Unit 2 Flashcards
(163 cards)
1
Q
Intellectual disability IQ requirement
A
IQ below 70
2
Q
language ability should be equivalent to
A
mental age
3
Q
those with intellectual disability go through the same
A
language acquisition and in TD children, only slower
4
Q
any language irregularities are due to
A
environmental experiences
5
Q
Mental Retardation
A
the less politically correct term for intellectual disability
6
Q
AAMR
A
American Association on Mental Retardation
(an old organization)
now called American Association on Intellectual and Developmental disabilities
7
Q
Intellectual disabilities
A
problems in:
intellectual funcitoning (IQ)
adaptive behavior
***no just raised on IQ
occurs in developmental period up to 18 years of age
heterogeneous population- language characteristics will vary
8
Q
adaptive behavior
A
particular tasks and behavior you would expect developmentally
-being able to care for yourself
9
Q
Vineland Adaptive behavior Scales II
A
measures adaptive behavior, norm-referenced instruments
receptive and expressive language, written communication, daily living skills, domestic, personal and community living skills, socialization, play, leisure, coping skills, fine and gross motor skills, maladaptive behaviors
information gained from parent or caregiver interaction.
birth to 90 years
10
Q
developmental disability
A
describes mental or physical disabilities that occur before 22 years of age
terms used by federal government
11
Q
standford binet intelligence scale 5th edition
A
IQ test
12
Q
welcher intelligente teste for children
A
school age kids IQ tests
13
Q
Haley Scales of Infant and Toddler Development
A
Measures IQ in infants and young children
14
Q
Leiter international performance scale
A
nonspeaking or nonverbal individuals
15
Q
table 6.1 on page 232 in book
A
labels that we use for ID
16
Q
Mild intellectual disabilities (educable)
A
50/55-70 IQ
89% of those with intellectual disabilities (the most common form of ID)
17
Q
Moderate intellectual disability (trainable)
A
35/40-50/55 IQ
7% of the population with ID
18
Q
Severe Intellectual disability (custodial)
A
20/25-35/40 IQ
3%of the population with ID
19
Q
Profound (Life-support)
A
below 20/25
1% of the population with ID
20
Q
intermittent support
A
short term supports such as during an acute medical crisis
short term, but effects life
Kristin’s surgery
21
Q
limited support
A
regular but brief support
an employ needing assistance to remediated a job- related skill deficit
22
Q
extensive support
A
ongoing and regular assistance such as ongoing home living support
23
Q
pervasive support
A
life sustaining support
skilled medical care
help taking medication
24
Q
cause of ID: organic
A
something you can actually see in the central nervous system i.e. genetic, chromosomal cause *** a known cause IQ below 50 found across SES accompanied by health problems physical abnormalities (i.e. cleft lip/ palate) die earlier than general population dependent on care of others less likely to marry atypical patterns of development.
25
Cause of ID: familial
IQ rarely below 50
more predominant in low SES
relate to IQ of siblings/parents
normal health
normal appearance
mortality rate similar to GP
with minimal support, lead independent lives
likely to marry and have low IQ children
more likely to experience neglect in homes
*** these individuals have slower rate of grow but typical language acquisition patterns
26
table 6.3 pg 235 and 6.5 pg 242
the different syndromes associated with ID
27
mental capacity
```
the measure of intelligence:
reasoning
planning
solving problems
abstract thinking
comprehending
the ability to learn
learning from experiences
```
28
significant ID
significant speech language and communication problems
29
improvement, prognosis, and learning of speech and language with ID clients
slow and inconsistent
| can do a worksheet one day, but then not understand it on day two
30
SLPs purpose with ID
increase a person's participation in the environment
increasing a person's quality of life (going to church, getting a job, having friends, etc.)
