Praxis Language Disorders In Children

Front 1

What are the general issues that typically describes language disorders in children?

Back 1

1) Limited amount of language
2) Deficient grammar
3) Inadequate or inappropriate social communication
4) Deficient nonverbal communication skills
5) Deficient literary skills

Front 2

Language disorders in children who are otherwise typically developing are described as what?

Back 2

Specific Language Impairment (SLI)

About 7-8% of kindergarten children exhibit SLI

Front 3

This is characterized by 'significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. The disability originates before the age of 18.

Determined on subaverage IQ tests of intelligence and limited communication skills is one of the significant features of this.

Back 3

Intellectual Disability / Developmentally Disabled (now preferred over mental retardation)

Front 4

Most experts agree that the language of children with intellectual disabilities is _________ rather than _______. Children with intellectual disabilities show language skills that commensurate with those of younger typically developing children' they follow the same sequence of language development.

Back 4

delayed, deviant

Front 5

Which disorders fall under PDD?

Back 5

1) Autism
2) Asperger's syndrome
3) Rett syndrome
4) Childhood disintegrative disorder

Front 6

When is Autism diagnosed and what are the diagnostic criteria?

Back 6

Diagnosed before age 3

Criteria:
1) Impaired social interaction
2) Disturbed communication
3) Stereotypic patterns of behavior, interests, and activities

Front 7

What are the general characteristics of children with autism?

Back 7

-Generally below-average intelligence (<70)
-Lack of responsiveness/awareness to others
-Prefers solitude & objects over people
-Lack of interest in nonverbal & verbal communication
-Stereotypic body movements such as rocking
-Insistence on routines; hate change
-Dislike of being touched/held
-Self-injurious behaviors such as biting, head banging
-Unusual talent in some area, such as arithmetic
-Seizures (in approx. 25%)
-Hyper- or hyposensitivity to sensory stim

Front 8

What do the language problems associated with Autism include?

Back 8

1) Inadequate/Lack of response to speech
2) Lack of interest in human voice --> better response to environmental noise
3) Slow acquisition of speech and language --> reflecting general disinterest in interaction with others
4) Use of language in a meaningless, stereotypic manner, including echolalia
5) Perseveration on certain words/phrases
6) Faster learning of concrete than abstract words
7) Lack of generalization of word meanings
8) Lack of understanding relationship between words
9) Pronoun reversal
10) Use of short, simple sentences
11) Omission of grammatical features such as plural inflections, conjunctions
12) Social communication problems: eye contact, topic maintenance, initiation, and lack of assertiveness
13) Difficulty establishing joint reference

Front 9

Children with _________ syndrome may talk obsessively about their preoccupations; their speech is often more a monologue than a dialogue; they may not allow others to take conversational turns; they may not grasp that their listeners are bored or in a hurry

Back 9

Asperger's syndrome

Front 10

What do the cognitive and language difficulties associated with TBI look like in children?

Back 10

1) Comprehension problems, especially of sentences
2) Word-retrieval problems leading to reduced fluency
3) Syntactic problems, including limited MLU, fewer utterances, and difficulty expressing/understanding long, complex sentences.
4) Reading/Writing/Academic problems
5) Pragmatic problems-- turn taking/ topic maintenance
6) Attention/Focus
7) Limited self-awareness
8) Reduced information processing
9) Reasoning/Organization

Front 11

This is a disorder of early childhood in which the immature nervous system is affected. It is not a disease. It is not progressive. It results in muscular incoordination and associated problems.

Back 11

Cerebral Palsy

Front 12

Why does cerebral palsy occur?

Back 12

1) Prenatal BI: maternal rubella, mumps. accidents, etc

2) Perinatal BI: difficulties in birth process/prolonged labor/premature breech delivery

3) Postnatal BI: anoxia, infections, accidents, diseases such as scarlet fever and meningitis

Front 13

Hemiplegia

Back 13

One side of the body is paralyzed

Front 14

Paraplegia

Back 14

Leg & lower trunk paralyzed

Front 15

Monoplegia

Back 15

One limb is paralyzed

Front 16

Diplegia

Back 16

Either 2 legs or 2 arms paralyzed

Front 17

Quadriplegia

Back 17

All 4 limbs

Front 18

What are the three major types of CP?

