Childhood Language Disorders

Significant deficits in learning to talk, understand, or use any aspect of language appropriately, relative to norm-referenced and environmental expectations for children of similar developmental level.

What is a childhood language disorder?

language delay, late talker

Outdated terms used to describe language disorders

“Language delay” implies that a child will catch up, but only half of ‘late talkers’ catch up with their peers by 3- or 4- years old

What is the problem with saying “language delay”?

late language emergence

LLE stands for …

etiology, manifestation, severity

Childhood language disorders are classified by ___________

• Organic = some underlying diagnosis —> neurobiological, anatomical, physiological (ex cleft palate)

• Functional = no known cause

Etiology: describe organic vs functional

• Developmental AKA congenital = present at birth/shortly after birth

• Acquired = after period of typical development

Etiology: describe developmental vs acquired

• Primary = occurs w/out another disability

• Secondary = consequence of another diagnosis

Etiology: describe primary vs secondary

Which aspects of language are affected?

The manifestation of a language disorder asks …

What is the extent to which the disorder affects a child’s ability to use language functionally?

The severity of a language disorder asks …

True

True or false: Language disorders are classified by their manifestation

• Receptive and/or expressive language

• Form, content, and/or use

• All modalities

Language disorders can affect…

focal disorder

Affects only one domain of language

Diffuse disorder

Affects multiple domains of language

• Form - syntax, morphology, phonology

• Content - semantics

• Use - pragmatics

List the domains for form, content, and use

False: affect spoken and/or written language

True or false: Language disorders only affect written language

true

True or false: many reading disabilities are secondary to language disorders

Mild 

May be perceived only by the child, his or her parents, or a professional. They may have little impact on the child’s ability to function in home and school.

moderate

perceived by others. They impact a child’s ability to function in home and school and require accommodations and interventions.

Severe

perceived by others. They significantly impact a child’s ability to function in home and school and require extensive accommodations, and interventions.

profound

limit a child’s ability to function in home and school (may understand and use very few words). These impairments are typically secondary to other disabilities.

1. Specific language impairment (SLI)

2. Autism spectrum disorder (ASD)/intellectual disability (ID)

3. Traumatic brain injuries

4. Reading disabilities

List the 4 types of language disorder that are prevalent in children

primary/functional, developmental

Specific language impairment (SLI) is a __________, ________ language disorder

Specific language impairment (SLI) 

Impairment of expressive and/or receptive language in preschool and school-age children that cannot be attributed to any other etiology. Language skills are poor relative to intellectual abilities. 

True

True or false: There is no single known cause of specific language impairment

• Genetic

• Environmental

  • Sensory deprivation

  • Biological

  • Physical health challenges

Factors that may affect a SLI

20-40%

__________of children with SLI have a sibling or parent with a language disorder

secondary

Autism spectrum disorder (ASD) causes __________ language disorders

Autism spectrum disorder (ASD)

An umbrella term for several developmental conditions. Characterized by difficulties in social interactions and communication, repetitive behaviors, and overly restricted interests

• Emerge during childhood

• Affect their ADLs

• Problems with social communication and social interaction

• Restricted and repetitive patterns of behavior

DSM-V Criteria for diagnosis of ASD

neurobiological 

There is no known cause of autism and it is currently considered a ________ disorder

4x

Boys are _______ more likely than girls to be affected, though girls have more severe symptoms when affected

True

True or false: The prevalence of other developmental or physical disabilities (encephalitis, Fragile X syndrome) can contribute to occurrence of autism

1. Genetic factors

2. environmental factors

Factors that may influence autism

1. Prenatal and perinatal complications, especially maternal rubella and anoxia

2. Severe sensory deprivation (severe neglect and abuse) may result in patterns similar to ASD

List 2 environmental factors that may be linked to autism

developmentally delayed

Previously, children with autism were labeled as ________

shifts in diagnostic practices rather than an actual increase in the number of children affected

Why may there be an increased incidence of ASD in recent years? 

neurodevelopmental

Intellectual disability (ID) or intellectual developmental disorder (IDD) is a ____________disability that causes secondary language disorders

1. when mental abilities are significantly below what would be expected based on age

2. The child simultaneously has problems functioning in society

   
   

When is an intellectual disability diagnosed?

True 

True or false: Intellectual disabilities can exist within a known syndrome or not

Chromosomal abnormalities or maternal ingestion of toxins (down syndrome, fetal alcohol syndrome)

Biomedical factors for intellectual disabilities

30-40%

There is no known cause for _________ of cases for ID

• Conceptual skills

• Social skills

• Practical skills

Individuals with ID show limitations in adaptive behavior and activities of daily living. There are deficits in…

85%

_______ of cases are mild for ID

true

True or false: Language skills in ID usually correspond to the degree of intellectual impairment

acquired, secondary

Brain injuries often cause an __________, _______ language disorder

• Infection - meningitis

• Disease - brain tumor

• Physical trauma - TBI, abuse

Possible causes of brain injuries

1.5 million

Brain injuries affect __________ people in the US each year

• Young children

• Adolescent males

• Elderly

What populations are at greatest risk for brain injuries

accidents 

The most common cause of brain injuries is ________

• Participating in contact sports/other recreational activities

• Drug or alcohol use

• Inexperienced driving

Risk factors for a brain injury due to accidents

car/motor vehicle

__________accidents are a leading cause of brain injury

consciousness

TBI severity is characterized by level of __________ after the injury and over time

• Glasgow Coma Scale (GCS)

• Rancho Los Amigos Scale (RLAS-R)

  
  

Two scales used to describe an individual’s consciousness

1. Eye response

2. Motor response

3. Verbal response

The components of the GCS

Level 1-10 based on level of responsiveness

What score does the RLAS-R give? 

• Close-head vs open-head injury

• Diffuse vs focal injury

List the different types of TBIs

diffuse, focal

_______brain injuries affect large area of brain, while ______injuries affect only one specific region

frontal, temporal

______ and_______ lobes are most susceptive to TBI

• Severity

• Site of lesion

• Characteristics of the child before the injury

Language disorders vary with…

decoding, comprehension

Reading impairments include ________ and _________ impairments

Decoding impairment

Difficulty applying alphabetic principle to identify words

Comprehension impairment

Difficulty understanding the meaning of text

True

True or false: Many reading and writing difficulties are secondary to language disorders

multistage, multidisciplinary 

Language Disorders are identified through a _______ process by a _______ team

Comprehensive Language Evaluation

A _________ is given to develop a profile of language strengths and weaknesses

• Record review

• Interview

• Systematic observation

• Questionnaire/survey

• Formal tests

Comprehensive Language Evaluations often include…

• Problems are significantly different from normal

• Problems impair child’s ability to function

• Performance is not the result of cultural or linguistic factors

How do we know when there is a disorder?

individualized, evidence-based

Treatment should be _________ and ________

targets, contexts

Planning treatment involves identifying _______, strategies, and _______