developing a sense of community
31
augmentative/alternative communication
helping a person become more involved in the participation of their environment
32
language characteristics of ID
| pragmatic problems
poor presuppositional capabilities (see other's perspective, modifying conversation)-- related to theory of mind
telegraphic speech (2-3 word phrasal repetition)
limited repair strategies
frequent communication breakdowns
passive communicators
-easier answering questions than initiating
poor peer interactions
poor conv. turn-taking
33
language characteristics of ID- semantic problems
```
nouns and vocabulary words are easier
abstract adjectives and verbs are worse
understand talking about the now rather than yesterday or tomorrow
clauses
take idioms literally
only include key content words (telegraphic speech)
word order
using morpheme
longer utterances
```
34
language characteristics of ID- phonology
over 70% of ID will have problems with speech sound productions related to phonological problems
35
down syndrome stats
1 in 733 live births there can be a diagnosis of downs
results from extra genetic material on chromosome 21
some literature argues that women over 35 have a higher risk of having a child with downs, but this is highly debated
4:1-5:1 male female comparison
15% meet the criteria of children with Autism Spectrum Disorders
multiple diagnoses in 1 individual
36
down syndrome ID problems
lack of communication abilities- theory of the mind
| mild to moderate cognitive deficits
37
down syndrome physical appearance
```
short in stature
small nose and chin
chronic protraction of tongue
large young
small oral cavity
excessive skin on the back of the neck
small ears- possible absence of ear lobs
hypotonic muscle tone (flaccid)
obesity
```
38
down syndrome medical issues
chronic hearing issues- conductive, sensorineural, or mixed (middle ear problems)
-unilateral or bilateral; mild to profound
mouth breathing
sleep apnea
thyroid disease
vision disorders
Alzheimer's disease and dementia increase
happy and willing, enjoy engagement and participation
meaningful relationships- will often get married
39
down syndrome language components
unintelligible- phonological in nature
receptive language is stronger than expressive language
combination of phonetic (articulators) and phonemic (knowing the parts of words) issues
dysarthria- may have difficulty with rate, range, and motion of articulators
may have childhood apraxia of speech- problems sequencing of sounds (the sequencing of saying sounds)
initiation, elaboration, and linguistic aspects of narratives
short and less com[ed sentence structure
slow and delayed vocabulary acquisition
between 3-6 there is a regression of syntactic development
40
between 3-6 years of age
expressive language decreases
41
down syndrome is also referred to as
Trisomy 21
42
young children with down syndrome
will be unintelligible
| AAC can be introduced as early as 18 months of age
43
greater severity of DS=
more severe speech ad language deficits
44
common characteristics from 6.5 table
receptive typically better than expressive language, difficulty with morphology + syntax
phonology awareness+auditory verbal memory deficits, difficulty with abstract language, limited vocab, reduced use of grammatical morphemes
chronic otitis media
65-80% have some type of hearing loss
conductive hearing loss 21-58%
sensorineural/mixed hearing loss 4-40%
45
William's syndrome physical features
```
small up-turned nose
long philtrum
wide- mouth with full lips
puffiness around the eyes
blue or green eye-color
white starburst pattern of the iris of eyes
small widely spaced teeth
shortening of jaw
WS presented at birth
large amigdlia in the brain
```
46
what causes william's syndrome?
