Week 1 Models of Language Disorders

Question 1

What is a disorder?

Answer 1

Deviation from the “average” in a similar group

But which group? How far must you deviate? Who decides?

Question 2

What factors can cause DLD?

Answer 2

Genetic
Neurobiological
Environmental

Question 3

Genetic factors?

Answer 3

DLD tends to run in families
Heritability estimates vary (twin studies)

Question 4

Neurobiological factors?

Answer 4

Localization (Auditory cortex, Broca’s, Wernicke’s areas,etc. )
Functional Specialization (synaptic pruning)
Structural anomalies increase risk of DLD (e.g., atypical asymmetry in the language cortex)
Causality is not obvious to us
Reduced lateralization of language in the cerebral cortex
ERP studies – delayed response to incongruent stimuli for DLD
Direction of causation is unclear for people with DLD

Question 5

Environmental factors?

Answer 5

Low SES associated with protracted language (and sensorimotor) development – why?
Fewer communicative interactions result in less gray matter for young children (Romeo, 2018)
Language Environment Analysis (LENA)- interaction matters more than vocabulary

Question 6

What is reduced lateralization?

Answer 6

measured by reduced blood flow to left hemisphere during language tasks in adults with DLD.
(direction of the cause isunclear) - do brain differences cause the delay, or does a lifetime of the delay cause the brain differences?

Question 7

Cognitive Models of Developmental Language Disorder – where is the deficit?

Answer 7

Auditory Processing
-Problems with perception and categorization of phonemic contrasts
-Criticisms – exceptions,and ineffective interventions (Fast ForWord Program)

Procedural Deficits
-Procedural vs. Declarative memory
-People with DLD struggle with procedural learning tasks; these weaknesses correlate with language scores
-Debate about degree that people can compensate with declarative memory

Limited Processing Capacity​
-Poor working memory, poor phonological short-termmemory.​
-Limited ability to “hold” informationstore while processing challenginginput​
-Tradeoff between processing andcapacity​​

Question 8

How can SLPs help with DLD?

Answer 8

Target language specific skills in intervention (rather than underlying cognitive skills)

Help caregivers to improve the linguistic environment

Choose tasks carefully when evaluating

Question 9

What can impact form, content, and use?

Answer 9

Language Delay/Late Language Emergence
Developmental Language Disorder (DLD)
Secondary Language Disorder
Language Difference (lumped in w/ disorders. Not really appropriate BUT there is often overlap between how they present)

Question 10

Language Delay/“Late language emergence” (LLE)

Answer 10

-More likely with family history
-Males are 3x more likely to have LLE than females
-More prevalent in twins
-At risk for developing other disorders of spoken & written language (if not using as much language because of delay, they can get behind in other areas too)

Question 11

Late bloomers vs. LLE

Answer 11

Late bloomers use more iconic gestures (have meaning, not just random gestures)

Late bloomers less likely to demonstrate concomitant comprehension delays

Question 12

Developmental Language Disorder (DLD)

Answer 12

~7% of population (6% girls, 8% boys)
-Difficult to diagnose before age 3- if it’s limited, is it a disorder or just delayed?
-Occurs in the ABSENCE of any other causal diagnosis (e.g., intellectual disability, hearing loss, etc.)
-No single cause (maybe multiple risk factors)
-Associated with risk for dyslexia and other learning disabilities
-Can be lifelong

Question 13

State of Arizona – Outcomes & Justification

Answer 13

These determine the
outcomes that are
written into the plan.

The “Service” is
Speech-language pathology

Question 14

Co-occurrence with other diagnoses…

Answer 14

A child with a primary diagnosis of something else may STILL have DLD. For example:
Child has Down Syndrome but language skills below what is expected for his diagnosis and severity level
-Adult has intellectual disability but language skills far below other skills at their developmental level (e.g., cognition, motor)

…Not the same as a secondary diagnosis!

Question 15

Secondary Language Disorders

Answer 15

Child demonstrates language skills consistent with their primary diagnosis and severity level.
May occur due to -
autism spectrum disorder (ASD),
intellectual disabilities (ID),
developmental disabilities (DD),
attention deficit hyperactivity disorder (ADHD),
traumatic brain injury (TBI),
psychological/emotional disorders,
hearing loss
May be described as -
“Language Disorder Associated with….”