4. Language Disorders in Children Flashcards
Specific Language Impairment (SLI)
AKA Language-Learning Disability (LLD)
- Lang. disorders in children who are otherwise typically developing; impairment specific to lang.
- Widely varied and heterogenous group
2 Major Explanations for SLI
i.e., SLI has a known etiology
1) Underlying deficits (i.e, due to deficits in cognitive, auditory, and perceptual and intellectual functions)
2) SLI reflects normal variation in linguistic skills: kids at lower end of normal continuum of lang. skills
SLI: Specific Characteristics
- Articulatory and phonological probs
- Less complex syllable structure; shorter MLU
- Late to talk; slow rate of word acquisition
- Overextend; underextend
- Word-finding probs
- Diff. learning abstract or figurative words; tend to use concrete>abstract words
- Morphological probs (may be due to perceptual and syntactic probs)
- Telegraphic speech
- Pragmatic skills vary greatly
Intellectual Disabilities (ID) (preferred term for "mental retardation") AKA Developmentally Disabled/DELAYed
- Significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills
- Originates before age of 18
- Diagnosis based on subaverage IQ scores
- Limited communication/lang. skills
- Diverse group (from syndromes, environ, genetics, pre-/postnatal factors, TBI, etc)
- Delayed vs deviant
- Concrete>abstract concepts/vocab
- Receptive>Expressive
- Morphological probs; telegraphic speech
- Usu. have other probs (e.g., medical, gross motor) –> Dx/Tx multidisciplinary approach
Autism Spectrum Disorders (ASD): Diagnostic Criteria (3)
- Impaired social interaction
- Disturbed communication
- Stereotypic patterns of behavior, interests, and activities
- May have associated probs (e.g., ID, CAP probs, motor deficits, brain injury, HL, etc) –> Dx/Tx multidisciplinary approach
ASD: Characteristics
Below ave. IQ (70 or below); Lack of responsiveness to and awareness of other people; Preference for solitude and objects vs people; Lack of interest in nonverbal/verbal comm.; Stereotypic body movements (e.g., constant rocking); Insistence on routines (strong dislike of change); Dislike of being touched/held; 25% have seizures; Hyper- or hyposensitivity to sensory stimulation
ASD: Language Problems
Inadequate or lack of response to speech; Lack of interest in human voices and better response to environmental noises; Slow acquisition of speech sound production and language, reflecting general disinterest interaction w/ others; Use of lang. in a meaningless, stereotypic manner, incl. echolalia; Perseveration on certain words or phrases; Faster learning of concrete>abstract words; Lack of generalization of word meanings; Lack of understanding relationship bet. words; Pronouns; Use of short, simple sentences; Omission of grammatical features (e.g., conjunctions); Social comm. probs (eg., eye contact, topic maintenance, reduced conversation initiation, lack of assertiveness); Joint reference
Asperger’s Syndrome
- Similar characteristics to ASD except for comm. skills and intellectual levels (IQ 70+)
- Impaired social interactions and repetitive and stereotyped behaviors are similar to ASD
- Acquire lang. skills better than ASD; may have excellent vocab and normal syntax
- Atypical social communication
- May talk obsessively about their preoccupations; speech is often more a monologue than dialogue (turn-taking probs); may not grasp if listener is bored/in hurry
- Tx: pragmatics
SCERTS model
- Popular tx paradigm for Asperger’s
- SCERTS acronym emphasizes the importance of targeting goals in social communication (SC) and emotional regulation (ER) by implementing transactional supports (TS). These supports include visual support, environmental arrangements, and communication style adjustments
Brain Injury Subgroups: TBI and CP
1) TBI (cerebral damage due to external force) and Immediate Effects (3)
- Focal injury: one area of brain; Diffuse injury: multiple areas b/c damage is widespread
- Dx/Tx: multidicipinary approach
