Language Disorders Children

Language Disorders Children - Language Delays and Disorders...

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Unformatted text preview: Language Delays and Disorders in Children Trici Schraeder, MS, CCC-SLP CCCUniversity of Wisconsin-Madison WisconsinDepartment of Communicative Disorders Research Based Lecture 20 resources are shown in the last 4 power point slides Nine Disorder Areas of Communication Fluency Hearing American Speech-Language-Hearing Association Swallowing Voice & Resonance Articulation/Phonology Cognitive Aspects of Communication Social Aspects of Communication Alternative Modalities Language Comprehension & Production Definition of Language "...a process of sharing experience till it becomes a common "...a possession. It modifies the disposition of both parties who partake in it." ~ John Dewey it." Symbolic Rule-Governed RuleSocial Code Language is Developmental Just as a child learns to crawl before learning to walk, a child learns language comprehension and production in a developmental sequence. Components of Language Word Order Grammar Vocabulary CONTENT Word Relationships FORM USE Social Aspects 1 Components of Language Word Order Grammar Syntax or Word Order The college student is intelligent, hard working and highly motivated. Is the college student intelligent, hard working and highly motivated? CONTENT FORM Development of Questions Development of Questions Mark yes/no questions with rising intonation by age 1.7 to 2.10 years Development of Questions Know and use What? What doing? Where? By age 1.7 to 2.10 years Development of Questions Know and use Who? Why? and How? By age 2.7 to 2.10 years 2 Development of Questions Development of Questions Know and use When? by age 2.11 to 3.6 years Know and use Which? By age 2.6 to 3.0 years Development of Questions Know and use How many? How much? How long? How far? How often? By age 2.11 to 3.6 years Development of Questions Know and use Tag Questions by age 7.0+ years Development of Questions Concrete Who question needs a person answer What question needs a thing answer Where question needs a place answer When question needs a time answer Why question needs a cause and effect answer Abstract How question needs a problem solving answer Cognition Underlies Language Thought processes that underlie language Perceiving Remembering Imagining Conceiving Judging Reasoning 3 Knowledge Essential to all higher levels of thinking Defined as remembering previously learned material by rote memory or recall Learning tasks at the knowledge level include Identify Label List Match Name Question at the Knowledge Level What are the 26 letters of the alphabet? Comprehension Student must be able to grasp the meaning Not just rote memory Restate in his or her own words Learning tasks related to comprehension Paraphrase Summarize Rewrite Question at the Comprehension Level What sounds can the letters l, m, n, o, and p make? Application The beginning of creative thinking The ability to use learned material in a new situation. Learning tasks associated with application Prepare Produce Solve Operate Question at the Application Level What letter can be put in front of these to make words? _ueen _uick _uest _uiet _uench _uarter 4 Analysis Requires the ability to categorize Break down material into components Organizational structure of the material is understood Learning tasks associated with analysis Diagram Outline Differentiate Subdivide Question at the Analysis Level What are the vowels and what are the consonants in this word? Onomotopoeia Synthesis Take what has been learned and create or invent something new Put parts together to form a new whole Learning tasks associated with synthesis Compose Create Devise Design Question at the Synthesis Level What poem could you make using the words Shoe New Who To Do Evaluation Judge the value of a material Must be able to tell why using sound reasoning to back up the opinion Learning tasks associated with evaluation Justify Critique Conclude Question at the Evaluation Level What do you think is a better teaching tool, A computer or a dictionary? 5 Emerging Perspectives Components of Language Vocabulary CONTENT Word Relationships FORM Language & Literacy Literacy is more than just learning to read. read. Literacy is a complex competency that also involves reading to learn. learn. Learning to Read Ages one through five are important for learning to read. read. Important Language Processes Phonological awareness Rapid automatic naming Phonological memory Letter identification Invented spelling Single word decoding Oral fluency Cause and effect Passage comprehension Story mapping Reflection Self Correction Hierarchical Definitions Figurative language Retell Prediction Learning to Read Children with language impairments are four to five times more likely than typically developing children to have reading problems during their school years. 