Children with Communication, Language, and Speech Disorders

1. Chapter 8 Children with Communication, Language, and Speech Disorders

2. Historical Overviews • In the United States during the 1800s, the focus was on elocution, or the ability to speak with elegance and propriety. • Alexander Graham Bell founded the School of Vocal Physiology in 1872 to help improve the speech of children who were deaf or who suffered from stuttering and/or articulation problems (He invented the phone!)

3. In 1925, the American Speech and Hearing Association (ASHA) was formed. Broca and Wernicke conducted early studies that showed the areas of the brain associated with speech and language. Refer to Figure 7.1 in the text for the parts of the brain named after these two individuals. (Broca’s afasia: understand language but use telegraphic speech) http://www.youtube.com/watch?v=f2IiMEbMnPM • http://www.youtube.com/watch?v=Fw6d54gjuvA • During the 1960s and 1970s, Chomsky studied the rules and sequences governing the acquisition of language. The area of pragmatics and the social aspects of communication is central in our current understanding and practice in this area.

4. Communication • Exchange of thoughts, information, and ideas • Sender • Message • Receiver

5. Language • An organized system of arbitrary symbols used to express and receive meaning • Receptive language • Expressive language

6. Language Form • Phonology – sound system • Morphology – meaning to words • Syntax – order and combination of words

7. Language Content • The content of a language is the information being communicated. Semantics is the meaning of the words and sentences.

8. Language Function • Pragmatics • Supralinguistics • Pragmatics is how language is used in different situations. The social context is important because it helps to clarify the meaning of the communication. Supralinguistics is the sophisticated analysis of meaning when the literal meaning of the word or phrase is not the intended meaning (Salvia et al., 2007). Being good at supralinguistics means that one can understand sarcasm, indirect requests, and figures of speech.

9. Speech • Normal speech is a combination of articulation, fluency, and voice. • Articulation is the clear pronunciation of words • Fluency refers to the appropriate flow of the words • Voice is the intonation and quality of the production (pitch, loudness, and resonance).

10. The production of speech involves (1) respiration—the process that generates the energy that produces sound, (2) phonation—the production of sound by the vibration of the vocal cords, (3) resonation—the process that gives the voice a unique characteristic and identifies the person (the product of sound traveling through the person’s head and neck), (4) articulation—the movement of the mouth and tongue that shapes sound into phonemes (the smallest units of sound), and (5) audition—the thought transformed into words that is received by a listener through hearing.

11. Figure 7.4: Speech Production

12. Language Development • An infant is innately programmed to communicate through smiles, eye contact, sounds, and gestures (the prelinguistic system). Most children learn language through their early social interactions with basic caregivers. • From birth to 3 months, infants begin to socially communicate by smiling and cooing. • This is followed, around 4 to 6 months of age, by babbling, sounds, and initial language use. Recognition of language by the child begins around 7 months of age. • Expressive vocabulary: • 20 words at 18 mos. • 300 words by 24 mos. • 1500 words by 48 mos. • 2000 words by 60 mos.

13. Actual words begin at about 12 months. Words are then turned into sentences; by 18 months, most children can speak in two-word sentences, and this process continues through the development of multiple-word sentences, usually in place by age 3. • By age 6, the child is a good communicator, with the knowledge of thousands of words, though this knowledge appears to decline when the child begins reading and writing instruction in school settings. Please refer to Table 7.1 in the text for more explanation on language development and ages.

14. Cooing (primary vowels, some back consonants) • Babble (ba ba, da da, repetitious) • Echolalia (imitates speech sounds) • Vocal play/jargon • Holophrastic use (12-18 mos.)

15. Prevalence of Communication Disorders • More than 1 million students having speech and language impairments were served in special education programs 2002 • 18.7% of children with disabilities • Not all children with speech-language disorders are in special education classes. In fact, 87 percent of children with speech and language impairments are served primarily in regular classes; only 8 percent are in resource rooms and 5 percent in separate classes (U.S. Department of Education, 2005). Children with speech and language disorders are more likely than children with other disabilities to be served in the regular classroom From U.S.Department of Education, 2005.

16. Classification of Disorders • Communication Disorders • Speech Disorders • Disorders of articulation • Disorders of fluency and speech timing • Disorders of voice • Language Disorders • Form • Content • Function

17. Communication Disorder • An impairment in the ability to receive, send, process, and comprehend concepts of verbal, nonverbal, and graphic symbol systems • A communication disorder may be evident in the processes of hearing, language, and/or speech. A communication disorder may range in severity from mild to profound. It may be developmental or acquired. Individuals may demonstrate one or any combination of communication disorders. A communication disorder may result in a primary disability, or it may be secondary to other disabilities (ASHA).

18. Language Disorder • An impaired in the comprehension and/or use of spoken, written, and/or other symbol systems. The disorder may involve (1) the form of language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in communication (pragmatics and supralinguistic) or any combination.

