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ECU Language Disorders > Chapter 4: Special Considerations for Special Populations > Flashcards

Chapter 4: Special Considerations for Special Populations Flashcards

1
Q

What services does an SLP provide in general?

A

Identifying communicative strengths and weaknesses

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2
Q

What services does an SLP provide in articulation?

A

Articulation

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3
Q

What services does an SLP provide in language?

A

Receptive, expressive related to academic

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4
Q

What services does an SLP provide in literacy?

A

Decoding, comprehension

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5
Q

In what areas do SLPs provide assessment and intervention?

7

A

Pragmatics

Semantics

Syntax

Phonology

Morphology

Cognition

Perception

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6
Q

Why do we need to understand clinical and educational reports?

A

They affect our assessment and intervention

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7
Q

Intellectual Disability is disability characterized by significant limitations both in _______ and ______ which covers many every day social and practical skills. This disability originates before age ______.

A

Intellectual functioning

Adaptive behavior

18

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8
Q

What are the Cognitive characteristics of Nonspecific ID?

2

A

IQ scores (70-75 limited >2 SD below mean)

Slower developmental trajectory compared to typical

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9
Q

How does ID affect our intervention of language Form?

A

Use shorter and simple utterances

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10
Q

How does ID affect our intervention of language Content?

A

Simplified syntax

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11
Q

How does ID affect our intervention of language Use?

4

A

Delayed development of intentional communication

Less clarification and request for clarification

Poor narrative cohesion

Poor humor comprehension

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12
Q

How does ID affect Literacy?

A

Children don’t initiate reading activities = read less

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13
Q

How does ID affect our implications for clinical practice?

A

Address developmental goals

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14
Q

How often does Down Syndrome occur?

Why does it occur?

A

1 in 700 live births

Extra Chromosome 21

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15
Q

What are they symptoms of Down Syndrom?

8

A

Mild to moderate ID

Hypotonia (low tone)

Small chin

Round face

Oversized tongue

Health concerns (heart defects, GERD

Otitis media

Thyroid dysfunction

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16
Q

What are the Cognitive Characteristics of Down Syndrome?

2

A

Developmental fine and gross motor delays

IQ 40-70

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17
Q

What are the general Language Characteristics of Down Syndrome?

(5)

A

Poor working memory

Visuospatial working memory

Learning rules

Poor attention

Poor problem solving

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18
Q

How does Down Syndrome affect Language Form?

5

A

Poor intelligibility

Vowel distortions

Apraxia

Poor syntax

Shorter utterances

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19
Q

How does Down Syndrome affect Language Content?

2

A

Delayed 1st words

Poor phonological Short term memory

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20
Q

How does Down Syndrome affect Language Use?

2

A

Strengths with narratives with picture supports

Poor responses

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21
Q

How does Down Syndrome affect Literacy?

A

Dependent on phonological skills and comprehension

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22
Q

What are the implications for clinical practice for clients with Down Syndrome?

(6)

A

Monitor hearing

Monitor articulation

Use gestures and pictures

Target early language development

Focus on tasks

Possible AAC (picture symbols, Voice output)

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23
Q

How common is William Syndrome?

How is it caused?

A

1 in 7,500

Deletion of 25 genes on 1chromosome 7q11.23

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24
Q

What are the common symptoms in William Syndrome?

3

A

Physical facial dysmorphology

Heart disease

Growth deficiency

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25
Q

What Cognitive Characteristics are seen with William Syndrome?

(4)

A

Global developmental delays

Mild to moderate ID

Visuospatial deficits

Poor motor development

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26
Q

What is seen in Language Form in William Syndrome?

3

A

Canonical babbling delayed

May have articulation problems

Poor grammatical understanding/comprehension (related to verbal working memory)

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27
Q

What is seen in Language Content in William Syndrome?

2

A

Good concrete vocabulary

Difficulty with temporal, spatial, dimensional concepts

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28
Q

What is seen in Language Use in William Syndrome?

1+3

A

Pragmatic deficits

  • Poor nonverbal facial expression perception
  • Poor provision of appropriate responses
  • Few cognitive inferences
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29
Q

What is seen in Language Literacy in William Syndrome?

2

A

Variable reading/decoding

Lower comprehension

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30
Q

What are the Implications for clinical practice for clients with William Syndrome?

(3)

A

Work with family to increase language

Systematic phonetics

Improve reading comprehension

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31
Q

What is Fragile X Syndrome?

