Download - (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Chapter Eleven Teaching Students with Communication Disorders This multimedia product and its contents

(c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004

Chapter Eleven

Teaching Students with Communication Disorders

This multimedia product and its contents are protected under copyright law. The following are prohibited by law:

•any public performance or display, including transmission of any image over a network;

•preparation of any derivative work, including the extraction, in whole or in part, of any images;

•any rental, lease, or lending of the program.


Introduction

Most of us take our ability to communicate for granted.

When communication is impaired, absent, or qualitatively different, the simplest interactions become different or even impossible.

Disorders in communication may result in social problems in school.

Communication problems are often complex. There are many different types of communication

disorders, involving both speech and language.


Definitions of Communication & Language

COMMUNICATION is the exchange of information and ideas. Communication involves encoding, transmitting, and decoding messages. It is an interactive process requiring at least two parties to play the roles of both sender and receiver. LANGUAGE is a

system used by a group of people for giving meaning to sounds, words, gestures, and other symbols to enable communication with one another.


Definition of Speech (Heward, 1995)

Although it is not the only possible vehicle for expressing language (gestures, manual signing, patterns, and written symbols can also be used to convey ideas and intentions), speech is a most effective and efficient endeavor. Speech is one of the most complex and difficult human endeavors.

SPEECH is the actual behavior of producing a language code by making appropriate vocal sound patterns.


Important Language Considerations (American Speech-Language-Hearing Association, 1982)

Effective use of language for communication requires a broad understanding of human interactions, including associated factors such as nonverbal cues, motivation, and sociocultural roles.

Language learning and use are determined by the interaction of biological, cognitive, psychosocial, and environmental factors.

Language is rule-governed behavior.

Language evolves within specific historical, social, and cultural contexts.


Normal and Disordered Communication

According to Emerick and Haynes (1986), a communication difference is considered a disability when:

the transmission or perception of messages is faulty. the person is placed at an economic disadvantage. the person is placed at a learning disadvantage. the person is placed at a social disadvantage. there is a negative impact upon the person’s emotional

growth. the problem causes physical damage or endangers the

health of the person.


Types of Communication Disorders

SPEECH DISORDERS

LANGUAGE DISORDERS


Speech Disorders

SPEECH DISORDERS include impairments of:

Voice Articulation Fluency


Prevalence About 2% of the school-age population were classified as

having speech or language impairments during the 1999-2000 school year.

Because many other students have other conditions as their primary disability but still receive speech-language services, the total number of students served by speech-language pathologists is about 5% of all school-age children (2/3s of these students are boys)

Students with communication disorders constitute about 20% of all students with disabilities.

Of the estimated one million students identified as speech-language impaired, over 90% are 6 to 12 years old.


Identification, Assessment, and Eligibility

Students with speech or language impairments are the most highly integrated of all students with disabilities.

During the 1998-1999 school year, 88.5% of students with communication disorders were served in general education classrooms, and 6.5% were served in resource rooms.

The small proportion served in separate classes most likely represents students with severe language delays and disabilities.


Types of Speech Disorders

Articulatory & Phonological Disorders

Voice Disorders

Fluency Disorders


Articulatory and Phonological Disorders

Articulation and phonological disorders are the most common speech disorder affecting about 10% of preschool and school age children.

The ability to articulate clearly and use the phonological code correctly is a function of many variables, including:AgeDevelopmental History Oral-Motor SkillsCulture


Most Common Types of Articulation Efforts

Distortions Substitutions Omissions Additions


Organic & Functional Causes of Articulatory & Phonological Disorders

FUNCTIONAL CAUSES: lack of opportunities to

practice appropriate/ inappropriate speech

transient hearing loss during early development

absence of good speech models

differences in speech related to culture (often do not constitute a speech disorder)

ORGANIC CAUSES: Cleft palate Dental malformations Tumors Hearing loss Brain damage Other related

neurological problems

The severity of articulation disorders can vary widely, depending in part on the causes of the disorder.


