3/5, 3/12, 3/14, 3/18- Language Impairments 2 Flashcards
(100 cards)
1
Q
What percentage of late talkers have persistent language problems?
A
- 40-50% (Might be later diagnosed as SLI)
2
Q
Is it difficult to predict future language problems based on early delays/late talking?
A
Yes it is, regardless of the severity of the delay
3
Q
For people who do catch up after being a late talker, are they often easy to distinguish from others?
A
No, they are often hard to distinguish, even at age 4
4
Q
What is a cause for late talking?
A
May likely be environmental in origin
—poverty, homelessness, etc.
5
Q
What can help late talkers improve their language skills?
A
- SLP services
- Suggestions for home can help.
6
Q
What does SLI stand for?
A
Specific Language Impairment
7
Q
What is SLI usually about?
A
Syntax and Morphology
8
Q
Is an LLD or SLI more involved?
A
LLD
9
Q
What does LLD stand for?
A
Language Learning Disability
10
Q
What are some features of a LLD?
A
- Language is getting in the way of the child being able to learn in school
- child might be in a special Day classroom
- child might be receiving special services
- Dyslexia
11
Q
SLI has significant limitations in what?
A
language functioning not attributed to:
- hearing
- oral function, or
- intelligence
12
Q
What percentage of children may be “late” (Language Delayed) with language development by 2 years?
A
10-15%
13
Q
Do children outgrow SLIs?
A
Yes, they seem to.
14
Q
(Of the percentage of children who may be “late” with language development by 2 years) What percentage of SLI children have language problems persisting into school?
A
20-50%
15
Q
True or False…SLI and LLD can be life long problems?
A
True
16
Q
Is SLI a primary or secondary disability?
A
Primary
17
Q
Is LLD a primary or secondary disability?
A
Secondary
18
Q
What percentage of Kindergarteners are in the SLI category?
And how many will continue to have difficulty with language as adolescents?
A
About 7.4%
2/3 of these kindergarteners will still have difficulty with language as adolescents
19
Q
True or False….SLI children do not have the perceptual difficulties of kids with LD and they won’t be dx with a language learning disability.
A
True- They do not demonstrate the perceptual difficulties of LD (learning disabled) or the intellectual difficulties of ID (Intellectually Disabled). Their cognition is good. They don’t have the cognition issues that LD kids have
20
Q
When the verbal IQ score is low and the non verbal score is normal does the child have an IQ problem or a language problem?
A
Language Problem
**Like LLD, language performance scores are lower than intellectual performance scores on nonverbal tasks: Nonverbal IQ usually above 85 and a low verbal IQ.
21
Q
Why is it difficult to dx SLI?
A
it usually is characterized by the exclusion of other disorders
22
Q
How is SLI defined?
A
Some suggest that it is not a distinct disorder, but is merely a category of children with limited language difficulties resulting from genetic and/or environmental factors combined.
23
Q
What impairment may appear delayed in one aspect of language (usually “Form”-syntax/morphology)?
A
SLI
24
Q
True or False- If dx with SLI, a child will catch up without intervention
A
False
25
True or False- With SLI, expressive abilities are usually below receptive
True
26
What are some characteristics of behavior at school with SLI kids?
- Perceived more negatively by teachers and peers
- Behavior problems emerge
- Take minor roles in cooperative learning because they contribute little
- Later in school self-esteem becomes affected
- Self perception decreases with regard to school and social abilities
27
What are some language characteristics for SLI?
- May be primarily receptive or expressive or a combination
- Different aspects of language affected—although language form (syntax/morphology) stands out
- These characteristics change as child matures, and it could be a lifelong problem
- Early language skills that affect later reading and writing are affected
- You need to have good syntax and morphology understanding to comprehend what you are reading
- Oral errors appear in writing
- writing will be missing correct verbiage, struggling to come up with a cohesive sentence, lots of erasing
- these kids have trouble learning the rules of language, using learned language in different contexts, and using word associations to increase vocabulary (double edged sword) (vocab and morphology help each other along)
- morphology and phonology rules are not learned and applied correctly and vocabulary does not develop
- Pragmatics problems develop because of difficulties with language use.