2

A

X Chromosome has duplications

Affects protein production needed for brain development, inherited

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32
Q

What Cognitive Characteristics are seen in Fragile X Syndrome?

(6)

A

½ have borderline IQ

Executive function deficit – sequential processing

Working memory

Selective attention

Fine and gross motor delays

Can have comorbid ASD, ADHD

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33
Q

What is seen in Language Form in Fragile X Syndrome?

4

A

Poor intelligibility

Phonological processing (awareness)

Shorter MLU

Simpler utterances

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34
Q

What is seen in Language Content in Fragile X Syndrome?

3

A

Mixed receptive vocabulary

Fewer different words

Slow rate of growth

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35
Q

What is seen in Language Use in Fragile X Syndrome?

5

A

Pragmatic limitations similar to ASD

Tangential language

Perseveration

Stereotypical phrases

Poor working memory

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36
Q

What is seen in Literacy in Fragile X Syndrome?

2

A

Nonword reading difficulties

Limited research

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37
Q

What are Implications for clinical practice for clients with Fragile X Syndrome?

(3)

A

Socially meaningful activities to increase communication

Early intervention

Differential diagnosis ASD

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38
Q

What are some strategies to assist clients with Visual Impairment?

(4)

A

May need Braille

Large pictures

Large print

Text to speech programs

(There is a range of visual impairment. Contact visual specialist in area, optometrist, ophthalmologist)

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39
Q

What may be seen in Language Form in clients with Visual Impairment?

(2)

A

May have delayed speech

May have appropriate MLU

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40
Q

What may be seen in Language Content in clients with Visual Impairment?

A

May develop age appropriate vocabulary depending on experiences

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41
Q

What may be seen in Language Use in clients with Visual Impairment?

(3)

A

May use few gestures

Need help with use of questions, initiation

Need structured language activities

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42
Q

What may be seen in Literacy in clients with Visual Impairment?

(2)

A

Dependent on vision

Focus of education

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43
Q

What are the Implications for clinical practice for clients with Visual Impairment?

(3)

A

Facilitate early social communicative exchanges between child and parents

Provide labels and descriptions, model pretend play

Model reading

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44
Q

What is Profound Hearing Loss?

A

91+ dB SPL

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45
Q

What are the three types of hearing loss?

A

Conductive (treatable, otitis media)

Sensorineural (loss due to damage of inner ear, cochlear implants may be used)

Mixed (both conductive and sensorineural)

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46
Q

What are Cognitive Characteristics seen with Hearing Impairment?

(2)

A

Depends on cause of loss

May have comorbid deficits

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47
Q

What is seen in Language Form seen with Hearing Impairment?

6

A

Delayed babbling

Intelligibility may be negatively impacted (hyponasal voicing errors, initial syllable deletion)

May need sign language (parents may need training)

Lower MLU

Morphological errors (-s, -ed)

Spelling may be impaired

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48
Q

What is seen in Language Content seen with Hearing Impairment?

(2)

A

Vocabulary may be delayed

More repetition of new words/sign

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49
Q

What is seen in Language Use seen with Hearing Impairment?

4

A

Depends on culture

Family beliefs

Aided hearing

Conversational structures

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50
Q

What is seen in Literacy seen with Hearing Impairment?

2

A

Depends on exposure to print

Phonological pairing/or signed vocabulary

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51
Q

What are the Implications for clinical practice seen in clients with Hearing Impairment?

(2)

A

Work closely with Audiologist

Language used or aides used need to be considered (look at development and needs/wants of parents)

52
Q

What is seen in Language Form in children with Otitis Media?

2

A

May be impacted dependent on length of conductive loss

May lead to speech sound disorder/delays

53
Q

What is seen in Language Content in children with Otitis Media?

A

May not be impacted, or may impact morphology (-s, ed) may impact spelling

54
Q

What is seen in Language Use in children with Otitis Media?

A

May impact interactions with others

55
Q

What are the Implications for clinical practice with children with Otitis Media?

(1+5)

A

Note differences in

  • Attention
  • Repetition of sounds
  • Phonological awareness
  • Decoding
  • Answering questions
56
Q

Do SLPS diagnose Auditory Processing Disorders?

A

Refer to Audiologist who can do nonspeech assessment to determine if the Auditory nerve is functioning

57
Q

What is often comorbid with Auditory Processing Disorders?

2

A

ADHD

DLD

58
Q

What are the Clinical Implications for clients with Auditory Processing Disorders?

