Test 3: Auditory Impairments, Written Language Disorders, Linguistically-Culturally Diverse Children

What is the difference between cultural and linguistic diversity?

Culture encompasses practices (greeting, eye contact, personal space) where linguistic diversity encompasses language and dialects

What is a multilingual learner?

Someone learning more than one language. More inclusive than English-language learner.

Is a silent period normal when a child is learning a second language?

Yes; A child, learning a second language, focuses on listening and absorbing the new language before actively speaking, often lasting from a few weeks to several months

Is the transfer of native language to a second language normal?

Yes

Is it normal to lose some of the native language while learning a second language?

Yes; The native language will eventually come back

Is code-switching a disorder?

No; Normal to switch based on social context

What should SLPs working with culturally and linguistically diverse patient do?

• Cultural competency

• Look at evidence-based research

• Use translators

• Acknowledge inherent biases

• Incorporate the client’s wants and goals into the session, be supportive to their needs

What is the main goal when assessing a bilingual?

Language disorder vs language difference: Disorder will present in all languages in the individual speaks, if it’s only in the second language it is a language difference.

Is it important to determine language dominance?

Yes; Giving a norm-referenced test that isn’t in their dominant language is not a fair assessment

How do we determine language dominance?

Interview patient and family and Natural-setting observations

Can you translate an English test into another language to administer to a child whose first language is something other than English?

NO!!!; Don’t do this even if your are fluent in the second language. The test is not normed on the second language, so the data wouldn’t be correct. Also, the test was made with English in mind and might not test what it needs to when translated.

Do SLPs give direct services to people with a language difference?

No, they don’t have a disorder. However, it is in our scope of practice to work with classroom teachers and other professional to help them out

What is the difference between conductive and sensorineural hearing loss?

Conductive HL is in the outer/middle ear and treated with surgery or antibiotics. HAs work best with type because they fix the issue of loudness, the patient’s clarity is fine. Sensorineural HL is in the inner ear. HAs don’t work for this type because they can’t help with clarity issues when the auditory nerve or something is impaired.

What type of HL is otitis media?

Conductive loss, usually temporary

Do Deaf and Hard of Hearing babies babble?

Yes; Babbling diminishes over time because they don’t have the auditory feedback

What was the paradigm shift from the 90s to modern day in deafness?

Hearing parents in the 90s largely chose for their children to use sign language but now most often adopt CIs and raise the child to use spoken language

What are the factors that affect the outcomes of early intervention for Deaf/HOH children?

• Age of diagnosis

• Family involvement

• Other health factors

• Need amplification by 3 months (Choice of Communication Modality)

• Need to be enrolled in a listening comprehension program by 6 months

What is an auditory processing disorder (APD)/Central Audio Processing Disorder (CAPD)?

A disorder where the person has an issues with the perceptual processing of auditory information but there are no signs of hearing loss and hearing acuity is normal

Who diagnoses APD/CAPD?

An Audiologist

Audism

Hearing people thinking they are better than Deaf/HOH individuals

Phonemes are the building blocks of?

Both speaking and reading

Is there a connection between oral and written language?

Yes; Oral language is important for emergent literacy skills and kids with oral language disorders are at a higher risk for reading/literacy disorders

Simple View of Reading (equation)

Word recognition x Language Comprehension = Reading Comprehension

What are emergent literacy skills?

Skills that are precursors to reading and are needed to know before reading begins

• Oral language

• Book handling

• Environmental print

• Phonological awareness

What are the two routes to word recognition?

Direct: sight word recognition; Indirect: see the word and decode (c-a-t = cat)

Language Profile: Dyslexia

Strengths: Oral language comprehension; Weaknesses: Word recognition, decoding, spelling, reading fluency, reading comprehension

Language Profile: Specific Comprehension Disorder/Hyperlexia

Strengths: Decoding, fluent reader, word recognition; Weaknesses: The foundational language skills needed to read, weak oral language, reading comprehension, listening comprehension

Hearing Impairment

A deficit in hearing sensitivity that can affect both loudness and clarity

Unilateral Hearing Loss

Loss in 1 ear. Can go unnoticed until it begins to affect specialized communication. Child with unilateral HL are at risk of academic difficulties

Congenital Hearing Loss

Occurs at birth or in immediate postnatal period

Acquired Hearing Loss

Occurs after birth when the child has had some exposure to oral language

Otitis Media

Infection in middle ear often with fluid in middle ear cavity

Where is the speech banana on an audiogram?

250-6000 Hz; Most vowels are low frequency and most consonants are high frequency; Someone with a moderate HL would hear vowels better than consonants whereas someone with a severe HL can’t hear most speech sounds.

