Causes: Language Disorders
Developmental and Intellectual Disabilities
Autism
Traumatic Brain Injury
Child Abuse and Neglect
Hearing Loss
Structural Abnormalities of the Speech Mechanism
Aphasia
Genetics
Environmental Influences
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Identification and Assessment
•Screening and Teacher Observation
•Evaluation components
• Case history and physical examination
• Articulation
• Hearing
• Phonological awareness and processing
• Vocabulary and overall language
development
• Assessment of language function
• Language samples
• Observation in natural settings
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Assessment of Children Who Are
Culturally Diverse
• Assess language proficiency in both the first and
second languages when determining a culturally and
linguistically different child’s communication
competence.
• Do not diagnose with a speech-language disorder if
problems are observed only in English and not in their
first language (or dialect).
• Include assessment of basic interpersonal
communication skills and cognitive academic language
proficiency.
• Assessment for the purpose of identifying children with
disabilities are required, by IDEA, to be conducted in
the child’s native language
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Educational Approaches
 Articulation and phonological errors:
• Discrimination and production activities
 Fluency disorders:
• Behavioral principles and self-monitoring
 Voice disorders:
• Medical Examination and Direct vocal
rehabilitation
 Language disorders:
• Vocabulary building, naturalistic interventions
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Augmentative and Alternative
Communication (ACC)
•ACC refers to a diverse set of strategies and
methods to assist individuals who cannot meet their
communication needs through speech or writing.
 ACC entails three aided or unaided components
• A representational symbol set or vocabulary
• A means for selecting the symbols
• A means for transmitting the symbols
• Symbol sets and symbol systems for ACC
• Selecting the symbols
• Transmitting the symbols
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Placement Options
•In 2011 to 2012, 87% of children with speech or
language impairments were served in the general
education classroom, 6% in resource rooms, and
4% in separate classrooms.
•Some examples of service delivery models:
 Monitoring
 Pullout
 Collaborative Consultation
 Classroom or Curriculum Based
 Separate Classroom
 Community Based
 Combination
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Autism Spectrum Disorder
• Autism is a developmental disability affecting
verbal and nonverbal communication and social
interaction, generally evident before age 3, that
adversely affects a child’s educational
performance.
• Other characteristics are engagement in
repetitive activities and stereotyped movements,
resistance to environmental change or change in
daily routines, and unusual response to sensory
experiences.
• Autism does not apply if the child has a serious
emotional disturbance.
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DSM Definition
• Subsumes all four related disorders into a
single diagnostic category, autism
spectrum disorder with the following
characteristics:
 Persistent deficits in social
communication and social interaction
across context
 Restricted, repetitive patterns of
behavior, interests, or activities
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DSM Definition
 Symptoms must be present in early
childhood
 Symptoms cause clinically significant
impairment in social, occupational, or
other important areas of current
functioning
 Symptoms are not explained by
intellectual disability or developmental
delay
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Characteristics
• Impaired Social Relationships
• Extreme aloofness
• Social situation difficulties attributed to deficits
in theory of mind
• Deficits in joint attention
• Communication and Language Deficits
• Some children with autism do not speak
• Echolalia is common among those who do talk
• Concrete or literal processing of verbal
information is common
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Characteristics
• Repetitive, Ritualistic, and Unusual Behavior
Patterns
Some children exhibit stereotypy which is a
pattern of persistent and repetitive behaviors
• Insistence on Sameness
Children with autism are inflexible with routines
• Unusual Responsiveness to Sensory Stimuli
70% to 80% of individuals with autism react
atypically to sensory stimulation
• Over and underresponsiveness
• Hyposensitive and hypersensitive
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Characteristics: Cognitive
Functioning
•ASD occurs across the full range of intellectual
abilities
There are deficits in executive functioning
About 10% to 15% exhibit “splinter skills”
About 1 in 10 have savant syndrome
Many exhibit overselectivity
•Theory called weak central coherence
Obsessive attention on a specific object or
content
Some possess a strong aptitude for rote
memory of certain things
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Characteristics: Challenging
Behavior
• Some students with autism exhibit
property destruction, aggression toward
others, and even self-injury
• Many experience a variety of sleep
problems
• Some have extremely narrow food
preferences
• Some engage in pica which is the
compulsive, recurrent consumption of
nonfood items
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Characteristics: Asperger
Syndrome
•Asperger syndrome is at the mild end of the ASD
Asperger is no longer a separate category in
DSM
•Impairment in the social areas
•Deficits in the use of nonverbal behaviors related
to social interaction
•No general language delay
•Most have average or above-average intelligence
•Their peculiarities and social skills deficits make it
difficult to develop and maintain friendships
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Prevalence
•Autism occurs in as many as 1 in 68 children
•Rise in autism prevalence is an international
phenomenon
•Autism is the fourth largest and fastest
growing disability category in special education
•Boys are affected nearly 5 times more often
than girls
•ASD appears in all racial, ethnic, and
socioeconomic groups
•In the 2012 to 2013 school year, 498,000
students ages 3 to 21 years received special
education services under the IDEA category of
autism
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Causes
•Autism is a neurodevelopmental disorder with no
medical or physiological marker.
