Copyright © 2008 Delmar. All rights reserved. Unit Five Language Disorders in Children.

Copyright © 2008 Delmar. All rights reserved.

Unit Five

Language

Disorders in Children


Chapter 16

Foundations of

Language Disorders

in Children


3

Language Disorder

• Impaired comprehension and/or use of spoken, written, and/or other symbol systems

• May involve form, content, and/or use


4

Language Delay

• Slower start at developing language but eventually catch up to peers


5

Language Difference

• Language affected by cultural and linguistic diversity


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)


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


Chapter 17

Specific

Language Impairments


9

Severity Levels

• Mild

• Moderate

• Severe

• Profound


10

Specific Language Impairments (SLI)

• Significant receptive and/or expressive language impairments that cannot be attributed to a cause or condition


11

SLI

• A complex disorder that may have multiple genetic influences that interact with environmental factors


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


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


14

Receptive Language

• Difficulty understanding and integrating information

• Difficultly understanding words


15

Phonology

• May produce unusual phonological errors– Substitutions of t/r or k/b


16

Morphology and Syntax

• Late developing morphology and syntax

• Use short, incomplete sentences

• Simple, active form


17

Vocabulary

• Small vocabularies

• Slow acquisition of vocabulary

• Poor word knowledge

• Word-finding problems


18

Discourse/Dialogue

• Difficulty having conversations with others


19

Narratives

• Difficulty telling stories or recounting events

• Due to limited vocabulary:– Challenges with morphology/syntax– Recalling memories of events– Organization of information


20

Pragmatics

• Initiate conversations less

• Difficulty gaining access to conversations

• Passive conversationalists


Chapter 18

Language-Learning

Disabilities


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


23

LLD

• Prevalence is 12 to13 percent for 5 year olds

• 4.5 percent also have speech disorders


24

Metalinguistics

• Ability to think about and talk about language

• Very difficult for children with LLD


25

Adolescents: Receptive Language

• Weak vocabulary

• Difficulty with abstract words and words with multiple meanings

• Figurative language (slang, jargon) is difficult


26

Adolescents: Expressive Language

• Use low content or no content words

• Simple syntax

• Violate pragmatic rules


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


28

Classification Systems

• AAMR system indicates amount of support for individuals with developmental disabilities

• See Table 18-1


29

Receptive Language

• Single word comprehension better than longer utterances

• Understand concrete information better than abstract information


30

Expressive Language

• Limited vocabulary

• Difficulty with word recall

• Don’t initiate conversations


31

Phonology

• Speech unintelligibility is common – Up to 70 percent of children with

developmental disabilities


32

Down Syndrome

• Most common chromosomal cause of developmental disabilities

• Impaired comprehension and expressive skills

• Speech affected by hypotonia and/or macroglossia


33

Autism

• Complex behavioral syndrome that appears by age 3

• Marked absent interest in social interaction

• Severely impaired communication

• Repetitive, stereotyped movements


34

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)


35

Autism: Receptive Language

• Receptive language abilities are similar to child’s mental age


36

Autism: Expressive Language

• 50 percent are nonverbal

• Echolalia– Automatic repetition of words, phrases,

sentences• Used by some

• Idiosyncratic language used


37

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


Chapter 19

Assessment and

Diagnosis of

Language-Learning Disabilities


39

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


40

Approaches to Assessment

• Normalist/Psychometric

• Naturalistic/descriptive/criterion-referenced


41

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


42

Criterion-Referenced

• Description of a child’s language abilities based on natural observations

• Comparison of present performance to past performance


43

Screening

• Brief one-on-one observation and measure of a child's communication abilities


44

Assessment Protocol

• Interview

• Formal evaluation– Articulation/phonology– Language– Orofacial structures

• Hearing screening

• Meeting to review test results


45

Evaluation of Receptive Language

• Single word vocabulary

• Morphology

• Sentence structures

• Following commands

• Questions


46

Evaluation of Expressive Language

• Sounds and words

• Morphology

• Naming

• Answering questions

• Narrative skills

• Conversations


47

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


48

Decision Making

• Child's strength and weakness

• Severity of impairment

• Contributors to the impairment

• Treatment recommendations


49

Therapy Approaches

• Traditional

• Functional

• Collaborative – Often used in schools


50

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


Chapter 20

Treatment of

Language Disorders


52

Baseline Measures

• Measure of a behavior at the beginning of treatment

• Future progress can be compared to this baseline


53

Selecting Goals

• Operationally defined goal must include:– An observable and measurable behavior– Setting/environment– Criterion– Percent accuracy– Stimuli used


54

Three Models of Therapy

• Within discipline

• Interdisciplinary

• Transdisciplinary


55

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


56

Structure of Sessions

• Use well-organized and structured sessions

• Clinician is preplanned but flexible to accommodate the child’s needs


57

General Session

• General conversation

• Review of what child has worked on

• Work on new targets

• Review of another skill

• Challenging tasks

• End of session


58

Other Therapy Approaches

• Functional language model

• Emerging language model

• Collaborative model

• Naturalistic model


59


• 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


60


• 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


61


• Be task oriented

• Use praise

• Provide opportunities to learn


Chapter 21

Literacy

Disorders in Children


63

Literacy Disorder

• Individual has both reading and writing impairments


64

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


65

Emergent Literacy

• Literacy development begins soon after birth

• Literacy and language are reciprocally related

• Children are active in literacy process


66

Skills Related to Literacy Achievement

• Phonological awareness

• Oral language

• Alphabet knowledge

• Concepts about print

• Name writing


67

Emergent Literacy

• Adult involvement is essential

• Shared storybook reading is important component


68

Possible Contributions of English to Reading Difficulties

• Inconsistencies in pronunciations of words

• Inconsistencies in letter-sound correspondence

• Inconsistencies in shapes of letters


69

Problems of Children with Literacy Disabilities

• Deficits in phonological processing

• Word recognition and spelling

• Underachievement


70

Secondary Consequences

• Academic difficulties

• Influences on occupation and career choices

• Reading as a leisure activity

• Interpersonal relationships


71

Writing

• Reading and writing are connected

• Different types of writing require different cognitive abilities and use different vocabulary


72

Writing Problems

• Inadequate reference to subject

• Inconsistent noun-pronoun agreement

• Inconsistent gender words

• Punctuation problems

• Spelling errors


73


• Children from culturally and linguistically diverse backgrounds – Greater likelihood of beginning school less

prepared to learn to read than other groups of children


Chapter 22

Emotional and Social

Effects of LanguageDisorders on the Child

and Family


75

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


76

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


77

Toddlers and Preschoolers

• May be perceived negatively by other preschoolers because of poor communication and social skills


78

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


79

Adolescents

• Emotional-social difficulties increase for adolescents with LLD

• Mental issues and anxiety disorders may develop


80

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

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Copyright © 2008 Delmar. All rights reserved. Unit Five Language Disorders in Children.

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