Child Language

age range of prelinguistic stage

0 - 18 months

types of oral motor reflexes (prelinguistic stage)

suckling

sucking

rooting

phasic bite

types of vocal development (prelinguistic stage)

quasivowels

cooing / gooing

marginal babbling

canonical babbling

first words / advanced forms

risk factors in the prelinguistic stage

prematurity

prenatal exposure

congenital or genetic disorders

other disorders including hearing impairment, ID, ASD

developmental milestones: 0-3 months

cooing

vocalizing vowels

cry for assistance

startle to loud sounds

visually track sounds / attend to voices

smile reflexively

developmental milestones: 4-6 months

responds to “come here”

responds to name with gaze / turn of head

explores vocal mechanism (growling, squealing, yelling)

more adult-like vowels

marginal babbling

vocalizes pleasure and displeasure

varies pitch, volume, rate

developmental milestones: 7-9 months

looks at common objects when named

comprehends “no”

begins some gestural language

uses a wide variety of sound combos

uses intonation patterns

variegated babbling

developmental milestones: 10-12 months

understands ~10 words

begins to relate symbol and object

uses their first word

gives items to a speaker upon request

obeys some commands

understands simple directions via gesture

gestures or vocalizes to indicate wants and needs

general course of speech sound acquisition

vowels first

nasals are usually first consonants

stops before glides

fricatives and liquids

affricates and clusters latest

joint attention acquisition age

12 months

communication functions (prelinguistic stage)

attention to self

attention to others/things/events

requesting objects

requesting actions

requesting information

greeting

transferring

protesting/rejecting

informing

age range of emerging stage

18 - 36 months

developmental milestones: 12-13 months

representation gestures, play schemes

first words emerge

gesture serves a complementary function to spoken forms

developmental milestones: 18-20 months

spoken word preference, gesture plus spoken word combinations

significant increase in words (types, tokens)

increased pointing in combination with spoken words

transition to empty-handed play schemes

developmental milestones: 2-5 years

speech-gesture integration, beat gestures emerge

gesture scaffolds spoken expression and comprehension

transition from body part as object gestures to imaginary object gestures

iconic and beat gestures accompany longer utterances

beat gestures

spontaneously produced hand gestures during speech that do not carry any speech content; occur in tune with the rhythm of speech

iconic gestures

hand movements that convey meaning in relation to speech

example: holding up two fingers to represent bunny ears

morphemes acquired in the emerging stage

-ing

plural -s

In

general development occurring in the emerging stage

overextensions

emergence of two-word combinations, later, increase to 3-4

children rapidly learn new words between 1.5-2 years

limited conversational skills

• may try to start conversation

• no theory of mind

• do not seek clarification

communication functions (emerging stage)

commenting

requesting

negating

questioning

age range of developing stage

36 months - 5 years

general development occurreing in the developing stage

phono patterns mostly no longer present

accurate production of most speech sounds

some difficulties remain (clusters, multisyllabic words)

use of grammatical/inflectional morphemes

use of derivational morphemes (un-, -ly, -ance, -er, -ful, -able)

syntax moves away from SVO

vocab rapidly increases

improved conversational skills

• increased turn taking

• responding to questions

• initial understanding of interruptions

emergence of narratives

developmental language disorder (DLD)

A communication disorder that interferes with learning, understanding, and using language. These language difficulties are not explained by other conditions such as hearing loss or autism, or by extenuating circumstances such as lack of exposure to language; accurate dx around 4 years old

hallmark feature of DLD

impaired morphosyntax

general principles of assessment in the prelinguistic stage

family-centered

team-based

focus on early identification to maximize prevention and/or intervention

topics of assessment in the prelinguistic stage

oral-motor / feeding

hearing / aural rehab

behavior / development

caregiver-child interaction / communication

child’s communication (9-18 months)

assessment in the NICU

assess readiness for oral nutrition

• 35-37 weeks gestational age

• cardiovascular and respiratory stability

• oral motor control and stability

• suck swallow breathe pattern

• show signs of hunger (rooting, sucking)

newborn hearing screening

assess readiness for interaction/communication (overall state of sickness/health)

NICU intervention

if infant is ready for oral feeding:

• encourage positive feeding experiences

• strategies like pacing, positioning (more detail in dysphagia)

caregiver counseling

preserve residual hearing if applicable

creating environment to support language development

collab with NICU team for communication / oral-motor education

advocate for non-nutritive suck / positive caregiver involvement

other characteristics of DLD

some speech sound errors

difficulty with phonological awareness

impaired morphosyntax

omission of grammatical morphemes

• past tense -ed, 3rd person singular -s, copula be

children > 5 years will have persisting difficulties

• wh- questions

• omitting verb arguments

• use of few verb alternations

difficulty with judgment tasks

• understanding passive sentences, embedded clauses, etc.

difficulty learning new words, needing multiple exposures

difficulty with figurative language

pragmatic challenges

major domains and modalities of assessment

domains

• content

• form

• use

modalities

• comprehension

• production

measures used for assessment

standardized tests

interviews and questionnaires

developmental scales

criterion-referenced measures

assessment of behaviors

• functional assessment

• dynamic assessment

• curriculum based assessment

purposes of intervention

elimination of underlying cause

change/modify the disorder/behaviors

teaching use of compensatory strategies

change the environment

criterion-referenced tests

a type of assessment that measures a person's performance against a predetermined set of standards or criteria, meaning it compares a student's knowledge or skills directly to a specific learning goal rather than comparing them to other students on the test

approaches to tx

clinician-directed

client-directed

hybrid

clinician-directed tx approach

drill

drill play

modeling

client-directed tx approach

indirect language stimulation

• no external reinforcers

• no required response

• no prompts to correct incorrect response

ways to implement indirect language stimulation (client-directed approach)

narrating your play

expanding upon child’s language

commenting on their play

extensions: add semantic info

recasting child’s production into a more complex sentence

hybrid tx approach

focused stimulation

• ex: “the chicken is in the truck, the cow is in the truck, is the ___ in the truck?”

vertical structuring

• child: “giraffe”; clinician: “yes, the giraffe is eating”

milieu teaching

• environmental structuring

• responsive interactions

• everyday conversation contexts

script therapy

milieu teaching

a practice that involves manipulating or arranging stimuli in a preschool child’s natural environment to create a setting that encourages them to engage in a targeted behavior; ex: putting desired item out of reach to create a communication temptation

if no canonical babbling by __ months, child is more likely to have word and word combination delays

10

babbling should start to sound more like sentences by about __ months

12

multisyllabic babbling increases up to __ months, different consonants in the same vocalization by about __ months

18; 12

intervention in vocal development for infants

clinicians can model developmentally appropriate vocalizations by exaggerating movements / vowel sounds

demonstrate how to shape vocalizations

encourage engagement and opportunities for vocalizing

• adult babbling

• adult talking

encourage responsivity to any sounds produced

encourage vocalizations with interactions like peekaboo; elicits response from infant

we should encourage families to have hearing screenings every _ to _ months for high-risk infants

3-6

before age _ is optimal for cochlear implant

2

areas to assess for older prelinguistic stage (9-18 months)

communicative intent

receptive

expressive

communication functions

functional communication

might use the Receptive Expressive Emergent Language Scale - 3, Preschool Language Scale - 5

how can SLPs facilitate communication between parents and infants?

emphasize frequent and high quality interactions

encourage shared attention, routines, responsivity to child’s communication attempts, shared reading activities, etc.

risk factors for language delay (emerging stage)

being male

recurrent otitis media

family hx of language, reading or learning difficulties

parental risks

• low SES and/or maternal ed.

• majority directive parent/caregiver interactions

• increased parental concern

principles of dx and tx in emerging stage

family-centered

team-based

determining risk factors for continued difficulties

prevention and intervention

school readiness focus

why include play in your assessment?

can provide insight into cognition and developmental level

language skills do not necessarily depend on presence of cognitive skills

get a more complete picture of child’s abilities

help inform tx planning

by about _ months, TD children are combining gaze with gesture and vocalization

15

by about _ months, TD children are using words and gesture to name objects

16

by about _ months, words will predominate as names for objects

20

children continuing to use gestures to label beyond _ months may be evidence of a language delay

20

< 10 communicative intent “acts” per 15 minutes is concerning for a child > _ months of age

18

tx in emergent literacy

parent/caregiver/teacher involvement

book reading and storytelling

SLPs can support book selection, encouraging labeling of pictures and short descriptions

encourage “writing activities:

• e.g. having child write a thank you letter

talking about family photos

keep cultural and linguistic differences in mind

encourage parents to take any opportunities where they interact with print to give language input