•In 85% of cases, the cause of autism is unknown
•There is a clear biological origin of autism in the
form of abnormal prenatal and postnatal brain
development, structure, or neurochemistry.
•Autism clearly has a genetic component.
•Combination of autism-related genes, exposure
to certain environmental factors may lead to the
development of autism in some children.
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Identification and Assessment
•Early diagnosis is highly correlated with
dramatically better outcomes
•Autism can be reliably diagnosed at 18 months of
age
 Screening Tools
• Modified Checklist for Autism in Toddlers (MCHAT)
• Social Communication Questionnaire (SCQ)
• Autism Spectrum Screening Questionnaire
(ASSQ)
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Identification and Assessment
•Diagnosis, for those who fail screening tests or
whose parents or caregivers have reasons for
concern undergo a complete diagnostic evaluation.
•Diagnostic Tools
Childhood Autism Rating Scale (CARS-2)
•Autism Diagnostic Interview-Revised (ADI-R)
•Autism Diagnostic Observation Schedule (ADOS)
•Asperger Syndrome Diagnostic Scale (ASDS)
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Educational Approaches
•Children with autism are among the most
difficult students to teach
•Early Intensive Behavioral Intervention
•The work of Ivar Lovass
•Applied Behavior Analysis (ABA)
•Discrete Trial Training
•Visual Supports
Visual Activity Schedule
Social Stories
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Social Stories
• Written at the student’s level of comprehension
and usually contain four basic types of sentences
written from the perspective of the student.
 Descriptive Sentences
 Perspective Sentences
 Directive Sentences
 Affirmative Sentences
• Constructed with one sentence per page and with
photographs or line drawings depicting key
information sometimes added.
• Not considered an evidence-based practice
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Unproven Treatment
• An Example
 Facilitated Communication is a process by
which a communication partner, called a
facilitator, provides physical support to assist
an individual who cannot speak or whose
speech is limited to type on a keyboard or
point at pictures, words, or other symbols on a
communication board.
• There is no rigorous scientific evidence to
support claims of success in the use of this
intervention.
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Unproven Treatment
• Parents and teachers are easy targets for
interventions that promise cures.
• Concerning a particular practice, teachers
should collect direct and frequent
measures of student learning to evaluate
effects on students.
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Placement Options
•Students with autism are increasingly placed in
general education classrooms for the purpose of
improved social integration
•During the 2012 to 2013 school year:
•approximately 40% of students with autism were
educated in the general education classrooms
•18% served in resource room programs
•33% in separate classes
•About 9% of students with autism attended special
schools or residential facilities
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General Education Classroom
Success in the general education classroom for a
student with ASD depends on the child’s ability to
reliably do the following:
•Display near-zero levels of problem behavior
•Participate and learn in group lessons
•Complete assigned tasks independently
•Interact with peers appropriately
•Comply with classroom rules/follow the
teacher’s directions
•Get the teacher’s attention/assistance
appropriately
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Resource and Special Classrooms
• The general education classroom is not the least
restrictive environment for all students with ASD.
• Instruction in the resource room or special class
typically features
 High frequency of instructional time per minute;
careful specification of and planning for transferring
the control of students’ responses from teachercontrived antecedent and consequent stimuli to
naturally occurring events; specific strategies for
promoting generalization of newly learned skills to
the regular classroom, the community, and the
home; continuous recording of data on performance
of targeted skills; and the daily review of data for
decision making
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