copyright © 2008 delmar. all rights reserved. unit five language disorders in children
TRANSCRIPT
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Unit Five
Language
Disorders in Children
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Chapter 16
Foundations of
Language Disorders
in Children
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3
Language Disorder
• Impaired comprehension and/or use of spoken, written, and/or other symbol systems
• May involve form, content, and/or use
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4
Language Delay
• Slower start at developing language but eventually catch up to peers
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5
Language Difference
• Language affected by cultural and linguistic diversity
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6
Prevalence and Incidence
• 7 to 8 percent of kindergarten children have specific language impairments with no other complicating conditions
• 2 percent more boys than girls have specific language impairment (SLI)
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7
Multicultural Considerations
• All clients must be respected as individuals with individual cultural and ethnic values
• Many children from CLD backgrounds live in poverty– Increases the risk for language problems
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Chapter 17
Specific
Language Impairments
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9
Severity Levels
• Mild
• Moderate
• Severe
• Profound
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Specific Language Impairments (SLI)
• Significant receptive and/or expressive language impairments that cannot be attributed to a cause or condition
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11
SLI
• A complex disorder that may have multiple genetic influences that interact with environmental factors
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12
Red Flags for a Potential SLI
• First word after 18 months
• Two word combinations later than 30 months of age
• Reliance on gestures
• Limited use of verbs
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13
Red Flags for a Potential SLI
• Lack of yes/no responses to questions
• Difficulty with rhyming and naming letters
• Difficulty initiating interactions with peers
• Poor conversational turn-taking
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Receptive Language
• Difficulty understanding and integrating information
• Difficultly understanding words
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15
Phonology
• May produce unusual phonological errors– Substitutions of t/r or k/b
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16
Morphology and Syntax
• Late developing morphology and syntax
• Use short, incomplete sentences
• Simple, active form
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17
Vocabulary
• Small vocabularies
• Slow acquisition of vocabulary
• Poor word knowledge
• Word-finding problems
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18
Discourse/Dialogue
• Difficulty having conversations with others
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Narratives
• Difficulty telling stories or recounting events
• Due to limited vocabulary:– Challenges with morphology/syntax– Recalling memories of events– Organization of information
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Pragmatics
• Initiate conversations less
• Difficulty gaining access to conversations
• Passive conversationalists
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Chapter 18
Language-Learning
Disabilities
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22
Language-Learning Disabilities (LLD)
• Term SLI is usually changed to language-learning disability when a child enters school
• LLD has effects on learning and educational achievement
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23
LLD
• Prevalence is 12 to13 percent for 5 year olds
• 4.5 percent also have speech disorders
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Metalinguistics
• Ability to think about and talk about language
• Very difficult for children with LLD
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Adolescents: Receptive Language
• Weak vocabulary
• Difficulty with abstract words and words with multiple meanings
• Figurative language (slang, jargon) is difficult
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Adolescents: Expressive Language
• Use low content or no content words
• Simple syntax
• Violate pragmatic rules
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27
Developmental Disabilities and Language Disabilities
• Disability originating before 18 years of age
• Significant limitations in intellectual functioning and adaptive behavior
• Prevalence is 1 to 3 percent
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Classification Systems
• AAMR system indicates amount of support for individuals with developmental disabilities
• See Table 18-1
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Receptive Language
• Single word comprehension better than longer utterances
• Understand concrete information better than abstract information
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Expressive Language
• Limited vocabulary
• Difficulty with word recall
• Don’t initiate conversations
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Phonology
• Speech unintelligibility is common – Up to 70 percent of children with
developmental disabilities
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Down Syndrome
• Most common chromosomal cause of developmental disabilities
• Impaired comprehension and expressive skills
• Speech affected by hypotonia and/or macroglossia
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Autism
• Complex behavioral syndrome that appears by age 3
• Marked absent interest in social interaction
• Severely impaired communication
• Repetitive, stereotyped movements
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Autism
• Intellectual disabilities occur in three-quarters of children with autism
• Autism is within the broader category of autism spectrum disorder (ASD)
• ASD is within category of pervasive developmental disorders (PDD)
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Autism: Receptive Language
• Receptive language abilities are similar to child’s mental age
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Autism: Expressive Language
• 50 percent are nonverbal
• Echolalia– Automatic repetition of words, phrases,
sentences• Used by some
• Idiosyncratic language used
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Traumatic Brain Injury (TBI)
• Acquired injury to the brain
• Children tend to have good recovery
• May have long-term speech and language deficits
• Cognitive impairments may occur– Memory, attention, problem solving
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Chapter 19
Assessment and
Diagnosis of
Language-Learning Disabilities
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Purposes of Assessment
• Does the child qualify for services
• Identification of language problems
• Description of patterns of language
• Factors associated with language problems
• Treatment planning
• Prognosis
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Approaches to Assessment
• Normalist/Psychometric
• Naturalistic/descriptive/criterion-referenced
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Psychometric
• Formal approach to assessment
• Standardized tests are administered and interpreted
• Tests are normed on a large group of children so comparisons can be made