19. Speech: Articulation Disorder • A speech disorder is an impairment of the articulation of speech sounds, fluency, and/or voice. An articulation disorder is the atypical production of speech sounds characterized by substitutions, omissions, additions, or distortions that may interfere with intelligibility. • In classifying the disorders from mild to severe, one looks at the number and kinds of misproductions. Disabling conditions associated with disorders of articulation-phonology are cleft palate, hearing impairment, cerebral palsy, and sometimes stuttering.

20. Common Articulation Errors • We yive in a yeyow house. (Substitution) • I like dis ball. (Substitution) • Did you see the wed twuck? (Substitution) • Oh, ook at the kitty. (Omission) • Did you see the moufse? (Addition) • I am seben years old. (Substitution) • I have fi fingers. (Omisson) • Can we play footsball. (Addition)

21. Speech: Fluency disorder • A fluency disorder is an interruption in the flow of speaking characterized by atypical rate, rhythm, and repetitions in sounds, syllables, words, and phrases. This may be accompanied by excessive tension, struggle behavior, and secondary mannerisms. Because fluency is the flow of speech, the most common type of fluency disorder isstuttering. For some children who stutter there is a genetic component (Yairi, Ambrose, & Cox, 1995). Many children recover spontaneously by school age (Bloodstein, 1995).

22. Speech: Voice disorder • Voice is the production of sound in the larynx and the selective transmission and modification of that sound through resonance and loudness. Associated with voice are (1) quality of sound or resonation, (2) pitch, and (3) loudness. A voice disorder is characterized by the abnormal production and/or absences of vocal quality, pitch, loudness, resonance, and/or duration, which is inappropriate for an individual’s age and/or sex. Dysphonia (disorder of voice quality) can be related to phonation and/or resonation. Variation or distortion in pitch can be an indicator of hearing impairment. • Dysphonia : Resonation (hyponasalilty, hypernasality), Phonation (breathy, hoarse, harsh), Pitch (male or female, young or old), Loudness

23. Identification and Assessment • Early language is the product of social and family interactions, and if the child comes from a background in which the language of the schools is not the home language, other considerations must be taken into account. Teachers must be multiculturally aware and knowledgeable about linguistic diversity so that they do not inappropriately refer a child for assessment.

24. Children who come from homes in which English is not the primary language must be assessed in their primary language to determine if a communication disorder exists. Even if English is the primary language, dialect differences may exist. A dialect difference may mask a communication disorder. Refer to Table 7.3 to discuss other problems in the area of communication, language, and speech that may accompany other disability areas.

25. Table 7.4: Identification and Assessment Source: Adapted from J. Salvia, J.E. Ysseldyke, and S. Bolt (2007). Assessment in special and inclusive education, 10th ed. (Boston: Houghton Miffl in) Reprinted by permission of Houghton Miffl in Harcourt Publishing Company.

26. Educational Adaptations • Adapting the Learning Environment • Adapting the Curriculum • Adapting Teaching Strategies • Assistive Technology

27. The three levels of intervention explained in the RTI approach is an excellent method for adapting the learning environment for a student with a communication disorder. Inclusion (Tier I) is the typical option because most children with primary speech disorders respond well to the regular education program if they receive additional help for their special communication needs.

28. The regular education teacher can use a variety of strategies to provide a positive learning environment for the student with a communication disorder. The strategies can include methods to promote student-to-student communication, cooperative learning strategies, as well as ideas from the speech-language pathologist. • Tier II of the RTI model includes collaborative interventions, such as small-group language activities, working directly with the speech-language pathologist in the regular classroom, and weekly conferences with the speech-language pathologist and the regular classroom teacher. to meet the individual needs of the student.

29. At Tier II, the speech-language pathologist helps by suggesting strategies that encourage talk, expand talk, and model correct forms and usage. She may help the teacher set up effective peer-mediated social supports) and may help teach students self-advocacy skills so that they can communicate their needs • Tier III of the RTI model includes the individualized educational services stated in the student’s IEP.

30. Because we know that children without communication disorders learn language through play and in naturalistic settings, this strategy becomes very important when working with the child who has communication disorders. Additional strategies include modeling the correct form, operant conditioning strategies, functional intervention programs based on social learning theory that use natural opportunities to promote appropriate speech and language through incidental teaching, and augmented and alternative communication such as American Sign Language (ASL) or communication boards. disorders (see page 325 of the text).

31. The classroom teacher can improve a student’s self-esteem by (1) disregarding moments of nonfluency, (2) showing acceptance of what the child has expressed rather than how it was said, (3) treating a child who stutters like any other member of the class, (4) acknowledging nonfluency without labeling the child, (5) helping the child feel in control of his or her speech, and (6) accepting nonfluency. It is equally important for the teacher to be aware of the terminology associated with communication

32. Life Span Issues • Teaching parents to model appropriate speech is crucial for the child with a communication disorder. Important changes have come about in helping students with communication disorders make transitions from high school to college and to the workplace. Many colleges and universities have support services and special programs for these students.