Clinical Analysis PaperBriana Vincent

CSD 146Holly Koegler

4/26/13

On March 14, 2013 from 9 to 10 am in Ford Building I observed a group of

young children who were in the 5-8 year old age range, for a speech and language

session. The abbreviation for this group is ELG, stands for Early Language Group.

This session was comprised of about 6 children and three teachers that worked on

them for the duration of the session with their language and articulation of certain

sounds. During my observation I found it slightly hard to understand what the

teachers and children were saying at some points because they would divide into

two groups to work with different children at a time. There were two children that

stuck out to me the most during this session Jason and Nick (real names will not be

used in this paper). Both of these boys had trouble working on their plurals and the

g-sound that the teachers were focusing on during this session. Jason may possibly

have a mild secondary language disorder because of ADD and Nick has a mild

primary language disorder because it has some impact on his social and academic

situations but they are still able to carry on conversations and function normally in

society.

Jason and Nick while both being able to hold substantial conversations with

their teachers for their age level ranging from 6 to 8 year olds, both of these boys

faced articulation errors when speaking during this session. For example, Nick had

trouble pronouncing the /g/ sound and was told to put his tongue down on the

lower part of his mouth in order to say the words, for example, pig and go. Jason on

the other hand had trouble pronouncing the /s/ and /n/ sounds together and even

had trouble pronouncing the phrase “got it”. Another language difficulty I observed

during this session was that Nick faced problems with consonant deletion. As

mentioned above, he had a hard time pronouncing the word pig. Instead of adding

the g sound on the end he would delete the consonant completely and just say pi.

Additionally both Nick and Jason, as mentioned above were able to carry on

conversations, but sometimes while doing this experienced a few articulation errors

along the way. According the Robin Harwood during the ages from two to five the

brain prunes the neural connections that aren’t used. This as a result makes more

frequently used neural connections more complex (Travis, 2011). For example,

when language is used around a young child often their language skills will develop

at a more rapid pace because the strong connections in the brain are being utilized.

According to our book and the chart that was comprised by Brown it states that by

27-30 months of age children should be able to acquire knowledge of forming plurals (-

s) like turning shoe into shoes (Brown, 1973). Unfortunately, both Nick and Jason had

trouble accomplishing this tasks during the session. They had trouble turning words like

cat and cookie into cat(s) and cook(ies). Overall, as a result could mean that these boys

were late in developing language skills that their peers had developed at the appropriate

time.

During this clinical observation the teachers were working on the articulation of the g-

sound. When an individual faces an articulation error this means that the child (or adult)

has difficult in producing certain sounds correctly (NICHCY Disability Fact Sheet 11,

2011). Jason and Nick both had trouble producing the g sound. The g-sound along with

the k, f, t, d, and n sound are all milestones that should be reached by the ages of 2-3 in

children (American Speech-Language-Hearing Association). Another aspect about these

boys that I noticed was their difference in voices. Jason, when he would want himself to

be heard, would talk louder increasing the volume in his voice. Whereas Nick would

speak in soft monotone sentences when asked questions by his teachers. Voice is a good

indicator of how a person is feeling and can significantly convey a good amount of

information to a person about how another is feeling (RCH Speech Pathology, 2010). For

example, when Jason would raise his voice we could tell that he was extremely excited

about something and wanted to actively participate. On the other hand, it was more

difficult to tell how Nick was feeling because he had a more reserved and quiet volume

when speaking to the teachers.

As mentioned previously by 27-30 months children should be able to form

plurals without any help. For Jason and Nick this was not the case. The teachers had

to teach Jason and Nick when it was and was not appropriate to make a word plural.

It is not uncommon for children to lag behind others in the language department. 1

out of every 20 children have symptoms of a language disorder (Medline Plus,

2011). While this is true, this is not the case for Jason and Nick. These two boys have

delayed language, where they are developing language in the same way as other

children, but at a later and slower pace. Therefore, I came to the conclusion that

these children have an expressive language disorder. They both understood what

was being asked of them when doing different play therapy activities and when

talking to others, but sometimes could not form the right tenses of words or know

what correct words to utilize when trying to form a complete sentence. For example

when shown pictures of items like beach balls and cats, that had more than one of

each on their, both boys would answer with either cat or beach ball instead of the

plural form of each word.

While both of these children had difficulty with certain aspects of articulation

and language I found something different in Jason than I did in Nick. I think Jason

might have a secondary language impairment called Attention Deficit Disorder or

ADD. While observing I noticed that he interrupted the teachers when they would

be talking to the other children. Jason also would bring up other topics, like wanting

to play a game, and disregard what the teachers would be asking him in that

moment. A child with ADD will usually exhibit behaviors of hyperactivity,

impulsivity, and even inattention. These are the specific behaviors that I noticed in

Jason during my time observing. Although, in order to be diagnosed with ADD he

must have had these behaviors occur over a span of at least 6 months (Morales,

2013). Jason had difficulty listening and following directions, which is another

strong characteristic that is associated with ADD.

According to our book it stated that the best way to treat children who have

ADD is through medical or behavioral methods. I was unable to fully receive a full

diagnosis of Jason on whether or not he actually had ADD, but according to what I

have learned through our book, the teachers were using behavioral methods in

order to keep Jason calm and focused on what was going on around him. In our book

and in class we also learned that a secondary language disorder occurs as a

“consequence of another disorder (e.g. intellectual disability, hearing loss, and brain

injury) (Koelger, 2013).

Another fact that I noticed that was similar between what we learned in class

and what I observed from the session is the explanation to the children on how they

should produce the /g/ sound. The g sound is made by the dorsum of the tongue

hitting the soft palate (Koelger, 2013). What I had noticed in the session was that

the teacher told both Jason and Nick to put their tongue down in order to

successfully make this sound. Additionally, minor speech impairments were noticed

when the kids spoke. As mentioned previously, one of their articulation disorders

was the ability to effectively produce the g sound before the teachers helped them

correct it. In class it was stated that articulation errors could occur in the initial,

medial, or final positions of words (Koelger, 2013). From what I had observed this is

true because both Jason and Nick omitted the /g/ sound in pig where the g is at the

end of the word, and got it where the g is at the beginning of the word.

Overall, during the observation I got to observe how children, who may be

more difficult to deal with when trying to diagnose them or help them with their

language impediments, are treated when going to therapy. I got to see and hear first

hand how the teachers work with the children and how the children respond. I have

heard about play therapy and I was happy that I actually was able to view a session

that not only helped the children develop better language and communication skills,

but also show the interaction between teacher and student. Interestingly, I liked

how each teacher got to work with each child at least once throughout the session.

It’s vital that more than one supervisor sees these children because one adult might

see a positive or negative aspect about the child’s speech or language that the other

had missed during their time with them. Conclusively, viewing the session has

helped me further my decision about which career path I wish to take when I

graduate from college. I definitely know that I want to work with children both

hearing, deaf, and hard of hearing and help them acquire proper skills that will help

them become more successful in society because of their effective communication

skills.

Works Cited