Language Disorders in Children

Pragmatic difficulties

(Semantic-Pragmatic Disorder (SPD), Pragmatic Language Impairment (PLI), Social Communication Disorder • "Cocktail party talk" (incessant chatter) • Poor turn-taking • Concrete interpretation • Echolalia (<6 years) • Stereotypic utterances • Neologisms: newly created words/words used in the wrong context • Difficulties on topic • Topic shifts and topic drifts • Poor eye contact • DSM-V Social/Pragmatic Language Disorder

Foundations of language

- Cognitive ability: awareness of objects—functions, attributes, relationships, problem-solving - Sensorimotor ability: perception—visual, auditory; movement; coordination; discrimination; feedback - Psychosocial: attempts at regulating environment; reciprocal behaviors; caregiver responsiveness • Model representing a hierarchy of behaviors

Communicative functions

-Comment -Call attention -Obtain response -Protest/reject -Direct action

What is needed to formulate intervention goals?

-Language sample -Coded language sample -Target child's highest level of achievement -We plan intervention goals based on highest skill level and matching it within the hierarchy of the plan

what to look for if a child is not using conventional form at 18-24ms

-Level of analysis: 1 prelinguistic -They should be producing sounds/babbling -Review precursors of language (imitation) -Approximating adult forms(reduplicated and non-reduplicated) -REVIEW LEVEL 1 FORM

MLU

-Measures morphosyntactic ability -We need 50 utterances to calculate MLU -Obtained thru a language sample -Low MLU can indicate language impairment but a high MLU cannot indicate absence of language impairment -Total number of morphemes divided by total number of utterances

Create a 4 constituents that code locative action

/I drive car home/

Create a 3 constituents coding action

/I eat apple./

Create a 3 constituents that code internal state

/I want coffee/

Create a 2/3 constituents that code existence plus attribution

/Is blue ball/

A child is shown a video of a dog digging a hole and is asked, "what's happening in this video?" One response which the clinician is attempting to elicit & the content category of the expected response

/dog is digging/ Action + temporal

The child is eating a cookie and the clinician asks, "what are you doing?" One response which the clinician is attempting to elicit & the content category of the expected response

/eating/ or /eating a cookie/ Action or action + temporal

The clinician puts the child's favorite toy, the green dinosaur, too high up for the child to reach. One response which the clinician is attempting to elicit & the content category of the expected response

/help me/ or /I want dinosaur/toy/ Internal state (for either)

Create a 2/3 constituents that code attributive state

/is yellow/ or /bottle yellow/

The clinician is blowing bubbles and then stops. One response which the clinician is attempting to elicit & the content category of the expected response

/more/ or /more bubble Recurrence or recurrence + existence

Create a 3 constituents that codes possessive state

/the car is hers/

Level 2

1-2 word utterances

Special Disabilities Model (Tallal & Piercy)

1. Deficit in auditory perceptual processes • The language disorder is the result of impaired auditory/perceptual processes. • Tallal: Weakness in processing auditory information that is short in duration or occurs in rapid succession. 2. Deficit in Working Memory • Poor working memory skills—measured by nonword repetition: a core problem in language impairment

Directive/Clinician-Directed: Specific Treatment Tasks

1. Drill: using elicited imitation and shaping 2. Modeling: using third-person model (parent, doll, puppet) - Child listens to repeated models, is expected to induce a rule, and eventually produce target - Ex: model uses 2- constituent utterances (S + V) to describe pictures, then child asked to "talk like" model

Models of Instruction

1. During most of the 20th century, schools taught only in English and ignored the maintenance of native languages. • Worked for highly motivated immigrants. Home language often never fully developed or lost; English mastered. Minority groups who did not assimilate well never learned to read and write and received no schooling in their native language. 2. In the '60s new programs were started to facilitate the learning of English. ESL was offered in pull-out situations + submersion programs during the summer. • Bilingual education was also started: after 2-3 yrs of bilingual instruction the child is placed in a monolingual English-speaking class room. • The child gets the message that the goal is to master English, which is more valued and may lose his native language. 3. A new model of bilingual instruction: instruction in both languages through Grade 12. Bilingual competency in oral an written language is the goal.

Childhood Bilingualism

1. Infant bilingualism: • Both languages are spoken to the child in early infancy. • Both languages develop simultanously in naturalistic situations—truly bilingual. • Sequential or consecutive language learners 2. Hear only one language at home, and later learn L2 in preschool 3. Hear only one language at home, and later learn L2 in school • Threshold and developmental interdependence hypotheses (Cummins). • The level of competence in L2 is partly a function of the level of L1 at the start of exposure of L2. • A threshold of competency in L1 must be obtained before exposure to L2, if problems are to be avoided. • According to Cummins, the child who is at risk is the preschool sequential language learner. • School-age L2 learners are at an advantage since they have acquired a good L1 base and some metalinguistic skills. Childhood Bilingualism (cont.) • The school-age bilingual child may not have any trouble with social communication, but may have trouble with cognitive/academic language skills. • However, it may be that there is an arrested language development of the primary language after exposure to the dominant language of the community. • L1 ceases to develop while the child is trying to learn L2. Childhood • "Subtracted bilingualism." • L1 is subtracted and replaced by L2. • L1 culture and language is less prestigious than L2.

Precursors of Use (Lahey, 1988)

1. Interpersonal behavior - (Gazing interpersonally, joint attention, taking turns (in routines)) 2. Making reference - (Show, give, point out object) 3. Regulating other's behavior -(Reach toward (with without fretting sounds), reach for object (with gaze and vocalization), gesture to request action (e.g., to get help), protest or reject (with gesture and vocalization))

Three major leaps of development of USE

1. Phase 1-3 2. Phase 4-5 3. Phase 6-8

Two General Theoretical Perspectives

1. The problem is language-specific. A lack of grammatical knowledge. 2. The problem is more general in nature. A problem of poor processing abilities underlying language comprehension and production. A) general processing B) specific mechanisms

If the child is not using complex sentences, they are in level

3

A. Missing INFL Account (Radford)

A grammar with only lexical categories (subjects, verbs, objects and adverbials) and missing functional categories (e.g., inflections, auxiliaries). • Has not been strongly supported by data in English, particularly if interpreted as functional categories being completely missing. • The problem in SLI seems to be frequency of use and not missing data.

Phrase

A group of words -A big house (noun phrase) -Watch TV (verb phrase) -At lunch (prepositional phrase) -Too slowly (adverbial phrase)

Specific Language Impairment

A term that was created for research purposes when investigators wanted to study a group of children where there was no explanation for their language learning difficulties. Exclusionary criteria: • Hearing • Sensorimotor functioning • Socio-emotional problems • Nonverbal intelligence • Congenital malformations of vocal tract Neurological Factors (exclusionary criteria for SLI) • Focal brain lesions • TBI - traumatic brain injury • Cerebral palsy • Severe seizure disorders Stark & Tallal (1981) • Hearing level: at least 25 dB across 250- 6000 Hz. • Nonverbal IQ of at least 85 (1SD below the mean of the general population). Training Studies Fey, Long and Cleave, 1994: • Children with below-average nonverbal performance benefit from language therapy as much as children with above average nonverbal performance. Discrepancy Identification (NVIQ- Language Scores) • Both NV IQ tests and language tests have measurement errors. • Children with and without discrepancies may not be different in a meaningful way. • A significant part of the population with normal NV IQs have language scores that are at least 15 points lower than their NV IQs. Purpose • Research purposes • Clinical purposes Inclusionary Criteria • No consensus. • Discrepancy criteria: difference between expected level of language performance based on age, grade level, or nonverbal IQ and actual language performance. Inclusionary Criteria Leonard -99: • Language test scores of -1.25 standard deviations or lower on standardized tests. • Tests differ. Results are defined by the test used. Normed on different populations. Often Seen in SLI • Mild neuromaturational delays. • Poorer attention. • Different in their profiles of NV functioning, even if reaching the cut-off level. Clinical Examination • Hearing screening • Oral motor structure and function • Language testing • Language sample (F/C/U) • Observation of motor function • Observation of level of attention Prevalence • Range between 2-12% in different studies, depending on population, tests, and cutoffs. • Tomblin et. al. (1997): 7000+ five-year-olds in Iowa and Illinois, SLI: 7,4%. Gender • Often 2:1 or 3:1, boys/ girls in studies (clinically defined sample). • In Tomblin et.al.: 1.33:1 (epidemiological). Outcome • Many individuals continue to have subtle language difficulties during their school years and adulthood. A language weakness can be manifested in different ways during different times of development. -Catts, Fey, Tomblin & Zhang (2002): • Approx 50% of children with LI in kindergarten - RD in 2nd and 4th grade. • Higher risk for nonspecific LI than for SLI. Predictors for Reading and Writing • Phonological awareness • Narrative skills • Word recognition - phonological awareness and rapid naming (Catts,1993) • Also letter recognition in Kindergarten • Reading comprehension: measures of spoken language comprehension

Verb relation coordination

A verb-relation utterance can have a coordination inserted, which will be coding one of the non-verb relation content categories. Examples: /I eat my big apple/ = Action + possession + attribution (3 const) /I was singing/ = Action+ temporal (2 constituents) In the example above we only have 2 constituents, because the verb in that case has 2 elements (was and singing). This is considered a complex verb form and is treated as 1 verb (and thus 1 constituent). (another example would be /I will run/) Only one content category can have 3 or 4 constituents: locative action (utterances with an implied change of location). This depends on the fact that some verbs are transitive (takes an object) and some verbs are intransitive (do not take an object). /I run to the train/ = 3 constituents /I put the ball on the table/ = 4 constituents (place is treated as a constituent in locative action)

