1
Q
Describe SLI
A
- Significant limitations in language functioning not attributed to hearing, oral function, or intelligence
- Do NOT demonstrate the perceptual difficulties of LD or the intellectual difficulties of ID
- Like LLD, language performance scores are lower than intellectual performance scores on nonverbal tasks: Nonverbal IQ usually above 85 and a low verbal IQ
2
Q
Approximately What percentage of kindergarteners have SLI?
A
- about 7.4% of kindergarteners have SLI
- 2/3 of these kindergarteners will still have difficulty with language as adolescents
3
Q
Is it difficult to identify students with SLI?
A
Yes
it is usually characterized by the exclusion of other disorders (it’s not ID… it’s lacking the perceptual deficits associated with learning disability… it’s not severe enough to be diagnosed as a learning disability…. and so on…
4
Q
What is the deficit in SLI specific to… Describe this a little bit…
A
SLI is specific to LANGUAGE
- some suggest that it is not a distinct disorder, but is merely a category of children with limited language difficulties resulting from genetic and/or environmental factors combined.
- While SLI often causes difficulties with reading and writing these difficulties are not considered to be severe as those having LLD
5
Q
What are specific Language characteristics of SLI?
A
- may appear delayed in one aspect of language-SYNTAX and MORPHOLOGY STAND OUT THE MOST
- while the language problems may be primarily receptive or expressive or a combination of both, expressive abilities are usually below receptive
- Will not catch up without intervention
- varies across children
- these characteristics change as the child matures
- early language skill that affect later reading and writing are affected
- oral errors appear in writing
- in general, these kids have trouble learning the rules of language, using learned language in different contexts, and using word associations to increase vocabulary
- because of this, morphology and phonology rules are not learned and applied correctly and vocabulary does not develop
- pragmatics problems develop because of difficulties with language use
6
Q
How is reading affected with a child with SLI?
A
Although SLI is not a reading disability, 50-75% of children with SLI also have reading difficulties
7
Q
Describe the semantics of a child with SLI
*Only Learn 2**
A
- slow vocabulary growth and lexical errors
- less able to recognize physical features (color, size, and shape), thematic elements within a topic (throw, hit, catch, go, with, game), and/or causation (who caused something, who or what received something)
- new words are not learned and stored quickly
- naming difficulties secondary to less elaborate storage of words
- this builds on itself–vocabulary growth builds on comparison to previous learning and repeated exposure to terms
8
Q
Describe the Syntax/Morphology of a child with SLI
*Only Learn 2**
A
- Fewer morphemes used correctly, affecting verb endings, auxiliary verbs, and articles and prepositions. Morphemes themselves receive little stress in speech
- GRAMMATICAL MORPHEME PROBLEMS=HALLMARK OF SLI
- instead of age 4, maybe age 7 they master verb tenses. late appearance of past tense-ed is a hallmark
- pronoun errors are common because they tend to overuse one form (he or she)
9
Q
Describe the phonology of a child with SLI
*Only Learn 2**
A
- vocalize less
- have less mature syllable structures
- poor non-word repetition (ex: bile dodge, viversumouge)
10
Q
Describe the comprehension of a child with SLI
*Only Learn 2**
A
- poor discrimination of units of short duration like bound morphemes (plural endings, etc.)-hallmark
- ineffective sentence comprehension
- reading errors are often not related to the text in terms of actual decoding or meaning
- Series of events presented visually or verbally are difficult to reconstruct (like event retell or story retell)
11
Q
Describe the pragmatics of a child with SLI
*Only Learn 2**
A
- may act younger than age
- less flexible with language use and don’t understand communication breakdowns
- trouble getting a turn to speak
- inappropriate responses to topic
- difficulty initiating a conversation
- incomplete, confusing narratives
- failure leads to decreased social interaction
12
Q
Describe processing factors in children with SLI
A
- reduced processing and storage of phonological information (the building blocks) leads to inefficient recognition of different words, ability to produce nonsense words, etc… inefficient word learning, slow word recognition, ineffective comprehension of sentences. Problems with incoming information with memory, and with transfer.
