Need for the

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Fueling Language Development Through Enhancing Interactions in an

Early Intervention Program for Vulnerable Infants/Toddlers

Janice Greenberg B.Sc., D.S.P., Joan Reisinger Ph.D & Lynne Katz EdD

ASHA Conference • Nov. 18, 2016 • 2:00 – 4:00 p.m.

© Hanen Early Language Program, 2016. All rights reserved. May not be further

reproduced or distributed without permission from The Hanen Centre.

Fueling Language Development Through

Enhancing Interaction in an Early

Intervention Program for Vulnerable

Infants/ToddlersJanice Greenberg B.Sc., D.S.P.

Director, Early Childhood Education Services

The Hanen Centre

Toronto, Canada

Joan Reisinger Ph.D

SLP

Fort Lauderdale, Florida

Lynne Katz EdD

Director, University of Miami

Linda Ray Intervention Center

Miami, Florida

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Disclosure Statements

Janice Greenberg, B.Sc., D.S.P., Reg CASLPO, is employed as

Director of Early Childhood Education Services at The Hanen Centre

and is the presenter and developer of this workshop and co-author of

the Learning Language and Loving It guidebook. Ms. Greenberg

receives no financial benefit from this workshop or sales of the

guidebook and has no other financial or non financial interest in this

workshop or guidebook. There will be no information about the

application of this workshop to similar products or services.

Lynne Katz EdD is a University of Miami faculty member as a

Research Associate Professor in the Department of Psychology. This

presentation is not intended to garner any financial aspects.

Joan Reisinger Ph.D was paid to deliver the training discussed in the

session and is a long standing Hanen member with a professional bias

toward dialogic services in the natural environment.

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Fueling Language Development Through

Enhancing Interaction in an Early Intervention

Program for Vulnerable Infants/Toddlers

Introducing the Linda Ray Intervention Program (LRIP)

Rationale for implementing

Learning Language and Loving It™

(LLLI)

Description of LLLI and supporting

research

How LLLI was implemented in the

LRIP

LLLI Program outcomes at LRIP

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LLLI Program outcomes at LRIP

Learner outcomes

The nature of high-quality, responsive adult-child

interactions that support language development in early

childhood settings

Hanen’s Learning Language and Loving It™ Program

(LLLI) - evidence-based strategies to enhance

educators’ daily interactions with children

How LLLI has contributed to changing the

developmental trajectories of vulnerable

infants and toddlers with language delays

born prenatally drug exposed in a

Part C University early

intervention program

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University of Miami Linda Ray

Intervention Center (LRIC)

Birth-Two Program within the Miami-

Dade County Public Schools Prekindergarten

Program for Children with Disabilities

100% children meet eligibility for Part C services as developmentally delayed

Children typically attend from infancy – 36 mos.

Compromised by risk factors (prenatal drug exposure, child maltreatment) and/or parents with limited parenting skills

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Need for the

LRIC

Initially designed in 1993

To examine three levels of early intervention on the developmental outcome of children who had gestational cocaine exposure

Families of the children present with a wide variety of co-occurring risk factors such as poverty, insecure attachment to caregivers, parenting stress and psychological symptomatology (Claussen et al. 2002)

Many of the children experience maltreatment and are connected with the child welfare system.

They change caregivers frequently either due to court intervention/familial upheavals.

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Crime Hotspot Zones Multi-faceted Research Center

Variety of research based strategies employed with the students

Use of curriculum tested in original randomized clinical trial

Conscious Discipline™behavioral support

Infant mental health consultation

Full assessment battery tracking language and behavior

Background

Children who are prenatally exposed to cocaine are at-risk for cognitive, language, and behavioral delays (Lester, et al., 2000)

LRIC staff have to be better than good to help compensate for so many of the disconnects the children experience on the home-front.

LRIC has always been determined to see what else could be done to raise language scores by age three.

Prevalence rates of

developmental delay

Overall delay in foster care

60%

• Language – 57%

• Cognitive – 33%

• Gross motor – 31%

• Growth problems – 10%

10Leslie, L.K. et al (2004) Journal of

Developmental and Behavioral Pediatrics

Overall delay in general population

4% to 10%

Addressing the need

Teachers, social workers, child welfare (foster) case workers and staffing specialists work with bio and foster families to develop Individual Family Support Plans and implement strategies in the classrooms.

