TO SIGN OR NOT TO SIGN:

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2 TO SIGN OR NOT TO SIGN: Does signing really benefit the hearing child? Does it improve I.Q.? Strengthen parent bonding? Increase confidence? Decrease tantruming? Helpful when working with children with special needs?

3 EARLY INTERVENTION In speech-language pathology, Early Intervention (EI) refers to services that are provided to infants and toddlers (birth to 3 years) who have, or are at risk for, communication, speech, language, hearing, feeding, swallowing, and/or emergent literacy problems. (Paul & Roth, 2011) Capacity building occurs when the EI providers offer support to strengthen the caregiver-child relationship, build the caregiver s confidence and competence to enhance their child s learning and accomplish familyidentified outcomes. With EI, the focus is placed on building the caregiver s capacity to promote their children s development within the context of their typical routines and activities. (Fridman, Woods & Salisbury, 2012)

4 4 GUIDING PRINCIPLES OF EI Services are family centered and culturally and linguistically responsive. Services are developmentally supportive and promote children s participation in their natural environments. Services are comprehensive, coordinated, and team based. Services are based on the highest quality evidence that is available. (ASHA 2008a, 2008b, 2008c, 2008d)

5 SHORT TERM VS. LONG TERM Short term goal: What can we strive for (and obtain) in the next 3 months that will have a positive effect on a child s communication skills? Child will be able to spontaneously request a desired object/action using a sign/word 5xs a day for 7 consecutive days. Long term goal: What would we like to see for this child in 1 year, 5 years, 10 years? Child will have sufficient speech and language skills to function in daily routines within their natural environment.

6 DETERMINATION OF THERAPY TECHNIQUES Which modality fits the child and family best? Picture exchange-giving a picture in exchange of desired item/action Object exchange-giving an object in exchange for desired item/action Gestures-pointing, nodding, common known gestures in community Sign Language Informal: child developed signs/baby signs Formal: ASL

7 DEVELOPMENTAL CONSIDERATIONS Pre-requisite skills needed for introduction of sign language Communicative intent Typically developing children become intentional around 6 months of age Examples: deliberate eye contact, use of gestures, persistence in trying to communicate Children must have intentionality to benefit from the use of sign to support communication development. Robertson, 2007

8 DEVELOPMENTAL CONSIDERATIONS Symbolic function Understanding that one thing can stand for another Example: a block can stand in for a car, or food, or telephone Language is symbolic in all modes (gestural, oral, and written); the symbol stands for the real object or concept. Robertson, 2007

9 DEVELOPMENTAL CONSIDERATIONS Joint attention capabilities When a child and their communicative partner are paying attention to the same thing. Example: parent and child can roll a ball back and forth, continuing a turn taking routine Children who are unwilling or unable to participate in joint attention will most likely not benefit from teaching sign Robertson, 2007

10 DEVELOPMENTAL CONSIDERATIONS Basic social skills Eye contact and a desire and ability to participate with others in a social setting is critical. Children who actively resist communication and eye contact many not be good candidates for sign language.

11 RELYING ON OUR BASIC SENSES Visual cue Many early signs are visual representations of item/action (e.g. ball, eat, drink, bath) Child sees the sign of the target word and learns to associate it with item/action Tactile cue Hand over hand modeling and learning Child begins to sign independently and learns to associate sign with both spoken word and object Auditory cue Child hears the target word used over and over with the same sign Typically a child s first verbal word is a sign they know and can use independently Improved parent understanding Signs and gestures helped clarify verbal attempts Child signing hot, verbalizing ah ah caregiver able to understand that ah ah means hat and can respond appropriately

12 HOW DOES SIGN ENHANCE VERBAL LANGUAGE? #1 All children use gestures before they use spoken words Language comes in 3 modes: gestural, oral, written (in this order!) At 7 months old babies are beginning to communicate with gestures Waving, blowing kisses, high fives, hugging, pushing, shoving, pointing Producing a gesture only requires the control of larger muscle masses, arm, hands, fingers Helpful for children who are not yet able to control small muscle groups such as oral muscles for speech movements. Let s build off of children s innate gestures to help them communicate more effectively! Robertson, 2007

13 #2 GESTURES AND SIGNS HELP ESTABLISH CRITICAL SOCIAL SKILLS NEEDED FOR COMMUNICATION Early signs and gestures help children connect with their environment and develop important relationships and social skills When a child raises their hands to be held, adult responds by picking them up; child learns that they can control their environment through communication As a child learns that their communication attempts get results they are more likely to continue to attempt to communicate Need face to face interactions for sign language to be successful Able to understand response contingency needed for conversational skills later on Alternatively, if a child does not develop a functional communication system early on they are less likely to initiate communication attempts later Robertson, 2007

