Midterm

Question 1

Define and differentiate communication, language and DLD.

Answer 1

Communication: umbrella term that includes sending and receiving messages that are written or spoken, verbal or non-verbal. Include voice, fluency, and artic.
Language: symbolic and rule governed system that is generative and dynamic. Include expressive and receptive language.
DLD: child’s language skills are consistently below the average for a child of that age group

Question 2

What are some risk factors that can impact language development?

Answer 2

Genetics and congenital conditions, prenatal factors, prematurity, environment, neglect, malnutrition, exposure to alcohol and other drugs.

Question 3

What are some of the main areas of assessment for children 0-9 months?

Answer 3

Feeding assessment, overall development, parent-child communication, vocal assessment, oral motor

Question 4

What are some of the main areas of assessment for children 9-18 months?

Answer 4

Looking for the jump to intentional communication and presence of functional communication, using observation of play, parent report, and if initiation can be elicited

Question 5

What are some of the main areas of assessment for children 18-36 months?

Answer 5

Assessment of play and gestures, screen for skills and assess risk factors, receptive language assessment, communicative intent, sematic/syntax lexicon, word combinations, semantic relationships

Question 6

What language skills are expected from 0-9 months?

Answer 6

(Perlocutionary) Functional communication such as smiles, cries, and coos, including eye contact, joint attention, and turn-taking

Question 7

What language skills are expected from 9-18 months?

Answer 7

(Illocutionary stage) Express themselves through intentional signals to others such as gestures, protowords, and babbling to direct attention, with first word between 11-13 months.

Question 8

What language skills are expected from 18-36 months?

Answer 8

Vocabulary size expands immensely, begin using 2-4 word sentences, receptive language precedes expressive for vocab and sentence length

Question 9

Describe language interventions for children 0-8 months, including activities to target these language skills.

Answer 9

Things that are tactile, visual, auditory, or kinesthetic ex. rhyming (if you’re happy and you know it), repetition activities. TIPS: take turns, imitate, point things out, set the stage.

Question 10

Describe language interventions for children 9-18 months, including activities to target these language skills.

Answer 10

Work closely with parents, communication temptation, pair words+actions, words+objects, words+descriptors ex. Songs, books, routines, toys

Question 11

Describe language interventions for children 18-36 months, including activities to target these language skills.

Answer 11

Parent training (ex. Hanen), hybrid (Prelinguistic Milieu Teaching Methods), child focused (routines and scripts, ex. Roman’s cooking corner, funny or unusual events, choose target words

Question 12

Describe the typical language norms for children 36-42 months. Include pragmatics, semantics, syntax, and phonology.

Answer 12

Pragmatics: more flexibility in requesting, direct requests decrease in frequency, narratives are primitive with theme and some temporal organization
Semantics: understanding of basic color words, use and understanding of basic kinship terms, semantic relations between adjacent and conjoined sentences include additive, temporal, causal, and contrastive.
Syntax: Brown’s stage IV, first complex sentences appear, auxiliary verbs are placed currently in questions and negatives, irregular past tense, articles, and possessives appear
Phonology: decreased reduplication, syllable deletion, assimilation, and final consonant deletion, continued use of fronting, cluster reduction, and liquid simplification.

Question 13

Describe the typical language norms for children 42-48 months. Include pragmatics, semantics, syntax, and phonology.

Answer 13

Pragmatics: begin new functions such as reporting on past events, reasoning, predicting, expressing empathy, creating imaginary roles and props, and maintaining interactions
Semantics: use and understanding of when and how questions and basic size vocab, understanding basic shape words, use of conjunctions and, because to conjoin sentences
Syntax: Brown stage IV-V, emerging complex sentence types include full prepositional clauses, wh- clauses, simple infinitives, and conjoined
Phonology: use of cluster reduction decreases

Question 14

Describe the typical language norms for children 48-60 months. Include pragmatics, semantics, syntax, and phonology.

Answer 14

Pragmatics: ability to address specific requests for clarification increases, narratives are chains with some plot but no high point or resolution
Semantics: knowledge of letter names and sounds, numbers and counting emerges, use of conjunctions when, so, because, and if.
Syntax: Brown’s stage V, develop Be verbs, regular past tense, third person /s/, past tense auxiliaries
Phonology: speech is 100% intelligible, ability to segment words into syllables emerges, most simplification processes stop.

Question 15

List the process stapes for determining if a child has DLD.

