martha kinney ma ccc-slp wendy...

Martha Kinney, MA CCC-SLP

Wendy Solomon, MA CCC-SLP

Learn More at www.thespeechvine.com

Copyright 2010 The Speech Vine, LLC

Communication Disorders

Speech Disorders Language Disorders

Articulation ReceptiveApraxia of Speech ExpressiveFluency/Stuttering ProcessingVoice Pragmatic (Social)


Articulation

An articulation disorder involves problems making sounds. Sounds can be substituted, left off, added or changed. These errors may make it hard for people to understand you.


Language Disorder

Source: American Speech-Language-Hearing Association


A Language Disorder is impaired comprehension (receptive) and/or use of spoken (expressive), written and/or other symbol systems.

Causes for Language

Impairment


Many types of disorders and syndromes that have secondary effects on language

Genetic Syndromes

Autism/PDD/Aspergers

ADD/ADHD

Hearing Loss

Emotional issues

Brain injury

Prematurity

Specific Language

Impairment


Specific Language Impairment is characterized by difficulty with language that is not caused by known neurological, sensory, intellectual, or emotional deficit. These children:

may be intelligent and healthy in all regards except in the difficulty they have with language

may be extraordinarily bright and have high nonverbal IQs

are usually are late talkers

are characterized at age 3 or 4 with limited vocabulary and short utterances

are often described as “smart but unmotivated” and should just “try harder”

(Ervin, M, 2001)

AKA…


Language Impairment may be referred to as

•Receptive or Expressive Language Disorder

•Mixed Receptive/Expressive Language Disorder

•Developmental Aphasia

•Language Processing Disorder

•Phonological Delay/Disorder

Incidence of SLI


In 2003, over 1 million students in public schools were categorized as Speech-Language Impaired (not including those with speech and language disorders secondary to other disabilities). (NICHCY.org fact

sheet on speech/language disorders)

7.6% of 5-year old children with language impairment (Ervin, M. 2001)

Facts about SLI


Often continues through life

Common for another family member to be affected

Often co-occurs with reading impairment and/or auditory processing disorder

Auditory Processing Disorder


Refers to how the central nervous system uses auditory information

• An auditory deficit that is not the result of other higher-order cognitive, language, or related disorders

Teri James Bellis PhD, CCC-A

Refers to only the audible signal not attributed to impaired peripheral hearing sensitivity

Co-occurrence of LI, RD, APD


Source: Journal of Speech, Language, and Hearing Research Vol.52 June 2009

Language


Receptive Language: How a child understands what he hears.

Understanding what words mean, following directions, question words,

concepts (spatial, temporal, size, color, quantity)

Expressive Language: How a child uses words to convey meaning;

relating an event, using new and varied words, putting words together to form

utterances (getting longer and more complex as child gets older), asking

questions, answering questions

Social Language: Using language for a variety of purposes and adjusting

behavior and language to fit the situation – greeting, initiating, informing,

demanding, changing according to needs of listener (i.e., talking differently to

baby than adult), following conversational rules (taking turns, staying on topic,

facial expressions, eye contact), joining in the group/play skills

Communication Umbrella


Red Flags!


He just doesn’t seem to understand what’s going on.

She understands a lot but seems to have difficulty coming up with the word.

His behavior falls apart when given a lot of directions.

Reads well but can’t answer questions about what she reads.

He’s so quiet! Cooperative but quiet.

Has he had his hearing checked?

What now?


Assessment:

Comprehensive speech and language evaluation should include formal and informal measures that address the following areas:

Phonological awareness/phonology Semantics

Syntax Pragmatics

Supralinguistic skills Auditory comprehension

Narrative skills Reading Comprehension

Classroom observation Parent/teacher input

Phonology



Phonology (Sounds)Difficulty perceiving subtle differences in sounds (can

change the meaning of a word or make an entire utterance nonsensical)

Children with multiple sound errors as a young child often do not perceive changes in sounds and can later affect their ease in learning to read

Phonological Awareness



Phonological awareness:

Good phonological awareness heavily predicts later reading success.

