home site map our company review board contact us update profile
| 
| 
| 
| 
| |
| News & Information » News » Articles » Interviews » Ask the Expert » Submissions |
| » 800.242.5183» Email Us |
| Home | Articles | Article Details |
  |
|
3/19/2007 Using Sign to Facilitate Oral Language: Building a Case with Parents Shari Robertson, Ph.D., CCC-SLP, Indiana University of Pennsylvania | |
| Speech-language pathologists (SLPs) and early childhood teachers who work with children with linguistic deficits often incorporate sign and gestures into their intervention protocols to facilitate the development of expressive language of children who are slow to talk (e.g., Good, Feekes, & Shawd, 1993/1994). Unfortunately, while most SLPs intuitively understand the rationale for using a manual mode of language to facilitate development of the oral mode, it is very common for parents of children who manifest deficits in the linguistic domain, but have normal hearing sensitivity, to be skeptical or even hostile to the use of sign as part of their children’s intervention plan. Generally, this stems from a fear that sign language will stifle oral language use rather than facilitate it. In many instances, this skepticism translates into reluctance (or outright refusal) on the part of the family to use sign when communicating with their child. As with any intervention technique, the best outcomes are most often achieved when the targeted intervention techniques are employed consistently in all communicative contexts including (and some would argue most importantly) the home environment. If we wish to work with families, rather than against them, to facilitate language development, it is critically important to be able to provide the information parents need to facilitate their acceptance and ideally their active participation–in a treatment protocol that includes sign. Clearly, thorough knowledge of the relevant research evidence is an essential tool for speech-language pathologists who seek to clarify their rationale for the use of sign with parents and, often, other professionals. Fortunately, there is a great deal of evidence to support the use of sign to develop oral language from a variety of research literature bases. Individually, each perspective we will explore in this article has the potential to provide a strong case for including sign in the intervention protocols of young children with limited oral language skills. Taken together, however, the evidence is compelling. Support from Normal Language Development One way to help parents better understand the rationale behind using sign to facilitate their child’s oral language can be drawn from what we know about normal language development. Currently, a substantial literature base exists regarding the relationships between language and gesture development in typically developing children (e.g., Bates, Benigni, Bretherton, Camaioni, & Volterra, 1979; Bates, Bretherton, & Snyder, 1988; Bates & Snyder, 1987; Bates, Thal, Whitesell, Fenson, & Oakes, 1989; Shore, Bates, Bretherton, Beeghly, & O’Connell, 1990; Thal & Bates, 1990; Thal & Tobias, 1992). Typically developing children use sign to communicate long before they begin to use words to express their needs and wants. In fact, the ability to purposefully communicate with others develops around six month of age in most children long before they develop the control necessary to coordinate the numerous muscle movements required to produce oral speech. In part, this is because producing a gesture requires control of larger muscles masses, such as hands and fingers, in comparison to the specific and substantially more refined motor movements required for oral speech (McLaughlin, 1998). Early gestures, although not associated with a formal system of sign, allow children to begin to communicate with others in their environment even before they are physically able to produce oral language. So, children wave bye-bye, hold up their arms to indicate they want to be picked up, and point to objects they want or need. These types of interactions also facilitate joint attention, a critical component to the development of language. Further, when people in the children’s environments respond to these gestures, they learn that they can control their environment through their actions. When a child learns that the sign for “more” has the power to, in fact, make “more” of the desired item appear, he or she has learned that communication gets results! This acts as a powerful catalyst for children to continue to develop their communication skills. Most children are born with a powerful drive to talk and as their motor skills improve they eventually learn to match a spoken word to the concept they have already learned to express using a gesture—in effect “mapping” the oral representation over the top of the gestural representation of the cognitive concept (Acredolo & Goodwyn, 1988). For instance, a child who has developed the understanding of what bye-bye means during the period when they are only able to wave is able to learn the words associated with the gesture much more quickly once their oral muscles are sufficiently developed. Support from the Neurological Perspective Another viewpoint often used to support the use of sign with children who are slow to develop language comes from research related to how the human brain processes information. Some investigators argue that sign stimulates