Language Disorders of Young Children CDIS 5015

Language Impairment or Language Difference You saw those ten baby mice in the house, right? (example of the Systems Model) Have the students in the class identify on the map where they came from and then say the sentence either the way they do now or in a way consistent with those in their region. Think about phonology and sentence structure. yous have saw those ten baby mice in the house, eh?

What Do You Know? About... Language development Populations Assessment and diagnosis Treatment and prognosis How children learn to talk One word by one. Two words by the time they have 50 words in their vocabulary. Single sentences by 3. Storys by 4. Blind children context and pragmatics. Form is good and synatx is but, cant see jestures and turn taking. Sensory, nero, gentic, environmental, international adoptions, cognitive are all examples of problems in learning language. Screening- is there a problem or isn’t there?

Terminology Language disorder Language difference Language delay Language deviance Childhood/congenital aphasia/disorder Language disorder: A significant discrepancy in language skills from what would be expected for age or developmental level Language difference: Rule-governed Deviates in some way from the standard usage of mainstream culture Language Delay Language is like that of a younger child and they will eventually be “normal” Seems prognostic, and this is not generally supported by the literature Language Deviance Development is not just slower than normal, but I some way different qualitatively Literature does not entirely support this view either, differences subtle, but sequence and nature of language are intact Childhood/Congenital Aphasia/dysphasia Old terminology Now reserved truly for language impairment related to neurological accident

ASHA’s Definition (1993, p. 40) An impairment in “comprehension and/or use of a spoken or wtitten and/or other symbolic system. The disorder may involve (1) the form of language ..., (2) the content of language..., and/or (3) the function of language in communication... in any combination” (as cited in Paul, 2007).

Fey’s Definition (p. 31, 1996) “a significant deficit in the child’s level of development of the form, content or use of language”?

Paul’s Definition of Language Disorders “Children can be described as having language disorders if they have a significant deficit in learning to talk, understand, or use any aspect of language appropriately relative to both environmental and norm-referenced expectations for children of similar developmental level.” (p 3) She likes this def best.

…significant deficit… What’s Significant & Below What? Below the 10th percentile = 1.25 standard deviations below the mean = standard score of 80 Adjusted Age, Chronological Age or Mental Age? Are delays of the same amount equivalent across the age span? How reliable is the measurement ? Standard scores, age equivalency, percentiles Assessment instruments How do you calculate or measure age? What are you going to use the information for? Caseload vs. research vs. administrative vs. counselling How do you tell if it's a problem? A) Compare to standardized assessment: Criteria based decisions •Below the 10th percentile = 1.25 standard deviations below the mean = standard score of 80 1 sd = 17% of the preschool population 2 sd = 2% of the preschool population B) Compare LA to MA or CA: Consistent with expectations - MA. Importance of equivalent delays across the age span - a 1 year delay in a 3 yr old is more debilitating that a 1 yr. delay in an 8 yr old Problems with MA - How do you determine - Full scale IQ vs. PIQ - are performance tasks alone representative of intellectual abilities - splinter skills - are there stronger relationships between some performance tasks and language than others? - Test instrument dependent • CA. - With CA there is determination of age is 100% reliable - but there may be variation with test stated age equivalencies - tests have different normative characteristics, populations, ranges, standard error of measurement, variability This makes comparison by age across test instruments difficult • CA. Language > MA e.g. Williams' Syndrome • MA. Language < MA Purpose Make your decision about what is significant and how you are going to measure it based on your purpose: CA: caseload decisions. Who should be on the caseload? CA allows children with cognitive deficits to be on the caseload MA: therapy targets. Developmental order for target selection MA: administrative criteria MA: research. homogeneity of research participants research vs. admin

…learning to talk, understand or use any aspect of language… Bloom & Lahey (1988) Syntax, morphology & phonology Function, context & rules Form Most formal assessment tools examine form and content in some manner Some tests assess only one area Very few examine use Therefore we need to use other assessment methods Represents Basic Goals Content Use Vocabulary & meaning

…environmental and norm-referenced expectations… Normative Neutralist Noticeable by caregivers Affects social or academic function Adaptive consequences Performs significantly below expectations on norm-referenced tests Normative vs. Neutralist : Mary Kate and Ashley ”Full House” example While infants, twins are hired to play a single acting role in a series What would happen if their language did not develop in the same way and at the same rate? What if one is normal and one is delayed? What if one is precocious and one is normal?

Problems Normative Neutralist caregiver perception - relative to what? environmental expectations institutional requirements availability of tests - age, communicative area standardized or naturalistic test construction applicability to intervention “significantly different” Normative Problems - caregiver perception - relative to what - environmental expectations - institutional requirements Neutralist Problems - availability of tests - age, communicative area - standardized or naturalistic - test construction - applicability to intervention - “significantly different”

Four Models of Child Language Disorders The Systems Model Language differences Severe disabilities The Categorical Model Medically-based Syndromes of behavior Categorical Pros: Can be prognostic or alert the clinician to concomitant problems or behaviors Might be needed administratively to qualify for services or financial support, insurance Understandable, common-sense Cons: Not necessarily causative e.g., how does MR cause lang delay? What caused the MR Same label, different manifestation Not all children fit into the categories, Some children fit into more than one category Comerbility – two problems happen at the same time Does not lead to treatment approaches

The Specific Disabilities Model Auditory Perceptual Deficits E.g., FastForWord Auditory Processing Limitations E.g., The Surface Hypothesis Research-Based Models Based on the idea that if we can identify the “source” or “underlying” cognitive-linguistic weaknesses, we could treat them directly and resolve all the surface manifestations Auditory Perceptual Deficits children with SLI show difficulty identifying auditiory stimuli that are very brief and/or followed rapidly by another stimulus Auditory Processing Limitation Children with SLI have difficulty storing enough information for long enough in memory while also integrating new, incoming information Also particular difficulty with phonological short-term memory

The Descriptive-Developmental Model Detailed description of the child's current level of functioning Semantics, syntax, morphology, phonology, pragmatics Comprehension and expression Research in normal language development guides intervention More direct connection between assessment and intervention Creation of a profile of strengths and weaknesses Don’t worry about cause…looking at kids as individuals…how does it compare to typical development?

It is not always possible to know the cause of the language problem Assumptions: It is not always possible to know the cause of the language problem A detailed profile of the child's language skills is crucial for intervention The best treatment decisions are based on where the child is now and what is next in the normal developmental sequence Assumptions: It is not always possible to know the cause of the language problem A detailed profile of the child's language skills is crucial for intervention The best treatment decisions are based on where the child is now and what is next in the normal developmental sequence Note: the goals may be developmentally guided, but the materials and activities should be more representative of chronological age. Problem: it does not lend itself to categorization or sub-typing of problems, e.g., receptive/ expressive, receptive, expressive, phonological e.g., Conti-Ramsden