Single words (nine content categories):

A. Coding object knowledge (cookie) B. Coding event knowledge (eat) C. Coding relational knowledge (more cookie, eat cookie)

Early word combinations

A. Emerging syntax: - 2-constituent verb relations - 3-constituent verb relations B. Coordinating content categories

Additive Chains

A. Simple listing: a monkey/ a dog/ a book/ B. Repeated actions: the dog went on the puppet/ the puppet went on the house/ the house went on the pigeon/ C. Descriptive sequences: once there was a big gray fox who lived in a cave/ he was mean and scary, really scary/ he had big giant eyes and a bushy tail that hit people in the face/ and he ate little rabbits/

Abbreviated Causal Chain

A1. Abbreviated causal chain • Statement of problem and resolution, but it's short, not much description • Become less frequent as skills develop • Baby cried/ the baby hurt his eyes/ the baby broke his eye/ then he got it all fixed/

Reactive/automatic causal chain

A2. Reactive/automatic causal chain • A reaction to a situation, but no goal to get characters out of it • Seems to be out of anyone's control • Continues throughout grammar school • Once there was a girl named Alice who lived down by the seashore/ Alice was in the water, floating on her back, when along came a shark and GULP GULP that was the end of Alice/

Content category for "Eat, drink"

Action

I am playing in the yard

Action, VR, 3/3, temporal, place

He is hitting the doll

Action, VR, 3/3, temporal, speculation

content categories that are coded with verb relations

Action, existence, locative action, locative state, state notice/perception

What is the content category and connective in the following complex sentence: "She was angry about it but even more so she was disappointed."

Adversative, But

Cohesive Tie Categories

Anaphoric (endophoric) reference (referring to linguistic context): • Andy and Charlie went out. They had fun. Lexical: • I like my car. My car (repetition) is wonderful. It's quite an auto (synonym). It's quite a vehicle (superordinate). Conjunctive (connectives) : • The dog killed my cat and (additive) my mom got angry. • The movie ended at 10. Then (temporal) we went home. Substitution: • I lost my pen. I need another one. • Infrequent in stories Ellipsis: • This is my car. Where is his? /car/ • Is he going with us? He said so. • Do you need some money? No. /I don't need any/ • Infrequent in stories. • Words are left out because it's redundant and/or not pragmatically correct to leave them in • Two types: exophoric and endophoric • Exophoric: refers to the nonling context • Endophoric: refers to the ling context

The chair is big

Attributive state, VR, 3/3

The theory behind ABA is...

Behaviorism

How does a clinician assess a child's narrative development?

By asking them to tell a story

What is the content category and connective in the following complex sentence: "Because I am hungry, I will eat a snack."

Causal, Because

Word Meaning

Children with language impairment know fewer words than TD children of the same age.

Notice

Code attention to a person, object or event AND include a verb of notice (see, hear, look, watch, show)

Communication

Codes a communicative act while the complement describes what is to be communicated (tell mom I have to finish this)

Content Category Functions

Comment, regulate, Protest/Reject, Emote, Routine, Report/Inform, Pretend, Discourse

What is the content category and connective in the following complex sentence: "His friends told him to come over for the party at 9."

Communication, to

/Mom eat salad/ (while looking at mom eating salad)

Content Category: Action Constituents: Mom= subject, Eat= verb, Salad= complement

/baby not drinking milk/

Content Category: Action Coordination: Nonexistance, temporal

/don't hit doggy/

Content Category: Action Coordination: Rejection

/Couch is brown/ (while pointing to couch in a book)

Content Category: Attributive State Constituents: Couch= subject, Is= verb, Brown= complement

/that is daddy again/

Content Category: Existence Coordination: Recurrence

/I want apple/ (to mom, while pointing to apples on table)

Content Category: Internal State Constituents: I= subject, Want= verb, Apple= complement

/put cup in sink/ (to dad while handing over cup/

Content Category: Locative action Constituents: Put= verb, Cup= complement, Sink= location

/I put my cup in the car/

Content Category: Locative action Coordination: Possession

/books are on table/

Content Category: Locative state Coordination: Quantity

/look at big trucks/

Content Category: Notice Coordination:Attribution, quantity

/Coat is mine/ (while looking at coat on coat rack)

Content Category: Possessive state Constituents: Coat= subject, Is= verb, Mine= complement

/baby eat/

Content category: Action Verb relation?: Yes # of major constituents: 2

/draw picture/

Content category: Action Verb relation?: Yes # of major constituents: 2

Lahey: Phases 2 and 3

Content category: Action - Ph 1 Form: SW /eat/ - Ph 2 Form: 2 constituents /eat apple/ /I eat/ - Ph 3 Form: 3 constituents /I eat apple/

/is dirty/

Content category: Attributive State Verb relation?: Yes # of major constituents: 2

/what is this ↑/

Content category: Existence Verb relation?: Yes # of major constituents: 3

/put dog here/

Content category: Locative Action Verb relation?: Yes # of major constituents: 3

/here is bed/

Content category: Locative state Verb relation?: Yes # of major constituents: 3

/my bottle/

Content category: Possession Verb relation?: No # of major constituents: N/A

/more tickle/

Content category: Recurrence Verb relation?: No # of major constituents: N/A

Verb Relations

Definition: a C/F interaction that requires a verb (included or implied by context) • Verb included: /baby kiss cat/ • Verb implied by context: /baby cat/ (said as child/doll kisses cat) • Must include at least two major grammatical constituents (S/V/C) The definition of a verb relation is that it has to have two of the three main constituents (subject, verb, complement): /I eat/ subject - verb 2 constituents /Eat apple/ verb - complement 2 constituents /I eat apple/ subject-verb-complement 3 constituents The complement can consist of more than one word: /I eat my big, green, juicy apple/ In this case "my big, green, juicy apple" is all part of the complement.

Content category for "No"

Denial

A boy said, "I feel sad." His therapist responds, "Why?" The child says, "because I missed my favorite TV show." This interchange is an example of the complex sentence discourse context described by Lahey as:

Dependent Cohesion

Quantity

Designate more than one object or person by use of a number word

Dative

Designate the recipient nof an object or action (give it to me)

Regulate

Directs others are requires a response such as an exchange of objects, the attention, an action, or utterance by another person.

The following utterances, considered together: "The boy was riding a bike. The girl was too," illustrates the use of...

Ellipsis

Content category for "Car, mommy, doggie"

Existance

Content Categories

Existence, Recurrence, Nonexistence/Disappearance, Rejection, Denial, Attribution, Possessopn, Locative Action, Action, Locative State, State, Quantity, Notice, Dative, Additive, Temporal, Causal, Adversatice, Epistemic, Specification, and Communication

This is a big chair

Existence, VR, 3/3, attribution

First 9 content categories

Existence, nonexistence, recurrence, denial, possession, locative action, rejection, attribution, and action

Protest/Reject

Express an objection to or refusal of objects or actions carried out by another person

A child says "No" when Mom puts a plate of food in front of him. This would be coded as the content category "denial."

False

Intervention goals are determined based on the child's maintaining factors, and intervention procedures are determined based on the child's performance compared to what we know about typical development.

False

Learning two languages will automatically lead to a language impairment.

False

The genotype of autism is completely clear.

False

The utterance /I eat big apple/ is an action utterance coordinated with attribution. The form is a four-constituent verb relation.

False

True or False: Intervention goals are determined based on the child's maintaining factors, and intervention procedures are determined based on the child's performance compared to what we know about typical development.

False

We can always presume that a fluent speaker always has good comprehension skills.

False, There are fluent speakers who still do not make sense.

If a child is using verb relations, the most appropriate level of analysis is level 2.

False, it is level 3.

Pragmatics deals with the literal meaning of an utterance, and semantics deals with the meaning beyond the literal meaning.

False, the other way around

child with Down syndrome will typically have a strength in oral motor skills.

False, this is an area of weakness

The clinician can modify the linguistic signal by using emphatic stress, speeding up his/her speech rate, and placing the target at the end of the utterance

False- All is correct except speeding up speech rate: rate should be slowed down.

MLU is a good measure of grammatical development.

False- It is a measure of utterance length but does not say much about the complexity of utterances.

True or False: Pragmatics deals with the literal meaning of an utterance, and semantics deals with the meaning beyond the literal meaning.

False- It's vise versa

Providing the listener with a conventional story starter "Once upon a time..." is part of content coding according to the C/F/U model.

False- No this is part of use coding in that it provides support for the listener.

Precursors of: CONTENT include how the child is interacting with other people FORM include how the child is producing vocalizations and speech sounds USE include how the child is interacting with objects and events (cognitive development)

False- Precursors of Content include how the child is interacting with objects and events (cognitive development). Precursors of Use include how the child is interacting with people (social development).

True or False: Precursors of: CONTENT include how the child is interacting with other people FORM include how the child is producing vocalizations and speech sounds USE include how the child is interacting with objects and events (cognitive development)

False- Precursors of Content include how the child is interacting with objects and events (cognitive development). Precursors of Use include how the child is interacting with people (social development).

True or False: The utterance /I eat big apple/ is an action utterance coordinated with attribution. The form is a four-constituent verb relation.

False- The content categories are correct, but the form is a three-constituent verb relation: /I eat big apple/

True or False: We can always presume that a fluent speaker always has good comprehension skills.

False- There are fluent speakers who still do not make sense.