28
What percentage of SLI kids also have a reading disability?
50%-75%
29
Is SLI a reading disability?
No
30
What does SLI look like in regards to semantics?
- slow vocabulary growth and lexical errors
- Less able to recognize physical features (color, size, and shape), thematic elements within a topic (throw, hit, catch go with game), and/or causation (who caused something, who or what received something)
- New words are not learned and stored quickly
- Naming difficulties secondary to less elaborate storage of words
- This builds on itself—vocabulary growth builds on comparison to previous learning and repeated exposure to terms
31
What does SLI look like in regards to Syntax/Morphology?
- Fewer morphemes used correctly, affecting verb endings, auxiliary verbs, and articles and prepositions.
- Morphemes themselves receive little stress in speech.
32
What is a hallmark marker for SLI?
Morphology errors.
33
What are examples of grammatical morphological errors with SLI?
- Past tense, the verb “to be.”
- Late appearance of past tense –ed is a hallmark.
- Pronoun errors are common because they tend to overuse one form (“he” or “she”)
34
What does SLI look like in regards to phonology?
-Vocalize less, have less mature syllable structures
- can do some of the basic things, can produce all of the sounds but phonological system is weak if we tax it
-Poor non-word repetition (biledodge, viversumouge)
• non-words: they learn to move their articulators, hear everything and put it together (the sounds are within the rules), isolates/tests working memory, not aided by top-down processing
35
What does SLI look like in regards to comprehension?
- Poor discrimination of units of short duration like bound morphemes (plural endings, etc). (hallmark)
- i.e.- knowing the tenses
- Ineffective sentence comprehension
- Reading errors are often not related to the text in terms of actual decoding or meaning has to do with overall discrimination.
* * He said this was a bad bullet point**
- Series of events presented visually or verbally are difficult to reconstruct (like event retell or story retell)
- i.e. sequencing
36
Which disorder has a deeper perceptual problem?
LLD
37
What is the difference between reception and perseption?
reception- Can see and hear
perception- can't process the information correctly & is the information being processed like other individuals.
38
How does SLI look in regards to pragmatics?
- May act younger than age (poop example….)
- Less flexible with language use and don’t understand communication breakdowns
- Trouble getting a turn to speak
- Inappropriate responses to topic
- Difficulty initiating a conversation
- Incomplete, confusing narratives
- Failure leads to decreased social interaction
39
What are the social effects of SLI?
Less likely to interact
- Less successful at play interactions-particularly if expressive language is significantly affected
- Fear of approaching others
- Reticence
- Often ignored by peers which leads to decreased interactional opportunities
- SLI + social skills problems=3X more likely to be victimized by peers (this is a big one!)
- By Junior High, these kids perceive themselves negatively scholastically and socially
40
Is it easy or difficult to determine the causal factors for SLI?
Difficult
41
What are the biological casual factors for SLI?
- Neurological disorder suggested:
- brain asymmetry/different patterns of brain activation
- Strong familial connections: 60% with SLI have an affected family member, 38% have an affected parent
- Pre-term births: Sizeable minority born at 32 weeks or less are at considerable risk.
42
What are the social-environmental casual factors of SLI?
- (While no one has suggested this is a cause) there is evidence that parental interaction with SLI children is decreased.
- parents might become discouraged when child doesn't respond and stops interacting with the child altogether.
- an effective language learning technique
43
What is a GIVEN social-environmental causal factors for SLI?
- neglect
- stimulation in the environment
- Locke said stimulation denied is grammar denied
44
what is a recast study?
looking at parents taking opportunities to expand on, modify, or restate a child’s utterance—an effective language learning technique.
* often parents don't do this when they don't get feedback from child and stop interacting with them.
45
what are the casual factors for Processing Factors--Executive function weaknesses?
* this card needs to be DUMBED DOWN!!! (slide #23)
- reduced processing and storage of phonological information (the building blocks) leads to inefficient recognition of different words, ability to produce nonsense words, etc., inefficient word learning, slow word recognition, ineffective comprehension of sentences. Problems with incoming info, with memory, and with transfer.
