Using Enhanced Milieu Teaching Strategies and Sign Language to Encourage a Child

with Autism to use Communication with Caregiver During Play Interactions.

Colleen Douglas
Kent State University

Introduction Methods Results

Participants
Parent Implemented Enhanced Milieu Teaching
Early Intervention is an area of Special Education that serves children birth to three Adult-Parent/Mother of the child
with special needs and their parents under IDEA Part C. It is important in Early Baseline
Baseline
Intervention
Intervention
Intervention to support families and provide them with the necessary strategies that Child-16 month individual with Autism who is nonverbal and using minimal
promotes their childs meaningful participation in daily routines. A primary reason gestures
children receive Early Intervention is due to their communication challenges, and Setting
these challenges often affect adult-child interactions. In this single subject study I
Home during play and mealtime routines.
worked with a family who has a 16 month old son who has symptoms consistent
with autism. My priority is to improve communication between this young child Intervention Procedures
and his caregiver in order to have a mutual understanding on needs and wants.
Independent Variables
Parent Implemented Sign Language
Purpose Coaching was utilized to train parents in
Examine the effects of Enhanced Milieu specific intervention strategies and sign language Baseline Intervention

Teaching on the communication during daily Enhanced Milieu Teaching (EMT): is a conversation-based intervention
routines with a caregiver and their child. that uses childs interests as opportunities to model and prompt language
throughout the day
Research Question 1. Environmental arrangement-arrange environment for interaction
Does coaching impact the fidelity of parent 2. Time delay-Expectant wait between caregiver and child
implemented EMT strategies?
3. Responsive Interaction- -getting into the childs world and matching Child Communication
. Does parent implemented EMT strategies increase communication in a child their turns
with Autism across daily routines? 4. Modeling-verbal and play modeling used in play routines Baseline Intervention

Coaching Sessions
Research
My research included articles that observed the effects of Enhanced Milieu Session 1: Session 2: Session 3: Session 4:
Environmental Time Delay Responsive Modeling
Teaching Procedures and Sign language for children with Autism. Arrangement & & Signs for Teaching & Signs & Signs for
Signs for More Sleep and for Eat and Water and
Kasinath, S., Woods, J., This study examined the effects of facilitating generalized use of teaching & All Done Play Please Milk
& Goldstein, H. (2006) strategies by parents of children with autism within daily routines. Parents used
Enhanced Milieu teaching Procedures Such as: environmental arrangement, Discussion
Time delay, imitating, modeling and prompting. These implemented strategies
had a positive impact on child communication outcomes. Alignment with Previous Research
This research aligns closely with the Parent-Implemented Enhanced Milieu
Wright, C.A., Kaiser, Effects of a naturalistic sign intervention on expressive language of toddlers Measurements Teaching journal by Kaiser & Roberts (2013). Which showed that the result of
A.P., Reikowsky, D.I., with developmental delay. The children in this study increased their number of
Roberts, M. Y. (2013) signs used when the interventionist implemented EMT strategies along with Dependent Variables consistent use of the parent implemented EMT strategies yielded a grow in the
Joint attention, symbolic play, emotional regulation, and 32 paired signs. child-parent directed communication.
Child communication
This study Extends the Previous Research
Hancock, T. B., & Trainers used Enhanced Milieu teaching procedures to teach children with 1. gestures (pointing, reaching, grabbing) In this study the researcher was interested in seeing the effects of EMT strategies
Kaiser, A. P. (2002). Autism social communication strategies. The children in the study paired with Sign language on children with Autism. By pairing these strategies
demonstrated positive changes in social communication. further the children 2. vocalizations
were able to use these strategies with their families. together the researcher thought that the child would be more immersed on
3. words words, play, and gesture and this would encourage more communication.
Ingersoll, B., Meyer, K., Comparison of developmental socialpragmatic and naturalistic behavioral Parent survey Social Validity
Bonter, N., Jelineka, S. interventions on language use and social engagement in children with autism . Frequency of child communication observed during routines (Pre and The mother indicated, through the parent survey that the EMT strategies were
(2012). the interventionists focused on responsive interactions and milieu teaching usually easy to implement throughout daily routines.
procedures (time delay, incidental teaching, modeling, mand modeling). all of Post surveys)
the five children in the study exhibited higher rates of language targets. Limitations
1. bedtime, playtime, mealtime, bath time, and transitions Since this study focused on a single family this research is unable to generalize
Mothers satisfaction with intervention (Post Survey) the effectiveness it would have across multiple children of different ages.
2. How easy intervention is to implement during daily routines Future research directions
Overall, these articles indicated communication growth in children with Further research is needed to determine the effectiveness of Parent-
autism. The communication consisted of: vocalizations, words, gestures and (Environmental arrangement, time delay, matched turns, and Modeling)
implemented EMT and Sign language on the communication of children with
signs across daily routines. Autism in natural environments with a larger sample population.