Nancy Brady, PhD

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Teaching Communicative Gestures to Young Children
Who Have Deaf-Blindness

• Nancy Brady, PhD
• University of Kansas
• Co-investigators
• Susan Bashinski, University of Kansas
• Karen Goehl, Indiana State University
• ASHA
• Novermber 17, 2006
• Miami, Florida

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Outline for talk

• Preliminary results from a research study
• Questions addressed
• Describe intervention Model (PMT)
• Adaptations for deaf-blindness
• Assessments
• Interventions
• Results (data)
• Future directions

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Research Question

• Does adapted PMT facilitate communication
  outcomes for children who are deaf-blind?
• Where did this research idea come from?
• PMT is an established intervention with children
  with developmental disabilities who are not
  deaf-blind

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? Key Elements of PMT

• communicating within motivating, naturalistic
  routines
• responding to a childs communicative attempts in
  contingent and appropriate ways
• intervention to increase a childs communication
  rate
• intervention to increase a childs conventional
  gestures and vocalizations

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Why PMT?
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Adaptations for children who are deaf-blind

• Directionality of communication act can be
  indicated through whole body orientation (not
  just eye gaze)
• Routines emphasize tactile and vestibular stimuli
• Prompts are physical rather than verbal

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Assessing current communication

• How are individuals communicating in real
  contexts?
• Use questionnaires and forms supplemented with
  direct observation
• e.g., Inventory of Potential Communicative Acts
  by Sigafoos, and Woodyatt.
• Please describe how the individual (greets, gets
  your attention, seeks comfort, lets you know
  they are happy..)
• Summarize responses in a behavior x function grid

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IPCA summary grids
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Standard Protocol

• Present opportunities for individuals to
  communicate
• e.g., CSBS (Wetheryby Prizant, 2003), ECBS
  (Seibert and Hogan, 1981), (McLean, McLean, Brady
  Etter, 1991, Brady, McLean, McLean and
  Johnston, 1995)
• Examples

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Specific Adaptations sensory and motor
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Examples of adaptations

• Does he comment?

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Interventions

• 4 days a week
• Average of 45 minutes per session
• 11
• Teaching routines designed to provide
  opportunities for children to use natural
  gestures and vocalizations to
• Request
• Reject
• Comment
• Greet

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Videotaped examples
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Teaching an open palm request
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Give for help
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More giving
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Hand over hand gesture
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Need to seek out partner
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High 5
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Vocalizations
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Eye gaze
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Research Design

• A multiple baseline across participants design is
  being used to evaluate effectiveness of the
  intervention
• Children are assessed every 6 months, and
  additional data comes from taped intervention
  sessions
• Each child is followed over 2 ½ years
• Length of baseline differs according to design
• Children receive intervention for 6 months, or
  until we see a noticeable increase in
  prelinguistic communication (criterion of 1
  CA/min)

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Participants

• N18 children
• 12 from NE Kansas- recruited with assistance of
  the Kansas and Missouri DB projects
• 6 from Indiana- recruited with assistance of the
  Indiana DB project
• between 3 to 7 years old at the time of inception
• documented vision and hearing losses
• produce less than one communicative act per
  minute
• nonsymbolic communication level

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Progress to date

• 7 children have completed interventions
• All children showed increases in rates of
  communication
• All children showed increased diversity in their
  communication forms

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• Children with significant motor impairments
  showed
• Less dramatic increases in rates
• Less diversity of communication forms

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Preliminary data
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Weeks
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Summary and Conclusions

• Our research is demonstrating that adapted PMT is
  effective in increasing prelinguistic
  communication rates and increasing diversity of
  nonsymbolic forms.
• -- Particularly for children with relatively good
  motor skills
• Through this type of intervention children are
  learning the power of communication before, or as
  they learn to use more symbolic forms of
  communication

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• Increasing prelinguistic communication may lead
  to
• Decreased frustrations by children and their
  communication partners
• More enjoyable interactions
• Greater participation by children in school and
  family activities
• Our research will provide concrete support for
  intensive interventions. This information may be
  used by families to advocate for services.

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• Further research is needed to investigate how
  childrens environments, including their
  communication partners, can support the use of
  prelinguistic communication.
• Further research is needed to identify
  strategies to help children transition from
  presymbolic to symbolic forms of communication.

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Questions and comments?
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Acknowledgements

• USDE grant award H324D0003-05
• James Sweeney, Joan Houghton, Kate Nielson, Gabe
  Holcombe
• Teachers and families who allowed us to complete
  research in their classrooms and homes

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Contact information

• Address
• Deaf Blind Research Project
• University of Kansas
• 1000 Sunnyside Drive
• Lawrence, KS 66045
• Email nbrady_at_ku.edu, sbashin_at_ku.edu