Evidence-based Outcome Curriculum emphasizes language development and socio-emotional development. (Socio-metrics)

Addressing the need with

professional Development

Behavioral strategies

Early literacy

Classroom design

Parent outreach

Social services

Child abuse and neglect

Substance abuse and recovery

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Core components

Age appropriate classrooms (1:3/4 adult to child ratio meets special education requirements}

Teaching degrees in education, psychology and/or early childhood

Classroom assistants are paraprofessionals

25 hours weekly of intervention using Outcomecurriculum

Continuity of caregivers throughout the child’s enrollment

Professional staff development to support child’s well-being and school readiness

Language assessments

McArthur Vocabulary, short

and long form (Fall)

Reel-3 (Spring)

PLS-5 for targeted intervention (18 months and at

post 36 months)

Battelle

Important role of the

educational staff

Adults encourage the development of linguistic capabilities:

Use complex syntax

Use richer vocabulary

Are responsive and sensitive to children’s

signals

Particularly for children at-risk for

developmental delays where

optimal caregiver input may be lacking

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121 children graduated from LRIC from

2008-2013

60% of these children no longer met criteria for special education services

Enrolled in regular Head Starts or community Pre-kindergartens.

19% entered regular Head Start with only speech services 1 hour per week.

21% of the 121 children transitioned to Part B special education services.

Classroom Observations

What was working

Structure and routines were providing behavioral guidance

Schedules and transitions were flowing smoothly

What could be better

Teachers and support staff needed more guidance on promoting language development

More individualization of strategies for children at different language stages

Historical connection with Miami-

Dade County Public Schools

Speech-language evaluations and transition planning

Need for additional training related to language development

Needed a staff training program with lots of frontline classroom feedback and support

Came together to plan a new

process for staff

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The Hanen Centre provides the important

people in a young child’s life with the

knowledge and training

they need to help the

child develop the best

possible language,

social and literacy skills.

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Mission Statement

The Hanen Centre

Resources

Training

• Direct

• Train-the-trainer Research

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Promoting language development naturally

throughout daily activities and routines

for ALL children

EnrichmentIntervention

Prevention

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Learning Language and Loving It ™ - The Hanen

Program ® for Early Childhood Educators/Teachers

1. Take a Closer Look at

Communication

2. Follow the Child’s Lead

Video

3. Take Turns

Video

4. Encourage Group

Interaction

Video

5. Adjust Language,

Extend the Topic

Video

6. Language Leads to

Literacy

Vide

7. Peer Interaction

Video

8. Wrap-up

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Daily routines, play and conversations

Incidental learning

Caregiver is the primary change agent

How do children learn language?

Naturalistic approach

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How do children learn language?

Social-interactionisttheories

Responsiveness

Extended interactions

Developmentally appropriate language

models

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The most important ingredient of high

quality early learning and care…

The amount and quality of

interaction between

caregiver and child

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Preschool experiences are important

Predict scores in reading

comprehension and receptive

vocabulary up to gr. 7

Vocabulary Conversation Literacy

environment

Performance in kindergarten1. Receptive vocabulary

2. Narrative production

3. Emergent literacy (Letter knowledge,

sound awareness)

Dickinson & Tabors, 200228

Talk matters!

“The most important aspect

to evaluate in early

childhood settings for very

young children is the

amount of talk actually

going on, moment by

moment, between children

and their caregivers."

Hart & Risley, 2002

What kind of talk?

Key ingredients

Responsiveness

Interactions are extended


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Interaction

Information

Responsiveness



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• 8% time – elaborated interaction with teachers

• 73% time – no teacher interaction

• 50% time – children actively engaged

INTERACTION

• Less than 20% time – conversations stayed on and deepened a topic

• 33% time – beyond here and now

INFORMATION

What does the research say?

Dickinson, 2001

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Not so good. I can’t read, I

can’t write and they won’t let

me talk!

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• Practical strategies for educators to implement in daily routines in the classroom

What we teach

• Train-the-trainer model

• Group training and individualized coaching, videotaping and feedback

• Learner-centred approach

How we teach

• Enhance interactions and information with practical strategies to be applied in daily activities and routines

What we teachWhat we teach

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Interaction? Information?

Key ingredients

Responsiveness



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Interaction? Information?

Key ingredients

Responsiveness



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The amount of interaction and information

depends on the role the teacher plays

Timekeeper

Entertainer

Director

Too quiet watcher

Helper

Cheerleader

Responsive partner

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Impact of Child’s

conversational style

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Sociable

Passive

Own

Agenda

Reluctant

Children’s conversational styles

impact on the teacher’s interactionTalk matters

Key ingredients

Responsiveness



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Responsiveness



Strategies

To promote responsiveness

To extend interactions

To add appropriate language

How RESPONSIVE is this teacher?

What would you suggest?