The ability to “play with” sounds. It the basis for reading and helps children recognize patterns in sounds and words. This knowledge is used to read and build words.

According to research, 73% of all second-grade students who are identified as poor readers have difficulties with phonemic awareness or spoken language in kindergarten (Catts, 1999).

Semantics



The system that governs the meaning of words

vocabulary knowledge (receptive)

concept knowledge (time, space, sequence, descriptions)

multiple meanings

Homophones

Word finding (expressive)

Syntax



The system that governs the grammar or structure of language

Verb tenses

Question forms (understanding)

Generating Questions

Word Endings

Grammatical Markers

Sentence Structures

Supralinguistics



Processing of higher level language functions

Ability to make inferences and predictions

Figurative Language

Using Context to derive meaning

Multiple Meanings

Nonverbal Cues

Narrative Skills



The ability to tell a story or relate an event. Involves

• Sequencing events

• Using precise vocabulary

• Conveying ideas

• Including story grammar elements (Characters, setting, time, events in logical sequence, conclusion, feelings)

Auditory Comprehension



The ability to attend to auditory information, process information, attach meaning, and respond appropriately

• Requires use of background knowledge

• Answering questions about information

• Following spoken directions

• Requires use of both short term and long term memory

• Sustained attention

Social Language



Pragmatic or social language is combining all these language skills for functional and socially appropriate use and understanding of communication.


Language Sample

7 year old with mixed expressive and receptive language delay:

How was your summer?

(long pause)

“Well, something happened. We had a um thing set up that you go in um um and we goed to a place to eat and it was blowed over”.


And the answer is…

Syntax: Hasn’t generalized verb tenses

Semantics: Unspecific Vocabulary, Word Finding

Narrative: No background information, No clear

beginning, middle, end

Processing: Delayed


Video Courtesy: ABC.com Modern Family



Therapy: A 3 Pronged

Approach

1. Improving specific skills (e.g., past tense verbs, categorization, sentence structure, phonological awareness)

2. Scaffolding/ Strategies

3. Accommodations and Advocacy


Strategies for Improving

Language Skills

Scaffolding

Using a framework for support of expressive and receptive language skills with the goal of fading the support and using strategies independently.



Language Skills

Vocabulary

Identifying unknown vocabulary words in literature or activity

Categorizing, associations, similarities/differences

Venn diagrams/Graphic organizers

Word retrieval strategies

Descriptions




Language Skills

Pre-discussion KWHL Chart

What do I know

Want to know

How will I learn it

What have I learned

Looking at cover , discussing title to determine what you think the book may be about




Language Skills

Metacognitive StrategiesQuestioning: Wh- questions during reading/activity

Who, what, where, when, why

Clarifying: Identifying story grammar elements (plot, characters, conflict, resolution); separating important information versus unimportant details

Sequencing

Summarizing: determining main idea, making inferences, deriving meaning from unstated information



Language Skills

Visual Strategies

Mental imagery

Visualizing and Verbalizing

Drawing Pictures

Sign Language

Boardmaker Symbols

Story Grammar Marker

Word Finding Strategies

Source: Jodi Kobernick, M.S. CCC/SLP www.speakingofspeech.com


Green----------------- Group Blue --------------------Do

What does it look like?

What is it Made of?

Pink----------Parts White----------Where What else do you know?



Language Skills

Teach explicit Listening Strategies

Learning to become a good active listener

Asking for repetition/clarification

Note taking

Self-advocacy

Providing opportunities just to practice listening


Accommodations

Helpful Classroom AccommodationsExamples:

Sit near the front of the room/near the speaker

Assign a “listening buddy”

Give T/F or multiple choice tests when possible

Allow extra time for processing when asking a question

Reduce the amount of vocabulary given during a week. Choose words that may be unknown yet familiar.


Advocacy

• Parent

• Team Members

• Teacher

• Child

Martha Kinney, MA CCC-SLP

Wendy Solomon, MA CCC-SLP

Learn More at www.thespeechvine.com

martha kinney ma ccc-slp wendy...

Documents