Section 5

Question 1

What are the 4 stages of normal language development?

Answer 1

Perlocutionary: 0-9mo
Illocutionary: approx. 9mo
Locutionary: 11-13mo
1 year
2 years

Question 2

Describe the perlocutionary stage of language development.

Answer 2

Infant smiles, cries, coos (“functional communication”)
Adult responds as if this was intentional communication
3 pragmatic behaviors: eye contact, joint attention, turn-taking
Receptive: startles at loud sounds

Question 3

Describe the illocutionary stage of language development.

Answer 3

Use of gestures that become conventionalized (e.g., wave, point)
Use ‘protowords’
Protoimperative pointing: affect others behavior (e.g., hand parent a container)
Protodeclarative pointing: affect other’s attention
(e.g., point to an airplane)
Babbling (canonical, variegated, jargon-> words)
Receptive: Turns and looks in the direction of sounds.

Question 4

Describe the locutionary stage of language development.

Answer 4

First word milestone 11-13 months
“A true word has to have a ‘phonetic relationship’ to the adult word and the child must use the word a to mark a particular situation or object”
Unstable vocabulary for first 10 words (different from regression)

Question 5

What should language look like around age 2?

Answer 5

Progress from 2 word to 5-6 word phrases. Begin with
subject-verb-object structure
Brown’s stage II (27-30 months): -ing, in, on, plural -s
Understands basic questions: who, what, where (begins asking ‘why’)
Increase symbolic play -> talk about imaginary and multi-step activities (including those from the past)

Question 6

What browns stages would be expected around age 3?

Answer 6

Stage III: 31-34 months (should have developed).
Irregular past tense: me fell down
Possessive ‘s’: man’s book
Uncontractible copula: is it Alison? Yes, it is. Was it Alison? Yes, it was
Stage IV: 35-40 months (new skills).
Articles: A ball on the book
Regular past tense: she jumped
3rd person regular, present tense: the puppy chews it

Question 7

Describe the content of a 3 year old’s language.

Answer 7

Expressive:
Vocabulary expands to include new word classes (e.g., spatial terms, temporal terms)
Around 3-3.5 the semantic relations between adjacent and conjoined sentences include the following: additive, temporal, causal, and contrastive

Receptive:
Understands abstract language e.g., colors, shapes, size
Understands who, what, where, when, and why questions

Question 8

How is language used around the age of 3

Answer 8

Improved conversational skills including maintains topic approx. 50% and begins clarification speech
More language in pretend play
Beginning to lie and tease
Narratives (stories) become more complex and connected over the year (between 3-3.5 it is primitive: themes and some temporal organization)
More flexibility in requesting, including the following: Permission directives (can you…?) and Indirect requests (would you…?)
Direct requests decrease in frequency, as indirect requests increase
Around 3.5-4 new functions emerge (reporting on past events, reasoning, predicting, expressing empathy, creating roles and props, maintaining interactions)

Question 9

What stage of language might you expect to see in a four year old?

Answer 9

Brown’s stage V: 41-46+ months
3rd person irregular:
Uncontractable auxiliary: are you helping?
Contractible auxiliary: they are laughing
Contractible copula: she’s smart!

Children’s progress from elaborating noun and verb phrases to producing complex sentences through
the processes of phrasal and clausal conjoining and embedding

Question 10

Describe the content of a 4 year old language.

Answer 10

Understands comparative and superlative adjectives e.g., ‘big, bigger, biggest” and time concepts (e.g.,
yesterday, tomorrow, days of the week).
Understands and uses ‘when’ and ‘how’ questions
At 4 years children’s expressive vocabulary is 1,600 words
Knowledge of letter names and sounds emerges
Knowledge of numbers and counting emerges
Use of conjunctions when, so, because, and if

Question 11

How might a four year old use language?

Answer 11

Uses words to invite others to play and to justify requests
Follows 3-step directions without cues
Talks about imaginary conditions “I wish” or “I hope”
Ability to address specific requests for clarification increases
Narratives are “chains” with some plot but no high point or resolution

Question 12

How does language change between four and five years old?