(5)

A

No clear plan for Assessment or Treatment

Look at perceptual attention, following directions, level of prompting and/or cueing needed

Look at Language Assessment results!

Work with Audiologist!

Determine if an FM system would work or not, classroom accommodations

59
Q

What historically causes Deaf-Blindness?

2

A

Rubella (German Measles)

Usher’s syndrome

60
Q

What sort of assessment and intervention needs to be performed with students who are deaf-blind?

A

Early dynamic

61
Q

Who do you need to consult with for students who are deaf-blind?

(3)

A

Audiologist

Vision Specialist (Ophthalmologist)

Talk with parents about goals, needs, concerns

62
Q

What kind of interventions can be used with students who are deaf-blind?

(4)

A

Object-based AAC

Loud toys (depends on hearing)

Light up toys

Tactile prompting (hand over hand) during activities

63
Q

What are the two types of TBI?

2

A

Focused

Diffuse

64
Q

What can impact the severity of a TBI?

2

A

Age

Severity of initial injury and areas impacted will impact development

65
Q

What are some Cognitive Characteristics of TBI?

3

A

Dependent on location of injury and pre-injury cognitive status

48% have IQ

66
Q

What is seen in Language Form in children with TBI?

2

A

May have short utterances or long utterances

Dependent on areas injured

67
Q

What is seen in Language Content in children with TBI?

2

A

Dependent on areas injured

Potential hearing difficulty

68
Q

What is seen in Language Use in children with TBI?

A

Output may be limited or excessive (tangential)

69
Q

What is seen in Literacy in children with TBI?

A

Dependent on pre-injury skills and focus of therapy

70
Q

What are some Implications for clinical practice in children with TBI?

(2)

A

Assessment and Intervention need to focus on areas of deficit and client and parent goals!

Look at school records, academic status pre-injury

71
Q

How do we assess Pediatric Test of Brain Injury?

3

A

10 subtests that assess neurocognitive, language, and literacy abilities that are relevant to school curriculum.

Use for dynamic assessment through different phases of recovery

Results should be compared to pre-injury function and used to determine Plan of Care.

72
Q

How do we design intervention for students with TBI?

4

A

Dependent on severity of injury and course of recovery

Retrain or develop cognitive skills

Teach compensatory strategies

Use structured tasks, address attention, impulsivity, language comprehension, problem solving, and Self-monitoring

73
Q

What are Focal Brain Lesions?

3

A

Caused by CVA (stroke)

Premature birth

Pediatric heart conditions

74
Q

What is seen in language development in children with Focal Brain Lesions?

(2)

A

Early delays in word comprehension and word processing (LCVA), gestures (RCVA)

Shorter narratives, simple sentence structure, fewer different words, no mention of character’s mental states

75
Q

What are Implications for clinical practice for children with Focal Brain Lesions?

A

Need to refer to assessment error analysis to determine areas of weakness

76
Q

What is Landau Kleffner Syndrome?

4

A

Acquired epileptic aphasia

Onset 3-6 yr of age

Loss of already acquired language skills

May have auditory comprehension deficits, expressive deficits - dependent on location of seizure damage

77
Q

What improves Prognosis for Landau Kleffner Syndrome?

A

Better if onset is after 6 yrs, language is already learned.

78
Q

What are Implications for clinical practice for children with Landau Kleffner Syndrome?

(2)

A

Language skills are dependent on pre-seizure language and speech abilities.

May need to investigate voice output devices to replace verbal language, use sign language, depends on client and parents.

79
Q

What is often seen in Autism Spectrum Disorders?

3

A

Poor eye contact

Limited expressive language

Poor joint attention

80
Q

What Cognitive Characteristics are often seen in Autism Spectrum Disorders?

(2)

A

50-70% nonverbal IQ is

81
Q

What is often seen in Language Form in Autism Spectrum Disorders?

(7)

A

Apraxia

Phonological errors (memory)

Nonsense word repetition deficits

Rhyme awareness

Poor prosody, grammar, morphosyntax

Simple sentence structure

Short utterances

82
Q

What is often seen in Language Content in Autism Spectrum Disorders?

(2)

A

Vocabulary deficits

Don’t use semantic information to facilitate encoding and recall

83
Q

What is often seen in Language Use in Autism Spectrum Disorders?

