1. Navigating Speech and Language Through Preschool Years
Hot Topic with the increase in diagnosis of Autism and Spectrum Disorders.
Walk you through trees in a forest and then zoom out to see the forest that is “Speech and Language Development”
Delay vs. Disorder?
C.L. Rigney

2. OBJECTIVES Participants will be able to:
Identify hallmarks of normal speech and language development
Define speech/language delay versus disorder
Identify characteristics that differentiate Autism vs. Language Disorder
Connect speech and language development to literacy
Justification: without identification of normal developmental processes, it is impossible to determine if the child’s characteristics are typical or atypical.
Speech and language development is a complex and global process.
ALL HUMANS COMMUNICATE, even when they don’t know it or are trying not to.
C.L. Rigney

3. FOUNDATIONS
The early stages of development are much like an irrigation system:
+ water flowing over land for nourishing plants
With proper set up it assists the thriving of the plants.
Same goes for development. When the foundations are set solid, symmetrical and balanced, kids thrive.
C.L. Rigney

4. COMMUNICATION Communication is the process by which we exchange ideas.
NONVERBAL
Nonlinguistic
Paralinguistic
VERBAL
Linguistic
Communication is the process by which we exchange ideas.
It can happen verbally (with linguistic symbols), or non-verbally (not symbolically)
“verbal” refers to language using verbal symbols:
Speech
Written language
ASL
“Non-verbal” refers to communication without verbal symbols.
Para = superimposed on speech
NON= can be present without verbal language (body language)
C.L. Rigney

5. 6 BASES OF COMMUNICATIVE DEVELOPMENT
Neurological- development of structures and landmarks in the brain used for processing language
Cognitive-mental activities involved in comprehension of received information; development of symbolism
Perceptual-use of sensory information and previous experience to make sense of new sensory information
Motor-muscle movement and associated neuro-feedback
Social –interactive processes that drive learning
Communicative- development of communicative intentions evident through goal directed behavior
6 bases of communication set the foundation for typical speech and language development.
Bases can be influenced by chromosomes, chemical environment, nutrition, stress, environmental pollutants and the birthing process.
C.L. Rigney

6. NEUROLOGICAL FOUNDATIONS
Brain weight is associated with neural development
Early sensation and perception provide the input to increase the number and complexities of neural connections
Brain weight is tripled by 2 years of age
EARLY EXPERIENCES ARE CRITICAL! Physiological change serves in the development of speech and language
Connections are organized through sensori-motor experience and processing.
We, the parents and the community are pivotal in providing the environment for “optimal growth”
C.L. Rigney

7. COGNITIVE FOUNDATIONS
Cognitive development
Sensation
perception
Motor control
cognition
(Hot stove example)
Language is circular like this too!
Cognitive growth sets the pace for linguistic growth.
C.L. Rigney

8. MOTOR FOUNDATIONS Initially underdeveloped muscles, floppy head
Stability at hips allows for kicking
Kicking leads to rolling over
Rolling over leads to pushing up
Pushing up leads to trunk strength and then sitting independently
Sitting
Crawling,
12 months walking leads to increased stability in the jaw then increased motor control in the mouth
Stability develops in an upward progression, motor control develops in a downward progression.
Motor sequences in the body will be mirrored in the mouth.
C.L. Rigney

9. SOCIAL AND COMMUNICATIVE FOUNDATIONS
Used to expand an individuals understanding of entities and relationships
Language is used as a social tool, motivated by improving communication and social connections
Symbolic communication is developed by associating real things to cognitive representations.
IF YOU ARE TREATED AS A COMMUNICATOR, YOU BECOME A COMMUNICATOR!
Parents do many things to teach their child how to communicate:
Time their interactions,
interpret bodily functions as communication,
Provoke vocalization
Use exaggerated facial expressions, rhythm and pitch
C.L. Rigney