both the visual and auditory neural pathways in the cerebral cortex of the brain while spoken language uses only hearing pathways. According to Gallaudet (as cited in Daniels, 1996), sign language stimulates both the visual and auditory neural pathways in the cerebral cortex of the brain, whereas spoken language uses only hearing pathways. In addition, both hemispheres of the brain have been found to be used during sign language use, whereas the left hemisphere is primarily dominant in the processing of auditory language. From this perspective, language input (and output) that is paired with sign has the potential to facilitate language development that is faster, more organized, and more durable than using oral language only. In addition, because the visual cortex matures before the auditory cortex, teaching sign allows children to take advantage of this developmental progression and better utilize their skills for language development. Support from the Cognitive Perspective Recent research related to working memory suggests that some children’s linguistic deficits may be related more to deficits in their ability to hold and retain information in working memory than in their ability to learn language, per se (e.g., Gathercole & Baddeley, 1990; Just & Carpenter, 1992). It has been hypothesized that some children may not be able to hold the acoustic components of a spoken word long enough in their working memory to process, decode, and compare it to information already stored in their long-term memory. As an example, when a child is unable to effectively attend to an auditory stimulus, such as a word, the information is not moved into the central systems for processing and storage. Hence, the word does not become part of the long-term storage system and is not “learned.” Similarly, even if a child is able to attend to the auditory input, if the capacity of the processing mechanism is unable to internally refresh the information while it is being processed (that is, keep it active in the working memory component), the signal will degrade and eventually be lost rather than being integrated into the cognitive system (e.g., Lahey & Bloom, 1994). Since the acoustic signal of a spoken word immediately degrades once verbalized, the only way to refresh information is to provide constant input (that is, repeat the word over and over again) to provide the child with enough exposure to process the information in his or her working memory. However, a sign, which is inputted through the visual rather than the auditory system, can be held indefinitely providing the child with a constant stimulus during which time he or she can more effectively process and store the concept that is being represented thus facilitating word learning (see Ellis Weismer, 2000, for an in-depth discussion of information processing related to language development). In addition, imitation has been identified by a number of cognitive researchers. For example, Bates (1979) argues that imitation is one of three prerequisite skills necessary for language learning to occur. Piaget (1962) also lists imitation as a cognitive prerequisite to language. In general, children who are unable to imitate will not be able to reproduce the strings of phonemes, which are necessary to produce speech, that they hear from competent (and not so competent) speakers in their environment. It is much easier to assist a child in imitating a gesture than a phoneme (or multiple phonemes) since the hand shape can be manipulated by an adult and the result seen by the child. Once the underlying ability to imitate is established, imitation of speech sounds can, as discussed previously, be mapped onto the gestures. Support from Studies of Typically Developing Children While most children learn English with seemingly little effort when exposed to traditional oral models, studies have suggested that when children are exposed to sign language, they learn vocabulary at a much higher rate, have a better understanding of the grammatical structure of English, and use language in a more productive manner (e.g., DeViveiros & McLaughlin, 1982). In a landmark study by Goodwyn, Acredolo, & Brown (2000), 103 typically developing infants were followed in a longitudinal study that investigated the effects of gesture on language development. The infants were divided into three groups: Sign Training, in which parents were encouraged to provide signs along with words; Verbal Training, in which parents used specific techniques to encourage the development of verbal skills; and a Control group, in which parents received no training. The children were followed from 11 months through 36 months with re-testing occurring at several intervals throughout the study. Results revealed that the children in the Sign Training group, who received both signs and words, demonstrated higher levels of language learning at all interval points than children in the other two groups. The children in the Sign Training group demonstrated substantially better skills in both the receptive and expressive vocabulary measures as well as in their use of syntax. These children continued to demonstrate better language skills throughout the course of the study, with the largest difference noted at testing intervals that occurred during the second year. In a study of school-aged children, Daniels (1996) compared the vocabularies of two groups of children who were exposed