- phonological awareness difficulties are not as profound as those with Dyslexia… however, working memory deficits restricts information processing (difficulty comprehending longer and more complex utterances-imagine having a rapid conversation with weak working memory. You can’t keep up–keep losing information as more comes in. Can’t relate new information to processed old information. Think about your experiences with other languages…) Orient more slowly to information… HAVE MORE LIMITED CAPACITY TO FOCUS AND REFOCUS AND SHIFT FOCUS
13
Q
What is a learning disability?
A
“significant difficulty in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities.”
14
Q
What are the six categories of characteristics associated with LLD?
A
- motor
- attention
- Perception** the way information is interpreted)
- Symbol **
- Memory
- emotion
**HALLMARKS
15
Q
What percentage of children with LD have difficulty with learning and using symbols?
A
> 75%–some professionals consider this group to have a LANGUAGE LEARNING DISABILITY
16
Q
What does LLD influence?
A
more significantly influences academic performance–child has a lot of trouble accessing the curriculum
17
Q
What are the semantic characteristics of a child with LLD?
*Only Learn 2**
A
-Smaller vocabularies full of high-frequency, short words
-difficulty relating and comparing items, difficulty with non-literal language and multiple meanings, word finding difficulties, confusion with meanings of conjunctions (and, but, so, because, etc….)
18
Q
What are the syntax/morphology characteristics of a child with LLD?
*Only Learn 2**
A
−Difficulty constructing negatives (I not like milk, etc.) and passives (Dad was chased by the dog), relative clauses that modify noun phrases (The man who bought my house), contractions (didn’t)
−Difficulty with tense markers (past and future), possession (“John keys,” “mines house,” “hims keys”), and correct pronoun use (he for she, she for he, etc)
−Repeats sentences in reduced forms which indicates difficulty learning sentence forms: “I went to the store to buy milk”=“I went to buy milk” or “I went to the store.” “The Coach gave the uniforms to the team that won”=“The coach gave to the team that won”)
−Confusion with articles (“a,” “an,” “the”)
−They typically produce simple or immature sentences with fewer complex sentences—sentences are often longer b/c they use fewer complex forms…tend to talk around things
19
Q
What are the phonology characteristics of a child with LLD?
*Only Learn 2**
A
−Inconsistent sound production, especially as word complexity increases—multisyllabics may be tough: Chrysanthemum, aluminum, alligator, etc.
−**Often more deeply affected than it is in SLI…
20
Q
What are the comprehension characteristics of a child with LLD?
*Only Learn 2**
A
−Confusion with wh-questions (Who? What? Where? When? Why?)
−Trouble following complex oral directions
−Poor strategies for interacting with printed information
−Confusion of letters that look similar (b/d) and words that sound similar (plane/pain)
21
Q
What are the pragmatics characteristics of a child with LLD?
*Only Learn 2**
A
−Turn taking is not a problem
−Difficulty answering questions or requesting clarifications
−Many “false starts”
−Incomplete or inaccurate descriptions
−Poor topic maintenance
−Difficulty initiating or maintaining a conversation
22
Q
Describe ID
A
- Originates before the age of 18
- Substantial limitations in present functioning
- Significantly sub-average (2 SD below mean of 100 = IQ of 68) intellectual functioning, co-occurring with limitations in 2 or more adaptive areas: communication, self-care, etc.
- Significant limitations in intellectual functioning and the adaptive behavior areas noted in conceptual, social, and practical skills
- **Must meet all criteria to be considered to be a person with an intellectual disability
- Language is often the most impaired area—most important characteristic
- Even when matched for mental age, ID children will use more immature forms than TD children
- ID language difficulties may reflect problems integrating learning into ongoing events—more energy going into understanding, not integrating
23
Q
What is dyslexia characterized by?
