Ch 3: Childhood Language Disorders & Basic Intervention Flashcards
What is a language disorder?
Significant and persistent difficulties with the comprehension and or expression of spoken or written LANGUAGE (Must be language and not speech)
May affect one’s form, content and use
May be a LD if not consistent with what is typically seen in children of similar age, culture, and linguistic background
Factors contributing to the definition of Language Disorder
Social, psychological, and education impact
Disorder vs. Difference
Meaning of Significant
Social, psychological and educational impact
Functional consequences
Does a child’s language performance have a negative impact on the child’s ability to function in society
If it doesn’t affect a child’s socially, psychologically or educationally, is it really a disorder?
Language Disorder Vs. Language Difference
Language difference: Child’s language skills within both normative and cultural expectations
Regional, social and cultural variations in language is NOT disordered
Meaning of Significant
Language disorders not serous enough to be classified as a disorder is not significant
LD is present if significant problems are present
Clinical terminology
Language disorder
Developmental language disorder
Specific language impariment
Research terminology
DLD
SLI
Insurance terminology
F80.1: Expressive LD
F80.2: Expressive and receptive LD
Educational terminology
Developmental delay
Speech or language impairment (SLI)
Specific learning disability
Not appropriate terminology
Childhood aphasia
Language deviance
Language Delay v. Disorder
Delay: Child gets late start with development, but is expected to catch up with their peers (Late bloomers)
Disordered: Children with LD is not and do not catch up in development
Common signs of LD in Preschool
Omission of grammatical inflections
Difficulty with oral resolution with conflicts
Shorter sentence length
Problems forming questions with inverted auxiliaries
Longer reliance on gestures for meeting needs
Errors of pronouns
Immature requests
Difficulty with conversing with 2 or more children
Difficulty comprehending complex directions and narratives
Common signs of LD in Elementary
Word finding problems with pauses and circumlocutions
Naming error
Slower processing speed in language comprehension
Difficulty responding to indirect requests
Difficulty with maintaining topics
Problem with figurative and nonliteral langauge
Problems with abstract language concepts
Problems with providing details
Difficulty with decontextualization
Common signs of LD in Adolescence
Socially inappropriate discourse with peers or adults
Inadequate sense of limits/boundaries
Redundancy
Poor social language
Inappropriate responses to questions and comments
Problems providing sufficient information to listeners
Difficulty expressing needs and ideas
Word finding difficulties
Pragmatic, interactional, and sociolinguistic competency problems
Prevalence
Number of existing cases of a disease
Incidence
Number of new cases of disease and can be reported as a risk/incidence rate
Basic prevalence and incidence statistics
1/36 children ASD
~15% of toddlers are Late Language Emergence (late talkers)
1/1000 children ID due to down syndrome
Late language emergence (LLE)
Late talkers, some LLE children are simply late bloomers and will catch up with peers without intervention
Some LLE children will have language disorder/disability and will need intervention
Cannot tell until after the fact but has a ~3 year limit
How are LD classified?
Etiology
Manifestation
Severity
Etiology
CAUSE
Primary language disorder vs. Secondary language disorder
Developmental language disorder vs. Acquired language disorder
Primary Language Disorder
Occurring in the absence of any other disability that can clearly be held accountable for LD
i.e. SLI
Secondary Language Disorder
Occurring as a consequence of another disorder, co-occurring
i.e. ASD, ID, HL, TBI, prenatal and postnatal exposure to toxins
Developmental Language Disorder
Present from birth
Can be primarily SLI or secondary with another congenital disorder such as ASD or down syndrome
Not always a child associated LD, children with developmental LD can grow into adults with developmental LD
Acquired Language Disorder
Experienced sometime after birth
Typically as a result of injury or toxins
i.e. shaken baby syndrome, lead, TBI
Always secondary
Has a foundation/prior experience with language
Manifestation
Which aspects of language are affected?
Comprehension/expression?
Form, content or use?
Reading or writing?