to sign for a single school year to another two groups of similar-aged children who were taught without sign language integration. Results suggested that the students who were taught sign language had greater vocabulary skill development throughout the school year than the children who were not exposed to sign at all. A follow-up study performed a year later showed that the retention level of vocabulary and language acquisition of the signing students was higher than the control group. The results of this investigation provided support for the notion that the more varied ways a child is exposed to language, the more retention and learning of that language will take place. Support from Direct Comparison of Treatment Approaches in Intervention A recent study by Robertson (2004) provides further support for the use of sign to facilitate expressive oral language in 2 children with linguistic delays. Using an alternating treatments design, 2 late-talking toddlers, aged 2:11 and 3:3, were exposed to 2 different sets of 10 vocabulary words. Treatment was administered during 13 bi-weekly, 1-hour sessions using a focused stimulation intervention framework and were conducted using a semi-random order of conditions (i.e., controlled so that no more than 2 sessions of 1 type of treatment occurred in sequence). Twenty-two target words that did not appear in the functional expressive vocabularies of either of the children previous to this treatment study were chosen for the study. The words were chosen using criterion guided by findings regarding the lexical development of typically developing children (e.g., Leonard et al., 1982). Specifically, words were chosen that contained one syllable; were predominantly of the CV, VC, or CVC syllable shape; consisted primarily of nouns or objects; and were easily represented through the use of a referent. In addition, efforts were made to select in-phonology words only—that is, words that contained sounds that the children were already able to produce. Two lists of 10 each 1 for the verbal modeling (VM) condition and 1 for verbal modeling plus a sign (VM+S) were developed and counterbalanced for both phonological and lexical difficulty to ensure equivalency. For instance, each list contained an equal number of nouns versus verbs and each included words related to food (egg, apple); clothing (shoe, hat); animals (cat, pig); action (eat, drink); and toys (bus, block). To control for effects of spontaneous maturation during treatment, 2 additional words were designated as control words. These words were not modeled during either treatment condition. One set of words was presented using verbal modeling only and the second set was presented using verbal modeling plus a sign. Each word was presented 10 times during each treatment session using a focused stimulation framework, but only under the condition to which it was originally assigned (that is, some words were only presented through verbal modeling and some words were only presented using verbal modeling plus a sign). The children were not required to repeat the target words during treatment sessions; however, production probes were used at the end of each session to determine expressive oral vocabulary acquisition. Specifically, once a treatment session was completed (i.e., each of the 10 target words had been presented to the child at least 10 times), participants were prompted to produce each of the targeted words by being shown an object or action and asked, “What is this?” or “What am I doing?” Only words from the VM list were probed after VM sessions and only words from the VM+S list were probed after the VM+S sessions. If a child gave no response to a production probe after 3 attempts, the treatment clinician simply moved on to the next target word. Only oral productions of the targeted words were recorded. Since focused stimulation was used as a treatment framework, children were not prompted to repeat target words either orally or by signing during the sessions; however, spontaneous productions of the target words were recorded and counted as an indication that the child had learned the word. The same procedure was used to assess the children’s production of the 2 control words (i.e., the child was prompted to say the word when presented with the appropriate referent) although these words were not modeled for the child during any of the treatment sessions. A comparison of the results of the 2 treatment methods suggested that while both conditions yielded an increase in the number of words spoken by the children, both acquired a larger quantity of the target words and incorporated the words into their expressive vocabulary at a more rapid rate when verbal modeling was paired with sign language. In fact, both children incorporated all 10 words in the verbal modeling plus sign condition into their expressive vocabularies during the 6-week treatment interval. In comparison, 5 and 6 words, respectively, were learned from the verbal modeling only list. Important Caveats Although results such as those provided in these studies provide strong support for using sign to facilitate oral language skills, it is also important to realize that certain prerequisite skills are necessary in order for children to be able to benefit from this technique. Cognitively, the child must have reached the intentional stage of pragmatic development, attained symbolic function (the ability to