Part 1

Question 1

What is the definition of an intellectual disability? When must it originate by? What is the IQ of someone with ID?

Answer 1

Significant limitations in intellectual functioning and in adaptive behavior which covers practical and social skills. Must originate before 18. IQ is around 70-75 (around 2 SD below mean).

Question 2

What does adaptive behavior cover?

Answer 2

Conceptual skills, social skills, and practical skills.

Question 3

What are cognitive characteristics of ID? What deficits are more pronounced?

Answer 3

Similar pattern of development to typically developing children but slower trajectory. More pronounced deficits in executive functioning and working memory (high order problem solving).

Question 4

What are language characteristics of ID in regards to form?

Answer 4

Slower pace of typically developing sequence, will use shorter, less complex sentences once MLU is above 3.

Question 5

What are language characteristics of ID in regards to content?

Answer 5

Vocabulary may be a strength, but conceptual knowledge is low.

Question 6

What are characteristics of ID in regards to use? How do children with ID do with narratives?

Answer 6

Slower to develop intentional communication. Able to engage in socially meaningful conversations, but less able to clarify meaning and request clarification (conversational repair). Difficulty constructing narratives.

Question 7

What are characteristics of ID in regards to literacy? What are their predictors for reading?

Answer 7

Slower to progress- predictors for reading are the same as typical peers. Phonological processing predicts word and nonword reading; Word reading and oral language predicts comprehension skills.

Question 8

What is the prevalence of ID?

Answer 8

Less than 1%.

Question 9

Does acquisition of language forms guarantee children with ID will use them?

Answer 9

No, not socially appropriately. Generalization is not great!

Question 10

What are some clinical implications for ID? What will each individual require?

Answer 10

Language development and academic success are key. Each individual will require a thorough assessment of language abilities in different contexts, detailed discussion with family about successes and challenges in daily communication, as is the case for each disorder.

Question 11

What is the most common genetic cause of intellectual disability? Prevalence?

Answer 11

Down Syndrome. Prevalence is 1 in 700 live births.

Question 12

What is Down Syndrome? What is distinctive about their physical appearance?

Answer 12

Named for John Langdon Down. DS children are born with an extra copy of chromosome 21, and mild to moderate ID. DS children often have round faces, hypotonia (low muscle tone), and shorter stature and limbs.

Question 13

What are some of the medical issues associated with Down Syndrome? What is it comorbid with? How often?

Answer 13

Congenital heart defects, reflux, ear infections, sleep apnea, early onset Alzheimers. Co morbid with autism 10% of the time.

Question 14

What are some of the cognitive characteristics of Down Syndrome? What is the typical IQ?

Answer 14

Global delays in gross and fine motor skills, deficits in verbal working memory but not visuospatial working memory, problems with impulse control, planning, learning new rules and applying, take longer to solve problems/lack persistency, and difficulty staying on task. IQ is between 4-70.

Question 15

What are language characteristics of DS in regards to form?

Answer 15

Speech intelligibility is poor in connected speech, difficulty learning/using syntax, produce shorter, less complex sentences and fewer question and negation forms.

Question 16

What part of language is most affected in DS?

Answer 16

Expressive more than receptive.

Question 17

What are language characteristics of DS in regards to content? Is vocabulary on par with other cognitive abilities? What is the preferred communication method and what does it predict?

Answer 17

Acquisition of first words is typically delayed, and growth of vocab is slower than expected. Vocab may or may not be on par with cognition. Preferential communication is gesturing, which predicts later language development.

Question 18

What are language characteristics of DS in regards to use?

Answer 18

Use comments answers and protests but not as many requests. Higher levels of contingent responses and topic maintenance, with great narrative skills. Produce fewer elaborative utterances in conversation, and are less likely to signal clarification.

Question 19

What are language characteristics of DS in regards to literacy?

Answer 19

Reading skills variable, with word reading better than comprehension.

Question 20

What are clinical implications for DS? What is the ultimate goal? What may DS children need most help with?

