Language Disorders Exam 2

Behavior = ___

Communication

One person assigns meaning to/interprets another person’s ____

behavior

All behavior and the resulting interpretations tell a ____

story

All behavior ___ something

means

All behavior is ___

learned

A behavior consists of a series of recognizable movements or ___

acts

Children learn to ___ according to what others assign meaning.

behave

All behavior has multiple ____

interpretations

All behavior results in social ____.

development (positive or negative)

What are the four stage of learning the meaning about behavior?

Sensory input, Perceptual patterns, Concepts/thoughts, and Language. attaching meaning to feelings.

Sensory input

interpreting meaning from a signal that is perceived from the senses.

Perceptual patterns

the firing neurons are formed into patterns.

Concepts/thoughts

created from the perceptual patterns

Language

attached to the concepts/ thoughts. usually comes from an adult.

All behavior affects ___

others

All behavior has ____

consequences

Natural Consequences

responses to sensation without language or thought about the meaning of the behavior. Most are environmental sensations.

Learning conceptually about the outcomes of behaviors that do not have immediate natural consequences requires….

someone else to assign the language of the behavior. Language attaches meaning.

Sensory systems

Taste/Gustatory, Smell/Olfactory, Sight/Vision, Sound/Auditory, Touch/Tactile, Movement/Vestibular, Body Position/Proprioception, and Interoception.

Sensory Integration

The organization of sensory input for use. Through this, the different parts of the nervous system work together so that a person can interact with the environment effectively and experience appropriate satisfaction.

Taste/Gustatory

Pertaining to the sense of taste.

Smell/Olfactory

Pertaining to the sense of smell.

Sight/Vision

Pertaining to the sense of sight.

Sound/Auditory

Pertaining to the sense of hearing.

Touch/Tactile

Pertaining to the sense of touch on the skin.

Movement/Vestibular

Semi-circular canals in the ear deals with this sense. The sensory system that responds to the position of the head in relation to gravity and accelerated or decelerated movement. Is the foundation which allows the body to be used in different positions.

Body Position/Proprioception

Sensory information that is coming through from the muscles and joints. The input tells the brain when and how the muscles are contracting or stretching, and when and how the joints are bending, extending or being pulled or compressed. This information enables the brain to know where each part of the body is and how it is moving.

Interoception

The sensory system related to sensations from internal organs/inside the human body. Feeling anxious, hungry or fluctuations of body temp.

Adaptive Response

An appropriate action in which the individual responds successfully to some environmental demand. It requires good sensory integration, and furthers the sensory integrative process.

Gravitational insecurity

An unusual degree of anxiety or fear in response to movement or change in head position; related to poor processing of vestibular and proprioception information.

Kinesthesia

Perception of the movement of individual body parts; dependent on proprioception.

Perception

The meaning the brain gives to sensory input. Sensations are objective. This is subjective.

Praxis

Motor planning. The ability of the brain to conceive of, organize, and carry out a sequence of unfamiliar actions.

Sensory Integration Dysfunction

An irregularity or disorder in brain function that makes it difficult to integrate sensory input effectively. May be present in motor, learning, social/emotional, speech/language or attention disorders.

Tactile Defensiveness

A sensory integrative dysfunction in which tactile sensations create negative emotional reactions. It is associated with distractibility, restlessness, and behavior problems.

Vestibular system

It integrates neck, eye, and body adjustments to movement.

Signs of sensory processing difficulties:

-Taste/gustatory: gagging, drooling, difficulty chewing, picky eater and putting objects in the mouth before and during play (should be gone by 3 yrs old)

-Smell/Olfactory: smelling things frequently, and experiencing adverse reaction to smells.

-Sight/Vision: poor eye contact, poor hand-eye coordination skills, bumps into things, difficulty learning to draw, copy shapes or acquiring handwriting skills.

-Sound/Auditory: responding fearfully to loud/sudden noises, distracted by clothing that makes noises, seems “to not hear” but testing reveals no deficits, enjoy making noises, covering/slapping ears when distressed.