6 Vocabulary Development The two strongest predictors of reading achievement are: Vocabulary Knowledge and Phonemic Awareness Reading to Learn Nine year old children learn 3,000 to 5,000 new words per year. Most of that new vocabulary comes from reading. Reading to Learn Important Language Processes Derivational morphology Text structures Purposes of texts Different styles of reading Text organization Context cues for comprehension Storage and retrieval Written fluency Vocabulary Executive functions Figurative language Inferences Synonyms, antonyms, homonyms, homophones Fourth grade and beyond is when children and adolescents use reading to expand their learning. Old School/New School Listening Speaking Reading Writing Spoken & written language have a reciprocal relationship, such that each builds on the other to result in general language and literacy competence. Big Message A language delay may influence a literacy delay at any age or at any level of development. 7 Stages of Literacy Preschool Listens to stories; can re-tell; reads pictures; recognizes printed rename; knows some letters Reads 50-100 sight words; uses alphabetic principle; decodes 1 50& 2 syllable words; finds environmental print Reads over 100 words per minutes; comprehends written text; reads to learn; decodes unknown words using structural analysis Gains most new information from reading; recognizes novel content; reads 180 words per minute; writes to express self & develop insights and own ideas Components of Language 2nd Grade 5th Grade Secondary Level USE Social Aspects Life Experiences Influence Development of Social Language 3 years 4 years 5 years 6 years 9 years Egocentric; dramatizes; asks questions Commands; requests; asks why; shares; engages in turn-taking turnEngages in responsive discourse showing reciprocity Asks for explanations Uses language to express subtle and refined emotions 3. 1. Cultural Influences Red-eye gravy is: a) gravy with food coloring in Redit; b) gravy made from ham grease or water and coffee; c) un-aged moonshine; or d) fish unsauce. Kiverlid is: a) a new born kitten; b) a hat; c) a kitchen utensil; or d) a bed cover. Light bread is: a) store bought bread; b) hot bread; c) corn bread; or d) cream puffs. 2. Socio-Economic Influences More than 1 million American Children are Homeless Today. More Than 1/5th Are between The ages of 3 to 6 Allied Drive Community 41% of families headed by single women 27% of children live in poverty Median Household incomeincome$21,600 Multicultural CommunityCommunitypopulation 4,333 70% African American 15% Southeast Asian 5% Latino 10% Other 8 Plan Launched in 1965 to help break the cycle of poverty Comprehensive Child Development Program Serve children from birth to 5, pregnant women, and their families Provides children of low-income lowfamilies with a comprehensive program to meet their emotional, social, health, nutritional, and psychological needs Do Review History of Head Start Causes & Co-Occurrences Coof Language Delays and Disorders Fetal Alcohol Syndrome Lead Poisoning Chronic Otitis Media Autism Spectrum Disorders Deafness Hard of Hearing Environmental Deprivation Drug Abuse Learning Disabilities Syndromes Cognitive Delays Cognitive Disorders Traumatic Brain Injury Cerebral Vascular Accident Fetal Alcohol Syndrome Disorders .2 to 1.5 per 1,000 live births Small size for gestational age or small stature in relation to peers peers Facial abnormalities such as small eye openings Poor coordination Hyperactive behavior Learning disabilities Developmental disabilities (e.g., speech and language delays) Lowered intelligence Problems with activities of daily living Poor reasoning and judgment skills Sleep and sucking disturbances in infancy (CDC, 2008) Lead Poisoning 310,000 U.S. children aged 1-5 years; blood lead levels 1<10 micrograms of lead per deciliter of blood. Lead poisoning can cause learning disabilities, behavioral problems, and, at very high levels, seizures, coma, and even death. Lead-based paints were banned for use in housing in Lead1978. However, approximately 24 million housing units in the United States have deteriorated leaded paint and elevated levels of lead-contaminated house dust. More leadthan 4 million of these dwellings are homes to one or more young children. Lead Poisoning (Continued) Other sources of lead poisoning are related to: hobbies (making stained-glass windows); work (recycling or making automobile stainedbatteries); drinking water (lead pipes, solder, brass fixtures, valves can all leach lead); home health remedies (azarcon and greta, which are used for upset stomach or indigestion; pay-loo-ah, pay- loowhich is used for rash or fever). Children