1. Speech- Neuromuscular act of producing sounds, used in language; involves producing sounds used in language. Involves coordination of respiration, phonation, resonance, and articulation. (R.P.R.A)

2. Language- Rule goverened symbol system for communicating through a shared code of arbitrary symbols

o Verbal/ Non verbal communication

o Allows for communication of ideas, thoughts and meaning

o Is creative and generalizes ideas

3. Communication is the active process of exchanging information and conveying ideas, needs, and desires

Four elements include:

1. Sender of the message

2. Receiver of the message

3. Shared intent to communication ( both want to talk)

4. Shared means of communication ( their way of doing it, speech or Language)

Language Disorder

As stated by IDEA (the law). ASHA describes it as a disruption of form, content and use

- Deviation may occur in one or more aspects of language ( i.e., syntax, semantics, pragmatics)

- May be receptive ( comprehension) or expressive ( production)

- Disorder may be in spoken on written language

- May range from mild to severe/profound

o Mild disorder: may involve articulation or use of word ending however the child it easily understood

o Severe disorder: This may involve extreme difficulty understanding what the speaker or others are saying. ( receptive and expressive)

- Related problems may occur with language disorder such as Autism or behavioral disorder

Signs of language disorder (A.S.C.B)

- Academic Performance: reduced academic peroformace including reluctance to participate in class, difficulty with organization, speech sound production, difficulty following directions and word finding

- Social interaction: reluctance to interact with peers, rejection by others, difficulty carrying a conversation or problems with rules and games

- Cognitive functioning: difficulty with organizational skills, response time, and being attentive

- Behavior: Demonstrates a high level of frustration, gets into arguments, fights with peers or withdraws from interactions.

Elements of language (Form, content, Use)

1. Form (Quantity)

- Phonology: Study of sound systems of language, including rules (Ex: Minimal pairs=Cat/bat)

- Morphology: study of words and the group of rules as to how they are formed ( there are 43 in total)

- Syntax: study of how words are joined to make sentences ( grammar)

2. Content (Quality)

· Semantics: Study of the meaning of words and sentences, semantic rules govern which words can be joined meaningfully

o We must understand the meaning of words to make meaningful sentences

3. Use (Manner)

· Pragmatics: study of rules that govern use of language for social interaction; rules govern reasons for communicating

Physiological Bases of Language Development

Four processes of speech production ( R.P.R.A)

1. Respiration: Muscles that control lungs and diaphragm

2. Phonation: Vocal folds and the larynx; the process of vibration

3. Resonation: Air resonates oral + nasal

4. Articulation: Air stream is manipulated by articulation

Cognitive Bases of Language Development

Theories:

- Psycholinguistic- Pinker- “language and cognition develop independently”- Language is an instinct

- Psychologist- Piaget- “Language is dependent on Cognition”—Cognition>Language; one of the functions of growth

- Psychologist- Vygotsky— “Language and Cognition are interdependent” – Language>Cognition

Social Bases of Language Development

· Social interaction is essential for language development

· Quantity and quality of interactions from a young age can help shape language development ( Ex: taking a child to the park or reading them bedtime stories)

· Socialization is the their piece in the puzzle of language development

· Physiological Development = “how” we communicate ( what we are able to do; Breathe control)

· Cognitive development = “what” we communicate (Semantics)

· Social Development = “why” we communicate (Pragmatics)

Language Acquisition and Play therapy

If a child has difficulty with social communication skills they might demonstrate:

- Difficulty getting adult attention

- Standing too close to the speaker

- Disorganized in storytelling

- Poor listening skills

- Dominant in conversation

- Difficulty in asking for clarification

- Difficulty in understanding tone of voice

- Difficulty understanding a different Point of view

Language Models

· Behavioral Model

o Developed by B.F Skinner

o Child is a passive recipient of external influences

o Child starts out with no language and gradually models sounds, get reinforcement and produces sounds again (operant Conditioning)

o Chaning occurs as verbal behaviors are strunf together to make and utterance

· Cons: Doesn’t account for grammatical structure

o Imitation doesn’t mean it is the first words commonly heard

o Children can learn things outside of imitation

· Nativist Model

o Developed by Noam Chomsky

o Based on the universality of language

o Language is innate to human species

o Born with Language Acquisition Device (LAD)

· Cons:

o Less importance on Parents

o Parents speak differently depending on the child’s age

o Different modes of speech between settings (you speak differently to your mom than to your professor)

· Semantic- Cognitive Model

o Developed by Lois Bloom

o Language is used to talk about things they already know

o Semantics precedes syntax in language acquisition (form over function)

