Late talkers
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Late Talkers. Phoniatric Dept., 1st Faculty of Medicine Charles University Prague, Czech Republic. O. Dlouhá. 15-25% of young children have some type of communication disorder. Incidence of SLI (specific language impairment) in 5 y. old was estimated to be 7,6%

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Late Talkers

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Late talkers

Late Talkers

Phoniatric Dept., 1st Faculty of Medicine

Charles University

Prague, Czech Republic

O. Dlouhá


15 25 of young children have some type of communication disorder

15-25% of young children have some type of communication disorder

  • Incidence of SLI (specific language impairment)

    in 5 y. old was estimated to be 7,6%

    National Institutes of Health – USA

    (a condition also called language-learning impairment, developmental dysphasia, developmental language disorder or dev. aphasia.

  • Late talkers - most 67% to 84% are boys

    (if a child has SLI, there is a 25% chance that another family member will be affected…)

  • Dysarthria, verbal apraxia, phonological disorder

  • Suttering – fluency disorders

  • Cleft palate


Timing of developmental milestones for language

Timing of developmental milestones for language

  • Vowel sounds

  • Localizes sounds

  • Babbles

  • First words 12 month

  • Follows one-step commands with gesture 12 m.

  • Follows one-step commands without gesture 17 m.

  • Follows two-step commands 24 m.

  • Uses two- or three-word phrases 24 m.

  • Uses pronouns

  • Says name, age, gender 3,5 y.

  • Can carry on conversations using adult-like grammar with 100% speech clar

  • Can talk about past, future,, and imaginary events 5 y.


Absolute indications for immediate evaluation of language delay

Absolute indications for immediate evaluation of language delay

  • No babbling, pointing, or gesturing

    by 12 months

  • No single words

    by 16 months

  • No two-word spontaneous phrases

    by 24 months

  • Any regression in language or social skills at any age


The heterogenity of sli specific language impairment

The heterogenity of SLI (specific language impairment)

  • Sprachentwicklungstörungen (SES) Developmental dysphasia

    Developmental language disorders (DLD)

  • At the heart of SLI is an disorder of auditory perception

  • Central auditory deficits may result in/or coexist with difficulties in other CNS-based skills: as speech-language impairment, attention defecot, developmental and learning disabilities


Auditory phonological processing presents the heterogenity of specific language impairment sli

Identification of speech sounds appears to be a problem

More typical SLI – where language comprehension is impaired, but the most

obvious problems are with expressive syntax and phonology

Problems with semantic and association function

Disorder of the short-time memory

Auditory processing deficit – inability to recognize the key words

Inabilty to use intrinsic- extrinsic redundancies to complete speech sound

Auditory-phonological processingpresents the heterogenity of specific language impairment (SLI)


Children with specific language impairment sli n 300

Children with specific language impairment (SLI) N = 300


Developmental dysphasia developmental dysphasia stuttering developmental dysphasia dysarthria

Developmental dysphasiaDevelopmental dysphasia + stutteringDevelopmental dysphasia + dysarthria


Children with sli handedness n 300

Children with SLI - handednessN = 300


Results of mentioned study of children with sli

Results of mentioned study of children with SLI

  • Positive family history in 185 children

  • Positive perinatal history in 145 children

  • Disorders of phonemic discrimination

    in 223 children

  • Phonological, lexical and syntactic deficits

  • LAEPs with prolonged latency of wave P3

  • EEG abnormalities

  • Integration deficit in dichotic listening


Children with sli positive perinatal risks n 145

Children with SLI - positive perinatal risksN = 145


Laep long latency auditory evoked potentials in children with sli

LAEP (long latency auditory evoked potentials) in children with SLI


Phonological awareness n 300

Phonological awarenessN = 300


Eeg abnormalities 223 children

EEG abnormalities (223 children)


Children central auditory disorders comprehensive central auditory assessment

Childrenś central auditory disorders – comprehensive central auditory assessment

  • CAPD (central auditory processing disorder) is an auditory processing deficit caused by deficiency in skills that are subserved by the Central auditory mechanism in the brainstem and brain and include (ASHA 1996):

    sound localization and lateralization,

    auditory discrimination and pattern recognition,

    temporal resolution-masking-integration-ordering, ability

    to identify or recognize degraded or competing targets


Central auditory deficits

Central auditory deficits

  • Auditory Decoding Deficit – they do not „hear“ (the „what“ child) poor discrimination of fine acoustic differences in speech

  • Integration Deficit - reflects delayed or abnormal interhemispheric communication

  • Prosodic Deficit – deficiency in ability to use prosodic features of target (it is all „too fast“)

  • Auditory Associative deficit – not applying rules of language to acoustic signal

  • Output-Organization deficit – behavioral manifestation of impaired efferent function or planning


Central auditory tests dichotic speech tests

Central auditory testsDichotic speech tests

  • auditory stimuli presented to both ear simultaneously+being different

  • The aim of study:

  • to analyse the role of auditory perception in children with developmental dysphasia using speech (dichotic) central tests

  • The experimental tasks consisted of 3 auditory measures (test 1-3): dichotic listening of two-syllabic target words presented like binaural interaction tests


Children with sli dichotic listening disability to synthesize 2 two syllabic words

Children with SLI - dichotic listeningDisability to synthesize 2 two-syllabic words


Late talkers

Dichotic listeningthe average number of correct responses was significantly lower in SLI children than in children from control group


Statistical analysis paired t test confirmed significant differences p 0 001

Statistical analysis (paired t-test)confirmed significant differences: p - 0,001


Conclusions

Conclusions

  • A longitudinal study was conducted to document and compare the evolution of children with linguistic acquisition impairment

  • Our results indicate the relationship between specific language impairment and central auditory processing disorder

  • The expressive disturbancies are a manifestation of decoding impairment in children with SLI

  • With an auditory training improve language abilities


Conclusions1

Conclusions

  • Recently, classification according to the perception deficit also occurred within the framework of non-uniform terminology in the area of developmental speech-language disorders.

  • The relationship between damaged speech comprehension and the deficit in speech expression has been sought, in which case the speech expressive disorders represent manifestation of worsened decoding of input acoustic information.


Wellcome in prague

Wellcome in Prague!


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