10. EARLY DEVELOPMENTAL TRENDS
Typical development happens without our efforts to make it progress
Motor skills development allows for freedom of movement
Freedom of movement allows for exploration
Exploration, in turn, drives development
Changes in development lead to cognitive and psychosocial development
Typical development happens without our push.
If we feel like we are pushing things along then something may be amiss.
Mommas ALWAYS know.
C.L. Rigney

11. EXPERIENCE DRIVES DEVELOPMENT
Experience and interaction help organize the brain and mind for cognitive growth.
Based on commonly accepted learning theories, we know cognitive growth sets the pace for linguistic growth.
Parallel development between cognition and language. Play is a vehicle for learning. Language and play are interdependent. Play sequences should be mirrored in a child’s language.
Play with stacking blocks 1 year of age
Pick up baby doll Feed baby doll 2 years of age
Playing trucks and rescue vehicles, loading people on trucks and taking them somewhere else-3 years of age
C.L. Rigney

12. STEPS IN LINGUISTIC PROCESSING
Attention- awareness to a learning situation
Discrimination-identification of relevant characteristics of different inputs
Organization- chunking related bits of information
Memory-recall of previously learned information (rehearsal is required for long term storage)
Process must happen in this order
Interference with attention will influence all others down the line
C.L. Rigney

13. LANGUAGE
Language is an accepted system of arbitrary codes and signals/symbols used to communicate ideas.
Used as a tool
Has specific rules
Productive and creative
Based on studies of language acquisition and use, we seem to have innate ability to learn language.
Environmental influences are pivotal for shaping our symbolic understanding of the world.
Example: needle
C.L. Rigney

14. COMPONENTS OF LANGUAGE
Form
Sounds
Combined sounds
Word order
Content
Word choice
Vocabulary
Use
Emotion
Attitude
Txt msgng………………… OMG! ………………… :-P
C.L. Rigney

15. SPEECH Expression of language with sounds
Humans understand speech by~ 7 months of age
Humans use speech productively (goal directed behavior) by ~ 12 months of age
Overlaid onto a biological system that has its roots in a primary survival function (feeding).
Key to understanding: GOAL DIRECTED
C.L. Rigney

16. THE SPEECH CHAIN Complex system working together Electrical energy
Speaker formulates a message
Motor nerves send impulses to lungs larynx and articulators
Sound waves are transmitted to listener’s ear (enter feedback link)
Listener’s ear transforms message
Listener’s brain decodes message
Complex system working together
Electrical energy
Electrical energy into mechanical energy
Mechanical energy into acoustical energy
Acoustical energy into mechanical energy
Mechanical energy goes back to electrical energy
LOTS of room for error here!
C.L. Rigney

17. SPEECH SOUND DEVELOPMENT
Sound classes, in order of emergence, based on *norms: vegetative sounds, cooing, vowels, babbling Earliest sounds: /p, b, m, n, h, w/ Followed by: /k, ɡ, d, t, ŋ, f, / Then:/j, r, l/ Finally: /s, ʃ , ʧ , z , v, Ө, ʤ/ *hypothetical children do not exist. A wide range of variability can be seen up to 36 months of age.
ALL sounds should be at least emerging by 5ish
If sounds are coming in out of order we should pay close attention and look for other clues that something “soft” may be going on.
C.L. Rigney

18. WHAT IS NORMAL SPEECH AND LANGUAGE?
Development in feeding, speech, language, voice and fluency that follows predictable developmental stages at expected age ranges
Goal directed- used to “get things done”
Symbolic
Social and interactive
Progression is based on refinement of sensori-motor and cognitive skills laid down in the first 24 months.
C.L. Rigney

19. COMMUNICATIVE TIMELINE: 0-6 months
Oral reflexes, vegetative sounds
sensory and motor perception drives learning.
Birth
3 months
Parent infers communicative intent
Vocalizations through reflexive crying, hunger, tension and pain.
Oral reflexes have disappeared
Circular reactions
Pleasure sounds, reduplicated babbling, vocal play
Co-action patterns, and “proto-conversations”
Mutual gaze, play routines
6 months
Initially parent driven communication
Baby is working on stability and motor control
C.L. Rigney

