Peds: Speech and Communication Development

Communication

The active process of exchanging information and ideas
**involves both expression and understanding

Phonology

The sounds and sound system of a language (p, b, t, d)

Morphology

The system for combining meaningful units (walk, walked, walking)

Syntax

The system for combining words into sentences. The grammar. ("I walking to the store")

Semantics

The meaning of the sentence. All these words put together, do they make sense? (Ex: the verb "move" can mean change place, push, pull or carry, or stir emotion).

Pragmatics

Knowledge that underlies successful and appropriate language use; the social components of language use

Speech

Involves using the vocal tract and articulators to produce the sounds in order to convey a message; everything to do with sound production

Language

Creating and decoding the words and sentences

T/F "Speech and language are synonymous"

FALSE

Speech and language are different. A person can have problems with one or both. When a child is difficult to understand, we determine WHERE they are breaking down

Receptive language

Ability to understand information. It involves understanding the words, sentences and meaning of what others say (auditory comprehension) or what is read (reading comprehension)

Expressive language

Ability to put thoughts into words or gestures so others understand you. **Can be verbal or nonverbal

T/F "Receptive language development is typically 6 months ahead of expressive language"

TRUE

What is a speech language pathologist?

Professionals who are educated to evaluate, diagnose and treat disorders of speech and language, cognitive-communication, and swallowing.

By 18 months a child's speech is typically _____ intelligible

By 18 months a child's speech is typically 25% intelligible

(A stranger can understand 1/4 of what they are saying)

By 24 months a child's speech is typically _____ intelligible

By 24 months a child's speech is typically 50-75% intelligible

By 36 months a child's speech is typically _____ intelligible

By 36 months a child's speech is typically 75% intelligible

By 4-5 years of age, a child's speech is typically _____ intelligible

By 4-5 years of age, a child's speech is typically 100% intelligible

Receptive milestones at 12 months

Starts to respond to simple words and phrases, like "No," "Come here," and "Want more?"
Plays games with you, like peek-a-boo and pat-a-cake

Expressive milestones at 12 months

Babbles long strings of sounds, like mimi upup babababa
Says 1 or 2 words, (hi, dog, dada, mama, or uh-oh.) This typically happens around child's first birthday, but sounds may not be clear.

Receptive milestones at 2 years of age

Points to a few body parts when you ask
Follows 1-part directions like "roll the ball"
Points to pictures in a book when you name them

Expressive milestones at 2 years of age

Puts 2 words together: "more soup", "what's that?"

Receptive milestones at 3 years of age

Follows 2-part directions: "Get the spoon and put it on the table"

Expressive milestones at 3 years of age

Asks "Why?"
Puts 3 words together to talk about things
May repeat some words and sounds
Has a word for almost everything
Talks about things that are not in the room

Receptive milestones at 4 years of age

Responds when you call from another room
Understands words for colors, shapes, family

Expressive milestones at 4 years of age

Answers who, what and where questions
Puts 4 words together
Talks about what happened during the day, 4 sentences at a time
Says rhyming words and pronouns

Narrative skills

The ability to use language to tell a story (real or made up)

What narrative skills will a child have at age 2?

Heaps: relates a group of unrelated ideas with frequent topic switching.

What narrative skills will a child have at age 2-3?

Sequences: telling a story with arbitrary links between elements such as characters, setting or topic

What narrative skills will a child have at age 3-4?

Primitive narratives: stories contain characters, setting and a topic, with events following a central theme. Cause and effects relationships emerge

What narrative skills will a child have at age 4-5?

Focused chain: stories contain all relevant elements such as characters, setting and topic. Stores are told in a logical sequence but listener may require additional knowledge to interpret.

What narrative skills will a child have at age 5-7?

True narratives: stories contain a true plot, including a problem which is resolved at the end. Follows a logical sequence of events

Does bilingualism cause speech and language problems?

NOPE!!

If a child is struggling with their second language but their first language is fine, is it a speech and language disorder?

Probably not

Should I stop speaking my native language to my child in order to focus only on English?

NOPE!!

Communication disorder

An impairment in the ability to send, receive, process, and comprehend concepts (verbal, non-verbal and graphic symbol systems)

Can be speech, language and or hearing
Ranges in severity
May be acquired or developmental
May result in a primary disability, secondary to other disabilities or can occur co-morbidly

Language disorder

Children with language disorders struggle to make sense of what people around them say (receptive) and/or struggle to put their thoughts into words (expressive)

Signs of receptive language deficit

Delayed developmental milestones
Difficulty following directions
May be forgetful
Withdraws during social conversation but are social during sports

Signs of expressive language deficit

Delayed developmental milestones
Overgeneralization of the names of things
Circumlocution: talking in circles
Missing grammatical structures
Narrative is missing necessary info

Speech delay

Children with speech production patterns that are typical for children who are younger

Often require a parent or sibling to interpret
Get frustrated because needs aren't getting met; are aware they sound different from other children
Leave off initial or final consonants of words

Childhood Apraxia of Speech and Red flags

Disruption in motor planning and/or programming

Red flags: Vowel distortion

Groping for articulator placement

Errors increase as length of word increases

Sound choppy and robotic when talking in longer utterances Poor imitative abilities

What are the clinical signs of Autism Spectrum Disorder/ Pragmatic Skill Deficits

Poor eye contact
Poor turn taking skills
Poor topic maintenance
Poor play skills
Rigid with routines
Poor response when name is called
Often doesn't answer yes/no questions

When is stuttering more concerning?

There is a family history of stuttering
Exhibit signs of frustration
Exhibits secondary behaviors: eye clinching, make fists, stomping feet, etc...
If it goes away and then comes back

When would you expect a stutter to occur?

Typical to see stutters during time of major language acquisition: 18 months - 36 months

Feeding disorders

Problems gathering food and getting ready to suck, chew, or swallow it

Dysphagia

difficulty swallowing

Oral phase of swallowing

sucking, chewing, and moving food or liquid into the throat

Pharyngeal phase of swallowing

starting the swallow, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking

Esophageal phase of swallowing

relaxing and tightening the openings at the top and bottom of the esophagus and squeezing food through the esophagus into the stomach

Signs and symptoms of feeding disorders

- Arching or stiffening of the body during feeding/pulling away from utensil
- Failure to accept different textures of food
- Long feeding times
- Difficulty chewing
- Coughing or gagging during meals
- Excessive drooling or food/liquid coming out of the mouth or nose
- Gurgly or hoarse voice quality after eating
- Frequent spitting up or vomiting

What is the best way a parent can encourage their child to develop language?

Tell parent to model the correct sound or language structure without calling negative attention to the error

Reduce getting in the cycle of asking lots of questions

What are the 5 major areas to assess when determining if you should refer a child to an SLP?

1. Receptive Language: can child answer simple questions
2. Expressive Language: narratives
3. Social Skills
4. Speech Production
5. Feeding Concerns