- Immediate effects: (1) coma or loss of consciousness; (2) confusion and post-traumatic amnesia (memory loss); (3) abnormal behaviors (e.g., aggression, anxiety, irritabiility, lethargy, hyperactivity, withdrawal)
TBI: Cognitive and Language Probs
Comprehension (esp. sentences); Word-retrieval (affects fluency); Syntactic probs (incl. limited MLU, fewer utterances, diff. expressing/understanding long, complex sentences); Reading/writing; Pragmatics (e.g., turn-taking, topic maintenance, due to poor inhibition and lack of self-monitoring); Attention/focus; Inability to recognize own difficulties; Slower information processing; Reasoning and organiation
2) Cerebral Palsy (CP) and Associated Problems
- Disorder of early childhood
- Immature nervous system is affected, resulting in muscular incoordination and associated probs
- CP refers to a group of symptoms associated w/ brain injury in still-developing children
- Not a progressive disorder; generally occurs due to prenatal, perinatal, postnatal brain injury
- Associated probs: orthopedic abnormalities, seizures, feeding difficulties, HL, perceptual disturbances, and intellectual deficits
CP: Paralysis (5)
Can manifest paralysis of diff. body parts–
- hemiplegia: one side of body, R or L
- paraplegia: only legs and lower trunk
- monoplegia: only 1 limb or part thereof
- diplegia: either 2 legs or 2 arms
- quadriplegia: all 4 limbs
Major Types of CP (3)
- Ataxic CP: disturbed balance, awkward gait, uncoordinated movements (cerebellar damage)
- Athetoid CP: slow, writhing, involuntary movements (damage to indirect motor pathways, esp. basal ganglia)
- Spastic CP: increased spasticity (increased tone, rigidity of muscles) as well as stiff, abrupt, jerky, slow movements (damage to motor cortex or direct motor pathways)
CP: Speech and Language
- Speech and language probs depend heavily on type of CP and presence of associated probs such as ID or HL. Some children with CP have normal lang. skills, while other have severe lang. probs.
- Dysarthria: common among children w/ CP
- Tx: Multidisciplinary team approach and use of AAC if necessary
Fetal Alcohol Syndrome (FAS)
- A leading cause of ID
- Pre- and postnatal growth probs
- CNS dysfunction: delayed motor development, mild-profound ID or learning disabilities
- Academics, incl. reading/writing
- Abnormal craniofacial (skull-face) features
- Malformations of major organ systems
- Behavior probs (e.g., AD(H)D)
- Poor play and social skills
- Speech probs, e.g., artic. delay
- Language delay
- May have cleft palate or oral-motor coordination probs
- Swallowing(impaired sucking reflex at birth)
- Cog. probs: reasoning, memory, learning
- Auditory processing probs
- hearing probs- conductive or SNL
Fetal Alcohol Effects (FAE)
- Babies with FAE do not meet the diagnostic criteria for FAS
- FAE are signs (e.g., mild physical and cognitive deficits) that have been linked to a mother’s drinking during pregnancy
ADHD
Greatest difficulty in auditory processing and social interaction skills/pragmatics
(+ expressive language organization)
Language Assessment
- Process of observation and measurement to determine a) existence of clinically significant problem, b) nature and extent of problem, and c) course of action that must be taken to help the child and family
- 3 categories of lang assessment: Screening, Standardized assessment, and Alternative assessment approaches (incl. language sampling)
Alternative Assessment Approaches (4)
[Cont’d in ch. 11]
- Especially relevant to assess CLD clients
- Samples more naturalistic comm. skills
1) Criterion-referenced and client-specific approaches
2) Authentic assessment
3) Dynamic assessment
4) Portfolio assessment
Language Samples:
MLU (mean length of utterance)
and TTR (type-token ratio)
*MLU: # of morphemes/# of utterances
[fillers (e.g., um, uh) and dysfluencies aren’t counted as morphemes]
*TTR: # of diff. words in sample/# of words in sample
(Also, look for Brown’s 14 morphemes)