14 #3 GESTURES AND SIGNS HELP ESTABLISH CRITICAL COGNITIVE SKILLS FOR COMMUNICATION Imitation skills: Cognitive foundational skill needed for language learning Signs are easier to imitate than words Able to help a child by doing hand over hand signing, impossible to do with oral movements Child is able to compare their movement to adults movement, leads to child comparing their word approximation to adult model Symbolic function: The ability to understand that one thing can stand for another; gestures can stand for a word Another cognitive foundational skill needed for language learning (oral and written) Robertson, 2007

15 #4 CHILDREN S BRAINS PROCESS GESTURES AND SIGNS MORE EFFICIENTLY THAN WORDS. Information processing theory: short term memory vs. long term memory Children who are language delayed have a reduced capacity and function of short term memory Unable to retain a spoken work long enough to process it and relate it to a given concept Showing a child a concrete sign allows the child to see it long enough to process it and move it to their long term memory Mirror neurons: a neuron that fires when a person acts, and also when the person observes the same action performed by another. Mirror neurons are thought to be in the pre-frontal cortex and inferior parietal cortex and are important for language development The more we encourage the growth of mirror neurons in gestures and signs the more we encourage overall language development Robertson, 2007

16 Sign stimulates the visual and auditory neural pathways in the cerebral cortex of the brain Visual cortex matures faster than the auditory cortex Spoken language uses only auditory pathway Sign stimulates both hemispheres, oral stimulates only the left hemisphere 90% of brain growth is in the first 3 years of life! Robertson, 2007

17 STUDIES SHOW USING SIGN IS BENEFICIAL FOR LANGUAGE DEVELOPMENT Goodwyn et al. (2000) 103 children at 11 months old 32 sign training with verbal training, 32 verbal training only, compared to 39 control group children testing periods at regular intervals up to 36 months old signing training children showed statistically significant higher receptive and expressive language scores than verbal and control groups Verbal training children did not show higher language scores than control group at any interval the results strongly support the hypothesis that symbolic gesturing facilitates the early stages of verbal language development. Instead of interfering with language development, use of signs and gestures appear to accelerate language growth. Children who learned signs showed an increase in IQ of 8-13 points compared to control groups who were not taught signs 8-13 point increase in IQ still evident at 8 years old

18 SIGN LANGUAGE IMPACT ON DAILY ROUTINES Hand over hand signing encourages parent/caregiver bonding and developing early social skills Building imitation skills (play, gross motor, fine motor) Controlling environment increase child confidence, decrease tantruming Makes communication easier and interactions more positive Able to request actions without crying (more, out) Able to request specific food items for clarification (goldfish, crackers, cheerios) Helped books, movies, TV shows become interactive with animal signs (monkey, zebra, bear) Descriptive signs helped share emotions and insights (hot, happy, afraid)

19 DEVELOPMENTALLY APPROPRIATE SIGNS

20 ERRORS AND MISUSES Only as accurate as the model who demonstrates YouTube videos, flash cards, ASL books are hard to imitate with out a competent model Signing face to face may lead to mirror imitations instead of a child using their dominant hand for signing Signs that are developmentally easier can be misused or overused more becomes a catch all and children can get stuck using it for all items and actions better to teach again for action words instead of always using more contextual difference between one more bite and more cereal all done often used for all gone contextual difference between all done and all gone Seal, 2010

21 TO SIGN OR NOT TO SIGN: Does signing really benefit the hearing child? Does it improve I.Q.? Strengthen parent bonding? Increase confidence? Decrease tantruming? Helpful when working with children with special needs? Language that is paired with gesture has the potential to facilitate language development that is faster, more organized and more durable.

22 REFERENCES American Speech-Language-Hearing Association (2008b). Roles and responsibilities of speech-language pathologists in early intervention [Guidelines]. Friedman, M., Woods, J., & Shelden, M. L. (2012). Caregiver Coaching Strategies for Early Intervention Moveing Toward Operational Definitions. Infants & Young Children, 25(1), Goodwyn, S., Acredolo, L., & Shawd, B. (2000). Impact of symbolic gesturing on early language development. Journal of Nonverbal Behavior, 24, Paul, D., & Roth, F. (2011). Guiding Principles and Clinical Applications for Speech- Language Pathology Practice in Early Intervention. Language, Speech and Hearing Services in Schools, 42, Robertson, S. (2007). Using Sign to Facilitate Oral Language: Building a Case with Parents. Seal, B. (2010, November 02). About Baby Signing. The ASHA Leader.