Language Impairment Flashcards

1
Q

Language impairment

A

Heterogeneous group
 Developmental and/or Acquired Disorders
and/or Delays
 Affects spoken and/or written language in comprehension and/or production
 Involves one or more aspects of language
 NOT a language difference

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2
Q

ASHA defines language disorder as

A

ASHA defines language disorder as the impairment or deviant development of comprehension &/or use of a spoken, written, and other symbol system
 May involve language form, content or use
 Can have deficits in receptive &/or expressive
language skills
 Can range from mild to severe

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3
Q

Communication disorder diagnose in childhood

A

 Expressive language disorder
 Mixed receptive and expressive language
disorder
 Phonological disorder
 Stuttering
 Communication disorder not otherwise specified

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4
Q

Expressive disorder

A

Limited vocabulary
 Shorter and less complex sentences  Production of Grammatical errors
 Difficulty with word recall

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5
Q

Mixed receptive and expressive

A

Same as expressive in addition to
 Difficulty understanding or comprehending
 Difficulty responding to simple directions
 Decreased ability to identify pictures or objects
 Decreased response to name
 Decreased ability to comprehend spatial relations, temporal concepts
 Expressive and mixed disorders can co-occur with mental retardation, sensory deficits, or environmental deprivation.

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6
Q

Delayed early communication skills

A

Rate of intentional communication may be lower in pre-linguistic period, leading to poorer language outcomes
 Limited vocalizations and fewer gestures
 Less joint action and lower social interaction
 Slow acquisition of first words
 May demonstrate delays in comprehending simple words or phrases
 Slow onset of word combinations
 Limited phonetic inventory
 Between ages 2-5 should begin to acquire more complex sentence structure marked by increase of usage of inflectional morphemes

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7
Q

Red flags in development disorders

A

Limited or no babbling by 12 months
 No gesturing by 12 months
 No single words by 16 months
 No two-word spontaneous phrases by 24 months
 Any loss of any language or social skills at any age

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8
Q

Signs of disorders shown in kindergarten

A

Difficulty with all elements of language including pragmatics
 Verb phrase elaboration
 Past tense verb forms
 Early problems learning to read
 Poor social interaction and academic success

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9
Q

Biological factors

A

Genetic/ chromosomal disorders- Down Syndrome
 Sensory Impairments- hearing loss, visual impairment
 Neurological Disorders- Seizure Disorder, Cerebral Palsy
 Congenital Malformations- Cleft Palate
 Developmental Disorders- Autism, Mental Retardation

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10
Q

Environmental factors

A

Age an health of mother  Nutrition
 Drug use/ alcohol
 Exposure to infection
 Failure to thrive
 Prematurity/low birth weight
 Child Abuse and Neglect

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11
Q

Associated disorders and related causes

A

Mental Retardation/intellectual disability  Learning Disabilities
 Specific Language Impairment
 Autism Spectrum Disorder
 Brain Injury
 Neglect and Abuse
 Fetal Alcohol Syndrome

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12
Q

Mental retardation/ intellectual disability

A

Now called Intellectual Disability
 Characterized by:
 *Substantial limitations in intellectual functioning
 *Significant limitations in adaptive behavior
 *Originates before age 18
 Severity based on IQ, ranges from mild to profound

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13
Q

Effects of mental retardation/ ID

A

Cause can be biological or socioenvironmental.
 Organization of information is challenging
 Memory and retrieval of information is poor.
 The more severe the MR, the more difficulty the person will have in discriminating.
 Children with MR/ID vary greatly in their communication abilities.

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14
Q

Language characteristics of MR/ ID

A

Language abilities can be below cognitive abilities
 Slower rate of development
 Later, begin to deviate from typical
developmental patterns
 Use shorter, more immature forms
 All areas of language can exhibit deficits.

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15
Q

Learning disabilities

A

Heterogeneous
 *Difficulties in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematics.
 *3% of all individuals have LD, but severity varies widely
 Language-learning disability-Primarily difficulty learning and using symbols.
 Affects males more than females

As many as 80% of those with LD have some form of reading problems.
 Organization is inefficient, so memory is less accurate and retrieval is slow.

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16
Q

6 Categories of learning disabilities

A

Six categories of characteristic
 *Motor, attention, perception, symbol, memory,
emotion

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17
Q

Attention Deficit Hyperactive Disorder (ADHD)

A

Attention Deficit Hyperactive Disorder (ADHD)
 *Underlying neurological impairment in executive
functioning that regulates behavior.

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18
Q

Dyslexia

A

 Dyslexia
 *Difficulty comprehending or producing written
symbols

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19
Q

Lifespan issues with LD

A

Little interest in language or books in preschool
 Slow oral language development
 May require special education services
 Can be successful with accommodations in the classroom
 Some receive special services while be included in regular classroom
 Some children with LD seem to outgrow aspects of their disability
 Some require lifelong adaptations.

