Chad Exam 2: Electric Boogaloo

Intelligence

General mental ability, reasoning, planning, problem solving, abstract thinking, complex idea comprehension, learning quickly and learning from experience.

Intellectual Disability

Significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills.

Age of Intellectual Disability

0-18 years old

Non-Specific Language Impairment

Children between 1 and 2 Standard Deviations below the average. Struggle socially and academically but not eligible for services.

Standard Deviation Cutoff for ID

2 SD's below the average

Intermittent Impairment

Short-term support (medical crisis)

Limited Impairment

Regular brief support (job skills)

Extensive Impairment

Ongoing and regular support (group home living support)

Pervasive Impairment

Life- sustaining support, 24/7, completely dependent

IQ score determination

Mental Age/Chronological age, multiplied by 100

Adaptive Behavior

Collection of conceptual, social, and practical skills that have been learned and are performed by people in their everyday lives

Example of Adaptive Behaviors

Dressing oneself, cooking, cleaning, rule following, money management

Adaptive Behavior Assessments

Vineland Adaptive Behavior Scales, Adaptive Behavior Assessment System

Biological Intellectual Disability

Caused by a syndrome that the client is born with.

Example of Biological ID

Downs syndrome, Prader-Willi Syndrome, Angelman Syndrome, Fragile X Syndrome, Fetal Alcohol Spectrum Disorder

Cultural-Familial Origin Intellectual Disability

Social, behavioral, or educational risk factors predominate.

Example of Cultural-Familial ID

Genie (the feral child with no language), effects of poverty, malnutrition, home dysfunction, lack of prenatal care, abandonment, impaired child-caregiver interactions

Mixed Intellectual Disability Example

A child with Down Syndrome that lives under the poverty line

Down Syndrome Prevalence

1/700 births

Down Syndrome Damage

Extra 21st chromosome (trisomy 21)

Full Fragile X Syndrome Prevalence

1 in 4000 (Men), 1 in 6000 (Women)

FXS Damage

FXMR1 gene mutation. X chromosomal damage

FXS Permutation Prevalence

1/151 (women), 1/458 (men)

Permutation vs. Full FXS

Permutation= not expressed, a recessive gene, normal intellect, learning disabilities, emotional disturbances, endocrine problems, neurological issues.

Full= expressed gene, intellectual disability

Fetal Alcohol Spectrum Disorder (FASD) Prevalence

Leading preventable disability, 50 in 1000 births. Alcohol consumption while pregnant

Williams Syndrome Prevalence

1 in 10-15 thousand births

Williams Syndrome Damage

Missing data in 7th chromosome, damaged elastin gene

Angelman Syndrome Prevalence

1 in every 10-25k births

Angelman Syndrome Damage

Deletion of the MOTHERS 15th chromosome, nonprogressive

Prader- Willi Syndrome Prevalence

1 in every 8-25k births

Prader-Willi Syndrome Damage

Deletion of the FATHERS 15th chromosome

Prader-Willi Syndrome Symptoms

Insatiable appetite, obesity by age 2, sleep problems, high pain tolerance

Hierarchical thought

The understanding of different levels of definition for the same thing. Dog=dachsund=canine=quadriped=Rover

Delay-Difference Controversy

Combination of delays and differences explain the cognitive and linguistic processes of individuals with ID

Angelman Syndrome Language Profile

Speech is not the main form of communication, hand-flapping, stereotypical/repetitive behaviors, sensory preoccupations overlapping with ASD, 20-80% demonstrate feeding problems (sucking/swallowing disorders)

Angelman Syndrome Assessment

Differentiate between AS and ASD (autism spectrum disorder)

AAC evaluation (ASAP)

Feeding and swallowing evaluation

Angelman Syndrome Intervention

AAC systems, ASL, enhanced natural gestures

Applied Behavior Analysis Therapy

Down Syndrome Language Profile (Difficulties)

Difficulties with syntactic elements of language. Delay in working phonological memory, phonological processing, expressive vocabulary, microstructural narrative elements, and syntax. Difficulties with phonological awareness, decoding, and writing. Compromised intelligibility. Common to have fluency disorders (stuttering). Hearing is a concern

Percentage of Down Syndrome with comorbidity of ASD

6-10%

Down Syndrome Linguistic Profile (Strengths)

Sight word reading, emergent literacy skills, word recognition, pragmatic and narrative skills, receptive vocabulary, receptive language. Gesture use and imitation is excellent.