20. COMMUNICATIVE TIMELINE: 7 -12 months
↑ᵈ goal directed behavior
“Early intentional communication”
Functional gesture and vocalization
more frequent and effective exchanges
9-12 months
↑ᵈ information processing and storage
Joint reference, joint action, turn-taking
Non-reduplicated (canonical) babbling, jargon and proto-words
12 months
↑ᵈ cognitive growth
Shift from pre-symbolic to symbolic communication
First TRUE words appear
early phonological productions and simplification processes
First glances at communication….Emergence of goal directed behavior!
Emergence of early intentional communication
Eye contact
Gesture
Vocalization
Emergence of symbolism via words
C.L. Rigney

21. COMMUNICATIVE TIMELINE: TODDLER ADVANCEMENTS
Form
SOUNDS-predictable patterns and processing /p,b,t,d,k,g,h,m,w,n/
SOUND COMBINATIONS-one word relationships
50% intelligible to unfamiliar listener
- Vocab. growth spurt months ( words by 24 months)
- Nouns and proper names predominate
- Two broad categories of words: agents and objects
WORD CHOICE
Content
Use
Ø presupposition
→Making demands
→Expressing wishes/displeasure
→Attitudes/states
Developments
They rely on emphasis
Use what they know to help them figure out what they don’t
Appearance of plurals, action verb endings, prepositions, attributes
Toddler “word recipes” for making 2-4 word combinations
Child uses identifiable strategies at this point
He uses what he does know to help him figure out what he does know.
Example “daddy” or “cup” and reason
Early grammar consists of modification of word endings
Child has little sense of social language as evidenced by…
C.L. Rigney

22. TODDLER’S RULES Author: Unknown
1. If I want it, it's mine 2. If it's in my hand, it's mine 3. If I can take it away from you, it's mine 4. If I had it a little while ago, it's mine 5. If it's mine, it must never appear to be yours in any way 6. If we are building something together, all the pieces are mine 7. If it just looks like mine, it's mine 8. If I think it's mine, it's mine 9. If I give it to you and change my mind later, it's mine 10. Once it's mine it will never belong to anyone else, no matter what
Everything you need to know about toddler language is in this rule set
Early pronouns “my, mine, you” appear
Early negation by way of “no”
They use short utterances “no mine!
Mommy gone!, more cookie!”
4. No sense of time or space except “now” “in” and “on”
5. NO social language skills.
C.L. Rigney

23. PRESCHOOL ADVANCEMENTS
Form
SOUNDS-↑ᵈ consonant development, processes dropped or dissolving by age 4
SOUND COMBINATIONS-syntactic agreements made to sentence elements and word order
WORD ORDER- basic forms of English (s-v-o) and modifications to this pattern
Content
WORD CHOICE
↑ᵈ concept development
↑ᵈverb forms
↑ᵈ pronouns
Limited conversational repair and topic maintenance
Participation in organized discourse
Early presupposition
Use-situation dependent!
Moves from modification of sentence elements to manipulation of word ordering, use of conjoining and embedding, and verb phrase development
Developments-
Appearance of pronouns “he/she/they” allows for the preschooler to presuppose another’s point of view.
Increase in verbs allows them to tell about what happened to them, though not in clear time order.
C.L. Rigney

24. PRE-LITERACY FACTS
Children between ages 2-3 years should be able to tell about plans, use scripts and descriptions to describe routines. At around 4 years of age children add physical and mental states to their descriptions. Emergent reading phases precede reading, and at around 4 years of age children begin to recognize and identify environmental print, and know the direction of reading. Narratives have roots in early social language skills.
C.L. Rigney

