Major focus area

Speech Therapy -> Pragmatics / Social Skills / Life Skills

Short description

Environmental manipulation strategies are used by the SLP to target prelinguistic communication skills of attention to build a foundation for communicative behaviors (Patten & Watson, 2011; Yoder & Stone, 2006; Kasari et al., 2006).

Long description

Environmental manipulation strategies are used by the SLP to target prelinguistic communication skills of attention so that communicative behaviors can be taught. This is highly researched for children with autism but can used with other specific language impairments that show deficits with joint attention.

Techniques for environmental manipulation are placing objects close to the child or sabotage, such as placing a desired item in a tightly closed jar so that the child would have to request assistance to get the item. Addressing features of attention in categories such as orienting, sustaining, and shifting can lead to joint attention.

1. Orienting attention is the initial physical adjustment toward a stimulus. This is an eye gaze shift or head turn toward a stimulus. Orienting deficits of children with autism directly affect intervention because if stimuli used in speech and language interventions fail to gain the attention of children with autism, they cannot have the desired teaching impact.
2. Sustaining attention is the ability to maintain attention to a stimulus. Children with autism can remain fixated on a particular stimulus while ignoring others and can be “over focused”. This may be related to the child having difficulty with shifting attention.
3. Shifting attention requires the child to disengage from one stimulus and then shift and reorient to a new stimulus. Children with autism seem to have more difficulty with disengaging then with reorientation. SLP may address this feature during activity transitions by hiding the toys that are no longer needed and quickly placing toys for a new activity in the child’s visual field. All of this information is important as it relates to joint attention, which refers to shared attention between two individuals and an object or another individual. Once joint attention is gained the SLP can target functional communication such as sign, gestures, AAC or words for the child to communicate their wants/needs (Patten & Watson, 2011; Yoder & Stone, 2006; Kasari et al., 2006).