· Cons:

o Some kids w/normal IQ don’t acquire verbal language

o Theory is based on normal development, no room for atypical development

o Kids learn at different rates

· Social Interactionist Model

o Developed by Vygotsky

o People talk in order to communicate

o Developed by the study of pragmatics

o Emphasis on environmental factors

· Cons:

o Does not account for specific syntax structures despite grammar age development still being within social environment

o Chidren with special needs might need more assistance

· Information Processing Model

o Language structures emerge from communication functions that drive the acquisition

o There is a match between form and function that develop over time

o Competition model: the words that are heard the most win the language competition (bates & macWhinney)

· Cons:

o can be seen as too linear and mechanistic when applied to the intricacies of human thinking

· Emergentist model

o Language emerges from the interactions of social patterns and biology of the cognitive system

o Language is not innate in humans

o Language is learned from cognitive development, changes in the neural network and experience

o suggests that language ability is the result of a child's environment and their learning abilities.

· Cons

o Child’s understanding of the word changes affects cognition

Language Development from birth to preschool

· Phase I (0-8 weeks):

o Language: Reflexive crying, Vegetative sounds, Sound discrimination

o Cognition: Biological and physical needs

o Behavior: Eye contact, body movement

· Phase II (8-20 weeks):

o Language: Cooing and laughing, Vowel-like sounds, Cry more controlled (more differentiation)

o Cognition: Differentiated crying (hunger, distress

o Behavior: Games Routines

· Phase III (16- 30 weeks)

o Language: Increased control over speech, Prolonged vocalizations, Babble (vocal play, CV)

o Cognition: Beginning of semantic functions

o Behavior: Intent to communicate

· Phase IV (25-50 weeks)

o Language: Repeated syllable clusters, Jargon speech, Some words

o Cognition: Expansion of semantic functions

o Behavior: Illocutionary stage (Joint attention; use of intentional communication; interest in objects)

· Phase V (9-18 months)

o Language: Protowords Transition to language (words and gestures to get what they want)

o Cognition: Overextensions Underextensions

o Behavior: Locutionary stage

Brown’s Stages of language Development

Purpose: serve as a framework to understand and predict the typical progression of a child's grammatical development, particularly in terms of morphology and syntax, by outlining different stages based on their "Mean Length of Utterance" (MLU), which indicates the complexity of their sentences.

Pragmatic Language

· Increase length of exchanges

· Number of utterances per change increases

· Turn taking develops

· Asking for clarification

· Staying on topic develops

· Politeness rules develop

Emergent Literacy vs. Reading Readiness

· Emergent Literacy: Reading and writing develop concurrently with language from an early age (moving together)

· Reading readiness: reading and writing develop after language is acquired (one needs to happen before the other)

Literacy Factors

· Alphabet knowledge: knowledge of the names and sounds associated with printed letters

· Phonological awareness: the ability to detect, manipulate, or analyze the auditory aspects of spoken language

· Rapid automatic naming of objects or digits: the ability to rapidly name a sequence of random letters or digits

· Rapid automatic naming of objects or colors: the ability to rapidly name a sequence of repeating random sets of pictures of objects or colors

· Writing or writing name: the ability to write letters in isolation on request or to one’s own name

· Phonological awareness: the ability to remember spoken information for a short period of time (Information retention)

· Concepts about print writing

· Understanding a book ( what is the title, author, illustrator, plot, etc)

· Reading comprehension

· Print knowledge: decode letters

· Reading readiness: alphabet knowledge, print vocabulary, memory, phonological awareness

· Oral language: understanding spoken language, vocabulary and grammar

· Visual processing: understanding visual symbols, matching and discriminating

Language and literacy in the school years

· Morphology & syntax continue to develop

· Semantics (10,000 words in first grade/ 40,000 by 5^th grade)

· Enhanced communication skills

· Understanding language

· Pragmatics

· Metalinguistic ability (the ability to think about language and apply it for varied purposes)

· Conversation competence

· Narrative abilities

· Adjusting the language to speak and the content

Figurative language (In School years)

· Metaphors (Ex: He is a wet blanket)

· Idioms (ex: Spill the beans)

· Jokes (ex: why don’t scientists trust atoms? Because they make up everything)

· Proverbs (ex: when in Rome, do as the Romans do)

· Sayings (ex: Break a leg)

· Poetry (ex: Haikus)

· Story writing (ex: Once upon a time…)

· Personification (inanimate/ animate) (ex: a raging storm)