Answer 20

Slower rate of language and literacy development. Build on strength of vocab and pragmatics. Difficulties in syntax, morphosyntax, and phonological verbal memory. Poor comprehension. Ultimate goal is to improve communication, academic, social, vocational areas. Attending, staying on task, and signaling clarification will need support.

Question 21

What is Williams syndrome? What is it’s prevalence? What are some of it’s features?

Answer 21

Complex neurodevelopmental disorder that involves deletion of 25 genes on a single chromosome. Prevalence is 1 in 7500 live births. There are multiple physical, cognitive and behavioral features, are often very friendly with marked anxiety. Physical features are facial dysmorphology, heart disease, growth deficiency and connective tissue abnormalities.

Question 22

What are cognitive characteristics of Williams Syndrome?

Answer 22

Global developmental delays with mild to moderate IQ. Difficulties with visual spatial construction (unique), which causes deficits in motor development and independence.

Question 23

What are language characteristics of Williams Syndrome in regards to form?

Answer 23

Canonical babbling is delayed, but no lasting effects on speech. Grammatical ability is usually around same as cognitive level, sometimes slightly lower.

Question 24

What are language characteristics of WS in regards to content?

Answer 24

Understanding concrete vocabulary is a strength, whereas there is a profound difficulty with relational or conceptual vocabulary.

Question 25

What are language characteristics of WS in regards to use? Are children with WS the opposite of ASD?

Answer 25

Pragmatic difficulties despite being overly friendly. JAR is delayed. No, not opposite, pragmatic skills evidently lower in conversational speech. Narratives are also weak, with difficulty monitoring their own comprehension. Literacy is variable, but low overall.

Question 26

What are implications for practice in WS children?

Answer 26

Similar to other ID disorders, must work with families to develop language and communication, with social skills training for older kids. Oral language is a good target for reading comprehension.

Question 27

What is Fragile X syndrome? What is the prevalence? Comorbidity?

Answer 27

A single gene disorder, where a trinucleotide CGG reepats too often on the fragile X mental retardation gene FMR1 on the bottom end of X chromosome. Prevalence is 1 in 4000 males and 1 in 8000 females. Co morbidity with ASD, ADHD, seizures, and esp anxiety.

Question 28

What are cognitive characteristics of FX? IQ? What is the intellectual growth rate?

Answer 28

Males have ID similar to DS. 25 percent of females under 70 for IQ, 50% borderline. Gradually declining IQ. Intellectual growth rate is half that of typical children. Core deficit in executive functioning, sequential processing, working memory, planning, fine and gross motor… Strengths are simultaneous processing and long term memory.

Question 29

What are language characteristics of FX syndrome in regards to form?

Answer 29

Articulation is a strength, phonological processing a weakness. Delayed in understanding/production of grammar and morphosyntax.

Question 30

What is the most common inherited form of ID?

Answer 30

FX syndrome.

Question 31

What are language characteristics of FX syndrome in regards to content?

Answer 31

Some report weaker vocab, others on par with mental age expectation.

Question 32

What are language characteristics of FX in regards to use?

Answer 32

Is a relative weakness. Pragmatics aligned with ASD in boys, with increased use of off topic language, repetitive speech and delayed echolalia. Difficulty maintaining conversation.

Question 33

What are some literacy characteristics of FX syndrome?

Answer 33

Little research has been done, but given oral weakness and pragmatic difficulties, comprehension is likely poor.

Question 34

What are implications for clinical practice for FX syndrome?

Answer 34

Often referred very young. Top priority is to work with family and other professionals to determine if there are comorbid conditions that affect language development. Increase linguistic competency in social context, and improve pragmatic skills. Improve literacy and decrease challenging behaviors/inappropriate communication skills.

Question 35

What is the role of diagnostic categories in developmental language disorders?

Answer 35

Eligibility for services- diagnosis may be needed
Identification of priorities for assessment and intervention- although not determiner, it may assist in forming plan. (ie: pragmatics for autism)
Understanding clinical and education reports- we must be educated about the different diagnoses that children may present with in order to make intelligent, clinical decisions.