Communication

Disorders

Presented by: Eric Scattaretico, Michael

Ducie, and Michael Mancuso

What is Communication?

Communication is the sending and receiving of information

The interactive exchange of information, ideas, feelings, needs, and desires

Communication includes:

A message

A sender who expresses the message

A receiver who responds to the message(Heward, 2013)

Functions of Communication

Narrating – The ability to tell a sequence of related events

Explaining/Informing – The ability to put what they learn into words

Requesting – The ability to express their wishes and desires to others

Expressing – The ability to express their personal feelings and opinions & respond to the feelings of others (Heward, 2013)

Definition:

An impairment in the ability to receive, send , process, and comprehend concepts or verbal, nonverbal and graphic symbols systems

May be evident in the processes of hearing, language, and/or speech

To be eligible for services:

Must adversely affect educational performance (American Psychiatric Association, 2013)

Prevalence

In the 2009-10 school year, 1,107,029 children ages 6 to 21 received special education services under the IDEA category of “speech or language impairments”

This number represents about 2.5% of the school-age population and 19% of all students receiving special education services

Speech or language impairments is the second-largest category after learning disabilities

Prevalence cont’d.

The actual number of children with speech and language impairments is much higher than the statistics show. Approximately 50% of children who receive special education services because of another primary disability also have communication disorders

School-based speech-language pathologists (SLPs) work with a median caseload of 50 students each month

Characteristics:

Four basic kinds of speech-sound errors exist:

1. Distortions (may sound like a lisp)

2. Substitutions

3. Omissions (dropping consonants)

4. Additions

Characteristics Cont’d

Articulation Disorder:

Child cannot produce a given sound physically

Phonological Disorder:

Child produces a given sound correctly in some instances, but not all

Fluency Disorder: Stuttering (MOST COMMON!!!)

Repetition of consonants or vowel sounds, usually at the beginning of words, prolongations, hesitations, interjections, and complete verbal blocks

Characteristics Cont’d

Voice Disorder:

Abnormal vocal quality, pitch, loudness, resonance, and/or duration for the speaker’s age & sex

Language Impairments:

Problems with phonology, morphology, syntax, semantics, and/or pragmatics; they are usually classified as either receptive or expressive

Workshop Activity ONE!

YOUTUBE VIDEO

Identification and Assessment

Screening and Teacher Observation

In some school districts, Speech Language Pathologists screen the spoken language abilities of all kindergarten children

Classroom teachers also play an important role in identifying children who may have speech and language impairments

Identification and Assessment cont’d.

Evaluation Components

Case history and physical examination

Articulation

Hearing

Phonological awareness and processing

Overall language development and vocabulary

Assessment of language function

Language samples

Observation in natural settings

Assessment of ELL/ Nonstandard English learners

Only a few standardized language proficiency tests are available in languages other than English. Translation or adaption of tests into other languages poses certain problems

Best practices in assessing speech and language competence of children who not speak standard English as their first language include assessments of basic interpersonal communication skills (BICS) and cognitive academic language proficiency (CALP)

Must take into account the individual's cultural and language context, particularly for individuals growing up in bilingual environments

Etiology

A speech or language impairment may be organic—that is, attributable to damage, dysfunction, or malformation of a specific organ or part of the body

A functional communication disorder cannot be ascribed to a specific physical condition, and its origin is not clearly known

Causes of Speech Impairments

Cleft palate, paralysis of the speech muscles, absence of teeth, craniofacial abnormalities, enlarged adenoids, and traumatic brain injury

Dysarthria - refers to a group of speech disorders caused by neuromuscular impairments in respiration, phonation, resonation, and articulation

Causes of Language Disorders

Factors that can contribute to language disorders in children include developmental and intellectual disabilities, autism, traumatic brain injury, child abuse and neglect, hearing loss, and structural abnormalities of the speech mechanism

Aphasia describes a loss of the ability to process and use language. Aphasia most often occurs after a cardiovascular event (stroke).

