with the child, sibling, or parent Discussion The more practice, the better!

43 Practice Parent practice with clinician Parent practice with child Clinician provides support, coaching, and feedback Use a prompting hierarchy: 1. Wait 2. Visual cue 3. General verbal cue try a strategy 4. Explicit verbal cue try commenting on the picture 5. Verbatim verbal cue say, Spot is a cute puppy!

44 Practice Activity 1. Select a partner 2. Select a target strategy 3. Describe the target strategy as if you were talking to a parent 4. Use the storybook page to provide two models of the strategy for the parent 5. Discussion: What is challenging about teaching an adult? What is your comfort level?

45 Self-Evaluation and Reflection Discussion and reflection using open-ended questions: How do you think that went? What went well? What didn t go so well? Video self-reflection Use of videotaped sessions is a powerful way to learn it is worth the effort! What went well? What didn t go so well? Identify target strategies within the video Identify missed opportunities

46 Ongoing Support Keep up the support and keep checking in! Prioritize the intervention and parent support Address new barriers and challenges This step may be especially important for children with ASD

47 Home Reading Logs Provides documentation and tracking Prompts parents to read regularly (accountability) Provides a way to remember questions, concerns, and feedback

48 Next Steps Ongoing assessment and data collection Update goals to meet parent and child needs

49 Questions? Thank you!

50 Resources American Psychological Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.) (Vol. Text Revision). Washington. DC. Catts, H., & Khami, A. (1999). Language and reading disabilities. Needham Heights: Allyn & Bacon. Centers for Disease Control (2011). Autism Spectrum Disorders. Retrieved from Crain-Thoreson, C., & Dale, P. S. (1999). Enhancing linguistic performance: parents and teachers as book reading partners for children with language delays. Topics in Early Childhood Special Education, 19(1), Drew, A., Baird, G., Baron-Cohen, S., Cox, A., Slonims, V., Wheelwright, S., et al. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism: Preliminary findings and methodological challenges. European Child & Adolescent Psychiatry, 11, Crowe, L. K., Norris, J. A., & Hoffman, P. R. (2000). Facilitating storybook interactions between mothers and their preschoolers with language impairment. Communication Disorders Quarterly, 21(3), Dawson, G., & Osterling, J. (1997). Early intervention in autism: Effectiveness and common elements of current approaches. In Guralnick (Ed.) The effectiveness of early intervention: Second generation research. (pp ) Baltimore: Brookes. Ezell, H., & Justice, L. (2005). Shared Storybook Reading: Building Young Children's Language & Emergent Literacy Skills. Baltimore: Paul H. Brookes Publishing Co., Inc.

51 Resources Girolametto, L., & Weitzman, E. (2002). Responsiveness of child care providers in interactions with toddlers and preschoolers. Language, Speech, and Hearing Services in Schools, 33, Hurth, J., Shaw, E., Izeman, S., Whaley, K., & Rogers, S. (1999). Areas of agreement about effective practices serving young children with autism spectrum disorders. Infants and Young Children, 12, Ingersoll, B. & Dvortcsak, A (2006). Including parent training in the early childhood special education curriculum for children with autism spectrum disorders. Journal of Positive Behavior Interventions, 8, Justice, L. M. (Ed) (2006). Clinical Approaches to Emergent Literacy Intervention. San Diego, CA: Plural Publishing. Justice, L. M., & Kaderavek, J. N. (2003). Topic controlling during shared storybook reading: mothers and their children with language impairments. Topics in Early Childhood Special Education, 23(3), Justice, L. M., & Pence, K. (2005). Scaffolding with Storybooks: A Guide for Enhancing Young Children's Language and Literacy Achievement. Newark: International Reading Association. Kaderavek, J., & Justice, L. M. (2002). Shared storybook reading as an intervention context: practices and potential pitfalls. American Journal of Speech-Language Pathology, 11(4),

52 Resources Kaderavek, J., & Sulzby, E. (1998). Parent-child joint book reading: an observational protocol for young children. American Journal of Speech-Language Pathology, 7(1), Kaderavek, J. N., & Rabidoux, P. (2004). Interactive to independent literacy: a model for designing literacy goals for children with atypical communication. Reading & Writing Quarterly: Overcoming Learning Difficulties, 20(3), Kashinath, S., Woods, J., & Goldstein, H. (2006). Enhancing generalized teaching strategy use in daily routines by parents of children with autism. Journal of Speech, Language, and Hearing Research, 49(3), Kluth, P., & Darmody-Latham, J. (2003). Beyond Sight Words: Literacy Opportunities for Students with Autism. The Reading Teacher, 56(6). Koegel, R. L., Bimbela, A., & Schreibman, L. (1996). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26(3), Koppenhaver, D. A., Coleman, P. P., Kalman, S. L., & Yoder, D. E. (1991). The implications of emergent literacy research for children with developmental disabilities. American Journal of Speech-Language Pathology, Leseman, P.P., & de Jong, P.F. (1998). Home literacy: Opportunity, instruction, cooperation and socialemotional quality predicting early reading achievement. Reading Research Quarterly, 33, Available:

53 Resources McConachie H, Diggle T. Parent-mediated early intervention for young children with autism spectrum disorder: a systematic review. Journal of Evaluation in Clinical Practice. 2007; 13: Moes, D.R. & Frea,, W.D. (2002), Contextualized behavioral support in early intervention for children with autism and their families. Journal of Autism and Developmental Disorders, 32 6 (2002), pp van Kleeck, A., Gillam, R. B., Hamilton, L., & McGrath, C. (1997). The relationship between middle-class parents' book-sharing discussion and their preschoolers' abstract language development. Journal of Speech & Hearing Research, 40(6), van Kleeck, A. (Ed) (2006). Sharing books and stories to promote language and literacy. San Diego, CA: Plural Publishing. van Kleeck, A., Stahl, S.A., & Bauer, E.B. (Eds.) (2003). On reading books to children: Parents and teachers. Mahwah, NJ: Lawrence Erlbaum Associates. van Kleeck, A., & Vander Woude, J. (2003). Book sharing with preschoolers with language delays. In A. van Kleeck, S. A. Stahl & E. Bauer (Eds.), On reading to children: parents and teachers (pp ). Mahwah: Erlbaum. Wells, G. (1985). The meaning makers. Portsmouth, NH: Heinemann. Whitehurst, G. J., Arnold, D. S., Epstein, J. N., Angell, A. L., Smith, M., & Fischel, J. E. (1994). A picture book reading intervention in day care and home for children from low-income families. Developmental Psychology, 30(5),