True or False: Fast Forward represents a "Top Down" view of language processing

False; Fast Forward represents a Bottom Up view of language processing

Two types of childhood bilingualism are simultaneous and specification

False; Simultaneous and Sequential

bottom-up model

From auditory perception --> understanding discourse and making inferences

Goals -vs- procedure

Goals= based on child's highest level of performance Procedure= based on the child's profile in terms of maintaining factors

Give an example of a complex sentence coding notice without a connective (and no obligatory context to use a connective)

I see the birds feeding their babies.

Give an example of a complex sentence coding causal with a connective

I'm hungry because I forgot to eat breakfast this morning.

Comment

Identifies or describes objects, persons, states, or events with no other function.

Rejection

If a child opposes an action or refuses an object using a form of negation.

Criterion-Referenced Assessment: Word Meaning

If child scores below normal range on standardized comprehension tests, check comprehension of important word classes in child's environment: - Words for common objects, body parts, locations - Question words - Spatial prepositions - Verbs

Denial

If the child negates the identity, state, or event expressed in a prior utterance. (either an utterance from the child or another)

Segmentation

Indentifying recurring phonological strings in the speech input - Indentifying the concepts that words express

Specification

Indicate a particular person, object, or event.

Possession

Indicate that a particular object is associated with a given person.

The Hanen Program for Parents

Indirect service delivery model o Empowers parents to facilitate language development in naturalistic contexts, maximizing daily opportunities for communication development • Preprogram assessment, minimum of 16 hours of group training delivered by SLP to parents, three video feedback sessions o Parents are taught to: ▪ Use child-centered strategies (eg. Follow the child's lead) ▪ Interaction promoting strategies (eg. Ask q's to continue conversation, wait for the child to take a turn) ▪ Language modeling strategies (eg. Label, expand, comment)

Precursors of Content (Lahey, 1988)

Is about the child's understanding of the world—understanding of objects and actions • 1. Object identity and search - (Gaze at moving object, object search during free play (object permanence, & search to relate one object to another) 2. Action on an object -(Attend to adult action on object, imitate object specific actions, & demonstrate object specific actions) 3. Object-to-object relations - (Separate objects, join objects as presented, join objects in new specific way, & join objects as intended)

Benefits of using Bloom and Lahey

It integrates CFU and it is a developmental hierarchy, we can meet the child where they're at. Patient centered care.

How does Fast Forward modify a sound's input signal?

It modifies the signal by increasing the length of time between consonant-vowel transitions

Categorical Model

Language disorders are classified with reference to a diagnostic category (syndrome) into which the child is placed (popular in the 1960s and 1970s) - Autism, Intellectual handicap, Deaf/hearing impairment, Specific language impairment (SLI) • Child's language disorder is described with reference to the general expectations of the assigned category

Operant conditioning

Language learning is controlled by the environment (the environment shapes or "operates" on the response) • Learning sequence involves a selection of the stimulus, a response to that stimulus, and then an outcome (favorable or unfavorable) • Responses are generally consistent and preplanned with the assumption that rewards increase a desired behavior and punishments will decrease it (e.g., applied behavioral analysis)

Is Expressive Language Disorder an Accurate Diagnostic Category?

Leonard (2009) argued that the term should be used with extreme caution. - Expressive language deficits may be caused by limitations in knowledge that extend beyond a problem with retrieval and output processes. - Lower language comprehension will have an effect on expressive language.

The ball was over there

Locative State, VR, 3/3, temporal

Content category for "Go, put"

Locative action

Nonexistence/Disappearance

Make reference to the disappearance of an object or action.

Attribution

Makes reference to properties of objects with respect to an inherent state (broken) or a specification that distinguishes it from other objects.

Recurrence

Makes reference to the reappearance of an object or another instance of an object or event.

Problems with Language Form

Many children with language impairment has problems with language form. • Sound system, e.g., fronting /t/ for /k/ and /d/ for /g/. • Grammar, e.g., inflections and word order. • Other children have difficulties with language use.

Epistemic

Mental states of affairs (know, think, remember, wonder) about an event or state described in the compliment (I think I can put him in the house)

Adaptations to Linguistic and Other Contexts: Goals of Use Interacting With Content/Form

Microstructure: cohesive devices that tie sentences together to form a connected unit 1. Conjunction • Using connectives/conjunctions to tie adjacent clauses, both within and between sentences 2. Referencing • How prior mention is connected with what follows • Most common referents are pronouns and definite articles • Two types: exophoric and endophoric

What is the highest level of narrative development?

Multiple Causal Chain

Precursors of use

Mutual gaze, joint attention, pointing (interaction)

Give a complex sentence coding communication without a connective (and no obligatory context to using a connective)

My dad told me I'm not allowed.

Is /this cookie/ a verb relation?

NO: if not 2 const YES: copula is omitted

Is /big doggy/ a verb relation?

NO: not 2 const

Is /more cookie/ a verb relation?

NO: not 2 const

Is /more push/ a verb relation?

NO: not 2 constituents

Is /no drink/ a verb relation?

NO: not 2 constituents

Why would we assign a child a 0 based on an utterance?

New initiation of a topic

Do we count IPU on level 2 utterances?

No

Children's phonological short term memory is usually tested through...

Non-word Repetition

Content category for "allgone, nomore"

Nonexistance

content categories that are NEVER coded with verb relations

Nonexistence, recurrence, rejection, denial, attribution, possession, quantity, temporal, specification, dative

I see many birds

Notice, VR, 3/3 quantity

Phase 4: Additional New Content Categories

Notice/Perception: /I see Daddy/ /look at that/ • Temporal: - Aspect (ongoing or not) /I sitting down/ - Irregular past /I did bath/ - Habitual -s: /this goes here/

Name a stylized beginning to a narrative.

Once upon a time

Goals of Use Interacting With Content/Form

Orientations (Stein & Glenn's "Settings") • Lets listener know who characters are, and where, when, and why events took place • Younger children likely to give only characters and where • Child needs to determine how much he needs to tell listener Evaluations • Expresses how characters felt about what happened • Directly: "I was so happy" • Indirectly: "and I got the very dollhouse I had pleaded for" • Implied: "I can't wait to show this to my friends" Appendages • Beginnings: e.g., "Once upon a time" or giving an abstract at the beginning that summarizes the narrative • Endings: e.g., "that's all," "the end," or tying it all together and stating what was significant about it

Level 1

Precursors of CFU

Planning Intervention Activities Modifying Linguistic Signal

Rate: • Reducing rate decreases no. of units/time unit that need to be processed. • Increases clinician's artic: clarity. • Children with SLI have particular difficulty processing and storing verbal information presented at a rapid rate Repetition: • LD need more repetition than typical learners to acquire same concept. • Ex: presenting pictured contrastive forms (e.g., singular vs. plural) and naming each with their respective forms provides many repetitions of linguistic rule Increasing perceptual saliency through prosody • Children with SLI have more difficulty perceiving morphemes of low phonetic substance. • Increase stress to weak syllables to direct attention to function words, morphological endings. - Ex: prepositions: Put it in the box/ Increasing perceptual saliency through word order • Vary word order (avoids unnatural stress). • Ex: 1. Put copula forms of "to be" in sentences where they receive greater natural stress (e.g., initial or final position). - Questions: Is he here?/ - Answers to questions: Where is the monkey? Here he is/ Ex. 2. Create a situation where the child must highlight the copula (i.e., negating the adult utterance), e.g., showing the child a picture of a girl crying. Adult: "See, this girl is not crying, but this one..." Child: "is. Obligating pragmatically appropriate responses • Complete sentence: use stimulus that obligates it (i.e., picture and model). • Elliptical response: - Ex: Cl: will he run?/ Ch: he will/ - (If rule of game is not to say Y/N) Considering complexity • Some clinicians recommended using sentences that are slightly longer and more advanced than child's utterances, but semantically accessible to child; others reduce utterance, generally omitting function words. van Kleeck et al. (2010) • Studied the use of two types of input - Simplified to the point of being ungrammatical (telegraphic input) - Simplified but grammatical input • Article considers two types of external evidence on this topic - A meta-analysis of relevant research, including intervention studies and processing studies - Four experts' opinions

Parallel Structures

Recurrence of a grammatical structure throughout one or more successive clauses • Three types: 1. Global: the structure and the lexical content of an entire clause is repeated • /this goes here, • this goes here • and this goes here/ 2. Lexical: both the lexical content of a verb phrase and its structure are repeated • Each clause has the same verb and same structure, but the other lexical choices can differ • / I ate a cookie • and then Joe ate one/ 3. Structural: the verb-phrase structure is repeated, but the lexical content (different verbs, nouns, etc.) can vary • I rode my bike to the school • and then brought my books to the library/

Endophoric Reference

Referring to something in the linguistic context (i.e., previous utterances) • Two types: - Example 1 (indirect association) • /We found a lost dog, the leg was broke/ - Example 2 (more direct association) • /the leg was broke, it had blood on it/

State

Refers to a state of affairs: 1. Internal (Feelings, attitudes, and emotions) a. Volition/Intention (Want, gonna, go) b.Obligation (should, must, have) c. Possibility (can, could) 2. External state (darkness or cold) 3. Attribiutive state (Referring o the condition or properties of an object. (broken) 4. Possessive state (Temporary state of ownership (I got a pen)

Locative Action

Refers to movement where the goal of the movement is a change in location (person or object).

Existence

Refers to objects or categories that exist in the environment

Action

Refers to the movement relationships among people and objects whee the goal is not to change location.

