title: Effects of a naturalistic sign intervention on expressive language of toddlers with Down syndrome.
abstract: OBJECTIVE
  In this study, the authors evaluated the effects of Enhanced Milieu Teaching (EMT; Hancock & Kaiser, 2006) blended with Joint Attention, Symbolic Play, and Emotional Regulation (JASPER; Kasari, Freeman, & Paparella, 2006) to teach spoken words and manual signs (Words + Signs) to young children with Down syndrome (DS).
  
  
  METHODS
  Four toddlers (ages 23-29 months) with DS were enrolled in a study with a multiple-baseline, across-participants design. Following baseline, 20 play-based treatment sessions (20-30 min each) occurred twice weekly. Spoken words and manual signs were modeled and prompted by a therapist who used EMT/JASPER teaching strategies. The authors assessed generalization to interactions with parents at home.
  
  
  RESULTS
  There was a functional relation between the therapist's implementation of EMT/JASPER Words + Signs and all 4 children's use of signs during the intervention. Gradual increases in children's use of spoken words occurred, but there was not a clear functional relation. All children generalized their use of signs to their parents at home.
  
  
  CONCLUSIONS
  The infusion of manual signs with verbal models within a framework of play, joint attention, and naturalistic language teaching appears to facilitate development of expressive sign and word communication in young children with DS.
authors.affiliation: Vanderbilt University, Nashville, TN, USA. courtney.a.wright@vanderbilt.edu
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Wright
authors.forename: Ann P
authors.initials: AP
authors.lastname: Kaiser
authors.forename: Dawn I
authors.initials: DI
authors.lastname: Reikowsky
authors.forename: Megan Y
authors.initials: MY
authors.lastname: Roberts
mesh_terms: D002652:Child Behavior; D002675:Child, Preschool; D003142:Communication; D004314:Down Syndrome / Q000150:complications / Q000534:rehabilitation*; D018479:Early Intervention, Educational / Q000379:methods*; D004519:Education, Special / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007805:Language Development Disorders / Q000209:etiology / Q000534:rehabilitation*; D008297:Male; D010988:Play and Playthings; D012813:Sign Language; D012919:Social Behavior