Answer 12

Increase in figurative language, including jokes
Increase language development using explicit teaching in school and from texts (stories)
Improved language-based conversation and reasoning skills

Question 13

Define the silent period.

Answer 13

In the early stages of learning L2 most students focus on comprehension and do very little speaking
Students introduced to L2 during the preschool years may speak very little in L1 or very little in L2 for one year or more
Generally, the younger the student, the shorter the silent period
This silent period can occur at home as well

Question 14

What might you see in a child with DLD compared to normal language development (Form, content, use)?

Answer 14

Form: omitting morphosyntactic markers, forming wh- questions, understanding complex syntax
Content: poor vocab, inflexible word knowledge, trouble with verbs
Use: immature pragmatics, weak theory of mind, troupe understanding emotion and non-verbal cues.

Question 15

What are some factors that have been linked to DLD?

Answer 15

Environmental factors: can be both protective or increase risk in the face of biological risk.
Biological: differences in genetic risk and neurological structure and function associated with disorder (ex. motor cortex anomalies)
Cognitive: differences in perception and information processing associated with disorder. (e. inefficient auditory processing)
Behavioural features: overt differences in behaviour that characterize the disorder (ex. delayed language acquisition)

Question 16

What are some factors that can impact normal language development?

Answer 16

Sensory: Hearing difficulties can result in individuals receiving degraded auditory signals and therefore will produce speech that has decreased intelligibility as they have
difficulty perceiving accurate auditory signals
Motor: reduced sensorimotor interactions, fewer opportunities to interact, inappropriate device choice
Cognitive: concrete vs. abstract, reasoning skills, sequencing memory, recognizing relationships between pictures and situations, visual analogies
Environmental: poor social interactions, reduced meaningful exchanges
Cultural: handling statues, social organization, value of talk, intentionality, language learning.

Question 17

How can prematurity and low birth weight affect language development?

Answer 17

Low birth weight associated with increased risk of developmental delay
Premature infants also more susceptible to a range of illnesses and conditions that produce developmental disabilities: i.e. respiratory distress syndrome, apnea (interrupted breathing), bradycardia (low heart rate),
necrotizing enterocolitis (a serious intestinal disorder), and intracranial hemorrhage
Respiratory distress in premature babies can sometimes lead to the need for intubation and the use of ventilators to aid breathing--in a minority of cases
this can lead to bronchopulmonary dysplasia (thickening of the immature
lung wall that makes oxygen exchange difficult)
- Children who have bronchopulmonary dysplasia may require long-term tracheostomy which can then affect both speech and
language development

Question 18

How does the communication environment impact language development?

Answer 18

Being in treatment settings where infants endure painful procedures like
suctioning and intubation can lead to oral defensiveness, aversion,
trauma, or tissue damage to the larynx
Parents are not able to spend as much time with newborns who require
hospitalization and medical treatment→ fewer early interactions, compared
to parents of larger babies
Perception of child receiving treatment as weak and sick can result in less
willingness to hold, handle, and play with the child
Children who experience abuse/neglect
SES

Question 19

What might you see in a child in preschool with DLD?

Answer 19

Sentences that are short and not grammatical in his or her dialect. For example:
○ Car go
○ Me happy
○ Him running
○ She not going
○ She play last night
Difficulty following directions when not embedded in a routine.
Difficulty understanding what is being said.
Difficulty asking questions.
Difficulty finding words to express thoughts.

Question 20

What might you see in a child ages 6-11 with DLD?

Answer 20

Difficulty following multistep directions.
Difficulty producing grammatical utterances.
Difficulty writing grammatical utterances.
Difficulty with reading, writing, spelling, or math.
Unorganized stories with few details.
Limited use of complex sentences.

Question 21

What might you see in an adult with DLD?

Answer 21

Difficulty understanding complex written material.
Difficulty writing grammatically correct sentences.
Difficulty finding the right words when speaking.

Question 22

Describe the disorder, form, content, and use of: down syndrome.

Answer 22

Trisomy 21 resulting in moderate intellectual disabilities and poor exec. functioning.
Form: poor intelligibility and syntax comprehension.
Content: delay in first word, poor word learning (due to exec. function), good compensatory strategies
Use: variable pragmatics, more interactive than typical developing kids by age 2. `

Question 23

Describe the disorder, form, content, and use of: fragile X syndrome.

