Communication Disorders Chapter 8 Communication Disorders Developed by: Blanche Jackson Glimps Tennessee State University

Chapter Objectives Identify and provide examples of four major functions of communication. Describe the characteristics of each of the following communication disorders: speech sound errors, fluency disorders, voice disorders, and language disorders. Explain why the number of children with speech and language impairments is much higher than the number of children who receive services under the speech or language impairment category.

Chapter Objectives Describe and identify causes of primary types of speech and language impairments. List the major components of a comprehensive evaluation used to detect the presence and extent of a communication disorder. Identify the basic goals and common elements of effective interventions for speech-sound errors and language disorders. Explain how the speech-language pathologist’s role changes as a function of the setting in which a child with communication disorders is served.

Definitions Communication is the interactive exchange of information, ideas, feelings, needs, and desires Communication involves A message A sender who expresses the message A receiver who responds to the message Functions of communication Narrating Explaining/Informing Requesting Expressing

Definitions Language is a formalized code that a group of people use to communicate with one another The five dimensions of language: Phonology Morphology Syntax Semantics Pragmatics Dialects are the learned patterns of speech and language appropriate to families and communities.

Definitions Speech is the oral production of language. Speech sounds are the product of four related processes: Respiration - Breathing that provides power Phonation - Production of sound by muscle contraction Resonation - Sound quality shaped as it passes through the throat, mouth, and sometimes the nasal cavities Articulation - Formation of recognizable speech sounds

Typical Speech and Language Development Most children follow a predictable sequence in the acquisition of speech and language skills. Children between the ages of 11 and 36 months of age are exposed to a tremendous amount of spoken language. Children who are learning to talk practice their new skill relentlessly. Bridging the “30 million word gap” is a reference to the vast difference in the number of words that some children from poverty background hear by age 4 years compared with the experiences of more affluent children.

Communication Disorders Defined ASHA definition An impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal, and graphic symbols systems. IDEA definition A communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance.

Speech Impairments Speech is impaired when it deviates so from the speech of other people that it Calls attention to itself Interferes with communication Provokes distress in the speaker or listener Three basic types of speech impairments are Articulation disorders-errors in the production of sounds Fluency disorders-difficulties with the flow or rhythm of speech Voice disorders-problems with the quality or use of one’s voice

Language Disorders Language disorder is impaired comprehension and/or use of spoken, written, and/or other symbol systems. Language disorder may involve in any combination: The form of language (phonology, morphology, and syntax) The content of language (semantics), and/or The function of language (pragmatics) in any combination. Language disorders may involve receptive or expressive disorders

Characteristics: Speech Sound Errors Distortions Substitutions Omissions Additions Articulation disorders A child is not able to produce a given sound physically because that sound is not in his repertoire Phonological disorders A child has the ability to produce a given sound and does so correctly in some instances but not others

Characteristics Fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm and repetition in sounds, syllables, words, and phrases. Stuttering and cluttering are examples Voice disorders A phonation disorder causes the voice to sound breathy, hoarse, husky, or strained Resonance disorders results in hypernasality or hyponasality

Characteristics: Language Disorders Language disorders involve problems in one or more of the five dimensions of language: Phonology Morphology Syntax Semantics Pragmatics Language delay implies a child is slow to develop linguistic skills but acquires them in a typical sequence. Language disorders suggests a disruption in the usual rate and/or sequence in which specific language skills emerge.

Prevalence In the 2012 to 2013 school year, about 1,356,000 children ages 6 to 21 years received special education and related services under the IDEA category speech or language impaired. It is the second largest disability category under IDEA. Approximately two thirds of school-age children served by SLPs are boys. About 50% of children who receive special education services because of a primary disability also have communication disorders. The percentage of children with speech and language disorders decreases significantly from the earlier to the later school grades.

Causes: Speech Impairments Cleft Palate Paralysis of the Speech Muscles Absence of Teeth Craniofacial Abnormalities Enlarged Adenoids Traumatic Brain Injury Dysarthria

Causes: Language Disorders Developmental and Intellectual Disabilities Autism Traumatic Brain Injury Child Abuse and Neglect Hearing Loss Structural Abnormalities of the Speech Mechanism Aphasia Genetics Environmental Influences

Identification and Assessment Screening and Teacher Observation Evaluation components Case history and physical examination Articulation Hearing Phonological awareness and processing Vocabulary and overall language development Assessment of language function Language samples Observation in natural settings

Assessment of Children Who Are Culturally Diverse Assess language proficiency in both the first and second languages when determining a culturally and linguistically different child’s communication competence. Do not diagnose with a speech-language disorder if problems are observed only in English and not in their first language (or dialect). Include assessment of basic interpersonal communication skills and cognitive academic language proficiency. Assessment for the purpose of identifying children with disabilities are required, by IDEA, to be conducted in the child’s native language

Educational Approaches Articulation and phonological errors: Discrimination and production activities Fluency disorders: Behavioral principles and self-monitoring Voice disorders: Medical Examination and Direct vocal rehabilitation Language disorders: Vocabulary building, naturalistic interventions

Augmentative and Alternative Communication (ACC) ACC refers to a diverse set of strategies and methods to assist individuals who cannot meet their communication needs through speech or writing. ACC entails three aided or unaided components A representational symbol set or vocabulary A means for selecting the symbols A means for transmitting the symbols Symbol sets and symbol systems for ACC Selecting the symbols Transmitting the symbols

Placement Options In 2011 to 2012, 87% of children with speech or language impairments were served in the general education classroom, 6% in resource rooms, and 4% in separate classrooms. Some examples of service delivery models: Monitoring Pullout Collaborative Consultation Classroom or Curriculum Based Separate Classroom Community Based Combination