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Criterion-Referenced
• Description of a child’s language abilities based on natural observations
• Comparison of present performance to past performance
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Screening
• Brief one-on-one observation and measure of a child's communication abilities
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Assessment Protocol
• Interview
• Formal evaluation– Articulation/phonology– Language– Orofacial structures
• Hearing screening
• Meeting to review test results
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Evaluation of Receptive Language
• Single word vocabulary
• Morphology
• Sentence structures
• Following commands
• Questions
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Evaluation of Expressive Language
• Sounds and words
• Morphology
• Naming
• Answering questions
• Narrative skills
• Conversations
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Language Samples
• A sample of the child's speech with a clinician and/or family member
• Allows for a systematic analysis to determine speech and language competence
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Decision Making
• Child's strength and weakness
• Severity of impairment
• Contributors to the impairment
• Treatment recommendations
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Therapy Approaches
• Traditional
• Functional
• Collaborative – Often used in schools
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Evaluation of Bilingual Children
• Both languages should be evaluated
• If one language is within normal limits, then a disorder probably does not exist
• A concomitant disorder may exist
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Chapter 20
Treatment of
Language Disorders
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Baseline Measures
• Measure of a behavior at the beginning of treatment
• Future progress can be compared to this baseline
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Selecting Goals
• Operationally defined goal must include:– An observable and measurable behavior– Setting/environment– Criterion– Percent accuracy– Stimuli used
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Three Models of Therapy
• Within discipline
• Interdisciplinary
• Transdisciplinary
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Traditional Approach to Teaching Language Skills
• Focus on functional language skills– Skills relevant to a child’s environment at
home and/or school
• Structured hierarchical approach to moving through goals
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Structure of Sessions
• Use well-organized and structured sessions
• Clinician is preplanned but flexible to accommodate the child’s needs
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General Session
• General conversation
• Review of what child has worked on
• Work on new targets
• Review of another skill
• Challenging tasks
• End of session
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Other Therapy Approaches
• Functional language model
• Emerging language model
• Collaborative model
• Naturalistic model
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Multicultural Considerations
• SLPs need to consider their own cultural beliefs, attitude, and values
• Do not use generic terms
• Beware of terms that have questionable or negative racial or ethnic connotations
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Multicultural Considerations
• Present clear explanations and objectives
• Use methods that do not violate beliefs of client
• Be flexible
• Interact with clients according to their perceptions and expectations
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Multicultural Considerations
• Be task oriented
• Use praise
• Provide opportunities to learn
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Chapter 21
Literacy
Disorders in Children
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Literacy Disorder
• Individual has both reading and writing impairments
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Dyslexia
• Most common learning disability in children and adults
• 75 to 85 percent of children with learning disabilities have reading impairments
• Prevalence is 4:1– Male to female
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Emergent Literacy
• Literacy development begins soon after birth
• Literacy and language are reciprocally related
• Children are active in literacy process
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Skills Related to Literacy Achievement
• Phonological awareness
• Oral language
• Alphabet knowledge
• Concepts about print
• Name writing
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Emergent Literacy
• Adult involvement is essential
• Shared storybook reading is important component
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Possible Contributions of English to Reading Difficulties
• Inconsistencies in pronunciations of words
• Inconsistencies in letter-sound correspondence
• Inconsistencies in shapes of letters
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Problems of Children with Literacy Disabilities
• Deficits in phonological processing
• Word recognition and spelling
• Underachievement
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Secondary Consequences
• Academic difficulties
• Influences on occupation and career choices
• Reading as a leisure activity
• Interpersonal relationships
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Writing
• Reading and writing are connected
• Different types of writing require different cognitive abilities and use different vocabulary
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Writing Problems
• Inadequate reference to subject
• Inconsistent noun-pronoun agreement
• Inconsistent gender words
• Punctuation problems
• Spelling errors
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Multicultural Considerations
• Children from culturally and linguistically diverse backgrounds – Greater likelihood of beginning school less
prepared to learn to read than other groups of children
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Chapter 22
Emotional and Social
Effects of LanguageDisorders on the Child
and Family
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Parents
• Parents alter their interactions if their child has a language impairment– Parents initiate more interactions– Ask more questions– Use fewer utterances per turn– Respond or comment less to their child
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Parents
• There is an emotional response by parents to learning that their child has a problem– IEP meetings may be overwhelming– Not all cultures support family involvement– Some parents may have their own
language or cognitive problems
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Toddlers and Preschoolers
• May be perceived negatively by other preschoolers because of poor communication and social skills
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School-age Children with LLD
• May be less accepted by their peers
• Children with LLD perceive themselves more negatively that their peers
• Tend to avoid social interaction
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Adolescents
• Emotional-social difficulties increase for adolescents with LLD
• Mental issues and anxiety disorders may develop
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Personal and Societal Costs
• Undereducation and underemployment are common results for an adult with a language disorder
• Adolescent language disorders are related to juvenile delinquency