some genetic material present on chromosome 7
| can be confirmed by blood test- 96% diagnosed with some degree of intellectual disability
47
William's syndrome personality
hyper-social
| "cocktail" speech- superficial conversation
48
prevalence of William's syndrome
1 in 20,000 births males and females equally affected
49
Developmental problems
```
feeding problems- due to low muscle tone
severe gag reflex when food enters oral cavity
tactile defensiveness (pull back when you bring spoon to them)
poor sucking ability
talking, walking, and toiling delays
excessive worrying
difficulty modulating emotions
aversion to loud noises
difficulty with visuo-spacial tasks
cardiovascular difficulties
```
50
strengths of William's syndrome
```
long term memory
auditory memory
speech is articulate/ intelligible
less chance of high blood pressure
good syntax
```
51
language problems for William's Syndrome
```
receptive language skills cannot support expressive language- sometimes they may not understand what they are saying
incessant chatter with syntactically complex sentences
long words with sophisticated vocabulary
stereotype phrases
word finding difficulties
some with hoarse vocal quality
excessive echolalia
meaning of words compromised
circo locution
```
52
FISH test
used to identify William's syndrome
53
Fetal Alcohol Syndrome (Fetal Alcohol Spectrum disorders) prevalence
CDC- estimates over 2 million people in the US have some form of FAS
1 for every 1000 to 1 in 2,400
many times the features go unnoticed until they are school aged
54
what causes FAS symptoms
low brain development
55
FAS physical problems
```
retardation of physical growth
could have cranial-facial abnormalities
-velopharyngeal insufficient (VPI)
chronic otitis media
sensorineural hearing losses
underdeveloped jaw
small teeth, malocclusion
problems with vision, heart, kidney, and bone
-global developmental issues
hearing loss attributed to alcohol impairing the developing brain sane of infant
```
56
FAS mental developmental problems
Executive funcitoning
| memory
57
FAS Personality components
could be seen as noncomplient
58
FAS language difficluties
deficits in vocabulary and pragmatics
reduced MLU
poor conversational and narrative skills
59
FAS language difficulties
deficits in vocabulary and pragmatics
reduced MLU
poor conversational and narrative skills
language problems attributed got lack of theory of mind
problems with mental state verbs (i.e. think)
articulation problems- due to craniofacial abnormalities + phonological disorders/ problems with sound acquisition
apraxia
60
angleman syndrome
severe cognitive-intellectual impairments with seizures
| non-progressive genetic neurological disorder
61
angleman syndrome causes
at least 50% is due to a piece of chromosome 15 missing
- attributed to mother's chromosome
this results in brain development and lacking in motor movement and language
62
angleman syndrome prevalence
1 in 10,000 to 1 in 25,000
63
angleman physical attributes
```
spaced teeth
jaw protrusion
deep-set eyes
fair complexion
stiff-legged gate
jerky movements of extremities
-hand flapping
normal hearing
-some otitis media
will hold objects in mouth
poor joint attention
-eye contact
```
64
angleman speech and language
speech and langauge do not develop
-non speaking
(AAC suitable)
communication through gestures
65
angleman diagnosis
unrecognized at birth
| diagnosed through FISH test
66
FISH test
florescent in situ hubidization
67
angleman personality/ other symptoms
80% will demonstrate seizures
| typically happy and affectionate
68
Fragile X diagnosis
hereditary- X lined through mother
long are on X Chromosome
identified through blood test
69
Fragile X prevalence
high in prevalence causing ID
males more effected 1 in 1,000
severity if in female, is much higher 1 in 2,000
70
Fragile X physical attributes
```
long face/ears
droopy eyelids
flate nasal bridge
small hands
low muscle tone
flat feet
blink rapidly
hyperextended finger/ other joints
-poor coordination
mitral valve prolaps
vision difficulties
```
71
Fragile X personality/ other characteristics
hyperactivity
sensory integration
tactile defensive
72
Fragile X speech/language
```
echolalia- Hallmark of these children
perseverate (persistent with one word)
false start/frequent syllable repetition
poor sequencing/organizing
-sytax abilities
-pragmatics
speech unintelligible
```
73
Rossetti
infant toddler test
| "can I hold your child"
74
Augmentative Alternative Communication (AAC)
area of of clinical practice that attempts to compensate (temporarily or permanently) for impairments or disabilities
For people with severe expressive communication disorders
E.g. speech generated devices for communication only
For people with severe expressive communication disorders
Mobile devices sign language
It can also be used for augmented input i.e receptive
-Using some sort of visual aid input
-like how mom uses a sheet with pictures to tell her so that's what she wanted them to do or where they are going
75
Number one parent concern with AAC
That it will stop the child from talking
AAC actually facilitates expressive communication
You are still prompting any unaided speech and nonverbal communication
76
AAC can be used with
Stroke, TBI trach/laryngectomy, Parkinson's, apraxia, aphasia, ALS – Lou Garricks disease
77
Dave Bukelman
"father of AAC"
| University of Nebraska
78
Lyle Lloyd
Purdue
79
Janice Light and Krista Wilkinson
Penn State
80
Goal of AAC
Not to find a technological solution but help people engage in a variety of interaction
81
Communication purpose
Communicate wants, information transfer, social closeness, social etiquette, internal dialogue
82
Multimodal communication
Use AAC with speaking and gestures
83
unaided communication
Communication with body gestures, facial expression, sign
84
Aided communication
Anything outside of your body
85
AAC for children that are not illiterate or too young
Visual graphic symbols, photographs, line drawings, pictures
86
Problems with AAC
Time-consuming for programming
physical access issues
typical AAC speaker can only say 7 to 13 words per minute
87
AAC videos
-anything other than speech used to communicate
SGD- speech generating devices
Can be mounted on the wheel chair
88
How can I support the use of AAC?