-Touch/Tactile: avoids certain textures, responds aggressively to others when touched, touching or feeling everything possible, oblivious to touch or pain, withdrawing from touch, and dislikes getting hands messy.

-Movement/Vestibular: Fearful of movement, increased tolerance for movement, poor balance and fall frequently, loves rough play/roughhousing, and may seem disoriented when moved out of position.

-Body position/Proprioception: Bump into walls or trips over objects frequently, may use strong force for all activities if unable to regulate pressure application, holds onto items very tightly or the opposite, drop objects frequently, may have difficulty completing tasks which require pressure, wiggles in seat constantly, and bangs and breaks toys often.

All on a scale from Hyposensitive to Hypersensitive.

Language for Learning

Children move from learning to talk to talking to learning and from learning to read to reading to learn.

Why are narrative skills important?

They form a bridge between familiar, contextualized language of conversation and abstract, decontextualized style of literate language. A child will talk about what they can see and develops into talking about what they cannot see.

An important goal is to develop a ___ language style in L4L

literate (ability to read and write)

What are the four guiding principles in L4L period?

Curriculum-based instruction, Integration of oral and written language, Focus on “meta” skills, and Preventive intervention.

Curriculum-based instruction

Synthesize language intervention with the demands students face in the classroom every day. Working with a patient with what they are doing in school. (as a tool).

Integration of oral and written language

Provide both oral and written opportunities for student to practice the forms and functions targeted in intervention. Grammar and word order- syntax

Focus on “meta” skills

Direct conscious attention to the language and cognitive skills a student uses in the curriculum. Talk about about talking and think about thinking. Meta-linguistics and meta-cognition. (4th grade and up is this main group to use this focus).

Preventive intervention

Use the 3 other principles (L4L 4 guiding principles) in primary grades to attempt to ward off DLDs/LLDs in vulnerable children. (children at risk foe failing). Better to catch earlier rather than later.

Multi-Tiered Support System (MTAA)

Used in public schools. Was formerly called Response to Intervention (RTI).

Goal: Provide support/prevent problems in the areas of academics, behavior, and social/emotional function.

-Tier One: EX: all kindergartners have picture agendas

-Tier Two: EX: small group evidence-based intervention

-Tier Three: EX: individual (one-on-one) evidence-based intervention.

Clinician-Directed Intervention Processes

Computer software programs/apps. Cognitive Behavior Modification (CBM)

Computer software/Apps

Uses drill (practice over and over) play contexts- can be used to work on phonological awareness, morphological markers, vocabulary and sentence structure.

EX: color coded different sentence/word components. (syntax and semantics) The patient is able to move around or change sentence/word structure (mad-Libs)

Cognitive Behavior Modification (CBM)

Clinician follows 3 basic steps:

• Tells client strategy that will be developed, why it’s important and what procedures will be used. Explains that they will model the strategy and have the client follow the model.

• “Thinks out loud” (aka “self-talk or “think-aloud”) to demonstrate how strategy is accomplished. EX: reading a paragraph go back over what did not make sense and draw a picture or asks for clarification (“let me ask siri”)

• Has client model the thinking-out-loud process. EX: child models it in their own way and show what they would do.

EX: 4th grader— how to understand what you read in your social studies textbook. It is important to understand what you read so you can ask questions.

Child-Centered Intervention Processes

Naturalistic, Theme-based approach and Scaffolding

Nautralistic, Theme-Based Approach

Centering the session around a particular theme and every activity is working on certain areas but still relates to a theme.

Scaffolding Process

“support”

3 forms:

• creation of optimal task conditions. Reduce amount of stress and undue effort student needs to complete task. (one step at a time)

• Guidance of selective attention. Highlight important information using visual, verbal and intonational cues.

  • Visual: written words and pictures

  • Verbal: spoken words (oral and/or written)

  • Intonational: rising-stress/ falling-relaxed

• Provision of external support. “Prime” students to succeed in classroom activities. (anything given that is outside of their body that helps them succeed)

  • EX: story thinking map.

