communication disorders

Title, EditionISBN

© 2009 Pearson Education, Inc.All rights reserved.

Exceptional Children: An Introduction to Special Education, 9th EditionISBN 013514454X

© 2009 Pearson Education, Inc.All rights reserved.

Chapter 8Communication Disorders

© 2009 Pearson Education, Inc.All Rights Reserved.2

Exceptional Children: An Introduction to Special Education, 9th EditionHewardISBN 013514454X


Focus QuestionsHow 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?




Focus Questions Continued 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?

Key Terms and ConceptsDefinitions: Communication Impairment, Definition and Examples of Receptive and Expressive language (disorders), Dysphonia, Aphasia, Phonology, Morphology, Semantics, Pragmatics, Articulation, Dysarthria, Syntax, Speech, Voice disorders, etc.

Treatments for voice disordersAugmentative and Alternative communication Definition, components, how to select vocabularyPECsTypes of speech and language disorders. Definitions, how to correct, examplesASHA, MonitoringTeacher tips

When does a child get special ed services – disability adversely impacts educational performance




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 Involves two participants acting as senders and

receivers




Definitions (cont.) Functions of communication

Narrating Telling of a story Sequence of related events connected in an orderly, clear and

interesting way Explaining/informing

Interpreting explanations of others Who? What? When? Where? Why? How?

Requesting Communicate wishes and desires to others in socially appropriate

ways More likely to get what they want in a socially positive way, less

likely to engage in inappropriate behaviors Expressing

Express personal feelings and opinions and respond to the feelings of others

Children develop a sense of self and an awareness of others




Definitions (cont.) Communication is made up of two

parts:

Language Speech




Definitions (cont.) Language is a formalized code that a group of people use

to communicate with one another The five dimensions of language: Form

Phonology - Rules determining how sounds can be sequencedMorphology - Rules for the meaning of sounds

Free morphemes - can stand alone in meaning Bound morphemes - do not carry meaning by themselves

Syntax - Rules for a language’s grammar Content

Semantics - Rules for the meaning of words and combinations of words

UsePragmatics - Rules governing the social use of language




Phonology (letter sounds) Linguistics rules governing a

language’s sound system Describe how sounds can be sequenced

and combined English language uses 45 different

sound elements called phonemes Example: pear/bear The phoneme sound /p/ changes the

word from being a fruit to a large animal




Morphology (words) The basic units of meaning and how those units are

combined into words Morphemes- the smallest element of language that

carry meaning, can be sounds, syllables or whole words

Free Morphemes- can stand alone (ex. Fit, slow) Bound Morphemes- do not carry meaning by

themselves, grammatical markers that change word meaning when attached to morphemes (un- to make unfit; -ly to make slowly)

The word baseballs consists of two free morphemes (base and ball) and one bound morpheme /s/




Syntax (grammar) System of rules governing the meaningful

arrangement of words into sentences (Grammar) If morphemes could be strung together in any order,

language would be an unintelligible tangle of words Syntactic rules are language specific (Japanese and

English have different rules) Specify acceptable relationships among the subject,

verb, object and other sentence elements The meaning of the sentence is derived from the

sequence of the words in the sentence. Example:

Help my chicken eat. Help eat my chicken.




Semantics (word meaning) Has to do with the meaning of words and

combinations of words Vocabulary and concept development, connotative

meanings by context Being able to use words correctly according to their

meaning It is cold outside. (air temp.) She is acting very cold towards me today. (mood)

Being able to categorize words Collies and beagles are types of dogs

Being able to make relationships between words Warm and hot are synonyms (mean the same) Warm and cold are antonyms (mean the opposite)




Pragmatics Rules governing how spoken language is used to

communicate (culture specific) Using language to achieve various communicative

functions and goals Greetings, information, demands, promising, requests

Changing language according to the conversational context

Talking differently to a baby than to an adult, giving background information to an unfamiliar listener, speaking differently in a classroom than on a playground

Following rules for conversations and storytelling Taking turns, staying on topic, rephrasing when

misunderstood, proximity when speaking to someone, facial expressions and eye contact




Review A child named Yoda who grew up in the U.S. and

learned English has trouble putting words in the correct order when he speaks. His sentences often sound like this, “Afraid of the dark, I am.”

Yoda is having trouble with which dimension of language?

A. MorphologyB. PhonologyC. SyntaxD. Semantics




ReviewDimension of Language Definition

Phonology Grammar

Morphology Word meaning

Syntax Language’s sound system

Semantics How language is used to communicate

Pragmatics Language’s units of meaning

Match the dimension of language with its definition.