Provide lots of opportunities for communications
Model the use of AAC
Wait and allow time for the child to communicate
Respond to the child’s attempts to communicate
Have fun
89
Visual scene displays
being able to scan a picture into the AAC system and then the child can click on the parts of the photo for different responses
90
Autism Spectrum disorders used to mean
there are different severities to characterize disorder
91
DSM 5
refined some of the subtypes of ASD in 2012
92
ASD is now
used as a global term- does not differentiate different severity levels
93
Leo Kanner 1943 Psychologist description of autism
```
the first to define autism
aloof
withdrawn from social interaction
echolalia
fascination with objects
intolerable to change
normal or near normal intelligence
everyone he worked with had normal intellegance
```
94
Asperger Syndrome
subtype of the ASD spectrum in DSM 4
dropped in DSM 5
but many still recognize it
95
Asperger’s S characteristics
considered high functioning
schedule oriented
primarily a disorder of pragmatic
semantic deficits
often get in trouble for using words atypically
most likely a lot of undiagnosed people with Asperger’s
typically strong visual memory
servant abilities (super natural abilities) i.e. music
not aware/unsure of their social behaviors
96
Autism Diagnosis
occurs frequently in families
can occur before, during, or after birth
ASD can be diagnosed by 18 months- trying to diagnose during 1st year
neurodevelopmental disorder
97
prevalence of ASD
1 in 68
| more predominant in males
98
DSM 4- pervasive developmental disorder not otherwise specified (PDD-NOS)
children that met some of the criteria for ASD, but not all
delays in development and social communication
ruled out any type of psychiatric disorders
99
infantile autism (DSM-4)
autism before 30 months of age
100
Autistic disorder (DSM-4)
type of Autism that is most severe
101
Heller Syndrome (childhood disintegrative disorder)
progressive disorder
normal developmental until age 2
after 2, begin to lose abilities until age 10 (social, emotional, cognitive, motor)
Associated with severe intellectual disabilities, dementia
Normal life expectancy
102
Retts syndrome
Progressive neurological disorder (not fit under autism spectrum)
Shares some symptoms that can present as autism
Pervasive developmental disorder
Everything appears intact for the first 5 months of life
Then you see deficits in social, motor, and cognitive abilities
Impaired language development
neurological problems: seizures
Sudden cardiac death
Many will survive into adulthood
Hand flapping
Apraxia
Metalinguistic deficits
Major oral- motor and feeding issues
103
ASD Characteristics personality
Primary deficits: social, emotional, communication skills
Social- pragmatics/interaction
Emotional- difficulty with regulating emotion
Communication- deficits in reciprocity
Gestural communication impaired
Problems with joint attention (precursors to comm. Development)
No interest in others
Eye contact avoidance
Want to be left alone
Deficits in ToM (theory of the Mind)-
difficulty understanding other people
Difficulty talking about own feelings
Stanley Greenspan- University of North Carolina- intervention focused upon emotions
Aloof- doesn’t seem to care for closeness unless on their terms
Imaginative play deficits
Difficulty with pretend play
Actions are repeated over and over again
-Speech and movements
Difficulty adapting to routine changes
Unusual reactions to taste, smell, sight, or sound
Sensory system deficits
Show aspects of normal development and then regress at one time
Poor proximity
Better with construction play (like Legos)
104
ASD Characteristics language
Unaware when people talk to them
Language abilities parallel with their IQ (cognitive abilities)
Echolalia
Immediate
Mitigated
Delayed
Speech intelligibility is fine
Monotone- No rhythm, stress or intonation (suprasegmentally)
Some use idiosyncratic language- a phrase or an utterance that they use that is unique to them
Sound prolongation
Avoid social interaction
Trouble with pronouns
Him for he you for themselves I for others
105
echolalia
a person will hear something and then they will repeat it back
106
immediate echolalia
preserves the exact utterance they heard and then repeats it back immediately
107
mitigated echolalia
parts of the utterance are preserved and repeated
108
delayed echolalia
child will repeat what they heard at a later date and time
109