A
difficulties in accurate, fluent word recognition when decoding words and spelling difficulties
24
Q
What deficits is dyslexia often associated with?
A
Phonological awareness, phonological memory, and Rapid Automatic Naming
25
What are the two distinct types of dyslexia?
- Language-based that may affect comprehension and/or speech sound discrimination (SLP involved)
- Visuospatial disorder that may affect letter-form discrimination with relatively unaffected language overall (not SLP focus)
26
Compared to TD kids, how do children with dyslexia present?
- Comparable verbal IQ scores and/or listening comprehension
- Below average word reading (decoding)
- Nonsense or non-real word reading is below real word reading (word attack skills)
- Well below average phonological processing scores
27
How is dyslexia different from a "garden Variety" reading problem?
- Dyslexia: The child with dyslexia that has trouble almost exclusively with the written (or printed) word.
- Garden variety: The child with dyslexia as part of a larger language learning disability—trouble with both the spoken and written word. (more generalized or “garden variety” reading problem…..not as specific as dyslexia)
28
Describe Hyperlexia
* Spontaneous ability to read—frequently by 2½ - 3 years
* However…little reading comprehension
* Intense preoccupation with letters and words
* Extensive word recognition/decoding by 5
* Language and cognitive disorders in reasoning and perceiving relationships
* Delayed language, difficulty with connected language in all modalities, difficulty integrating language with context to make meaning
29
Describe Selective Mutism
* Relatively rare, but it’s out there. 0.2-0.7% of all children may have this at some point.
* Child does not speak in some situations (school, etc.), but may speak normally in others.
* Girls nearly 2X as affected as boys
* Related factors: social anxiety, extreme shyness, LI (30-50% may have LI), Second Language Learning (silent periods).
* ASHA position paper recommends ruling out emotional factors-school psychologist, etc.
* SLP services may be indicated
30
Describe literacy related difficulties
•Involves all systems of language and phonological processing (phonological awareness, and rapid automatic naming (RAN))
31
Describe Nonspecific language impairment (as compared to specific language impairment)
a.General delay in language development
b.Nonverbal IQ of 86 or lower
•SLI and LLD—85 or higher
c.No obvious sensory or perceptual deficits
•SLI or LLD—sensory and/or perceptual deficits are present
d. Perform more poorly on some language tasks than SLI kids
e. Take longer to generalize rules
f. Therapy indicated!
32
What is the mean/average score on many tests?
100
33
What is one standard deviation from the mean?
15
34
What is a qualifying score?
1.5 standard deviations from the mean on 2 or more measures
1 std. dev=15
1/2 std dev=7.5
1 1/2 std dev=22.5
35
Do the math to qualify a child
The math to qualify:
•Average – 1.5 std dev
•100 – 22.5 = 77.5 (or 78 if rounding up)
36
Perception is one of the categories that goes along with LD. Describe it.
- Different from reception, not as severe in SLI as it is in LLD
- May have any of the following:
- Perceptual difficulties = interpretational difficulties: occur after stimuli are received
- Confusion of similar sounds and words/ similar printed letters and printed words
- Difficulty with figure ground perception (isolate an auditory stimulus against background noise)
- Sensory integration difficulties-- ability to make sense of visual and auditory stimuli occurring at the same time.
- Gestures, facial expressions, body language, intonation, and verbal language all work together to convey information. Each alone is not enough to convey info
37
Memory is one of the categories that goes along with LD. Describe it.
- Short and long-term storage and retrieval,
- Difficulty remembering directions, names, sequences,
- Word finding problems are common
38
Emotion is one of the categories that goes along with LD. Describe it
- Often reaction to or accompany frustration related to situational difficulties
- Common descriptors: aggressive, impulsive, unpredictable, withdrawn, impatient
- May demonstrate poor judgement, unusual fears, or adjust poorly to change
- May be overly independent on routines when language interpretation is required
39
Motor is one of the categories that goes along with LD. Describe it.