Verb Relation + Coordination

Required: a verb relation (at least 2 constituents) + nonverb category(ies) • Nonverb categories: nonexistence, recurrence, rejection, denial, attribution, possession, quantity, temporal, specification, dative

Results of the intervention studies

Results - Children in the majority of the intervention studies showed no difference in language comprehension based on type of input. - In processing studies, which measured immediate comprehension, children from clinical populations responded inconsistently when listening to the two types of input. - Children who had typical language, however, favored grammatical input in their responses. - Regarding the experts' opinions: • Two suggest that telegraphic input is sometimes warranted; • One, who previously indirectly promoted its occasional use, no longer believes it should be used; • One provides reasons why telegraphic input should not be used and may even be harmful. • Conclusions: weak evidence base regarding the best type of input.

Speech vs. Language

Speech: Production of sound, more physical and anatomical. Language: Communication, the content of the language.

Routine

Stereotypes utterances that are used certain rituals (greetings)

Story Grammar

Story grammars specify the natural components of a story. • The story schemata—structures we use for production and comprehension of stories. • Knowledge guides our expectations of what should come next in the story. Setting • This story is about a lady who is in the park with her baby. The lady is sitting on a bench and the baby is in a baby carriage. Next to the carriage there is a cat sleeping on the ground. There is also a frog coming out of the pond. Initiating event • The baby and the cat see the frog jumping into the carriage. The lady doesn't see the frog. She gives the baby a bottle but the frog takes it. The lady still doesn't see the frog because she is reading a magazine. Response state The cat gets angy and jumps onto the carriage. The baby starts to cry and the lady notices the frog and the cat. Response plan • The cat is going to chase off the frog. Attempt • He runs after it and scares it off. Consequence • The carriage falls over and the baby is screaming. The frog is frightened and runs off. Resolution/reaction • The mother takes care of her baby

Language Impairment and Word Meaning

Studies of "incidental learning" show that children with LI understand fewer new words than children with TD after brief exposures in the naturalistic context of a TV show.

3-constituent utterances

Subject --> Verb --> Complement/object /baby hit cat/

3- or 4-constituent utterances (loc. action)

Subject --> Verb --> Object --> Place /John put dog on table/ /I sit down/

C/F/U coding system

TWO major aspects of language USE: 1. Use of nonlinguistic and linguistic context 2. Communicative function

Report/Inform

Talks about objects or events that are not present. (Past or narrative stories count)

Naturalistic Intervention

Teaching in the places where children are living, playing, or participating in educational tasks

Representative Approaches of Naturalistic Intervention: Indirect Language Stimulation

Techniques with nontalkers: • Self-talk: clinician describes own actions while engaging in parallel play with child - Provides match between words and actions • Parallel talk: clinician talks about child's actions, focus of attention - E.g., talk about child smelling blocks, or focusing on texture of rug, or rolling objects Techniques with children producing speech ' • Buildups and breakdowns: associated with language growth in typically dev children - First, expand child's utterance - Ch: doggy house/ Cl: yes, the doggy is in the house/ - Then break it down into several phrase-sized pieces - Cl: the house, he's in the house, in the house, the doggy, the doggy is in the house/ • Recast sentences: expand child's utterance into a different type of sentence • Ch: doggy house/ Cl: Is the doggy in the house?/ Cl: The doggy is not in the house/

We code ____ for "ing" suffix

Temporal

What level is this narrative? Were the referents easily retrieved? Once upon a time there was a princess She had a lot of friends and one day went to her friend Sam's house He made them macaroni and cheese and the best kale salad The princess was so excited because kale is her favorite food After that, they watched a movie called "Trolls" Sam drove her home on his chariot and said good night The princess felt full and happy The end

Temporal, Yes (Princess, she; Sam, he)

Why would we assign contingent?

The child is on topic

Temporal

The coding of aspect, tense, and temporal dependency w. sequential events

Why is discrimination of tone pairs so dependent on duration in young children with language impairment?

The encoding of an auditory trace into a more durable representation is much slower than in normally developing children. • No problem if there is a long interval between stimuli or if the duration is long— but for brief stimuli most of the info from the auditory trace will have decayed before it is encoded. • OR: If two stimuli occur in rapid succession, the second will occur before the encoding of the first one is complete.

Mapping

The first domain (phonology) onto the second (conceptual)

Additive

The joining of two objects/events/states without a dependency relation. (I got a pen & a knife)

heaps, narritive

The lowest level is _____ and the highest level is _____.

Adversative

The relationship between 2 events or states is one of contrast

Evans Theory (2008)

The same age child with a language disorder may show less behavioral stability and more sensitivity to external contextual demands and/or changes in the child's current state.

Pretend

The utterance sets an imaginary scene

Discourse

The utternace serves to maintain and regulate conversational exchanges. (Placed within other categories)

Why would we assign IPU(imitation of prior utterances)

They repeated what the adult said

Give an example of a complex sentence coding specification with a connective

This is my friend that I was telling you about.

Fetal Alcohol Syndrome

Three diagnostic criteria: • Growth deficiency • Specific facial features • Microencephaly, tremors, hyperactivity, motor difficulties, poor attention, learning disabilities, cognitive impairments, or seizures + info that the mother did in fact use alcohol

Precursors of form

Tongue clicks, babbling, sound production (speech prod)

A language disorder will be apparent in both languages that the child is learning.

True

A verb relation has to have two major constituents.

True

ADHD is diagnosed based on behavior rating scales.

True

Anaphoric referencing is when the speaker refers to something in the linguistic context (previous utterances).

True

Content categories that are coded with verb relations can be coordinated with other content categories that are not coded with verb relations.

True

Context and appropriacy are central concepts when you study pragmatics.

True

Conversation analysis focuses on whole interactions without setting up hypotheses ahead of time. All contributions to the interaction are considered valuable.

True

Functional speech at approximately age 6 is a strong prognostic factor, indicating a positive development.

True

In English-speaking children the main problem for children with SLI is with verb morphology.

True

In a nonverbal child with autism, precursors to C/F/U should always be evaluated.

True

In early child language the same form can express different content depending on the context.

True

Individuals with an intellectual handicap will have problems with executive functions.

True

Intervention approaches can be child directed, clinician directed, or a hybrid.

True

Narrative analysis includes the content level (macrolevel) and the form level (microlevel) and the latter entails narrative cohesion.

True

Poor comprehension is not going to affect the intervention goals we determine, but it will affect the intervention procedures.

True

Researchers recommend a cut-off of approximately 1.25-1.5 standard deviations below the mean on a comprehensive test battery to diagnose a language disorder.

True

Sensitivity of a test is the degree to which the test accurately identifies a child with a disorder.

True

Task analysis is the process of really thinking of and analyzing what you are asking the client to do, and what is required to be successful in the task.

True

The classic way to evaluate short-term phonological memory skills in children is nonword repetition.

True

The clinician's task following the assessment is to determine if there is a problem and, if so, to determine intervention goals and intervention procedure.

True

The study mostly referred to for prevalence rates of SLI indicates that approximately 7% of all kindergarten children have SLI.

True

There are two types of bilingualism in children: simultaneous and sequential.

True

True or False: A clinician following a social cognitive model would follow the child's lead.

True

True or False: A verb relation has to have two major constituents.

True

True or False: Consistent phonetic forms can be unconventional but can be the child's word for an item.

True

True or False: Content categories that are coded with verb relations can be coordinated with other content categories that are not coded with verb relations.

True

True or False: Context and appropriacy are central concepts when you study pragmatics.

True

True or False: Conversation analysis focuses on whole interactions without setting up hypotheses ahead of time. All contributions to the interaction are considered valuable.

True

True or False: Sensitivity of a test is the degree to which the test accurately identifies a child with a disorder.

True

True or False: Task analysis is the process of really thinking of and analyzing what you are asking the client to do, and what is required to be successful in the task.

True

True or False: The clinician's task following the assessment is to determine if there is a problem and, if so, to determine intervention goals and intervention procedure.

True

True or false: In the specific disabilities model, the attempt is to profile each child's weaknesses and to understand underlying causes for the language impairment.

True

Vowels have critical information spread over a longer duration than consonants and are therefore easier to perceive.

True

onsistent phonetic forms can be unconventional but can be the child's word for an item.

True

There can be several reasons for comprehension breakdown.

True- Yes, for example, auditory memory issues, poor attention, and language processing problems.

True or False: There can be several reasons for comprehension breakdown.

True- Yes, for example, auditory memory issues, poor attention, and language processing problems.

Latino English

Two major Hispanic groups: • Puerto Rican-Carribean • Mexican-Central American • Different dialectal features

Hearing Impairment

Type - Sensorineural: in the cochlea (hair cells) or the neurological pathways, irreversible. Mild-total degree. - Conductive: external or middle ear—changing the transmission to the cochlea. Can be compensated for with amplification. • Measure: dB. 0 dB is roughly the softest sound that we can hear. 120 dB causes pain. • Average speaking level is around 40 dB. • National screening for newborns. • Brainstem audiometry. • Mild • Moderate (/s/, some vowelinformation) • Severe • Profound • Total • Deafness: hearing loss of more than 70 dB—cannot understand conversational speech

Clause

Typically consists of a subject (agent) and a predicate (verb/action).

Syntactic Bootstrapping

Using syntactic Context to Infer Meaning • Function words such as articles "the" and "a" • Inflections such as "-ing" and "ed" give information about the word class of an unknown word • Evidence that children with language impairment have difficulties with synt. bootstrapping • From approx. 3rd grade, the child has to encounter words that are common in written language but not so common in oral language in order to continue to develop their vocabulary.

Locative State

Utterances in the locative-state category refer to spatial relations (i.e. a person or object and its location) where no movement within the context of the speech event (i.e. immediately before, during or after the child utterance) established the location.

