Babble Boot Camp: Yes, it’s a thing

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Pretty much all therapy we do is reactive, as in response to a diagnosed speech or language delay. But what about preventative therapy? As early interventionists, we often see young children who have diagnosed conditions that will almost certainly lead to speech and language delays. What is the best way to work with families in this particular situation? Peter et al. studied a preventative intervention they coined “Babble Boot Camp.” Aside from the adorable name, this parent-implemented program actually had some pretty neat results.

The children in this study had been diagnosed with Classic Galactosemia (CG), which is a genetic disorder that can be diagnosed at birth. Children with CG have a very high rate of speech and language disorders, but, as is typical with EI, often don’t receive intervention until the speech and language delays become apparent. Instead of waiting for the inevitable, these researchers started young—at two months, to be exact.

Babble Boot Camp is a program of activities and routines specifically developed for children in the pre-speech or very early speech and language stages of development. Parents met with an SLP via telepractice for 10 minutes per week to receive training and consultation. Examples of activities included reinforcing and stimulating coos and babbles, joint book reading, naming objects, imitation, and expanding children’s utterances. The SLP provided ideas for incorporating these techniques into routines and daily activities.

All children who participated in this study showed greater babbling complexity and increased complexity of meaningful speech compared to the control child (who also had CG). The majority of the children also demonstrated age-appropriate expressive vocabulary and communication skills at 24 months, which is pretty impressive for children with such a high chance of delay. Although this study used a small sample size, it does provide preliminary evidence that a proactive approach to speech/language intervention may be effective in the long-term; so get those families enlisted!

 

Peter, B., Potter, N., Davis, J., Donenfeld-Peled, I., Finestack, L., Stoel-Gammon, C., . . . VanDam, M. (2019). Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia. F1000Research. doi:10.12688/f1000research.18062.1

Throwback (2014): Can toddlers learn language from participating in video chats?

Screen time, visual media, tablets, computers, video games, Skype, FaceTime…

Young kids are exposed to a variety of technology whether directly or indirectly on a daily basis. The American Academy of Pediatrics has provided recommendations for the amount of exposure and screen time for young children based on their age. But, these suggestions don’t answer the question of whether toddlers and preschoolers are actually getting anything out of the language they’re being exposed to through screen media.

Previous research (e.g., Kuhl, Tsao & Liu, 2003) has demonstrated what is referred to as a “video deficit” (Anderson & Pemek, 2005), which suggests that mode of input (live person versus a comparable media source) matters when it comes to language acquisition. While this is good information, the real question is—what’s happening during the live interaction compared to the video-based interaction that makes the difference for language learning? And, does that mean that kids can never benefit from linguistic input provided in a video?

Evidence outside of the field of speech–language pathology has shown that socially contingent interactions (Troseth, Saylor & Archer, 2006; Zimmerman et al., 2007) make all the difference when it comes to early language development. Socially contingent conversational partners provide immediate, reliable, and accurate responses, use the child’s name, make eye contact, ask questions, and take conversational turns (e.g., Csibra, 2010). 

Given this information paired with the rising popularity of video chat platforms like Skype, FaceTime, and Google Chat, the authors of this study wanted to determine the role of social contingency in word learning by comparing live interaction, video chat, and a prerecorded video chat. Thirty-six two-year-olds were randomly assigned to one of these three training conditions, and were taught one of four novel verbs:                                                                                         

blicking (= bouncing)

twilling (= swinging)

frapping (= shaking)

meeping (= turning)

In addition to measuring the children’s ability to learn one of these verbs, the researchers also collected eye-tracking data to determine whether eye contact had a relationship to word learning.

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Results from the study suggested that the toddlers were only able to learn novel words from video chats and live interaction—the two conditions that included socially contingent interactions—but, not from the prerecorded video formats. And, the children who learned the verbs in these conditions were able to generalize their understanding to different contexts. Eye contact also played a role in word learning: the children who attended to the experimenter’s eyes learned the novel words better than those that had less consistent eye contact.

Put together, these results suggest that social contingency is, in fact, the key ingredient when we’re thinking about teaching children under the age of three new words. Regardless of whether we’re interacting with the child in person or via video chat (think, telepractice!), including all of the elements of social contingency—eye contact, immediate responses, using the child’s name, asking questions, and taking and encouraging conversational turns—can make the difference in terms of the child actually benefiting linguistically.*

(*In fact, previous research (e.g., O’Doherty et al., 2011) has shown that toddlers learn better from watching a social interaction between two characters versus watching shows that follow a similar format to the prerecorded video chat condition. So, shows like Blue Clues that attempt to interact with the audience indirectly by posing questions, pausing, and then providing a response, may not be as beneficial as one might think.)

 

Roseberry, S., Hirsh-Pasek, K., & Golinkoff, R. (2014). Skype me! Socially Contingent Interactions Help Toddlers Learn Language. Child Development, 85(3), 956–970.

Parent training: supporting complex communication needs

Many early intervention centers are moving from a direct therapy model to a parent training/coaching model. This shift in philosophy can be challenging for many therapists, especially those who have heard “all you do is play!” from parents a few too many times. Teaching our intricate strategies to a parent with no background in language development is not easy!

Douglas et al., sheds some light on effective parent training and coaching. The study included four children with complex communication needs, multiple developmental areas impacted. At baseline, parents struggled to provide communication opportunities and often did not give adequate wait time. Parents then participated in training sessions based on the POWR method which involved the following steps:

  1. Prepare” a developmentally appropriate activity
  2. Offer opportunities for communication” (e.g. giving choices, asking questions, commenting)
  3. Wait for the child’s communication” (at least 5 seconds)
  4. Respond” appropriately to child’s communication
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The best part of this training? It was all provided online. Parents participated in the training by watching videos on various modules on their own time. Their skills were then assessed in person. Do you see kids at daycare? Do you work with kids whose parents clean the kitchen during therapy? Of course you do. Providing training for parents to watch on their own time might motivate them to become more involved in their child’s communication. 

After receiving this online training parents increased their communication opportunities provided to the child and increased their responses to the child’s communication. The children also showed increased communicative attempts. Parent feedback indicated that they would prefer to have in-person coaching sessions to go along with the online trainings (us too!), as well as more video examples of strategies being implemented. This is definitely something to consider if you’re working with a parent training model for your EI students.

Douglas, S. N., Nordquist, E., Kammes, R., & Gerde, H. (2018). Online parent training to support children with complex communication needs. Infants & Young Children, 30(4), 299–303.