from all social and economic levels can be affected by lead poisoning, although children living at or below the poverty line who live in older housing are at greatest risk. Children of some racial and ethnic groups and those living in older housing are disproportionately affected by lead. For example, 3% of African American children compared to 1.3% of Caucasian children have elevated blood lead levels. (CDC, 2008) 9 Chronic Otitus Media Autism Spectrum Disorders Prevalence is controversial and ranges between 5.2 to 7.6 per 1,000 live births. CDC (2007) documents the prevalence as 1 in 150 eight year olds. Deaf and Hard of Hearing The number of Americans with hearing loss has nearly doubled in the last 30 years. 1 to 6 per 1,000 live births. 391,000 school-age children have unilateral loss. school14.9% of school-age children have either low schoolfrequency or high frequency loss. Profound, early-onset deafness is present in 4 to early11 per 10,000 children and is attributable to genetic causes in at least 50% of the cases. (ASHA, 2008) Environmental Deprivation 39% of children in the United States live in poverty (29 million). The poverty rate for young children is higher than for older children 43% of children below the age of six live in poverty 37% of children over the age of six live in poverty (NCCP, 2008) Pre-Natal Drug Exposure A survey conducted by the National Institute on Drug Abuse conducted in 1992 indicated that more than 5% of all newborn children had been exposed to illicit drugs before birth. "Generally, most studies of physical and neurobehavioral outcomes in newborn infants have shown that prenatal exposure to marijuana, cocaine, and/or opiates increases the risk that exposed infants will be born prematurely, weigh less, have smaller heads, and be shorter than unexposed infants. However, assessing the full consequences of prenatal drug exposure for these children as they get older is a more complex task. The timing and amount of prenatal exposure, the mother's abuse of multiple drugs, poverty, poor nutrition, and inadequate prenatal and postnatal care are just some of the factors that can cloud the the effects of prenatal maternal drug abuse on infants and children." children." (NIDA, 2008) Learning Disabilities 6 to 10% of all school-aged children exhibit some schoolform of learning disability Dyslexia difficulty with reading Dyscalculia difficulty with math operations, measurement, and/or numbers Dysgraphia difficulty with writing Co-occurrence of Attention Deficit/Hyperactivity CoDisorders 10 Genetic Syndromes Anomaly deviation from normal structure, form, or function. Syndrome presence of multiple anomalies in the same individual with all of those anomalies having a single cause. There are approximately 450 different syndromes (including subtypes) that co-occur with speech, colanguage, and/or hearing delays and disorders. Prevalence varies among these syndromes. (Schpintzen, 1997) Cognitive Delays or Disorders Approximately 3% of the total population have cognitive challenges challenges demonstrating Intelligence Quotients below 70 (100 is considered as average). Mild: IQ of 55-69. About 85% of children with cognitive challenges are in Mild: 55this range. These children may be able to learn to read and write at the 4th or range 4th 5th grade level; live relatively independently; and work with special training. special Moderate: IQ of 40-54. 10% of children with cognitive challenges are in this Moderate: 40group. These children may have academic potential at the kindergarten or 1st kindergarten grade level; may have limited ability to read, and will usually need some support and supervision in daily living activities (like with a supportive family or supervised group home) and work (with special training). Severe: IQ of 25-39. 5% of children with cognitive challenges are in this Severe: 25group. Children at this level are unlikely to be able to learn to read or write. to They usually require total supervision and support for daily living activities. living Profound: IQ of < 24. <1% of children with cognitive challenges are in this : Profound this group. (Keep Kids Healthy, 2008) Traumatic Brain Injury Traumatic Brain Injury (TBI) is defined within the IDEA as an acquired injury to the brain caused by an external physical force, force, resulting in total or partial functional disability or psychosocial psychosocial impairment, or both, that adversely affects a child's educational educational performance. The term applies to open and closed head injuries resulting in impairments in one or more areas, such as cognition; cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor problemabilities; psychosocial behavior; physical functions; information information processing; and speech. The term does not apply to brain