Foundations of Child Language

5 domains of language

-Phonology (sounds and how they’re combined)

-Pragmatics (how lang. is used in context & social comm.)

-Morphology (structure of words & how meaningful units are combined)

-Semantics (meaning of words/phrases)

-Syntax (rules of sentence structure and how words are arranged)

Timeline of Lang. Development

Prelinguistic Stage: birth - 18 mos.

Emerging Stage: 18 mos. - 3 years

Developing Stage: 3 years - 5 years

Prelinguistic stage: Oral Motor Reflexes

Oral Motor Reflexes

• Suckling: Early form of sucking. Extending/retracting tongue. Up/down jaw movements. Loose lip closure

• Sucking: More refined movements. Increased intra oral negative pressure. Elevation of tongue tip. Jaw movement is more coordinated

• Rooting: When infant turns head toward the direction of touch to the lower lip/cheek

• Phasic Bite: Small jaw openings & closings when nipple is placed in infant’s mouth

Prelinguistic Stage: Vocal Development

• Quasivowels

• Cooing/Gooing

• Marginal Babbling (e.g. “baaa”, “maaaa”)

• Canonical Babbling: Rapid formant transition between consonant & vowel to form syllable. More speech-like production. (e.g. “ma ma”)

• First Words/advanced forms

Prelinguistic Stage: Gestures

*Develop before words

• Referential: Consistent meaning for a specific referent

• Deictic: Act of referring to an item/person near the child (e.g. pointing or showing)

By 1 year children are generally producing first word

• Usually approximations

• Understanding of some words & short phrases

True word

Clear purpose, used across contexts, production is recognizable/similar to real word.

Child’s first words are approx. 50% nouns (names of family members, familiar objects, foods, body parts, routines)

Joint attention (9-12 mos.)

• Noticeable change in how they interact with others relative to other things (e.g. raising their arms to help when a caregiver is dressing them)

• Communicative Pointing (12 mos.) Child simultaneously points and looks at partner

Communication functions

• Attention to self

• Attention to others/things

• Requesting objects

• Requesting actions

• Requesting info

• Greeting

• Transferring

• Protesting/rejecting

• Informing

Emerging Language (18 mos.-3yrs)

Speech Intelligibility

• 50% intell. = 31-47 months (2;7-3;11)

• 75% intell. = 49-87 months (4;1-7;3)

• 90% intell. = 83-120+ months (6;11-10+)

(Hustad et al., 2021)

Use of morphemes

• -ing

• Plural s

• In

First words are those that are marked with morphemes

Overextensions: Regular past tense used on irregular verbs

Emerging Stage: Language

Emergence of 2-word combinations. More words added to increase to 3-4 word combos.

Word order becomes increasingly consistent

Language is used for commenting, requesting, negating, & questioning

Children rapidly learn new words between 1.5-2 years

• Limited conversation skills

• May try to start a conversation

• No theory of mind

• Do not seek clarification

Developing Stage: Speech sounds

• Phonological patterns are no longer evident

• Children are accurately producing most speech sounds

• Some sounds may continue to be challenging (clusters and multisyllabic words)

Developing Stage: Language

• Use of grammatical/inflectional morphemes

• Use of derivational morphemes

Developing Stage: Syntax

Syntax moves away from SVO sentences to more complex forms:

• Subject-verb-object-adverb

• Subject-verb-complement-adverb

• Subject-auxiliary-verb-adverb

Compound and complex sentences begin to take shape (multiple clauses)

Vocab is rapidly increasing

Shift from overgeneralizing

Learning all types of new words

• Opposites

• Temporal

• Interrogatives

• Prepositions

Improved convo skills (increased turn taking, responding to questions)

Emergence of narratives

Language Disorder

Impairment in the comprehension and/or use of spoken, written, and/or other symbol system that affects:

• The form of language (phonology, morphology, syntax)

• The content of language (semantics)

• The function of language in communication (pragmatics)

in any combination.

