88825 charlie
Language Disorders
Review
Speech:
Breath Stream
Voice
Articulation
Fluency (Phonological disorders, MSD)
Language:
Form
Content
Use
Review
Speech:
Breath Stream
Voice
Articulation
Fluency
Language:
Form
Content
Use
Speech more muscular; language cognitive linguistic; deals with symbolic representations
Language Development
Stages of Vocal Development:
-Phonation (0-2 month)
-Gooing and Cooing (2-4 months)
-Expansion Stage (4-6 months)
-Babbling (6+ months)
Jargon (10+ months)
First Words (12+ months)
Language Development- Review
Intentional Communication (7+ mos):
beginning of reciprocity (eye gaze,
pointing, gestures)
Transition to symbolic representation around 12 mos (utilizing words for ideas)
Milestones in Toddlerhood
Achievements in Form:
-transition to multi-word utterances
**increasing Mean Length Utterance
-distinct grammar that governs word order
Achievements in Content:
-vocabulary spurt (“naming explosion”)
-receptive lexicon much greater than expressive lexicon
Achievements in Use
Use a variety of language functions
(still learning to responds appropriately, keep listener in mind, maintain topic)
Justice Communication Sciences and Disorders: An Introduction
Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.
Overextension vs underextension
Milestones in Preschool
Achievements in Form:
-grammatical & derivational morphology
-sentence complexity
2.37
Justice Communication Sciences and Disorders: An Introduction
Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.
Achievements in Content:
-Lexicon development: average of 13,000 words by kindergarten
-Decontextualized language
-
Achievements in Use:
-Even more language functions: including interpretive, logical, participatory, and organizing
-Turn-taking skills
Decontextualized language: language outside of the here and now
Language Delay
“late start” with language development
“late talkers”
Will generally catch up to peers by entrance to primary school.
**if children do not “catch up” gap between their skills and skills of peers begins to widen
Language Disorder
When an individual exhibits significant and persistent difficulties with the comprehension or expression of spoken or written language.
Language Disorder
The disorder is somehow impacting:
Form
Content
Use
Things to Consider (outside of the theoretical):
Extent observed/suspected language problems negatively impact social, pyschological or educational aspects of child’s life
Differentiate between language disorder and language difference
Deciding if language problems are significant enough to be considered a disorder
Describing Language Disorders
Significant
Persistent
Reception
Expression
Spoken
Written
Language Delay
Language Impairment
Language Disorder
Language Disorders
Have an impact on a person’s life:
Social
Psychological
Educational
Primary vs. Secondary
Primary Language Disorder
Secondary Language Disorder
Primary vs. Secondary
Primary Language Disorder
Occurs without any other disability that would be accountable
Developmental Language Disorders
Primary vs. Secondary
Secondary Language Disorder
Occurs as a consequence of another disorder:
Intellectual Disability
Hearing Loss
Autism Spectrum Disorder
What is Language?
Language is:
Shared code
Symbolic
Arbitrary
Multi-modal
Rule-Governed
A Shared Code
English Speaker
Spanish Listener
English Speaker
English Listener
Share the same code
Do not share the same code
“bathroom”
“bathroom”
Symbolic
Symbol: representation of something else
Arbitrary
No necessary or absolute connection between symbols and the thing they represent
“Dog”
“Chien”
“Perro”
Multi-modal
Expressive language: Encoding
Speech
Gesture
Writing
Receptive language: Decoding
Listening
Watching
Reading
Rule-governed
Language Acquisition
Language Disorders
Classification of language disorders focuses on three key features:
Etiology
Manifestation
Severity
Etiology
Primary language impairments: language difficulties in the absence of any other disability that can be held accountable
Secondary language impairments: language difficulties that are a consequence of another disorder, intellectual disability, brain injury, etc.
