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Language Disorders Final Exam

Terms in this set (75)

Speech Language Therapy for Autism
is designed to coordinate the mechanics of speech and the meaning and social value of language
-therapy may be one-on-one, in a small group or in a classroom setting
-goals are different for each individual
(aim is to help the individual learn useful and functional communication)
-provided by a speech-language therapist
Occupational Therapy for Autism
aim of OT is to enable the individual to gain independence and participate more fully in life
-for a child with autism, the focus may be on appropriate play, learning and basic life skills
-goals of an OT program might include independent dressing, feeding, grooming, and use of the toilet and improved social, fine motor and visual perceptual skills
-provided by a certified OT
Sensory Integration Therapy for Autism
-designed to identify disruptions in the way the individual's brain processes movement, touch, smell, sight, and sound to help them process these senses in a more productive way
-sometimes used alone, but often part of OT
-does not teach higher-level skills, but enhances sensory processing abilities in order for the individual to be more available acquire higher-level skills
-may be used to calm an individual, reinforce a desired behavior, or help with transitions between activities
-therapy often includes equipment such as swings, trampolines and slides
-provided by certified OT and PT
Physical Therapy for Autism
focuses on any problems with movement that cause functional limitations
-children with autism frequently have challenges with motor skills such as sitting, walking, running, and jumping
-also addresses poor muscle tone, balance, and coordination
-provided by certified PT
Gluten Free, Casein Free Diet for Autism
removal of gluten (protein found in barley, rye, wheat, and oats) and casein (protein found in dairy products)
-not sufficient scientific studies to support this theory
-many families report the diet has helped regulate bowel habits, sleep activity, habitual behaviors and contributed to the overall progress of their child
-some children benefit, some may not
*if you give them a nutritional diet, it will help them learn
Applied Behavior Anaylsis (ABA)
Discrete Trial Therapy (DTT): type of ABA
-primarily practitioner-directed
-skill rather than activity based
-parents and trained therapists implement DTT intervention in the child's home for 20-40 hours per week on an individual basis
-after 1 to 3 years, intervention takes place with a paraprofessional in an inclusive classroom
-Level 2 intervention effectiveness
Social Communication/Emotional Regulation/Transactional Support (SCERTS)
based on social interaction, developmental and family system theories
-addresses child's social communication abilities and social relationships as the primary focus of intervention
-children learn with and from children who provide good social language models in inclusive settings as much as possible
-Level 3 intervention effectiveness
-promotes child initiated communication in everyday activities
-GOAL: is for children to learn and spontaneously apply functional and relevant skills in a variety of settings with a variety of partners
SC (social communication)
development of spontaneous, functional communication, emotional expression and secure/trusting relationships with children and adults
-proven to be effective, but not a 1 yet
ER (emotional regulation)
development of the ability to maintain a well-regulated emotional state to cope with everyday stress, and be most available for learning and interacting
TS (transactional support)
development and implementation of supports to help partners respond to the child's needs and interests, modify and adapt to the environment, and provide tools to enhance learning
-ex: picture communication, written schedules and sensory supports
SCERTS Training Sequence
-follow the child's lead
-offer choices and alternatives within the child's daily routines and activities
-respond to child's intent and reinforcing communication attempts
-model a variety of communication functions at the child's level
-elaborate the child's verbal and nonverbal communication attempts
*usually provided in a school setting by SCERTS-trained special education teachers/speech therapist
DSM-5: Criteria for Autism Spectrum Disorder (ASD)
-deficits in social communication and social interaction
-RRBs (restricted, repetitive behaviors interests and activities)
-symptoms present in EARLY childhood
-symptoms limit or impair everyday functioning
DSM-5: New Category
SOCIAL COMMUNICATION DISORDER
individuals who have difficulties with social skills, but not restricted or repetitive patterns of behavior (RRBs)
-rule out ASD before diagnosing social communication disorder: you have to see that they don't meet DSM-5 criteria
Characteristics of ASD
-low functioning autism (LFA)
-high functioning autism (HFA)
Communication and Social Differences of ASD
central deficit of ASD
limited responsiveness
difficulty with peer relationships (has been revised)
echolalia
difficulty with joint attention
less positive emotion affect
less frequent use of gestures and communication strategies during interaction
many individuals are nonverbal
Behavior Differences of ASD
often hypersensitive to sensory stimulation
stereotypical behaviors(hand flapping/rocking)
narrow and rigid interests (fixation)
Motor and Perceptual Differences of ASD
many have delated motor development
some children may toe walk
limited body awareness
motor deficits affect development of self-help skills
Learning Differences of ASD
significant cognitive and learning differences
memory for meaningful information is often impaired
better at rote memory tasks
deficit in empathizing
RRB
Restrictive Repetitive Patterns of Behaviors and Interests
-they are an expert of whatever they are interested in
-hand clapping, flickering, spinning
Screening Tool for Children with Autism
MCHAT
-modified checklist for autism in toddlers
-can be used early
-screens children 16-30 months
Average age for Diagnosis of ASD is
5 years 7 months
Assessment of ASD should include:
-first goal is to rule out any other diagnosis
-speech/language evaluation
-core features of ASD evaluation
-evaluation of child's ability to demonstrate communication functions
-observation of child's abilities during a variety of activities
-involve caregiver in assessment process
ID: Intellectual Disability
a disability characterized by SIGNIFICANT LIMITATIONS both in INTELLECTUAL FUNCTIONING and in ADAPTIVE behavior as expressed in CONCEPTUAL, SOCIAL and PRACTICAL skills.
