1. Language Disorders in Children
Unit Five
Language
Disorders in Children

2. Foundations of Language Disorders in Children
Chapter 16
Foundations of
Language Disorders
in Children

3. Language Disorder
Impaired comprehension and/or use of spoken, written, and/or other symbol systems
May involve form, content, and/or use
This is ASHA’s definition (1993) 3

4. Language Delay
Slower start at developing language but eventually catch up to peers

5. Language Difference
Language affected by cultural and linguistic diversity

6. Prevalence and Incidence
7 to 8 percent of kindergarten children have specific language impairments with no other complicating conditions
2 percent more boys than girls have specific language impairment (SLI)

7. Multicultural Considerations
All clients must be respected as individuals with individual cultural and ethnic values
Many children from CLD backgrounds live in poverty
Increases the risk for language problems

8. Specific Language Impairments
Chapter 17
Specific
Language Impairments

9. Severity Levels Mild Moderate Severe Profound
See Figure 17-1 of Paul’s (2001) list of variations in severity 9

10. Specific Language Impairments (SLI)
Significant receptive and/or expressive language impairments that cannot be attributed to a cause or condition

11. SLI
A complex disorder that may have multiple genetic influences that interact with environmental factors

12. Red Flags for a Potential SLI
First word after 18 months
Two word combinations later than 30 months of age
Reliance on gestures
Limited use of verbs

13. Red Flags for a Potential SLI
Lack of yes/no responses to questions
Difficulty with rhyming and naming letters
Difficulty initiating interactions with peers
Poor conversational turn-taking

14. Receptive Language
Difficulty understanding and integrating information
Difficultly understanding words

15. Phonology May produce unusual phonological errors
Substitutions of t/r or k/b

16. Morphology and Syntax Late developing morphology and syntax
Use short, incomplete sentences
Simple, active form
Refer to list from Hegde and Maul (2006) and Leonard, McGregor and Allen (1992) in text.

17. Vocabulary Small vocabularies Slow acquisition of vocabulary
Poor word knowledge
Word-finding problems
See Table 17-1 in text.

18. Discourse/Dialogue
Difficulty having conversations with others

19. Narratives Difficulty telling stories or recounting events
Due to limited vocabulary:
Challenges with morphology/syntax
Recalling memories of events
Organization of information

20. Pragmatics Initiate conversations less
Difficulty gaining access to conversations
Passive conversationalists
Case study of Michael is presented.

21. Language-Learning Disabilities
Chapter 18
Language-Learning
Disabilities

22. Language-Learning Disabilities (LLD)
Term SLI is usually changed to language-learning disability when a child enters school
LLD has effects on learning and educational achievement

23. LLD Prevalence is 12 to13 percent for 5 year olds
4.5 percent also have speech disorders

24. Metalinguistics Ability to think about and talk about language
Very difficult for children with LLD

25. Adolescents: Receptive Language
Weak vocabulary
Difficulty with abstract words and words with multiple meanings
Figurative language (slang, jargon) is difficult

26. Adolescents: Expressive Language
Use low content or no content words
Simple syntax
Violate pragmatic rules

27. Developmental Disabilities and Language Disabilities
Disability originating before 18 years of age
Significant limitations in intellectual functioning and adaptive behavior
Prevalence is 1 to 3 percent

28. Classification Systems
AAMR system indicates amount of support for individuals with developmental disabilities
See Table 18-1
See Table 18-1 for levels of impairment.

29. Receptive Language
Single word comprehension better than longer utterances
Understand concrete information better than abstract information

30. Expressive Language Limited vocabulary Difficulty with word recall
Don’t initiate conversations

31. Phonology Speech unintelligibility is common
Up to 70 percent of children with developmental disabilities

32. Down Syndrome
Most common chromosomal cause of developmental disabilities
Impaired comprehension and expressive skills
Speech affected by hypotonia and/or macroglossia

33. Autism Complex behavioral syndrome that appears by age 3
Marked absent interest in social interaction
Severely impaired communication
Repetitive, stereotyped movements

34. Autism
Intellectual disabilities occur in three-quarters of children with autism
Autism is within the broader category of autism spectrum disorder (ASD)
ASD is within category of pervasive developmental disorders (PDD)
See Figure 18-2.

35. Autism: Receptive Language
Receptive language abilities are similar to child’s mental age

36. Autism: Expressive Language
50 percent are nonverbal
Echolalia
Automatic repetition of words, phrases, sentences
Used by some
Idiosyncratic language used

37. Traumatic Brain Injury (TBI)
Acquired injury to the brain
Children tend to have good recovery
May have long-term speech and language deficits
Cognitive impairments may occur
Memory, attention, problem solving
Case study of Azzie presented.

38. Assessment and Diagnosis of Language-Learning Disabilities
Chapter 19
Assessment and
Diagnosis of
Language-Learning Disabilities

39. Purposes of Assessment
Does the child qualify for services
Identification of language problems
Description of patterns of language
Factors associated with language problems
Treatment planning
Prognosis

40. Approaches to Assessment
Normalist/Psychometric
Naturalistic/descriptive/criterion-referenced

41. Psychometric Formal approach to assessment
Standardized tests are administered and interpreted
Tests are normed on a large group of children so comparisons can be made

42. Criterion-Referenced
Description of a child’s language abilities based on natural observations
Comparison of present performance to past performance

43. Screening
Brief one-on-one observation and measure of a child's communication abilities
Figure 19-1 provides examples of language screening instruments.

