Semester 1 Week 6

Question 1

what areas of speech, language and communication might children with DLD struggle with? (8)

Answer 1

• Phonology.
• Syntax.
• Semantics.
• Pragmatics and social use of language.
• Discourse.
• Verbal learning and memory.
• Reading and writing.
• Processing.

Question 2

what is phonology

Answer 2

underlying speech sound pattern

Question 3

what is discourse

Answer 3

being able to tell a story or string together a good explanatio

Question 4

what’s included in verbal learning and memory

Answer 4

remembering new words and what happens in social situations

Question 5

do children with dld also have dyslexia?

Answer 5

some children have both and some only have one condition. however if spoken comprehension is affected then reading and writing is usually affected

Question 6

how is processing affected

Answer 6

slower speed

Question 7

what did dld used to be known as?

Answer 7

specific language impairment

Question 8

difficulties associated with a child with a language disorder

Answer 8

Child with language difficulties that:
- Significantly impair social and/or educational functioning
- With indicators of poor prognosis
- Not explained by lack of familiarity with ambient language

Question 9

how are language disorders categorised?

Answer 9

if they are associated with a known biomedical condition then they are ‘Language disorder associated with X’
however if they are not associated with a known biomedical condition then they can be diagnosed with DLD

Question 10

some conditions that language disorder can be associated with (6)

Answer 10

• Known genetic condition (e.g. Down syndrome, Klinefelter syndrome)
• Cerebral Palsy
• Acquired brain injury
• Sensorineural hearing loss
• Severe intellectual disability
• Autism

Question 11

what is tricky with the terminology of ‘associated with’

Answer 11

‘Associated with’ does NOT mean ‘explained by’
Not exclusionary factors

Question 12

is there a cause for dld?

Answer 12

no

Question 13

what are some co-occurring disorders common alongside DLD

Answer 13

• ADHD
• DCD
• Dyslexia
• Dyspraxia
• Speech
• SEMH

Question 14

how do children with dld compare to children without dld?

Answer 14

• These children do not follow the typical rate and progress of speech and language development
• may have a spiky profile of development

Question 15

do children with dld ‘catch up’ with their TD peers

Answer 15

no these children don’t catch up and the disorder persists throughout their lifetime

Question 16

what are 4 things that would get a child referred for a dld evaluation?

Answer 16

1. concern about their speech, language or communication
2. behaviour or psychiatric difficulties
3. extreme departures from typical development in under 5 year olds
4. persistent problems with comprehension or using language to communicate in children aged 5+

Question 17

if a child is under 2 and not talking is this sufficient cause for referral

Answer 17

no, they’ll be reassessed later and if there is still cause for concern then they may be referred for an evaluation

Question 18

what is involved in an assessment of speech, language and communication

Answer 18

1. info combined from multiple sources - caregivers reports, observation, standardised tests and language learning context
2. uses staged approach - initial assessment that taxes both expressive and receptive skills and then get more specific later
3. measures of language learning can complement static tests of knowledge/skill
4. pragmatics/social communication should also be assessed
5. assessment by an SLT will determine whether a problem with speech production is linguistic, structural or motor in origin

Question 19

why is it sometimes hard to determine dld

Answer 19

language ability is continuous - there’s no specific score/cutoff between normality and impairment that determines dld

Question 20

what impact does a child’s social background have on their language ability

Answer 20

different aspects of language vary in sensitivity to social and biological background but it is unrealistic to use language profile to distinguish social vs biological origins, there is no research that proves you can you can differentiate between social and biological causes

Question 21

what does poor prognosis mean in this context

Answer 21

issues with SLC are unlikely to resolve by 5 years of age and will persist into adulthood

Question 22

red flag behaviours for dld between 1 and 2 years of age

Answer 22

(a) No babbling
(b) Not responding to speech and/or sounds
(c) Minimal or no attempts to communicate (both verbal and non-verbal)

Question 23

red flag behaviours for dld between 2 and 3 years of age

Answer 23

(a) Minimal interaction;
(b) Does not display intention to communicate;
(c) No words and/or gestures
(d) Minimal reaction to spoken language;
(e) Regression or stalling of language development.

Question 24

red flag behaviours for dld between 3 and 4 years of age

Answer 24

(a) At most two-word utterances;
(b) Child does not understand simple commands;
(c) Close relatives cannot understand much of child’s speech

Question 25

red flag behaviours for dld between 4 and 5 years of age

Answer 25

(a)Inconsistent or abnormal interaction;
(b) At most three word utterances;
(c) Poor understanding of spoken language;
(d) Strangers cannot understand much of child’s speech;
(e) Close relatives cannot understand more than half of what child says

Question 26

red flag behaviours for dld age 5+

Answer 26

(a) Difficulty in telling or re-telling a coherent story (producing narrative)
(b) Difficulty in understanding what is read or listened to
(c) Marked difficulty in following or remembering spoken instructions
(d) Talking a lot but difficulties with engaging in reciprocal conversation
(e) Many instances of over-literal interpretation, missing the point of what was meant.

Question 27

at what age is language likely to change dramatically even if there’s no intervention

Answer 27

4-5 years

Question 28

how low do the scores need to be on a standardised assessment for the child to have a language disorder?