CheckDimension of Language Definition

Phonology Language’s sound system

Morphology Language’s units of meaning

Syntax Grammar

Semantics Word meaning

Pragmatics How language is used to communicate




Definitions - Speech Speech is the oral production of language Vehicle for expressing language Fastest most efficient method of communication by language

Speech sounds are the product of four related processes: Respiration - Breathing that provides power supply for speech Phonation - Production of sound when the vocal folds of the larynx are drawn together by the contraction of specific muscles, causing the air to vibrate (muscles) Resonation - Sound quality shaped by the throatArticulation - Formation of recognizable speech by the mouth, and sometimes nasal cavities - recognizable speech sounds by the tongue, lips, teeth, and mouth




Speech




Normal Development of Speech and Language

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 normal language development can help determine whether a child is developing language at a slower-than-normal rate or whether the child shows an abnormal pattern of language development




Communication Disorders Defined

American Speech-Language Hearing Association definition An impairment in the ability to receive, send, process,

and comprehend concepts of verbal, nonverbal, and graphic symbols systems

A communication disorder may be evident in the processes of hearing, language, and or/speech




Communication Disorders Defined

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

Vary widely by degree and severity Child cannot make themselves understood or

cannot comprehend ideas that are spoken to them by others - impacts learning and interpersonal relationships




NJAC 6A:14 Definition "Communication impaired" corresponds to "communication handicapped" and

means a language disorder in the areas of morphology, syntax, semantics and/or pragmatics/discourse which adversely affects a student's educational performance and is not due primarily to an auditory impairment. The problem shall be demonstrated through functional assessment of language in other than a testing situation and performance below 1.5 standard deviations, or the 10th percentile on at least two standardized language tests, where such tests are appropriate one of which shall be a comprehensive test of both receptive and expressive language. When the area of suspected disability is language, assessment by a certified speech-language specialist and assessment to establish the educational impact are required. The speech-language specialist shall be considered a child study team member.

i. When it is determined that the student meets the eligibility criteria according to the definition in (c)4 above, but requires instruction by a speech-language specialist only, the student shall be classified as eligible for speech-language services.

ii. When the area of suspected disability is a disorder of articulation, voice or fluency, the student shall be evaluated accordingly and, if eligible, classified as eligible for speech-language services according to N.J.A.C. 6A:14-3.6(a).




ReviewIn order for a student to be considered for special education services, the disorder must:

A. effect them at homeB. effect them in schoolC. effect them at home and in schoolD. effect them before age 3




Speech Impairments Considers speech to be impaired when it

deviates so far from the speech of other people that it: Calls attention to itself Interferes with communication Provokes distress in the speaker or listener

Its important to keep student’s age, education and cultural background in mind when determining a speech impairment Age 4 “pwease weave the woom” (not a speech

impairment)




Speech Impairments and Language Disorders

Types of speech impairments Articulation disorders Fluency disorders Voice disorders




Speech-Sound Errors Distortions

Sounds more like the intended phoneme than another speech sound, but is obviously wrong; can be misunderstandings, but teacher and parents get used to them

/s/ in sleep- “schleep”, “zleep” or “thleep”

Substitutions Substitutes one sounds for another; speaker

is sure they have said the word correctly; cause confusion to the listener

says “train” for crane; says “doze” for “those”




Speech-Sound Errors Omissions

Omit certain sounds; drop consonants for from the ends of words, makes speech intelligible

says “cool” for school; says “pos” for post

Additions Addition of extra sounds makes

comprehension difficult Says “buhrown” for brown; says “hamber” for

hammer




Articulation Disorders Child is not able to produce a given sound

physically with the use of the tongue, lips teeth and mouth

Child pronounces so many sounds poorly that peers cannot easily understand

“yeh me yuh a da wido”… Let me look out the window




Letter Sounds Age Pronounced by 90% of Girls

Age Pronounced by 90% of Boys

d 3 years 3½ years

g 3½ years 4 years

initial j 4 years 5 years

voiced th 4 ½ years 7 years

th 6 years 8 years

l 5 years 6 years

ch, dz,sh, and final l

6 years 7 years

From Speech and Language Impairments Assessment and Decision Making Technical Assistance Guide. Services for Students with Speech and Language Disabilities, based on The Iowa Articulation Norms and It’s Nebraska Replication. http://dpi.wi.gov/sped/speech.html