Teaching Suggestions

Take note of how understandable or intelligible the student’s speech is.

Consider how many different errors the student makes.

Consider whether the errors could be due to physical problems.

Evaluate whether the speech errors may have an impact of the student’s ability to read and write.

Observe whether the articulation errors cause the student problems in socialization or adjustment.


Voice Disorders Defined

VOICE DISORDERS are abnormalities of speech related to volume, quality, or pitch.

Voice disorders are not very common in children. It is difficult to distinguish an unpleasant voice

from one that would be considered disordered. Two basic types of voice disorders:

Phonation - production of sounds by the vocal folds EXAMPLE: Hoarseness

Resonance - hypernasality or hyponasality


Causes of Voice Disorders

Vocal Abuse and Misuse Trauma to the Larynx, Nodules, or Tumors Learned Speech Patterns Medical Conditions or Trauma

Reye’s syndrome Juvenile arthritis Psychiatric problems Tourette syndrome

When voice disorders are related to a medical condition, the child may be referred to an otolaryngologist (ear, nose, and throat doctor). Most voice disorders are due to functional problems, resulting

from learned speech patterns.


Questions to Ask Before Referring a Student for a Possible Voice Disorder

Might the voice quality be related to a hearing loss?

Is there a possibility that the voice disorder is related to another medical condition?

Has there been a recent, noticeable change in the student’s vocal quality?

Does the student habitually abuse or misuse his voice?

Does the student’s voice problem make him difficult for others to understand?

Is the student’s voice having such an unpleasant effect on others that the student is teased or excluded

from activities?


Fluency Disorders Defined FLUENCY refers to the pattern of the rate and flow of

a person’s speech. Normal speech patterns include some interruptions in

speech flow. When the interruptions in speech flow are so frequent

or pervasive that a speaker cannot be understood, when efforts at speech are so intense that they are uncomfortable, or when they draw undue attention, then the dysfluencies are considered a problem.

Many young children exhibit dysfluencies; these typically disappear by age 5.


Fluency Disorders Fluency problems consist of blocking,

repeating, or prolonging sounds, syllables, words, or phrases.

The most frequent type of fluency disorder is stuttering, which affects about 2% of the school-age children.

More boys than girls are affected.


Stuttering

In stuttering, interruptions in speech are frequently obvious to both the speaker and the listener.

Stuttering has received much attention, even though it is not as prevalent as other communication disorders.


Causes of Stuttering

There are many causes of stuttering.

There is growing evidence supporting a genetic and physiologic basic of stuttering.


Is the student concerned about his dysfluencies?

Is there a pattern to situations in which the student stutters?

Is the student experiencing social problems?

Are the dysfluencies beginning to occur more often in the student’s speech or beginning to sound more effortful or strained?

When Fluency Disorders are Considered a Serious Problem


Classroom Accommodations for Students with Speech Disorders

Build a Positive Classroom Climate Help Students Learn to Monitor Their Own

Speech Pair Students for Practice Teach Students Affirmations and Positive

Self-Talk Modify Instruction and Materials Encourage Parents to Work with Their

Children Teach Students Their Own Strategies


Build a Positive Classroom Climate

Reward the student.Accept the child.

Be a good listener.Be positive.

Don’t interrupt or finish the student’s sentence for him or her.

Encourage the student.

Educate other students in the class about speech disorders, when appropriate.

Don’t refer to students in terms of their behaviors (“students” not “stutters”

Maintain eye contact when the student speaks.

Work closely with the speech-language pathologist.

Provide lots of opportunities for student to participate in oral activities.

Encourage the student’s family to actively support the educational and communication program.

Give student chances to model and practice appropriate speech.

Talk with the student privately about his speech problems.


Pair Students for Practice

To master speech skills, students will need to practice the skills taught by the speech-language pathologist (S/LP).