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OWL

Be face to face

Follow the child’s lead

Join in and play

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What has the teacher changed?

How has Mari changed?

OWL

Be face to face


Join in and play

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Follow the

Child’s Lead

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Extend the interaction

Waits for another turn

OWL

Be face to face


Join in and play

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Keep the Conversation Going

Facial

Expression

Questions

Comments

Gestures

Eye Contact

Body

Language

Repetition

Waiting

Intonation

Look, I made a

car!

Turn 1

I’m going to

Africa. Going to

see elephants.

Turn 3

No, it won’t. My

car can fly. It

goes really fast!

Turn 5

That’s an amazing

car! Where are you

going in your car?

Turn 2

All the way to Africa!

Africa is very far. I think

it will take you a long

time to get there!

Turn 4

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Encourage interaction in small groups

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Interacting

Participating

Attending

Not Attending 46

What does Helen do to involve Sara?

What more could she do?

Attends

inconsistently

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What does Helen do? Is she successful? What kind of talk?

Key ingredients

Responsiveness



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Interaction

InformationDevelopmentally

appropriate language

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Say less and stress

Go slow and show

Adjust the way You talk

Imitate Interpret

Label Expand

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Meaningful differences, Hart & Risley

Breadth

Depth

Vocabulary

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How does the teacher adjust the way

she talks?

Say less and stress

Go slow and show

Imitate

Interpret

Label

Expand

Quantity of words matters,

but the quality of the interaction matters more

How you talk

What you talk about

Hirsh-Pasek et al, 2015

Quantity matters, but quality matters more!

Rowe, 2012

• Vocabulary at 30 mos.

# words parents used between 12-24 mos.


Parents’ use of variety of sophisticated words between

24-36 mos.


Parents’ use of narratives (talking about past/future) and

explanations between 36-48 mos. 54

Learning to Talk

Talking to Learn

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Extend the TopicUse language to think and learn about the world

Talk about

feelings and

opinions

Talk about

the future

Explain

Inform

Pretend/

Imagine

Project

How do these children extend the topic?

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Explain

Talk about feelings

Talk about the future

Inform

Pretend

Project

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Extend the topic all through the day

Daily routines

Creative activities

Sensory activities

Dramatic play

Playtime

Science

Circle

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Foster peer interaction

Plan

ahead

Support the

interaction

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• Practical strategies for educators to implement in daily routines in the classroom

What we teach

• Train-the-trainer model

• Group training and individualized coaching, videotaping and feedback

• Learner-centred approach

How we teach

• Enhance interactions and information with practical strategies for educators to implement in daily routines

What we teach

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How many psychologists does it

take to change a light bulb?

Only one, but

the light bulb

has to want to

change!

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What the learner brings

Knowledge

Experiences

Values and beliefs

Seek to understand not to be understood.

Group training

sessions

Individualized videotaping,

coaching and feedback sessions

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Group training

sessions

Seek to understand not to be understood.

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Delivering effective

group training sessions

• Participative

• Non-judgmentalInteractive

• Personal experiences

• Specific examplesRelevant

• “Don’t know it till you try it”

• Step by stepInclude practice

• Transfer to classroom

• AccountabilityInclude personal

Action Plans64

Videotaping and feedback is powerful

How LLLI uses videotaping

Participants develop an Action Plan

Participants are videotaped using their Action Plan

Online coaching provided if necessary

Participants view video with program leader

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Ask, don’t tell

• How well are the strategies being used?

• How aware is the participant of what she is doing and how the children are responding?

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Post-LLLI Outcomes

Girolametto, Weitzman & Greenberg, 2002, 2003

• Increased talkativeness

• Become more child-centred

• Promoted children’s active participation & turn-taking

• Moved to viewing book-reading as a conversational activity

• Increased direct and indirect peer referrals

• Maintained changes over 9 month period

• Initiated more utterances to teacher & peers

• More diverse vocabulary

• Longer utterances

• Engaged in longer peer interactions

• Used more complex utterances in book reading

www.hanen.org

68Booth # 907

Pre-LLLI LRIC

Observations

Most interactions with the sociable or demanding children

Teachers requesting strategies for children not on target for language skills

Missed opportunities for language interaction (morning circle, daily routines)

Some Observations

Teachers were loving and interactive but missed opportunities for interaction and conversation

Some teachers naturally scaffolded interactions to support language development - others did not

Teacher styles impacted on language strategy effectiveness

The First LLLI session yielded

immediate results!

What the Teachers Said…

I was surprised that how as a teacher

I was doing the right thing unknowingly.

I liked that there was a lot of

participation with my co-workers.