Answer 15

1. Consider the impact to function
2. Familiarity with local language: are the unfamiliar with the local language but competent in another? If yes, not DLD
3. Consider the prognosis: are the features suggestive of a poor prognosis?
4. Associated biomedical condition: if yes = language disorder associated with X, if no = developmental language disorder
5. Seek out additional information such as co-occuring disorders, risk factors, and areas of language impairment.

Question 16

What are some key language assessment criteria for children 3-5 years?

Answer 16

Vocabulary: test receptive first but treat expressively (formal or informal)
Syntax and Morphology: assess expressively and receptively, look for contingent responses that relate semantically to the previous utterance.
Risk factors
Pragmatics, literacy, and play

Question 17

What are some intervention procedures for children ages 3-5 years?

Answer 17

Clinician-directed drill-based (good for elicitation but not generalization), can be more naturalistic
Child-centered includes parent training, language facilitation (in any context), recasting
Facilitated play can model higher levels of play and introduce scripts, can target functional language
Additional considerations regarding conversation and narratives

Question 18

Describe an intervention for children aged 3-5 years.

Answer 18

Family centered care that takes place in the home, preschool, private clinical, or public Children’s treatment Centers.
Language goals are often forms of expression for the ideas and concepts the child has, enabling them to understand others, and giving the child the tools to make communication effective, efficient, and rewarding, and to strengthing the oral language basis for success in literacy
Can also use focused stimulation or speech.

Question 19

Give the CASLPO definition of culture.

Answer 19

Culture embodies the beliefs, customs, values, forms, arts, and ways of life of a particular society, group, place, or time. It encompasses elements such as age, ancestry, colour, race, citizenship, ethnic origin, place of origin, creed, disability, family status, marital status, gender expression, SES, gender, identity, sex, and sexual orientation.

Question 20

How does culture impact assessment and therapy?

Answer 20

Generally immigrant parent can face additional barriers to accessing care such as a language barriers, understanding and accessing services, completing paperwork for referrals, stigma and shame. They may not realize they have the right to these services. As such it is import to have culturally sensitive care in which we have an understanding and empathy for their values, beliefs, and goals.

Question 21

How can learning multiple languages affect language development? How does this need to be taken into account when considering assessment and therapy options?

Answer 21

When bilingual, you must be careful to determine if you are looking at a language delay or a language difference. A language difference is when the child learns their first language at the normal rate but is slower when learning the second language. Further, you must consider is the child is a simultaneous or sequential language learner, how much exposure they have to L2 and how the language norms differ between the two languages. In addition, we need to think about what the catch-up period is, who the reference groups for norms is, and whether or not standardized tests should be administered in L2, as they may not be accurate or culturally sensitive but necessary for admittance to a program.

Question 22

What is the intersectional theory?

Answer 22

Intersectionality is defined as being concerned with simultaneous intersections between aspects of social difference and identity, and forms of systemic oppression at macro and micro levels in ways that are complex and interdependent. For example, women with and without disabilities are more likely to be unemployed or not economically active.

Question 23

What are the three levels of culture?

Answer 23

Cultural Competence: Skills you can learn that makes the care you provide more effective
Cultural Humility: Your ongoing commitment to self-evaluation and longer-term awareness of bias
Cultural safety: Outcome of effective learning and practices on part of individuals and organizations when people feel safe receiving health care

Question 24

Summarize the general principles of post-natal neurodevelopment.

Answer 24

1. Neurodevelopment is characterized by over-development followed by pruning
2. Neurons are born biased for certain functions but uncommitted
3. The ultimate function of cells depends on what other cells they connect with and what input they receive
4. Nervous system develops on a use-it-or-lose-it basis, where developmental plasticity permits correction of minor mistakes resulting in the cortex being somewhat different from the typical pattern

Question 25

Define working memory.

Answer 25

Gateway to and from long term declarative memory involving the frontal systems including the frontal lobes and anterior structures of the limbic system. Generally involved in the control processes (active, voluntary) but not the automatic processes (passive, stimulus-driven), seen as a workspace for executive functions

Question 26

Define declarative memory.

Answer 26

Episodic (semantic with a time frame ex. Had cereal for breakfast), semantic (ex. Can have cereal for breakfast), or lexical (memory for words)
Stored by semantic association, using association cortex

Question 27

Define non-declarative memory.

Answer 27

Skills and habits, emotional associations, and priming

Stored by surface feature association, using basal ganglia and cerebellum

Question 28

Define declarative learning.

Answer 28

Memories are formed in the hippocampal structures and then sent out to the lateral surface of the cortex for storing

Question 29

Define non-declarative learning.