Level 3

Verb relations (3-constituents)

Vocabulary Learning: Children With SLI

Vocabulary learning involves: -Formation of concepts that words then express -Perception and identification of sounds and formation of phonological representations - Mapping the second domain (form/ phonology) onto the first (conceptual) • Most can identify concepts that words express, but maintain an expressive word problem • Retrieval difficulty may be due to: - Inadequate perception and/or memory of sound sequences comprising words: phonological representation - Insufficient knowledge of concepts or features that word represents: semantic representation

Emote

When the only function of the utterance is to express an emotion

Why would we assign a NC(non-contingent)

When they are completely off topic

FORM in Level 3,

When we code FORM in Level 3, we look at: • In how many utterances did the child use 3 constituents out of the utterances where 3 constituents were obligated • Obligatory contexts

Is /baby fall/ a verb relation?

YES: 2 constituents

Is /drink milk/ a verb relation?

YES: 2 constituents

In the specific disabilities model, the attempt is to profile each child's weaknesses and to understand underlying causes for the language impairment.

Yes

Is /daddy car/ a verb relation?

Yes: if context indicates that "drive" is omitted

CAPD (Central Auditory Processing Disorder)

broadly defined as a deficit in the processing of info that is specific to the auditory modality in the presence of normal hearing • "Limitations in the ongoing transmission, analysis, organization, transformation, elaboration, storage, retrieval and use of information contatined in audible signals." CAPD • Poor listening skills. • Difficulty in following directions. • Distractibility and inattentiveness. • Problems in reading, spelling, using written language, and memory. • Typically diagnosed on the performance on certain audiological tests by audiologist. • Poor attention could be the reason for poor performance on these tests. CAPD • Typically diagnosed by an audiologist. • Intervention should target language.

Brown's Stages

described 5 stages of language learning based on a child's MLU, because he felt that MLU was a good measure of a child's overall language development.

Causal

having to do with cause and effect (ether implicit or explicit)

Precursors of content

object permanence, searching for objects, using toys together, cognitive skills

naturalistic sample

observing and recording behavior in naturally occurring situations without trying to manipulate and control the situation -Determine their individual level

Complex Sentences: Form—Conjunction

• (Additive: successive utt with and without and to join clauses or phrases) • Content: Additive first without "and": • /That be the stove/want cook it/ • I dump out this way/ stir it • Ph 5: VP - c + VP • /a chair, a bed/ NP - c + NP • /a chair and a bed/ NP + c + NP, c = and • Content: Temporal • /Jocelyn's going home and take her sweater off/ Ph 6 • VP + c + VP, c = and • /J going home then take her sweater off/ • VP + c + VP, c = then, Ph 7 • /he sings when he talkes a shower/ • V + c + VP, c = when, Ph 7 • Content: Causal • /I am hungry hafta eat/ • VP - c + VP, Ph 5 • /I gonna step in puddle with sandals on and get it all wet/ VP + c + VP, c = and, Ph 6 • Content: Causal • /I wanna come with you, cause I have shoes on/ • VP + c + VP, c = cause, Ph 7 • Content: Adversative • /the butterflies saw the bumblebees here but they are not coming out/ • VP + c + NP + VP, c = but, Ph 8 • Content: Specification • /looks like a fishing thing and you fish with it/] • V + c + VP, c = and, Ph 7 • /this is a truck and you drive it/ • VP + c + VP, c = and

Embedded causal chains

• 1st episode brought about 2nd episode; they're causally related, not two separate strands 1st episode: • A man named Mr. Dirt lived in the country all by himself and owned a farm/ One calf got away and went into the woods and headed for the mountains/ So Mr. Dirt went up the mountain after the calf/... 2nd episode: • ...On the way a bear came after Mr. Dirt/ He ran up a tree and the bear came after him/ Mr. Dirt threw his ax at the bear and hit the bear in the head/ Blood poured out of his head and the bear fell down and died/ A few minutes later the calf ran over to Mr. Dirt and they went back to the farm/

Syntax and Morphology

• A 2- to 3-year-old child can understand agentaction-object instructions. • Also rely on "a probable event strategy." (The mommy feeds the baby. The baby feeds the mommy.) • 3- to 4-year-olds understand both probable and improbable sentences.

Cochlear Implants (CI)

• A CI sends, via a speech processor, a pattern of electrical pulses to the electrodes in the cochlea—the auditory nerve carries the signal to the brain where the signals are interpreted as a form of hearing. • Not ideal for all candidates—careful consideration • Can offer a tremendous amount of benefit • Completely destroy any residual hearing • Controversial (e.g., in the deaf community) • As young as 12-24 mos. must have a bilateraal profound HL, receive minimal benefit from amplification, be enrolled in auditory therapy, and have no other medical contraindication. • After the surgery: • Activation of speech processor • Electrodes gradually turned on (mapping) • 9- to 12-month process • Also, after the mapping process, auditory and speech/language therapy is usually needed • Successful outcomes depend on: • Age at implantation • Cognitive skills • Support/education • More research is still needed

Maltreatment

• A child with a developmental issue and a communication impairment may be less satisfying for a parent to care for and thus more likely to experience abuse. • Maltreatment itself constitutes a risk for communication impairments. • Family-centered intervention.

African-American English

• A dialect used in inner cities of most large urban areas and the rural south. • Not all African Americans speak this dialect. Also linked to socioeconomic factors. • Formal-informal continuum. • A systematic language rule system. Not a deviant or improper form of English. • Its linguistic variations are not errors. As complex as SAE. • Language-difference vs. language disorder.

Enhanced Milieu Teaching

• A naturalistic, conversation-based strategy for teaching language and communication skills to children in the early stages of language development • EMT is a hybrid intervention based on three components: -Environment arrangement -Responsive interaction (RI) (contingent semantic feedback, modeling language targets in descriptive talk, expansions, balanced turn taking) -Milieu teaching (MT) (elicitive models, mands, time delays, and incidental teaching) • Effective use of EMT requires high fidelity in the implementation of these three components and precise teaching of specific child targets

Autism

• A neurobiological disorder • Genetic base • Syndrome defined based on observed behaviors • Prognosis: related to two factors • Cognitive skills • Language skills • Functional speech by 6—better prognosis • Lifelong condition • Frequently co-occurs with intellectual handicaps, and other conditions, such as ADHD, OCD • Can be hard to assess (may have to use tangible reinforcement and present easy items first) • Important to remember that no child should be denied an in-depth assessment of communicative skills because of a presumed diagnosis • Pattern often seen: - n discrimination or identification of small differences between stimuli, ST memory - Excessively responsive to some stimuli or underresponsive to other stimuli • Neuropsychological studies: - n memory, visuospatial, sensoriperceptual, single-modality problem-solving, detail - p transfer information across sensory modalities, complex tasks involving multiple domains of information processing, gestalt • Face recognition, imitation of other's actions and emotions • Do form attachments, but these are qualitiatively different and emotional expression is impoverished • Social cognition includes understanding how other people think and feel • Mentalizing/theory of mind/presupposition • Has been identified as a core problem in autism • Difficulty understanding other people's motivations, intentions, and actions • Social cognitive impairment—core. • Young children often fail to respond to others, do not seem interested in social interaction, and do not initiate communication with others. • Some young children even seem very frightened by other people approaching them. • A child may not respond to his/her name. • 75% of verbal children show use of echolalia. Prizant (1983) • Older children: • Difficulties establishing a shared frame of reference • (Assuming the listener to have too much or too little knowledge) • No sensitivity to social norms (you're ugly) • Excessive use of stereotyped expressions or topics • No sensitivity to nonverbal cues in interaction • Take comprehension difficulties into account—simplify input. • Always try to see how the child responds to written language. • Make available language forms used in more functional contexts. • In nonverbal children: - Assess precursory behaviors and try to assess comprehension. - Provide some conventional means for communication (gestures, signs, vocalizations, written language) • Augmentative communication: - PECS (picture exchange communication system) widely used system for requesting - Signs - Other visual systems • Genetics: - Twin and family studies suggest that both autism and SLI are genetically mediated. - The genetic mechanisms are not clear, though. - Autism concordance rate for MZ twins is approx. 65%.

Patterns of Communication Skills

• About 50% have language skills at levels expected from cognitive levels. • 25% have comprehension skills at level of mental age but poorer production skills. • 25% have comprehension and production poorer than mental age level • An in-depth assessment is always needed in order to plan intervention. • In general, the sequence of development follows normal development. • MLU levels are reached at later ages • Gram morphemes learned in the same order • Fewer complex sentences, fewer elaborations and relative clauses • Phonological processes used longer • More inconsistent artic errors • Vocabulary learned more easily than syntax • Semantic relations expressed in a similar way as mental-age children • Concrete words preferred to abstract concepts • Young children do use gestures like children without IH • Poor performance in referential communication tasks • Poor ability to seek clarification • Do not ask questions to the same extent

Social Communication Disorder Pragmatic Language Impairment

• Affects both verbal and nonverbal communication • Responding to others • Taking turns • Using gestures • Staying on topic • Talking about emotions/feelings • Adjusting style of talking to fit different listeners • Asking questions • Making and keeping friends • NOT repetitive/restricted behaviors as seen in autism • Poor language comprehension • Poor reading comprehension • Can be distinguished from SLI and ASD Taylor & Whitehouse (2013), Gibson et al. (2013)

Social Cognitive

• Also referred to as social learning; transactional learning. • Language is learned through social interaction with a more competent member of the culture. • Adults provide models of behavior. • Children learn through abstracting rules based on these models. • Approaches are modeling, scaffolding, routines and scripts. • Has influenced concept of "dynamic assessment." • Example of social cognitive theory: Vygotsky's "Zone of Proximal Development" (ZPD)

Risk Factors

• Any risk factors, such as maternal substance abuse, malnutrition, neglect, social deprivation, will have a negative impact on development in general, even if they do not directly lead to a language impairment.