Down Syndrome Assessment

Closely monitor hearing status (otitis media)

Nonword repetition or memory-span tasks

Language and narrative samples

Writing skills

Fluency (stuttering behaviors)

Down Syndrome Intervention

Break down tasks into smaller steps

Repeated opportunities to hear words and sentences

Brief instructions

Target grammatical morphemes, acquisition and use of complex vocabulary, and production of intelligible speech

Use reading activities to develop improved spoken language and verbal short-term memory skills during preschool years

Down Syndrome Language Goals

Phonological awareness

Understanding and using letter-sound rules

Decoding skills

Fetal Alcohol Disorder Language Profile

Difficulties with syntax

Strong receptive language skills

Problems using language in sophisticated social contexts

(ex: understanding abstract language, accessing peer groups, negotiating compromises, resolving conflicts, maintaining friendships)

Difficulty with narrative language coherence nad cohesion

Difficulty with mental state verbs (think, thought, consider, believe, etc.)

Deficits in social perspective and empathy

Difficulty with phonological awareness, word reading, spelling, and math.

Delayed suck reflex, poor feeding, conductive hearing loss

What impacts FASD?

Level of alcohol consumption of the mother

Percentage of ADHD in FASD?

49-94%

FASD Assessment

Differential diagnosis of FASD and ADHD

Hearing status due to craniofacial anomalies

Feeding and swallowing evaluation due to facial anomalies

FASD Intervention

Focus on theory of mind goals (mental state verbs)

Children's Friendship Training Procedure

Complex syntax, general language competence, production of cohesive narratives

Early lit skills (phono awareness)

Infants: addressing attachment, feeding problems, and sensory integration techniques (feeding prep work)

Fragile X Syndrome Language Profile

Girls have less language delay than boys

Boys demonstrate severe delays in receptive and expressive language

Boys tend to have strengths in receptive and expressive language

Conversational discourse skills are difficult

Perseveration

Strong narrative abilities

Difficulty with pragmatics

Complex clauses (noun/verb phrases) impaired

Struggle with decoding and phonological awareness

Conversational speech intelligibility is a concern

FXS and ASD Comorbidity Rate (male)

75%

What is perseveration?

Unwillingness to change topics (common with ASD)

FXS Comorbidities

developmental phonological errors, voice problems, CAS, speech/fluency disorders, frequent otitis media, ASD

FXS Assessment

Thorough speech evaluation

AAC system consideration (depends on severity)

Differentially diagnose ASD

Language production and comprehension, vocabulary, syntax, pragmatics, and narrative production

Presence/absence of perseveration

Hearing status (otitis media)

FXS Intervention

If ASD is present, focus on social and conversational language use

Increase expressive syntax, reduce perseveration, production of more complex narrative elements

Use sight-word reading strengths to build other skills

Intensive phonological awareness intervention, complex sentences/ embedded clauses, etc.

Prader-Willi Syndrome (PWS) Linguistic Profile

Expressive language is more impaired than receptive

Difficulties in morphosyntactic, narrative, and conversation skills

Oral motor impairments may impact articulation (vowel errors and multisyllabic words)

Relative strengths in vocab and pragmatic development

PWS Assessment and Intervention

Speech Assessment

Evaluation of morphosyntactic abilities, conversational skills, and narrative abilities

Intervention for both language and articulation will most likely be required

Williams Syndrome Linguistic Profile (Strengths)

Phonological short-term memory, speech production, and concrete receptive vocabulary

Williams Syndrome Linguistic Profile (Weaknesses)

Comprehension and production of relational/conceptual vocab

Turn taking, topic maintenance, understanding conversational requirements of partner

Perseveration

Maintaining theme, cognitive inferences, conjunctive ties in narratives

Feeding disorders (hypotonia)

Strong gag

Poor sucking/swallowing

Otitis media and hyperacusis

WS Assessment and Intervention

Pragmatic Language- conversational skills

Perseveration

Eval feeding and swallow

Hearing status monitor

Pragmatic language, language and literacy

Teens- focus on a conceptual/relational language

Monitor hearing

Guidelines for ID Population

Functional, flexible, recurring, increased learning opportunities in naturalistic contexts.

Actively engage teachers, parents, and caregivers

Address learned helplessness and poor decision making

T/F ID kids will not respond well to typically developing intervention

F

Which parents 15 chromosome causes Angelman's?

Mother

Which parents 15 chromosome causes Prader-Willi?

Father

Which ID is known for poor language in social situations?

Fetal Alcohol Spectrum Disorder

Which ID is known for learned helplessness?

Down Syndrome (trisomy 21)

How do you segment C-Units?

Divide speech acts by independent clauses, and count the morphemes within.

How many C-Units are in this speech production?

Sally drove her car all over the city, the smog was horrid. She went to the store and grabbed some apple, oranges, and mangoes. The fruit was 43$, Sally was horrified and put them back.