Answer 29

Subcortical structures, such as basal ganglia and cerebellum

Question 30

Compare declarative and non-declarative memory in terms of their development.

Answer 30

Non-declarative: adult-like very early on

Declarative: linear increase around the age of 10

Question 31

When does the striatum come online and how does this affect the motor system?

Answer 31

Striatum comes online (myelinated) around 1.5 years, resulting in functioning of the basal ganglia. This allows voluntary and involuntary movements.

Question 32

When do the pyramidal tracts come online and how does this affect the motor system?

Answer 32

Pyramidal tracts are myelinated around 1 year, connecting the fibres in the motor tract to the lower motor neurons, bringing the coroticospinal tract online. This allows precise control (smooth) of the motor units connected to the LMN. Ex. Scooping becomes pincer grip.

Question 33

When does the frontopontine tract come online and how does this affect the motor system?

Answer 33

Frontopontine tract (connecting the cerebrum to the cerebellum) is myelinated around 2.5 years, allowing the cerebellum to come online and is needed for the control of the LMNs. It allows for trajectory control.

Question 34

Define a motor unit.

Answer 34

A motor unit is a group of muscle fibres that are connected to a single lower motor neuron and contract or relax together. These can be small or large, resulting in either weaker but precise movements or stronger but less precise movements

Question 35

What are the levels of organization/orchestration of the motor unit activity?

Answer 35

First level: firing frequency, the faster the firing the greater the force. When a small force is required, small motor units are activated first. As larger force is required, larger motor units are recruited.
Second and third level: Agnoist and antagonist actions of the muscles move in a reciprocal patters of motor unit activity, the agonist coming on to start the movement and the antagonist coming on after.
Fourth: multiple muscles, multiple times, across multiple joints.

Question 36

What are the different speech sound disorders and their categories?

Answer 36

Phonology: phonological impairment or inconsistent speech disorder
Motor speech: articulation impairment, childhood apraxia of speech, or childhood dysarthrias

Question 37

Define phonology

Answer 37

Speech sounds in a language and the rules about how they are combined

Question 38

What is an inconsistent speech disorder?

Answer 38

A phonological assembly difficulty without accompanying oro-motor difficulties, characterized by highly variable productions, may have planning component.

Question 39

What is a phonological impairment?

Answer 39

A cognitive-linguistic difficulty with learning the phonological system of a language, characterized by pattern-based speech errors

Question 40

What is an articulation impairment?

Answer 40

A motor speech difficulty involving the physical production of specific speech sounds, characterized by speech sound errors typically only involving the distortion of sibilants and/or rhotics

Question 41

What is childhood apraxia of speech?

Answer 41

A motor speech disorder involving difficulty planning and programming movement sequences, resulting in errors in speech sound production and prosody

Question 42

What is childhood dysarthria?

Answer 42

A motor speech disorder involving difficulty with the sensorimotor control processes involved in the production of speech, typically motor programming and execution.

Question 43

What are the 6 areas that inform the guiding principles that underly SSD intervention?

Answer 43

Phonology principles: need to learn the rules that govern sound use, including perception and meaning
Speech perception principles: need diverse opportunities to listen to sounds and judge their accuracy
Motor Learning principles: practice and feedback
Cognition and meta-awareness: phonetic awareness, metaphonology, phonological awareness
Behavioural learning principles: reinforcement increases a behaviour, punishers decrease a behaviour
Neurological principles: practice must be salient, well-timed, and repeated

Question 44

Create a minimal pairs activity.

Answer 44

For a child who drops the final consonant, might use kit and kid if they have one of the sounds, helping the child differentiate between having a sound on the end and not.

Question 45

Define and differentiate constructive and non-constractive phonological interventions.

Answer 45

Constrative: use minimal pair words (word pairs that differ or contrast by one phoneme)
Non-constrative: minimal pair words are an optional component

Question 46

Apply the traditional articulation hierarchy for the ‘s’ target.

Answer 46

Stage 1: Senesory-perceptual (ear) training ex. Silly sally book
Identifying
Locating
Stimulation
Discrimination
Stage 2: pre-praactice instruction – learning how to articulate the target sound using cues as necessary
Snake sound
Show image of the tongue in the /s/ position
Draw a continuous S shape on their arm while making the sound
Stage 3: Practice
Isolation: using your smile /s/
Smile, keep your tongue behind your teeth/gently touching the bump behind your teeth, blow the air to your teeth
Nonsense syllables: say, see, ye, sow, su, practice each 5 times
Words: start with initial /s/ and eventually move to medial, final, multisyllable & s-blends
Sentences: tell me something about (inserts word here)
Stage 4: transfer and carry over
Stage 5: maintenance

Question 47

What are some questions that should be asked when discussing children with speech sound disorders?

