© 2013, 2009, 2006, 2003, 2000 Pearson Education, Inc. All rights reserved. William L. Heward Exceptional Children An Introduction to Special Education Tenth Edition

Chapter 8 Communication Disorders

Focus Questions  How are speech and language impairments related to one another and to typical language development?  What types of communication disorders might statements such as “The dogs runned home” and “That foop is dood” signal?  How are causes of speech and language impairments classified?  What are the major components of a comprehensive evaluation to detect the presence and extent of a communication disorder Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-2

Focus Questions (cont.)  What are basic goals and common elements of effective interventions for speech-sound errors? for language disorders?  What is augmentative and alternative communication (ACC) and who can it help?  How does the role of the speech-language pathologist change as a function of the educational setting in which a child with communication disorders is served? Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-3

Definitions Communication is the interactive exchange of information, ideas, feelings, needs, and desires Communication involves – A message – A sender who expresses the message – A receiver who responds to the message Functions of communication – Narrating – Explaining/Informing – Requesting – Expressing Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-4

Definitions (cont.) Language is a formalized code that a group of people use to communicate with one another The five dimensions of language: – Phonology - Rules determining how sounds can be sequenced and combined – Morphology - Rules for the meaning of sounds ○ Free morphemes - can stand alone in meaning ○ Bound morphemes - do not carry meaning by themselves – Syntax - Rules governing the meaningful arrangement of words – Semantics - Rules for the meaning of words and combination of words – Pragmatics – rules governing the social use of language Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-5

Definitions (cont.) Speech is the oral production of language Speech sounds are the product of four related processes: – Respiration - Breathing that provides power – Phonation - Production of sound by muscle contraction – Resonation - Sound quality shaped by throat – Articulation - Formation of recognizable speech by the mouth Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-6

Typical Speech and Language Development Most children follow a relatively predictable sequence in their acquisition of speech and language Birth to 6 months: Communication by smiling, crying, and babbling 7 months to 1 year: Babbling becomes differentiated 1 to 1.6 years: Learns to say several words 1.6 to 2 years: Word “spurt” begins 2 to 3 years: Talks in sentences, vocabulary grows 3 years on: Vocabulary grows Knowledge of typical language development can help determine whether a child is developing language at a slower- than-usual rate or whether the child shows an atypical pattern of language development Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-7

Communication Disorders Defined ASHA definition An impairment in the ability to receive, send, process, and comprehend concepts of verbal, nonverbal, and graphic symbols systems IDEA definition A communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-8

Speech Impairments Speech is impaired when it deviates so from the speech of other people that it Calls attention to itself Interferes with communication Provokes distress in the speaker or listener Three basic types of speech impairments are Articulation disorders-errors in the production of sounds Fluency disorders-difficulties with the flow or rhythm of speech Voice disorders-problems with the quality or use of one’s voice Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-9

Language Impairments Language disorder is impaired comprehension and/or use of spoken, written, and/or other symbol systems Language disorder may involve in any combination: The form of language (phonology, morphology, and syntax) The content of language (semantics) The function of language (pragmatics) Language disorders may involve receptive or expressive disorders Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-10

Communication Differences Are Not Disorders  Dialects result from historical, linguistic, geographical, and sociocultural factors  Dialects share a common set of rules with the standard language  The dialect of any group of people is neither inferior nor superior to the dialect spoken by another group  A child who uses a dialect different from the dominant culture of the school should not be treated as having a communication disorder  Some children with communication differences have communication disorders within their dialects that should not be overlooked Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-11

Characteristics Speech sound errors Distortions Substitutions Omissions Additions Articulation disorders A child is not able to produce a given sound physically Phonological disorders A child has the ability to produce a given sound and does so correctly in some instances but not others Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-12

Characteristics (cont.) Fluency disorders Stuttering and cluttering are examples Voice disorders A phonation disorder causes the voice to sound breathy, hoarse, husky, or strained Resonance disorders results in hypernasality or hyponasality Language impairments A receptive language impairment interferes with understanding of language An expressive language impairments interferes with expression through language Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-13

Language Disorders Language disorders involve problems in one or more of the five dimensions of language: Phonology Morphology Syntax Semantics Pragmatics Language delay implies a child is slow to develop linguistic skills but acquires them in a typical sequence Language disorders suggests a disruption in the usual rate and/or sequence in which specific language skills emerge Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-14

Prevalence About 2.5% of school-age children receive special education for speech and language impairments 19% of all children receiving special education services are served in this category It is the second largest disability category under IDEA Approximately two thirds of school-age children served by SLPs are boys The percentage of children with speech and language disorders decreases significantly from the earlier to the later school grades Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-15

Causes of Speech Impairments Cleft palate Paralysis of the speech muscles Absence of teeth Craniofacial abnormalities Enlarged adenoids Traumatic brain injury Dysarthria Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-16

Causes of 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 Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-17

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 test ○ Assessment of language function ○ Language samples ○ Observation in natural settings Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-18

Language Function Echoic- repeating words spoken by others Mand- asking for desired items, actions, etc. Tact-naming items, actions, properties, etc. Listener- responding to language Intraverbal- answering questions Textual- reading Transcription- spelling Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-19

Intervention Strategies Across Communication Functions  Include a test of language function  Establish intervention priorities  Implement an intervention program  Track skill acquisition  Practice and generalization For students whose first language is not English, include assessments of basic interpersonal communication skills and cognitive academic language proficiency Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-20

Educational Approaches Treating speech sound errors Articulation and phonological errors: – Discrimination and production activities Fluency disorders: – Behavioral principles and self-monitoring Voice disorders: – Direct vocal rehabilitation Language disorders: – Vocabulary building, naturalistic interventions Augmentative and alternative communication – A diverse set of strategies and methods Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-21

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 Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-22

Using PECS To Teach Functional Communication Skills PEC is a form of augmentative and alternative communication and is divided into several phases How to Get Started  Conduct preference assessment  Create a set of pictures  Teach basic picture exchange  Stretch the lesson  Teach discrimination  Teach simple sentence structure  Teach attributes, responding to questions, and commenting Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-23

Educational Placement Alternatives The vast majority of children with speech and language impairments are served in general education classrooms Some examples of service delivery models: Monitoring Pullout Collaborative consultation Classroom or curriculum based Separate classroom Community-based Combination Heward Exceptional Children, 10e © 2013 Pearson Education, Inc. All rights reserved. 8-24