Foundations of Language and Clinical Practice (Language Disorders Test One)

language

a complex and dynamic system of conventional systems used for thought and language

speech

the articulation and the rate of speech sounds and quality of an individuals voice

communication

includes symbolic and non-symbolic information (facial expressions, body language, gestures, etc.)

language disorder

impaired comprehension and/or use of spoken, written, and/or other symbol systems; may be evident in the process of hearing, language, and speech or in a combination of all three; can be represented by a deficit in receptive, expressive, or both/combined language

children with speech, language, and hearing disorders make up _____ of the total school population

19%

developmental language disorders/SLI

no medical reason why they have this; most frequently diagnosed language disorder

descriptive developmental framework

a focus on a student's language development and function in a variety of natural consequences; works to understand the individuals strengths and limitations; works with the individual at their developmental capacity; support the individuals developmental progress; instead of a diagnosis label; consideration of cultural and linguistic diversity

the speech chain

a model that reminds us that language has both receptive and expressive components; communication requires a number of mechanisms to occur -> acoustic information must be transferred, motor activity must take place, and the brain must be activated to create meaningful and symbolic information

the speech chain: level one

the acoustic level of communicative function

the speech chain: level two

the internal physical/motor system required for communication

the speech chain: level three

the linguistic component of communication

form

morphology, syntax, phonology

use

pragmatics

content

semantics

morphology

the structure of words and the construction of word forms

syntax

the order and combination of words to form sentences; relationships among the elements within a sentence

phonology

the sound system of language; rules that govern the sound system

pragmatics

the system that combines language components in functional and socially appropriate communication (social and tone)

semantics

the system that governs the meanings of words and sentences (vocab and meaning)

evidence based practice (EBP)

refers to the process that practitioners use to evaluate whether a clinical practice, strategy, program, curriculum, or interventions is backed up by rigorous evidence of effectiveness and whether a practice is appropriate for a particular individual; ASHA's def -> an approach in which current, high-quality, research evidence is integrated with practitioner expertise into the process of making clinical decisions

clinical expertise

encompasses the knowledge, judgement, and critical reasoning gained through training and experience, constituting a key element of EBP; evolves over time; crucial for clinicians to embrace rational thinking, rooted in scientific learning and critical evaluation of research to ensure clinical expertise and alignment with EBP principles

EBP levels of screening level one criteria

evidence from well conducted, randomized control trials; systematic reviews or meta-analysis of high quality research studies

EBP levels of screening level two criteria

similar findings demonstrated from several non-randomized (but high quality with good design) studies from different researchers

EBP levels of screening level three criteria

results from high quality non-large group studies (eg case studies, single case study design) or correlational studies

EBP levels of screening level four criteria

expert committee reports, clinical consensus, reports of respected authorities

high quality research

randomized subjects, limiting extraneous factors, use valid instruments to document results, avoid research bias by using blind studies, clinical versus statistical significance

five principles we know to be true of normal development

1. development is predictable

2. developmental milestones are attained in about the same age in most children

3. developmental opportunity is needed

4. children go through developmental changes or periods at different rates

5. individuals differ greatly

nature

plato, chomsky; sometimes referred to as nativists or rationalists, language is an innate ability of humans

nuture

B. F. Skinner, played a role in Piagetian theory, empiricists, language is a function of an individual's environment

behaviorist theory

B. F. Skinner, learning occurs when an environmental stimulus triggers a response or behavior; increasing the frequency of positive behaviors and decreasing or altering negative behaviors

clinical implications of the behaviorist theory

drill and practice activities; focus on observable and measureable behaviors

limitations of the behaviorist theory

not a comprehensive theory; doesn't explain when they say things that they haven't been directly taught

shaping

when an individual is expected to produce closer approximations to the behavioral target prior to reinforcement

reinforcement

doing something that makes it more likely that the behavior will occur in the future

extinction

when a child's response is not reinforced, the behavior will decrease or disappear

antecedant

a stimulus that precedes a behavior

punishment

a consequence following a behavior that intends to reduce the likelihood that a behavior will occur again

chaining

a complex behavioral sequence is broken down into smaller units so the child can learn to complete a multistep task

constructivist theory (aka cognitive theory)