Answer 47

Does the child’s phonological error or sound error need to be corrected at this age?
Are the errors affecting the child’s intelligibility or participation?
Do you suspect a phonological disorder or a motor speech disorder and how does that affect your treatment decisions?
Who will provide the therapy and what format would be best?
What evidence is available about frequency, duration and timing to move on (new goals or discharge)?
Recall the child’s language, social-emotional development, learning, motivation. We don’t look at speech in isolation.
What is the family’s preference for goals, involvement, expectations?

Question 48

Define a language learning disability.

Answer 48

A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations

Question 49

Define dyslexia.

Answer 49

An inadequate ability in word identification due primarily to deficiencies in phonological skills, with the involvement of specific brain regions demonstrated through neuroimaging studies. Primary difficulty is in the phonological awareness, memory, and coding skills that allow children to do phonemic segmentation and synthesis tasks (decoding print)

Question 50

Define comprehension disorder.

Answer 50

Seen in children with long-standing delays in oral language acquisition, learn to decode and manage simple text but struggle with the switch from learning to read to reading to learn

Question 51

What phonological communication characteristics are associated with LLD?

Answer 51

May have intelligible speech but more likely to have a speech sound disorder, often have difficulty with speech perception, phonological memory, and phonological awareness, language skills are a good predictor of later reading difficulties

Question 52

What syntax communication characteristics are associated with LLD?

Answer 52

Common to have deficits in comprehension and production of complex syntax, difficulties understanding passive voice, negation, or relative clauses, have high error rates and less complex sentences in written language along with morphological errors

Question 53

What semantic communication characteristics are associated with LLD?

Answer 53

Small vocabularies, weak word knowledge with retrieval difficulties, receptive difficulties with complex directions, figurative language, and integrating information from a large discourse

Question 54

What pragmatic and socio-emotional communication characteristics are associated with LLD?

Answer 54

Limited verbal fluency, conversational challenges (eg. Not sensitive to the needs of listeners, difficulties with repairs, miss responses to others initiations, language may be more hostile, less assertive, tactful, or polite), converstational pragmatics deficit, less accepted by peers, have poorer social skills, and higher levels of problem behaviours, may be withdrawn

Question 55

What background communication characteristics are associated with LLD?

Answer 55

If reading is impaired, cannot gain that domain specific knowledge needed for reading comprehension, have less existing knowledge to help them learn the new information (spiral)

Question 56

What attention/activity communication characteristics are associated with LLD?

Answer 56

Behavioural and emtoinal difficulties, unclear if behavioural causes the learning disorder, ADHD

Question 57

What are some things to consider when looking at oral language in the classroom?

Answer 57

Academic talk
Hidden curiculum
Decontextualized language
Cultural considerations
Metalinguistic skills
Metacognitive skills and self-regulation

Question 58

What is academic talk?

Answer 58

High levels of control by the teacher, questions with known answers, precise academic vocabulary, morphologically complex words, passive sentences, inferential language, and linguistic complexity

Question 59

What is the hidden curriculum?

Answer 59

Unstated rules and expectations about how to behave and communicate in the classroom setting that are key to school success

Question 60

What is decontextualized language?

Answer 60

Conversation outside the here and now and is more often used in the classroom than at home, low SES children may have less exposure to decontextualized language (can be taught)

Question 61

What cultural considerations need to be taken into account in the classroom?

Answer 61

Number of speakers and whether you would publicly correct someone else

Question 62

What are metalinguistic skills?

Answer 62

Ability to use language to talk about language eg. Defining words, recognizing synonyms and antonyms

Question 63

What are metacognitive skill?

Answer 63

Ability to reflect on, talk about and arrange one’s thinking process ex. Planning

Question 64

What are the different components of literacy?

Answer 64

Language comprehension: background knowledge, vocabulary, language structures, verbal reasoning, and literacy knowledge all improve strategic reading
Word recognition: phonological awareness, decoding, and sight recognition all increase automatic

Question 65

What are the different stages of reading? Provide an activity for each of these stages.

