language disorders in children and child language development

Question 1

risk factors for language disorders

Answer 1

Natal conditions:
- Prenatal (e.g., maternal substance abuse or infection).
- Perinatal (e.g., abnormal labor, brain injury at birth).
- Neonatal (e.g., prematurity, birthweight, poor feeding, infection).

Genetic syndromes (e.g., Down Syndrome, family history of language disorders).

Environmental factors (e.g., poverty, neglect, abuse).

Prelinguistic communication deficits (e.g., excessive or no gesture use, little-no eye contact or babbling).

Failure to respond or follow simple instructions.

Lack of social smile or interest in social play.

Delayed first words.

Impaired learning of speech sounds.

Question 2

SLI Description

Answer 2

Impairment is specific to language and not secondary to any other etiology/condition.
Sequence of language development is same as TD.
Heterogenous group, affecting different components of language.

Question 3

specific characteristics of SLI

Answer 3

Literacy
At risk for later problem with reading and writing.

Question 4

sli also has deficits in

Answer 4

Deficits in the following cognitive domains: planning/organization, processing speed, attention and task-shifting, working memory, emotional regulation.

Question 5

intellectual disability definition

Answer 5

Defined as “disorder with onset during developmental period that includes deficits in both intellectual and adaptive functioning in conceptual, social, and practical domains”.

Question 6

does intellectual disability have language disorders associated? how much? what kind?

Answer 6

Language tends to be the most impaired, but is delayed rather than abnormal

Poor morphology.
Reduced receptive and expressive syntax.
Poor understanding of abstract concepts.
May be passive or physically aggressive communicators (from frustration).

Question 7

asd definition

Answer 7

Defined as “persistent deficits in social communication and social interaction across multiple contexts, as manifested by deficits in social-emotional reciprocity, nonverbal communicative behaviours, and in developing/maintaining/understanding relationships”.

Question 8

asd is generally characterized by (less important)

Answer 8

Generally characterized by: lack of responsiveness/awareness of people, preference for solitude and objects, dislike of physical touch, stereotypic body movements, insistence on routines, hyper/hypo-sensitivity to stimulation

Question 9

Articulation Phonology
Morphology
Syntax
Semantics
Pragmatics

in ASD

Answer 9

Articulation Phonology
Slow acquisition of sounds (reflecting disinterest).

Morphology
Omissions (e.g., plural, conjunctions).
Pronounce reversals (e.g., “you” for I, referring to self in 3rd person).

Syntax
Use of short, simple sentences.

Semantics
Underextensions.
Deficits in comprehension (especially abstract or figurative language).
Lack of understanding of word relationships.
Language in meaningless manners (e.g, echolalia, perseveration).

Pragmatics
Lack of interest in communication.
Preference for environmental noises > human voice.
Difficulty establishing joint references.
Lack of eye contact.
Poor topic initiation and maintenance.

Question 10

Traumatic Brain Injury

what is it

Answer 10

Cerebral damage by external force, which can be focal or diffuse.

Question 11

in tbi, Language deficits are primarily due to

Answer 11

Cognitive impairments (e.g., memory, attention, information processing speed, organization, awareness of difficulties).

Question 12

are standardized tests good for tbi? what about fasd/fae

Answer 12

no. especially insensitive to problems

Question 13

tbi characteristcs

Answer 13

Syntax
Reduced MLU.

Semantics
Problems with word retrieval.

Pragmatics
Poor turn-taking.
Reduced topic maintenance (related to cognition).

Literacy
Poor reading and writing (resulting in poor academic performance).

Question 14

Cerebral Palsy definition

Answer 14

Defined as “a group of symptoms associated with brain injury (pre/peri/post-natal) that affects the nervous system in still-developing children, resulting in musculature incoordination and associated problems”.

Question 15

types of CP paralysis

Answer 15

Paralysis may be (1) hemiplegic, affecting 1 full side of body, (2) paraplegic, affecting lower trunk/limbs of body, (3) monoplegic, affecting 1 limb of the body, (4) diplegic, affected 2 arms or 2 legs, (4) quadriplegic, affecting all 4 limbs.

Question 16

classification of CP

Answer 16

Classified as ataxic (cerebellar damage - disturbed balance, gait, coordination), athetoid/dyskinetic (indirect pathway of basal ganglia - slow, involuntary movements), spastic (direct pathway of basal ganglia and motor cortex - increased tone/rigidity - most common).

Question 17

Language deficits in CP are related to

Answer 17

dysarthria and/or associated issues (e.g., HL, ID).

Question 18

o social environmental factors & language disorders

Answer 18

**Limited Access to Healthcare. **
Children with inadequate medical treatment will miss more school when sick.
Children who come to school sick have difficulty concentrating and learning.
More likely to have untreated ear infections.

**Low Socioeconomic Status. **
Mothers are less likely to have adequate prenatal care, affecting fetal development (associated with language/cognitive problems).