*This disability originates before the age of 18. (AAIDD definition)
-used to be known as mental retardation
-IQ must be 70 or lower to get diagnosis
-adaptive behaviors are really low
Dimension 1 of ID
IQ, Intellectual Ability
-must be 2 standard deviations below the mean
-70 or lower
Dimension 2 of ID
Adaptive Behavior
-ability to act as independently and responsibly as other people of the same age and cultural background (common sense/street smarts)
*Conceptual Skills: reading, expressive language, money concepts
*Social Skills: self-esteem, responsibility, following rules
*Practical Skills: eating, dressing, work skills, mobility, independent living
Dimension 3 of ID
Participation and Interaction in Social Roles
-professionals observe individual's participation, interaction and social rules in everyday activities.
-how well do they participate or act in social settings?
Dimension 4 of ID
Health
-mental and physical health: some may be significantly affected by health condition, some may not
Dimension 5 of ID
Context
-describes individual's family, neighborhood and community at all 3 levels of the environment
1. Microsystem: Family and Caregivers
2. Mesosystem: School, Neighborhood
3. Macrosystem: sum of society's cultural views and practices regarding individuals with ID
Prevalence of ID
1-3% of the population
-more frequently in males than females
-15% of caseload of SLPs in the schools
Genetic Causation
-greater than 750 genetic causes resulting from ID
-cause of 50% of cases of ID
-chromosomal disorders (downs, fragile x, williams)
Prenatal Causation/Risk
during the pregnancy
-physical injury or substance abuse causing injury to the fetus
(Fetal Alcohol Syndrome)
Perinatal Causation/Risk
during delivery
-risk of hypoxia: inadequate (partial) oxygen to the brain, may result in brain damage
Postnatal Causation/Risk
after delivery
-TBI (traumatic brain injury):
acquired injury to the brain caused by an external physical force-car accidents, falls, physical abuse
Characteristics of ID
Bottom-Up Learning
-data based processing
-attention
-discrimination
-organization
-simultaneous and successive processing
-transfer of information
-memory
Top-Down Learning
-knowledge based processing
-focuses on functional communication
-strategies to facilitate top-down learning
-motivation
ID Subtype 1: Down Syndrome
-leading genetic cause of ID
-results in 3 copies of all or part of chromosome 21 (trisomy 21)
-can be identified at birth, trying to identify before birth
-best studied subgroup of children with ID
-vocabulary skills can exceed IQ
-advanced maternal age is most common risk factor (1:12 in mothers age 40 years, <1 in 1,000 in mothers under 30 years)
ID Subtype 2: Fragile X Syndrome
-2nd leading cause of ID
-primarily affects males
-mutation of single gene on X chromosome
-range of cognitive impairment is broader than DS
-characteristics:
social avoidance
anxiety
eye gaze aversion
inattention
hyperactivity
abnormal responses to sensory stimulation
*resemble individuals with autism and is misdiagnosed with autism
ID Subtype 3: William's Syndrome
-verbal abilities are a strength
*language abilities are equivalent to mental age and some skills surpass mental age during adolescence.
