© 2011, 2007, 2003 pearson education, inc. all rights reserved. chapter 5 childhood language...

© 2011, 2007, 2003 Pearson Education, Inc.All Rights Reserved.

Chapter 5Childhood Language Impairments


CHILDHOOD LANGUAGE IMPAIRMENTS

Language impairment Language development through the

lifespan Associated disorders and related

causes Assessment Intervention


LANGUAGE IMPAIRMENT

Developmental and/or acquired disorders and/or delays

Affects spoken and/or written language in comprehension and/or production

Involves one or more aspects of language

NOT a language difference


LANGUAGE DEVELOPMENT THROUGH THE LIFESPANPre-language Learning to be a communicator Distinguish caregivers from strangers by 2 weeks. First 3 months learn stimulus-response sequence. 3 to 4 months, rituals and game playing emerge. 8 to 9 months, Intentionality develops. Communicative behaviors emerge. Initially, gestures appear without vocalization but are gradually

paired.

Learning to represent and symbolize is strongly related to cognitive abilities. Representation: The process of having one thing stand for

another. Symbolization: Using an arbitrary symbol to stand for

something.


LANGUAGE DEVELOPMENT TODDLER

Toddler Language 50 single words; combining at 18 months Use

May use a single word for various purposes Express early intentions

Content and Form By 2, expressive vocabulary of 150-300 words Lexicon Early word combinations follow predictable word-

order patterns


LANGUAGE DEVELOPMENT PRESCHOOL

Preschool Language Expanded conversational skills Form hypotheses about language rules & use this to

produce more complex language Ex: “goed” “eated” Children with ID/MR or LD may have difficulty

Caregivers provide feedback Use

Topic maintenance for 2-3 turns Begin to consider listener Tell simple sequential stories


LANGUAGE DEVELOPMENT PRESCHOOL

Content 3 yrs: 900 words 4 yrs: 1,500 words Learning relational words and phrases

Form Dramatic change in syntax; more complex Calculated in mean length of utterance (MLU) in morphemes.

• By age 3, most utterances contain a subject and a verb.• Articles, adjectives, auxiliary verbs, prepositions, pronouns, and

adverbs are added.• Adult-like negative, interrogative, and imperative sentences evolve.• What, where, who, which, whose, and finally when, why, and how.• By the end of preschool, children form compound and complex

sentences.• Bound morphemes are added: present progressive -ing, plural,

possessive, past tense.


LANGUAGE DEVELOPMENT SCHOOL AGE & ADOLESCENT

School-Age and Adolescent Language Peers are the primary communication partners Means of communication changes with reading and

writing development Metalinguistic skills: Enable the child to consider

language in the abstract, make judgments about its correctness, and create verbal contexts.

Semantic and pragmatic development blossoms More effective and efficient communicator Slang


LANGUAGE DEVELOPMENT SCHOOL AGE & ADOLESCENT

Use Refine conversational skills Narratives gain essential elements

Content First graders- expressive vocabulary of approximately 2,600 words

but may understand as many as 8,000 roots. Receptive vocabulary grows to 30,000 by 6th grade and to 60,000

words by high school. Definitions become more dictionary-like Understand and use figurative language

Form By age 5, use most verb tenses, possessive pronouns, and

conjunctions Syntax: Passive sentences, reflexive pronouns,

compound/complex sentences


LANGUAGE DEVELOPMENT ADULTS

Adult Language Development continues but at slower pace Adults add new words and perfect grammatical forms,

especially writing. Should continue to develop if no neuropathologies Specialized vocabulary

Reflects work environment, religion, hobbies, etc.


ASSOCIATED DISORDERS AND RELATED CAUSES

Mental retardation/intellectual disability Learning disabilities Specific language impairment Autism spectrum disorder & PDD Brain injury Neglect and abuse Fetal alcohol syndrome and drug-exposed children


MENTAL RETARDATION/INTELLECTUAL DISABILITY

Now called Intellectual Disability (ID) Characterized by

Substantial limitations in intellectual functioning Significant limitations in adaptive behavior Manifests before age 18

Severity based on IQ, ranges from mild to profound Severity based on IQ

Mild 52-68

Moderate 36-51

Severe 20-35

Profound Below 19



Causes can be Biological or Socio-Environmental Biological

• Genetic & chromosomal abnormalities• Maternal infections• Toxins & chemical agents• Nutritional and metabolic causes• Gestational disorders• Complications from pregnancy & delivery• Brain diseases

