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**Terms that cannot be found in book/slides are intentional! Professor wants us to tell the difference between right/wrong answers for multiple choice questions
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Cultural competence
To recognize, honor, + respect beliefs, interaction styles, behaviors of individuals + families
Challenges in serving adults with Culturally and Linguistically Diverse (CLD) Backgrounds
Low income
Poor diet
Lack of health insurance
Lack of access to medical services
Barriers to service delivery
Barriers to Service Delivery
Limited English
Lack of health insurance
Lack of transportation
Differing beliefs about optimal health care
Ethnocentrism
View that members of a culture do things the “right way”
ex. Assuming your own language is superior, or that everyone should speak your language
Cultural tendencies
Patterns of behavior + values commonly observed among a culture; Recognizes heterogeneity + diversity within cultures
ex. Religion, age, beliefs
Cultural relativism
Other people’s ways of doing things are different yet equally valid
ex. In some cultures, bowing is the preferred greeting form; in others, handshakes are the preferred greeting
Code switching
Using different linguistic styles for different situations
ex. Speaking politely to parents, yet using slang around friends
Language difference
Regional, social, or cultural variations of language, such as a specific regional dialect
ex. In Spanish, the adjective is placed after noun, whereas in English the adjective is before noun
Dynamic Assessment
Analyzes how much + what types of support/assistance needed to bring individuals’ communicative performance to higher level; Rooted in theories from Leo Vygotsky
Static testing
An individual is assessed at given point in time, + results of test determine what they can/cannot do on their own
Norm referenced + Criterion referenced fall under this
Systematic observation
Process of observing how individuals use communication for functional purposes in real world activities; Allows professionals to examine one’s communicative performance at home, school, work, in the community
Steps to interpret assessment findings
Diagnosis (differential diagnosis)
Determining severity of disorder (very mild-very severe)
Characterizing client’s prognosis
Differential diagnosis
Diagnosis that differentiates a person’s disorder from other similar disorders
ex. Spastic dysarthria differs from flaccid dysarthria
Language disorder
Impaired comprehension and/or use of spoken, written, and/or other symbol system
Impacts semantics, syntax, morphology, phonology, or pragmatics
Can affect children/adults
Can compromise reading development (reading disabilities)
*Language deviance
A child's language development that differs from normal expectations; A unit of language that doesn't follow grammar rules
ex. Using an question mark instead of a period when writing
Specific language impairment (SLI)
Primary developmental language disorder; Impairment of expressive/receptive language in (pre)school-age children that cannot be attributed to other causal conditions (with no known cause); Language skills seem poor relative to intellectual capabilities
Language delay
Children exhibiting problems with language achievements get a late start with language development + can be expected to catch up with their peers; Late talkers who end up catching up with other children
Silent period
Little to no talking when exposed to second language
ex. Father speaks Spanish to child, yet child solely responds in English (or does not respond to second language at all)
Simultaneous bilingual acquisition
Under 5 years of age; Two languages acquired simultaneously from birth
Sequential bilingual acquisition
Over 5 years of age; First language learned from birth + second language learned later
Language loss
Skill reduction of first language when learning second language; Second language becomes dominant
ex. If a child who experienced this concept tests in the first language, they may show low scores in first language than in their second language
Error transfer
Errors in second language caused by influence of first language
Anomia
Means “no name”; Word-finding problems/inability to retrieve a word; Persistent deficit in aphasia, word retrieval problems may remain even after recovery
Telegraphic speech
Phrases/sentences made of content words (nouns + verbs) with function words omitted; Seen in Broca’s aphasia + transcortical motor aphasia
ex. “Tom go store”
Word-finding problems (Anomia)
Inability to come up with words/names of items in spontaneous conversation/naming tasks; Seen in Broca’s aphasia, transcortical motor aphasia, global aphasia, Wernicke’s aphasia, conduction aphasia, transcortical sensory aphasia, anomic aphasia
Jargon
Production of language that is meaningless + may run ongoing; Seen in Wernicke’s aphasia
Neologisms
Making up a new word; Seen in Wernicke’s aphasia
ex. “The bramble-thingie is over here”
Agrammatism
Leaving out grammatical markers in sentences/phrases, like verb inflections, articles, + prepositions; Seen in Broca’s aphasia, transcortical motor aphasia
ex. “He go store”
Semantic/Verbal paraphasia
Substituted word, likely in same category as targeted word
ex. Identifying a photo of a sofa as “furniture” or “chair”
