1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. Autism Spectrum Disorder
Autism is a developmental disability affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance.
Other characteristics are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual response to sensory experiences.
Autism does not apply if the child has a serious emotional disturbance.

8. DSM Definition
Subsumes all four related disorders into a single diagnostic category, autism spectrum disorder with the following characteristics:
Persistent deficits in social communication and social interaction across context
Restricted, repetitive patterns of behavior, interests, or activities

9. DSM Definition Symptoms must be present in early childhood
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning
Symptoms are not explained by intellectual disability or developmental delay

10. Characteristics Impaired Social Relationships Extreme aloofness
Social situation difficulties attributed to deficits in theory of mind
Deficits in joint attention
Communication and Language Deficits
Some children with autism do not speak
Echolalia is common among those who do talk
Concrete or literal processing of verbal information is common

11. Characteristics Repetitive, Ritualistic, and Unusual Behavior Patterns
Some children exhibit stereotypy which is a pattern of persistent and repetitive behaviors
Insistence on Sameness
Children with autism are inflexible with routines
Unusual Responsiveness to Sensory Stimuli
70% to 80% of individuals with autism react atypically to sensory stimulation
Over and underresponsiveness
Hyposensitive and hypersensitive

12. Characteristics: Cognitive Functioning
ASD occurs across the full range of intellectual abilities
There are deficits in executive functioning
About 10% to 15% exhibit “splinter skills”
About 1 in 10 have savant syndrome
Many exhibit overselectivity
Theory called weak central coherence
Obsessive attention on a specific object or content
Some possess a strong aptitude for rote memory of certain things

13. Characteristics: Challenging Behavior
Some students with autism exhibit property destruction, aggression toward others, and even self-injury
Many experience a variety of sleep problems
Some have extremely narrow food preferences
Some engage in pica which is the compulsive, recurrent consumption of nonfood items

14. Characteristics: Asperger Syndrome
Asperger syndrome is at the mild end of the ASD
Asperger is no longer a separate category in DSM
Impairment in the social areas
Deficits in the use of nonverbal behaviors related to social interaction
No general language delay
Most have average or above-average intelligence
Their peculiarities and social skills deficits make it difficult to develop and maintain friendships

15. Prevalence Autism occurs in as many as 1 in 68 children
Rise in autism prevalence is an international phenomenon
Autism is the fourth largest and fastest growing disability category in special education
Boys are affected nearly 5 times more often than girls
ASD appears in all racial, ethnic, and socioeconomic groups
In the 2012 to 2013 school year, 498,000 students ages 3 to 21 years received special education services under the IDEA category of autism

16. Causes
Autism is a neurodevelopmental disorder with no medical or physiological marker.
In 85% of cases, the cause of autism is unknown
There is a clear biological origin of autism in the form of abnormal prenatal and postnatal brain development, structure, or neurochemistry.
Autism clearly has a genetic component.
Combination of autism-related genes, exposure to certain environmental factors may lead to the development of autism in some children.

17. Identification and Assessment
Early diagnosis is highly correlated with dramatically better outcomes
Autism can be reliably diagnosed at 18 months of age
Screening Tools
Modified Checklist for Autism in Toddlers (M-CHAT)
Social Communication Questionnaire (SCQ)
Autism Spectrum Screening Questionnaire (ASSQ)

18. Identification and Assessment
Diagnosis, for those who fail screening tests or whose parents or caregivers have reasons for concern undergo a complete diagnostic evaluation.
Diagnostic Tools
Childhood Autism Rating Scale (CARS-2)
Autism Diagnostic Interview-Revised (ADI-R)
Autism Diagnostic Observation Schedule (ADOS)
Asperger Syndrome Diagnostic Scale (ASDS)

19. Educational Approaches
Children with autism are among the most difficult students to teach
Early Intensive Behavioral Intervention
The work of Ivar Lovass
Applied Behavior Analysis (ABA)
Discrete Trial Training
Visual Supports
Visual Activity Schedule
Social Stories

20. Social Stories
Written at the student’s level of comprehension and usually contain four basic types of sentences written from the perspective of the student.
Descriptive Sentences
Perspective Sentences
Directive Sentences
Affirmative Sentences
Constructed with one sentence per page and with photographs or line drawings depicting key information sometimes added.
Not considered an evidence-based practice

21. Unproven Treatment An Example
Facilitated Communication is a process by which a communication partner, called a facilitator, provides physical support to assist an individual who cannot speak or whose speech is limited to type on a keyboard or point at pictures, words, or other symbols on a communication board.
There is no rigorous scientific evidence to support claims of success in the use of this intervention.

22. Unproven Treatment
Parents and teachers are easy targets for interventions that promise cures.
Concerning a particular practice, teachers should collect direct and frequent measures of student learning to evaluate effects on students.

23. Placement Options
Students with autism are increasingly placed in general education classrooms for the purpose of improved social integration
During the 2012 to 2013 school year:
approximately 40% of students with autism were educated in the general education classrooms
18% served in resource room programs
33% in separate classes
About 9% of students with autism attended special schools or residential facilities

24. General Education Classroom
Success in the general education classroom for a student with ASD depends on the child’s ability to reliably do the following:
Display near-zero levels of problem behavior
Participate and learn in group lessons
Complete assigned tasks independently
Interact with peers appropriately
Comply with classroom rules/follow the teacher’s directions
Get the teacher’s attention/assistance appropriately

25. Resource and Special Classrooms
The general education classroom is not the least restrictive environment for all students with ASD.
Instruction in the resource room or special class typically features
High frequency of instructional time per minute; careful specification of and planning for transferring the control of students’ responses from teacher- contrived antecedent and consequent stimuli to naturally occurring events; specific strategies for promoting generalization of newly learned skills to the regular classroom, the community, and the home; continuous recording of data on performance of targeted skills; and the daily review of data for decision making