Childhood Language Impairments Lecture Notes

3–6 months (Pre-linguistic)
- Emergence of gaze coupling: infant and caregiver alternate eye contact → foundation for joint attention.
- Social games such as peekaboo foster turn-taking and anticipation.
- Vocalizations
- Cooing with noticeable changes in inflection (early prosody awareness).
- Experimentation with pitch, loudness, and duration.
6–10 months
- Canonical babbling (reduplicated + variegated syllables).
- Intentionality appears → gestures or vocal acts have a communicative goal.
- Gestural representation: e.g., using a hand-towel as a blanket for a doll (early symbolic play).
- Symbolization: child realizes a word, sign, or gesture stands for an object/event.
≈ 12 months
- First single words appear alongside residual babbling.
- Vocabulary highly context-bound; words often function as holophrases.

Vocabulary grows to ≈ 50+ words by 18–24 months.
Onset of two-word combinations (telegraphic speech):
- Examples: “throw ball,” “my car,” “eat cookie,” “more drink.”
Development of a personal lexicon
- Word meanings shaped by each child’s experiences and environment.
- Over- and under-extensions are common.

2 yrs: consistent production of 2-word utterances.
3 yrs: emergence of short phrases/sentences; basic S-V-O order.
4–5 yrs: ability to follow multi-step directions (e.g., “Pick up the block, put it in the box, then close the lid”).
Vocabulary/Content skill – Fast mapping
- Child infers meaning from context and uses new word in a similar fashion after minimal exposure.
- Critical for rapid lexical growth (≈1–5 new words/day).

Refinement of verb tenses and morphological endings (e.g., plural ‑s, past ‑ed).
Acquisition of figurative language
- Idioms: “hit the road,” “off the wall.”
- Correlates with adolescent literacy comprehension.
Growth of metalinguistic awareness
- Ability to reflect on language as an object.
- Skills: provide word definitions, judge grammaticality, manipulate sounds (phonemic awareness).
- Strong predictor of reading and writing success.

General categories
- Developmental: present from birth (genetic, congenital).
- Acquired: result of accident, injury, or environmental factors.
- May affect language form, content, and/or use.

Significant language difficulties not attributable to neurological, sensory, intellectual, or emotional deficits.
Frequently associated with deficits in working memory and executive functioning (e.g., planning, inhibition).

Characterized by limitations in intellectual functioning and adaptive behaviors (conceptual, social, practical skills).
Onset before 18 yrs.
Etiologies: biological (genetic conditions, prenatal toxins) or socio-environmental.
Diagnostic criterion often includes IQ < 70 (≈2 SD below the mean).

Continuum of disorders once labeled “Pervasive Developmental Disorders.”
Core areas affected:
1. Verbal and non-verbal communication (delayed speech, echolalia, atypical prosody).
2. Social interaction (joint attention deficits, reduced reciprocity).
3. Creative / imaginative play (restricted, repetitive behaviors; limited symbolic play).

Standardized (Norm-Referenced) Tests
- Compare child’s performance to a normative sample.
- Eligibility for school services often requires a score ≥ 2 SD below the mean:
  (\text{Score} \le \mu - 2\sigma)
Language Sampling
- Collect spontaneous speech in conversation or narratives.
- Allows analysis of MLU, type-token ratio, pragmatic skills.
- Clinician “stretches” performance by prompting stories or problem-solving discourse.
Informal/criterion-referenced tasks complement standardized results.
Example tools (Simucase demonstration):
- Melody (8 mo) vocal play sample.
- PLS-5 screening, Stella receptive language battery.
- Hadley & Paulie language samples (ASD focus).

Adult-Centered / Direct Therapy (often for school-age & older)
- Clinician selects goals, materials, provides explicit instruction.
Child-Centered Therapy ("speech on the run")
- Follow the child’s lead in play; embed targets naturally.
- Four core techniques:
1. Self-Talk – clinician narrates own actions (“I’m building a tall tower”).
2. Parallel Talk – narrate the child’s actions (“You’re driving the truck fast!”).
3. Description – label and describe objects/events in the immediate context.
4. Language Expansion – take the child’s utterance and extend it to a full grammatical model (“Doggy run” → “Yes, the doggy is running fast!”).

Impact of unintelligible speech on assessment (may mask true language ability; need alternative measures like visuals/gestures).
Family education strategies for carry-over:
- Shared book reading, modeling target structures, creating routines.
Relationship between phonological awareness and early literacy—sound manipulation skills predict decoding ability; speech sound disorders can hinder awareness.
Adjusting feedback criteria by age:
- 5-year-old: concrete, immediate (“Good /s/! Keep your tongue behind your teeth”).
- Older child: more meta-linguistic (“Notice how the airflow stays continuous for /s/…”).
Differentiated facilitation depending on diagnosis:
- Articulation: placement cues, phonetic shaping.
- Phonological: minimal pairs, contrast therapy.
- CAS: motor-planning drills, multisensory cueing, repetitive practice.
Session management: minimize distractions (clear workspace, limit toys), increase productions via drill-play or games with high turn density.

Read Chapters 5–6 for next class.
Guest lecture on speech–language & literacy disorders in school settings: 7/7.
Complete assigned Simucase by Mon 7/7/25.
Midterm study guide posted; exam scheduled Wed 7/9/25.