Topic 1

Question 1

Name a variety of terms used to describe language difficulties in children (6)

Answer 1

language impairment, language disorder, language delay, language disability, language deviance, and childhood aphasia.

Question 2

A language disorder/ impairment may involve what 3 parts of language?

Answer 2

(1) the form of language (phonologic, morphologic, and syntactic systems)
(2) the content of language (semantic system)
(3) the function of language in communication (pragmatic system), in any combination

Question 3

How does Fey describe a language impairment/deficit?

Answer 3

a significant deficit in the child’s level of development of the form, content, or use of language

Question 4

How far below the mean would a standard score qualify a child for a diagnosis of language impairment?

Answer 4

A standard score of 1 to 2 SD below the mean for the child’s age is used to diagnose a child as having language impairment and qualify him for services

Question 5

What is the DSM scale related to language disorders?

Answer 5

According to the revised DSM, the level of severity of the language disorder can range from 1 to 3, with 1 suggesting that the child will require very substantial support and 3 suggesting that the child will require some support.

Question 6

According to the DSM-5, for a diagnosis of Specific Learning Disorder the individual must have at least one of the following: (8)

Answer 6

1. Inaccurate or slow and effortful word reading
2. Difficulty understanding the meaning of what is read 3. Poor spelling
3. Poor written expression
4. Difficulties remembering number facts
5. Inaccurate or slow arithmetic calculation
6. Ineffective or inaccurate mathematical reasoning.
7. Avoidance of activities requiring reading, spelling, writing, or arithmetic.

Question 7

To qualify as SLD, a child’s learning difficulties should not be better explained by…

Answer 7

The learning difficulties are not better explained by Intellectual Developmental Disorder, Global Developmental Delay, neurological, sensory (vision, hearing), or motor disorders.

Question 8

What are descriptive feature specifiers? What are the three domains?

Answer 8

Specify which of the followingdomainsof academic difficulties and their subskills are impaired, at the time of assessment. Domains include reading, written expression, and mathematics.

Question 9

Reading Descriptive Specifiers cover…

Answer 9

a) Word reading accuracy
b) Reading rate or fluency
c) reading comprhension

Question 10

Written Expression Specifiers cover….

Answer 10

a) Spelling accuracy
b) Grammar and punctuation accuracy
c) Legible or fluent handwriting
d) Clarity and organization of written expression

Question 11

Mathematics Expression Specifiers cover…

Answer 11

a) Memorizing arithmetic facts
b) Accurate or fluent calculations
c) Effective math reasoning“

Question 12

When is a child considered to have a language delay?

Answer 12

A child is considered to have a language delay if he exhibits typical development in all areas except language.

Question 13

When does a language delay become a language impairment/disorder?

Answer 13

For many children with language impairment, the early delay involves not only the late emergence of language but also the slow development of language until the point of mastery.
This slow development can continue until adulthood. It opens a gap that widens as children get older, making it difficult for them to “make up” for lost time. At this point the language delay can be viewed as a language impairment/disorder.

Question 14

What is language deviance?

Answer 14

Suggests that the child’s language development is not just slower than the typical but is different in some qualitative way.
Not true for most children exhibiting language difficulties.
Tend to follow the same developmental patterns as typically developing children suggesting that the order of typical language acquisition should guide intervention.

Question 15

When describing language impairments in children, what is the “correct” word order?

Answer 15

‘children with language impairment’ and NOT ‘language-impaired children’
‘children with autism’ and NOT ‘autistic children”

Question 16

What is language difference?

Answer 16

Paul (2001) defines language difference as a rule governed language style that deviates in some ways from the standard language used by the mainstream culture.
Some children from culturally diverse backgrounds may also exhibit language impairment.
Distinguishing between a language difference and a true language impairment is one of the challenges of the SLP.

Question 17

What is the cause of children language disorder’s?

Answer 17

Causal factors that put children at risk for developing communication and language disorders are either biological or environmental

Question 18

What are congenital (biological) factors of children language disorders?

Answer 18

Congenital factors: influence before or during birth:
Chromosomal disorders
Genetic disorders
Prenatal exposure to toxins (substance abuse)
Infections that affect the central nervous system
CNS complications

Question 19

What are some post natal (biological) factors related to language disorders?

Answer 19

Postnatal factors: occur after birth
Premature delivery
Trauma to the brain from injury (TBI, Acquired aphasia)
Acquired sensory impairments (HL, visual impairment) - recurrent and persistent OME (middle ear infection)
Toxins (lead poisoning)
Ingestion of dangerous substances (poisoning from prescription drugs, pesticides).
Infections (meningitis)

Question 20

What are some environmental factors related to language disorders?

Answer 20

Environmental factors:
Poverty – malnutrition
Abuse or neglect

Question 21

Primary Prevention for Language Disorders

Answer 21

Avoiding the occurrence of the disorder by:
Vaccination (rubella, measles)
Genetic counseling (Fragile X)
Family centered early intervention programs that encourage:
good maternal nutrition and parental care
teach parents how to maximize interaction
educate the public about the effects of drugs and alcohol on the fetus.

Question 22

Secondary Prevention for language disorders

Answer 22

Early identification and intervention to minimize the impact of the disorder on the child’s development, communication abilities, and everyday leaving.
Mass screening and early identification

Question 23

Preventative Intervention for language disorers

Answer 23

target children who are at risk for developing a language or communication disorder; such as
Premature babies
Language disorder in the family
Environmental – poverty, deprivation.