Answer 28

Tomblin et al. investigated a range of possible criteria in an epidemiological study. They settled on: five composite scores from norm-referenced tests of receptive and expressive language in three domains of language.
* Children with two or more composite scores below the 10th centile (i.e. 1.25 standard deviations or more below the mean) were considered to have a language disorder.

Question 29

how does dld affect grammar?

Answer 29

• Potential difficulty with verb endings and syntax.
• They might leave out “is” and “are,” or not put an “s” on the end of a verb when they should.
• Later stage of sentence development - words are left out.
• As they get older, they may avoid complex sentence/utterance structures.

Question 30

ways word finding difficulties manifest in children with dld

Answer 30

will often use substitution of words (e.g. ‘sleeve end’ for ‘cuff’) or may present with a lack of fluency - taking a long time to think of the word

Question 31

in young children how are words stored

Answer 31

In young children, a representation consists of the semantic information and the phonological information

Question 32

what is the semantic info for the word apple

Answer 32

round, green, you eat it

Question 33

what is the phonological info for the word apple

Answer 33

starts with ‘a’ sound and has two beats (syllables)

Question 34

why do children with dld experience WFD

Answer 34

either the semantic or phonological information is incomplete and so there is inadequate storage and the child will not be able to access the word correctly

Question 35

what work so SLTs do with children with DLD

Answer 35

• Facilitate inclusion for children with DLD
• Provide specialist interventions for children with DLD
• Work in partnership with teachers and families (and others!) to:
• Remove barriers for learning for children
• Support the development of spoken and written language development
• Assess students and provide detailed information about their strengths and difficulties
• Advocate for specialist educational
  provision (e.g. 1:1 or special school)
• Identification and diagnosis
• Regular monitoring of progress and modifications to management
• Support transition points e.g. from home to nursery, from primary school to secondary school and from secondary to post-16 provision.
• Devising and deliver pathways and programmes of therapy
• Supporting schools to integrate strategies into the curriculum in order to foster children’s language learning and use
• Maximising communication potential by skilling others in their use of facilitative strategies and/or use of augmentative communication systems
• Raising awareness, support and train professionals in identifying and working with children with developmental language disorder
• Supporting parents
• Facilitating communication in functional settings

Question 36

what are some examples of individual level intervention?

Answer 36

• Working on understanding of time concepts (e.g. Today / yesterday / tomorrow)
• Understanding of Blank’s levels of questioning
• Using Shape Coding by Susan Ebbels TM to work on syntactic targets
• Increasing word findingproficiency
• Teaching tier 2 words
• Teaching verbs
• Delivering narrative interventions for a range of targets
• Working on a functional target (e.g. the bus home / lunchtimes)
• Developing comprehension monitoring strategies (self-advocacy skills)
• Write social stories to work on scenarios that are causing difficulties
• Support to understand diagnosis or profile of strengths and needs

Question 37

what are some examples of school level intervention?

Answer 37

• Sharing information with all teaching staff about communication profiles / strategies / inclusion
• Advocating for pre-teaching curriculum-relevant language
• Increasing use of visual supports across the curriculum
• Increasing use of communication supporting strategies during teacher talk
• Inputting into literacy/oracy support
• Allow more time for processing questions and forming responses
• Alert students to the content of likely questions when presenting new information i.e. what they should listen out for
• Demonstrating, mentoring and coaching learning support staff
• Joint planning/Team teaching

Question 38

why is shape coding a good strategy

Answer 38

makes grammar very visual

Question 39

what are tier 2 words?

Answer 39

academic words that are not subject specific (e.g. evaluate, contribute)

Question 40

if an SLT delivers training/advice to parents/teachers what should be done next to make it most effective

Answer 40

follow up coaching, observation and feedback

Question 41

7 principles of word learning

Answer 41

1. Aspects of new word – semantic/phonological/morphological/grammatical/orthographic
2. mapping word onto action
3. transferable word learning strategies
4. generalisation to real-life contexts
5. deep understanding
6. repeated exposure across contexts
7. explicit discussions and opportunities to derive meaning

Question 42

explain the process of a word learning session (11 steps)

Answer 42

1. give definitions
2. display key words with a visual image
3. give examples
4. discussion
5. list key words on the board
6. teach how to derive meaning from morphology
7. encourage students to draw on personal experience…
   8…. relate this to the word through scaffolded questioning
8. students write the word
9. students say the word aloud
10. students generate their own definition

Question 43

classroom strategies

Answer 43

• use visual supports
• Use the child’s name to draw attention of the child
• Use eye contact / get down to their level
• Use natural gesture
• Use symbols and props
• Encourage new words
• Provide ‘scripts’ Now it is xxx time. What do we do first?
• Use contrast to highlight differences in lexical items / syntactic structures
• Praise listening
• Praise turn taking
• use a slow pace
• pause expectantly and frequently to encourage turn taking
• respond to all attempts at communication - don’t ignore any utterances
  *comment on what the child is doing
• extend what the child has said with small amounts of info
• label - lots of opportunities to label actions, objects, concepts

Question 44

why are visual supports so useful?

Answer 44

• Visuals are permanent
• Allow extra time for processing
• Act as a memory support
• Prepare for transition (e.g. now/next)
• Can be consistent across lessons
• Scaffold independence
• help all students