Letter Sound Pronunciation Differences Between Boys and Girls




Phonological Disorders Has ability to produce a given sound

and does so correctly in some instances but does not produce the sound correctly at other times

May affect academic areas, especially in reading

Must determine whether problem is with articulation or phonology




Articulation Vs Phonological DisorderArticulation Disorder Phonological Disorder

Difficulty with a few sounds, limited effect on intelligibility

Consistent misarticulation of specific sounds

Sound errors are motoric

Co-existing communication disorders possible but not as likely as with phonological disorders

Multiple sound errors with obvious impairment of intelligibility

Inconsistent misarticulation of sounds

Can motorically produce sounds, but not in appropriate places

Errors consistent with phonological process (final consonant deletion, produce sound correctly in one word, but not in a specific position in another word, pronounces “t” in “post”, but not in the word “time”

Other language delays likely because phonology is a component of language




ReviewWhich parts of the body are needed to “articulate” a word?

A. mouth, lips, teeth and tongueB. mouth, lips, teeth and noseC. mouth, lips, teeth and eyesD. mouth, lips and teeth only




Fluency Disorder Interruption in the flow of speaking

characterized by atypical rate, rhythm and repetitions in sounds, syllables, words and phrases

Examples: Stuttering Cluttering




Stuttering Rapid-fire repetitions of consonant or vowel sounds,

especially at the beginning of words, prolongations, hesitations, interjections and complete verbal blocks

Situational in that appears to be related to setting or circumstances of speech Ex: stutter when speaking with someone important,

called on to speak in front of a class Begins between ages 2 and 5, most before age 10 More common among males than females

Teachers should pay attention to what the child is saying, don’t finish sentences, don’t tell the child to start over.




Stuttering Stuttering Foundation Web Site http://www.stutteringhelp.org/Default.aspx?tabid=535Stuttering: Straight Talk for Teachers (by students) http://www.stutteringhelp.org/content/stuttering-straight-talk-teachers Stuttering for Kids, by Kidshttp://www.youtube.com/watch?v=Po-WMo8vXRYKids Talk About Stuttering http://www.youtube.com/watch?v=2Jk3AtlfWKQOnline video – new technology to reduce stutteringhttp://www.youtube.com/watch?v=HuO3DbnQjxE

http://www.stutteringhelp.org/Default.aspx?tabid=535

http://www.stutteringhelp.org/content/stuttering-straight-talk-teachers

http://www.stutteringhelp.org/content/stuttering-straight-talk-teachers

http://www.youtube.com/watch?v=Po-WMo8vXRY

http://www.youtube.com/watch?v=2Jk3AtlfWKQ

http://www.youtube.com/watch?v=HuO3DbnQjxE




Cluttering Speech is rapid with extra sounds or

mispronounced sounds Speech is garbled to the point of

intelligibility Usually improved by monitoring speech




Cluttering

CLUTTERING – audio onlyhttp://www.mnsu.edu/comdis/isad8/papers/dewey8.html

Videohttp://www.youtube.com/watch?

v=2AFygz-bxwQ

http://www.mnsu.edu/comdis/isad8/papers/dewey8.html

http://www.mnsu.edu/comdis/isad8/papers/dewey8.html




Voice Disorder Abnormal production and/or absence of vocal quality, pitch,

loudness, resonance, and/or duration which is inappropriate for an individual’s age and/or sex

Dysphonia – poor or unpleasant voice quality Phonation disorder- voice sounds breathy, hoarse, husky or

strained most of the time, sometimes no voice at all Can have an organic cause (growths on vocal cords) Usually from abuse of the vocal cords

Resonance disorder- too many sounds coming out through the air passages of the nose (hypernasality-sounds like talking through the nose), or not enough resonance in the nasal passage (hyponasality-sounds like constant stuffy nose)

Can be organic in nature also Or learned speech patterns or behavior problems




Language Impairments Language Impairments

Can effect one of the five dimensions of language: phonology, morphology, syntax, semantics, pragmatics

Receptive language disorder- Children who have difficulty understanding language

Trouble understanding spoken sentences or follow a sequence of directions

Expressive language disorder- Children who have difficulty producing language

Limited vocabulary, uses incorrect words or phrases, may not even speak at all, communicates only through gestures




Language Impairments

Language delay- child is slow to develop linguistic skills but acquires them in the same sequence as other typically developing children do

Language disorder- disruption in the usual rate and sequence of specific emerging language skills Ex. Student has trouble with answering who,

what, when questions but other areas of language are fine.

