Major focus area

Speech Therapy -> Expressive Language

Short description

Milieu Language Teaching (MLT) is a hybrid intervention approach where the SLP prompts pre-selected grammatical targets during child centered play and routines. Incidental teaching method and Mand-model are two variations of MLT (Warren, 1991, Yoder, et al, 2011, Paul, 2001).

Long description

Milieu Language Teaching Procedure: This is a hybrid intervention approach which combines methods from both child-centered and clinical-directed interventions. SLP uses child centered play and routines to elicit the child’s need to use utterances that contain pre-selected grammatical targets. The child’s current focus of attention or communicative request provides the context and timing for the SLP to prompt an utterance that contains a language structure that the child does not use often or consistently. Incidental teaching method and Mand-model are two variations of MLT (Warren, 1991, Yoder, et al, 2011, Paul, 2001).

Incidental Teaching Method Clinician arranges therapy situations so that the child is likely to initiate a conversational exchange (place attractive toys on a shelf the child can see but cannot reach; arrange desirable food items). The clinician stays close to the materials and gives nonverbal cues to speak by having focused attention on the child and a questioning look. Child selects the topic of conversation by making some kind of request, such as gesturing or looking toward the desired item. The clinician gives an elaboration of the child’s response (e.g. “What do you want?”) or models an elaboration (“You want that ball! What do you want?”); if the child responds appropriately to the prompt, praise is provided and the communicative goal is achieved. If not, one more attempt should be made. If this also fails, the child still gets what he or she wanted.

Mand-Model: This is an extension to incidental teaching method. The clinician uses attractive stimulus materials, designs a naturalistic interactive situation, but the clinician does not need to wait for the child to initiate communication. Joint clinician-child attention to a particular material is set and then the clinician “mands” (requests) a response from the child with a stimulus, such as “Tell me what that is.” or “Tell me what you want.” If the child gives no or a very limited response, the clinician models the complete, correct response "I want ball". If the child does not imitate the entire modeled sentence, the clinician prompts (“Tell me the whole sentence”). The child is praised for imitating or for responding correctly and is given the item he or she wanted.