- Phonological Awareness difficulties are not as profound as those with Dyslexia
- Working memory deficits restricts information processing (difficulty comprehending longer and more complex utterances-Imagine having a rapid conversation with weak working memory. You can’t keep up—keep losing information as more comes in. Can’t relate new information to processed old information. Think about your experiences with other languages……). Orient more slowly to information, have more limited capacity to focus and refocus and shift focus
46
What are intervention strategies that can be used for SLI? And whicih are traditional vs. functional?
- Naming letters and objects (traditional)
- Recalling spoken sentences (traditional)
- Using melody as a memory aid (functional)
- Listening to and repeating stories (storyboard) and nursery rhymes (Dr. Seuss…..) (traditional)
- Acting out pictures and rhymes (functional)
- Using gestures to aid in recall (functional)
- Repeating novel and “nonsense” words (gets at phonology) (“gobstopper”) (traditional)
- Verbal rehearsal (a stick of butter, a pint of milk,….) (functional)
- Categorization games with words and objects (Matching games with picture cards/objects, Guess who, etc.) (traditional)
47
What is LD vs. LLD (what do they stand for?)
- Language Learning Disability (LLD)
| - Learning Disability (LD)
48
What is the definition for LD (Learning Disability)
- Significant difficulty in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities (across the board)
- Intrinsic to the individual, presumed to be related to CNS dysfunction
- May occur across the lifespan
- LDs may occur concomitantly with other “handicapping” conditions or with other outside influences. They are not the result of those conditions or influences, however.
- The definition assumes that the cause of LD is not environmental or caused by other accompanying conditions
- (in a nutshell) It is assumed that these children have normal or near normal intelligence
- A gap exists between ability and achievement in some area
(i. e. IQ 89, Reading 64, Math 82, Writing 65, Language 62. Math problems on exam may have been word problems. LD - normal IQ with discrepancies. Is language at the root or a big part of this LD?)
49
What are characteristics are associated with children with LD: “there are many and varied”
Six categories of characteristics associated with LD
- Motor
- Attention
- Perception
- Symbol**** (pay particular attention to this category)
- Memory
- Emotion
50
True or False- SLI can have weaknesses across systems of lanuage, but most profound are syntax and morphology?
True
51
True or False- LLD is part of a learning disability?
True
52
what characteristics do we see with LLD kids?
- will see some or all of these 6 categories demonstrating weakness, for sure perception and symbol (especially symbol);
- deficits in all systems of language, not just syntax and morphology
53
What is a Language Learning Disability (LLD)?
- Most children with LD do not have all of associated characteristics (Motor, Attention, Perception, Symbol, Memory, Emotion)
For example:
- 15% have difficulty with motor learning and coordination
>75% have difficulty learning and using symbols—Some professionals consider this group to have a language learning disability
54
What is language all about?
Symbols
55
True of False: majority of learning disabilities have a language componant?
True
56
When an SLP asks the questions...is the language problem getting severe enough to impact academics, what are they referring to?
SLI becoming an LLD but in the field they don't use these labels. (except in research)
57
Of the characteristics associated with LD what does motor look like?
- Usually involves hyperactivity
- overactivity characterized by constant motion.
- Can lead to short attention/concentration span.
- About 5% of children have hyperactivity. Nine times as prevalent in boys.
- Not all kids with hyperactivity have LD.
- Not all kids with LD have hyperactivity.
- poor sense of body movement,
- poorly defined handedness
- poor hand-eye coord.
- poorly defined concepts of space and time (all over the place)
58
Of the characteristics associated with LD what does attention look like?
- Short attention span and inattentiveness
- Easily distracted by irrelevant stimuli and easily overstimulated
- Affects ability to learn and organize life
- Perseveration often is present—repeat utterances over and over, appear unaware.
- NOT to be necessarily confused with a diagnosis of ADHD
59
What is perseveration?
Focused on one this over and over again (repeating that one thing again and again)
60
How is ADHD characterized?