Jean Piaget; sequences of progressively more sophisticated cognitive skills, from primitive thinking to advanced cognitive ability; proposes specific cognitive achievements are fundamental to linguistic development; linkages exist between children's motor ability, play behavior, and language development

clinical implications of the constructivist theory

making sure that kids have certain skills and do it in an environment that they are used to

schema

a concept, mental category, or cognitive structure

assimilation

when one takes in new information and incorporates it into his existing schema

accomodation

when a child adjusts his schema from new information; when a person alters existing schema or makes new ones to fit new information into

equilibrium

the balance between assimilation and accomodation

symbolic play

when the child uses one object to represent another

object permanence

an object exists even when it cannot be seen

means-end

when the child identifies a problem and makes a plan to solve the problem

social interactionist theory

based on the principle that communication interaction plays a central role in children's acquisition of language; highly influenced by Vygotsky and Brunner; the child and a more capable partner problem solve together, eventually the child internalizes the process and can solve problems independently; cognitive development is socially mediated, a child's interactions with other influence his cognitive understandings

zone of proximal development

initially a child and a more capable partner solve problems together, but eventually the child internalizes the process and can carry out the function independently

private speech

occurs when children speak aloud when they are engaged in play; plays a role in cognitive development

motherese

communication that enhances a child's ability to learn language; increased pitch, talking about objects in the here and now, etc.

coordinating attention

adults follow a child's focus of attention and match their communication to the child's eye gaze

scaffolding

the adult support that allows a child to engage in a challenging activity

mediation

the goal is to provide the learner with insights in order to teach the learner "how to learn"

emergentist theory

language is an interconnected system, highly complex biological system; a child's biology adapts to his/her environment; middle ground between nature and nurture; uses computer stimulation and analysis of children's language samples to understand language development

clinical implications of emergentist theory

note inconsistencies in child's language use; note emerging patterns; target linguistic features to promote system-wide change

the five communication subdomains

1. early pragmatics

2. vocabulary

3. early word combos

4. morphosyntax

5. discourse (advanced pragmatic and discourse development)

early pragmatic skills (subdomain 1)

includes prelinguistic communication; early developments -> between 10 and 12 months: joint visual attention (one of the first interactive communication acts), 8 and 15 months: refusal of objects or activities, refusal, comments, 16 and 23 months: requesting information, answering questions, acknowledging a response; early discourse skills -> begins in preschool and continues: initiating a conversation, taking turns during a conversational exchange, maintaining an ongoing topic, conversational topic switching, making conversational repairs, code switching

clinical implications of early pragmatic skills

these underlie all later communication; first aspect of communication that is considered during observational process; if the practitioner identifies a weakness in the individuals ability in early pragmatic functions, communication subdomain one becomes the focus of intervention

vocabulary development (subdomain 2)

begins toward the end of the first year of life and continues to develop throughout life; first words are typically produced between 10 and 16 months; by two years, children typically produce 200-500 words and understand many more; semantic deficits are characteristics of many language disorders including: ID, ASD, hearing impairments, SLI, etc.

clinical implications of vocabulary development

at early stages, practitioners consider whether children's word usage reflects a variety of semantic categories; the interventionist may train caregivers to facilitate a variety of semantic forms; successful vocabulary interventions should: integrate new word meaning with familiar words, provide repeated, meaningful, and contextual opportunities to learn new words, provide explicit and implicit learning opportunities, aim for fluent an automatic understanding and use of new words, teach students to be more independent word learners

multiple word combinations (subdomain 3)

once an individual produces approximately 50 individual words, word combinations begin to emerge; at this early word combination level, children are not governed by adult syntax rules and do not use morphological forms; children create combinations of words by: naming people or objects of interest, stating the actions, objects, or people preform, describing the objects or person's characteristics, describing who owns or possesses the object

clinical implications of multiple word combinations

once a child is able to demonstrate early pragmatic skills and has more than 50 single words, practitioners engage children in early play activities to facilitate multiple word combinations, a child's parents and/or caregivers are trained for facilitate semantic combinations; for older individuals with significant communication impairments, practitioners may incorporate an AAC

morphosyntax development (subdomain 4)

children's utterances begin to demonstrate characteristics of syntax and morphological development (ex: language forms); occurs between 24 and 36 months for children who are developing typically; examples: present progressive -ing verbs, plurals; by age 5, children's sentences evidence complete syntax including the use of embedded phrases and clauses

clinical implications of morphosyntax development

once an individual demonstrates the ability to use foundational pragmatic functions and produce multiword combinations using a variety of semantic categories, practitioners typically evaluate a speaker's use of morphosyntax using the framework developed by Brown; used in language analysis; demonstrated in the student's ability to read difficult texts and write at the level required for school success

advanced pragmatic and discourse development (subdomain 5)

between the ages of 3 and 7, children's developing pragmatic/discourse skills include the ability to use language to: reason and reflect on past experiences, predict events, express empathy, maintain status and interaction with peers, use and understand sarcasm and politeness forms, code switch in order; students also have to learn to modify discourse styles for different situations, some forms of discourse are called narratives

clinical implications of advanced pragmatic and discourse development

skilled practitioners track children's ability to use vocabulary and produce sentences, and use advanced language within sophisticated discourse genres; observe student: in the classroom, with peers, producing narratives; discourse analysis; focus on intervention for students in peer groups, etc.