Back 18

1) Ataxia CP: disturbed balance, awkward fait, uncoordinated movements (CEREBELLAR)

2) Athetoid CP: slow, writhing, involuntary movements (INDIRECT MOTOR PATHWAY ESP BASAL GANGLIA)

3) Spastic CP: increased tone, rigidity of the muscles as well as stiff, abrupt, jerky, slow movements (MOTOR CORTEX/MOTOR PATHWAYS)

Front 19

What is more critical to language development than ethnic background?

Back 19

SES

The factor most highly related to SES is the mother's educational level

Front 20

Limited access to health care can affect language development/skills how?

Back 20

1) Missing school bc of sickness--limiting academic/language exposure

2) Difficulty concentrating/learning when sick

3) Untreated ear infections

4) Inadequate prenatal care --> preemies, neurological issues

Front 21

How might growing up in a home with parents who have limited education affect language development?

Back 21

1) Can't provide adequate oral language stimulation for child
2) Can't provide opportunities for literacy
3) Don't have economic means to expose child to variety of enriching experiences
4) Don't have economic means to purchase toys/books that stimulate development

Front 22

What are some of the language deficits seen in children from backgrounds of poverty?

Back 22

1) Reading/Writing
2) Referencing time and temporal concepts due to lack of routine/structure in home
3) Lack of familiarity with "school-type" tasks such as reciting the alphabet, singing rhyming songs, reading books
4) Delayed vocabulary skills due to lack of stimulation/exposure
5) Delayed morphosyntactic skills
6) Less verbal elaboration and overall verbalization

Front 23

What kind of language delays are often seen in children who undergo abuse?

Back 23

Expressive Language Delays

Front 24

What is microcephaly?

Back 24

Small head

Front 25

What tend to be the two most difficult things for students with ADHD?

Back 25

1) Auditory processing
2) Social interaction skills

Front 26

How do you calculate MLU?

Back 26

# of morphemes / # of utterances

Front 27

How do you calculate type-token ratio (TTR)?

Back 27

# of different words in a sample / # of words in a sample

Front 28

What does the TTR represent?

Back 28

The variety of different words the child uses expressively, thus assessing the child's semantic or lexical skills.

Front 29

Infants and toddlers may fall into one of two categories

1) Established risk
2) At risk

Define both

Back 29

Established Risk: biological or disease related

At Risk: environmental factors, genetic background and some disease-related conditions

Front 30

When do language problems become apparent and when are hey frequently brought to surface?

Back 30

-Elementary School Age
-Surface with reading and writing problems and even failure

Front 31

How can you assess syntactic skills?

Back 31

Calculate MLU and complexity of utterances

Evaluate:
-Verb phrases
-Noun phrases
- Prepositional phrases
-Sentence types such as simple, declarative, compound complex, active, questions, negatives, and requests

Front 32

How can you assess morphological skills?

Back 32

-Regular/Irregular plural nouns/ Present progressive -ing with appropriate pictures

-Comparatives and superlatives by showing three pictures and saying things like "This man is big; this one is even ______, and this man is very ______."

-Evoke the possessive morpheme "Whose hat is this?"

-Evoke the production f the third-person singular such as "What flies"

-Assess production of adjectives by showing pics and asking child to complete such sentences as "This boy is ____(short), This car is _____(green)."

-Evoke past-tense constructions by telling a short story through pictures, and asking child to use pictures to retell story

Front 33

How can you assess semantic skills?

Back 33

-Ask parents to list words the child uses
-Ask parents to describe the types and number or words the child uses at home
-Have the child name and describe pictures, toys, and objects
-Have child tell a story depicted pictorially
-Tell the child a short short and then have the child retell the story to you
-Note unusual word usage, over- and underextensions of words, signs of misundersanding words, use of general terms (this, that, thing) for more specific ones.

Front 34

How can you assess pragmatic skills?

Back 34

- Eye contact and other nonverbal behaviors
-Narrative skills
-Topic initiation and maintenance
-Turn taking skills
-Conversational repair (asking for clarifications when messages are not clear and responding appropriately when a listener asks for clarification)

Front 35

How can you assess language comprehension?

Back 35

-Note inappropriate or irrelevant responses that indicate lack of comprehension
-Note the complexity level at which comprehension break down
-Give specific commands that gradually increase in length and complexity
-Ask the child to point to correct pictures that help assess comprehension of grammatical morhemes
-Assess comprehension of abstract statements by asking the child to explain the meaning of common proverbs

Front 36

Explain discrete trials

Back 36

-Useful in the initial stages of treatment when skills have to be shaped or established.