**Low Educational Levels of Caretakers. **
Reduced oral language stimulation.
Reduced toys and books to stimulate language.
Reduced opportunities for literacy.
Reduced variety of enriching experiences (e.g., going to zoos, museums)

Question 19

how can you combat the risk of poverty on language development

Answer 19

access to literacy materials and parental education

Question 20

Neglect & Abuse and language disorders

Answer 20

NA cause language disorders, with degree based on extent/severity of NA.
- If physical/social isolation, resulting in reduced language stimulation.
- If punished when speaking, only speaking “for necessity” and resulting in reduced oral language practice.
- If punished for exploration/risk-taking that is necessary for development.

Tend to have expressive language delays.
May also result from language disorders (children with special needs are more subject to NA due to parental frustration).

Question 21

FASD associated with:

Answer 21

Pre/postnatal growth problems (e.g., craniofacial disorders).
Abnormal development of CNS (e.g. microcephaly, ID, motor development) and major organ system (e.g., trachea, heart).
Hearing and auditory processing problems.
Swallowing problems (e.g., impaired sucking reflex at birth).
Speech and language disorders.
Behaviour problems (e.g., ADHD, poor play and social skills).
Learning and academic problems.

Question 22

ADHD definition

Answer 22

“difficulties with inattention, hyperactivity, and impulsivity for at least 6M before 7Y”.

Question 23

adhd Manifests itself most through ___

Answer 23

pragmatics and social interaction (if pragmatics not evaluated, would not qualify for services):

Question 24

Assessment Principles & Procedures : general
prior to ALL assessments, must obtain any available:

Answer 24

medical history, audiological or visual evaluations, psychological data, and interview family members.

Question 25

prior to assessment With school-aged students, must additionally obtain:

Answer 25

data on educational achievement, writing samples, understanding curriculum, and interview teacher(s).

Question 26

Screening is typically done through

Answer 26

language samples but some formal tools exist

Question 27

Standardized Assessment are used to

Answer 27

quantitatively compare a child’s scores to children of same age (e.g., “language age”, percentile rank, SD).

Question 28

standardized assessments shouldnt be the only assessment because:

Answer 28

limitations: unnatural sample, not enough Qs for each language feature, not a national sample of children, culturally and linguistically insensitive, no family involvement.

Question 29

Alternative Assessment Approaches

Answer 29

• Aim to assess language in more naturalistic form, considering child’s daily functioning.
• For example, assessments which are:
  Criterion Referenced
  Dynamic
  Portfolio

Question 30

Language Sampling

Answer 30

• Recording a student’s language under conditions that are relatively typical (e.g., peers, family members).
• Multiple samples should be recorded to ensure representative.
• May be in/formally analyzed.

Typically include:
- MLU (# morphemes / # utterances).
- Brown’s 14 Grammatical Morphemes
- Type-Token Ratio (# different words in sample / # words in sample)

Question 31

infants and toddles with established risk

Answer 31

(e.g., congenital disorder)

Question 32

at-risk infants and toddlers

Answer 32

(e.g., pre/post-natal complications, chronic middle ear infections, dysfunctional interactions, parent education, lack of health insurance).

Question 33

Early warnings that a child may have a language impairment include:

Answer 33

(1) difficulty establishing eye contact/joint attention/joint reference,
(2) too much or no gesturing at all,
(3) reduced, non-complex babbling.

Question 34

“late talkers” refers to children with

Answer 34

an expressive delay at 24-30M.
- They are typically less vocal, exhibit smaller sound inventories, delays in morphosyntactic development, smaller vocabularies, and problems with narratives.
- Even if they catch up, must continue to monitor.

Question 36

Specific Assessment Procedures
for infants & toddles

Answer 36

• Often conducted through parent-report questionnaires.
• Receptive and expressive language (use developmental milestones).
• Attention and physiological state (e.g., alertness, toleration of handling).
• Hearing (if suspected loss, refer to audiologist).
• Readiness for communication (i.e., if reciprocal relationship with environment).
• Infant-caregiver interaction: infant’s mood/affect; if caregiver modifies interaction if shown negative cues; how caregiver visually focuses on infant, handles infant, and expresses affection.
• Play activities with 1+ other children (e.g., if cooperative, aggressive) and type of play (i.e., solitary, parallel, associative, cooperative).

Question 37

4 types of play

Answer 37

solitary play: a child playing with blocks alone in a corner.

parallel play: two or more children playing with blocks near each other but not talking with each other.

associative play: two or more children playing with blocks building the same thing, talking with each other but not working together to create something.

Cooperative play is when children play together with shared goals.

Question 38

for infants with language disorders, general assessment guidlines include (when, what to assess, what type of information to possess)

Answer 38

Begin assessment as early as possible and repeat throughout childhood.
Assess family dynamic, resources, and communication patterns (e.g., frequency, languages).
Obtain information on prenatal, perinatal, and postnatal health and development.