6

/Sally drove her car all over the city,/

/the smog was horrid/

/She went to the store for some apples, oranges, and mangoes./

/The fruit was 43$/

/Sally was horrified/

/and put the fruit back/

2 multiple choice options

t/f Watch for coordinating conjunctions (so, and, then, and then) (NOT SO THEN) when separating C-Units

T

T/F: (Because, when, after, before, so that, that, who, which, although, if unless, while, as, how, until, as, like, where, since, before, how, while) are subordinating conjunctions and cannot be separated from the main clause in a C-Unit

T

Adolescent Service Delivery Models

Traditional Pull-Out model (ineffective, just like usual. LOL. you won't forget this one now.)

Collaboration- work with the teacher and classroom enviro

Consultation

Group Work

SLP as the teacher

Story Grammar Elements

Characters, setting, initiating event, response, plan, attempt, direct consequence, resolution

What is the standard deviation range for mild language impairment?

77.5-85 percentile

What is the standard deviation for moderate language impairment?

70-77.5 percentile

What is the standard deviation range for severe language impairment?

70 or below percentile

What are some PreLinguistic/ Early Language Skills?

Localization, joint attention, mutual gaze, joint action and routine, vocalizations (vegetative babble or reduplicated)

Nonverbal Pragmatic Skills

Eye contact, proxemics, gestures, facial expressions

Verbal Pragmatic skills

Turn taking, maintain topic, initiate topic/topic shifts

AAC Barriers (for the child themselves)

Policy, practice, knowledge, skill, attitude, access

How to access a speech generating device (SGD)

Direct: Touch

Switch Access: Scanning

Scan Pattern: Linear, circular, row-column (most common), block, auditory (if vision impaired)

Scan Mode- automatic, inverse, step

Head tracker

Eye gaze tracker

AAC Assessment

Capabilities: positioning, neuromuscular, sensory/perception, communication/cognitive ability, symbols, literacy skills.

AAC Participation Model

It will work for the child today and in ten years.

AAC Myths

AAC is a last resort

AAC hinders speech development

Must have good cognition to use

SGD is only good for a child with intact cognition

Chronological age is a factor

Prescribed hierarchy of symbols to be used

What is the mean and standard deviation on a bell curve?

Mean: 100

SD: 15

How many morphemes are in this sentence?

Claire was worried about her test, so she studied all day.

Claire (1) was (1) worry (1) -ed (1) about (1) her (1) test (1), so (1), she(1) study (1) -ed (1) all (1) day (1).

13

What should I make sure I know for counting morphemes and C-Units?

Subordinating and coordinating conjunctions, auxiliaries and copulas

Do Deaf and HoH clients typically use AAC?

No, they rely on sign language, SEE, cochlear implants, lipreading, writing, and gestures.

Populations commonly nonverbal

Learning disability, ASD, apraxia, spinal cord injury, tracheostomy, TBI, ID, Deaf, HoH, CP

Define Minimally Verbal

Produces simple, isolated word responses, a few phrases, but no sentence structure

Define Transpecialty

Learn and become proficient in a treatment/program outside of your specialty. (BE CAREFUL)

What are the types of play?

Primitive, functional, symbolic, parallel, full play partner

What should you evoke in structured play?

social interaction, communication initiation, joint attention, requests for an object/action, declaratives, protest

Receptive language assessment

receptive vocabulary (body, colors, objects, shapes, letters, numbers)

Pronouns

Singulars vs plurals

Prepositions (in, on, under, beside, etc.)

Basic concepts (big, little, full, empty)

Y/N comprehension

What limits verbal communication prognosis?

Primary diagnosis is associated with lack of speech and lang developing

History of regresssion

Poor stimulability

Inability to imitate verbalizations

Few canonical vocal comm acts

Age of child (0-5 yrs=less likely to develop oral speech)

What is AAC?

Study and provision of communication approaches that compensate for temporary or permanent communication impairments, activity limitations, and/or participation restrictions of individuals with severe communication disorders

What is an aided AAC?

SGDs, (speech generation devices), communication symbols, line drawings (external)

What is an unaided AAC?

Manual signs, gestures, fingerspelling (internal)

What is a High Tech AAC?

Utilizes microcomputers, tablets, and specialized software

What is Low Tech AAC

No electronic parts, PECS, letter boards, schedule boards, symbol boards

Who needs AAC?

CP, ID, ASD, CAS, TBI, Dysarthria, Locked-In syndrome, Guillain-Barre Syndrome, Severe language delays

What causes device abandonment?

Too difficult, not easy to use, not reliable, not supported, not fast enough