ASD diagnosing
Challenging to administer a standardized test to this population
Parent-interview often used as means of assessment
SLPs so not diagnose ASD- group of professionals collaborate to make it
110
Causes and risk factors of ASD
There are multiple causes
There is an environmental contribution
Biological contribution (brain development)
Genetic factors – higher risk if sibling has ASD
ASD occurs more frequently with Fragile X syndrome
Children born to older parents have higher risk for ASD
Can occur before, during or immediately after birth
Prescription drugs: valproicacid, thalidomide
111
SCERTS model
Barry Prizant
Social Communication, emotional regulation, transactional support
Helping them participate in the world
At a high risk for emotional difficulties
A team of multiple disciplines makes a plan with the family
Behavior is secondary to primary communication
**is trying to understand the behavior before trying to provide remediation what is causing the behavior
112
Social communication
Focus on joint attention
Using symbol use with them
**we are trying to provide more traditional and conventional ways to communicate with their environment
importance of developing symbolic play
113
Emotional regulation
```
Self-regulatory skills
-impact on communication
-we all need language where we use an internal dialogue to
Mutual regulation
-teachers and SLPS can help them regulate
-holding a child's hand
-What others do to help us regulate
Recovery from dysregulation
```
114
Transactional support
dynamic and on going
Interpersonal support
-How do others include them, how do we support them
Learning or educational supports
-Visual strategies- visual learning is a strength for ASD
Support to families
-Educational support, what do you need to teach the parents to help the children learn
-Emotional support
Support among professionals
115
berry prizant
brown university
116
amy wetherby
florid state university
117
increase in ASD
700% in 10 years
118
ASD and seizures
15%
119
ASD and gastrointestinal problems
40%
120
symbolic play and ASD
if a child has symbolic play than they will be able to understand speech because language is symbolic as well
121
DSM-5
2013
| used for diagnosis/labels- needed for repayment of services from insurance companies
122
DSM-5 changes for autism
no longer uses aspergers or PDD-NOD, childhood disintegrative disorder, or autistic disorder
broad term of ASD now used
diagnostic # 299.00
123
backlash from change
people are still using old labels, especially children already diagnosed
124
Criteria for ASD persistent deficits in social communication and interaction
across multiple contexts
1. deficits in social/emotional reciprocity
- abnormal social approach, failure of normal back and for conversation, reduced interest, emotion, or affect
2. deficits in nonverbal communicative behaviors used for social interaction
3. deficits in developing, maintaining, and understanding relationships
- difficulty adjusting behavior, imaginative play, making fiends, disinterest in others
125
Criteria for ASD restricted repetitive patterns of behavior, interest, or activities
must have at least two of the following:
- stereotyped or repetitive motor movements with objects or speech
- insistance on sameness (inflexible adherence to routine)
- highly restricted/ fixated interests that are abnormal in intensity or focus
- hyperactivity to sensory input (indifference to pain and temperature adverse response to specific sounds or textures, fascination with lights and movement)
126
other criteria of ASD
- symptoms must be present in early developmental period
- symptoms must cause cynically significant impairment in social, occupation, or other important areas of current functioning
- deficits not explained by ID or global development delay- however can co-occur
- social communication should be below that of general developmental level
127
severity of ASD level 3
"requiring very substantial support"
| severe deficits in verbal and nonverbal social communication skills restricted, repetitive behaviors
128
severity of ASD level 2
"providing sustained support"
social impairments apparent
marked deficits in verbal and nonverbal communication
129
severity of ASD Level 1
"requiring support"
noticeable impairments, deficits in social communication cause noticeable impairments
-difficulty initiating social interactions
-a person who si able to speak in full sentences and engage in communication but whose to and fora conversation with others fail
