Clinics in communication disorders最新文献

Because young children with language disabilities frequently are placed in group-care settings, there is a need to make judgments concerning the language environment of those settings. The GCLC is offered as one procedure for assessment of the language environment provided by the caregiver(s) in a group setting. The assessment provides information that may assist in matching the environment to a particular child's needs and may provide a basis for assisting caregivers in improving the language environment and addressing a child's needs. The authors welcome comments from the readers.

Generalization of treatment effects remains a consistent goal of clinicians who treat aphasic adults. Specifically, various types of stimulus/response generalization designs are available, depending on the level of generalization desired. We have reviewed training matrices designed to elicit gestural subject-plus-verb targets and treatment studies designed to answer more global questions regarding treatment efficacy. As Kearns (1989) so eloquently states, "clinical accountability cannot, in fact, be fully achieved without documentation of communication skills trained in the clinic generalized to other settings and situations." Although the studies cited and data reviewed in this article did not meet this standard specifically, an attempt was made to provide a brief prelude to the data now emerging in the aphasiology literature. Additionally, with an increasing data base in the literature specific to generalization, more efficacious treatment paradigms will be made available. Clinicians treating aphasic adults thus should have the opportunity to choose the treatments shown to be most effective for a specific type and severity of aphasia.

We described creative and innovative language programs for students with LLD and BD, or both. There are three models of learning that have had considerable impact on how language services have been designed and executed for these two populations of students. Our principal argument is that there is a fourth approach or model based on empowerment. We presented the premises and principles of the empowerment model and described two programs using empowerment as the foundation for the provision of communication and language services. Language and communication programs grounded in an empowerment model offer greater possibilities for students to acquire the discourses necessary for successful participation in the culture of school, as well as the cultures in which they participate outside of school. Discovering strengths and competencies across a wide spectrum of learning affords students opportunities for developing self-knowledge based in capability and adeptness rather than in deficiency and impairment. The emergence, unfolding, and eventual maturation of these competencies and capabilities are critical not only to those students who discover them, but also to the future of all of us.

Services for developmentally delayed children from birth to age three consider the family first. Eligibility for services is determined through a multidisciplinary assessment. Once a child qualifies for service, a multidisciplinary team that includes the family develops an IFSP. The SLP may serve as the service coordinator for the plan or as a team member. The plans must contain specific information that includes documentation of current status and major outcomes for the coming year. An SLP may find that contributing effectively to an IFSP requires new competencies. First, the SLP will need to learn to function in the family-centered, multidisciplinary process of early intervention. Second, the SLP may need to develop creative models to deliver effective service. SLPs can contribute valuable information to the IFSP by finding ways to activate daily life routines to promote a child's communication skills. SLPs can explore the child's life-space, including routines and partners, as a source of contexts for treatment. SLPs also can explore partner communication strategies, note their effects on the child's communication experiences, and recommend additional strategies for treatment. The case study illustrated an individual, home-based intervention program (Gillette, 1989; Lombardino and Magnan, 1983). Other service delivery models can include classroom-based approaches (Wilcox, Kouri, and Caswell, 1991); group parent training approaches (Weistuch, Lewis, and Sullivan, 1991; Cheseldine and McConkey, 1979); and video-assisted approaches (McConkey, 1988; Johnson and Harrison, 1990; Gillette, in press). Many SLPs may find that the process of early intervention with the birth-to-three population offers unique opportunities for practice in their profession. To function effectively in this process, the SLP needs communication-based information to promote the child's communication skills within his or her daily life and sensitivity with which to design a plan that considers the family first, yet meets the needs of the child. Although alternative models of delivering speech-language service have been explored, the process of early intervention will continue to require professionals who can creatively match family priorities with the child's intervention needs.