Goals for following directions are commonly seen in Individualized Education Plans (IEPs) of language disordered kids. Anecdotally speaking, they’re probably the most common language goal. Most of them tend to have some serious problems though, which perhaps we can illuminate from a quick analysis of one or two examples. And there’s one thing that’s really conspicuous by its absence. We’ll see if we can use these examples to figure it out.
Example 1: “Paul will follow two step directions in the classroom for three consecutive days.” What’s wrong with this? Plenty, actually, but one thing especially. Let’s say that for three straight days Paul is handed some trash, and after receiving the directions, “Paul, take this to the trash can and throw it away,” he does it. Goal achieved, right? There’s two steps and three days in the classroom, after all.
But what if Paul is twelve years old? What if Paul has been throwing away trash like this for years? Maybe he has done it so often, he knows what to do merely by giving him trash. He may not have even been listening to the directions. In this case, Paul has not been taught, nor has he accomplished anything that he wasn’t already able to do, despite having “achieved his goal.” The goal did not include something measurable that he wasn’t already able to do. And there still is that one thing that’s seriously missing.
Example 2: Mary will follow multi-step directions in the classroom or wherever at some percentage. Okay, this admittedly is a softball example, but it’s one I’ve seen plenty. What’s wrong? It’s not specific enough. I’m assuming it means more than two, but it doesn’t really say. Again too we run across the difficulty of the fact that no two directions tend to be equal in difficulty. “Get the ball and give it to me!” and “Please walk to the board and write the answer below the date,” are both notably two step directions. But they’re vastly different in difficulty. Which leads us to the one biggie that’s missing in these goals, and almost all following directions goals that I’ve ever seen. It’s the language itself.
Oral Motor Therapy and Facilitated Communication
…it is far easier to come up with an idea than it is to do the grunt work of scientifically verifying if that idea is a good one.
The stories of both non speech oral motor exercises and facilitated communication are both fascinating, and have sometimes had, at least in the case of facilitated communication, tragic results. So, then, what are the similarities? And what can we learn from them?
Facilitated communication (FC) is the technique of using a helper’s hand to guide a severely disabled person’s fingers or hands to type or point at a letter board. It is a practical requirement that the disabled person must not be able to communicate in any other way. The facilitator is trained in ways to help hold and support, but theoretically not guide, the patient’s hand to enable communication. FC was first enthusiastically embraced by many media outlets, and by the general special education community in the 1980’s and 1990’s, before being thoroughly refuted by research, and denounced by every major association that matters, including the American Psychological Association and the Association for Science in Autism Treatment. It seemed also that in many cases, these facilitators’ extreme desire to help their students led them to trump up stories of parental sexual abuse – stories that they didn’t seem to realize that they were concocting. FC seemed to generally fade from the public consciousness, but lately it has been revived. Unbelievably, Syracuse University helped its reemergence under the re-branding of “supported typing” by promoting its founder, Douglas Biklen to Dean of its School of Education, and by renaming its Facilitated Communication Institute as the School of Communication and Inclusion. (Maybe these people have been trying to jump on the autism explosion gravy train that earlier FC had just missed?)
While oral motor therapy has been less – let’s just say – notorious than FC, it has certainly garnered its fair share of criticism and controversy.
parallel talk - a great method for motivating children to talk without the frustration of high demand – the child is given opportunities to engage in activities that he finds interesting, while the caregiver talks about what the child is doing -the caregiver uses language that is at or just above the child’s level – often used in collaboration with self-talk
examples: for a child playing with a plane, say things such as, “You’re flying the plane. The plane is high. The plane is low. You gave the plane to me.”
play therapy – very useful for initiation, social language, turn-taking, sharing – can involve moving child from lower levels of play (such as banging or shaking toys) to higher (such as self directed play, play directed toward others, relational play, and symbolic play) – strategies are taught to caregivers, often involving allowing child to lead play, with adult redirection as necessary
priming – introducing topics beforehand – can involve stories, index cards, explanations, or anything that can quickly familiarize student with upcoming material – can occur immediately preceding the lesson, the prior morning, or the prior evening – especially effective when part of a routine
example: an autistic child’s anxiety increases in response to certain things, such as handwriting, so the morning activities are briefly explained to the child ahead of time each morning, including handwriting
Looks like this conference will be focusing on Social Stories…
— ASHA (@ASHAWeb) July 23, 2014“
I just hope they mention a few other autism therapies while they’re at it – Such as the thirty or so on this list.
The author of this post from the Language Log blog, Ben Zimmer, makes three main points, two of which I really like. (There’s nothing wrong with the other point, I just don’t think it’s as great.) The points are in reference to the evident uproar in the linguistic community caused by Weird Al Yankovic’s Word Crime’s video. The uproar has been caused by Weird Al’s suggestion to everybody who can’t use proper grammar – which is just about everybody – to obtain the services of a linguist for help. Many linguists, to the contrary, have been fighting for years to get everybody to loosen up their prescriptive shackles, and focus on everyday, more casual language – as pointed out in this article.
The first great point is this: “…the notion of “Proper English” typically serves to prop up the already-privileged speakers whose native language variety it is (sort of) based on. This puts speakers whose native language variety does not approximate “Proper English” at an immediate disadvantage in society, the same way that privileging Whiteness puts those who are not White at an immediate disadvantage in society.”
The second great point is… “that the view of “grammar” as “you must learn the rules or else be ostracized” just makes grammar no fun at all! Studying language—really digging into it, uncovering its remarkably complex yet orderly structure, investigating what makes it different across speakers and communities—is SUPER FUN! Giving people a list of rules of things to do in order to not be criticized is NOT FUN!”
(note: this is another installment in an ongoing series on various language therapies)
Mand-Model approach -This is an extension of the incidental teaching model. The mand-model approach involves the teacher or caregiver modeling and/or manding (requesting) a response from the child. In modeling, sometimes known as child-cued modeling, the teacher or caregiver observes the focus of the child’s interest (e.g., a ball) and models the correct verbalization (e.g., “that’s a ball”). If the child makes the correct verbal response the teacher or caregiver then praises the child and provides the object of interest.
example: child reaches for a candy – caregiver keeps candy out of reach, while saying “candy. Say, ‘Candy please!” – caregiver gives candy immediately if child requests, or after a time delay, while modeling correct request if child doesn’t request
Milieu Teaching -As a naturalistic, conversation-based teaching procedure, in milieu teaching the child’s interest in the environment is used as a basis for eliciting elaborated child communicative responses. Milieu teaching includes other strategies, such as incidental teaching, mand-model, and time delay. It is based on behaviorism, but rewards are from natural environment. With incidental teaching the teacher waits for response, while mand-model requires asking (mands) for response. While often the subject of research, few SLPs seem to actually claim to use milieu teaching. Maybe it’s the odd pronunciation.
Literature based language intervention involves using books that do not specifically control for reading difficulty to address other skills, such as sentence structure, vocabulary and comprehension. It saw increasing popularity in the 1980s and 1990s, when language therapy in general saw a shift from skills based intervention to “holistic” “collaborative” models. Literature based language intervention is effective as one component of an overall approach, especially when the book is determined by the skill.