Martha Kinney, MA CCC-SLP Wendy Solomon, MA CCC-SLP

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1 Martha Kinney, MA CCC-SLP Wendy Solomon, MA CCC-SLP Learn More at

2 Communication Disorders Speech Disorders Articulation Apraxia of Speech Fluency/Stuttering Voice Language Disorders Receptive Expressive Processing Pragmatic (Social)

3 Articulation An articulation disorder involves problems making sounds. Sounds can be substituted, left off, added or changed. These errors may make it hard for people to understand you.

4

5 Language Disorder A Language Disorder is impaired comprehension (receptive) and/or use of spoken (expressive), written and/or other symbol systems. Source: American Speech-Language-Hearing Association

6 Causes for Language Impairment Many types of disorders and syndromes that have secondary effects on language Genetic Syndromes Autism/PDD/Aspergers ADD/ADHD Hearing Loss Emotional issues Brain injury Prematurity

7 Specific Language Impairment Specific Language Impairment is characterized by difficulty with language that is not caused by known neurological, sensory, intellectual, or emotional deficit. These children: may be intelligent and healthy in all regards except in the difficulty they have with language may be extraordinarily bright and have high nonverbal IQs are usually are late talkers are characterized at age 3 or 4 with limited vocabulary and short utterances are often described as smart but unmotivated and should just try harder (Ervin, M, 2001)

8 AKA Language Impairment may be referred to as Receptive or Expressive Language Disorder Mixed Receptive/Expressive Language Disorder Developmental Aphasia Language Processing Disorder Phonological Delay/Disorder

9 Incidence of SLI In 2003, over 1 million students in public schools were categorized as Speech- Language Impaired (not including those with speech and language disorders secondary to other disabilities). (NICHCY.org fact sheet on speech/language disorders) 7.6% of 5-year old children with language impairment (Ervin, M. 2001)

10 Facts about SLI Often continues through life Common for another family member to be affected Often co-occurs with reading impairment and/or auditory processing disorder

11 Auditory Processing Disorder Refers to how the central nervous system uses auditory information An auditory deficit that is not the result of other higherorder cognitive, language, or related disorders Teri James Bellis PhD, CCC-A Refers to only the audible signal not attributed to impaired peripheral hearing sensitivity

12 Co-occurrence of LI, RD, APD Source: Journal of Speech, Language, and Hearing Research Vol.52 June 2009

13 Language Receptive Language: How a child understands what he hears. Understanding what words mean, following directions, question words, concepts (spatial, temporal, size, color, quantity) Expressive Language: How a child uses words to convey meaning; relating an event, using new and varied words, putting words together to form utterances (getting longer and more complex as child gets older), asking questions, answering questions Social Language: Using language for a variety of purposes and adjusting behavior and language to fit the situation greeting, initiating, informing, demanding, changing according to needs of listener (i.e., talking differently to baby than adult), following conversational rules (taking turns, staying on topic, facial expressions, eye contact), joining in the group/play skills

14 Communication Umbrella Copyright 2010 The Speech Vine, LLC

15 Red Flags! He just doesn t seem to understand what s going on. She understands a lot but seems to have difficulty coming up with the word. His behavior falls apart when given a lot of directions. Reads well but can t answer questions about what she reads. He s so quiet! Cooperative but quiet. Has he had his hearing checked?

16 What now? Assessment: Comprehensive speech and language evaluation should include formal and informal measures that address the following areas: Phonological awareness/phonology Syntax Supralinguistic skills Narrative skills Classroom observation Semantics Pragmatics Auditory comprehension Reading Comprehension Parent/teacher input

17 Phonology Phonology (Sounds) Difficulty perceiving subtle differences in sounds (can change the meaning of a word or make an entire utterance nonsensical) Children with multiple sound errors as a young child often do not perceive changes in sounds and can later affect their ease in learning to read Source: American Speech-Language-Hearing Association

18 Phonological Awareness Phonological awareness: Good phonological awareness heavily predicts later reading success. The ability to play with sounds. It the basis for reading and helps children recognize patterns in sounds and words. This knowledge is used to read and build words. According to research, 73% of all second-grade students who are identified as poor readers have difficulties with phonemic awareness or spoken language in kindergarten (Catts, 1999). Source: American Speech-Language-Hearing Association

