9. COMMUNICATION, LANGUAGE & SPEECH DISORDERS

COMMUNICATION, LANGUAGE & SPEECH DISORDERS

What areas can be affected in communication pathologies?

Communication, language, speech (sometimes more than one).

What is communication?

A complex human process requiring: sender, message, receiver, channel, context, & shared code.

: What is language?

A system of arbitrary signs structured by rules that allow expression of thoughts, feelings, & desires.

What are the components of a linguistic sign?

Signifier (word/form) & meaning (content).

Levels of verbal language?

Phonetic, phonological, morphosyntactic, semantic, pragmatic.

Disorders mainly affecting COMMUNICATION?

• Autism Spectrum Disorder (ASD)

• Pragmatic (Social) Communication Disorder

• Communication Disorder NOS

• Intellectual Disability

• Mutism

Disorders mainly affecting LANGUAGE?

• Language Disorder

• Hearing disability (not DSM-5)

Disorders mainly affecting SPEECH?

• Phonological disorder

• Fluency disorder (stuttering)

Where are communication disorders classified in DSM-5?

Neurodevelopmental Disorders.

DSM-5 Communication Disorders include?

• Language Disorder

• Speech Sound Disorder

• Childhood-Onset Fluency Disorder

• Social (Pragmatic) Communication Disorder

Core DSM-5 criteria for ASD?

• Persistent deficits in social communication and interaction

• Restricted and repetitive behaviors/interests

• Symptoms present in early childhood

Social communication deficits in ASD include?

• Poor verbal/nonverbal communication

• Lack of social reciprocity

• Difficulty maintaining relationships

Restricted/repetitive behaviors in ASD?

• Stereotyped movements/speech

• Rigid routines

• Restricted interests

• Sensory abnormalities

What does DSM-5 emphasize about ASD?

Dimensionality & severity levels instead of subtypes.

Riviere Autistic Spectrum Inventory measures what?

• Social interaction

• Communication & language

• Anticipation & flexibility

• Symbolization
  (Max score: 96)

What is AQ (Autism Quotient)?

A screening questionnaire for autistic traits.

What is M-CHAT used for?

Early ASD screening in toddlers.

What is CARS?

Childhood Autism Rating Scale — observational diagnostic tool.

What is ADOS?

Autism Diagnostic Observation Schedule — structured play/interaction assessment with modules based on language level.

What is ABA (Applied Behavior Analysis)?

Behavioral intervention using reinforcement (Lovaas).

What is Total Communication (Benson Schaeffer)?

Simultaneous use of speech and signs to promote functional communication.

Goals of Total Communication?

• Spoken language

• Signed speech

• Sign language

What is PECS?

Picture Exchange Communication System — teaches communication initiation using pictures.

What is Environmental Structuring?

Use of visual supports to organize space & time (pictograms, schedules).

Core difficulty in pragmatic communication disorder? PRAGMATIC (SOCIAL) COMMUNICATION DISORDER

Social use of language & communication.

Pragmatic deficits include? PRAGMATIC (SOCIAL) COMMUNICATION DISORDER

• Poor adaptation to context/listener

• Difficulty with conversation rules

• Problems with inference, humor, metaphors

DSM-5 criteria include what consequences? PRAGMATIC (SOCIAL) COMMUNICATION DISORDER

Functional impairment in social, academic, or occupational life.

What disorders must be ruled out? PRAGMATIC (SOCIAL) COMMUNICATION DISORDER

ASD, intellectual disability, language disorder, neurological conditions.

What is Unspecified Communication Disorder?

Communication symptoms causing impairment but not meeting criteria for a specific disorder.

When is UCD diagnosed?

When data is insufficient or criteria are not fully met.

DSM-5 term replacing “mental retardation”? INTELLECTUAL DISABILITY

Intellectual Developmental Disorder.

Core features of intellectual disability?

• Deficits in intellectual functioning

• Deficits in adaptive behavior

• Onset in developmental period

DSM-5 emphasis vs DSM-IV?

Adaptive functioning over IQ score alone.

Domains of adaptive functioning?

Conceptual, social, practical.

Two main assessment types of INTELLECTUAL DISABILITY

• Cognitive tests (IQ)

• Behavior/adaptive ratings

What is mutism?

Absence of speech related to psychological or neurological causes.

Types of mutism?

• Selective mutism

• Total mutism

• Akinetic mutism

Selective mutism DSM-5 category?

Anxiety Disorders.

Key feature of selective mutism?

Speaks in some contexts but not others.

Intervention principles for mutism?

• Do not force speech

• Safe environment

• Structured routines

• Gradual exposure

What is Language Disorder (DSM-5)?

Persistent difficulties in language comprehension or production across modalities.

Language disorder affects which areas?

Vocabulary, sentence structure, discourse.

Expressive vs receptive language?

• Expressive: producing language

• Receptive: understanding language

DSM-5 exclusion criteria?

Not due to hearing loss, motor disorder, ID, or ASD.

APHASIA

Acquired language disorder due to brain injury.

Broca’s aphasia characteristics?

• Non-fluent, telegraphic speech

• Good comprehension

• Frustration

Wernicke’s aphasia characteristics?

• Fluent but meaningless speech

• Poor comprehension

• Lack of awareness

What is a phonological disorder?

Difficulty using speech sounds appropriately for age

What is a fluency disorder?

Disruption of speech rhythm (stuttering).

What is dysarthria?

Motor speech disorder caused by muscle weakness.

What is childhood apraxia of speech (CAS)?

Neurological disorder affecting speech motor planning (DSM-5: verbal dyspraxia).

Dyslalia

phoneme errors

Dysarthria

motor weakness

Aphasia

language impairment

Apraxia

motor planning impairment

Speech intervention techniques?

• Articulation practice

• Imitation

• Breathing exercises

• Voice training

Communication guidelines for ID?

• Simple language

• Visual supports

• Extra time

• Focus on trust and interaction