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20
Q

Specific language disability (sld)

A

Significant limitations in language, with no known neurological, sensory, behavioral or cognitive deficits
 Occurs more often in boys
 Strong family history of SLI
 Limited vocabularies, late onset of first words, shorter utterances and sentence length, word finding deficits and omissions grammatical morphemes
 Exhibit some information processing and memory problems
 Expressive language delay is greater than receptive
 Problems with reading once they begin school

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21
Q

Language characteristics of sli

A

Difficulty with:
 *Extracting regularities from language
 *Registering different contexts for language
 * Constructing word-referent associations for lexical growth
 Inappropriate use of language forms cause pragmatic problems
 Difficulty in grammatical markers
 May speak slowly with disruptions
 Less efficient use of syntax
 Difficulty using context for vocabulary development

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22
Q

Late bloomers

A

 Late bloomers are children who appear to be delayed in the first few years of life, but “catch up” to their typically developing peers by age 4
◦ Though they appear delayed initially, in early years, comprehension tends to be better than “Late Talkers” and LB tend to use more gestures to communicate

23
Q

Late talkers

A

 Late talkers appear delayed early on, and the delay continues past age 4
◦ Typically identified as having a language impairment by this age

24
Q

Genetic chromosomal disorders

A

Fragile x
Sex linked genetic disorder
Most common inherited cause of mental retardation
Down syndrome
Most common chromosome anomaly Trisomy 21

25
Q

Down syndrome

A

Usually demonstrate difficulties with all aspects of communication and language acquisition
 Delayed acquisition of linguistic symbols
 Rely primarily on concrete word meanings
 Shorter less complex sentences
 Phonological processes
 Poor attention and organization
 Poor memory skills

26
Q

Primary sensory deficits

A

Visual impairment
Visual difficulties may create a greater delay in early gestural communication development
Usher syndrome which may affect both the visual and auditory systems. Most common cause of deafness/ blindness. Born with hearing loss and progressive loss of vision
CHARGE association present at birth C=coloboma
H=heart, A=atresia choanae, R=retarded growth and development, G=genital, E=ear

27
Q

Usher syndrome

A

Usher syndrome which may affect both the visual and auditory systems. Most common cause of deafness/ blindness. Born with hearing loss and progressive loss of vision

28
Q

Charge syndrome

A

CHARGE association present at birth C=coloboma
H=heart, A=atresia choanae, R=retarded growth and development, G=genital, E=ear

Facial Asymmetry
 Smaller Lower Jaw
 Facial Paresis
 Cleft lip and/or palate  Feeding Disorders

29
Q

Intervention with change syndrome

A

Providing compensatory strategies such as hearing aids or cochlear implants
 Glasses or eye surgery
 Remediation strategies to train functional
skills
 Speech and language therapy.
 Augmentative communication systems for individuals who are deaf and blind

30
Q

Neurological disorders

A

Cerebral Palsy (static encephalopathy)
• Results from brain injury or anomaly that occurs early in development
• Occurs in 2-5 children per thousand births
• Can occur during pregnancy (genetic
condition)
• Can occur at birth (asphyxia) or after birth due to head trauma
• Prematurity

31
Q

Cerebral palsy

A

Children with CP are at risk for
 Seizures
 Feeding difficulties
 Speech and language delays  Learning disabilities
 Mental retardation

32
Q

SpinaBifida

A

SpinaBifida
• Incomplete closure of the neural tube
• Vitamin supplements with folic acid have shown to significantly reduce the occurrence
• 80 percent of cases results in decreased absorption of cerebro spinal fluids which causes hydrocephalus and learning disabilities . Spina Bifida itself does not cause DLD

33
Q

Children exposed to drugs and alcohol

A

 Low birth weight, microencephaly, heart problems, developmental delay
 Experience irritability/overstiumulated
 Failure to thrive
 Disruptive sleep cycles
 Difficulty sucking
 General developmental delays
 Hyperactivity/distractibility

34
Q

Autism

A

Considered to be a neurological disorder, but specificity not identified
 Dominant in boys
 Three components for a diagnosis
 Qualitative impairment in social interaction
 Qualitative impairment in communication
 Restricted repetitive/ stereotyped behaviors
 Rett’s Disorder,Childhood disintegrative disorder, Asperger’s, PDD-NOS

35
Q

Autism cont

A

Some children never develop speech or functional language
 Others develop functional, but idiosyncratic use
 Because of limited communication skills, you see
an increase in behaviors
 About 50% have MR
 Significant deficits in the area of semantic language skills; pronoun usage
 Perseveration on topic
 Echolalia
 Limited capacity for joint attention
 Limited capacity for symbol usage- e.g. play skills

36
Q

Correlation with Autism

A

PERVASIVE DEVELOPMENTAL DELAY (PDD)  HYPERLEXIA
 SEMANTIC-PRAGMATIC DISORDER
 ASPERGERS SYNDROME (AS)

