Unit Five
Language
Disorders in Children
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Chapter 16
Foundations of
Language Disorders
in Children
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Language Disorder
• Impaired comprehension and/or use of
spoken, written, and/or other symbol
systems
• May involve form, content, and/or use
3
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Language Delay
• Slower start at developing language but
eventually catch up to peers
4
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Language Difference
• Language affected by cultural and
linguistic diversity
5
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Prevalence and Incidence
• 7 to 8 percent of kindergarten children
have specific language impairments
with no other complicating conditions
• 2 percent more boys than girls have
specific language impairment (SLI)
6
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Multicultural Considerations
• All clients must be respected as
individuals with individual cultural and
ethnic values
• Many children from CLD backgrounds
live in poverty
– Increases the risk for language problems
7
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Chapter 17
Specific
Language Impairments
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Severity Levels
•
•
•
•
Mild
Moderate
Severe
Profound
9
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Specific
Language Impairments (SLI)
• Significant receptive and/or expressive
language impairments that cannot be
attributed to a cause or condition
10
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SLI
• A complex disorder that may have
multiple genetic influences that interact
with environmental factors
11
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Red Flags for a Potential SLI
• First word after 18 months
• Two word combinations later than 30
months of age
• Reliance on gestures
• Limited use of verbs
12
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Red Flags for a Potential SLI
• Lack of yes/no responses to questions
• Difficulty with rhyming and naming
letters
• Difficulty initiating interactions with
peers
• Poor conversational turn-taking
13
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Receptive Language
• Difficulty understanding and integrating
information
• Difficultly understanding words
14
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Phonology
• May produce unusual phonological
errors
– Substitutions of t/r or k/b
15
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Morphology and Syntax
• Late developing morphology and syntax
• Use short, incomplete sentences
• Simple, active form
16
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Vocabulary
•
•
•
•
Small vocabularies
Slow acquisition of vocabulary
Poor word knowledge
Word-finding problems
17
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Discourse/Dialogue
• Difficulty having conversations with
others
18
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Narratives
• Difficulty telling stories or recounting
events
• Due to limited vocabulary:
– Challenges with morphology/syntax
– Recalling memories of events
– Organization of information
19
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Pragmatics
• Initiate conversations less
• Difficulty gaining access to
conversations
• Passive conversationalists
20
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Chapter 18
Language-Learning
Disabilities
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Language-Learning Disabilities
(LLD)
• Term SLI is usually changed to
language-learning disability when a
child enters school
• LLD has effects on learning and
educational achievement
22
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LLD
• Prevalence is 12 to13 percent for 5 year
olds
• 4.5 percent also have speech disorders
23
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Metalinguistics
• Ability to think about and talk about
language
• Very difficult for children with LLD
24
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Adolescents:
Receptive Language
• Weak vocabulary
• Difficulty with abstract words and words
with multiple meanings
• Figurative language (slang, jargon) is
difficult
25
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Adolescents:
Expressive Language
• Use low content or no content words
• Simple syntax
• Violate pragmatic rules
26
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Developmental
Disabilities and Language Disabilities
• Disability originating before 18 years of
age
• Significant limitations in intellectual
functioning and adaptive behavior
• Prevalence is 1 to 3 percent
27
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Classification Systems
• AAMR system indicates amount of
support for individuals with
developmental disabilities
• See Table 18-1
28
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Receptive Language
• Single word comprehension better than
longer utterances
• Understand concrete information better
than abstract information
29
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Expressive Language
• Limited vocabulary
• Difficulty with word recall
• Don’t initiate conversations
30
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Phonology
• Speech unintelligibility is common
– Up to 70 percent of children with
developmental disabilities
31
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Down Syndrome
• Most common chromosomal cause of
developmental disabilities
• Impaired comprehension and
expressive skills
• Speech affected by hypotonia and/or
macroglossia
32
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Autism
• Complex behavioral syndrome that
appears by age 3
• Marked absent interest in social
interaction
• Severely impaired communication
• Repetitive, stereotyped movements
33
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Autism
• Intellectual disabilities occur in threequarters of children with autism
• Autism is within the broader category of
autism spectrum disorder (ASD)
• ASD is within category of pervasive
developmental disorders (PDD)
34
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Autism: Receptive Language
• Receptive language abilities are similar
to child’s mental age
35
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Autism: Expressive Language
• 50 percent are nonverbal
• Echolalia
– Automatic repetition of words, phrases,
sentences
• Used by some
• Idiosyncratic language used
36
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Traumatic Brain Injury (TBI)
• Acquired injury to the brain
• Children tend to have good recovery
• May have long-term speech and
language deficits
• Cognitive impairments may occur
– Memory, attention, problem solving
37
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Chapter 19
Assessment and
Diagnosis of
Language-Learning Disabilities
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Purposes of Assessment
•
•
•
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•
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Does the child qualify for services
Identification of language problems
Description of patterns of language
Factors associated with language problems
Treatment planning
Prognosis
39
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Approaches to Assessment
• Normalist/Psychometric
• Naturalistic/descriptive/criterionreferenced
40
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Psychometric
• Formal approach to assessment
• Standardized tests are administered
and interpreted
• Tests are normed on a large group of
children so comparisons can be made
41
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Criterion-Referenced
• Description of a child’s language
abilities based on natural observations
• Comparison of present performance to