- ADHD itself is characterized by overactivity/inability to attend for increased periods of time, BUT without many of the associated difficulties of LD.
- It is most likely linked to an Executive Functions impairment of the brain in the area that regulates behavior—particularly impulsivity.
61
Of the characteristics associated with LD what does perception look like?
- Different from reception
- USUALLY COMPROMISED IN LLD!!! (Not as severe in SLI)
- LD is not equal to a sensory or reception disorder.
- May have any of the following:
- Perceptual difficulties=interpretational difficulties: Occur after the stimuli are received.
- confusion of similar sounds and words/Similar printed letters and printed words
- Difficulty with figure ground perception (isolate an auditory stimulus against background noise)
- Sensory integration difficulties. Ability to make sense of visual and auditory stimuli occurring at the same time. Gestures, facial expressions, body language, intonation, and verbal language work together to convey information. Each alone is not enough to convey info.
62
Of the characteristics associated with LD what does memory look like?
- If it's an LLD this is big!
- Short and long-term storage and retrieval
- These kids often have difficulty remembering directions, names, and sequences.
- Word finding problems are common.
i.e. - Think back to information processing/executive functions
63
Of the characteristics associated with LD what does emotion look like?
- Emotional problems may accompany LD, but are not causal (unless something caused it i.e. witnessed murders, etc.)
- Often reaction to or accompany frustration related to situational difficulties
- Common descriptors: Aggressive, Impulsive, Unpredictable, Withdrawn, Impatient
- May demonstrate poor judgment, unusual fears (Owen’s example of shoes), or adjust poorly to change
- May be overly dependent on routines when language interpretation is required
64
Of the characteristics associated with LD what does symbol look like?
- All aspects of language—spoken and written—are affected (often the case with LD—75%)
- The difficulties are perceptual. Language perception, not reception (sensory)
- Even though these kids play TV/Radio loudly, squint and rub eyes when reading, etc., or have concomitant hearing or vision problems, the problem is not sensory.
- May struggle with conversational turns, and form and content of language—Form (morphology and syntax) does not stand out as in SLI.
- Synthesizing language rules is difficult, so delays in acquiring morphological rules and complex syntax development.
- Morphological errors and syntax errors are present in both speaking and writing. Most common morphological error is omission.
- Overall language development may be slow, resembling language of younger children but with even less use of mature structures
- Little preschool interest in books or language. Cannot follow a story.
- Word finding is a particular problem during conversations and narratives.
- Greater time needed to respond verbally
- When young, often struggle with literal meanings
- When older, the struggle moves on to multiple meanings (rock, nursery) and figurative meanings
- The language demands of the classroom are often too high for the oral language of these children
- Many end up in Special Day Classrooms: Discuss both LH and CH placements (best places for these kids to be). Our assessment is VITAL (do they need specific language scaffolding to learn?)
- Underachievement of these kids further underscores language-learning links.
- Oral language skills are single best indicator or reading and writing success in school.
65
Is dyslexia a LD?
Yes
66
Is dyslexia a LLD?
Yes but it is specific to the symbol characteristic specific to the phonologic core/phonological processing.
67
What are the characteristics of dyslexia?
- Characterized by difficulties in accurate, fluent word recognition when decoding words and spelling difficulties
- Often associated with phonological awareness, phonological memory, and Rapid Automatic Naming (RAN) deficits
- It is believed that decreased phonology, specifically phonological awareness/phonological memory leads to trouble with phonics (sound-symbol correspondence) can lead to decreased reading fluency, which impacts reading comprehension
68
What disability is characterized as the CODE being the problem?
Dyslexia
69
Is dyslexia about oral language?
- No, it is a decoding problem and a comprehension problem of the code.
- They have a problem with their written word, and have average to above average intelligence and oral language.
70
Describe the dyslexia hypothesize.
- Decreased rapid naming, leads decreased reading fluency, which impacts reading comprehension
71
What is the single and double deficit hypothesize and which one is the treatment resisters?
