Child language disorders test

Speech vs language

Speech= verbal expression of sounds, words, and utterances (articulation, voicing, fluency)

Language= arbitrary combo of sounds and structure to communicate for expression and understanding using different forms like AAC speech ASL (form- phonology morphology syntax content- semantics use- pragmatics)

When language goes “wrong”

Late Language Emergence/ Language Delay= delay in language onset with no other diagnosed disabilities
or developmental delays, expressive and/or receptive delays and will catch up with peers later

Language Difference= Dialect, bilingualism, etc meaning no disorder

Language Disorder= categorically- diagnosed using criteria from a known condition assuming similarities in all those diagnosed. Descriptive/developmental- describing based on skills in form/content/use and compares to other kid’s development milestone. occurs in 5 language domains, impact reading/writing/listening, can occur with disorders or be causes by it (secondary) or in isolation

SLI vs DLD

SLI- children who have limited language ability but a lack of language learning problems seen, used in research, too specific and excludes some conditions like ADHD etc and promotes the idea of a gap of nonverbal IQ and language use

DLD- a subset of language disorders and consensus for children with language deficits, broader and allows for co-occurring conditions (adhd), lets symptoms of delay change over lifespan and is better to use in language disorders in isolation. Word finding phonemes morphology memory all technical language difficulties. DLD is a subset of
Language disorders

-Labels matter because of public awareness, funding needed for support programs, research and people getting help for it to have the best results and insurance gets the best coverage though potential of treatment is something insurance loses quickly (don’t do developmental if it’s something life-long, they think over time it will be get better naturally)

Labels, Laws, & Eligibility for Services

-Health care system uses international statistical classification of diseases and related health problems (ICD 10 shifting to ICD 11) which classifies disease

-Educational system uses individual with disabilities education act (IDEA) federal law defines disability and those eligible for free public special education with some IEP (individualized education plans)

SLP roles

Education
• Prevention
• Screening & Assessment
• Intervention
• Support & Counselling

-Prevention

Primary Prevention- Elimination or inhibition to lessen susceptibility
Secondary Prevention- Early detection preventing further complications,  risk factors are systemic like poverty and includes birth defects

-Identify disorders early, Reduce impact, identify at-risk populations and education (teachers, parents, general public, admin)

Assessment

multi-step process for observing

Screening- brief no formal diagnosis formal instrument or checklist

Assessment- diagnose & develop intervention goals well-constructed, reliable, & valid. medical status (education, socioeconomic, cultural, and linguistic backgrounds, info from teachers+service providers), auditory, visual, motor, and cognitive status, intervention strategies. Cultural and linguistic Competency, refer to other professionals

Intervention & Support

data and evidence-based practice (EBP), culturally appropriate, counsel collab and advocacy, family-centered intervention. child be understood + 1 word plus utterance, multi-step directions, verb tense

DLD defining

subset of Language disorders, # of people with disorder, vary across individuals.

Form- fewer grammatical
morphemes, Simplified grammatical
structures, weak phonemes

Content- delay first words, less vocabulary, poor use figurative language, Difficulty word finding

Use- bad long convo, coherent narrative, understanding abstract language

Developmental, brain based, genetic

DLD understudied

complex with multiple brain pathways with language areas as deep structures, neuroimaging tech hard with kids, brain diffs cause of language difficulties, or result of difficulties

DLD brain differents

brain asymmetries, white matter pathways
important to language less robust, Abnormalities in the basal ganglia, particularly the caudate nucleus

50-70% genetic but does not follow a Mendelian
(recessive/dominant)

info from- twin studies with shared genes and environmental influences, KE family & FOXP2 mutation in a single autosomal-dominant gene for word process, speech intelligibility mouth movement complex sentence structure

FOXP2- not a “gene for language”, help them transform into RNA with relevance to speech and language phenotypes, “Risk factor” alleles with different genes

DLD across lifespan- early childhood

CATALISE not recommend diagnosis of DLD until age 5, language delay catches up, though fear that toddlers will not receive services without a Dx label, differentiate typical variations in language development from language delay or language disorder, language milestones though normal variations

Infancy lang development

Pre-intentional- birth to 7 months, developing cognition skills with no meaning to actions with adults reaction like they do matter, vocalizes recognizes laughs

Pre-linguistic- ~7 months-first word (12-14 months) intentional communicators with gestures, responds to name babbles points reaches waves

Emerging language- gesture/intent using words/lexicon and combos, 13-24 months (objects people body parts 2 words, pronouns, possessives, when/where) 25-36 months (past tense, plural, conjunction, why/how, request and protest focus and comments). less than 10 cause for concern

18-24- requests and comment

Risk factors in infancy

Fragile X syndrome, craniofacial differences, maternal alcohol/drugs poverty abuse, In-utero infections (illness and low birth weight), frequent middle ear infections, toxin and malnutrition

Observe communication differences to look for disorder/delay, responsiveness, respond to activities and narrative activities

-hearing screenings for newborns might not get follow-up, look for otitis media

Late Language Emergence (LLE)

late talkers with no diagnosis, less than 24 months 50 words or less no word combos. 50%–70% catch up to peers, can evolve into other conditions or language/literacy issues

Preschool years – Developing Language

50 words + vocab, form sentences, articles prepositions, “why” questions

Individuals with Disabilities Education Act

broad categories of disability, primary disability, for IEPs. Speech or Language Impairment for voice, fluency, or
speech sound disorders, DLD reading, writing, mathematics and/or
language

School-aged children issues

issues in past possessives be and do, hard to use complex syntax, higher demands plus writing, MLU not accurate, negation relative clauses passive, less complex less elaborate less propositional “cat in the hat”, subject and verb components, relative clause (where when why), smaller vocabularies, word finding, convo and narratives with poor decontext (talking about things not in room) and non-explicit (rules)

Reading

language-based, Decoding words (sounding words out), Reading comprehension

Standardized tests not enough

to fill in gaps, may only have one or two items per target, validity, reliability, sensitivity/specificity

Validity- Face validity (valid first glance) Construct validity (construct measured by this, language or attention) Concurrent validity
(similar measures) Predictive validity (predict later performance)

Reliability-
Test-retest Reliability (fluctuate score short periods) Inter-rater/inter-examiner Reliability - (person administering/scoring)

Sensitivity- language impairment identification

Specificity- doesn’t get people without the impairment

Language
Language Sample Analysis

naturalistic communication contexts, , MLU, PGU, Type-token ratio, use of subordinate clauses. Fill in gaps, gloss (repeat child’s narrative back to them to encourage more narration. 50 utterances, turnabouts “That sounds scary. I wonder what happened next”

activities, play and pictures