Hybrid Intervention Processes

Combine the processes of clinician-directed and child-centered.

Works on:

• semantics

• syntax and morphology

  • pragmatics

Sematics: Goals are to improve the student’s…

• vocabulary: ability to understand, use and define words

• understanding of words with multiple meanings

• word finding abilities

• ability to integrate information and infer/make inferences

• understanding of figurative language

• ability to paraphrase (when speaking, writing and studying)

• ability to identify main ideas (in spoken and written forms of language)

Syntax and Morphology: Goals are to improve the student’s…

• ability to integrate what he/she hears/reads/sees so that understanding is possible

• understanding and use of advanced morphology (word structure, meaning and segmentation)

• ability to understand and use complex sentences (when listening, reading, speaking and writing)

Pragmatics: Goals are to improve the student’s….

• conversational and classroom discourse. (what to do in conversations - prevent interruptions and budding into them)

• ability to comprehend and produce narratives (stories) —both spoken and written; getting and giving the “gist” of the story.

• message cohesion: ability to provide the listener/reader with adequate information.

• understanding of figurative language

• turn-taking, topic maintenance, and topic closure abilities. —when to stop talking.

Classroom performance/Characteristics of students with DLD

• negative attitude about learning in school

• does not seem to listen or follow directions

• asks irrelevant questions

• does not organize work space, materials, desk, locker, binder, etc.

• uses gestures instead of words

• mispronounces words

• does not follow classroom rules

Tutoring

Tends to use the same neural pathways.

Goals: Student will finish the assignment. Student will pass the test.

Therapy

Forms and strengthens new neural pathways.

Goals: student will learn about how she learns. Student will use strategies in all classes/situations.

Learning Disability (LD)

Exclusion: not mental retardation/intellectual impairment, not emotional disturbance, not a lack of opportunity to learn and not modality-impaired.

Children with LD experience a great deal of:

Frustration, Anxiety and Tension (FAT).

Processing Problems

inability to process language at the same pace as a typical kid.

The pace of a class may seem ___ for a child with LD.

too fast

• The child with LD are busy processing the question while typical children are already processing the answer.

  • Technique to help: secret signal teacher has with the child.

Distractible vs. poor attention span

Distractible pays attention to everything; poor attention span pays attention to nothing.

An LD child is usually ___.

Distractible

Teacher use these tactics when kids have trouble:

• “look at it harder”

• bribing

• take away privileges

• blaming the victim

LD is not a ___ problem.

motivation.

• motivation only enables is to do what we are already capable of doing to the best of our abilities.

LD kids can see, but not always _____.

Perceive. Bring meaning to something.

95% of textbooks and 93% of teachers teach comprehension through ___.

Vocabulary

Visual motor integration problems

hands and eyes are getting mixed messages/contradictory information.

Dysomia (anomia)

word finding problem; a problem between storage and retrieval.

Associative task

multitasking; doing multiple things at a time.

Cognitive task

singular task; doing one thing at a time.

The greatest gift you can give a LD child is ____.

Time

If decoding requires extensive energy/effort, then ____ is compromised.

comprehension

_____ does not mean that everyone gets the same; rather, it means everyone gets what they need.

Fairness

Auditory Processing Disorder (APD)

any breakdown in the child’s auditory abilities that results in diminished learing through hearing, even though peripheral auditory is normal.

Characteristics of APD in individuals

• Difficulty with background noise

• Difficulty following oral directions

• Poor listening skills

• Academic difficulties

• Poor auditory association skills

• Distracted

• Inattentive

• Hyperacusis (sensitivity to loud sounds)

• Difficulty following long conversations

• Difficulty learning foreign languages or challenging vocabulary words

• Difficulty understanding people with accents

What professionals should be involved with when diagnosing APD

• audiologist

• SLP

• psychologist

Red flags for APD

• History of otitis media

• History of hyperbilirubinemia (high bilirubin/ jaundice)

• Family history of APD

• Issues/complications during pregnancy

• Severe childhood illness

• Neurologic issues

• Maternal smoking

• Anesthesia

What are considered “Lower Level” auditory skills

• Awareness/Localization

  • If a sound occurred and where it came from

• Discrimination

  • Tell difference between multiple sounds

• Recognition

  • Can the person repeat a sound

• Auditory attention

• Figure-ground

  • Can the person attend to speech sounds and block out background noises.

