I had the pleasure of attending my first WATCH video conference on January 11th.  The session was entitled,

Identifying Infants and Toddlers with (or at risk for) Communication Deficits: It takes A Village.  It was facilitated by Dr. Elizabeth Crais, a speech-language pathologist and professor at UNC-CH.  I participated in this session at the Tammy Lynn Center.  The other three host sites included the Raleigh CDSA, Learning Together and the TelAbility Center. In total, 34 people attended this session.  I think everyone would agree that the 2 hours held our attention as it was packed FULL of thought provoking and exciting information, that reinforces the importance of Early Intervention.

Dr. Crais' passion about the early identification of children with communication disorders and/or Autism Spectrum Disorders was evident and some very interesting information was shared. Some of the things that stood out to me were the importance of a child's ability to use gestures and symbolic play as predictors of later language, the relationship between play behaviors and gesture use, and the "Red Flags Approach" when looking at social concerns, intentionality, play and language skills.

Regarding gestures and symbolic play, Dr. Crais highlighted the importance of looking at a child's "pointing-giving-showing" behaviors. I liked this wording as I felt like as an interventionist, I could talk about these abilities with parents and caregivers and in any activity we may be working on, these skills could be targeted.  Someone raised the question about "late bloomers" or "late talkers" and I found it interesting that the research actually has been able to distinguish between them and true language deficits by looking at gesture use! Late talkers will have a lot of varied gesture use early on and good comprehension whereas true delay has decreased gesture use, variety and difficulty with receptive skills. 

Play behaviors and gestures use being so closely related, made me think about the important relationship between the disciplines that may be providing Early Intervention Services to a child. Throughout the Levels of Play Development, the child's ability to use variety kept showing up as an important indicator. For example, in studies of gesture use and play in children with an Autism diagnosis and those without, gesture use and play may be present, but one gesture or game may be prevalent vs. the use of many. As a CBRS therapist, this is something I feel we focus on frequently and it seems that improving a child's repertoire of play related behaviors or gestures can help a child better receive Speech  or Behavioral Therapy.  The concept that "first words and first play schemes coincide" clarifies for me the relationship between all disciplines when working in early intervention.

Finally, the Red Flags Approach gave a concrete framework to look at. Looking at Social development, intentionality, play skills, comprehension skills, sound production and word productions and combinations, the guides give end ranges for seeing a child use a skill or strategy.  For example, by 18 months, you should be able to observe a child communicating for a variety of reasons such as protesting, requesting, seeking social interaction, and commenting. If a child only shows one type of social communication, there may be cause for concern. The evidenced based information that was presented supports(as usual) the presence of indicators early on in a child's life can tell us where others concerns may be present. For example, language skills are a strong predictor of cognitive skills--the child's ability to communicate in their first and second year of life is indicative of later ability.

This format was interesting to me because I think sometimes the general population still perceives children with social/communication disorders as non-communicative or non-interactive. Dr.Crais pointed out the research that shows children with autism may have language, but they aren't using it to be social. Or there may be gestures and interaction, but the array is limited and repetitive.