Students can practice specific sounds using practice exercises with a partner using a program such as Loehr’s Read the Picture Stories for Articulation (Loehr, 2002).


Teach Students Affirmations and Positive Self-Talk

Low self-confidence and a positive attitude are important for students with speech disorders, especially stuttering.

Negative self-talk is common among individuals with speech disorders.

The goal of positive self-talk is to replace negative thought patterns.

Encourage students to mentally erase negative ideas and immediately think of something positive.


Modify Instruction and Materials

Suggestions from Pre-Referral Intervention Manual (McCarney & Wunderlich, 1988): Set up a system of motivators to encourage student’s

effort. Highlight material to identify key syllables and words in

a passage. Give student practice listening so that they can learn to

discriminate among sounds, fluent speech patterns, and good vocal habits.

Tape the student’s reading so that he/she can evaluate self related to communication goals.

Reduce the emphasis on competition.


Encourage Parents to Work with Their Children

There are many ways to structure practice activities so that students can work at home with their parents.

One program is the book. Oral-Motor Activities for School-Aged Children. This program is a series of homework activities

designed to build speech skills.


Teach Students Their Own Strategies

Help student come up with strategies for dealing with specific people or situations that make them nervous.

Teach student to self-reinforce by recognizing when they are doing well.

Allow student to record his/her own speech and listen carefully for errors.

Encourage student to participate in groups in which responses do not have to be individually generated.

Let student practice skills with a friend in real situations.

Teach student to relax with breathing exercises or mental energy.


Language Disorders

LANGUAGE is the system we use to communicate our thoughts and ideas to other.

Language is an integral component of students’ abilities in reading, writing, and listening.

Disorders of language may have a serious impact on academic performance.

In recent years, the emphasis in the field of communication disorders has shifted away from the remediation of speech problems to an increased focus on language disorders.

Approximately 50% to 80% of children seen by speech-language pathologists have language disorders.


There are two modes of communication: Receptive Language - involves receiving and and

decoding and interpreting language EXAMPLE: reading and listening

Expressive Language - involves encoding or production of a message

EXAMPLE: writing and speaking

There is a sequence of normal language development.

Language Disorders


Three Dimensions of Language

FORM describes the rule systems used in oral language.

CONTENT refers to the intent and meaning of language and its rule system. Semantics deals with the meaning of words and

word combinations. FUNCTION refers to the use of language in

social contexts. Pragmatics are the rules of social language.


Language Form

Involves three different rule systems:

Phonology - rule system that governs the individual and combined sounds of a language (e.g., vowel sounds)

Morphology - rule system controlling the structure of words (e.g., prefixes and suffixes)

Syntax - rule system that governs the ordering of words (e.g., verb tense, questions)


Content Of Language

Semantics - deals with the meaning of words and word combinations.

When students fail to comprehend concrete and abstract meanings of words, inferences, or figurative expressions, it is difficult for them to understand the more subtle uses of language such as jokes, puns, similes, proverbs, or sarcasm.


Function Of Language

Pragmatics - language that is used in various social contexts.

If children are to build and maintain successful relationships with others, they need to understand and effectively use language skills that are appropriate to the context.

Students from different cultural backgroundsmay be particularly challenged in this area.


Types of Language Disorders

Absence of Verbal Language

Qualitatively Different Language

Delayed Language Development

Interrupted Language Development


Indicators of Language Impairment

PRIMARY GRADESProblems in Following Verbal DirectionsDifficulty with Preacademic SkillsPhonics ProblemsPoor Word Attack Skills Difficulties with Structural Analysis Problems Learning New Material

INTERMEDIATE GRADESWord Substitutions Inadequate Language Processing and Production that Affects Reading Comprehension and Academic Achievement

MIDDLE AND HIGH SCHOOL GRADESInability to Understand Abstract Concepts Problems Understanding Multiple Word MeaningsDifficulties Connecting Previously Learned Information to New Material that Must Be Learned IndependentlyWidening Gap in Achievement When Compared to Peers