past performance
42
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Screening
• Brief one-on-one observation and
measure of a child's communication
abilities
43
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Assessment Protocol
• Interview
• Formal evaluation
– Articulation/phonology
– Language
– Orofacial structures
• Hearing screening
• Meeting to review test results
44
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Evaluation
of Receptive Language
•
•
•
•
•
Single word vocabulary
Morphology
Sentence structures
Following commands
Questions
45
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Evaluation
of Expressive Language
•
•
•
•
•
•
Sounds and words
Morphology
Naming
Answering questions
Narrative skills
Conversations
46
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Language Samples
• A sample of the child's speech with a
clinician and/or family member
• Allows for a systematic analysis to
determine speech and language
competence
47
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Decision Making
•
•
•
•
Child's strength and weakness
Severity of impairment
Contributors to the impairment
Treatment recommendations
48
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Therapy Approaches
• Traditional
• Functional
• Collaborative
– Often used in schools
49
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Evaluation of Bilingual Children
• Both languages should be evaluated
• If one language is within normal limits,
then a disorder probably does not exist
• A concomitant disorder may exist
50
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Chapter 20
Treatment of
Language Disorders
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Baseline Measures
• Measure of a behavior at the beginning
of treatment
• Future progress can be compared to
this baseline
52
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Selecting Goals
• Operationally defined goal must include:
– An observable and measurable behavior
– Setting/environment
– Criterion
– Percent accuracy
– Stimuli used
53
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Three Models of Therapy
• Within discipline
• Interdisciplinary
• Transdisciplinary
54
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Traditional Approach
to Teaching Language Skills
• Focus on functional language skills
– Skills relevant to a child’s environment at
home and/or school
• Structured hierarchical approach to
moving through goals
55
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Structure of Sessions
• Use well-organized and structured
sessions
• Clinician is preplanned but flexible to
accommodate the child’s needs
56
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General Session
•
•
•
•
•
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General conversation
Review of what child has worked on
Work on new targets
Review of another skill
Challenging tasks
End of session
57
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Other Therapy Approaches
•
•
•
•
Functional language model
Emerging language model
Collaborative model
Naturalistic model
58
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Multicultural Considerations
• SLPs need to consider their own
cultural beliefs, attitude, and values
• Do not use generic terms
• Beware of terms that have questionable
or negative racial or ethnic connotations
59
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Multicultural Considerations
• Present clear explanations and objectives
• Use methods that do not violate beliefs of
client
• Be flexible
• Interact with clients according to their
perceptions and expectations
60
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Multicultural Considerations
• Be task oriented
• Use praise
• Provide opportunities to learn
61
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Chapter 21
Literacy
Disorders in Children
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Literacy Disorder
• Individual has both reading and writing
impairments
63
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Dyslexia
• Most common learning disability in
children and adults
• 75 to 85 percent of children with
learning disabilities have reading
impairments
• Prevalence is 4:1
– Male to female
64
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Emergent Literacy
• Literacy development begins soon after
birth
• Literacy and language are reciprocally
related
• Children are active in literacy process
65
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Skills Related
to Literacy Achievement
•
•
•
•
•
Phonological awareness
Oral language
Alphabet knowledge
Concepts about print
Name writing
66
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Emergent Literacy
• Adult involvement is essential
• Shared storybook reading is important
component
67
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Possible Contributions
of English to Reading Difficulties
• Inconsistencies in pronunciations of words
• Inconsistencies in letter-sound
correspondence
• Inconsistencies in shapes of letters
68
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Problems of Children
with Literacy Disabilities
• Deficits in phonological processing
• Word recognition and spelling
• Underachievement
69
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Secondary Consequences
• Academic difficulties
• Influences on occupation and career
choices
• Reading as a leisure activity
• Interpersonal relationships
70
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Writing
• Reading and writing are connected
• Different types of writing require
different cognitive abilities and use
different vocabulary
71
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Writing Problems
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•
•
•
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Inadequate reference to subject
Inconsistent noun-pronoun agreement
Inconsistent gender words
Punctuation problems
Spelling errors
72
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Multicultural Considerations
• Children from culturally and linguistically
diverse backgrounds
– Greater likelihood of beginning school less
prepared to learn to read than other groups
of children
73
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Chapter 22
Emotional and Social
Effects of Language
Disorders on the Child
and Family
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Parents
• Parents alter their interactions if their
child has a language impairment
– Parents initiate more interactions
– Ask more questions
– Use fewer utterances per turn
– Respond or comment less to their child
75
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Parents
• There is an emotional response by
parents to learning that their child has a
problem
– IEP meetings may be overwhelming
– Not all cultures support family involvement
– Some parents may have their own
language or cognitive problems
76
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Toddlers and Preschoolers
• May be perceived negatively by other
preschoolers because of poor
communication and social skills
77
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School-age Children with LLD
• May be less accepted by their peers
• Children with LLD perceive themselves
more negatively that their peers
• Tend to avoid social interaction
78
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Adolescents
• Emotional-social difficulties increase for
adolescents with LLD
• Mental issues and anxiety disorders
may develop
79
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Personal and Societal Costs
• Undereducation and underemployment
are common results for an adult with a
language disorder
• Adolescent language disorders are
related to juvenile delinquency
80
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