Hybrid Intervention Approaches 2. Milieu Teaching

• Applies operant principles to quasinaturalistic settings • Clinician arranges setting to elicit child's initiation • Uses child's interest and initiation as opportunities for modeling, prompting, and questioning to get child to produce language • Uses extrinsic and intrinsic (e.g., getting something after saying "I want") reinforcement

Hybrid Intervention Approaches 3. Script Play

• Assumption: reduces the cognitive load of language by embedding it in the context of familiar routines • Can create a routine or reenact scripts child already knows (e.g., snack time, eating at fast food restaurant) with accompanying language • Once child knows the script, can violate the routine by asking child to do something outside of the routine (e.g., pour juice before cups are given out, substitute inaccurate words) • Violations of routine challenge child to call attention to them

ADHD

• Attention deficit hyperactivity disorder • Most common behavior problem in school-age children • Excessive inattention • Overactivity/impulsivity • Lack of objective criteria • Context-dependent • Often present along with other diagnoses: - Fragile X - Autism - Learning disabilities - SLI - CAPD • Diagnosis based on rating scales such as: • The Child Behavior Checklist (Achenbach) • Behavior management—useful strategy • Older children cognitive-behavioral approaches (self-monitoring) • Medication

Responsivity Education/Prelinguistic Milieu Teaching

• Based on the premise that prelinguistic communication development establishes the foundation for later language development. When prelinguistic language is delayed or disordered, a carefully targeted and well-implemented treatment program can help to develop the critical intentional communication skills necessary for early language intervention. • Consists of two components: -Prelinguistic milieu teaching (PMT) which is delivered by the clinician to the child -Responsivity education (RE) which is delivered by the clinician to the parents • PMT is designed to increase the frequency and complexity of intentional nonverbal communication acts to set the stage for later language learners.

Precursors of Language

• Before the use of conventional words, the infant is fairly proficient at communicating. • He/she lets us know when he is happy or unhappy, when he/she wants something or does not want something, or calls our attention to something.

Minimal Story

• Beginning state: The boy was lonely. • Middle: The daddy gave him a puppy. • End: Now he is happy

A Focus on the Environment in Intervention: Directive

• Behavior modification, traditional, (high structure): the focus is clinician directed • Specific goals and responses may be more strictly predetermined by clinician

Sensory Seficits

• Blindness • Deaf-blindness • Hearing impairment

1. Narrative Level Analysis Children 2-5

• Centering: a story nucleus, core, or theme • Chaining: when children develop a sense of time • Centering is earlier, children focus on some aspect that interests them • Six levels of developmental patterns • Appelbee (1978)

C. Extended Optional Infinitives Account (Rice et al.)

• Children at an early stage are not aware that tense marking is obligatory. • They treat it as optional, using infinitives (drink juice). • Children with SLI stay in this phase longer than other children. • Predicts that tense and agreement markings are sometimes omitted, but when used, they are used appropriately. • Support from data from English-speaking children with SLI.

L2 Learners

• Children from homes where English is not spoken or where English is limited cannot be expected to perform as well on language tests in English. L2 Learners (cont.) • ASHA: in order for LEP children to be considered communication handicapped, they must have limited communicative competence in both languages. • Recommended: - LEP-children be tested in their native language in order to assess if that too is delayed. - Federal mandates require that all assessments be conducted in the client's primary language.

Understanding Word Meaning

• Children with typical language development (TD) can pick up notion of word's meaning with only brief exposure (fast mapping). • Studies show that children with SLI understand fewer new words than TD after brief exposures in naturalistic context of TV show. • Children with SLI know fewer words than children with TD of same age.

Hybrid Intervention Approaches 1. Focused Stimulation

• Clinician maintains control, but tempts child to spontaneously produce targets in obligatory contexts. • Clinician gives multiple examples of target forms in contexts that highlight the content and use of that form. • Child not required to produce target. • Clinician gives feedback, like expansions.

comprehension

• Comprehension has to be infererred. • How do we know if someone had understood? • Task analysis. • There are clinical conditions where an individual presents with poor language comprehension but fluent speech. • Poor language comprehension will always have an effect on language production. • Therefore, if a child has problems with language production, we always have to consider the possibility that language comprehension is not at age level. • If a child is fluent, but it is difficult to follow what he/she says, we always have to assess language comprehension.

Fast ForWord

• Computerized treatment program using temporally modified speech signals at different levels of language processing. • Creators claim benefits for children with DLD and reading disorders. • Has been much discussed and studies have shown mixed results—several studies have not been able to show improvements in naturalistic language skills or results on language or reading tests. • Computerized treatment program using temporally modified speech signals at different levels of language processing. • Creators claim benefits for children with DLD and reading disorders. • Has been much discussed and studies have shown mixed results - several studies have not been able to show improvements in naturalistic language skills or results on language or reading tests.

/I wanna run/

• Content category: Action + volition/intention • Phase 4

Intervention Approaches Continuum of Naturalness

• Continuum of naturalness: child centered → hybrid → clinician directed • More naturalistic activities will lead to better generalization • But if a less naturalistic activity is more effective, it's the better choice • Can move to more natural contexts once child is producing targets Are intrinsic (natural) reinforcements always best? • Natural reinforcers more likely lead to increase in target behaviors, as well as better maintainence and generalization • But if child can't understand natural reinforcers for language behaviors (listener attention, having questions answered, getting what he asked for) • May need extrinsic (secondary) reinforcers (praise, tokens)

Genres: Hierarchy

• Conversation • Narration • Expository • Persuasive

2b. Processing Deficit in Specific Mechanisms

• Deficits are specific but have far-reaching consequences for language development and function A. Deficits in temporal processing (Tallal et al.) • SLI: poor processing of stimuli of brief duration or stimuli presented in rapid succession. B. Deficits in phonological memory (working memory) (Baddeley & Hitch, 1974: Gathercole & Baddeley, 1990) • Locke' s neuro-developmental account. (Locke, 1994) • Language and linguistic capacity develops in sequential and critically timed phases. • Each phase in language development is served by a distinct neural specialization. • The child begins to discover the rules of grammar. • A certain number of words is needed in order to activate a pre-programmed grammatical analysis mechanism. • There is a time-window for the mechanism to be activated (20-36ms). • A general neuromaturational delay is the cause of SLI. • Poor lexical development leads to no activation in grammatical modules in the left hemisphere - other less well-adapted mechanisms in the right hemisphere take over linguistic processing.

Narrative Development Lahey

• Development of C/F interactions: macrostructure/logical-temporal structure • Represents a developmental hierarchy • Four levels of ↑ing complexity: additive, then temporal, then causal, then causal with multiple episodes

9 Content Categories with Complex Sentences

• Developmental order: Phases 4 through 8 -Phase 4: State -Phase 5: Additive, Causal -Phase 6: Temporal -Phase 7: Specification, Epistemic, Adversative, Notice -Phase 8: Communication

Autism and Communication

• Disorder primarily of communication rather than language • Problems with intentional communication • But autism may co-occur with language impairment • 1-year-olds later diagnosed with autism: • Lack of joint attentional behavior • Abnormal response to human voices • May use gestures to request, protest, and regulate other people's actions, but • Do not to show and point—like other children • 50% of all children with autism never develop speech. • When speech is absent, it is not replaced by communicative gestures as in HI or IH for example. • Maladaptive behaviors for expressing requests and to protest may develop (e.g., head-banging, self-injuring). • Late onset of language • Speech develops slower • Some children acquire a few words, but fail to acquire more or lose the ones they had • Aspects of FORM may be relatively intact • Content and use impaired • Lack of spontaneity • Problems adapting to the listener • Politeness rules • Inferring • Relevance • Maintaining topic (outside their own interest) • Use of nonreciprocal speech (interpersonal) • Use of language that is stuck in the original context when it was spoken • Literal interpretations (lack of humor) • Echolalia (may be communicative attempts or self-stimulatory) • When language skills improve, echolalia decreases

Visual Impairments

• Do not have as much negative effect on language development as HI • Input different • Semantics and pragmatics • SLP consultative approach • Some children may need extra stimulation

Identification

• Due to newborn hearing screenings: average age of identification is 2-3 months. • 47 states have implemented newborn and infant hearing screening programs. • DeLuca & Cleary, 2017

Nonword Repetition

• Early screening test to predict later language difficulties (e.g., Bishop et al., 1996) • Not experience based nor culturally biased (e.g., Campbell et al., 1997; Kamhi,1998) • Particularly difficult for children with SLI and poor readers (e.g., Gathercole & Baddeley, 1990, 1993; Gathercole et al., 1994)

Non-Word Repetition

• Early screening test to predict later language difficulties. - (e.g., Bishop et al. 1996) • Not experience-based nor culturally biased. - (e.g., Campbell et al. 1997; Kamhi,1998) • Particularly difficult for children with SLI and poor readers. - (e.g., Gathercole & Baddeley,1990; 1993; Gathercole et al. 1994)

Narratives

• Early skills predict later academic development—reading comprehension in particular. • Contain a structure that children encounter also in books. Narratives vs. Conversation: • ↑ MLU • ↑ More advanced grammatical structure • ↓ Fluency (more hesitation phenomena) • ↓ Intelligibility • E.g., Reuterskiöld-Wagner et al. (2000)

After Complex Sentences

• Eventually when the child is producing complex sentences, he/she will start stringing them together. • He/she is now expressing the content category communication, and in terms of USE, he/she is now sharing content with more advanced form. • Now we can start to look at narrative development.

