LD&A Midterm

speech

a physical act that uses structures that support respiration and eating. Coordinated by cognitive-linguistic processes in the central nervous system(brain), spinal cord, and cranial nerves

language

a lexicon of abstract symbols (words), a grammar for combining these symbols into sentences, and the competence to use lang effectively in various social contexts and situations

communication

an interactive process that includes: a sender, a message, a medium (speech, writing, gesture, or combo), and a receiver

3 systems of language

form, content, and use

form

phonology, morphology, and syntax

phonology

speech sounds and how they are organized to create meaning (e.g. saying goggie for doggie), may have poor phonological awareness (rhyming, separating words into sounds)

morphology

word structure (root words, prefixes, suffixes) e.g. saying the doggie goed out and drink water

syntax

sentence structure (how to put words together to make sentences) e.g. saying where do doggie?

content

semantics: delayed first words, limited vocab, word finding problems

semantics

vocab knowledge, lexicon of words, knowledge of objects and events

use

pragmatics

pragmatics

the ability to use lang in context for social purposes (e.g. turn taking, asking for clarification, social contexts)

developmental language disorder definition

a language disorder not associated with a known biomedical etiology, affects the way that people understand and use language, affects learning, relationships, employment

prevalence of DLD

1 in 14 people, or about 7% of school aged children

what age are children usually diagnosed with DLD

usually diagnosed by 4-5 years, before age 4 may be referred to as a language delay

one way to characterize a language disorder

use norm referenced tests: a difference from the average level of ability achieved by a similar group of people

another way to characterize a language disorder

functional assessment: child presents with a language deficit that impairs participation in everyday life (social, academics, employment)

language disorder vs language difference

disorder: a significant discrepancy in lang skills

difference: rule-goverened lang style that differs from standard, but not indicative of a limitation to learn language

genetic factors for lang disorder

DLD is highly heritable, isolating genes specific to DLD is difficult because multiple genes are implicated in multiple disorders: no control over which genes we inherit

neurobiological factors for lang disorder

no lesions in the brains of people with DLD, appear to process lang in left hemisphere, studies of brain structure and function yield mixed results, brain scans don't diagnose DLD

environmental factors of DLD

socioeconomic status, quality and quantity of moms interaction, lack of stimulation, drug or alcohol use, exposure to toxins, prematurity, brain injury

diagnostic label importance

may be needed to secure SLP services and educational support, knowing classification can provide hints about what areas to look at in assessment

protective factors of lang disorder

parental resilience, social connects and support for families, knowledge of parenting and child development, sociability, being female*

primary prevention

avoid disorder entirely, elimination or inhibition of the onset and development of a communication disorder: reduces incidence (rate of new cases), leads to decrease in prevalence

e.g. legislation and enforcement, providing education about healthy and safe habits

secondary prevention

identify and intervene early, early detection and treatment of communication disorders may lead to the elimination of the disorders progress

e.g. screening every kindergartners speech and lang, newborn hearing screening

tertiary prevention

provide rehabilitation to reduce effects, reduction of a disability by attempting to restore effective functioning through intervention

e.g. providing speech and language therapy, providing vocational habilitation program

diagnosis definition

the assignment and labeling of the clinical condition by means of the interpretation of the assessment info, defined by national or international criteria

eligibility for services definition

whether both the clients patterns of strengths and needs AND their impact on the way they can function in age appropriate environments, determined by local standards and regulations

skill development or remediation: purpose of intervention

teach communication behaviors the client has not acquired by the typical age

teach compensatory strategies: purpose of intervention

teach tools and strategies to help the client function with the skills they have

modify the communicative context: purpose of intervention

change the entire system of communication, including the physical and interactive enviro

zone of proximal development

forms and functions that the child understands but does not produce yet might be in their ZPD

continuum of naturalness

least natural: clinician directed approach (drill, drill-play, modeling)

hybrid

most natural: child centered approach (facilitated play, self-talk, parallel talk, expansions, recasts)

2 types of infants slp's work with in the NICU

1. those with causative conditions that present at or shortly after birth (e.g. down syndrome, spina bifida)

2. children who have conditions that put them at risk for later speech and lang development (e.g. low birth weight, prematurity)

three main roles of the SLP in the NICU

1. conduct clinical and/or instrumental assessment of infant and family

2. provide support and intervention to the infant and family

3.provide education and counseling to families, other caregivers, and staff

neuro-protection in the NICU

prevent or minimize additional risk of secondary disorders

e.g. protecting babies hearing, keeping lights low, skin to skin, feeding positioning

important features of family-centered practice for birth-8 months

thinking about the needs of the high-risk infant means thinking about the needs of the family: in order to provide the infant with the best enviro for growth and development

main areas of focus of therapy targets for birth-8 month intervention

coaching parents on responsive care and scaffolding their baby's communication attempts through reciprocal dialogues (serve and return)