Phonemic Awareness

· Ability to manipulate phonemes in words

· Needed for reading

· Poor phonological skills lead to:

o difficulty in identifying sounds

o difficulty associating sounds of words and printed letters

o poor word recognition

o poor comprehension

· Reading success requires phonological awareness, syntax, sematics, vocabulary, linguistic awareness, and pragmatic use (FORM, CONTENT, USE)

Types of literacy

· Basic literacy: say and define the words on the page ( say and define)

· Critical literacy: interpret, analyze, synthesize, and explain texts (Synthesize)

· Dynamic Literacy: act on the content gained from texts, interrelating, the content from problem raising ( asking questions and problem-solving)

Benefits of play

· Abstract thinking

· Problem solving

· Life skills

· Leadership skills

· Communication development

· Social skills development

· Understading safety

· Understanding taking other’s perspective

· Self confidence

· Symbolic thinking

· Make- believe

· Play complexities

Types of play

· Functional play

o Begins before 2 years

o Motor play; Sensorimotor play

o Interact with objects and people

· Symbolic play

o 3 years

o Construction play

o Building houses

· Game Play

o Turn-taking games, Sports

o Dramatic play: 3-5 years, acting out roles, pretend mom/ dad

Social stages of play

· Onlooker play: watching but reluctant to join

· Solitary play: playing with themselves

· Parallel Play: alongside others with their own toys (2-3 years)

· Associative play: group play, using the same materials, sometimes working together, starting to share

· Cooperative play: reached at the end of kindergarten

Function of play

· Play considered to be a social experiment

· Self-initiated play stimulates learning (interacts and processes reality by manipulating objects and the environment)

· Use of symbols in play has important implications for cognitive and linguistic development (Symbolic representation)

Levels of play

· Random & Exploratory (< 1 yr. old)

o Child shakes, mouths, bangs – explores with all senses ( Listening, eye contact)

o Child has the opportunity to explore

o Five senses are incorporated in play

· Early Functional (12-18 mos.)

o Child begins to use object functionally ( Brush is for brushing hair)

o When a child is playing appropriately with a toy or object, give attention to it and praise the behavior

o Choose one or two objects at a time to tach a child

· Later Functional (18-24 mos.)

o Beginning of “structured play”

o Introduce more toys, puzzles, stacking/nesting/ sorting, because it is more complex

o Introduce crayons and simple crafts because it maintains interest

· Creative-Symbolic (2-3 yrs. old)

o Child begins to use “symbols” during play (symbolic representation)

o Introduce pretend play

o Introduce varous toys/ items for the child to iteract with

· Imaginative (3-5 yrs.)

o Play involves creativity and imagination

o Enhance imagination by helping to remember things and asking them questions (do you remember….what did you like?)

o Reading to child

o Dress up: performing roles, acting, narrative abilities

Carol Westby hypothesized that symbolic play skills provide a basis for assisting cognitive development.

o Symbolic Play Scale Checklist assesses ten stages of play/language development

o Relationship exists between language, cognition, and play

Normal Play Performance

· Play with objects

· Plays with peers

· Imitative/repetitive

· Differential responses to objects and peers ( play with toy one way)

· Functionally appropriate ( bouncing the ball, not throwing it)

· Knowledge of objects within contexts ( pencil is for writing at school)

· Exhibits communicative structures in play interactions ( expanding utterances)

· Play as a social exchange process (socially reciprocal)

Ways to help develop play

1. Provide Objects and toys to child’s level ( don’t give a 2-year-old a puzzle)

2. Play alongside with the child of possible: MODEL.

3. Call attention to item use ( building blocks not throwing it; Show them the right way of use)

4. Pick only a few toys to work with. Don’t overwhelm the client

Impaired Play performances

· Lack of interest in peer/social interaction

· Fixation with one type of manipulation

o Only playing with blocks; Only one way to play)

· Limited development of communicative behaviors

o Not requesting or asking for clarification

· Lack of differential responses to peers and objects

o Not acknowledging the person or the objecting

· Play performance not functionally appropriate

o Socially and with object functionality

WEEK 3: Language and Learning impairment

Learning Disabled: Disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language

Speech or Language Impairment: A communication disorder such as stuttering, impaired articulation, a language impairment, or a voice impairment. This can negatively affect a child’s educational performance.

Specific Language Impairment: A language deficit, but without accompanying factors such as hearing loss, low intelligence scores, or neurological damage.