Three Major Theories

• Executive function • Central coherence • Theory of mid/mentalizing/ social cognition

Early Content Categories That Are Expressed With Verb Relations

• Existence /is french fry/ /this is Lizzy/ /that ball/ (said as pointing to ball) • Action /hit monkey/ /girl paint/ /mommy read book/ • Locative action /put book/ /man go train/ I put book • Locative state /here spoon/ (said as pointing out location of spoon) /where is it↑/ /is there/ • Notice: need specific verb of notice (look, see, watch, hear, show, etc.) /hear monkey/ /I see mommy/ State: • Internal: /want spoon/ /I love monkey/ /me hungry/ • Possessive state: /that is mine/ (Compare with: This is my car (existence + possessive) /I got cookie/ /have book/ • Attributive state: /stove is hot/ /is pretty/ (Compare with: This is a pretty dress (existence + attribution)

Level 3 Analysis: Included and Expected Constituents

• Expected no. of constituents: the number obligated by the context in the ambient language • Included no. of constituents: what is actually produced by the child • Included/expected = level of achievement • If there were four examples where 3 const were obligated and the child produced 2: (2/4 = 50% achievement)

Testing

• Expressive skills (e.g., naming test) • Receptive skills (e.g., PPVT Peabody receptive one-word vocabulary) • Word-finding problems (tip of the tongue) -Child knows the word receptively, but can't produce it in a naming task • Give a sentence completion task or the initial sound • Many standardized tests are available in other languages than English, e.g., Spanish. • Standardized on monolingual Englishspeaking children and then translated into Spanish. • Even when standardized on a Spanishspeaking population, the normed sample consists of a monolingual Spanishspeaking population and not on speakers with Spanish as an L1 and English as an L2. • Compare with the SALT program. • Even if it has been normed on a Spanish speaking ESL population, the Spanish speaking population is very heterogeneous both linguistically and culturally. • Thus bilingual SPLs should not rely too heavily on tests when assessing children.

Down Syndrome

• Extra (third) copy of the 21st chromosome • 1/800 births • Occurrence increases with increased maternal age • Mild-moderate IH • Hypotonia • Characteristic face • Hyperflexibility of joints Ear anomalities (frequent otitis media) • Oral-motor difficulties • Poor speech-language and hearing • Rough breathy voice • Poor speech intelligibility • Poor articulation (oral motor control) • Semantic development: an area of strength • Gestural use: area of strength—can be used for manual signing • Literacy should be part of intervention. • A few studies indicate that DS children can reach reading levels in advance of their oral language levels. Rely more on whole word recognition

Behavioral Disorders

• Frequently co-occur with language and communication impairment • Can be categorized in different subtypes

Aspects of Intervention

• Goal planning • Procedure planning -Consideration of maintaining factors -Consideration of learning theories • Three major areas (sensorimotor, psychosocial, cognitive) • Clinical syndrome categories may suggest any of the above factors • These factors will influence goals and procedure planning - Affect prognosis (ultimate achievements) - Number of goals - Approach in goal facilitation

Determination of Intervention Goals

• Goals directed at the speech language behavior itself (the plan) • Formulating goals at three phases - Long term -Short term -Session • Some goals may be directed at factors maintaining the language problem - Eliminate factor - Modify factor - Compensate for factor

Understanding Intended Meaning (Social Aspects)

• Going beyond the literal propositional meaning of the utterance. • Children can infer a great deal about the communicative intentions of others before they can interpret literal meaning (e.g., 2-year-olds looking up). • Theory of mind: the ability to build complex mental representations of other people's attitudes to propositions (metarepresentations)

Goal-based causal chains without obstacle

• Had a plan, went and carried it out • Resolution of problem isn't automatic, it's related to attempts to carry out the goals • Once there was a big gray fox who lived in a cave near the woods/ One day he decided that he was very hungry and that he need to catch something for dinner/ So he went outside, spotted a baby rabbit, caught him, and had him for dinner/

SLI - LI, LD

• Identifying and describing SLI - relevant for research purposes; • Describing language behavior in LI (LD) is relevant for clinical purposes. • Main vulnerability in English-speaking children with SLI is verb morphology, past tense -ed, 3rd person singular -s, copula. • Also poorer vocabulary learning.

Categorical Perception

• If we manipulate acoustic features (e.g., VOT of p and b) of a synthesised consonant along a continuum • Do not see a gradual change in how the stimulus is perceived: is perceived as a /p/ up to a certain point, and then as a /b/ • Non-native adult speakers perceive a speech sound in another language as the sound in their own language that is most closely related in terms of acoustics

Early Autism Diagnosis

• Important • Difficult, e.g., fewer typical behaviors at age 18 mos. or 2 yrs than later • Variability • Joint attention, interest in looking at faces, limited response to own name • CHAT: Checklist for Autism in Toddlers • CARS: Childhood Autism Rating Scale • M-CHAT: Modified Checklist for Autism in Toddlers

Conclusion

• Important to try to understand the child's level of comprehension: both in testing situations and in naturalistic situations with contexual support. • This information will inform how we determine our intervention procedures (HOW we work toward the intervention goals).

Comprehensive case study for bilingual children

• In addition to usual information: • Language use in the home (form and nature) • Code-switching • Sociocultural factors • Age of exposure/acquisition, sequential, school setting • Developmental milestones in L1 • Contact with homeland, motivation

Focused Stimulation Approach to Language Intervention

• In focused stimulation, a child is exposed to multiple exemplars of a specific linguistic target (eg. Specific vocabulary item or grammatical morpheme) within meaningful communicative contexts. • Child may be given opportunities to produce the linguistic construction • Imitation procedures are not used- instead attempts are made to elicit spontaneous productions of target by taking advantage of naturalistic conversational contexts promoting the use of the target • Can be used to promote form, content, and/or use of language and typically involves a contextually based service delivery model implemented by clinicians and/or parents

Hierarchical Developmental Model

• In terms of analyzing the child's language: • Now we know that he/she is showing all of these behaviors. • Now we are going to look for the next developmental feature, and we do not code number of constituents or coordinations anymore: Level 4.

Immature Style of Phonological Processing

• Incoming stimuli would be compared with all lexical items with a common onset. • Young children gradually seem to analyze words into subsyllabic units (at the sound level). • LI: persist in a more global syllabic analysis of word structure: • New word learning will be slowed down + lexical access/word retreival will be slow and inefficient.

Early Development

• Interaction between genetic programming and environmental factors: influencing neurophysiological development, which underlies the development of behavior, including language and communication

Autism Interventions

• Intervention: - Applied Behavior Analysis (ABA, Lovaas). Behavior modification, intensive training program. - ESDM (Early Start Denver Model) incorporates both ABA approaches and developmental approaches. - DIR (Developmental, Individual difference, Relationship) Floor time: developmental approach—naturalistic (Greenspan): child's affect and engagement are stressed - Sensory Integration Therapy (OTs) 1. Facilitated communication: views problems with communication as a motor handicap. A facilitator helps the individal communicate: controversial, not evidencebased 2. Auditory integration therapy—listening to electronically manipulated music in headphones. Does not meet criteria for efficacy or safety according to ASHA.

Intervention (Lahey)

• Lahey: Include comprehension during assessment, but focus on production during intervention. • Studies have shown that working on expressive language leads to ↑ receptive skills but not vice versa.

Piagetian Cognitive

• Language learning involves the organization of nonlinguistic and linguistic information. • The organization of this information results in the construction of cognitive structures, mental representations and rules, underlying form, content, and use. • Adult should provide the right opportunities for the development of nonlinguistic concepts (should create a problem-solving situation, obstacles; temptations). • Responses should facilitate further problem-solving (reflection on behavior).

Children With CIs

• Many children with CIs are now successfully integrated in regular classrooms. • Some children do not develop language and/or literacy skills at the level of TD children. • Some researchers have suggested a subgroup of children with CI + LI

2a. General Processing Limitations

• Many studies: children with SLI also have problems in non-verbal domains. • Simultaneous interaction of different processes with each other, with the context, and with the nature of the material to be processed. Limited Processing Capacity • Space - memory • Energy - mental resources • Time - rate of processing A. Generalized slowing hypothesis (Kail 1994) • A generalized deficit in speed of processing. • Children with SLI respond more slowly on both linguistic (picture naming, word recognition) and non-linguistic tasks (e.g., block design, mental rotation) compared to children with NL. • Operations central to language learning are more time-dependent than other cognitive operations. • Language tasks are therefore more vulnerable to slow processing speed. • Some support - Not broadly applicable as an account of SLI B. The surface account (Leonard 1989; 1992) • Morphological problems in children with SLI are attributed to perceptual limitations, particularly speech of processing. • Difficulties perceiving sounds of low phonetic substance. B. The surface account (Leonard 1989; 1992) • Problem: combined effect of a non-salient syllable or segment and its role as a grammatical functor. • Predicts problems with grammatical morphology but also lexical development (inflections carry information about the meaning and function of words). • Not supported by data from other languages. C. The sparse morphology account (Leonard et al. -87) • The child focuses on easily accessible forms, e.g., morphology for a German-, Italian-, and Hebrew-speaking child, but word order for an English-speaking child.

HIV

• Maternal-infant blood transmisson before or during birth. • 25-40% of infants born to women with HIV develop AIDS. • If they do not, they seem to develop language which is at the level of their peers at the age of 3-5. • In cases of AIDS, the frequent infections and illnesses have a negative effect on the development of language.