19 Semantics The system that governs the meaning of words vocabulary knowledge (receptive) concept knowledge (time, space, sequence, descriptions) multiple meanings Homophones Word finding (expressive) Source: American Speech-Language-Hearing Association

20 Syntax The system that governs the grammar or structure of language Verb tenses Question forms (understanding) Generating Questions Word Endings Grammatical Markers Sentence Structures Source: American Speech-Language-Hearing Association

21 Supralinguistics Processing of higher level language functions Ability to make inferences and predictions Figurative Language Using Context to derive meaning Multiple Meanings Nonverbal Cues Source: American Speech-Language-Hearing Association

22 Narrative Skills The ability to tell a story or relate an event. Involves Sequencing events Using precise vocabulary Conveying ideas Including story grammar elements (Characters, setting, time, events in logical sequence, conclusion, feelings) Source: American Speech-Language-Hearing Association

23 Auditory Comprehension The ability to attend to auditory information, process information, attach meaning, and respond appropriately Requires use of background knowledge Answering questions about information Following spoken directions Requires use of both short term and long term memory Sustained attention Source: American Speech-Language-Hearing Association

24 Social Language Pragmatic or social language is combining all these language skills for functional and socially appropriate use and understanding of communication. Source: American Speech-Language-Hearing Association

25 Language Sample 7 year old with mixed expressive and receptive language delay: How was your summer? (long pause) Well, something happened. We had a um thing set up that you go in um um and we goed to a place to eat and it was blowed over.

26 And the answer is Syntax: Hasn t generalized verb tenses Semantics: Unspecific Vocabulary, Word Finding Narrative: No background information, No clear beginning, middle, end Processing: Delayed

27 Video Courtesy: ABC.com Modern Family

28 Therapy: A 3 Pronged Approach 1. Improving specific skills (e.g., past tense verbs, categorization, sentence structure, phonological awareness) 2. Scaffolding/ Strategies 3. Accommodations and Advocacy Source: American Speech-Language-Hearing Association

29 Strategies for Improving Language Skills Scaffolding Using a framework for support of expressive and receptive language skills with the goal of fading the support and using strategies independently.

30 Strategies for Improving Language Skills Vocabulary Identifying unknown vocabulary words in literature or activity Categorizing, associations, similarities/differences Venn diagrams/graphic organizers Word retrieval strategies Descriptions

31 Strategies for Improving Language Skills Pre-discussion KWHL Chart What do I know Want to know How will I learn it What have I learned Looking at cover, discussing title to determine what you think the book may be about Source: American Speech-Language-Hearing Association

32 Strategies for Improving Language Skills Metacognitive Strategies Questioning: Wh- questions during reading/activity Who, what, where, when, why Clarifying: Identifying story grammar elements (plot, characters, conflict, resolution); separating important information versus unimportant details Sequencing Summarizing: determining main idea, making inferences, deriving meaning from unstated information Source: American Speech-Language-Hearing Association

33 Strategies for Improving Language Skills Visual Strategies Mental imagery Visualizing and Verbalizing Drawing Pictures Sign Language Boardmaker Symbols Story Grammar Marker

34 Word Finding Strategies Source: Jodi Kobernick, M.S. CCC/SLP

35 Green Group Blue Do What does it look like? What is it Made of? Pink Parts White Where What else do you know?

36 Strategies for Improving Language Skills Teach explicit Listening Strategies Learning to become a good active listener Asking for repetition/clarification Note taking Self-advocacy Providing opportunities just to practice listening

37 Accommodations Helpful Classroom Accommodations Examples: Sit near the front of the room/near the speaker Assign a listening buddy Give T/F or multiple choice tests when possible Allow extra time for processing when asking a question Reduce the amount of vocabulary given during a week. Choose words that may be unknown yet familiar.

38 Advocacy Parent Team Members Teacher Child

39 Martha Kinney, MA CCC-SLP Wendy Solomon, MA CCC-SLP Learn More at

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