25. EARLY SCHOOL AGE ADVANCEMENTS
↑ᵈ conjoining, embedding, and passive sentence types
COMBINED SOUNDS/WORDS-↑ᵈ noun and verb phrase development, ↑ᵈ markings of comparisons, action, and reversals (addition of prefixes and suffixes)
SOUNDS-by age 8 all sounds competently produced
Form-
Content-
↑ᵈ specificity of definitional skills
↑ᵈ quantifiers
↑ᵈpronouns
↑ᵈ adjective development
↑ᵈ use of figurative language
Conversational repair with ↑ᵈ skill
Topic introduction and closure
Presupposition/alternation
Use-
↑ᵈresources available to adapt language and adjust to needs of listener
Use of deictic terms
Developments
Literacy
-reading
-writing
-narratives
C.L. Rigney

26. EXPECTED SKILLS Up to 4 years Up to 5 years Up to 6 years SPEECH
RECEPTIVE LANGUAGE
EXPRESSIVE LANGUAGE
FLUENCY
/p,b,m,n,h,k,g,t,d/ /f, v, ʃ, ʤ,ȝ, j, w, l, s/ /Ө, r, r+vowels/
Basic concepts, pronouns, Qualitative ,spatial concepts, Time /sequence,
Negatives, categories, time concepts, noun early math,
Analogies modifiers inclusion/exclusion
passive voice
Object ID, asks ?’s, varied word Gives location, reason, Similarities, 1:1
combinations, 4-5 word categorizes, adjectives, divergent naming,
sentences, categorizes, past tense, convergent repairs absurdities
object use, possessives, naming
descriptors,
Hypothesizes, gives analogies
Partial/whole word repetition,
reformulations, phonemic Reformulated phrases
Repetitions with ↑ᵈ
production accuracy
C.L. Rigney

27. When things go wrong… ATYPICAL DEVELOPMENT Dyspraxia Language Disorder
With these complicated foundations, what could POSSIBLY go wrong?
Dyspraxia
Language Disorder
Autism
C.L. Rigney

28. WHAT COULD GO WRONG?
Children quickly compensate for their own missing links. What initially may have appeared to be a delay may actually be a disorder hiding under the “wide range of variability in early childhood development. Language Disorder: receptive/expressive or both Articulation Disorders :dyspraxia, dysarthria, phonological processing disorder Autism or Spectrum Disorders Congenital Disorders: Acquired or Degenerative Disorders

29. BROKEN LINKS
When skill sets do not appear when expected, we must define a delay or a disorder.
Developmental delay implies “…an impairment… in the meeting of milestones that a child should achieve by a specific chronological age.” (Taber’s Cyclopedic Medical Dictionary, 2001)
The term “disorder” implies a pathologic or abnormal condition. In other words, absence or atypical acquisition and/or presentation of a skill.
C.L. Rigney

30. RISKS
As high as 70% of children exhibiting oral language impairments will later exhibit difficulties with literacy.
Toddler and preschool language development is critical for school success.
Autism is the fastest growing childhood disorder, and is primarily a disorder of verbal and non-verbal language.
A labeling of “delay” does not necessarily mean an absence of disorder.
Excellent memory for rehearsed or rote learned skills (colors, letters, numbers) is not the same as symbolic learning.
Literacy includes reading and writing.
Literacy has it’s roots in social language as it is a language based task used to inform or entertain.
C.L. Rigney

31. RED FLAGS for AUDITORY PROCESSING
Difficulty with phonemic awareness
Asking “what” repeatedly after directions are given, or “I don’t know” to avoid responding
Answering wh- questions incorrectly
Using semantic substitutions (word for word)in expressive language that cannot be explained by articulation concerns
Evidence of increased distraction or fatigue after periods of listening
Body language indicating “shutting out” of active or potential communicative partners
C.L. Rigney

32. RED FLAGS for RECEPTIVE LANGUAGE
Need for frequent repetition
Need for extra explaining before following through with directions
Difficulty answering questions
Difficulty understanding time concepts
Difficulty understanding prepositions or spatial concepts
Difficulty with 1:1 correspondence
Difficulty organizing or categorizing
Poor eye contact during listening tasks
C.L. Rigney