Research indicates that genetics may contribute to communication disorders

Environmental influences also play an important part in delayed, disordered, or absent language

Educational Placement Alternatives

Monitoring

The SLP monitors or checks on the student’s speech and language performance in the general education classroom. This option is often used just before a student is dismissed from therapy

Pull-Out (intermittent direct service)

An isolated approach in a separate room

Collaborative Consultation

The SLP often provides training and consultation for the general education classroom teacher, who may do much of the direct work with a child with communication disorders

The specialist concentrates on assessing communication disorders, evaluating progress, and providing materials and techniques

Educational Placement Alternatives cont’d.

Classroom or Curriculum Based

SLPs are working as educational partners in the classroom, mediating between student’s communication needs and the communication demands of the academic curriculum

The SLP trains classroom teachers and parents to promote children’s speech and language development

Separate classroom

Students with the most severe communication disorders are served in special classrooms for children with speech or language impairments

Educational Placement Alternatives cont’d.

Community based

Language therapy is provided outside the school, usually in the home

Combination

Variations of all these models exist, and many schools and SLPs serve children using combinations of two or more models

QUICK CHECK!

What abilities do speech or language impairments interfere with?

A. Receiving information

B. Sending Information

C. Processing Information

D. Comprehending Information

E. All of the above

QUICK CHECK CONT’D

What is the most common type of fluency disorder?

A. Phonological

B. Stuttering

C. Dysphonia

D. Production

E. Expressive

QUICK CHECK CONT’D

A child that has problems in areas of phonology, morphology, syntax, semantics, and or/pragmatics would most likely be classified as:

A. Phonological Disorder

B. Articulation Disorder

C. Language Impairment

D. Voice Disorder

Related Services

Speech-language pathologist (SLP) is the school-based professional with primary responsibility for identifying, evaluating, and providing therapeutic services to children with communication disorders

Terms such as speech therapist, speech clinician, and speech teacher are used in some schools as well

Related Services cont’d.

The SLP is a key member of the IEP team

The SLP’s goal is to correct the child’s speech and/or language problems or to help the child achieve the maximum communication potential, which may involve compensatory techniques and/or augmentative and alternative means of communication

Related Services cont’d.

Speech-language pathology addresses both organic and functional causes and encompasses practitioners with numerous points of view who use a wide range of accepted intervention techniques

Some SLPs employ structured exercises and drills to correct speech sounds; others emphasize speech production in natural language contexts.

Some prefer to work with children individual therapy sessions; others believe that group sessions are advantageous for language modeling and peer support.

Accommodations/Modifications

Minimize unnecessary classroom noise/distractions as much as possible

Provide verbal cues

Give simple directions (break down complex tasks)

Increased wait-time

Visual cues

Positive learning environment

Spelling/Vocabulary list

Alternative placement

Workshop Activity TWO!

Blowing Bubbles – Helps children control breath and purse lips as well

AAC

Augmentative and Alternative Communication

3 Components

1. Representational symbol set or vocabulary

2. Means for selecting the symbols

3. Means for transmitting the symbols

ACC MODEL

ACC May be: Unaided/Aided

Unaided

Techniques that do not require physical aid/device

Oral Speech, gestures, facial expressions, body posture, and manual signs

Aided

Techniques that involve an external device

No Tech – Pencil/Paper

Low Tech - Switch that transmits one word/phrase

High-Tech – Computerized voice-output device

Materials/Equipment

Communication Buttons

PECS

Basic Communication Device

Advanced Comm. Device Springboard

IPad/IPhone Apps

Curriculum

What will the child need to communicate on a daily basis?

Focus on vocabulary that peers in similar situation and settings use

What are the child’s annual goals?

Curricula should reflect student’s progress towards a long-term objective

What is the child interested in?

Engage the student with authentic activities and teach to their interests

Curriculum Cont’d

Adapted to child’s unique needs!

Low-risk interpersonal opportunities!

Articulation Errors

Discrimination/Production Activities

(e.g. - /t/ tape vs. /k/ cape)

Phonological Errors

Card activities where they differentiate between similar words with different final consonants (e.g. – sea, seed, seal, seam, and seat)

Curriculum Cont’d

Voice Errors

Guidelines or a checklist of tips to help student relax before speaking and be aware of controlling aspects of his/her voice

Fluency Errors

Model proper speech

Teach behavioral/coping principles when child faces verbal block

Ignore child’s stutters, praise fluent utterances frequently

Workshop Activity THREE!