inflexibilities causes interference with functioning
130
screening
- eye case
- response to name
- lack of pointing
- lack of pretend play
- reduced language development
- lack on NV communication
131
evaluation process
relevant case history
medical evaluation
medical and mental health history of family
administer speech and language assessment
genetic testing
metabolic testing
132
relevant case history includes
health
development
behavioral history
medical status
133
medical evaluation includes
physical
neurodevelopment evaluation
testing of hearing
134
instruments for ASD diagnosis
standardized test
parent/teacher/self report measures
systematic observation (naturalistic observation)
criterion referenced assessment
135
assessments tests us
recommendations
diagnosis of and
severity level, referrals
136
assessment always considered
ongoing
137
audiological evaluation necessary
may be challenging to obtain valid results
138
Autism screening instrument for educational planning- 3 (ASIEP-3)
for children 2-13.11
autism behavioral check list
sample of vocal behavior (spontaneous speech)
interaction assessments
educational assessment
functional levels (can child say in seat)
prognosis of learning rate
139
Child Autism Rating Scale- 3rd edition (CARS-3)
```
ages 2+
15 item rating scale to id autism from developmental disabilities
through direct behavioral observation
looks at behaviors:
-relating to people
-emotional expression
-body use
-object use
-restricted interested
-adaptation to change
-taste, smell, touch
- anxiety
-fear or nervousness
```
140
autism spectrum rating scale
2.5-6.18
5 point likerst scale
measures:
-socialization, communication, unusual behaviors, sensory sensitivity, self regulation, behavioral rigidity
141
Gillam Asperger Disorder Scale (GADS)
3-22
competed by parents or professionals
help with developing behavioral objectives/goals for IEPs
normed on 371 participants
142
what to look for with ASD diagnosis
social and pragmatic behavior!!
143
dynamic assessment
test, train, retest
| successful model for children with ASD
144
most assessments are
criterion referenced
145
functional assessment
looking at how communication can be enhanced, participation that is relevant to client's life
146
vertical goals are more appropriate for ASD
because they are focused on one goal and less intensive
147
horizontal goals
2, 3, or 4 goals that are complimentary of each other and worked on at the same time too cognitive demanding for ID clients
148
Autism and Intervention
social skills training/intervention
gentle touching
-natural, supportive interactions
AAC
149
social skills training
taking turns
150
AAC for intervention
- ideas and concepts related to the topic displayed in pictures
- Picture Exchange Communication System (PECS)
151
PECS
initially designed for communication with turn-taking
become more of an AAC program
for those with little to no communication abilities
scientifically accepted and proven
fondation skills in operant conditioning
152
6 phases of PECS
1. child learns to communicate
2. increasing distance between them and the comm. partner
3. add more pictures to the board that you create, they learn to discriminate between pictures
4. learns to produce simple sentences
5. answering questions
6. commenting
- 1985 Andrew Bondy, Laurie Frost
153
Oliver Wendt
Speak all- Purdue
-newer version of PECS that uses iPad
symbols moved to the speak window to create a communication
behavioral program
154
ABA
can work best with beginning communicators
| more naturalistic approach should be used for higher-level language
155
contemporary ABA
using natural environment + behavioral techniques
156
Autism is a disorder of
Theory of the Mind
157
social stories
fits under the concept of theory of the mind
models different perspective for child with autism
something that is function that is relative to the child's life can be represented through animation/a story that you come up
so they can understand the feelings of others
158
comic strips
teach child about specific concepts
| similar to social stories
159
lack of understanding emotions
therapy target could be to understand and express emotion
160
board maker
Picture Communication System
161
DSM-5
category for social-pragmatic disorder
162
Mand
for of prompt to elicit communication
| "say I want a cookie"
163
Parallel talk
providing naturalistic interactions