Answer 23

Expansion of trinucleotide (CGG) on FMR1 resulting in mild-moderate intellectual disability and poor exec. functioning.
Form: appropriate speech, phonological awareness but poor expressive and receptive morphosyntactic skills.
Content: slow vocab growth and small expressive vocabulary.
Use: impairment in pragmatics in both FXS and carriers pre-muttation, poor theory of mind.

Question 24

Describe the disorder, form, content, and use of: william’s syndrome.

Answer 24

Deletion of 25 genes on the 7q11.23 chromosome resulting in overly friendly anxious kids with mild-moderate intellectual disability and poor visual-spatial construction.
Form: delay onset of babbling and 1st word, grammatical abilities are similar to cognitive abilities.
Content: strong concrete vocab, weak conceptual vocab.
Use: very social, poor pragmatics, delayed joint attention, first words come before communicative gestures.

Question 25

Describe the disorder, form, content, and use of: ASD

Answer 25

Combination of genetics and environment results in impaired social communication and restricted repertoire of interests/behaviours.
Form: good intelligibility, poor phonological processing, deficits in morphosyntax
Content: poor vocab but highly variable.
Use: pragmatic deficits.

Question 26

Describe the disorder, form, content, and use of: hearing loss.

Answer 26

Form: babbling and morpheme acquisition is influences by access to sound, sequence of phoneme learning is typical.
Content: varies, vocab may be delayed.
Use: access to communication partners influences pragmatics, better speech perception is correlated with lower levels of loneliness.

Question 27

Describe the disorder, form, content, and use of: FAS

Answer 27

Form: Poor arctic, fluency disorders
Content: receptive language disorders
Use: poor social communication skills.

Question 28

What are some psychosocial and emotional disorders that are associated with language impairments in infants?

Answer 28

Problems with emotion and behaviour regulation (e.g. difficulty being soothed, eating and sleeping) are most common.
Physical and expressive vocabulary are associated with spoken vocabulary as early as 19 months of age.
From the preschool years, the most common diagnosis among children with language impairments in the community who are referred to speech-language and mental-health clinics is Attention Deficit (Hyperactivity) Disorder.
Language impairments do not exist in isolation and from early childhood, language development is also linked with cognition, social cognition and motor skills

Question 29

What are some psychosocial and emotional disorders that are associated with language impairments in children?

Answer 29

Language and communication impairments are consistently related to learning and psychosocial and emotional disorder from infancy to adolescence.
The prognosis is poorest for children who have difficulties in understanding language or in multiple areas of language that continue beyond the age of five years
Both genetic and environmental factors contribute to language and psychosocial and
emotional development
Children who are poor communicators do not send clear messages and therefore may be difficult to read and respond to appropriately

Question 30

What could you watch for during low-structure observations?

Answer 30

Expressive language (length of utterance, intelligibility and complexity of utterances),
fluency and grammar
Comprehensive language (is child able to respond to questions/comments, follow
directions)
Pragmatics (facial expressions, eye contact, asks for calcification, can initiate and maintain conversation)
Motor skills

Question 31

How could you assess communicative intent in children ages 18-36 months?

Answer 31

We want to evaluate communicative behavior independent of conventional language used
When assessing communicative intention think: frequency, form, function!
Between 2-3 years old children’s communication becomes more frequent,
increasingly verbal, and with a range of intentions.
Recall: proto-imperatives (get an adult to do something e.g., request an object, request action, protest), proto-declarative(get an adult to focus on an object or
event: starts with comments, by 24 months they request information, acknowledge previous utterance, and answer questions

Question 32

What assessments might we complete on a child in the perlocutionary stage of language?

Answer 32

Feeding assessment
Hearing assessment
Overall development
Parent-child communication and relationship (formal
and informal)
Vocal assessment

Question 33

What assessments might we complete on a child in the illocutionary stage of language?

Answer 33

Has the child made the jump to intentional communication?
Observation of play
Parent report instrument
Can initiation be elicited?