Etiology
Developmental: disorder that is present from birth
Acquired: disorder that is acquired sometime after birth, result of some insult or injury
Acquired: lead exposure, TBI
Manifestation
Reception vs. Expression:
Language comprehension/reception disorder
Expressive language disorder
Mixed receptive-expressive disorder
Manifestation
Disorder of form:
syntax, morphology, and phonology
Disorder of content:
semantics
Disorder of use:
pragmatics
Manifestation
Focal disorders = only one domain affected
Diffuse disorders = multiple domains affected
Severity
Ranges from mild to profound
Mild: relatively little impact on a child’s ability to function at home or school
Profound: may have no language skill at all and therefore may be severely limited in ability to participate in activities at home, school, or in the community
Common Disorders
Specific language impairment (SLI)
Autism spectrum disorder
Intellectual disability
Traumatic brain injury
SLI
Children who show significant impairment of expressive and/or receptive language that cannot be attributed to any other cause
Diagnosed after age 3, to rule out just “late talkers”
Diverse group – some show problem in only one area and some with problems in all areas of language
No known cause, but probably genetic
SLI
Not attributed to:
Low intelligence
Neurological impairments
Motor or sensory disturbances
Hearing loss
Etiology- most likely genetic:
Environmental factors (amount of language input)
Biological factors
Perinatal influences (premature, low birth weight)
Postnatal (nutrition, exposure to toxins)
SLI
Difficulties:
**Inconsistent skills across different language domains
*Slow vocabulary development
**Problems with word finding
*Problems with grammar
**Problems in social skills, behavior, and attention
https://www.youtube.com/watch?v=Pqu7w6t3Rmo
Autism Spectrum Disorder
ASD prevalence (NIH, 2014):
1 in 58 (1 in 38 males; 1 in 150 females)
Umbrella term for describing variety of developmental characteristics marked by:
Difficulty with social interactions
Engagement of repetitive behaviors
Restriction of interests
https://www.youtube.com/watch?v=x2hWVgZ8J4A
ASD Etiology
Organic brain abnormality
Risk factors:
Maternal Rubella
Anoxia
Encephalitis
Sensory neglect
**no reliable link seen between vaccinations and the development of ASD; continues to be a focus of research
Rubella=german measles
ASD- DSM V Diagnostic Criteria
Symptoms must emerge during childhood
Symptoms must affect individual’s everyday functioning (ie social/occupational)
Symptoms include problems with social interaction (conversation, initiation, understanding nonverbal communication)
Symptoms include restricted and repetitive patterns of behavior (repetitive speech, fixed interests, hyperawareness to sensations in environment)
ASD- SLP focus
Communication: understanding/using words & gestures, following directions, reading & writing, askng & answering questions, participating in conversation, use of AAC if needed
Social Skills: joint attention, turn taking, understanding how others may feel
Eating: assist in diet modification and increasing child’s ability to try new food
Treatment Team includes: Psych, SLP, OT, PT, dietician, developmental specialist, teachers and aides
Intellectual Disability
Condition of arrested or incomplete development of the mind
Prevalence:
Approx 1.83% children (ASHA, 2011)
Causes:
30-40% have unknown etiology
65-75% biomedical or psychosocial
Prenatal (brain malformation, maternal disease, toxins)
Perinatal (labor related events/ anoxia)
Genetic (Downs Syndrome/Fragile X)
Environmental influences (sensory/social deprivation, toxins)
Intellectual Disability
Co-occurrence & Comorbidities:
ASD
CP
Downs Syndrome
Fetal Alcohol Syndrome
Fragile X
Anxiety Disorder
Bipolar Disorder
ADHD/ADD
And more…
IDD Defining Characteristics
Diagnosed before age of 18
Mental abilities (intelligence) below average
Limitations of adaptive behavior:
Difficulty mapping behaviors and actions to any given situation
IDD Defining Characteristics
Decreased Conceptual Skills
Communication
Functional academics
Health & Safety
Decreased social skills
Social relationships
Participation in leisure activities
Decreased practical skill
Self-care
Home living
Community participation
Language Presentation
| Classification | IQ Range | Language Skills |
| Mild ID | 50-69% | Adequate language skills Good Social Relationships Mild to moderate learning disability Acquires academic skills @ 6th grade level |
| Moderate ID | 35-49 | Significant difficulties across various areas Functional language and communication Requires support in community and in employment |
**Language/ Communication skills depends on severity and presentation of IDD;
**can plateau at times with slow rate of development; can see regression in some presentations, especially in degenerative diseases
Mild: difficulty with abstract concepts, figurative language, complex syntax, complex conversational participation
Moderate: (Cheryl & Uncle Al)– basic skills (basic arithmetic and reading)
Language Presentation
| Classification | IQ Range | Description |
| Severe ID | 20-34 | Significant delays across multiple areas Very little language or ability to communicate with others Use of AAC or sign Continuous support required for community activities |
| Profound ID | <20 | Severe limitations in self care Very limited communication Requires constant aid and support |
Acquired Brain Injury (ABI)
Any type of damage to an individual’s brain
Occurs after birth
**The leading cause of death & disability among young children
Causes
Transportation related accidents
Accidental falls
Recreational accident
Infection (i.e. meningitis)
Disease (i.e. brain tumor)
Physical Accidents (i.e. abuse, intentional harm, accidental poisoning)
Possible effects
Receptive/Expressive Language: anomia, organization, fluency
Pragmatics: Initiation, Maintenance, turn taking
Speech: apraxia/dysarthria
Cognition: processing time, following direction, STM, concentration
Receptive/Expressive Language
Cognition
Pragmatics
Speech
Voice
Swallowing/Feeding
Behavioral
Language disorders from brain injuries are influenced by:
Severity of the injury: more severe the injury, the less chance of a full language recovery
Site of the damage: often affects the frontal lobe, causing impairments in language use, and cognitive, executive, and behavioral functions
**Characteristics of the child before the injury
7.35
Justice Communication Sciences and Disorders: An Introduction
Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.