responsive care: observation, interpretation, and action

transition to intentionality

between 9-18 months, children move from being participants in interactions to being intentional communicators

how can you tell if the baby has transitioned to intentionality

observe play: if a child is demonstrating some recognition of common objects and their uses (putting a toy phone to ear) or can engage in simple pretend play

prelocutionary stage

0-8 months

pre-intentional, early reflective or purposeful behaviors are interpreted by the adult as communicative

illocutionary stage

9-12 months

babies have a message to send and they express intentional communication through signals like gestures

locutionary stage

12+ months

when the communicative message is formulated with actual words

3 f's for 9-18 month olds

frequency, form, and function

frequency (9-18m)

rate of communication per minute, how often is the baby communicating

form (9-18m)

intentional communication forms

e.g. nonverbal (gestures, eye gaze, facial expressions), vocalization, and verbal (single words and word combos)

function (9-18m)

communicative functions or intentions

overall goal of intervention for 9-18 months

to develop functional communication that has the potential to grow into symbolic language

FGRBI

family guided routines based intervention

4 caregiver coaching strategies for FGRBI

1. conversation and info sharing

2. direct teaching with demonstration

3. practice with feedback

4. review and reflection

gestures relating to language development

objects infants point to tend to appear in their expressive vocabularies in the forthcoming months

gesture inventories early in the second year of life predict expressive and receptive vocab at age 3 1/2

deictic gestures (7-12m)

require referent to be present in order to understand what they mean

give, push, reach, show, point

representational gestures (7-12m)

do not require presence of a referent, symbolic, learned in social contexts

nod, wave, shh, hand up for wait, shrug, clap

behavior regulation

requesting and protesting

e.g. reaching out and grunting to ask for more cheerios, pushing away the broccoli

social interaction

drawing attention to oneself to initiate or continue a social interaction, initiating or sustaining a social game, teasing, showing off; dyadic

e.g. covering moms eyes to take a turn during peek-a-boo

joint attention

most advanced, communicating to draw another person's attention to a third object or event: triadic

e.g. pointing to a dog and saying "gog", saying cupcake to label a picture of a cupcake

Part C of IDEA(individuals with disabilities act)

serves children under the age of three through IFSPs (individualized family service plans), a developmental delay in one or more areas (cognitive, physical, language and speech, and psychosocial

Part B of IDEA

serves 3-21 years, IEP instead of IFSPs

two areas of focus for IFSP

1. maximizing the development of the child

2. optimizing the family's capacity to address the child's speech needs

least restrictive environment

children with disabilities must be educated with children without disabilities, promote children's participation in natural environments

typically developing language for 18 months

communicating with gestures and vocalization combinations, expressive vocab 50-100 words, 2-5 communicative acts per minute, a vocab burst is on the way

typically developing lang for 24 months

75% are using 2 word combos, gesture+word are coming, average expressive vocab of about 300 words, understands 2-3 words from a sentence, 5-7 communicative acts per minute

typically developing lang for 36 months

90% use 3-4 word sentences, understand 2-3 step directions, unfamiliar adults can understand most speech, names many objects and actions (around 1,000 words), can take a few turns in convos

lang and communication development for 18-36 months

1. most children with communication disorders evidence their delays during this period, are identified as needing services

2. a time rapid and important growth that we don't want to miss (brain plasticity)

4 areas to assess when conducting lang evals for emergent language

1. language production

2. language comprehension

3. social communication

4. play

local homologies

time periods in development during which certain language and play milestones coincide

percentage of children that are late talkers

10-20% of 2 year olds

signs of a late bloomer

language comprehension is age-appropriate

child is communicating with gestures

frequency of communication acts in robust

child's play and cognition are age appropriate

what percentage of late talkers will have persistent problems

75% catch up with their peers by early school age

late bloomers and catching up

can catch up but score lower on language and literacy measures at school age

global developmental delay

nonverbal cognition significantly below age level, social communication skills are delayed

Autism

goes beyond expressive and receptive lang with a broader impact on social communication, social interaction is significantly impacted, repetitive behaviors are evident

parent-implemented intervention for emerging language

research based, empowers parents, promotes generalization of skills in routines that are relevant to families, makes the most of the time that the SLP isn't there

cognitive connectionism

As information is attended to and perceived, neural networks are strengthened by multiple exposures to patterns, which are learned and other competing connections are weakened and eventually disappear

biological maturation

Language is a product of brain structures and functions that are the result of genetic and environmental influences

cognitive constructivism

Evolution of thought and language both start with disequilibrium between current cognitive schemas and new evidence, followed by adaptation and elaboration

linguistic

Through the LAD or "language acquisition device", the parameters of a particular language are learned within the framework of the principles of a universal grammar

social

A responsive parent plays a large role in scaffolding a child's communication attempts so that they can develop language