Persons with Speech and Language Disorders Chapter 10 Persons with Speech and Language Disorders

Speech Expression of language with sounds Willed, planned, and programmed by the central nervous system Brain Spinal Chord Peripheral nervous system Dependent upon Respiration Phonation Articulation

Language A code of ideas and concepts about the world Governed by complex rules and relationships Phonology Morphology Semantics Syntax Pragmatics

Components of Language Pragmatics Phonology Morphology Semantics Syntax Application of social and contextual cues Sound discrimination and articulation Grammatical structure and use of words Understanding of word meanings Use of grammar and grammatical rules

Communication Exchange of ideas, information, thoughts, and feelings The process does not require speech or language Gestures Posture Eye contact Facial expression Head and body movement

IDEA (PL 105-17) Communication Disorder Referred to as to “speech and language impairment” Eligibility includes Stuttering Impaired articulation Language impairment Voice impairment Must adversely affect a child’s educational performance

Speech Disorders A deviation so far from the speech of others that it: Calls attention to itself Interferes with communication Provokes distress in the speaker or listener (Van Riper & Erickson, 1996)

Types of Speech Disorders Articulation Speech sounds Fluency Rhythm and timing of speech Voice Quality of speech production

Articulation Disorder Errors in the production of speech sound Distortions Substitutions Omissions Therapy concentrates on Identification and acquisition of the correct speech sound Generalization and maintenance of the sounds

Fluency Disorder Interruption in the flow of speaking characterized by: Atypical rate and rhythm Cluttering – fast and jerky speech Repetitions in sounds, syllables, words, and phrases Stuttering – rapid-fire repetition of consonant or vowel sounds

Voice Disorders Problems with the quality or use of one’s voice that result in an abnormal or absence of: Pitch Loudness Resonance Hyper-nasality Hypo-nasality Duration Phonation Breathiness Hoarseness Huskiness Straining

Language Disorders I Phonological disorder Apraxia of speech Involves the abnormal organization of speech sounds Apraxia of speech Neurological, phonologic disorder attributed to weak or slow speech muscles Frequent omissions, substitutions, and distortions

Language Disorders II Morphological disorder Semantic disorder Difficulty using grammatical morphemes such as nouns, verbs, and adjectives that signal different meanings (example – s added to dog, signals plurality) Semantic disorder Characterized by poor vocabulary development and the inappropriate use of word meanings

Language Disorders III Syntactical deficits Difficulty acquiring the rules that govern word order or other aspects of grammar Often manifest in an inability to organize and express complex ideas Pragmatic difficulties Problem understanding or using language in different social context Unaware of conversational conventions

Language Disorder IV Central auditory processing disorder (CAPD) Difficulty in the processing of sound, not attributed to hearing loss or intellectual capacity Limitations in sound: transmission, analysis, transformation, elaboration, storage, and retrieval May be a primary or secondary disorder that affects listening skills necessary for language development

The History of Speech and Language Disorders I Objects of curiosity Balbus Blaesus Wild Boys (feral children) Objects of pity or scorn Used in the context of religious practices To be dumb, as in not able to speak A rewarding source of humor Topic of jokes and cartoons

The History of Speech and Language Disorders II 1910 – Chicago public schools hire the first speech correction teacher Terminology defines attitude Speech correctionist Speech specialist Speech teacher Speech therapist Speech-language pathologist

Etiology Functional – occurring after birth Acquired: traumatic insult after birth (TBI); disease complication, hearing loss Developmental: environmental, emotional disturbance Organic – occurring prior to birth Congenital: Cleft palate; teratogens; deafness Developmental: mental retardation, cystic fibrosis, cerebral palsy

Influences on Language Learning (McCormick, 2003) Biological preparation Successful nurturance Sensorimotor experiences Linguistic experiences

Developmental Milestones Cognitive- thinking, reasoning, problem solving, understanding Language- expressive and receptive abilities Motor coordination- gross/fine motor, jumping, hopping, throwing/catching, drawing, stacking Social interaction- initiating peer contact, group play Self help- dressing, eating, washing

Early Language Development I By age one Recognizes name, recognizes words as symbols for objects, imitates Between one and two Understands no, combines two words, uses 10-20 words, follows simple instructions Between two and three Forms some plurals, combines nouns and verbs, ask simple questions, gives first name, carries on conversation with self and toys, 450 word vocabulary

Early Language Development II Between three and four Tells a story, names one color & last name, understands time,1000 word vocabulary Between four and five Uses past tenses, points to colors and shapes, can identify abstract conditions such as hope,1500 word vocabulary Between five and six Has as sentence of 5-6 words, knows address, identifies spatial relationship, counts, opposites, asks questions for information, 2000 word vocabulary

Expressive Language Problems Limited use of vocabulary Searches for the right word Poor social language skills Hesitates to ask questions Jumps from topic to topic Topics chosen are concrete rather than abstract, temporal, or spatial Repetitive and unspecific

Receptive Language Problems Encounters difficulty with oral presentation of information Cannot detect breakdown in communication Does not understand humor, figurative language, or abstract thought May reverse the order of sounds or confuse the sounds of letters that are similar

Speech Assessment Should include information on Hearing, motor skills, oral and respiratory mechanism, general physical condition, educational records Should evaluate Articulation, voice, fluency, and sounds or phonemes not produced correctly for the student’s age Should consider Developmental level, maturity, gender, ethnicity, and cultural background

Assessing Communication Disorders (Cohen & Spenciner, 1998) Screen for possible communicative disability Refer to professionals for formal assessment Review eligibility for disability services indicated by child’s strengths and weaknesses Plan a program, formulate an IEP Monitor student progress Evaluate IEP and program goals for effectiveness

Figure 10.4 Educational Placement of Students with Speech and Language Disorders

Central Auditory Processing Problems in the Classroom Use selective seating Reduce external auditory distraction Decrease environmental distraction Gain the child’s attention before giving oral information Emphasize key words and eliminate unnecessary verbiage Check frequently for understanding Do not ask child to listen and write at the same time

Young Children PL 99-457 provides for an evaluation of toddlers between the ages of 3-5 Concentrates on an assessment of family interaction patterns, strengths, and needs Type of vocabulary used with child Attempts to engage child in conversation Quality of voice animation and body language Response to child’s effort to communicate Imitation of the child’s efforts

Issues of Diversity Approximately 9 million children do not speak European American English as their primary language Limited English Proficient (LEP) or Potentially English Proficient (PEP) Lack of valid and reliable tests for bilingual children makes it difficult to identify speech and language impairment May be misidentified as learning disabled, mentally retarded, or speech and language disordered

Intervention for PEP Children Techniques similar to those used with monolingual children Focusing on morphology, syntax, phonology, semantics, and pragmatics Incorporates techniques for second language learners Vocabulary and syntax in context of ongoing activities Comprehension before production Using predictable books Using peer buddies and parents as teaching partners

Technology Augmentative and alternative communication Non electronic communication boards – choices represented by real items, symbols or pictures Electronic communication boards include voice, scanning options, programmed to handle multiple templates

Trends, Issues, and Controversies The need for early and accurate diagnosis and intervention is confirmed by research Human Genome Project unlocks complexities of heredity and creates the potential for medical intervention Cultural diversity, non-standard English, and dialect occupy educational and political agendas Etiology of CAPD and stuttering remains controversial