Naturalist vs. Normative

Naturalist: Diverging from a group; below average skill level

Normative: How the impairment affects everyday life; considers society and values

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 other circumstances such as lack of exposure to language.

DLD: Language Form

*Some speech sound errors and difficulty with phonological awareness

Impaired morphosyntax = hallmark feature of DLD

• Omission of grammatical morphemes (past tense -ed, 3rd person singular, -s, copula be)

• Children older than 5 yrs will have persisting difficulties:

  • Wh- questions

  • Omitting verb arguments

  • Use of few verb alternations

DLD: Language Content

• Difficulty learning new words

• Need multiple exposures to learn new words- hear & see them many times

• Make naming errors for words they do not know

• Difficulty with figurative language

• Difficulty with learning verbs

• Challenges learning words with multiple meanings

DLD: Language Use

Challenges with social understanding

Difficulties with “rules” of language

• Initiating convo

• Maintaining topic of conversation

• Asking for and/or providing clarification

• Turn-taking

• Moderating conversation style

Theory of Mind

Figurative Language

Producing coherent narratives

Etiology of DLD

• Difficult to find a single gene connected to DLD

• Genetic info isn’t necessarily helpful for TX planning

• Neurobiological differences: atypical symmetry in language cortex, white matter volume, cortical organization

• No lesion area

Early Intervention

Provides services to eligible children ages birth-3 years old.

Locations

• In the home

• At the daycare

• Caregiver coaching

Areas to target

Receptive: Following simple commands, understanding words, answering simple questions, manipulating toys during pretend play, understanding location words

Expressive: Improve functional communication (gestures. words, signs), turn-taking in convo, using verbs/action words, expanding utterances. May utilize comm. boards/AAC

Which perspective informs assessment?

Naturalist: Medical model with appraisal & diagnosis

Normative: How the impairment affects/impacts everyday life

Reasons for Assessment

• Screening

• Collection of Baseline Data

• Selecting Goals

• Determining Progress

Approaches to Treatment

Clinician Directed

• Drill

• Drill Play

• Structured Modeling

Hybrid

• Focused Stimulation

• Vertical Structuring

• Milieu Teaching (environmental structuring, responsive interactions, everyday convo contexts)

• Script Therapy

Client-Directed

• Indirect Language Stimulation

Drill

• Fade prompting

• Reinforcement (increase expectations)

• Motivating event after reinforcement

Drill Play

Motivating event before target behavior AND after target behavior

Modeling

• Highly structured

• Extrinsic reinforcement

• Child listens in formal context

Indirect Language Stimulation

• No external reinforcers

• No required response

• No prompts to correct incorrect response (natural consequences)

Cueing

• High Support (e.g. direct model, hand-over-hand)

• Moderate Support (choices, hints, sentence completion)

• Low Support (visual cue for structural support, reminder to use a strategy)

Individualized Family Service Plan

Legal document that is written when a child is eligible for early intervention services. Family/caregiver involvement is critical

Principles of Assessment

• Family-centered

• Team-based

• Focus on early identification to maximize prevention and/or intervention

Assessment in the NICU

• Feeding (35-37 weeks gestational age)

  • Is infant ready for oral feeding

  • Any tube feeding?

• Hearing

  • Universal newborn hearing screening

  • NICU is noisy, can lead to NIHL

  • Ototoxic drugs

• Development

  • Determine when/where baby functions optimally

  • Determine stressors

  • What is their tolerance for stimulation/handling/interaction

  • Identify disruptions of homeostasis

• Communication

  • Turning In: Severely ill, crisis mode

  • Coming Out: Able to breathe, not in crisis, interactionc can begin

  • Reciprocity: Close to discharge, consistent interactions

• Vocal development

  • Communication sample. 50-70 vocalizations

  • Rate of babbling (# of vocalizations/ # of minutes)

  • Consonant/vowel ratio

  • Multisyllabic babbling

  • Intonation contours (around 12 mos.)