Phonemic/Literal paraphasia
Substitution or transposition of a sound
ex. Identifying a sofa as a “tofa” or “fosa”
Standard Scores
Index that identifies how a person’s test performance compares to their normative peers
Screening tools
Designed for quick administration; Given to large number of children
Echolalia
When one frequently repeats auditory stimuli
Evidence-based practice
Process where clinician integrates these areas for a client’s best action plan:
Scientific evidence
Clinical expertise
Client perspective
Clinical expertise
Knowing how to do a method; Evidence that it works
Client perspective
When a client believes a method does not work for them, prompting to try new method
Norm-Referenced Test
Compares performance with same-age peers; Is standardized, has normative sample
Norm-Referenced Test Differences
Ranks students based on test achievement, scores given as rank based on other students’ scores
Assesses large number of students
Takes longer period of time
Normed for certain group (ex. Testing individuals across USA) → can cause issues that may not be normed for other populations
Criterion-Referenced Test
Determines achievement levels in particular area/criteria; Requires establishment of a clear performance standard, specific design tasks, + provide guidelines for interpretation
Criterion-Referenced Test Differences
Measures skills + knowledge a student has mastered
Student scores are given as 100%
Assesses small number of students
Lasts a class period usually
Family-centered approaches/intervention
Based on family systems theory; Emphasizes the “family as a whole is greater than sum of its parts”
Family centered approaches/intervention: Treatment goals
Emphasize an individual’s participation within + access to family activities/contexts
Incorporate family members’ perspectives on viable treatment approaches
Child-centered approaches
Child sets pace + chooses the materials; Professional seeks ways to facilitate language form, content, or use in child-selected activities
Behaviorist approaches
Based on learning theory; Emphasizes how environment shapes behavior + influence of consequences on behavioral change
Behaviorist approaches: Clinicians’ responsibilities
Identifying observable + measurable goals
Specify level of mastery at each goal
Controlling each intervention session
Collecting data in each session
Clinical-directed approaches
Adult (therapist, teacher, parent) selects activities, materials, + sets instruction pace
Naturalistic environment
Intervention for children is effective when it engages them in environments where they must use their skills
ex. Environments include homes, child-friendly classrooms, etc.
Natural Environment characteristics
Increases carryover
Increases discourse skills
Respects least restrictive environments when consultant/collaborative model is used
Involves family
Produces functional outcomes
Enhances access to curriculum
Intervention
Action plan to improve individuals’ communicative abilities
Purpose of Intervention
Prevention
Remediation
Compensatory
Comprehensive Language Evaluation
Determines if a language disorder is present:
Profiles linguistic strengths/weaknesses
Identifies supports to improve language skills
Involves case history + comprehensive analysis of child’s language
False positive
Child who doesn’t have a language disorder is diagnosed as having one
False negative
Child who has a language disorder isn’t accurately identified as having one
False positive/negative causes
Poorly constructed tests, or linguistically/culturally biased tests; Child’s illness, shyness, underlying conditions, etc. may cause poor test results
Reading + Writing goals
Addressed within language intervention; Emphasize skills foundational to reading achievement (decoding/comprehension); Includes:
Phonological awareness
Alphabet knowledge
Print-concepts knowledge
Alphabetic principles
Reading fluency
Alphabet knowledge
Knowledge of letters, upper/lower case correspondence, letter-sound correspondence
Print-referencing
When reading books/texts, adults refer to letters by pointing to them + commenting on them so child learns letters
Motor learning
How practice/experience leads to “permanent changes in capability for movement”; Important for understanding normal + disordered speech motor control
Phonological awareness
Awareness of rhyme patterns; Syllabic composition of words; Onset + rime boundary in single-syllable words; Initial, medial, + final sounds in words
Print-concept knowledge
Knowledge about rules that govern print; Includes:
Knowing how books are organized (ex. cover page, title page, text)
Functions of print in various genres (ex. lists, invitations)
Major print units (ex. letters, punctuation, words)
Language disorders classification
Etiology
Manifestation
Severity
Etiology
Cause of language disorders
Primary disorder
Impairment attributable to no other cause; Occurs in absence of any other disability
ex. Autism can cause language disorders, but language disorders do not cause autism
Secondary disorder
Impairment caused by another primary source; Occurs in presence of another disability
ex. Hearing loss causes language disorder
Manifestation
Language disorders classified according to affected language aspects
Does disorder affect: comprehension, expression? Form, content, use? Spoken language or reading/writing?