Classroom Adaptations for Students with Language Disorders

Teach Some Prerequisite Imitation Skills Increase Comprehension in the Classroom Give Students Opportunities for Facilitative Play Encourage Students to Talk with Their Teachers and

Peers Use Naturalistic Techniques and Simulated Real-Life

Activities to Increase Language Use Encourage Students’ Conversational Skills Through

Story Telling


Classroom Adaptations for Students with Language Disorders

Use Music and Play Games to Improve Language Arrange Your Classroom for Effective Interactions Use Challenging Games with Older Students Modify Strategies to Develop Students’ Learning

Tools Work Collaboratively with the Speech-Language

Pathologist Use Storytelling and Process Writing


Children’s patterns of speech and language reflect their culture and may be different from that of some of their peers.

It is important not to mistake a language difference for a language disorder.

Cultural variations in family structure, childrearing practices, family perceptions and attitudes, and communication style can each influence students’ communication.

Language Differences


Relationship Between

Communication Style and Culture Culture has a strong influence on the style of

communication. Communication style can be affected by factors

such as: Gender Age Status

Communication differences in style can be manifested through nonverbal means such as:

Gestures Facial expressions Physical space Use of silence


Multicultural Considerations in Assessment Observation is an important form of assessment,

particularly when students are linguistically diverse. Considerations for assessment personnel who work with

students having cultural and linguistic differences include: Selection of tests that have valid items Using procedural modifications (e.g., lengthening time limit) Assess whether the linguistically or diverse child has had

access to the information Consider scoring the test in two ways, first as the manual

indicates, then allowing credit for items considered correct in the child’s language system.

Focus on what the child does well rather than what he or she cannot do.


Augmentative and Alternative Communication (AAC)

AUGMENTATIVE COMMUNICATION denotes techniques that supplement or enhance communication by complementing whatever vocal skills the individual already has.

ALTERNATIVE COMMUNICATION are techniques used by individuals who must employ techniques that serve in place of speech.

AAC is a multimodal system consisting of four components: symbols aids techniques strategies


Aided and Unaided Communication Techniques

AIDED communication techniques require a physical object or device to enable the individual to communicate (e.g., charts, communication boards).

UNAIDED communication techniques do not require any physical object or device to enable the individual to communicate (e.g., speech, manual signs or gestures, facial communication).


Examples of

Communication

Aids Non-Electronic Aids

Communication Boards Charts, Frames or Books

Electronic Aids Voice Output Communication Aids


Facilitated Communication

Facilitated communication is a process involving having someone (a facilitator) support the arm or wrist of the student with autism, who then points to letters on a keyboard. The keyboard is often connected to a computer so that the student’s words can be displayed or printed.

Efficacy research on facilitated communication has yielded mixed results.


Promoting Inclusive Practices for Students with Communication Disorders

In years past, pullout models were used for students requiring speech-language services.

Today, the trend is toward the provision of speech-language services in the general education classroom.

Collaboration between classroom teachers and speech-language pathologists is essential.


Future Trends

In addition to providing services in the more traditional area of oral communication skills, speech-language pathologies now are called upon to have expertise in areas such as:

Addressing swallowing disorders Medicaid billing Selecting AAC systems Providing interventions for children with TBI

Promoting and enhancing literacy skills


Future Trends

There is an increasing demand for services, especially in the area of language disorders.

The traditional “pull-out” model will still be offered, but the trend is toward a more collaborative and consultative framework.

To address personnel shortages, alternate methods might include:

Employment of SLP assistants Flexible scheduling Cross-disciplinary service provision Increased use of natural supports


Future Trends

Another area of change is the expected continuation of technological advances. This means that students with severe

communication disorders will have increased opportunities to participate in ways that seemed impossible several years ago.

Distance learning and telehealth services will become more commonplace.

Download - (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Chapter Eleven Teaching Students with Communication Disorders This multimedia product and its contents

Top Related