There are several intervention strategies that are administered among the language impaired toddlers and children. One of these strategies used to support production longer and more complex utterances is the Environmental Language Intervention Strategy (ELIS) developed by James D. MacDonald and Judith Presser Blott in 1974. ELIS follows grammar approaches from theorists Lois Bloom (1971), Izchak Schlesinger (1971) and Roger Brown (1973), which consisted of the basic concepts of grammar when formed in the early development of language such as two-word utterances. During ELIS, using nonlinguistic and linguistic cues the client is able to use a more generalized approach to understanding the context of each word through “real communication.” (MacDonald & Blott, 1974) ELIS is a clinician directed approach, as most therapy sessions include organizing the materials in a way that allows the clinician to provide the initial interaction for a response. With such focus on production of words, this type of intervention was developed for those with a severe expressive language delay. The population that would benefit from this intervention strategy would be pre-school aged or Head start children, especially those whom are delayed due to environmental features (neglect, genetics, hearing impaired delay) as well as autistic students (Simons,1976).
In the original proposal for ELIS, MacDonald and Blott focused on the eight rules for semantic functioning with addition to verbal and nonverbal cues to expand on what the child is able to produce, rather than expecting the client to produce more. Somewhat comparable to the phrase “quality over quantity”, as the goal of the sessions to expand utterance length by expanding on what they already know through direct modeling and imitation.
Although there is not an extensive amount of research available, clinicians who administered this intervention strategies have seen adequate results to support the theory. One of these findings was noted in the Journal Article, “A Parent-Assisted Early Childhood Environmental Language Intervention Program” which consisted of a study conducted by Robert L. Kemper. In this study, Kemper administered the ELIS to five children who showed “a wide discrepancy between their comprehension and production”. (Kemper, 1980, pg. 228) Once exposed to ELIS (parent-assisted) for 12 weeks, all of the children expanded on their expressive language and were able to produce four of the eight semantic-grammatical rules proposed for this intervention by MacDonald and Blott. (Kemper, 1980) Another study in which there is proof of effective results with ELIS was one conducted by Charlann S. Simons (1976). Simons had three autistic students which were not responding to traditional structural language approaches. Instead, they produced two-word utterances or repetitions of one to two words of speech. Following this, Simon proposed that ELIS be provided to focus on the semantic importance of those utterances. Following a dozen sessions, these students dramatically increased their responsiveness (90% accuracy), and this strategy was generalized to the classroom setting as teachers were able to see the effectiveness of these sessions. (Simons,1976, pg. 557)
ELIS is simple to administer, as procedures can be done at home, school, and therapy. In the therapy setting, a clinician directed play session using toys of interest is a reinforcing way to enhance communication production. During this session, a clinician would first give a stimulus through a linguistic cue by asking a “wh- or tell me” type of question. An example could be a clinician saying, “What am I doing?” while providing the nonlinguistic cue of placing an object inside the bag. Next, the client would be provided with another linguistic cue (cued imitation) such as “in bag”.
The type of grammatical language inventory that is expected to be imitated during each exchange include “agent + action”, “action + object” and “x + locative”. These grammatical characteristics are found at the beginning of semantic structuring. Although it seems basic, the language inventory provides a rule of the semantic structure for basis of future production. Allowing imitation may seem as if the client is just being given the correct response rather than attempting, such as a simplification technique, but the imitation and direct modeling give generalization to the utterances and promote conversation. (MacDonald & Blott, 1974, pg. 249) At home, ELIS can be introduced through games or through daily routines. During play, such as playing catch with a ball, if a parent or guardian holds the ball and states “Tell me what I’m doing” and then throws the ball, once the client is exposed to this action, the guardian would state “Say throw ball” and then they get a turn to “throw ball.” In addition to play, ELIS can be implemented in routines that will be done daily, such as brushing teeth, washing hands, and even eating food. In all of these situations, whether at home or in a therapy session, the client is exposed to cueing and modeling. Providing ELIS at home is a great way to continue the use of generalization and therapy in a naturalistic setting.
Overall, this intervention strategy is successful, yet, still seems to be lacking in research material. Although there has been proven success through client interactions (Kemper & Simons) there isn’t nearly as many articles, books, or even websites on ELIS as there is compared to other intervention strategies. Due to the nature of it being for severe expressive language delay clients, it may not be as commonly practiced and therefore making research less noted. Through research, most seem to agree with the current produces of ELIS, and have positive results. Another reason that there may not be many much research is that it’s based off of grammatical evidence already published and used for diagnosis of language delay.
The procedure in whole is simple and the benefits begin with the session. Since it is clinician based, there is much more control over the session as long as cooperation of the client is reciprocated. Materials can be anything, and as seen in the study by Kemper (1980) it can be implemented in the home setting by parents and guardians. In a speech and language therapy session, you may see a more constructed chart of what is going to be linguistically cued, non-linguistically cued, and some play-based material to focus these responses off of. However, since this can be used for a home program as well, materials can be anything that will allow expansion upon the speech as long as imitation and cueing are done correctly. This type of therapy is only going to be useful for those of a low MLU, and severe expressive delay. Some limitations would include complete nonverbal communication, or producing several word utterances as that would be too advances. Kemper (1980) provided a research study (as mentioned above) that proved successful as stated, “At the end of the training period, all five children were using two-word constructions in at least four of the eight rule classes sampled.” (Kemper, 1980, pg. 334) Although there are not hundreds or even dozens of articles about ELIS, the procedure given by MacDonald and Blott was adequate enough to understand, learn, and administer with ease. In conclusion, the Environmental Language Intervention Strategy is both successful, simple, and easy to generalize into home and schooling for those with a severe expressive language delay.
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