Clinician:
-Places a stimulus pic in front of child
-Asks child relevant question
-Immediately models the correct response for the child and waits for a few seconds for child to imitate
-Reinforce
-Give corrective feedback if child misses the target responses
-Records response on recording task
-Waits for next trial

Front 37

Explain Basic Behavior Techniques

Back 37

-Instructions
-Modeling
-Prompting
-Shaping
-Manual guidance
-Fading
-Immediate, response-contingent feedback

Front 38

Explain Focused Stimulation

Back 38

-Clinician repeatedly models a target structure to stimulate the child to use it. Usually during a play activity that the clinician designs to focus on a particular language structure.
-Clinician does not correct the child's incorrect responses but instead models the correct target

Front 39

Explain Milieu Teaching

Back 39

Refers to a group of techniques that have been evaluated and shown to be effective. Teaches functional communication skills through the use of typical, everyday verbal interactions that arise naturally.

-Incidental Teaching: adult waits for the child to initiate a verbal response.
-Mand Model: the clinician mands a response from the child "tell me what you want"
-Time Delay: clinician waits for child to initiate verbal responses in relation to stimuli that are separated by predetermined waiting period.

Front 40

Explain Joint Routines or Interactions

Back 40

-Repetitive activities that are frequently used for early-on stimulation.

Clinician uses routines such as peek-a-boo to establish interaction.

Front 41

Explain Joint Book Reading

Back 41

Allows for repetitive use and practice of the same concepts and phrases and is also helpful for joint attention. Can also help develop vocab acquisition as well as a sense of story grammar.

-Clinician uses prosodic features frequently to draw attention to specific language structures.
-When child is quite familiar--clinician stops at points containing target language structures and prompts children to supply the appropriate words, phrases, or sentences.

Front 42

Explain Narrative Skills Training

Back 42

Narratives should be produced in a cohesive, logically consistent, temporally sequenced manner. Narratives are part of pragmatic language skills.

-Script therapy is a way to teach narrative skills.

Front 43

How can a clinician teach narrative skills?

Back 43

-Act out stories
-Use scripts based on real life events and have them act out the parts
-Use video modeling--watch videotaped interactions between children with normal language and have the children imitate.
-Peer-training method
-Get children involved in routinized, daily activities
-Repeatedly tell or read same stories so they memorize characters, events, words, and temporal sequences.
-Ask to tell stories or narrate events

Front 44

Explain Parallel Talk

Back 44

The clinician plays with the child and describes and comments upon what the child is doing and the objects the child is interested in.

Front 45

Explain Recastign

Back 45

Recasting children's limited productions into longer or syntactically different forms can be useful in teaching complex grammatical forms.

The child's own sentence is repeated in modified form, but the clinician changes the modality or voice of the sentence rather than simply adding grammatical or semantic markers.

Front 46

This is when the clinician repeats what the child says during language-stimulation activities.

Back 46

Reauditorization

Front 47

This is when the clinician describes her own activity as she plays with the child. Using language structures that are appropriate for that child.

Back 47

Self-talk

Front 48

This approach believes that learning written language should be like learning oral language. Through being immersed in a literate environment, communicating through print, and getting supportive feedback.

Back 48

Whole-Language Approach

Front 49

In this kind of AAC, no instruments or external aids are used. Rather, the child uses gestures and other patterned movements, which may be accompanied by some speech.

Back 49

General (Unaided) AAC

Front 50

Give some examples of General (Unaided) AAC

Back 50

1) Pantomime
2) Eye-Blink encoding
3) American Indian Hand Talk
4) ASL
5) Limited manual sign system
6) Left-Hand Manual Alphabet

Front 51

In this kind of AAC, gestures or movements are combined with an instrument or message display device. Gestures are used to (a) display messages on a mechanical device such as a computer or (b) to scan or select messages displayed on a nonmechanical device such as a communication board.

Back 51

Gestural-Assisted (Aided) AAC

Front 52

This type of AAC is useful for children who have such profound motoric impairments and limited hand mobility that they cannot use a manual switching device. This type of AAC uses bioelectrical signals such as muscle-action potentials to activate and display messages on a computer monitor

Back 52

Neuro-Assisted (Aided) AAC