Question 24

traditional prevention for language disorders

Answer 24

Providing services to children exhibiting language and communication impairment
Helping children achieve optimal levels of functioning within the constraints of their preexisting conditions.
The central role of the SLP

Question 25

What is the purpose of intervention in children? (4)

Answer 25

1. Elimination of underlying problem – reaching normal/typical language
2. Changing the disorder – improving the child’s function by teaching new behaviors/linguistic forms to improve communication.
3. teaching compensatory strategies instead of specific linguistic forms
4. focusing on changing the child’s environment (may be in conjunction with one of the formers)

Question 26

Elimination of underlying problem – reaching normal/typical language

Answer 26

Not frequently achievable  when etiology is unknown or the conditions are incurable (MR, ASD)
Can be achieved in some cases (early detection of HL, Articulation disorder)
if alleviating the basic deficit is the purpose, the SLP can discuss with the family how much intervention is needed and for how long.
Since the long term goal is normal language, SLP discusses only short term goals.

Question 27

Changing the disorder – improving the child’s function by teaching new behaviors/linguistic forms to improve communication.

Answer 27

Does not guarantee that the child will not need further therapy at a later time
Most common when working with children with developmental language disorders (SLI/PLI, LLD)
Both long term goals and short term goals need to be discussed with the family
Discussion of length of therapy is tricky and difficult to do.

Question 28

teaching compensatory strategies instead of specific linguistic forms

Answer 28

Providing tools to support better communication and overall functioning with the deficits
WF – teaching retrieval strategies in stead of vocab.
Both long term goals and short term goals need to be discussed with the family

Question 29

focusing on changing the child’s environment (may be in conjunction with one of the formers)

Answer 29

Justin’s example – p#62
The child’s environment and learning context can include: the physical space (home, school), the use of devices, the family, teachers, peers, etc.

Question 30

Identifying the purpose of intervention is based on:

Answer 30

The child’s age
Intervention history of the child
The nature of the disorder
The child’s environment
Data collected during assessment

Question 31

Once the purpose of intervention is determined, are long or shorts intervention plans devised.

Answer 31

Both. Once the purpose of intervention is determined, an intervention plan (long term and short term goal) is devised.

Question 32

What must every intervention plan be based on?

Answer 32

Evidence-Based-Practice (EBP)

Question 33

EBP includes

Answer 33

External evidence (published literature) and Internal evidence

Question 34

Notes on External Evidence

Answer 34

Not all published research is true or accurate!
Should be critically reviewed and assessed by the SLP before implementation
Should be reviewed critically based on the studied population.

Question 35

Notes on Internal evidence

Answer 35

The client and the family’s willingness to participate in the treatment process and their preferences
The SLP’s professional competency, expertise, preferences and values
The values, policies, and culture of the institution in which the SLP works

Question 36

Incorporating EBP into your intervention plan (PICO)

Answer 36

Patient or problem (ASD – increase communicative acts)
Intervention being considered (Floor Time)
Comparison treatment (or no treatment) (ABA)
Outcome (evaluate decision by documenting outcomes – baselines)

Question 37

There are 3 aspects of the intervention plan:

Answer 37

The objectives (the goals)
The processes (the strategies or approaches used to achieve the goals)
The context (the environment in which the intervention takes place)

Question 38

How are goals and objectives set?

Answer 38

The selection of intervention goals and strategies is guided by the information obtained in the assessment

Question 39

What are long term goals?

Answer 39

they are a general statement about the best performance that can be expected of a client in one or more targeted communication areas
It suggests that the ultimate outcome of intervention planning is improved communication

Question 40

When is a client dismissed?

Answer 40

The achievement of a long term goal can be equivalent to the termination of therapy

Or if a Client reaches a plateau and stops progressing

Question 41

Short term goal

Answer 41

a specific linguistic form that has been given priority within a hierarchy of linguistic forms to be targeted in therapy
It includes the skill to be learned, the context in which the skill is expected, and the criteria to evaluate the goal

Question 42

Should short term goals be prioritized?

Answer 42

Since children with developmental language disorders have multiple linguistic deficits, there is a need to prioritize the short term objectives.

Question 43

what should prioritization be based on?

Answer 43

Age of acquisition – typical language acquisition
Communication needs – functional communication (particularly important for children with ASD and Intellectual Disabilities, who are unlikely to achieve adult communicative levels)

Question 44

how do we show accountability to achieve our goals”?

Answer 44

We should be able to show (based on data collected, baselines) that the changes in the child’s performance are the result of the intervention plan and would not have happened if the intervention had not taken place.

Question 45

How do we show that objectives have been met?

Answer 45

One way to show that the objectives have been met is by determining a termination criterion.

Question 46

what is termination criterion?

Answer 46

The termination criteria for each objective is the level of use of a targeted structure, the child must achieve (typically 80-90% in structured activity and at least 50% accuracy in spontaneous speech) in order to consider the structure learned.

Question 47

ASHA’s discharge criteria

Answer 47

Communication is now within normal limits
All goals/objectives have been met
The client’s communication is comparable to those of others of the same age, sex, and ethnic and cultural backgrounds
The individual’s speech or language skills no longer adversely affect social, emotional or educational status
The individual uses an AAC system and has achieved optimal communication across partners and setting.
The client has attained the desired level of communication skills.

Question 48

What 3 reasons does fey give for discontinuing therapy?

Answer 48

The child has reached all the goals identified in the treatment plan and is no longer viewed as having a language disorder
The child has reached a plateau and any changes made to the intervention plan have not yield any improvements
The child is making progress but this progress cannot be attributed to the intervention plan.