(4)

A

Conversational deficits

Lack of initiation or over initiation

Poor topic maintenance

Poor referencing in narratives, difficulty with figurative language (idioms, sarcasm)

84
Q

What is often seen in Literacy in Autism Spectrum Disorders?

(2)

A

Hyperlexia with poor comprehension

Not much research

85
Q

What are Implications for clinical practice for children with ASD?

(4)

A

Dependent on the child’s level of functioning and parent’s goals.

May be behavioral problems, lack of structure/too much structure

Sensory processing deficits (textures, smells, lights, hearing
Referral to OT, PT, Nutrition when needed)

Focus on each child and their needs with broad goals

86
Q

What is Pragmatic Language Impairment?

2

A

language deficits affect communication, social interaction and use of language in context.

No repetitive behaviors

Term can be used to describe children with DLD and ASD

87
Q

What is a Nonverbal Learning Disability?

6

A

Opposite of DLD
Children with average Verbal IQ but below aveage Nonverbal IQ

Difficulty with visual-spatial and visual-motor, and fluid reasoning compared to other DLD

Poor mechanical math skills, poor novel problem solving, concept formation, repetitive speech, poor social perception and judgment.

Strength in single word reading and fluent speech

May be more likely to be diagnosed with ASD.

Lack of research!

88
Q

What are symptoms of ADHD?

2

A

Inattentiveness – poor attention and concentration, poor organization, difficulty completing tasks without supervision.

Hyperactivity/Impulsiveness – fidgety, always moving, interrupting and talking incessantly, and acting without thinking.

89
Q

What Cognitive Characteristics are often seen in ADHD?

2

A

Nonverbal IQ in normal range

Poor working memory, planning, inhibition, and motivation

90
Q

What is often seen in Language Form in ADHD?

2

A

Difficulty with processing speed

Some grammatical errors

91
Q

What is often seen in Language Content in ADHD?

6

A

Poor mapping semantic features

Word recall deficits

Poor inferences

Figurative language

Metaphors, and humor

Good receptive vocabulary

92
Q

What is often seen in Language Use in ADHD?

4

A

Inappropriate initiation

Interrupting

Poor topic maintenance

Too much or too little detail.

93
Q

What is often seen in Literacy in ADHD?

2

A

25-40% comorbid reading Disorder and ADHD

Poor decoding and comprehension

94
Q

What are Implications for clinical practice for students with ADHD?

(4)

A

Provide structured activities and teaching models

Focus on important information (main idea, details) and provide strategies

Give breaks between activities

Work with family, teachers, and client toward a common goal

95
Q

What is Selective Mutism?

2

A

Child does not speak in certain situation where there is an expectation of speaking, especially school.

Must persist for more than 1 month (ELL for 6 months)

96
Q

In what populations is Selective Mutism more common?

2

A

More common in girls 2:1

Social anxiety disorder – 60-75% also have DLD

97
Q

What do we need to do when assessing children with Selective Mutism?

(2)

A

Detailed case history from parents and teachers

Observation of the child in class, playground, etc. is recommended.

98
Q

What do we need to remember when designing interventions in children with Selective Mutism?

(3)

A

Behavioral interventions and medical treatment may be considered

Positive reinforcement for speaking, desensitization to stressful situations, self modeling techniques, and family counseling.

Rote tasks – days of the week, months of the year, holidays

99
Q

What parental behaviors can cause Environmental Disadvantage?

(5)

A

Substance abuse

Neglect

Low socioeconomic status

Abuse (emotional, physical, sexual)

Neglect (abandonment, poor supervision, poor nutrition/clothing)

100
Q

How can Environmental Disadvantage impact language?

3

A

Decreased motivation to speak

Decreased language developmental models

Decreased opportunities to have normal social interactions and language learning

101
Q

How common is Abuse/Neglect?

A

40 million children

102
Q

Are children with developmental disorders and language impairments more likely to be abused than typically developing children?

A

Yes

103
Q

How can Abuse/Neglect affect language?

5

A

Reduced vocabulary growth

Shorter MLUs (deficits persist into adulthood)

Difficulties using language to discuss feeling and needs, convey abstract concepts

Poor reading/literacy

Poor pragmatic skills

104
Q

What is Fetal Alcohol Spectrum Disorder?

3

A

Substance abuse during prenatal development

Alcohol interferes with cell chemical processes

Cocaine and related drugs increase risk of premature delivery

105
Q

What Caregivers Environmental Factors can occur with Fetal Alcohol Spectrum Disorder?