- Hyperactivity-- overactivity characterized by constant motion. Can lead to short attention/concentration span. 9 times as prevalent in boys. Not all kids with hyperactivity have LD, not all kids with LD have hyperactivity
- Poor sense of body movement, poorly defined handedness, poor hand-eye coordination, poorly defined concepts of space and time
40
Symbol is one of the categories that goes along with LD. Describe it.
- All aspects of language-- spoken and written-- are affected
- May struggle with conversational turns, and form and content of language-- Form does not stand out as in SLI
- Synthesizing language rules is difficult, so delays in acquiring morphological rules and complex syntax development
- Morphological errors and syntax errors are present in both speaking and writing. Most common morphological error is omission
- Overall language development may be slow, resembling language of younger children but with even less use of mature structures
- Little preschool interest in books or language. Cannot follow a story… A warning sign of things to come for some considered to have SLI
- Word finding is particular problem during conversations and narratives
- Greater time needed to respond verbally
- When young, often struggle with literal meanings
- When older, the struggle moves on to multiple meanings (rock, nursery) and figurative meanings: Think about the Amelia Bedelia
What happens in school?
- The language demands of the classroom are often too high for the oral language of these children
- Many end up in Special Day Classrooms
- Underachievement of these kids further underscores language-learning links
- Oral language skills are single best indicator for reading and writing success in school
41
Attention is one of the categories that goes along with LD. Describe it.
- Short attention span and inattentiveness
- Easily distracted by irrelevant stimuli and easily overstimulated
- Affects ability to learn and organize life
- Perseveration often is present-- repeat utterances over and over, appear to be unaware
- NOT to be necessarily confused with a diagnosis of ADHD
42
Of the 6 LD categories, which is most impactful to LLD?
Symbol and Perception
43
Name 3 things are differentiate LLD and SLI
LLD
- LLD demonstrates diffuse weaknesses across the systems of language and may be associated with other impairment areas (motor, attention, perception, memory, emotion)
- ”Perception” and “Symbol” problems are hallmarks of LLD
- Language perception difficulties are the essence of LLD.
- The ability to attend actively, be responsive, and anticipate stimuli is also compromised in LLD, not SLI.
- Problems learning language that ultimately impacts a student’s ability to learn are evident in LLD (reading decoding and comprehension, ability to access the curriculum, etc.)
SLI
- Unlike LLD—in SLI the focus is on language (particularly form- syntax & morphology) and other disorders are excluded.
- Perceptual difficulties are limited to rapid, sequenced sound stimuli only in SSI.
- The ability to attend actively, be responsive, and anticipate stimuli is NOT compromised in SLI.
44
Additional differences between LLD and SLI (JUST READ THIS CARD, IT'S INFO WE ALREADY KNOW)
LLD
- we will see a variety of systems impacted. They are more deeply more impacted and form (syntax and morphology) doesn’t necessarily stand out, although they do have difficulty with:
- constructing negatives (I not like milk, etc.) and passives (Dad was chased by the dog), relative clauses that modify noun phrases (The man who bought my house), contractions (didn’t)
- Difficulty with tense markers (past and future), possession (“John keys,” “mines house,” “hims keys”), and correct pronoun use (he for she, she for he, etc….).
- Repeats sentences in reduced forms which indicates difficulty learning sentence forms: “I went to the store to buy milk”=“I went to buy milk” or “I went to the store.” “The Coach gave the uniforms to the team that won”=“The coach gave to the team that won”)
- Confusion with articles (“a,” “an,” “the”)
- Synthesizing language rules is difficult, so delays in acquiring morphological rules and complex syntax development.
- Morphological errors and syntax errors are present in both speaking and writing. Most common morphological error is omission.