Comprehension and Expression
Some children will have problem with comprehension but normal expressive language: Language comprehension disorder
Expressive language disorder is the VV
Mixed receptive-expressive LD is both
Form, content and use
Form: Structure of language such as phoneme, morphology and syntax
Content: Meaning such as semantics
Use: How language is used in social contexts, pragmatics
Only affecting 1 domain: Focal disorder
Affecting multiple domains: Diffuse disorder
Reading and writing
Both decoding and comprehension crucial to reading
Decoding: Identifying written word and spoken word correspondance (Sounding it out)
Comprehension: Understanding what is being decoded
Dyslexia: decoding issue
Reading comprehension disorder: comprehension issue
Mixed reading disorder: both
Severity
Ranges from mild to severe
Determined based on the extent to which a disorder hinders child’s ability to use language functionally
What are the prevalent types of LD?
SLI
ASD
ID
TBI
SLI (Specific Language Impairment)
Significant impairment of expressive/receptive language in Pre-k and school-aged children not associated with any other causal conditions
Typical hearing, normal intelligence, and no obvious neurological or motor and sensory issues
Language skills disproportionately poor relative to intellectual capabilities
Typically diagnosed 3+ years of age
Extremely diverse manifestation and language profile
Causes/risks: No known etiology
Suggested biological component
Risk factors of limited language input and toxins
Intellectual Disability (ID)
Cognitive and adaptive behavior disorder
Incomplete development of the mind characterized by impairment of skills manifested during developmental period
Mental abilities significantly below peers and have problems functioning in society and have limits in adaptive behavior (set of skills people learn to meet daily needs and functions to adapt into society)
Causes/risks: 30-40% no cause
60-70% stems from biomedical and psychosocial factors such as prenatal and perinatal damage, chromosomal abnormalities and sensory deprivation
Brain injury (TBI)
Any type of damage to the brain
Always acquired
Injury prenatal and perinatal is considered ID, injury must be after foundation of language
Causes/risks: Accidents, falls, sports injuries, car accidents, drugs/alcohol usage during activity, shaken baby syndrome, infections and disease
Five main areas of development
- Cognitive development
- Communication development
- Physical development
- Social and emotional development
- Adaptive development
Potential team members for LD identification
SLP
Special and general educators
AUD
Pediatricians
Psychologists
Parents
Assessment process
Referrals, screening
Comprehensive language evaluation
Diagnosis
Referral
Usually made by pediatrician or a parent, etc.
Referrals usually made when children have secondary developmental or secondary acquired precursors (ID and TBI)
Delayed attainment of key language milestones usually warning signs of possible LD
Screening
Identifying children who should receive comprehensive assessment of language skills
Could be used as a referral
Designed for quick, mass administration
Comprehensive Language Evaluation
Determines whether or not language disorder is present
Develops full profile of linguistic strengths and weaknesses (language profile)
Identifies supports needed to improve language skills
Case history and comprehensive analysis of child’s language skills
Examines all domains of language and characterizes extent of functional impact
Uses multiple methods to gather information
Diagnosis
Careful consideration of evidence from assessment used to evaluate whether disorder is present or not
Determines:
Type of impairment: Primary or secondary?
Manifestation: Receptive or expressive? Form content or use? Reading or writing?
Severity: mild, moderate, severe or profound?
How are language disorders treated?
Treatment approaches tailored to the unique needs to individuals in regards to targets, strategies and contexts
Treatment of childhood LD in EBP: Optimal treatment requires clinician to use EBP, after considering EBP, treatment will specify:
1. Targets
2. Strategies
3. Contexts
Treatment targets
Elements of language addressed during intervention
Treatment Strategies
Describes the manner in which treatment targets are addressed
1. Child-centered
2. Clinician-directed
Treatment Contexts
The setting in which treatment takes place, natural environment (LRE)
Natural environment
Includes homes, classrooms, and community
More ideal because treatment in natural environment promotes transfer of skills learned in therapy to functional activities done in day to day.
Legally, LRE is mandated by federal law
More comfortable and familiar