Oral Motor Exercises

Making Silly Faces- Helps stretch muscles in the children’s face

Naturalistic Strategies

Also called: Milieu/incidental teaching

Takes advantage of naturally occurring activities throughout the day to provide motivation and opportunities for a child to use language skills

Involves structuring environment to create opportunities for desired student response and structured adult response

6 Naturalistic Strategies

1. Interesting Materials

2. Out of reach

3. Inadequate portions

4. Choice-making

5. Assistance

6. Unexpected Situations

Instructional Methodologies

Thoroughly Explain New Vocabulary – Students with language impairments often have problems learning and retaining new words

Embed New Vocabulary Across the Curriculum – Students will need a lot of practice and repetition with new vocabulary

Provide Longer Wait Time – Students with language impairments sometimes need a little longer to formulate and express responses to questions

Break Multistep Directions into Smaller Components – Do not move on to a new direction until the student completes each task successfully

Post-Secondary/Vocational

The needs of an Exceptional Student at post-secondary level that should be to taken into consideration:

Secondary school credit substitutions/curriculum modifications on post secondary course prerequisitesAlternate assessments/documentationHuman/other resources (e.g. tutoring/note takers/readers/audio or visual tape recordings of course materials and lectures/alternative formats for tests and exams)Student/parent preferences/professional recommendations

Post-Secondary/Vocational Cont’d

Additional Considerations:

Consider the student’s strengths and needs and identify necessary program/workplace modifications and accommodations

provide guidance with career choices and opportunities to increase knowledge and familiarity with employment

Specialized supports (mentors, job coaches, reader)

Make student and family aware of how to access services in the future, link up with advocacy groups

Organizations/Agencies

CEC (Council For Exceptional Children)

CASANA (Childhood Apraxia of Speech Association of North America)

NASET (National Association of Special Educators)

ASHA (American Hearing-Speech Language Association)

Workshop Activity Three!!!

Please turn your attention to the case study on stuttering!!

Recreational Programs/Facilities

http://www.oafccd.com/summer-camps-communication-disorders/ (Summer Camps)

http://www.seattlechildrens.org/clinics-programs/childhood-communication-center/ (Hospital Clinic Program)

http://www.uri.edu/hss/cmd/centers.html (University Center)

Webliography

http://www.csu.edu.au/__data/assets/pdf_file/0008/227654/Books-and-moviesaboutcommunicationimpairments.pdf (Books/Movies)

http://www.mnsu.edu/comdis/kuster4/part106.html (Books)

http://www.ohioslha.org/pdf/Convention/2010%20Handouts/Fluency%20SC22%20Kuster.pdf (Stuttering Resources)

Webliography Cont’dhttp://www.journals.elsevier.com/journal-of-communication-disorders/ (Professional Resources)

http://journals.pubs.asha.org/journals.aspx (Professional Resources)

https://sites.google.com/site/communicationdisordersproject/resources (Teacher Resources)

http://www.supportforfamilies.org/internetguide/specdisab.html (Parent Resources)

Bibliography

Stuttering (Fluency Disorder)

http://www.stutteringhelp.org/content/stuttering-kids-kids (Video)

Articulation Disorder

http://www.mnsu.edu/comdis/kuster2/disorderbooks/charlie.pdf (Children’s)

Phonological Disorder

http://www.youtube.com/watch?v=CzE7Wm9dz14 (Video)

http://web.shs.ohio-state.edu/Faculty/Fox/Fox_Publications/Edwards_Fox_Rogers_2002.pdf (Professional)

http://www.youtube.com/watch?v=g4XdGZupV_4 (Childrens)

Bibliography Cont’d

Voice Disorders

http://www.youtube.com/watch?v=VTUiId-4VcE (Video)

Language Impairments

http://eprints.gold.ac.uk/2592/1/hill_ijlcd_2001.pdf (Professional)

http://www.youtube.com/watch?v=BnRNeDtme0g (Video)

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Heward, William L. Exceptional Children An Introduction to Special Education (10th Edition). Upper Saddle River: Pearson Education, 2013. Print.

Shriberg LD, Tomblin JB, McSweeny JL: Prevalence of speech delay in 6-year-old children and comorbidity

with language impairment. J Speech Lang Hear Res 42(6): 1461–1481, 1999