Purpose of this lec:
- understand language disorder and DLD
- to have a full understanding of how to assess for a language disorder
- why we assess this and what info we get from different types of assessment
Language disorder and DLD
- Language disorder is mostly paired with something like autism, as DLD- developmental language disorder - it’s own thing
What is a Language disorder? Definition?
- have persistent difficulties with language which interfere with communication and learning
- doesn’t get better unless intervention
- difficulty learning and using language in any or all of these forms (speaking, writing, understanding, reading or signing)
- It affects their ability to communicate effectively in daily life.
- Language disorder can also be, for example, someone producing word sentences clearly, but semantics are impaired, so the meaning of the sentences wouldn’t make sense.
- may have trouble understanding or using language due to any of these areas:
phonology- words’ sound
morphology- words built
syntax- grammar/ sentence structure
semantics- meaning
pragmatics- how language is used e.g knowing when to speak in social setting
Content Form Use
Content:
semantics
word knowledge
Form:
phonology
morphology
syntax
Use:
pragmatics
DLD- Developmental language disorder
- difficulties talking/ understanding
condition from birth, not acquired through any injury/ illness - cause: way the brain has developed
- unknown origin
- interferes with learning/ comm
Reasons to get diagnosis:
- parental support- so can advocate and get access to services for the child
Criteria for diganosis for language disorder
- child must have language difficulties that significantly impair socially and educationally
- poor prognosis- unlikely that they will get better, and unresolved by the age of 5
- once diagnosed- decide whether the language disorder is DLD or a language disorder associated with X (something else, e.g Down syndrome)
Language disorder- associated with X (something else)
- 1/5 of all people with SLCN have a language disorder
mostly associated with something like:
- DS
- brain injury
- hearing loss
- disability
- autism
- klinfector syndrome
DLD risk factors
- If one or more of these things are present, a person is more likely to have DLD
- family history of DLD
- poverty
- family of low educational level
- neglect/ abuse
- pre/perinatal problems
- male
Issues with diagnosis
- all tests are based on WEIRD data (westernised)
- Some assessments provide
- Children with LD are at a disadvantage when doing the standardised tests
Co-occuring disorders
Attention
Motor skills- of communication
Literacy - the link between this and LD is big when looking at children from primary to sec
Speech
Executive function
Adaptive behaviour and in general
Mental health
ASD and DLD
- Most people think children with LD have ASD and are diagnosed with autism - sometimes this is an overdiagnosis
- So some things that we may be looking for in DLD will be in children with autism
Prevalence
- In the UK 9.92% have LD
- of that, 7.585 have DLD and 2.34% have LD associated with X (something else)
- 2 in every 30 children
- hidden but common- impacts comprehension, emotional well being
What does LD look like?
CONTENT
- smaller vocab- breadth and depth
- breadth (knowing these words have roots and differentiations like walk, walking, walked)
- depth (all the words that they know)
- find it harder to remember new words
- difficulty with metaphors and figurative language -
- semantics - not knowing the meaning of a word will make it hard to understand in different contexts, like jokes, for example
- may know the word- however word retrieval is difficult
What does LD look like?
USE
Pragmatic and social communication side of things:
- understanding others’ thoughts/ feelings/ emotions
- because they can’t understand, they make their own assumptions/ inferences of what the person means
- difficulty with:
- telling a story in chronological order
- starting and maintaining a conversation
- turn-taking in convo
- changing how they speak depending on who they’re talking to, e.g teacher
What does LD look like?
FORM
GRAMMAR
Difficulty with:
- may miss word endings like ‘ed’, ‘s’, ‘ing’
- questions
- verbs
- complex grammar- clauses, passive sentences, pronouns, words associated with direction, place, transition
Speech sound difficulties in DLD include:
- unable to say certain sounds clearly
- speech errors are strange/ keep changing- mistakes aren’t always the same.
DLD image
What does DLD look like?
Challenges with:
- paying attention, listening
understanding words/sentences
- instructions, questions
- words in order
- grammar
- convos
- social
- read/write
- basically like dyslexia, but for speaking instead of reading
Prognosis- outcome of LD
How would LD affect an individual’s life?
Mental health, QOL, RS, ED, employment
may feel isolated
- low self-esteem/confidence -relationships
- anxiety/depression- psychological problems
- less social - harder to build relationships- frustration not being able to understand
- treated differently
- education- low academic level - poor mental health
- leaving education earlier- a poor future for them
- non-professional job/ lower quality
- unemployed 4x longer than peers
How would LD affect an individual’s life? Financially and Economically
- an individual’s family impacted - lot of their time is supporting child
- increased burden on the health and welfare system
- impact of future earnings
- carers working fewer hours to stay home with the child
- managing finances
- most need support from parents- bills, loans, etc…
- takes a toll on carers- looking after their whole life
Principles of assessment
Reasons for assessment:
- referral, case history, communication samples, observations- through this, we create and test a hypothesis formally or informally- provides more info
- assess to get baselines so we know what we’re working on, able to see progress
- excluding/referring to may have another issue and be referred for something else
- depending on what the needs are, able to plan an intervention
Questions:
- Is there an underlying problem?
- Cause of the problem genetic? - gradual or sudden
- Does the problem vary in severity- e.g get worse in certain settings/people
- How does the family see the child/ environment
Low structure observations:
What SLT can do to gather more info
- engage in free play with the child
- video recordings
- observing child in class/ outside of class
LSO- to get info on childs expressive language abilities
Look at
- length
- complexity
- intelligibility
- word finding difficulties
- fluency
- structured speech
- follow
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Lec 1a- Disabilities and Impairments-week11
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Lec 1b- Assesments week122
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Lec 2a Assesment proccess continued-week 115
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Lec 2b week 1- Targets and intervention16
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Lec 3a week 2- Case studies + assessment and intervention2
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Lec 3b- week 2 Report writing7
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Lec 4a- week 2 Multicultural and bilingualism13
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Lec 4b week 2- Supervision, Risk Management Prioritisation and Delivery Pathways28
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Lec 5a Language disorders31
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Lec 6a Language Disorders intervention25
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Lec 7a- Autism60
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Lec 7b Autism- Intervention and Support53
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Lec 8a Under 7s Stammering- Assessment and Intervention36
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Lec 8b Over 7s22
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Lec 9 Assessment and intervention in deafness40
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Lec 10 Speech sounds26
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Lec 10b Speech sounds intervention + assessment19
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Lec 11 Selective Mutism42
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Lec 12 Social, emotional, mental health and trauma informed practice40
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Lec 13 Paediatric dysphagia0