37
Q

Asperger’s syndrome

A

 Language is not a problem
 Score average or above average on
intelligence tests
 Have same social problems or limited interests as children with autistic disorders

38
Q

Pervasive developmental disorder include

A

Autism
 Rett’s disorder
 Childhood disintegrative disorder
 Asperger’s
 PDD/NOS most common form of autism

39
Q

Characteristics of PDD

A

Difficulty with verbal communication, including problems using and understanding language.
 Difficulty with non-verbal communication, such as gestures and facial expressions.
 Difficulty with social interaction, including relating to people and to his or her surroundings.
 Unusual ways of playing with toys and other objects.
 Difficulty adjusting to changes in routine or familiar surroundings.
 Repetitive body movements or patterns of behavior, such as hand flapping, spinning and, head banging.
 Changing response to sound. (The child may be very sensitive to some noises. Also, seem to not hear others when their name is called.
 Temper tantrums
 Difficulty sleeping
 Walk on tip-toes
 Lining up toys in a row
 Lack of eye contact or fleeting eye contact

40
Q

Retts syndrome

A

Girls only
 Most common cause of mental retardation in
females
 Normal development form 6-18 months with a period of stagnation and then by a rapid regression in motor and language skills
 Screaming fits and inconsolable crying are common

41
Q

Childhood disintegrative disorder

A

Average age of onset is between 3 and 4 years of age
 Communication and social skills are normal up until this age
 Loss of vocabulary is extremely dramatic
 Seizures
 Low IQ
Communication difficulties

 Decreased expression of intentions
 Failure to develop joint attention to objects  Echolalia (immediate and delayed)
 Poor eye contact
 Delayed symbolic and pretend play skills

42
Q

Identification of developmental language delay

A

AUTISM-guidelines for immediate further evaluation for possible autism or PDD
 No babbling by 12 months
 No gesturing by 12 months (bye-bye)
 So single word by 16 months
 No eye contact
 No response to name or commands
 Any loss of language or social skills at any age

43
Q

Brain injury

A

Includes traumatic brain injury (TBI, stroke, congenital malformation, convulsive disorders, and encephalopathy

44
Q

TBI

A

Diffuse brain damage due to external force
 1 million children and adolescents in US
 Site and extent of the lesion, age of onset, and age of injury impacts recovery/post accident function
 Range of cognitive, physical, behavioral, academic, and linguistic deficits
 Social disinhibition may occur

45
Q

Lifespan issues with TBI

A

Immediately after accident
 *Possible unconsciousness and amnesia
 *Disoriented
 *Physical and personality changes
 Recovery may take years
 *Spontaneous recovery in the first months
 Neural recovery is unpredictable and irregular
 Young children often recover quickly
 *Need to recover language AND continue to learn language
 Often subtle cognitive and social deficits persist

46
Q

Language characteristics of TBI

A

Evident even after mild injuries
 Some deficits remain long after injury
(pragmatics)
 Language Comprehension and higher level language are often affected, but not form
 Word retrieval, naming, object description are difficult
 Narration is often difficult

47
Q

Neglect and abuse

A

1 Million children per year in the US
 Child-mother attachment more significant in
language development and maltreatment
 Lifespan Issues
 *Possible recurring physical, psychological and emotional problems
 LANGUAGE CHARACTERISTIC
 Pragmatics is most affect language area
 *Less talkative with fewer conversational skills
 *Less likely to volunteer information
 Shorter and less complex utterances

48
Q

Other language impairment

A

Nonspecific Language Impairments  Late Talkers
 Childhood Schizophrenia
 Selective Mutism
 Otitis Media
 Children who receive cochlear implants.

49
Q

Assessment

A

Testing
 Standardized Tests
 Dynamic Assessment
 Sampling
 *Select variety of discourse types and contexts
 *Record for later transcription
 *Analysis
 Quantitative and qualitative measures
 Code Switching

50
Q

Intervention

A

Goal is effective use of language in everyday situations.
 Goal of intervention is to improve functioning in the identified deficit area.
 Child’s abilities determine methods selected.
 Training should be within meaningful
contexts when possible.
 EVIDENCED-BASED PRINCIPLE
 Targets should not focus on one deficit area

51
Q

Intervation cont

A

Basic tenets of good teaching behavior
 *Model desired behavior
 *Cue client to respond
 *Respond with reinforcement or corrective feedback.
 *Plan for generalization.
 Success occurs when there is generalization to the everyday language environment.

52
Q

Early Intervation

A

Family is the center of services.
 Facilitate family’s ability to support their
child’s development.
 Provided in a variety of settings, home- based, school or center-based, preschools
 Provide intervention in the child’s natural environment
 Provide within the context of the child’s daily routines.

53
Q

CPSE

A

After or close to age three
 Paid for by the Board of Education
 Center-based or home-based
 Inclusion Classes where kids who are typically developing are mixed with children who are delayed in development