44. Assessment Protocol Interview Formal evaluation Hearing screening
Articulation/phonology
Language
Orofacial structures
Hearing screening
Meeting to review test results

45. Evaluation of Receptive Language
Single word vocabulary
Morphology
Sentence structures
Following commands
Questions
See Table 19-1 for a list of tests for different age levels.

46. Evaluation of Expressive Language
Sounds and words
Morphology
Naming
Answering questions
Narrative skills
Conversations
See Table 19-1 for tests.

47. Language Samples
A sample of the child's speech with a clinician and/or family member
Allows for a systematic analysis to determine speech and language competence

48. Decision Making Child's strength and weakness Severity of impairment
Contributors to the impairment
Treatment recommendations

49. Therapy Approaches Traditional Functional Collaborative
Often used in schools

50. Evaluation of Bilingual Children
Both languages should be evaluated
If one language is within normal limits, then a disorder probably does not exist
A concomitant disorder may exist

51. Treatment of Language Disorders
Chapter 20
Treatment of
Language Disorders

52. Baseline Measures Measure of a behavior at the beginning of treatment
Future progress can be compared to this baseline

53. Selecting Goals Operationally defined goal must include:
An observable and measurable behavior
Setting/environment
Criterion
Percent accuracy
Stimuli used

54. Three Models of Therapy
Within discipline
Interdisciplinary
Transdisciplinary
General principles of therapy are presented in Figure 20-2.

55. Traditional Approach to Teaching Language Skills
Focus on functional language skills
Skills relevant to a child’s environment at home and/or school
Structured hierarchical approach to moving through goals
Text prides a structure approach for a

56. Structure of Sessions Use well-organized and structured sessions
Clinician is preplanned but flexible to accommodate the child’s needs

57. General Session General conversation
Review of what child has worked on
Work on new targets
Review of another skill
Challenging tasks
End of session

58. Other Therapy Approaches
Functional language model
Emerging language model
Collaborative model
Naturalistic model

59. Multicultural Considerations
SLPs need to consider their own cultural beliefs, attitude, and values
Do not use generic terms
Beware of terms that have questionable or negative racial or ethnic connotations

60. Multicultural Considerations
Present clear explanations and objectives
Use methods that do not violate beliefs of client
Be flexible
Interact with clients according to their perceptions and expectations

61. Multicultural Considerations
Be task oriented
Use praise
Provide opportunities to learn

62. Literacy Disorders in Children
Chapter 21
Literacy
Disorders in Children

63. Literacy Disorder
Individual has both reading and writing impairments

64. Dyslexia Most common learning disability in children and adults
75 to 85 percent of children with learning disabilities have reading impairments
Prevalence is 4:1
Male to female

65. Emergent Literacy Literacy development begins soon after birth
Literacy and language are reciprocally related
Children are active in literacy process

66. Skills Related to Literacy Achievement
Phonological awareness
Oral language
Alphabet knowledge
Concepts about print
Name writing

67. Emergent Literacy Adult involvement is essential
Shared storybook reading is important component

68. Possible Contributions of English to Reading Difficulties
Inconsistencies in pronunciations of words
Inconsistencies in letter-sound correspondence
Inconsistencies in shapes of letters
See Table 21-1

69. Problems of Children with Literacy Disabilities
Deficits in phonological processing
Word recognition and spelling
Underachievement

70. Secondary Consequences
Academic difficulties
Influences on occupation and career choices
Reading as a leisure activity
Interpersonal relationships

71. Writing Reading and writing are connected
Different types of writing require different cognitive abilities and use different vocabulary

72. Writing Problems Inadequate reference to subject
Inconsistent noun-pronoun agreement
Inconsistent gender words
Punctuation problems
Spelling errors

73. Multicultural Considerations
Children from culturally and linguistically diverse backgrounds
Greater likelihood of beginning school less prepared to learn to read than other groups of children

74. Effects of Language Disorders on the Child and Family
Chapter 22
Emotional and Social
Effects of Language Disorders on the Child and Family

75. Parents
Parents alter their interactions if their child has a language impairment
Parents initiate more interactions
Ask more questions
Use fewer utterances per turn
Respond or comment less to their child

76. Parents
There is an emotional response by parents to learning that their child has a problem
IEP meetings may be overwhelming
Not all cultures support family involvement
Some parents may have their own language or cognitive problems

77. Toddlers and Preschoolers
May be perceived negatively by other preschoolers because of poor communication and social skills

78. School-age Children with LLD
May be less accepted by their peers
Children with LLD perceive themselves more negatively that their peers
Tend to avoid social interaction

79. Adolescents
Emotional-social difficulties increase for adolescents with LLD
Mental issues and anxiety disorders may develop

80. Personal and Societal Costs
Undereducation and underemployment are common results for an adult with a language disorder
Adolescent language disorders are related to juvenile delinquency