-hoarse voice
-overly friendly
-articulation and prosody are good
-inappropriate eye contact
-difficulty with topic initiation and maintenance
-difficulty with turn taking
Assessment of ID
*Criterion Referenced Assessment
-spontaneous language sample
-discourse analysis to assess social communication abilities
-classroom or work place assessment
-interview with individuals with ID, family, caregivers, teachers
-evaluation of AAC devices, if appropriate
*Functional Assessment
-look at individual's behavior to determine function or purpose of an aversive behavior
-used with students with ID that have challenging behaviors
-usually trans-disciplinary team completes the assessment
-intervention follows Functional Assessment
Intervention of ID
-early & intense
-provide intervention from prelinguistic stage to adulthood (move out of school setting to work place)
-ecological approach: consider interests and motivation, use intervention that maximize generalization and transfer of communication to daily life
-Milieu Teaching
-peer training models
-functional communication training (behavioral intervention)
-IT's Fun Program
-transition
SLI: Specific Language Impairment
diagnosis is based on exclusionary criteria:
-a language test score -1.25 standard deviations or lower
-nonverbal IQ of 85 or higher
-normal hearing
-no oral structural or oral motor abnormalities
-no evidence of neurological disorder
-normal social ability (not on autism spectrum)
-this is a language disorder that stands alone
-SLI children do have family members with diagnosis.
Prevalence of SLI
7%
-more occurrence in males than females
-3:1 ratio
Causation of SLI
*Genetic Factor:
-tendency to run in families (60% of children with SLI have an affected family member)
*Language Learning Environment-LLE
-child's environment does affect language development
-lack of language stimulation is not typically the reason for SLI
-parent/child communication should be monitored
Diagnosis of SLI
-they aren't hearing impaired
-normal IQ
-normal social ability
-not autistic
-no structural oral deficits
*-1.25 standard deviations or lower
If you have a child with SLI and you have to use the DSM-5, they can only be:
Language Disorder Receptive
Language Disorder Expressive
Mixed
Social Communication Disorder
PECS: Picture Exchange Communication System
a six-phase intervention program designed to teach functional communication.
-main goal: teach the power of functional communication
-helps teach requesting
-used frequently with children with autism
-based on principles of ABA
-limited research to support the use of PECS as a language intervention approach
Phases of PECS
-teaching the communicative exchange
-teaching persistence
-discrimination training
-teaching "I want" sentences
-teaching a response to "What do you want?"
-teaching use of additional sentences starters
AAC: Augmentative and Alternative Communication
an area of research in addition to clinical and educational practice
-it addresses temporary or permanent impairments, activity limitations and participation restrictions of people with complex communication needs (receptive or expressive)
Aided AAC
picture boards, alphabet boards, electronic communication aids, apps
Unaided AAC
no external support or prosthesis
-gestures, ASL (signs), facial expressions
Who is on the AAC assessment team?
SLP
Family Members
Nurses
PT
OT
Rehab Engineer
Teachers
Caregivers
Education Assistant
Physician
-whoever is needed or in the client's environment to see what they need to communicate
Sensorineural Hearing Loss
damage to the inner ear structures or auditory nerves
-considered irreversible
-reduced sensitivity to sound and distortion of incoming speech sounds
-severity ranges from mild to total loss
*causes: genetic disorder, birth defect, premature birth, infections
Conductive Hearing Loss
cause of loss is in the outer or middle ear
-typically results from a medical problem: otitis media, perforated eardrum
-HL is usually temporary
-appropriate amplification is effective treatment
MOST COMMON
Mixed Hearing Loss
cause of loss is sensorineural and conductive
Degree of Hearing Loss
degree or severity of HL determines which sounds are inaudible to a person
*Frequency/Pitch:
-measured in Hz
-hearing tests=sounds range from 250 Hz to 8000 Hz
*Intensity/Loudness:
-measured in decibels (dB)
-hearing threshold
-person with normal hearing acuity has hearing thresholds in the range of 0 dB to 15 dB across the frequency range
Degrees of Hearing Loss
Normal: -10 to 15 dB
Slight: 16-25 dB
Mild: 26-40 dB
Moderate: 41-55 dB
Moderately Severe: 56-70 dB
Severe: 71-90 dB
Profound: 91+dB
Listening and Spoken Language (LSL)
-children can learn to listen and talk
-follows normal developmental sequence
-take into consideration the child's hearing age
(amount of time child has had exposure to sound)
-use of cochlear implants has contributed to successful outcomes
*parents must: access high-quality and ongoing audiological services, implement all available technology, provide intensive auditory and language experiences in age appropriate/natural contexts
American Sign Language (ASL)
-used by people in the deaf community
-manual communication
-learn this and then learn written English language as a second language
Total Communication (TC)
-combination of everything
-ASL
-signing exact english
-pidgin
-uses different forms of sign
Ling Test Assessment for Hearing Impaired
-used to determine if child has auditory access
-evaluates a child's ability to detect and discriminate sounds across the speech spectrum
**-6 Ling sounds: m, ah, oo, ee, sh, s
**-acoustic hoop is used to ensure child is hearing not seeing sounds
-once child hears sounds, determine distance the child is able to detect the sounds repeatedly
Sound Sandwich
emphasize auditory cue while providing a visual cue when necessary
Sabotage
adult makes a deliberate mistake to provide child with opportunity to recognize and repair the mistake
Hand Cues
-encourages child to attend to spoken language
-place hand near or in front of the mouth to signal person is speaking
Form
Phonology: SOUND SYSTEM of a language and rules that govern it.