Learning Disability (meant to be broad based)

· Used to describe a child who is not learning at the expected rate (despite adequate instruction)

· Used for a heterogeneous group of children with diverse characteristics; does not specify specific dysfunction

· Used through “process of elimination”; does not denote specific etiology

· does not include learning problem due to visual, hearing, motor, emotional, or cultural disadvantage

· Language and reading are two common problems of LD

Early warning signs of LLD:

· Phonological awareness

· Morphology (word finding)

· Syntax (putting words to make sentences)

· Semantics

· Pragmatics

· Articulation difficulties may also exist

Common Learning Disabilities

DYSLEXIA

· Language-based disability

· Trouble understanding words, sentences, paragraphs

· Processing words is reduced, affecting comprehension

· Delayed spoken language

· Word finding

· Fluent expression difficulties

· Poor spelling

· Handwriting

· Decoding

· Incomplete interpretation

· Confusion with concepts

· Daydreaming

· Dysfluency in reading

· Reduced rapid naming

DYSCALCULIA

· Math difficulties; solving math concepts

DYSGRAPHIA

· Writing difficulties

· Hard to form letters within a defined space (writing outside of the lines)

AUDITORY PROCESSING

· Difficulties understanding language despite having normal hearing or vision

Early Signs for LD in Preschool Years

· Late talking

· Articulation deficits

· Word finding difficulty

· Slow vocabulary growth

· Difficulty rhyming

· Difficulty with numbers, days of week

· Restless and easily distracted (co-occur with ADHD)

· Difficulty following directions

Warning Signs in Grades K-4

· Slow to learn the connection between letters and sounds

· Confuses basic words (run, eat, want)

· Consistent reading and spelling errors/reversals (b/d), inversions (m/w), transpositions (felt/left) substitutions (house/home)

· confuses arithmetic signs (+ =)

· Slow recall of facts

· Slow to learn new skills

· Relies on memorization

· Impulsive

· Lack of planning

· Unstable pencil grasp

· Trouble learning time (time management)

· Poor coordination

Adhd/hyperactivity/impulsivity symptoms

ADHD

· Fails to give close attention to details

· Doesn’t seem to listen when spoken to

· Often forgets daily activities

· Easily distracted

· Organizational difficulties

HYPERACTIVE-IMPULSIVITY

· Fidgety

· Often leaves the classroom or the chair

· Excessive talking

· Difficulty awaiting turns

· Interruptions

·

Assessment

Interview students, parents, teachers to identify aspects of the curriculum that present the most significant challenges to the student.

Four Questions to guide process:

1. What communication skills are needed for successful participation in this part of the curriculum? (to Participate)

2. What does the student do when attempting the curricular task? (to complete task)

3. What communication skills and strategies might the student acquire to become more successful? (to assess)

4. How should the task be modified to meet student needs? ( to modify)

A Comprehensive Evaluation should be completed by a multidisciplinary team that includes:

· Person knowledgeable in the area of the suspected disability

· Classroom teacher

· At least one additional specialist qualified to administer diagnostic assessments (e.g., psychologist, SLP, reading specialist)

Treatment

Individualized Education Plan is prepared by the evaluation team:

Treatment requirements include:

1. Heighten awareness of task demands

2. Provide strategies to facilitate success

3. Model use of strategies

4. Provide guided practice and feedback

5. Provide instruction for generalization of strategies ( out of the therapy room)

Intervention Principles for Children with Learning Disabilities

Basic factors to include:

1.Content match: Info and task similar to chils’s way of learning; ZPD (zone of proxmimal development)

2. Sequence: instructions should be sequenced

3. Pace: instructions should be practiced, repeated and learned

4. Structure: Teach across disciplines while addressing curriculum and content demands.

5. Motivation: information should take interest into account as well as learning style with reinforcement

Intervention Strategies

1. Find alternate ways for learning

2. Due to impulsivity, prompt for student to take their time (provide a visual schedule)

3. Provide steps for problem solving, which may offer methods such as visualization or verbalizing each step

4. Word Finding ( teach functions of words to help find the word)

5. Vocabulary ( link words with definition)

6. Narratives (retelling, creating stories)

Executive Functioning (preparation, planning, performance

· Executive functioning plays a key role in academic and social success. In order to perform well in school ,the student should be organized, able to follow directions and respond appropriately to tasks.

· Sometimes this skill needs to be taught and should be part of the intervention process.

· The SLP can help with teaching this skill in therapy by promoting better listening skills, encouraging following directions, helping students understand the rules of a game, turn taking skills, etc.

· Academic preparedness, to do lists, equipment checklists, agendas, etc. can lead to improved preparedness, planning and performance.

· Mindfulness activities done in therapy either as a break in the session or at the onset of the session can lead to better focus and therefore better performance.