- Overall language development may be slow, resembling language of younger children but with even less use of mature structure
- Academic performance is more impactful with LLD than SLI. Child has trouble accessing the curriculum
All aspects of language—spoken and written—are affected (often the case with LD as well—75%)
the difficulties are perceptual. Language perception, not reception (sensory)
- Dr. P said that is when he knows it’s an LLD, when the teacher says it isn’t just about their speech, they can’t cut it in class.
- Problems learning language that ultimately impact a student’s ability to learn are evident in LLD (reading decoding and comprehension, ability to access curriculum)
Language perception is very impaired in LLD more so than SLI.
- Perceptual difficulties for SLI are limited to rapid, sequenced sound stimuli
- Refer to videos (Britain kids SLI, and JZ-LLD)
- Word finding is a particular problem during conversations and narratives. This is a difficulty on its own and can be complicated by associated lower vocabulary of LDs.
- Greater time needed to respond verbally
- When young, often struggle with literal meanings
- When older, the struggle moves on to multiple meanings (rock, nursery) and figurative meanings
- The ability to attend actively, be responsive, and anticipate stimuli is also compromised in LLD, not SLI
SLI
- May appear delayed in one aspect of language (usually “Form”-syntax/morphology)
- Other systems of language may be affected—although language form (syntax/morphology) stands out
- While the language problems may be primarily receptive or expressive or a combination of both, expressive abilities are usually below receptive
- Will not catch up without intervention
- Perceived more negatively by teachers and peers
- Behavior problems emerge
- Take minor roles in cooperative learning because they contribute little
- Later in school self-esteem becomes affected
- Self perception decreases with regard to school and social abilities
- In general, these kids have trouble learning the rules of language, using learned language in different contexts, and using word associations to increase vocabulary
- Because of this, morphology and phonology rules are not learned and applied correctly and vocabulary does not develop
- Pragmatics problems develop because of difficulties with language use.
45
What is facilitative play?
Low structured modeling of language strutures & outwitting some resistant children
based on 2 key factors:
1. Topic of Immediate interest to child
2. Power relations between child and adult de-emphasize adult’s image as power figure & authority: be equals
Hubbell Suggested:
- appealing activities
- following the child’s lead
- avoid directing
- talk about what the child is doing
- use language appropriate for child
(I remember him saying to basically use this for building rapport with the kid, but it’s too unstructured for his preference)
46
What is Hanen play?
Parent involvement, OWL (Observe, Wait, and Listen).
- This focuses more on expanding than facilitative play
- The goal is to increase parents’ use of general interaction strategies to facilitate children’s communication.
especially good with late talking toddlers and preschool-age children with developmental delays
trains SLPs to working with parents
- Techniques to use during facilitative play using the Hanen approach:
- Self Talk
- Parallel talk
- Imitation
- Expansion
- Extension
- Buildups/breakdowns
- recast sentences
4 types of communicators:
- Discoverers: reacts to how s/he feels
- communicator: sends specific messages without use of words
- First word users: single words, signs, pictures
- Combiners: combines words into 2-3 word utterances
47
For Hanen play what is OWL and the three As?
OWL:
- Observe
- Wait
- Listen
Three A’s
- Allow
- Adapt
- Add
48
What is Greenspan play?
Different in that child is challenged more to work to their potential, by using more barriers
- You get down on the floor, but you do more than play
- Floortime meets children where they are and builds up their strengths and abilities through interacting and creating a warm relationship
- It challenges them to go further and to develop who they are rather than what their diagnosis says
You do three things:
- Follow your child’s lead (ie: enter the child’s world and join in their emotional flow)
- Challenge her to be creative and spontaneous
- Expand the action and interaction to include all or most of her senses and motor skills as well as different emotions
(This has much more to do with creating barriers, and giving options therefore forcing the child to talk..)
49
Review case studies in the study guide and review the summary of student assessment results
.
50
Review CELF 5 case studies in the study guide
.
Fall '14-223 (Exam 2)
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