Morphology: system that governs STRUCTURE of a word
Syntax: system governing the ORDER/COMBO of words to MAKE A SENTENCE
-morphemes begin to emerge:
~s (plural)
~'s (possessive)
~ing (present progressive verb)
~prepositions in and on
Content
Semantics: system that governs the MEANING of words and sentences
-early vocal learning: agents, actions, modifiers
-late vocal learning: prefixes, suffixes, root words, figurative language, relationship between words, vocabulary for academic use, idiomatic phrases, compound word construction
Use
Pragmatics: system that combines the language combined in SOCIALLY ACCEPTABLE and FUNCTIONAL communication.
-early pragmatics: eye contact, nonverbal and verbal turn taking, joint visual attention
-later pragmatics: requests, demands, questions, responses, state
-early discourse: initiate and maintain topics, repair communication
-later discourse: use language for interaction with peers, politeness, sarcasm, humor, produce narratives
Subdomain 1: Early Pragmatic Skills
USE
assess individuals communication function and means:
-use non-linguistics (gestures and pointing)
-meaning based symbols (words, signs, pictures)
Subdomain 2&3: Vocabulary Development and Multiple Word Combinations
CONTENT
-parent checklists
-semantic combinations
-lexicon/vocabulary to describe his/her environment and communicate socially
-able to initiate communication and produce multiword combinations spontaneously
-child in Brown's stages 2 & 3 begin to use morphosyntax features in multiword combinations
Subdomain 4: Morphosyntax Development
FORM
-receptive morphosyntax tasks: assess students understanding of the meaning of a morpheme, understanding of a correct sentence structure
-expressive morphosyntax tasks
Subdomain 5: Advanced Pragmatic and Discourse
USE
-later pragmatics: request, demand, question, respond, state
-early discourse: initiate and maintain topics, repair communication
-later discourse: use language for interaction with peers, politeness, sarcasm, humor, produce narratives
Norm-Referenced Assessments
provide a means for comparing a child's score to the normative sample.
*types of scores obtained: standard/scale, percentile rank, age equivalency
*static assessment: a snap shot of an individuals performance in a particular point in time.
M O R E R E L I A B L E ! !
-advantages: efficient to administer, instructions are very clear, needed to figure if a child is eligible for therapy
-disadvantages: may not capture client's best performance, very difficult to use for child with significant impairments
EX: CELF-5, CASL-2
Criterion-Referenced Assessment
tests that do not compare to a normative sample
*checklists
*may use protocols
*language sample
*progress monitoring
*static assessment
*determine goals and objectives
M O R E V A L I D ! !
-advantages: provides a treatment plan, scoring is simple
-disadvantages: can be very subjective, assessment protocol may be well-defined
If your target is to maintain a topic for 5 minutes, what domain does it fall under?
USE
EMT: Enhanced Milieu Teaching
INTERVENTION FOR SLI
a naturalistic approach appropriate for children who:
a) are able to imitate sounds and words
b) have a vocabulary of at least 10 words
c) have a MLU between 1.0 and 3.5
-parents are trained to be main language teacher: practitioner generally needs 20-30 sessions to train parents
-parents learn to follow child's lead
-practice modeling, mand-model procedure, time delay, incidental teaching
CRT: Conversational Recast Training
INTERVENTION FOR SLI
an effective approach that facilitates grammatical development in children with SLI.
-most effective with children above the two-word level.
-primary technique is the use of sentence recasts
*Sentence recasts vary the sentence modality to heighten the child's awareness of the targeted form, and CRT facilitates a higher rate of production than more traditional language expansion techniques.
SC: Sentence Combining
INTERVENTION FOR SLI
a) combine smaller related sentences into a compound sentence using conjunctions and, but, because.
b) embed an adjective or adverb from one sentence to another
c) create complex sentences by embedding an adverbial and adjectival clause from one sentence to another
and/or d) make multiple embeddings involving adjectives, adverbs, adverbial clauses and adjectival clauses.

-open combining: combining simple sentences to make a longer, more complex sentence
-sentence expansion: adult provides student with a kernel sentence and then asks the student to elaborate the sentence.
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