Question 39

for pre-school & elementary age kids,

Question 40

Response to Intervention (RtI) is a model where

Answer 40

at-risk students are given targeted individual or small-group support in classroom before special education referral; if they are still struggling, they will get a referral (dynamic assessment).

Question 41

Description of Language Disorders in Adolescents

Question 42

Goals should focus on

Answer 42

academic (e.g., literacy) and social language (e.g., behaviours that would create social penalties).

Question 43

Service Delivery Models

Answer 43

1. Individual Intervention (using “pull out” model or in-class).
2. Small-Group Intervention (using “pull out” model or in-class).
3. Indirect Intervention (i.e., SLP sets goals and carried out by parent, aide, etc.)

Question 44

Discrete Trial Procedure

Answer 44

• Used for initial stages to teach the structure; it is not natural and meant to generalize.
• SLP places stimulus picture in front of child → asks relevant question → immediate models correct response → child imitates → SLP reinforces for correct imitation or feedback for incorrect respond.

Question 45

Basic Behavioural Techniques

Answer 45

Basic Behavioural Techniques
Instructions: set clear expectations for what you want to see.
Model: good for when the skill is not yet established.
Prompt (give hint/cues).
Shape: complex response broken down into smaller components and taught sequentially.
Manual guidance (i.e., hand-over-hand).
Fade.
Immediate, contingent feedback/reinforcement.

Question 46

Expansion

Answer 46

Expansion
SLP expands child’s telegraphic utterance by making it more grammatically complete.

Question 47

Extension

Answer 47

Extension
SLP expands child’s telegraphic utterance by making adding more detail. Working on expressive L

Question 48

Focused Stimulation

Answer 48

Focused Stimulation
SLP repeatedly models a target structure repeatedly during a play activity.
SLP does not correct incorrect responses, but instead immediately models the corresponding response.
Focus is on providing high exposure and less on child’s production.

Question 49

Milieu Teaching

Answer 49

To teach functional communication skills through natural, everyday verbal interactions using following techniques:
1. Incidental Teaching. Adult waits for child to initiate response → prompts an elaboration of the response (i.e. through question/command) → praise.
2. Mand-Model. Adult has attractive stimulus (communication temptation) → requests response (e.g., “tell me what you want”) → gives stimulus OR a model to be imitated → praise.
3. Time Delay. Adult has attractive stimulus (communication temptation) → expectantly waits for a response (for set # of seconds) → gives stimulus OR a model to be imitated → praise.

Question 50

Joint Routines & Interactions

Answer 50

• Using routines and repetitive activities with targets built-in (e.g., sessions begins with same story).
• Establishes interaction and confidence in the child, because they know what’s to come.

Question 51

Joint Book Reading

Answer 51

• SLP and child read book together for repetitive use/practice of same concepts.
• SLP can use prosodic features to draw attention to specific structures (e.g., vocabulary, grammar).
• Establishes interaction (joint attention) and confidence in the child, because they know what’s to come.

Question 52

Narrative Skills Training

Answer 52

• Using scripts based on everyday events (e.g., birthday parties, eating in restaurant, running a store).
• Getting children involved in everyday conversations (e.g., weather, hobbies).
• Repeating same stories so the child can memorize characters and temporal sequence; then, pausing at important moments for the child to jump in.
• Using video model of an interaction between typically-developing children.
• Letting children act out stories.

Question 53

Story Grammar

Answer 53

1. Setting Statement. The introduction - who, what, when, where.
2. Initiating Events. The episode that begins the story.
3. Internal Response. The characters’ thoughts, emotions, reactions.
4. Story Theme. The main idea of the story.
5. Character Goals. What the characters are trying to accomplish.
6. Attempts. The action(s) the characters are taking to achieve their goal(s).
7. Direct Consequences. The results of the characters’ action(s).
8. Conclusion. The conclusion of the episode; the lessons or morals learned.

Question 54

Recasting

Answer 54

SLP expands child’s telegraphic utterance by changing the syntactic form (e.g., declarative → interrogative, active → passive).

Question 55

PARALLEL TALK

Answer 55

SLP narrates (describes, comments) on what the child is doing.

Question 56

SELF TALK

Answer 56

SLP narrates on what their doing while playing with the child.

Question 57

Literacy Skills

Answer 57

• Educate family on importance of literacy-rich home (e.g., trained to read more to child, encourage printing of alphabet and writing).
• Promote literacy in therapy by using storybooks (e.g., complex language, print awareness) and accompanying pictures/objects with printed words.
• Target morphological awareness and phonological awareness (rhyming, syllable awareness, phoneme isolation, blending and segmenting) in therapy.

Question 58

Executive Functioning

Answer 58

Targeting both language skills and executive functioning in therapy for cross-domain interaction and improvement.