- Single deficit: PA or RAN
| - Double deficit: Both (treatment resisters)
72
what is dyslexia?
- it is a specific LLD
- it's not about oral language, it's about the printed word
- Specific to the phonologic core/phonological processing
- All systems of language besides phonology is impacted
- Often associated with phonological awareness, phonological memory, and Rapid Automatic Naming (RAN) deficits (can't decode the words)
- related to the "symbol" category
- Characterized by difficulties in accurate, fluent word recognition when decoding words and spelling difficulties
73
What is dyslexia believed to be?
A decreased phonology, specifically phonological awareness/phonological memory leads to trouble with phonics (sound-symbol correspondence) can lead to decreased reading fluency, which impacts reading comprehension
74
Owens describes 3 types of dyslexia, but what are the distinct types of dyslexia we talked about in class?
1. Language Based that may affect comprehension and/or speech sound discrimination (SLP involved)
2. Visuospatial disorder that may affect letter-form discrimination with relatively unaffected language overall (not SLP focus)
75
What is often noted when comparing children with dyslexia to their TD peers?
- Comparable verbal IQ scores and/or listening comprehension
- Below average word reading (decoding)
- Nonsense or non-real word reading is below real word reading (word attack skills)
- Well below average phonological processing scores
76
What is the difference between dyslexia and a "garden variety" reading problem?
- ASHA reminds us that language-based learning disability is an even better title than dyslexia because of the relationship between spoken and written language.
- The child with dyslexia has trouble almost exclusively with the written (or printed) word.
- The child with dyslexia as part of a larger language learning disability has trouble with both the spoken and written word.
- Many in the field would consider this a more generalized or “garden variety” reading problem…..not as specific as dyslexia.
77
What does LLD look like in regards to semantics?
difficulty with:
- relating and comparing items
- non-literal language (hear and now)
- multiple meanings
- word finding difficulties
- confusion with meanings of conjunctions (and, but, so, because, etc….)
78
What does LLD look like in regards to syntax/morphology?
Difficulty with:
- constructing negatives (I not like milk, etc.) and passives (Dad was chased by the dog), relative clauses that modify noun phrases (The man who bought my house), contractions (didn’t)
- tense markers (past and future), possession (“John keys,” “mines house,” “hims keys”), and correct pronoun use (he for she, she for he, etc….).
- Repeats sentences in reduced forms which indicates difficulty learning sentence forms: “I went to the store to buy milk”=“I went to buy milk” or “I went to the store.” “The Coach gave the uniforms to the team that won”=“The coach gave to the team that won”)
- Confusion with articles (“a,” “an,” “the”) (these have no real meaning)
79
What does LLD look like in regards to phonology?
Inconsistent sound production, especially as word complexity increases—multisyllabics may be tough: (i.e. Chrysanthemum, aluminum, alligator, etc.)
80
What does LLD look like in regards to pragmatics?
- Turn taking is not a problem
- Difficulty answering questions or requesting clarifications
- Difficulty initiating or maintaining a conversation
81
What does LLD look like in regards to comprehension?
- Confusion with wh-questions (Who? What? Where? When? Why?- "why" is the most difficult one for them to answer)
- Poor strategies for interacting with printed information
- Confusion of letters that look similar (b/d) and words that sound similar (plane/pain)
82
What are possible causal factors for LD?
- Biological
- social environmental
- processing
83
What are the biological causal factors for LD?
Biological:
- Heredity is indicated
- Parent with dyslexia combined with late talking in the child=indicator of language impairment to come.
- CNS dysfunction, success of Ritalin with some students
- Dyslexia brain studies----all suggest biological basis present
84
Keeping in mind the formal definition for LD takes environmental causality out of the equation but what do we know about language that can bring environment back into the causal equation for a LD?
- Abuse
- Neglect
- No stimulation
85
What are the social environmental casual factors for LD?
Social Environmental Factors:
- Language and interactional difficulties of these children must affect development
- Acting out in response to frustration, accusations of not trying, learned helplessness, fear of trying, attention seeking (even negative attention is attention).
