Part 2

Question 1

How is language use affected in visually impaired children?

Answer 1

Pragmatics are similar to children with ASD- fewer gestures, inappropriate responses.

Question 2

What are clinical implications for visually impaired children?

Answer 2

Facilitate early interactions with parents, finding new ways to establish JAR. (Label and describe items for child, share book experiences, share pretend play experiences…)

Question 3

What is hearing impairment characterized by?

Answer 3

Degree- Average threshold on pure tone testing
Type–
1. Conductive: Interference in auditory canal to inner ear- usually treatable and associated with OM.
2. Sensorineural: Damage to inner ear from injury or genetics. (Drug use ex)
3. Mixed: Both.

Question 4

What are cognitive characteristics of hearing impaired children?

Answer 4

No intellectual delays, 30% with mod to severe loss may be comorbid with another disease that affects cognition.

Question 5

What are language characteristics of HI children?

Answer 5

Must understand whether it is a language problem or a cultural difference. Cochlear implants now available for 1 year old children, HI is diagnosed at birth.

Question 6

What are language characteristics of HI in regards to form?

Answer 6

Early speech and babbling is different, more likely to produce nasality, voicing errors, initial syllable deletion. Severe levels have lower intelligibility. Morphology and syntax delayed.

Question 7

What are language characteristics of HI in regards to content?

Answer 7

Delayed, but with CI use can be typical. ASL users have similar vocabulary to hearing children.

Question 8

What are language characteristics of HI in regards to use?

Answer 8

Early exposure to communication more important than hearing status- minimal research.

Question 9

What are characteristics of HI in regards to literacy?

Answer 9

CI results in near normal comprehension. Important to expose to books, demonstrate writing, provide attractive writing opportunities… Focus on hearing sometimes depletes the time spent on literacy. May be some deficits in reading/spelling.

Question 10

What are implications for HI in regards to practice?

Answer 10

Work through CI process with family and child. Teach listening and response skills to new words- foster social communication.

Question 11

What are implications of otitis media?

Answer 11

3/4 of all children experience- some hearing loss during episode is to be expected. Populations that are at risk for OM should be monitored closely so language learning difficulties are not increased. Normal children- no difficulties associated.

Question 12

What is auditory processing disorder? How do we diagnose? What is it comorbid with?

Answer 12

Not currently in DSM, but, the efficiency and effectiveness by which CNS utilizes auditory info. 50% comorbid with other developmental disorders (ADHD). More research and consensus on diagnosis is needed.

Question 13

What is deaf blindness caused by? What is needed for these children? Intervention techniques?

Answer 13

Can be caused by congenital factors (rubella, German measles) or genetic Usher’s syndrome. Dynamic, contextualized assessment is needed, with AAC’s being very helpful, especially tactile finger spelling… Braille, adapted signs/gestures.

Question 14

What are the two types of TBI? Who are they most common in? What is the prognosis?

Answer 14

Open head, which affect a specific area, and closed head injuries, which affect global areas. Occur most often in boys. Spontaneous recovery in children with poor outcomes- prognosis depends on severity.

Question 15

What are cognitive characteristics of TBI?

Answer 15

Variable- reduced cognitive abilities can impact info processing speed, pragmatics, executive functions and attention, concentration, impulsivity…

Question 16

What are language characteristics immediately following trauma? In the second phase?

Answer 16

At first, may be mute, follow simple commands and seem to be confused- can have sparse or excess language production.
In second phase may show rapid improvement, though full recovery is rare. Impaired attention and executive control, with deficits in naming, word fluency, expressive vocab. Repeating and tacting are not impaired.

Question 17

What are characteristics of TBI in terms of use?

Answer 17

Vulnerable pragmatic skills- problems with turn taking, topic maintenance, verbal responses, understanding intentions of others. Difficulty understanding non literal language and interpreting ambiguous messages. Will rely on verbatim memory in tasks - repeat exactly as heard.

Question 18

What are characteristics of TBI in terms of literacy?

Answer 18

Reduced reading fluency, with slow word recognition in connected text. Reading comp goes down when struggling with text.

Question 19

What are the implications for clinical practice in children with TBI? Assessment process for each phase?

Answer 19

Work with families to deal with new reality.
Phase 1: Child is recovering medically- focus on physical needs
Phase 2: Medically stable, begin therapy for functional strengths and needs in bx, cognition, and communication- what a child needs to communicate with those around them.
Phase 3: Ongoing assessment is needed in the child’s educational and daily living settings.

Question 20

What are intervention issues for TBI? What are two types of intervention? What are the phases of intervention?

Answer 20

Need close collaboration with families and multidisciplinary team. Intervention to retain/develop cognitive skills or to teach compensatory strategies. Phase 1 of intervention is a period of spontaneous recovery- keep sessions short, stimulate one modality at a time. Phase 2 is structured tasks, repetitive, predictable, and rewarding to develop functional and adaptive behaviors. (Verbal problem solving, self monitoring, language comp). Phase 3 is working with school staff to facilitate child’s transition back to learning environment- pass torch. Must target Pragmatics/social language, regulating and learning behavior, ensure generalization. Start slow, few hours a day to reintegrate, as fatigue is a huge factor.

Question 21

What are focal brain lesions? What causes them? What is the prognosis?

Answer 21

Lesions that are focal, localized to one area of the brain. Caused by cerebrovascular accidents, so are rare in children. Children recover in terms of speech and language. Subtle deficits in higher level tasks such as narratives- tell shorter, less complex stories, and don’t understand cognitive states of characters.

Question 22

What is Landau Kleffner syndrome?

Answer 22

Rare seizure disorder that causes severe language impairment- onset is between 3-6 years of age. Child loses language rapidly after developing normally, with comprehension most affected. Deafness is often suspected. If severe, child may revert back to using only gestures to convey meaning.

Question 23

How do SLP’s work with children with Landau Kleffner syndrome?

Answer 23

Provide alternate means of communication (ASL, AAC). Social communication, imaginative play, emotional understanding of self and others important. Develop language and conversation in everyday settings.

Question 24

What is associated with visual impairment?

Answer 24

Early delays in language acquisition- largely resolved by school age.