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Transcript of Milieu Teaching
(Warren et al., 2008) When is it recommended? It is recommended for children of mixed etiologies and intellectual disabilities.
The intervention takes place in a naturalistic environment. (Preferably at home)
The main goal of Milieu techniques is to help children to improve language communication skills; therefore no specific age is required.
(Hancock & Kaiser, 2006) Method It is a type of response to a child in a more efficient way, to expand the child's verbal and nonverbal skills.
It is based on :
Arranging the environment
Following the child's attentional lead
Building social routines
Use specific consequences When is it more effective? Although EMT can be used effectively for many children, children with the following characteristics are most likely to show rapid change.
1. Children who are verbally imitative
2. Children who have at least 10 productive words
3. Children with MLU between 1.0 and 3.5
(Hancock & Kaiser, 2006)
RE/PMT is more effective with parent training and involvement while working in child's zone of proximity. Specific Methods: Mand-model strategy: The adult initiates the teaching episode through questions, commands, and directives.
Time-delay strategy: Nonverbal cue approach to encourage a response.
Incidental teaching strategy: Promotes the development of more complex responses by following a child's request. (Kaiser, et al., 2013) Milieu Teaching Different Milieu Techniques PMT (prelinguistic milieu teaching): A modified milieu intervention for children who are making little or no use of conventional words at this level. (Warren et al., 2008)
RE/PMT (Responsivity education/ prelinguistic milieu teaching): Targets nonverbal communication skills combined with parental response to the child's communicative attempt. (Yoder & Warren, 2002)
EMT (Enhance Milieu Teaching): Hybrid approach involving three components: (1) environmental arrangement (2) response of interaction (3) milieu teaching. (Hancock & Kaiser, 2006) Disadvantages There is controversy about the effects of the parent's-implemented intervention because it can put a strain on the parent and child's relationship.
Although direct parent involvement increases child communications acts, children without parents support are limited. (Fey, et al., 2006) Advantages Studies suggest naturalistic language interventions implemented by parents and therapists together has a positive impact on children's everyday use of language at home.
Milieu Teaching enhances optimal language development.
Greater opportunities increase the responses between the child and parent. (Fey, et al., 2006) In conclusion Milieu teaching may be an effective intervention to consider when working with children of mixed etiologies and intellectual disabilities.
Milieu teaching is a building block for a child's later language development and skills.
Research is limited; there is a need for continued research among diverse populations.
Fey, M. E., Warren, S. F., Brady, N., Finestack, L. H., Bredin-Oja, S. L., Fairchild, M., & ...
Yoder, P. J. (2006). Early Effects of Responsivity Education/Prelinguistic Milieu Teaching for Children With Developmental Delays and Their Parents. Journal Of Speech, Language & Hearing Research,49(3), 526-547. doi:10.1044/1092-4388(2006/039)
Hancock, T. B., & Kaiser, A. P. (2006). Enhanced milieu teaching. Treatment of Language
Disorders in Children, 203-233.
Kaiser, A. P., Roberts, M. Y., Oetting, J., & Loeb, D. (2013). Parent-Implemented Enhanced
Milieu Teaching With Preschool Children Who Have Intellectual Disabilities. Journal Of Speech, Language & Hearing Research,56(1), 295-309. doi:10.1044/1092-4388(2012/11-0231)
Warren, S. F., Fey, M. E., Finestack, L. H., Brady, N. C., Bredin-Oja, S. L., & Fleming, K. K.
(2008). A Randomized Trial of Longitudinal Effects of Low-Intensity Responsivity Education/Prelinguistic Milieu Teaching. Journal Of Speech, Language & Hearing Research, 51(2), 451-470. doi:10.1044/1092-4388(2008/033)
Yoder, P. J., & Warren, S. F. (2002). Effects of Prelinguistic Milieu Teaching and Parent
Responsivity Education on Dyads Involving Children With Intellectual Disabilities. Journal Of Speech, Language & Hearing Research,45(6), 1158