Therapy Ideas

· Create one activity for a child that demonstrates:

· Difficulty attending to material presented

· Limited vocabulary to describe objects

· Reduced MLU

· Joint attention: visuals sensory items, proximity, organization of space

· Play therapy, books, hands on material, manipulation, of objects and items

· Start with 2 words and gradually increase to phrase and then to sentences

Behavioral Characteristics of Autism

· Fascination with mechanical objects

· Unusual motor behaviors (e.g., toe walking)

· Gaze aversion- lack of eye contact

· Ritualistic behaviors/insistence on routine- little room for flexibility

· Temper tantrums - i.e., pulling hair/biting/head banging/pinching

· Self-stimulatory behaviors- noncommunicative and noninteractional

· Hypo or hyper-sensitivity to stimuli

· Impairment in imaginative play

· Difficulty with transitions

· Increased Hyperactivity

· Intellectual Disabilities

· American Association on Intellectual and Developmental Disabilities

· (AAIDD)

· Definition: “Disability characterized by significant limitations both in intellectual functioning and in adaptive behavior which covers many everyday social and practical skills. This disability originates before the age of 18.”

· Rosa’s Law – put into effect by President Obama in 2010

Intellectual disability causes

· Genetics

· Problems during pregnancy -alcohol abuse

· Problems at birth- low oxygen

· Problems after birth- childhood diseases or injuiry

· Poverty and malnutrition- - poverty puts a person at risk for malnutrition, and or risk for poor healthcare

Pragmatics in Intellectual Disabilities

o Mixed strengths and weaknesses

o Varies depending on the specific disorder

o Difficulty contributing to conversation

o Difficulty repairing conversation

Cognitive Behaviors for Learning

· Orientation: inability to sustain attention

· Reaction time: - allow for reaction time, given enough time to process the question

· Discrimination: - inability to identify the stimuli

· Organization: Difficulty coming up with new categorization skills, difficulty with categorizing new material

· Generalization: -inability to apply previously learned material repetition is good, generalizing what they learned from one week to the next

· Memory: - overall recall may be slower than it should be

· Attention: ADHD, limited awareness of the learning environment, difficulty attending to the material

IQ Classification: Mild (55-69), Moderate (40-54), Severe (25-39), Profound (<25).

• Language & Learning Challenges: Delayed rather than different development, difficulty with conversation, generalization issues.

• Intervention Strategies: Teaching in natural settings, early intervention, reinforcement, and task simplification.

Autism Spectrum Disorder (ASD)

• Defined by DSM-V as impairments in social communication and restrictive, repetitive behaviors.

• Behavioral Characteristics: Poor social skills, difficulty with transitions, ritualistic behaviors, sensory sensitivities, and communication challenges.

• Possible Causes: Brain abnormalities, genetic mutations, environmental influences.

• Social Communication Disorder (SCD): Overlaps with ASD but lacks repetitive behaviors.

• Early Signs: Lack of response to voices, limited gestures, joint attention deficits.

• Language Issues: Echolalia, pronoun reversal, mutism, and limited generalization.

Interventions:

• Applied Behavior Analysis (ABA)

• TEACCH (Structured teaching)

• PECS (Picture Exchange Communication System)

• Pivotal Response Training

• Sensory Integration Therapy

Response to Intervention (RTI)

• Multi-tiered approach to help students with learning challenges.

• Tier 1: General classroom instruction.

• Tier 2: Small group interventions.

• Tier 3: Intensive, individualized instruction.

• Reduces unnecessary referrals to special education and ensures appropriate instruction.

Dementia

Definition & Characteristics

• Dementia is a progressive decline in intellectual functioning, affecting memory, cognition, language, and behavior.

• Can sometimes be reversible if caused by depression, drug toxicity, infection, hydrocephalus, nutritional deficiencies, or cardiopulmonary disorders.

• 1 in 20 people over 60 and 1 in 5 over 80 are diagnosed with dementia.

Dementia vs. Alzheimer’s Disease

• Dementia is a general term for cognitive decline affecting daily life.

• Alzheimer’s Disease (AD) is a specific cause of dementia, making up 60-80% of cases.

Alzheimer’s Disease Symptoms

• Cognitive decline: Poor memory, reasoning, judgment, and problem-solving.

• Language issues: Word-finding difficulties, decreased meaningful speech.

• Behavioral changes: Anxiety, paranoia, impulsivity, poor social awareness.

• Progression: Symptoms worsen over 6 months to a year.

Dementia vs. Normal Aging

• Normal aging: Slower thinking and word retrieval, but recognition remains intact.

• Dementia: Severe memory loss, confusion, and inability to perform daily tasks.