Signs of Distress

• Turning away

• Looking away

• Grunting

• Back arching

• Spreading fingers

Zone of Proximal Development

The distance between what a child can do with help and without help.

Risk Factors of Language Delay

• Male

• Otitis Media

• Family history of language/reading/learning difficulty

• Parental risks

  • Low SES

  • Majority directive parent-caregiver interactions

Emerging Language: Principles of Assessment & Intervention

• Developmental Level 1;6-3;0

• Family centered

• Team-based approach

• Determining Risk Factors for continued difficulties

• Prevention and Intervention

• School readiness focus

Emerging Language: Areas to Assess/Intervene

• Play/gesture (provides insight into cognition & developmental level)

• Communicative intent

  • Function

  • Frequency

  • Form

• Receptive Language

• Expressive Language

• Caregiver-Child communication

• Oral/motor/feeding

• Hearing

• Behavior/development

Norms for frequency of Communicative intent

• 18 mos.= 2 intentional acts/min

• 24 mos. = >5 acts

• <10 acts /15 min. is concerning for child >18 mos.

Communicative Intent: Form

• 8-12 mos.= Gestures

• 12-18 mos.= Vocalizations

• 18-24 mos.= Word Combos

Communicative Intent: Intervention

• Communication Temptation (Hybrid Approach)

  • Opportunities and models (model for the child with the caregiver)

  • *Environment is deliberately manipulated to encourage a child to initiate communication by making requests or expressing needs

• Prelinguistic Milieu Teaching

  • *Creating a natural environment that encourages a child to initiate communication using non-verbal cues like gestures, vocalizations, and eye gaze by following the child’s lead, setting up routines, & providing consistent responses to their attempts to communicate)

• Scripts and Routines

  • pre-planned sequences of words/phrases used to practice specific communication skills

  • e.g. “Ready….Set…Go!” usually child starts to say “Go!”

Communicative Intent: Intervention (continued)

• Functions

  • Start with proto-imperatives (act used as a request for objects/actions that may take the form of vocalization or gesture) and proto-declaratives (joint attention, looking between object & person, pointing at object)

  • Highly-motivating activities are great opportunities for modeling.

• Forms

  • Focused stimulation may help increase the variety & maturity of forms

  • Model full requests plus non-verbal/gestural support to help with transition

  • Shape child’s production towards words/phrases

Assessment: Receptive & Expressive Language

Formal Measures

• PLS-5

Informal Measures

• Observation

• Caregiver interview (validate with an observation)

• Selecting from object array

• Commands (increase level of difficulty, single word to combos to phrases) *Receptive

• Language Sample *Expressive

  • Vocabulary (number, type /e.g. noun/verb/, semantic category)

  • Once children reach approx. 50 words

  • Syntax

    • frequency of multi-word utterances

    • # of multi-word/total utterances (expect approx 50% at 2;0)

    • Compare to parent diary

  • Semantic relationships (combining words)

Intervention: Language

• Language stimulation

  • Child directed

    • Modeling

    • Expanding/Extending

    • Recasting

    • Labeling

    • Defining

    • Repeating/imitating

    • Self/parallel talk

    • Connecting

• Direct targeting of expressive language (e.g. Milieu Teaching, Scripts)

Selecting targets

• Functional

• Allow for different communicative functions

• Related to child’s interest

• Consider phonological load

• Opportunity for regular exposure and use

Who is in the developing stage?

Kids…

• With more than 50 words

• Who are producing word combinations and are on their ways to sentences BUT are not producing all sentence types

• Who are in Brown’s stages II-V (MLU is 2-5)

* Generally 3-5 yrs. old

Developing Language: Assessment Principles

• Domains

  • Child Language (rec. & exp., vocab, morphology, syntax, pragmatics)

  • Caregiver-Child communication

  • Other (e.g. hearing, cognition, behavior, speech, motor, artic/phono)

Developing Language: Assessing vocabulary

• Obtain full picture of child’s skills (rec. & exp.)