Usually have trouble socializing, reading and writing

Communication differences are not disorders The way each of us speaks is the result of a complex

mix of influences




Communication Differences Are Not DisordersDialects 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




ReviewWhich is the best example of receptive language disorder?

A. a child cannot express their ideas orallyB. a child cannot ask for what they needC. a child cannot tell his mommy what he did in schoolD. a child cannot understand his mom’s command to give her something




PrevalenceAbout 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 boysThe percentage of children with speech and language disorders decreases significantly from the earlier to the later school grades




Causes of Speech Disorders

Cleft palate Paralysis of the speech muscles Absence of teeth Craniofacial abnormalities Enlarged adenoids Traumatic brain injury Dysarthria – (more detail, next slide)




Dysarthria Group of speech disorders caused by

neuromuscular impairments in respiration, phonation, resonation, and articulation

Lack of precise motor control need to produce and sequence sounds causes distorted and repeated sounds

May be present with Intellectual Disabilities or cerebral palsy

Talking with Dysarthia-Intermittent - #1 http://www.youtube.com/watch?v=DHoRMmFswB0&feature=related




Causes of Language Disorders

Developmental and intellectual disabilitiesAutismTraumatic Brain InjuryChild Abuse and NeglectHearing LossStructural Abnormalities of the speech mechanismAphasia (more detail, next slide)GeneticsEnvironmental Influences




Aphasia Loss of speech functions. Loss of ability to

process and use language Most often to occur in adults, typically after

a stroke Occurs in children with head injury Can affect expressive (common) or receptive

(less common) language Mild aphasia- have trouble recalling words Severe aphasia- marked reduce storehouse

of words and language forms




Review

Dystharia is _______ in nature.

A. neuromuscularB. neurodevelopmentalC. psychologicalD. social




Review

Aphasia is a the loss of ability to _____ and ______ language.

A. process and hearB. process and recallC. process and useD. process and articulate




Identification and Assessment 290-293 Communication disorders are usually first identified by teacher observations Evaluation components

Case history Birth and developmental history (first walk/talk)

Physical examination Articulation test

Assess speech errors Hearing Test Phonological awareness

Ability to tell the differences between sounds Vocabulary and overall language development tests Assessment of language function Language samples

Look at dimensions of language with structured tasks Observation in natural settings




Language Function (294)

•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




Interventions Across Communication Function (295) Include a test of language function Establish intervention priorities Implement an intervention program Track skill acquisition Practice and generalizationFor students whose first language is not English, include assessments of basic interpersonal communication skills and cognitive academic language proficiency




Educational Approaches Treating Articulation Errors

Discrimination Activities Designed to improve the child’s ability to listen carefully and detect the

difference between similar sounds (ex. /t/ in take and /c/ in cake); differentiate between correct and distorted speech sounds; match speech of a standard model using auditory, visual and tactile feedback

http://www.youtube.com/watch?v=LO6z0uMLY_I

Production Activities Ability to produce a given speech sound alone and in various contexts Therapy emphasizes repetitive production of sounds Model how to produce sound, then have student practice in a mirror Go from simple sounds to complex sentences Practical magic for /s/ http://www.youtube.com/watch?

v=k1juKhiqReU&feature=related




Educational Approaches Treating Phonological Errors

Help child identify the error pattern and gradually produce more linguistically appropriate sound patterns

Sounds are not taught in isolation; student can often produce sounds

Ex. Omits final consonants Teach to recognize the different between words with

word cards- sea, seed, seal, seam, seat Have student give you the card with the correct word “give me the seal card” Forces student to attend to the final consonant Speech Sound discrimination

http://www.youtube.com/watch?v=lHGHwnAJPsI




Educational Approaches Treating Fluency Disorders

May learn to manage speech by deliberately prolonging certain sounds, or by speaking slowly to get through a “block”

Behavioral principals Sees stuttering as a learned behavior Goal is to replace it with encouraging fluent

speech Lidcombe Program:

http://www.youtube.com/watch?v=hTpYlNpnNXs&feature=related






Educational Approaches Treating Voice Disorders

Medical Surgery can treat organic causes

Direct Vocal Rehabilitation Exercises to increase breathing capacity,

relaxation techniques Behavioral

Break patterns Self monitoring

Environmental Use of a microphone if speaking in a noise

setting




Educational Approaches Treating Language Disorders

Pre-communication Activities Connect Oral Language with Literacy Vocabulary Building Naturalistic Strategies