33. RED FLAGS for EXPRESSIVE LANGUAGE
Switching or omission of pronouns (sometimes I am you and you are me and me is you)
Omission or difficulty using spatial or time concepts
Difficulty retelling actions or events
Omission of connector or functor words (telegraphic speech)
Verb irregularity
Frequently switching topics in conversation
Overuse of rote phrases and communicative exchanges
Inability to tell about something
C.L. Rigney

34. RED FLAGS for ARTICULATION
Inconsistent speech sound substitutions
Immature sounding speech toward later preschool years
Irregular airflow during speech
“wet” speech
Hypernasal/hyponasal
Jaw sliding during speaking
Parent difficulty understanding speech
A child should be 80% intelligible to their primary caregiver by 3 years of age, to other listeners by 4 years of age
Messy eating, drooling, or restricted food preferences
Poor stability; open mouth posture, uncoordinated gate + immature or disorganized speech or feeding.
C.L. Rigney

35. RED FLAGS for VOICE
Hoarseness or raspiness in the absence of chronic allergies or recent illness
Loss of voice within an utterance or conversation
Breathiness during speech
Difficulty changing pitch during speaking
C.L. Rigney

36. RED FLAGS for FLUENCY
Repetitions of phoneme at the beginning of a word, thought or phrase
Episodes of stopped airflow and/or sound during speech
Very rapid speech
Variable rate of speech
Avoidance of conversational interaction
C.L. Rigney

37. IS IT AUTISM?
DSM-IV (1994)Criteria for Autism requires specific characteristics that include a total of at least 6 variations and manifestations from the following categories:
“qualitative impairment in social interaction…, qualitative impairments in communication…, restricted repetitive and stereotyped patterns of behavior, interests and activities…”
“Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play”
“The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder”
C.L. Rigney

38. AUTISM vs. LANGUAGE DELAY?
Based on DSM-IV criterion, the primary difference between a language delayed/disordered child and an autistic child is that the child with Autism will demonstrate impairment in areas of social interaction and symbolic play, as well as language form, content, and/or use. A child without spectrum characteristics will still initiate and/or engage in social interactions and play routines.
C.L. Rigney

39. AUTISM FACTS
According to Pathfinders for Autism, Maryland estimates indicate 1:142 children are diagnosed with Autism, a complex neurological disorder. Boys are 3-4 times more likely to be diagnosed with Autism than girls.
According o the National Institute of Mental Health, causes of Autism have been investigated with the following results: “The Institute of Medicine (IOM) conducted a thorough review on the issue of a link between thimerosal (a mercury based preservative that is no longer used in vaccinations) and autism. The final report from IOM, Immunization Safety Review: Vaccines and Autism, released in May 2004, stated that the committee did not find a link. ..All these disorders are characterized by varying degrees of impairment in communication skills, social interactions, and restricted, repetitive and stereotyped patterns of behavior…Evidence points to genetic factors playing a prominent role in the causes for ASD. A U.S. study looking at environmental factors including exposure to mercury, lead and other heavy metals is ongoing.”
C.L. Rigney

40. WHAT TO DO? Educate yourself. Find out what is “typical”.
Be the “eyes” of the community. Be observant for early warning signs.
Document your concerns. It is hard to remember details as time goes by.
Interview the child in a non-threatening way. Many children are aware of their own weaknesses.
Come alongside parents who suspect their child has a problem and direct them to community resources.
Use community resources. Pediatricians, Child Find, and private practice specialists can help.
C.L. Rigney

41. ADDRESSING CONCERNS WITH PARENTS
Be prepared. Have all of your observations, papers, and examples ready. Plan how you want the meeting to go. Educate yourself. Consult a speech-language pathologist about concerns you may have. Make an approach. Ask the parent when would be a good time to talk about some observations your have noticed in your setting. Use sensitivity. No-one wants to be told their child is different or irregular. Chose words like “I noticed”, or “based on classroom performance/behavior”, or “lets err on the side of caution and have [concern] ruled out”. Emphasize the importance of early intervention! Labels can drop off with early and appropriate intervention.
C.L. Rigney