  • Assess comprehension first, but intervene with comprehension and production

  • *Except for children with limited sound inventories (word retrieval issues)

• Assess breadth and depth of understanding and use. NOT JUST NOUNS

• How children learn words, not just which ones they know.

• Specific info about understanding and/or production of categories of words. Elicit multiple productions/opportunities in a play-based activity.

  • Foods

  • Shapes

  • Colors

  • People

  • Question words

  • Verbs

  • Prepositions

Developing Language: Assessing Morphology and Syntax

• Context supports understanding and production (carefully assess each)

• Standardized tests/decontextualized tasks = information about linguistic knowledge

  • Info from standardized test probes deeper into certain structures

    • Decontextualized (receptive): e.g. Simon says

    • Contextualized (receptive): e.g. Answering questions in school, following directions, contingency of responses in convo

    • Decontextualized (expressive): e.g. Picture description

    • Contextualized (expressive): e.g. Language sample. 50-100 utterances. MLU, NDW, morpheme use, sentence forms

• Comparing contextualized and decontextualized performance

  • Contextualized is better: Children are using other skills to compensate, may benefit from client-centered approach

  • Same in either: might need additional support, more explicit instructions

Mean Length of Utterance (MLU)

total # of morphemes/total # of utterances (usually 100)

A way to measure linguistic productivity. MLU should increase with age.

Number of Different Words (NDW)

# of different words/total number of words (usually 100)

Developing Language: Assessing Pragmatics

Purpose

• Observe where skills are relative to other domains

• Useful info for selecting TX targets

• Identify pragmatic contexts for language therapy (might be primary for ASD, nonverbal learning disabilities)

Skills to be Assessed

• Self-directed vs. other-directed utterances

• Topic initiations

• Topic maintenance

• Topic contingency

• Topic appropriateness

• Discourse skills

• Story comprehension

Products of intervention

Domains: Child language, caregiver-child communication, other

Areas: Receptive & Expressive Language —>Vocabulary, morphology, syntax, pragmatics

Scaffolding

High Support

• Modeling

• Elicitation

• Co-participation

• Reducing the # of choices

Low Support

• Prediction

• Explanation

• Relating

• Encouragement

Semantics Intervention (for children with DLD)

Kids with DLD—>

• Repeated experience with targets

• Common and uncommon words

• All parts of speech

• Semantic features

• Semantic relationships

• Language stimulation from adults and feedback

Morphosyntax is the main focus but not the only focus

• Bound morphemes

• Tense and agreement markers

• Closed class morphemes

• Articles

• Pronouns

• Auxiliary verbs

• Sentence elaboration/complex sentences

Syntax and Morphology Intervention

Determining goals & prioritizing targets

• Communicative power and understanding are critically important

• Measure generalization in real-life contexts

• Consider the other language domains when providing TX for syntax and morphology

• Practice skills in multiple activities and settings

• Stimulability

• REPEATED EXPOSURE

• Target expression & comprehension together

Pragmatics Intervention

• Communicating in daily life

• Reliance on semantic and syntactic development

  • Social and everyday situations

  • Practice pragmatic skills in real time

  • Turn-taking

  • Topic maintenance

  • Breakdown repair

Preliteracy Intervention

• Phonological awareness

• Print concepts

• Early narrative skills

Reciprocal relationship amongst language and literacy development

Preliteracy Skills

• Vocab knowledge

• Understanding narratives

• Phonemic/phonological awareness

• Awareness of print —> book organization, print meaning

  • Letters

  • Words

Dynamic assessment

• A less-biased approach to assessing a child’s skills

• Focuses on process; language learning; ZPD

  • Use of test-teach-retest model

  • Mediated Learning Experience (MLE)

• Difference or disorder?

• Supports that child needs to be successful