Socio-environmental

Organization of information is challenging Memory and retrieval of information is poor and slow



Language Characteristics Language abilities can be below cognitive abilities Slower rate of development Later, begin to deviate from typical developmental

patterns Use shorter, more immature forms All areas of language can exhibit deficits

INFORMATIONAL PROCESSING DIFFERENCES IN MR Attention Discrimination Organization Memory



Lifespan Issues Early intervention Educational placement depends on severity

Inclusion, self-contained classroom, special services Adulthood

Independent living and competitive employment With family or in group home and supervised

employment or day treatment program Institutionalization


LEARNING DISABILITIES

Difficulties in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematics

3% of all individuals have LD, but severity varies widely Language-learning disability: Primarily difficulty

learning and using symbols Affects males more than females

LANGUAGE CHARACTERISTICS OF PERSONS WITH LD All aspects of language may be affected in

both written and spoken language for reception and production Difficulty with give-and-take of conversation Difficulty synthesizing rules, especially

syntax and morphology Word finding problems

Slow oral language development Little interest in language

Result in academic underachievement Frequent communication breakdowns



Attention Deficit Hyperactivity Disorder (ADHD)• Underlying neurological impairment in executive functioning that

regulates behavior, causing impulsiveness

Dyslexia• Difficulty comprehending or producing written symbols• As many as 80% of those with LD have some form of reading problem



Language Characteristics As high as 80% of children with LD have some form of

reading problem. All aspects of language may be affected Cluttering

Overuse of fillers and circumlocution associated with word-finding difficulties, rapid speech, repetitions, and lack of awareness



Lifespan Issues Little interest in language or books in preschool Slow oral language development May require special education services Can be successful with accommodations in the

classroom Some children seem to outgrow their disability

Can have successful professional career Some require lifelong adaptations


SPECIFIC LANGUAGE IMPAIRMENT

Approximately 10-15% of middle-class U.S. children have delayed language development.

Significant impairment in language functioning Language performance significantly lower

than intellectual performance (like LD) Exhibit some information processing and

memory problems Increased prevalence in families with a

history of speech and language problems. More males than females have SLI



Language Characteristics Difficulty with:

Extracting regularities from language Inappropriate use of language forms cause pragmatic

problems Deficits in recognizing the impact of and expressing

emotion Difficulty with grammatical markers May speak slowly with frequent disruptions Less efficient use of syntax Difficulty using context for vocabulary development



Lifespan Issues Preschoolers with SLI are viewed negatively by peers Poor social skills Many are later identified as having LD Many adolescents with SLI view themselves negatively

and are less independent


AUTISM SPECTRUM AND PERVASIVE DEVELOPMENTAL DISORDERS

Autism Spectrum Disorder (ASD) Qualitative impairment in:

Social Interaction Communication Restricted repetitive and stereotyped patterns of behavior, interests and

activities

Disturbances in• Developmental rates and sequence of motor, social-adaptive, and

cognitive skills• Responses to sensory stimuli• Speech/language, cognition, nonverbal communication• Capacity to appropriately relate to people, objects, and events

Asperger's syndrome Normal intelligence and typical language development with deficits in

social and communication skills

Did you know…

An estimated 1 out of 54 boys and 1 in 252 girls are diagnosed with autism in the United States.

Autism prevalence figures are growing More children will be diagnosed with autism this year

than with AIDS, diabetes & cancer combined Autism is the fastest-growing serious developmental

disability in the U.S.

(autismspeaks.org)

http://www.unl.edu/asdnetwork/images/umbrella.png



NO medical test for autism Diagnosis based on observed behavior and educational and psychological

testing. Cause (autismspeaks.org)

Over the last five years, scientists have identified number of rare gene changes, or mutations, associated with autism.