- Social successes and failures have a great influence on subsequent interactions
86
What are the processing causal factors for LD?
- Several executive functions are involved
- Information that is poorly attended to and poorly discriminated will be poorly organized
- Memory is related to storage and retrieval. These kids have later and slower growth with respect to creation of necessary semantic networks, leading to slower and less accurate retrieval (think about RAN)
87
Effective learners need to what?
- actively process
| - interpret, and synthesize information through use of effective strategies that monitor and organize learning.
88
When is an LLD confirmed?
when a student with a language impairment begins to struggle in school.
89
What techniques do we use with LLD kids?
- Functional technique, make it all contextualized
- Curriculum-relevance is vital (vocabulary from the curriculum
- storyboards from the curriculum
- syntax exercised from the curriculum)
90
What are similar impairments that present like LD but have different diagnostic categories?
- prenatal drug exposure
- fetal alcohol spectrum disorders (FASD)
- fetal alcohol syndrom (FAS)
- Alcohol-related neurodevelopment disorder (ARND)
91
What are some indicators of a prenatally drug exposed child?
- 11 to 35 % of pregnant women ingest one or more illegal drugs
- Infant effects vary by amount and type, method of ingestion, and age of fetus
- low birth weight, small head circumference; jittery and irritable, cry excessively (not listening, or attending)
- easily overstimulated
- avoids human face
- disrupts typical bonding which delays motor, social, and language development. Environment may reinforce this cycle.
- few infant vocalizations, inappropriate gesturing, lack of oral language
- By preschool word retrieval problems, short disorganized sentences, language use lacks variety, poor eye contact, turn taking, off topic
- By Kindergarten short, simple sentences, limited vocabulary, inability to deal with abstract language and multiple word meanings, temporal/spatial problems
- School age years involve word retrieval, word order, and poor pragmatics
- Often diagnosed with an LD and/or with ADHD
92
What life long difficulties may a FASD child have?
INFORMATION PROCESSING:
- attention
- memory
- executive functions in general
Followed by:
- learning
- behavior
- control
- mental health
- academics
93
How is FAS characterized?
- DD
- growth deficiencies
- distinct facial characteristics
94
How is ARND characterized?
- significant impairments in several areas of development
| - distinct facial characteristics
95
How is FASD characterized?
- Mean IQ in borderline ID category (but range from 30 to 105)
- Concrete learners
- Poor problem-solving
- Difficulty generalizing
- Easily distracted, overstimulated, impulsive, perseverative
- Poor memory, interpersonal skills, and judgment
- Language development delayed, echolalia, language production exceeds comprehension
- Language development delayed, echolalia, language production exceeds comprehension
- Problems with word order, word meaning, turn taking in conversation
- Executive functions are interrupted. Limited in amount of information they can process. Cannot easily formulate concepts or regulate responses
- Often diagnosed with an LD and or ADHD
96
What is perseveration?
hearing something and saying it over and over again
97
What is echolalia?
- Repeating the same thing another speaker is saying.
- Receptive language isn't good.
- Highest definition of holophrases.
98
What are intervention strategies that can be used for FASD?
- Preferential seating
- Reduce stimuli
- Picture cues to aid verbal instructions
- Careful explanations, require child to repeat instructions back
- Use eye contact and child’s name to increase attention
- “Hooks”—find things child likes
Behavioral limits need to be set
- Peer buddys
99
How is SLI different from LLD?
SLI:
- the focus is on language (particularly form) and other disorders are excluded.
- Perceptual difficulties are limited to rapid, sequenced sound stimuli
LLD:
- demonstrates diffuse weaknesses across the systems of language and may be associated with other impairment areas (motor, attention, perception, memory, emotion)
- Language perception difficulties are the essence (much deeper)
- The ability to attend actively, be responsive, and anticipate stimuli is also compromised
- Language impacting the ability to learn is evident (reading decoding and comprehension, ability to access the curriculum
100
How would you differentiate between the following diagnoses? Is there a relationship between them?
-Language Delayed
-SLI
-LLD
Discuss: Ages, severity, compare it across system of language.
.