What I liked best was the different

things to look for – observing, following

the child’s lead.

Her sessions are very hands-on. Video

presentations contained important details

we did not notice.

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Group Sessions

0 02

5

9

0

1

2

3

4

5

6

7

8

9

10

1 not veryhelpful

2 3 4 5 very helpfulhelpful

Planning and running a

LLLI Program

Advantages to staff

• Certification hours for teachers

• Continuing Education Units for Child Care License

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Where?

• School system

• Birth-2 agency

• Private day care

Program set-up

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At first I really thought it would be a

long, boring training. But, much was

learned and the training was very

interesting and great!

Although there was a lot of material

in each session it was understandable

and helpful!

When?

• Limitations for workdays and after school hours

• Access to school for videotaping

During the day

• School access

• Dinner providedEvening

Length of the Program

Hanen requirements

• 20 2 ½ hour (15)

• 8 sessions (5)

• 6 video feedbacks (4)

It was just enough

time – not too much

at one time to learn.

The sessions were

a little long, but

interesting with a lot

of information.

How $$$

As part of your job description

Cements your relationship with any private daycare/ organization

Makes a world of difference to the staff and the children!

The advantages go

way beyond the money you

make.

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How $$$

Private practice

Hourly

Daily rate

Printed Materials

Folders

Books

Candy/fruit snacks such as Halos

Location for group sessions

Adequate space for movement for small group activities, and snack table

Available bathrooms

Secure parking lot

Writing tables with candy, healthy snacks, fiddle baskets

Available toys (brought by teachers or provided)

Evaluations after each session

Reviewed at next workshop

– the good, the negative,

the ugly!

Dialogue, Dialogue, Dialogue!

What the Teachers Said…

I was a little nervous about them but by

the second videotape I was comfortable.

The feedback was great!

I liked that I was able to see how I interacted

with the children and learn the areas I needed to

improve in.

I really liked learning from ourselves,

reflecting on the videos and developing

better strategies.

I prefer not to be videotaped but I LOVE

the feedback!

Videotaping and Feedback

0

2

4

6

8

10

12

1 Poor 2 3 4 5 Excellent

Videotape and immediate Feedback

Written permission from participants and children’s parents

Always get participants’ permission to show a video

Show a video where positive comment can be made - Never show a negative video

Rarely share videos with administrators – and only with participant’s permission

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Setting for videofeedback

(45-60 minutes)

Classroom during outside play

Library

Planning area

Office lent from a member of the staff

Private!

Planning and Running the

Sessions

• Adult learning principles and strategies help everyone feel engaged according to their learning styles

LLLI Making Hanen Happen Leader’s Guide

• Evidence based effectiveness

• Know your participants.Role Plays

Role Plays

0

1

2

3

4

5

6

7

8

9

10


Learning Language and Loving It

(Weitzman & Greenberg, 2002)

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2

4

6

8

10

12


Handouts

0

2

4

6

8

10

12


Helping participants use the

strategies every day

Handouts printed from DVD/Hanen website

Be mindful of participants’ literacy level

• Action Plans written during

each workshop address all

the main strategies

• Help participants focus on

strategies (especially if

time lapse between

sessions)

• Also post OWL and

children’s language stages

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Post-LLLI observations

Teacher’s Growth

Children’s Growth

LLLI increased teachers’ awareness of

their interactions with the children

I was overlooking the quiet kids

and asking too many questions.

I find myself doing more observations

and slowing down my language pace.

I am reminding myself to be on their

level – face to face.”

Children who lead get the language they need!

I am letting go of the lead and joining in the play!

Specific changes in teachers’

Interactions

I am taking turns, waiting, not talking

too fast and being at their level.

We started breaking into small groups

consistently which definitely promotes more

communication and language.

Now when reading a book I wait for

responses and interactions.

I am face to face. I give them an opportunity

to take turns.

Results of these changes

Reluctant students have gone from

attending to interacting.”

There is more interaction and communication

The children are more calm and they

interact more.

I have noticed that children who weren’t using

language to communicate are now opening up

and using a lot of words I didn’t know they had.”

Presenting the Learning Language

and Loving It Program is one of my favorite

things!

After Learning Language and

Loving It

More productive language exchanges

Greater ability to scaffold strategies for different language stages

Staff clearly following children’s lead to promote language

Increased turn-taking

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Fueling Language

Development Through

Enhancing Interaction

in an Early

Intervention Program

for Vulnerable

Infants/Toddlers

98

Janice Greenberg

416-921-1073

[email protected]

www.hanen.org

Joan Reisinger

[email protected]

Lynn Katz

[email protected]

Need for the

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