Enhanced Milieu Teaching

- Is a behavior language intervention that uses naturally occurring interactions to

facilitate young children’s language skills
- Also a set of tools to help facilitate a child’s communication growth
- Parents can learn to implement EMT strategies with a high level of fidelity
- MILIEU means enhanced social environment CONVERSATION BASED
- With EMT, maintain a child’s motivation to verbalize throughout a session

PURPOSE
- “EMT is used to increase the diversity, frequency, complexity, and generalizability of
communication”
- To use more diverse and complex forms of language
- Increase vocabulary

EMT Steps, Intervention, and Strategies

- Environmental arrangement:
o Setting up a naturalistic place to play and engage
 Play room
 Pre-school
 Participant’s home
- Responsive Interaction
o Mirroring and mapping:
 Follow the child’s lead in play and activity
o Matched turns
o expansion
- Time Delay
o Time for child to respond
- Modeling/Prompts
o Open-ended questions (mand)
o Close-ended questions (mand)
o Mand model
- EXAMPLE
- TARGET POPULATION
o Children with diverse disabilities
 Down syndrome
 ASD
 Language delays
 Intellectual disabilities
o Children who show emerging linguistic development
 Increase a child’s MLU and/or vocab
 Preschool-kindergarten
 o EMT has been used by therapists, researchers, teachers, and parents to teach
language to children
- CRITIQUE
o Best results are achieved with parent participations and commitments
o Some interventions rely entirely on one set of materials to teach target words
(vocab acquisition)
o EMT results can vary, and the result is not always significantly better than when
standard community interventions are used
o Teaching words in multiple context with multiple exemplars is considered best
practice in vocabulary teaching in early childhood.

FOCUSED STIM
The targets would include a variety of word types/concepts (e.g., spill, soft, alike, is, caught,
etc.). These target words should be presented to the child at least 10-15 times a day within a
meaningful routine (e.g., pretend play, mealtime, etc.).
Below is an example of targeting “is” as a copula through focused stimulation. Child and adult
are playing dress up and the adult narrates the following sequence:
"Where is my hat?
"Where is it?
"Oh, here it is.
"Here is my hat.
"Here it is.
"It is in the drawer.
"That is where it is."