Question 34

What assessments might we complete on a child in the locutionary stage of language?

Answer 34

Play assessment (formal or
informal)
Relationship between use of words as labels and functional play
Receptive language assessment: Start with familiar words, be careful not to give away non-verbal cues
Communicative function
assessment: frequency, form, function

Question 35

What can you gain from a language sample?

Answer 35

Analyze sample for the number, types and consistency of errors, accurate sound production, intelligibility, speech rate, prosody and language errors
Calculate mean length of utterance (MLU) for number of morphemes/utterances and Brown’s morphological markers

Question 36

What impact might DLD have on psychosocial and educational wellbeing of a child?

Answer 36

Psychosocial: difficulty making friends and difficulties with pragmatics. “DLD cohort had significantly worse social adaptation (with prolonged unemployment and a paucity of close friendships and love relationships)”
Education and Vocation: individuals with DLD were associated with lower academic and vocational
qualifications than typical population

Question 37

How might we determine a prognosis?

Answer 37

1) The patient’s previous level of functioning
2) Current level of functioning
3) Amount of family support (i.e. family can help with homework, can monitor health concerns, etc.)
4) Amount of motivation
5) Insight into deficits
6) Any comorbidities and the severity of each

Question 38

What are some target areas for intervention relating to receptive language?

Answer 38

Receptive Vocabulary (e.g., identification, categorization, antonyms, synonyms,
associations etc.)
Receptive Grammar (e.g., plurals, pasttense, pronouns etc.)
Receptive Narrative Skills
Following Directions (length and complexity) – Working Memory
Understanding of Complex Language (e.g., inferencing, determining main idea
etc.) – Cognition

Question 39

What are some target areas for intervention relating to expressive language?

Answer 39

Mean Length of Utterance (increase in meaningful
linguistic units)
Expressive Vocabulary (e.g.,labelling of vocabulary,
antonyms, synonyms, categories, associations etc.)
Word Retrieval Difficulties
Expressive Grammar (e.g., plurals, past tense,
pronouns etc.)
Expressive Narrative Skills
Use of Complex Language (e.g., metaphor, humour, negotiation etc.)

Question 40

What might intervention look like for a child in the perlocutionary stage?

Answer 40

Rich - tactile, visual, auditory, kinesthetic
Providing enriching and
responsive communication
TIPS - Take turns, Imitate, Point things out, Set the stage
Developing self-monitoring
skills
Using songs and rhymes especially those with actions

Question 41

What might intervention look like for a child in the illocutionary stage?

Answer 41

Work closely with parents
Communication temptations
Parent scaffolding
Pairing words with actions or objects
Use of books (early literacy)
Baby games and routines
AAC can be introduced (i.e.
PECS)
Use of songs, books, toys and routines
Observe the child's interests
model and wait
Scaffold the language
Lots of repetition and routine

Question 42

What might intervention look like for a child in the locutionary stage?

Answer 42

Hanen parent training program:
- Important not to make parents feel that the delay is their fault
Hybrid:
- Prelinguistic Milieu Teaching Methods
- Principles: follow the
child’s lead, use social
routines, provide positive
feedback, time delay
prompts, imitate and
model
Child focussed:
- Do not respond to the use of gestures or vowel sounds, provide specific models for early words and respond
when they use consonant sounds or words.
- Use language that says you
understand what the child meant and need them to show you by x (e.g.,
gesture or word)
Strategies include:
- Routines or script therapy (May promote generalization to everyday use)
- Using funny or unusual events
*Strategies may depend on your goal:
- Building receptive or expressive vocab -> focussed stimulation
- Building expressive or receptive phrase length -> imitate and add

Question 43

What should be considered when choosing target words?

Answer 43

The more familiar, the better
Use a variety of word categories (nouns, verbs, adjectives)
Consider the sound and syllable complexity of the word, as well as the child’s interests

Question 44

Describe the cueing hierarchy.

Answer 44

Imitation: direct, delayed
Choice: of incorrect and correct, varied presentation
Repetition up to error: with verbal and visual cues, with visual cues only, w/o verbal or visual.
Repetition of error: with questioning intonation, with statement intonation
Pardon