An evidence-based, practical, and inspiring guide to Triadic Gaze Intervention. This foundational key will open doors to successful engagement for families of young children who previously struggled to connect with others.

—Gay N. Burton, M.S., PT, Program Director, Boyer Children’s Clinic

“While the TGI protocol was being developed and refined, it was amazing to see the impact it had on therapists as well as the families they were working with. To now have this protocol available in book form is a HUGE resource for the field!” —Jon Botten, CEO, Childhaven

“This book is an outstanding example of evidence-based practice that is accessible and extremely applicable for all practitioners serving clients with basic communication needs.”
—Cynthia J. Cress, Ph.D., CCC-SLP, Associate Professor, Communication Disorders, University of Nebraska-Lincoln

Building Preverbal Communication & Engagement

Triadic Gaze Intervention for Young Children With Disabilities and Their Families

by Lesley B. Olswang, Ph.D., CCC-SLP University of Washington Seattle, Julie L. Feuerstein, Ph.D., CCC-SLP University of Central Florida Orlando, Gay Lloyd Pinder, Ph.D., CCC-SLP, C/NDT Children’s Therapy Center Kent, Washington

Section I Understanding Early Communication Development and Triadic Gaze Intervention

Chapter 1 The Child–Adult Dance and the Gift of Engagement and Communication

The first year of life is instinctively dominated by nurturing moments between babies and families, filled with holding, feeding, and socializing. Imagine the beautiful dance that takes place between adult and child as they become finely tuned partners learning to engage and communicate with each other. Children grow and thrive in the context of close and dependable relationships that provide a safe and predictable environment and encourage exploration. Research has overwhelmingly demonstrated the importance of these first relationships to build a strong foundation for children’s future social-emotional, language, and cognitive learning.

The fundamental ingredient for these early moments is the reciprocal interaction (i.e., turn taking) that takes place between adult and child. Arnold Sameroff and colleagues have described this dynamic back-and-forth behavior between child and adult in their well-accepted Transactional Model. The connection established between the adult and child sets the stage and provides the context for all kinds of future learning.

Early Engagement: The Context for Learning

The context for early engagement, learning to communicate, and, in fact, all future learning, is naturally present from birth. The caregiver holds the infant, and the stage is set. Engagement begins with the infant’s first cries and whimpers; they serve to immediately engage the adult. Over time, the infant becomes more organized in response to the environment, and gross movements become increasingly more precise as motor control develops.

Child Behaviors and the Emergence of Intentional Communication

Early communication behaviors produced by infants and toddlers begin long before first words. These preverbal communication behaviors typically include gaze, gestures, and vocalizations and emerge along a communication continuum in three phases: preintentional, intentional, and symbolic communication. The Communication Complexity Scale defines a sequence of conventionally recognizable preverbal behaviors that have been documented as preceding symbolic language.

Conclusion

The beautiful dance that occurs between adults and children as they interact during the first 12 months of life reflects children’s gradual development of behaviors (e.g., gaze, gestures, vocalizations) that caregivers recognize and interpret as early forms of communication. Both become skilled at reading and responding to each other. For some children with disabilities, behaviors may be challenging to produce and will interfere with their ability to engage and communicate with others. Triadic Gaze Intervention is designed to address breakdowns in the child–adult dance and provide a strategy for bringing the partners back into synchrony.