Language Development & Language Disorder

Language Development & Language Disorder

  • Receptive and Expressive language.

  • Form, content, use- Intentionality model (pragmatics).

  • Brown’s morphological stages (morphology).

  • Blank levels.

  • Key word levels

  • Look at Language Acquisition lecture in Year 1 (SLT 402).

  • Play and language development, social interactions. Hanen, MIJY? and it takes 2 to talk.

Key Phases in Language Development

Prelinguistic Phase

  • Involves multiple domains of language, including:

    • Babbling

    • Speech sounds

    • Grammar

Morphological Development

Understanding Morphemes

  • Definition of Morpheme: A morpheme is the smallest grammatical unit that conveys meaning.

  • Examples of morphemes:

    • un (prefix)

    • happy (root)

    • est (suffix)

    • ily (suffix)

Morpheme Length Examples

  • Example 1:

    • Sentence: "He meets the unhappiest boys"

    • Analysis:

    • 1 sentence, 5 words, 8 syllables, 9 morphemes

  • Example 2:

    • Sentence: "The girl's mother slowly filled the bucket with water"

    • Analysis:

    • 1 sentence, 9 words, 13 syllables, 12 morphemes

Stages of Communication

Perlocution Stage

  • Age Range: Birth to approx 10 months

  • Description:

    • Babies exhibit prelinguistic behaviors such as eye gaze and sound play.

    • Adults interpret these behaviors as communication.

Illocution Stage

  • Description:

    • Gestures and vocalizations become intentional.

    • This stage marks the use of these actions to communicate.

Locution Stage

  • Milestone: Occurs between 10-14 months.

    • This is when the child says their first word (Singleton & Shulman, 2020).

Families of Speech Acts

  • Categories of Illocutionary Acts:

    • Assertives: Statements that convey information.

    • Directives: Requests or commands.

    • Commissives: Commitments made by the speaker.

    • Expressives: Expressions of the speaker's emotional state.

    • Declarations: Acts that change the state of affairs by the mere act of saying.

    • Source: Muller et al. (2008)

Information Carrying Words (ICWs)

  • Definition: ICWs or KWLs (Key Words for Learning) are significant in clinical practice.

  • Emerging Evidence: Suggests that the concept might not universally apply beyond the English language.

Language Disorder Overview

  • Speech Language and Communication Needs (SLCN):

    • Overall diagnostic category that encompasses a wide range of conditions.

    • Recommended particularly for pre-school children where diagnosis may be unclear.

    • Unlikely to be resolved unless specialist intervention is provided and likely to continue into middle childhood.

Definition of Language Disorder

  • Language disorder refers to children with language difficulties that impair social and educational functioning.

  • Indicators of poor prognosis include:

    • Difficulties likely to persist into middle childhood (beyond age 5 - RCSLT, 2017).

  • Language delay refers to children that may have a difficulty with language but will likely to catch up. This is typical but better to refer to it as a difficulty.

Language Disorder Associated with X (another condition).

  • Within the language disorder category:

    • Describes children with language disorders accompanied by a differentiating condition (as defined by CATALISE panel, 2017).

    • Differentiating Conditions: Biomedical conditions where language disorder forms part of a more complex impairment pattern.

    • Management of the language disorder is influenced by the biomedical condition context.

Developmental Language Disorder (DLD)

  • Definition: Refers to children whose language disorder does not occur in the context of a biomedical condition.

  • Co-occurring Issues: DLD may accompany conditions such as:

    • Attention Deficit Hyperactivity Disorder (ADHD)

    • Motor problems (e.g., Developmental Co-ordination Disorder)

    • Developmental dyslexia

    • Speech difficulties

    • Behavioral disorders

  • Does not have a mis match between verbal and non-verbal ability.

  • Neurodevelopmental condition. Mix of genetics and the environment. They have the gene but it is switched on by the environment.

  • Siblings or parents may also have ADHD or dyslexia alongside DLD.

Specific Language Impairment (SLI)

  • Historical Label: Used for children with atypical language development without an obvious cause (Bishop, 1999).

  • Criteria: At least 2 standard deviations below age norms on standardized assessments.

  • SLI and DLD are not interchangeable. They have a different diagnostic criteria and it is a different diagnosis. SLI is still used as a diagnosis, may see it in the literature.

Cause of Developmental Language Disorder (DLD)

Genetics

  • FOXP2 Gene Disorder: Affects development of speech and language beginning in early childhood.

  • Importance of FOXP2: Responsible for making a protein essential for normal speech and language development.

Inheritance Patterns

  • Neurodevelopmental disorders often run in families.

  • DLD is observed more frequently among relatives of affected children.

  • Statistics: 50-70% of children with DLD have at least one family member with similar challenges.

Diagnosing DLD

Diagnostic Flow Chart

  • Presents a pathway for assessing children with SLCN who demonstrate language difficulties impacting their social and educational functionalities.

Risk Factors in DLD Assessment

  • Assessment Consideration: Therapists must evaluate several risk factors while diagnosing DLD.

  • Reference: Risk factors checklist is available in the All Wales DLD pathway.

  • Babbling, perlocutionary stage, non-verbal communications, lack of progress after intervention, family history, male (more prevalent), deprivation (socio-economic), hearing, ALN, functional impacts- parents and school. Can helo to make a clinical decision- outreach provision, sessions with TI or LRP.

Clinical Markers for DLD

Areas of Assessment

  • Expressive Language:

    • Vocabulary

    • Grammar (Morphology, Syntax)

  • Receptive Language:

    • Understanding of concepts

    • Semantic skills

  • Social Communication:

    • Conversational skills and social understanding.

Possible Assessments

Expressive Language

  • Semantics: Understanding relationships between words and vocabulary size/diversity.

  • Morphology: Correct use of grammatical markers.

  • Syntax: Mean utterance length and sentence complexity.

Receptive Language

  • Understanding words and concepts, including abstract language, and idioms.

Social Communication

  • Conversational initiation, topic maintenance, and acknowledgment of breakdowns.

  • Non-verbal communication skills and understanding emotions.

Assessment Tools

  • The Renfrew Language Scales:

    • Includes various tests like Action Picture, Bus Story, and Word Finding tasks.

  • CELF 5 - Clinical Evaluation of Language Fundamentals:

    • A standardized assessment with multiple language domains and standalone subtests.

CELF 5 Subtests Include

  • Observational Rating Scale

  • Sentence Comprehension

  • Linguistic Concepts

  • Vocabulary, Syntax, Semantic Relationships, and Pragmatics.

Impact of DLD

Risks Associated with DLD

  • Research indicates various risks, including:

    • Lower academic performance

    • Lower post-school employment outcomes

    • Increased risk of anxiety and depression

    • Challenges in establishing friendships.

Statistics

  • Approximately 7% of children have a language disorder, which is significantly higher than the 1% for autism.

  • Discussions on the implications of these statistics for affected individuals in society.

Interventions for DLD

  • Language-based Interventions: Found to be effective, though variability exists across language domains.

  • Specific gaps noted in research regarding bilingual children’s interventions.

  • Importance of Early Intervention: Enhances communication skills and social participation for better opportunities.

General Intervention Strategies

  • Get the student’s attention before speaking to them.

  • Use clear, slow language and provide visual aids.

  • Use short sentences and allow thinking time.

Summary of DLD

  • Language disorders can significantly affect educational and social functioning.

  • DLD is categorized under the broader language disorder category as a neurodevelopmental disorder with undefined aetiology.

  • SLTs can diagnose DLD through holistic assessments, keeping in mind risk factors and various interventions available.