A small number of these are sufficient to cause autism by themselves. In most cases, appears to be caused by a combination of autism risk genes

and environmental factors influencing early brain development. Incidence is higher in those with a family history Males are affected more often than females Physical and Medical Issues that may Accompany Autism

Seizure Disorders Genetic Disorders GI Disorders Sleep Dysfunction Sensory Integration Dysfunction Pica



Lifespan Issues Usually identified by 2-3 years

Failure to bond as infant Delayed speech and language, lack of gestures and verbal responding Demonstrate echolalia

Failure to meet developmental milestones may indicate need for evaluation• No babbling by 12 months• No gesturing by 12 months• No single words by 16 months• No 2-word spontaneous speech by 24 months

Loss of language or social skills at any age (Pragmatics & Semantics) Misinterpret subtleties of conversation

Educational placement depends on severity Regular education Special education

May live independently and hold a job Some live similarly to those with ID/MR


BRAIN INJURY

Includes traumatic brain injury (TBI), stroke, congenital malformation, convulsive disorders, and encephalopathy

TBI Diffuse brain damage due to external force 1 million children and adolescents in U.S. Site and extent of lesion, age at onset, and age of injury impacts

recovery/post accident function Range of cognitive, physical, behavioral, academic, and

linguistic deficits Psychological maladjustment or acting-out behaviors called

social disinhibition may occur.


BRAIN INJURY

Language Characteristics Evident even after mild injuries Some deficits remain long after injury

(pragmatics) Language comprehension and higher level

language are often affected, but not form Word retrieval, naming, and object

description are difficult Narration is often difficult


BRAIN INJURY

Lifespan Issues Immediately after accident

Possible unconsciousness and amnesia Disoriented Physical and personality changes

Recovery may take years Spontaneous recovery in the first months Neural recovery is unpredictable and irregular Young children often recover quickly

• Need to recover language AND continue to learn language

Older children have more to recover from memory but less new information to learn.

Often subtle cognitive and social deficits persist


NEGLECT AND ABUSE

1 million children per year in the U.S. Language Characteristics

Pragmatics affected• Less talkative with fewer conversational skills• Less likely to volunteer information• Shorter and less complex utterances

Lifespan Issues Possible recurring physical, psychological, and

emotional problems


FETAL ALCOHOL SYNDROME AND DRUG-EXPOSED CHILDREN FAS

1 in every 500-600 live births Exposure to alcohol during embryonic

development Low birth weight, CNS dysfunction, growth

deficiency, dysmorphic features Demonstrate hyperactivity, motor problems,

attention deficits, cognitive disabilities Mean IQ is in borderline ID/MR range

Drug-exposed children Low birth weight and small head circumference Jittery and irritable


FETAL ALCOHOL SYNDROME AND DRUG-EXPOSED CHILDREN

Language Characteristics FAS: Delayed oral language, echolalia, comprehension problems Drug exposure: Few vocalizations, inappropriate gesture, language

deficits Behind peers in reading and academics

Lifespan Issues More likely to die and have developmental difficulties Caregiver-infant bonding may be disrupted Behave like children with LD


OTHER LANGUAGE IMPAIRMENTS Include: Nonspecific language impairment, Late talkers,

Childhood schizophrenia, Selective mutism, Otitis media, Children who received cochlear implants

Children with NLI have a general delay in language development, a nonverbal IQ of 86 or lower, and no obvious sensory or perceptual deficits.

Child health is an important factor among late talkers. Childhood schizophrenia is uncommon; about half have

language delay (pragmatics). In selective mutism, children do not speak in specific

situations although they speak in others. The effect of chronic otitis media can be delayed language

development. Children who receive cochlear implants have relatively

typical language development.


ASSESSMENT

Referral and screeningDetermine the presence or absence of a

problemReferral and evaluation may occur in an

interdisciplinary team Case history and interview Observation

Influence of context on languageForm hypotheses from observation


ASSESSMENT

Testing Standardized tests Dynamic assessment

Sampling Select variety of discourse types and contexts Record for later transcription Analysis

• Quantitative and qualitative measures Code Switching Collect samples of written language for those with

literacy difficulties.


INTERVENTION

Goal is effective use of language in everyday situations

Child’s abilities determine methods selected Training should be within meaningful contexts

when possible Evidence-based principle

Targets should not focus only on one deficit area


INTERVENTION

Basic tenets of good teaching behavior Model desired behavior Cue client to respond Respond with reinforcement or corrective

feedback Plan for generalization

Success occurs when there is generalization to the everyday language environment


INTERVENTION

Early intervention Presymbolic and early symbolic training Possible (AAC) training

Preschool Language form and continued vocabulary growth

Higher functioning individuals Conversational skills, semantics, academic skills

Adolescents and adults may continue to need services

© 2011, 2007, 2003 pearson education, inc. all rights reserved. chapter 5 childhood language...

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