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Navigating Speech and Language Through Preschool Years

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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

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

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

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

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

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

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

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

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

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

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

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

↑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

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

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

↑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

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

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

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

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

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

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

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