• Synthesis

  • can the person create meaning from another’s speech sounds

• Closure

  • Can the person fill in missing phonemic information from a word.

What is considered “Upper Level” Auditory skills

• Dichotic listening (seperation, integration)

  • can the person attend to and repeat back two different words

• Auditory memory

  • Can the person recall and store information heard

• Sequencing

  • Can the person recall what was heard in the correct order

• Temporal resolution

  • can the person do all things above at an age appropriate speed.

What is the recommended treatment for APD

• Auditory training

• Communication and/or educational strategies

• Metalinguistic and metacognitive skills

• Hearing assistive technology

• Acoustic enhancement and environmental modifications

Attention Hyperactivity Disorder (ADHD)

Problems with attention and Impulsivity-Overactivity/Hyperactivity.

Can be mild, moderate or severe.

Treatment of ADHD

• Medication (Ideal)

• behavior therapy

• diet modifications

• Enhance organization and notebook arrangement

• Energy discharge control

• Distraction control

• Adjust workload

• Help note-taking

• Employ “school success calendar”

• Enhance homework productivity

• Involve parents/family

• Teach social skills

• Teach decision-making and problem solving

• anger control

• foster hobbies/skills/talents/interests

Instructional therapy strategie

self talk:

• model self-talk

• ask client to use self-talk

• encourage client to share effective self-talk strategies

• provide written scripts for clients to practice

• encourage client to analyze his/her self-talk and look for ways to make it more effective.

Mnemonic therapy strategies

• First letter

  • EX: FANBOYS—> conjunctions

• Acrostics

  • Never Eat Soggy Waffles (NESW)

• Keywords

  • select a keyword that is already familiar, sounds like the target word and can be pictured easily.

• Pegwords

  • EX: Fundraiser ideas one-sun= #1 idea (most popular/common) bake sale —> cake that looks like the sun

• Rhymes and Associations

  • “I before E except after C and in words like neighbor and neigh.

  • Fall back and SPring forward

  • Righty tighty and Lefty loosey

• Method of Loci

  • visualize a familiar place, and place items to be remembered in these places.

    • Presidents and walking inside your house after coming home

    • 1st president is washington on the washing machine.

• Songs and Chants

  • 50 states song or preposition songs

• Story

  • put information into a story to be remembered. (the weirder the better)

Visual therapy strategies

• post behavior and academic rules (using graphics)

• Use cartoons, pictures or props

• Use stick drawings

• Provide step charts

• highlight margins

• put reminders on desks or binders

• Use clocks or timers

• add color to salient aspects of new tasks

  • color coded notes

• give students actions to do with study materials

  • moving locations while studying

• use graphic organizers

Organizational therapy strategies

• Establish routines for placement of objects

• Tell client where each piece of paper goes and allow time to follow through

  • color coded folders for each subject

• Teach client to use calendars, schedules, do/due sheets, etc.

• Provide direct instruction on notebook organization

• Teach study skills

Test-Taking therapy strategies

• Be positive

• Teach relaxation strategies

• practice different test formats

• Teach student to:

  • think of a positive event to put their brain in a good mood

  • look through the test first so they can plan their time

  • mark difficult items and return to them if there is time

  • underline key words

  • cross out the number or letter identifying incorrect multiple choice responses

  • trust your gut and stick with first answer to a multiple choice question.

Test Accommodation therapy strategies

Depending on client’s needs:

• provide extended time

• allow for more frequent breaks

• provide a quiet room

• paraphrase instructions prior to test

• allow the use of a calculator

• allow use of spell check