Teach when the child is interested Teach what is functional for the student in the

moment Stop while both the student and the teacher

are still enjoying the interaction




6 Strategies for Increasing Naturalistic Opportunities for Language Teaching

(300)

Interesting Materials Out of Reach (need to ask for item) Inadequate portions (didn’t receive something

needed to do activity/assignment) Choice-making Assistance Unexpected situations




ReviewMedical, Behavioral, and Environmental educational approaches can be used to treat:

A. Language DisordersB. Voice DisordersC. Speech-Sound DisordersD. Fluency Disorders




Augmentative and Alternative Communication (AAC)

Refers to a diverse set of strategies and methods used to assist individuals who cannot meet their communication needs through speech or writing

AAC entails three components: p 301,304 A representational symbol set or vocabulary

(representational set) A means for selecting the symbols A means for transmitting the symbols

SMART 128 http://www.youtube.com/watch?v=_JKPdMn91cw




Http://www.youtube.com/watch?v=dKc1Ss5d1Nw&feature=related

http://www.youtube.com/watch?v=E2LnUxFAaMQ&feature=related

Proloquo2go




AAC Continued When selecting what representational

symbol set or vocabulary to include, must take into account: Vocabulary that peers in similar situations

and settings use What communication partners (teachers,

parents) think will be needed Vocabulary the student is already using in all

modalities Contextual demands of specific situations

Do not consider whether the child can pronounce the word




AAC Continued Symbol Set and Symbol System

Choose or develop a collection of symbols to represent the vocabulary

Many sets already exist Oakland Picture Dictionary Picture Communication System Pictogram Ideogram Communication Symbols Blissymbolics




AAC Continued Student selects the symbol by”

Direct selection- points to symbol from a varied selection

Scanning- present items one at a time, user responds when wants one

Encoding- giving multiple signals to indicate location of the symbol or the item

Symbols sorted by color and numbers Child chooses the color, then chooses the

number




AAC Continued Transmitting the symbol:

Communication boards Electronic devices

Switches Computerized speech Dynavox




Using PECS To Teach Functional Communication Skills (302-303)

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

Dynavox




ReviewYou are choosing items to include in a child’s AAC device. The child can pronounce the words “hello”, “mommy” and “bye”.Which set of words should be included in the AAC.A. mommy, daddy, sisterB. hello, good night, good morningC. eat, food, yummyD. bye, day, good




ReviewYou are instructing a teacher on what to include in a student’s AAC. What should you be sure to go over with the teacher.

A. selecting an instructional set of vocabularyB. how the student will select the word on the AACC. how the student will transmit his responseD. all of the above




Educational Placement AlternativesThe vast majority of children with speech and language impairments are served in general education classroomsSome examples of service delivery models:

Monitoring Pullout Collaborative consultation Classroom or curriculum based Separate classroom Community-based Combination




Monitoring The speech language pathologist

checks on the students progress just before dismissing them from speech therapy

Normally performed in naturalistic environments (classroom).

Expectation of ASHA




Tips for Teachers Ways to support students with language disorders

Thoroughly explain new vocabulary Embed new vocabulary across the curriculum Provide longer wait time Break multi-step directions into smaller components Do not confuse typical speech-sound development with

serious articulation errors Consult with your school’s SLP if you have a hard time

understanding a child’s speech Consistently model a relaxed and unhurried speaking

style Don’t anticipate what the student wants to say and finish the

utterance for him/her Ask the student what strategies he/she used to speak more

fluently.




ResourcesLinda C. Schrenko. Speech-Language Impairment - Accommodations http://teacherweb.com/ON/JohnMcGregorSecondarySchool/LearningandEnrichmentCentre/modificationlangimpair.pdf

The Stuttering Foundation http://www.stutteringhelp.org/

Speech vs. Language: What’s the Difference? http://www-tce.stjohns.k12.fl.us/teachers/butlera/Speech%20&%20Language.pdf

Speech and Language. National Data on Speech and Language http://dpi.wi.gov/pld/pdf/ysn-08.pdf

Speech Easy device http://www.speecheasy.com/?mm_campaign=5261d1f6e8520bd432d311604ed8043c&mm_replace=TRUE&gclid=COCdz7TXmrYCFYdlOgodBx0Abg

communication disorders

Education

pearson education

special education

definitions communication

edition isbn

desires communication

communication impairment

edition heward isbn

expressive language