injuries injuries that are congenital or degenerative, or brain injuries induced by by birth trauma. [(Code of Federal Regulations, Title 34, Section 300.7(b)(12)] Traumatic Brain Injury (TBI) TBI is the leading cause of death and disability in children and adolescents in the United States. The most frequent causes of TBI are related to motor vehicle crashes, falls, sports, and abuse/assault. More than one million children sustain head injuries annually; approximately 165,000 require hospitalization. However, many students with mild brain injury may never see a health care professional at the time of the accident. Cerebral Vascular Accident Hemorrhagic Stroke Bleeding on the brain. Average annual incidence rate in children of 1.89/100,000/year Ischemic Stroke - Artery to the brain is blocked. Prevalence among children = 0.63/100,000/year Overall average annual incidence rate for children through fourteen years of age is 2.52/100,000/year. (NINDS, 2008) Examples of Evidence-Based Practices That Remediate and/or Facilitate Language Development 11 5 Evidence-Based Practices Indirect Language Stimulation/ Expansions The SLP reformulates what the child said into an expanded, grammatically complete sentence ( e.g., Child: "Dat a truck."; SLP: "That's a big truck with black wheels.") truck." That' wheels." Focused Language Stimulation - The SLP manipulates the environment to evoke the child's spontaneous production of a specific linguistic target using child' strategies such as false assertions, feigned misunderstandings, forced choices, violation of routines, etc. Facilitative Play Approach The SLP models target language forms and functions using self-talk and/or parallel talk during client-centered activities in selfclientauthentic settings. The child's interest is maintained by using high-interest, child' highdevelopmentally appropriate activities. 5 Evidence-Based Practices Model-Imitation/ Modeling Plus Evoked Production The SLP provides a Modelmodel of the target and the child imitates it. Specific verbal praise and/or praise corrective feedback are provided. Edible, tangible, social, and/or natural and/or reinforcements may or may not be provided. Parent-Directed The SLP models specific techniques while Parentinteracting with the child; the parent observes; parent's questions parent' are answered; then the SLP observes the parent use the techniques while the SLP observes; the SLP provides specific positive and/or corrective feedback to the parent; a home carryover program is established. Questions Resources Adler, S. (1993). Multicultural communication skills in the classroom. Allyn & classroom. Bacon: Needham Heights, MA. American Speech-Language-Hearing Association. (2001). Roles and Speech- Languageresponsibilities of speech-language pathologists with respect to reading and speechwriting in children and adolescents. Rockville, MD: Author. American Speech-Language-Hearing Association. (2008). The prevalence and Speech- Languageincidence of hearing loss in children. Available at Centers for Disease Control and Prevention. (2008). Available at Resources Child Development Institute. (2008). Available at Code of Federal Regulations, Title 34, Section 300.7(b)(12)] Forehand, M. (2008). Bloom's taxonomy. Available at Bloom' Keep Kids Healthy (2008). Available at McCauley, R. (2001). Assessment of language disorders in children. Lawrence children. Erlbaum Associates: Mahwah: NJ. McLean, J., & Snyder-McLean, L. (1999). How children learn language. Singular SnyderPublishing: San Diego, CA. Resources (Continued) Montgomery, J. (2001). Beyond who, what, and where: Expository text as the link text to school success. Tenth Symposium on Literacy and Disabilities, Cary, NC. National Information Center for Children and Youth with Disabilities. (2008). Disabilities. Available at National Center for Children in Poverty. (2008). Available at National Institute on Drug Abuse (2008). Available at National Institute on Neurological Disorders and Stroke. (2008). Available at 12 Resources (Continued) Nicolosi, L., Harryman, E., & Kresheck, J., (1996). Terminology of Nicolosi, Harryman, Kresheck, communication disorders. Williams & Wilkins: Baltimore: MA. Powell, T. (2003). A brief overview of language and approaches to its assessment: to one professional's perspective. retrieved from the world wide web professional' www.apraziaRobl, G. (1980). Normal language acquisition outline. Cooperative Education Cooperative Services Agency 14: Fennimore, WI. Schraeder, T. (2008). A guide to school services in speech-language pathology. speechPlural Publishing: San Diego, CA. Shprintzen, R. (1997). Genetics, syndromes, and communication disorders. Shprintzen, Singular Publishing Group, Inc.: San Diego, CA. 13 ...
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