understand that one thing can stand for another), and possess adequate imitation skills. Further, a desire and ability to interact with clinicians in a social play environment is important. Children must have the ability to participate in joint attention tasks and demonstrate basic social skills—most specifically eye contact. Children who do not, or are not, willing to look at or interact with the SLP (such as some children with autism) may not benefit from the addition of a sign component to their intervention protocol. Summary The use of signs and gestures as a part of an intervention protocol for children who demonstrate constrained expressive skills can be drawn from theoretical, clinical, and empirical bases. However, while SLPs often intuitively understand the rationale for using a manual mode of language to facilitate development of the oral mode, it is not uncommon for families to express skepticism regarding the use of this technique with their children. In fact, many parents expressed concern that this technique will often discourage, rather than encourage, their children from talking. Consequently, in the interest of achieving the best possible intervention outcomes, it is important that SLPs be prepared to provide parents with the background information they need to become active members in their child’s intervention team. While additional empirical evidence is warranted, especially in terms of direct comparison of intervention methodologies, current information suggests that routinely incorporating sign into intervention with children with constrained expressive language facilitates development of linguistic skills more quickly and with better results. References Acredolo, L., & Goodwyn, S. (1988). Symbolic gesturing in normal infants. Child Development, 59, 450-456. Bates, E. (1979). The emergence of symbols. New York: Academic Press. Bates, E., Benigni, L., Bretherton, I., Camaioni, L., & Volterra, V. (1979). The emergence of symbols: Cognition and communication in infancy. New York: Academic Press. Bates, E., Bretherton, I., & Snyder, L. (1988). From first words to grammar: Individual differences and dissociable mechanisms. Cambridge, MA: Cambridge University Press. Bates, E., & Snyder, L. (1987). The cognitive hypothesis in language development. In I. Uzgiris & J.M. Hunt (Eds.), Research with scales of psychological development in infancy (pp. 168-206). Champaign, IL: University of Illinois Press. Bates, E., Thal, D., Whitesell, K., Fenson, L., & Oakes, L. (1989). Integrating language and gesture in infancy. Developmental Psychology, 25, 1004-1019. Daniels, M. (1996). Seeing language: The effect over time of sign language on vocabulary development in early childhood education. Child Study Journal, 26(3), 193-209. DeViveiros, C.E., & McLaughlin, T.F. (1982). Effects of manual sign use on the expressive language of four hearing kindergarten children. Sign Language Studies, 35, 169-177. Ellison, G. (1982). Hand to hand: The joy of signing among hearing children. Young Children, 37(4), 53-58. Ellis Weismer, S. (2000). Language intervention for children with developmental language delay. In D. Bishop & L. Leonard (Eds.), Speech and language impairments: From theory to practice (pp. 157-176). Philadelphia, PA: Psychology Press. Gathercole, S., & Baddeley, A. (1990). Phonological memory deficits in language disordered children: Is there a causal connection? Journal of Memory and Language, 29, 336-360. Good, L.A., Feekes, J., & Shawd, B. (1993/94, Winter). Let your fingers do the talking: Hands-on language learning through signing. Childhood Education, 81-83. Goodwyn, S., Acredolo, L., & Brown, C. (2000). Impact of symbolic gesturing on early language development. Journal of Nonverbal Behavior, 24, 81-103. Just, M., & Carpenter, P. (1992). A capacity theory of comprehension: Individual differences in working memory. Psychological Review, 99, 122-149. Lahey, M., & Bloom, L. (1994). Variability and language learning disabilities. In G. P. Wallach & K. G. Butler (Eds.), Language learning disabilities in school-age children and adolescents. New York: Macmillan. Leonard, L., Schwartz, R., Chapman, K., Rowan, L., Prelock, P., Terrell, B., Weiss, A., & Messick, C. (1982). Early lexical acquisition in children with specific language impairment. Journal of Speech and Hearing Research, 25, 554-564. McLaughlin, R. (1998). Introduction to language development. San Diego: Singular. Piaget, J. (1962). Play, dream, and imitation (C. Gattegno & F. Hodgson, Trans.). New York: Norton. (Original work published in 1951). Robertson, S. (2004, November) . Using sign to facilitate expressive vocabulary in late talkers. Paper presented at the annual convention of the American Speech-Language-Hearing Association, Philadelphia, PA. Shore, C., Bates, E., Bretherton, I., Beeghly, M., & O’Connell, B. (1990). Vocal and gestural symbols: Similarities and differences from 13 to 28 months. In V. Volterra and C. J. Erting (Eds.), Gesture to language in hearing and deaf children (pp. 79-92). New York: Springer-Verlag. Thal, D., & Bates, E. (1990). Continuity and variation in early language development. In J. Columbo & J. Fagan (Eds.), Individual differences in infancy (pp. 359-383). Hillsdale, NJ: Erlbaum. Thal, D., & Tobias, S. (1992). Communicative gestures in children with delayed onset of oral expressive language use. Journal of Speech and Hearing Research, 35, 1281-1289. | |