Auditory Neuroplasticity

Despite damage or disease, the auditory system can develop appropriately with early stimulation

Language Profile: Children with Auditory Impairment

Syntax/Morphology: Simple sentence structure with the omission of auxiliary or function words; Semantics: Reduced word use, no incidental learning, difficulty with abstract words; Pragmatics: Inappropriate and ambiguous responses to utterances; Speech: Frequent consonant errors, lacking rhythm, breathy, little control over pitch, inappropriate loudness

Detection Level (Levels of Auditory Skills)

Most basic level of sound awareness; The ability to detect the presence or absence of sound

Discrimination Level (Levels of Auditory Skills)

Discrimination of the suprasegmental aspects of language (pitch, prosody, rhythm, stress, inflection) and later the segmental aspects of language (phonemes, morphemes, syllables)

Identification Level (Levels of Auditory Skills)

The ability to identify (point) or label an item. Auditory memory and recall, attention, and auditory closure are essential at this stage.

Comprehension Level (Levels of Auditory Skills)

The comprehension of speech and environmental sounds in all settings. The ultimate goal of the hearing maturation process and critical for learning

Signal-to-Noise Ratio

The relationship of the signal that a child needs to hear to the level of background noise that is present. S:N of +20 dB is suitable for normally hearing children. S:N of +30 dB is needed for hearing-impaired/deaf children

What are the 2 main communication modalities?

• Spoken communication

• Sign language

Listening and Spoken Language (LSL) Philosophy

In order for children to obtain sufficient auditory experience parents must maximize auditory input, implement all available technology, provide intensive auditory and language experience

What is the effect of a good language model with sign language?

Children with HL with parents who are fluent in ASL: Rate and pattern of early ASL development parallels early spoken language development in hearing children.; Children with HL with parents who aren’t fluent in ASL: The child has significant language deficits compared to native speakers, even after 20-30 years

Total Communication

A more common manual communication approach that incorporates a variety of different forms of sign language

Developmental Continuum of Literacy

Oral Language → Early Literacy → Later Literacy

The 6 Core Skills of Reading

1. Phonological Awareness

2. Decoding

3. Sight Word Recognition

4. Vocabulary

5. Fluency

6. Comprehension

How is the amount of literacy knowledge children acquire during the Emergent Literacy Period determined?

Depends on how much exposure the child has to literacy artifacts and events as well as their interest in reading

Development of Word Recognition Skills

Logographic Stage: Associations between spoken words and one or more salient features of the printed word or its surrounding context → Alphabetic Stage: Reading words by processing sound-letter correspondences → Orthographic Stage/Automatic Sight Word Recognition: Use of letter sequences and spelling patterns to recognize words by sight without phonological decoding

Why is phonemic decoding important to reading success?

It provides a relatively reliable way to identify words that have not been seen before

What does reading comprehension require?

• Recognizing or decoding words

• Understanding difficult words

• Parsing complex sentences

• Reasoning beyond what’s explicitly stated

Mental Graphemic Representations (MGRs)

When individuals use these language blocks successfully to spell and read new words and they develop mental images of those words

The 5 Spelling Benchmarks

1. Precommunicative Spellers: 3-5 years old; Just scribbling but can be informative

2. Semiphonetic Spellers: 5-6 years old; String letters together without space. Can sometimes have the correct first/last letter

3. Phonetic Spellers: Practicing phonetically mapping out words

4. Transition Spellers: Less phonetic spelling and more conventional spelling

5. Conventional Spellers

Language Profile: Mixed Decoding/Comprehension Deficit

Strengths:N/A; Weaknesses: Language comprehension, word recognition

Mixed Reading Disability

Typical poor reader, difficulties in word recognition and listening comprehension, significant problems in language comprehension

Spoken Language/Reading/Writing Profile: Mixed Reading Disability

• Depressed oral skills

• Mild or no deficits in phonological processing

• Early language impairment

• Deficits in production of oral language narratives

• Deficits in use of morphological and syntactic forms

• Bad reading comprehension and writing

What are the extrinsic factors of reading disabilities?

Matthew Effects: Merely considering a child to be reading deficient can cause lower expectations from parents/teachers and language problems

What are the intrinsic factors of reading disabilities?

• Genetic Basis

• Attention-based deficits

• Language-based deficits

Cultural Diversity/Multiculturalism

Regional, ethic, social, racial, linguistic, and cultural variations in any society

What are some differences in communicative behavior across American Cultural Groups?

When is there likely to be a language disorder in a Culturally-Linguistically Diverse Child?

• Language skill is considered to be defective by the child’s cultural community

• Language skill operates outside the norms of acceptability

• Language skill calls attention to itself/interferes with communication

• Language skill results in difficulties in adjustment for the child

What do SLPs need to know to have cultural competence?

• That a particular dialect is a rule-governed linguistic system

• Of the phonological and grammatical features of dialect

• Knowledge of non-discriminatory testing procedures

What are some of the ASHA guidelines for Monolingual SLPs working with Clients who speak another language?