Answer 65

Stage 0 (Pre-reading) – Pre-K: Literacy socialization ex. Orienting children to how books work. 
Stage 1 (Decoding) – 1-2: Phonological analysis and segmentation/synthesis in single words. Ex. Clapping out syllables, pointing at words, repetition and practice
Stage 2 (Automaticity) – 2-4: fluent reading, greater resources for comprehension available. Ex. Practicing sight words
Stage 3 (Reading to learn) – 4-8: more complex comprehensions, increased rate. Ex. Working sheets, giving book summaries. 
Stage 4 (Reading for ideas) – 8-12: recognition of differing points of views, use of inferencing. Ex. Book reports, essays, etc. 
Stage 5 (Critical reading) – college: synthesis of new knowledge, critical thinking. Ex. Research papers.

Question 66

What are the discourse genres?

Answer 66

Oral, conversational language that is contextualized -> narrative discouse with the use of story grammar -> written literate discourse style that decontextualized.

Question 67

What are the stages of narrative development?

Answer 67

1. Heap stories (2-3years): no central theme or organization with simple, declarative sentences, with no sequence.
2. Sequence stories (3 years): theme with various statements and labels but no central characters or plot, might be in order
3. Primitive narrative (4-4.5 years): no real conclusion or emotions for the characters but is organized around a character or plotline
4. Chain narrative (4.5-5 years): lacks details but contains a conclusion
5. True narrative (5-7 years): similar to chain but has more details connect with better cohesion and contains motivations

Question 68

What are the different types of narratives?

Answer 68

Personal: child recounts a salient personal experience
Script: Routine series of events
Fictional: generate a story, retell

Question 69

What are the different elements of story grammar?

Answer 69

Character, settings, feelings, lift off (initiating event), feelings, plan, action, problem, resolution, wrap-up (ending)

Question 70

Create a literal assessment strategy for comprehension of a narrative.

Answer 70

Amelia Bedelia: what did she bake, who is the main character

Question 71

Create an inferential assessment strategy for comprehension of a narrative.

Answer 71

What might happen next, what will Mrs. Rogers reaction be

Question 72

How can outcomes be measured within an ICF framework for preschoolers?

Answer 72

Body structure/function
Activity
Participation

Question 73

How can body structure/function be used as an outcome measurement for preschoolers?

Answer 73

Body structure includes measuring surgical procedures or prostheses to improve structures in the ear, mouth, throat, brain, or nervous system. Body function includes improved speech and voice production and intelligibility, fluency, hearing acuity, swallowing, memory, problem solving, attention, and mental function.

Question 74

How can activity be used as an outcome measurement for preschoolers?

Answer 74

Activity includes improved understanding of language, use of language, use of communication technologies, non-verbal communication, reading and writing skills, phonological awareness, and production of narratives.

Question 75

How can participation be used as an outcome measurement for preschoolers?

Answer 75

Participation includes increased ability to converse and interact with others, improved interpersonal relationships, increased engagement in play with peers, and involvement in classroom or home-based activities.

Question 76

Describe the FOCUS

Answer 76

The FOCUS is an evaluative parent-report outcome measure of preschoolers’ communicative participation. It aims to capture communicative participation changes following SLP intervention in children. It consists of 50 or 34 items depending on the version. It aims to provide a measure of change over time for children, allowing SLPs to see the impact of therapy.

Question 77

What do the different levels of the CSCS look like in accordance to the focus?

Answer 77

Level 1: effective sender and receiver with unfamiliar and familiar partners – minimal increase then levels out around 66 months
Level 2: Effective but slower paced sender and/or receiver with unfamiliar and familiar patterns: more rapid increase in skills, leveling out around the same area as level 1
Level 3: Effective sender and receiver with familiar patterns – More rapid increase, similar to level 2
Level 4: Inconsistant sender and/or receiver with familiar patterns - More steady increase, starting at a lower point but ending near a similar area
Level 5: seldom effective sender and receiver with familiar patterns – much slower, steady growth, not reaching the same level

Question 78

How do outcomes of the focus vary for different groups of children?

Answer 78

Gender: statistically (p<0.05) but not clinically (>16 pts)
Multilingual status: statistically but not clinically
Early learning environment, intervention status, time in intervention, intervention goals: both

Question 79

How can the focus be used to inform SLPs’ understanding of outcomes in clinical practice?

Answer 79

When shown in a clinical study, the Focus was noted to be able to track changes across a treatment with good clinical effectiveness in measuring communicative participation skills, with late-to-talk children showing improvement

Question 80

How can participation be targeted in an intervention?

Answer 80

Participation can be targetted in three different place for preschoolers: home, school, or in the community. Home can include playing with siblings, outdoor activities, daily routines, celebrations and social engagements, or social outings. School can include story time, crafts, meals, socializing with peers and teachers, and field trips. Community can include classes and group activities, organized or unstructured physical activities, community events, and recreational activities.