Severity
Language disorders range from mild to profound; Extent it hinders child’s abilIties to use language for social and/or educational functioning
ASD
Autism Spectrum Disorder; Developmental conditions characterized by:
Repetitive behaviors
Difficulties w/ social relationships + communication
Restricted interests
ASD risk factors
MMR vaccine said to have linkage, but studies proved it does not
Prenatal/perinatal complications
maternal rubella + anoxia
Purposes of Assessment
Identify skills one has/doesn’t have in a communication area
Guide design of intervention for enhancing one’s skills in a communication area
Monitor one’s communicative growth/performance over time
Qualify one for special services
TBI
Traumatic brain injury; Caused by car accidents, falls, recreational sports; Most common type: Closed-Head Injury (CHI)
TBI Characteristics
Open-head: Penetrated skull + meninges
Closed-head: Brain jostled within skull, yielding diffuse brain injury
Polytrauma: Mix of open + close-head injuries, etc
Aphasia
Language disorder acquired after one has developed language competence; Absence of language
Dysarthria
Motor speech disorder
Right-hemisphere dysfunction (RHD)
Damage to right cerebral hemisphere:
Language + cognition impacted, symptoms differ from aphasia
Cognitive-linguistic disorder
RHD Characteristics
Lack of awareness of cognitive-linguistic deficits + denial of problem areas
Lack of awareness of left side of body + external stimuli to left side
Difficulty recognizing faces
Compromised pragmatics
Wordy expression
Difficulty understanding/using higher-level cognitive-linguistic skills
Dysarthria, Dysphagia
Dementia
Chronic + progressive decline in memory, cognition, language, + personality; Results from central nervous system dysfunction
Mild Dementia
Forgetfulness of basic info/common routines
Losing/misplacing items
Missing appointments/plans
Decreased vocab
Reduced/verbose conversation, anomia
Moderate Dementia
Increasingly disoriented in time + place
Poor attention + memory
Marked language difficulties
Deficits of language (anomia, difficulty repeating)
Misunderstanding humor + empty conversations
Restlessness + roaming
Severe Dementia
Extreme disorientation
Minimal cognitive ability
Language skills compromised (limited meaningful communication)
Frequent repetitions + jargon
Comprehension skills impaired
May be unable to control bladder/bowel functions + may need wheelchair
3 Dementia Traits
Memory impairment
Cognitive skills impairment
Presence of aphasia, apraxia, agnosia
Broca’s Aphasia
Damage to frontal lobe, causing:
Slowed, halting, labored, + telegraphic/robot-like speech
Mild to moderate auditory comprehension problems when messages increase in length + complexity/when contextual cues removed
Nonfluent + expressive
Motor aphasia
Transcortical Motor Aphasia
Damage to superior + anterior frontal lobe portions, causing:
Good repetition skills, better than spontaneous speech
Strong oral reading performance
Good language/auditory comprehension
Nonfluent
Global Aphasia
Damage to large brain region or multiple sites of brain injury in language-dominant hemispheres, causing:
Deficits across all language modalities
Non-fluent
Poor language comprehension
Naming/word finding problems
Wernicke’s Aphasia
Brain injury to superior + posterior temporal lobe regions (can reach parietal lobe of language-dominant hemisphere), causing:
Spontaneous speech + flow with normal prosody
Fluent + receptive
Poor language/auditory comprehension
Sensory aphasia
Transcortical Sensory Aphasia
Injuries to language-dominant hemisphere (border of temporal/occipital lobes, or parietal lobe’s superior region), causing:
Echolalia
Fluent
Jargon + naming difficulties
Poor language/auditory comprehension
Conduction Aphasia
Injury to brain’s temporal-parietal region, Arcuate fasciculus, causing:
Difficulties w/ repetition + reading aloud
Fluent
Naming difficulties
Normal prosody + articulation
Anomia aphasia
Damage to multiple potential lesion sites, causing:
Fluency
Word-finding problems
Rancho Levels of Cognitive Functioning Scale
Level I-III [1-3]: Severe (early recovery phase)
Level IV-VI [4-6]: Middle (middle recovery phase)
Level VII-X [7-10]: Mild (late recovery phase)
Treatment settings
Aphasia therapy not limited to clinic or office
Therapies encompass other environments to facilitate carryover + generalization of progress different settings
Group approach may help
Fluent
Aspect of communication/speech describing forward flow, phrasing, intonation, + rate
Easy, smooth, + well paced
Correlates with posterior brain damage (ex. temporal-parietal regions)
Non-fluent
Short/choppy phrases
Slow/labored speech production
Grammatical errors
Telegraphic quality
Correlates with anterior brain injury (ex. frontal lobe)
Polytrauma
Mixture of open + closed-head injury, multiple medical concerns, + posttraumatic stress
Compromised pragmatics
Inability to take turns, read others’ cues, recognize others’ communication interests, + use physical space + affect during communication
Dysphagia
Swallowing disorder; Difficulty chewing/managing food + triggering/maintaining a swallow
Types of Strokes
Ischemic strokes
Hemorrhagic strokes
Ischemic strokes
When blood supply to brain is inhibited because of artery occlusion
Hemorrhagic strokes
When blood vessel/artery ruptures + excessive amounts of blood enter brain
Intellectual disability
Arrested/incomplete development of mind; Impairment of skills during developmental period
Intellectual disability risk factors
Prenatal/perinatal damage
Viral infections
Environmental influences, abuse
Biomedical + psychosocial factors
Trauma, infection, poisoning
Heredity
Brain injury
Damage/insult to one’s brain; Can occur in utero, perinatally, or acquired