(2)

A

Poor child care and supervision

Decreased positive communication exchanges and teaching opportunities

106
Q

What are common Characteristics in Fetal Alcohol Spectrum Disorder?

(6)

A

Flat upper lip

Flattened philtrum

Flat midface

Low birth weight

Small stature

Slow weight gain

107
Q

How does Fetal Alcohol Spectrum Disorder affect the Central Nervous System?

(4)

A

Smaller cranium at birth

Structural brain abnormalities

Developmental delays in feeding and speech and language

Sleep disturbances

108
Q

What are the Clinical Implications for children with Fetal Alcohol Spectrum Disorder?

(4)

A

Legal duty to report maltreatment!

Increased risk of Otitis Media, ADHD, and behavioral challenges

Deficits in Executive Function, language processing, and social skills (pragmatics)

May have sensory deficits (need a multidisciplinary team)

109
Q

What are Assessment Goals for Nonspeaking Children?

3

A

Determine the children level of comprehension

Determine if any intentional communication is occurring and for what purposes

Consideration of testing to be used

110
Q

How can Alternative and Augmentative be used for Nonspeaking Children?

A

A bridge between current communication level and verbal communication

111
Q

What disorders create
Severe Speech-Motor Disorders?

(4)

A

Cerebral palsy

Cleft palate

Apraxia

Dysarthria

112
Q

What do we want to look for in Severe Speech-Motor Disorders?

A

Physical impairments (consult OT and PT)

113
Q

What should we be concerned about in Severe Speech and Physically Impairment (SSPI)?

(3)

A

Limited sensorimotor interactions with people and objects because of physical limitations

Limited access to communication systems due to limited knowledge of parents/case managers/SLPs

Limited provision of AAC products and devices due to cost (Not all SLPs are comfortable with AAC)

114
Q

What is Low Tech AAC?

A

Picture symbols and object schedules

115
Q

What do you need to create Low Tech AAC?

2

A

Need computer, color printer, laminator

Possibly Boardmaker program

116
Q

What are the different types of Voice Output Communication Systems?

(4)

A

One message (Single switch)

Multiple messages (Go Talk 20, Cheap talk 4/8, Tech plus 32)

Dynamic display (Tobii Dynavox, Prentke Romich, Saltillo)

Ipad applications

117
Q

What do you need when starting AAC use?

7

A

Assessment and intervention plan

Look at speech and language skills including Articulation (apraxia, dysarthria)

Look at receptive and expressive language skills

Look at motor skills (fine motor, gross motor)

Look at visual skill (eye gaze needed)

Look at cognitive and motor abilities (Do you need mount?)

Family support and training needs

118
Q

What is the only prerequisite for AAC?

A

Consciousness

119
Q

What is Childhood Apraxia of Speech?

A

A neurological childhood speech disorder in which precision and consistency of movement underlying speech are impaired in the absence of neuromuscular deficits….results in speech sound errors and prosody.

120
Q

How does Childhood Apraxia of Speech differ from SSPI?

A

There is no underlying neurological weakness or impairment

121
Q

How do we assess Childhood Apraxia of Speech?

2

A

Look at volitional speech motor movements – Oral Peripheral Exam

Mouth, lips, tongue, sequencing (diadochokinetic)

122
Q

How do we differentiate the 2 types of CAS?

2

A

Inconsistent production of stress – naming 2 syllable words

Variation in the timing of speech – prosody

123
Q

How do we plan intervention in CAS?

3

A

MOTOR Approaches – masses practice, drilling

PROSODIC Approaches – analyze words into syllables, blending and timing with stress

Consider AAC – low to high tech to support language and speech development

124
Q

What goals should we set for Nonverbal Children with ASD?

A

Establish intentional and functional communication

125
Q

What can be comorbid in Nonverbal Children with ASD?

3

A

Apraxia of speech

ADHD

Other conditions

126
Q

How should we design intervention for Nonverbal Children with ASD?

(5)

A

Start with gestures : signs with verbalizations

Picture boards (Need to be meaningful)

Choose core words that are powerful

Talk with parents to see what is important to them!

Work with parents, teachers concerning supporting AAC use

127
Q

How should we design Intervention for children with ASD?

5

A

Direct therapy is recommended!

Multidisciplinary therapy is recommended

OT – address sensory issues, support language development, and help with fine motor skills needed if use AAC

PT - address positioning issues, gross motor, and support language development.

Parent training is vital!

ECU Language Disorders (12 decks)

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