Otits Media

• Middle-ear occlusion • Tube insertion for ventilation • No empirical support for the view that OM is a causal factor in the emergence of language impairment

Dialects

• Most languages have a standard version: • Deficit approach—anything else than the standard version is less valued. • Languages are not static—constantly changing and fluid—great variation. • Context dependent. • Variations of a language that characterize the language of a particular group are called a dialect. • A language-rule system used by an identifiable group of people—varies in some way from the ideal language standard. • Usually differ from the standard version in frequency of use of certain structures—not in presence or absence of these structures. • Each dialect shares a common set of grammatical rules with the standard language. • No dialect is better than any other and should not be considered a deviant or inferior form of the language. • To devalue a dialect is to devalue a culture or the individuals of this culture. • Sociolinguistics. Related factors: • Geography • Socioeconomic factors • Race and ethnicity • Situation/context • Peer-group influences • Code-switching • Sound patterns • Words and idioms • Syntactic features • Prosodic features Racial and ethnic dialects in the United States: • African-American English • Spanish-influenced English • Asian English

1. Deficit of Linguistic Knowledge

• Most theories have their roots in a Chomskyan framework: the principles and parameters theory.

Normal Toddlers

• Nelson (1973): most middle-class toddlers produce simple 2-word utt. at 18 mos. • Miller (1981): MLU in morphemes at 24 mos. between 1.5-2.4. (SW—3W) • (Compare Lahey's Phase 1-4.)

Asian English

• No such entity exists. • Various Asian American dialects: - Mandarin Chinese, Cantonese Chinese, Filipino, Japanese, Khmer, Korean, Laotian, and Vietnamese.

Maternal Substance Abuse

• Often difficult to separate different causal factors, e.g., substance abuse and general neglect. • Prenatal drug exposure should be considered a risk for communication disorder rather than a cause of it.

Intellectual Disability

• Older definitions only focused on IQ scores. • Newer definitions use both IQ scores and level of adaptive behavior to decide diagnosis. • Difficulties with: - Directing attention to relevant aspects - Discrimination tasks - Organization - Recall - Use of strategies - Generalization • Cognitive skills grow throughout adulthood. • Limitations in communication skills may be a first sign. • Language acquisition follows a slowed-down sequence of development.

Goal-based causal chains with obstacle

• Once there was a fox who lived in a cave near a forest/ He wanted some food for dinner, and went out looking for something/ He looked and looked, but nothing/ Suddenly, he saw a rabbit hopping by/ He ran really fast and tried to catch him, but he kept missing cause the rabbit was smarter than the fox/ So he didn't get any dinner/

Complex Sentences: Form— Complementation

• One clause (the complement) serves as a main constituent of another clause (the matrix) • A. Infinitival complementation (V +/- c + V) • /I want to eat/ c = to • /I want put in here/ V - c + VP • B. Sentential complementation • /Todd says that he has a crane/ V + c + NP + VP • /I think you closed up the windows/ V - c + NP + VP • /I want Mommy get it/ V+ NP - c + VP Content: Epistemic • /I know what car that is/ • V + c + NP + V, c = what • /I know where it is/ V + c + NP + V, c = where • /I think I put it here/ V - c + VP, Ph 7 Content: Notice • /look I found/ V - c + V, Ph 7 • /I see Mommy running/ V - c + NP + V • /I see what Mommy is eating/ • V + c + NP + VP, c = what Content: Volition/Intention • /Wanna go home/ V - c + VP, Ph 4 • /I want to go home/ V + c + VP, c = to, Ph 5 Content: Communication • /Mommy said I can have it/ • V - c + NP + VP • /Mommy said that I can have it/ • V + c + NP + VP, c = that, Ph 8 Content: Specification • /This is what I said/ • Dem (+is) + c + VP, c = what • /That is where it is/, c = where, Ph 7 • Dem (+is) + c + VP

Complex Sentences: Form— Relativization

• One clause modifies a constituent in another clause. • Appear late and are rare. Content: Relativization • Object/person specification • /This is the big one, that goes over here/ • VP + c + Rel Cl, c = that • /this is the man, who drives the truck/ • VP + c + Rel Cl, c = who, Ph 8

True Narritive

• Organized around a conceptual center or a theme that evolves over the course of the story.

When Assessing Language Disorders

• Pay close attention to pragmatic skills • Do not automatically assume that deviant behaviors such as poor eye contact are shyness or a result of a language impairment. • Use a tool such a CCC-2 to capture different aspects of the pragmatic dimension. • Monitor changes over time.

Content category: action + temporal

• Phase 4: • + -ing (present progressive—shows ongoing activity) sitting, eating, sleeping • + irregular past tense

Poor Non-word Repetition in Children with LI (Gathercole & Baddeley, 1990)

• Poor working memory skills - measured by non-word repetition: a core problem in language impairment.

Five Levels of Analysis of Form/Content/Use (Lahey, 1988)

• Prelinguistic • Single words • 3+ constituent utterances • Complex sentences • Narratives

Most Studies on SLI English-speaking Data

• Problems with morpho-syntax or grammar, particularly verb-morphology. • Researchers have tried to relate these problems to hypotheses of underlying deficits.

Relevance of Language Learning Theory to Treatment

• Provides a basis for understanding "how" children learn language • Provides a basis for answering very important clinical intervention questions: "How should I facilitate a particular target in a child?" and "why?" • Provides a basis for procedural decisions

Exophoric reference

• Referring to something that's present in the nonlinguistic context • Decreases with development • Ex: if there's a book in front of child, he can just say "here it is" and the referent for "it" (the book) will be retrieved from nonlinguistic context

Selective Mutism

• Refusal to speak in certain situations • Often along with anxiety disorders • SPL often first person to contact • Co-occurrence with speech and language problems

Deaf-Blindness

• Rubella in pregnant mother • German measles in pregnant mother • Usher's syndrome (genetic syndrome), affects hearing, vision, and balance. • Severe sensory deficits but normal cognition • Extensive assessment of needs—AAC

Evaluating Intervention Outcomes

• SLP should be accountable for choice of goals and demonstrate achievement of goals • Need to specify a criterion to determine that our LT goals have been achieved • For example: child will achieve C/F/U interactions through Lahey Phase 8+ • ASHA (1994) Discharge Criteria (Paul), for example: - Communication is WNL - Sp/lang skills no longer adversely affect social, emotional, or educational status - Treatment no longer results in measurable benefit - Client and family are unwilling to participate in treatment Termination criteria: Achievement levels (for individual C/F/U goals) • Paul - Structured setting: 80-90% correct usage - Spontaneous speech: at least 50% correct usage • Lahey - Spontaneous speech: 80-90% correct usage (for morphological inflections) - >50%: continue to monitor

Arrested Language Development and Language Loss in L2 learners

• SPL has to distinguish between the child with LEP (limited English proficiency) and the child with language-learning difficulties (who has difficulties learning ANY language).

SLI and Autism

• Several research groups have been searching for genes that contribute to autism and SLI. • Probably several genes that interact to produce the autism phenotype, which is complex. • About 25% of parents and siblings of children with autism have delayed onset of speech or reading and spelling difficulties. • Greater-than-expected prevalence of language disorders in the families of autistic children + greater-than-expected prevalence of autism in the families of children with SLI. • Some cases where features of both autism and SLI overlap.

Screenings

• Should continue throughout childhood as some conditions have postnatal onsets or progressive hearing loss. • In many countries infants of a few months are fitted with hearing aids and 6- to 12-month infants can be fitted with cochlear implants. • DeLuca & Cleary, 2017

Conjoined causal chains (multiple causal chains, or episodes)

• Start out giving one causal episode and then another causal episode • The 1st causal episode is not causally related to the 2nd, but is joined in an additive or temporal fashion • 1st episode: • A few years ago Henry Tick lived in a hippie's hair, but he got a crew cut so Henry had to move/ He went to the pet shop but it was closed too/ Finally he found a nice basset hound/ So he moved in/.... 2nd episode: • ... He got a good job at the circus jumping 2 inches in midair into a glass of water/ One day he jumped but there was no water/ He was rushed to the hospital/ They put 12 stitches in his leg/ Well, he never went there again/ The end/

Nine Content Categories

• State: makes reference to the state of affairs—either internal, external, attributive, or possessive Verbs like: wanna, gonna, have to, etc. Often without a connective/conjunction (catenatives) E.g., I wanna go now. • Additive: involves the joining of two objects, events, or states without dependency on order Usually associated with connective AND E.g., I sit here and you sit there. I eat and I drink. • Temporal: coding of a temporal (timing) dependency between and among events, or simultaneity Often coded with the connective THEN E.g., I take a bath, then go to bed. I eat breakfast and then I go to school. • Causal: coding of cause and effect relationship Often coded with BECAUSE or SO E.g., Bend her legs so she can sit! I ate candy because I was hungry. • Adversative: involves the coding of two events or states that are in contrast to one another Often coded with BUT E.g., This one big, but this one tiny. I like red, but you like blue. • Epistemic: coding that refers to mental states about events or objects Involves verbs like: know, think, wonder Often without a connective/conjunction E.g., I think I can put that here. I believe I will see her there. • Specification: coding that describes a particular person, object, or event mentioned in the first clause Often includes contrasting use of THIS and THAT (and use of THE vs. A) May use a variety of connectives E.g., That is the man, who drives the truck. This is what I'm talking about. • Communication: coding that describes communicative acts Often used with verbs SAY, TELL May not have a connective/conjunction E.g., Mommy said not to do that. Mom told me to come home. • Notice: coding a relationship that calls attention to a person, object, or event named in the second clause Often used with verbs: see, hear, look, watch, show Often without a connective/conjunction E.g., Look what Mommy gave me. I see a bird flying way up there.

Children With Language Impairment

• Stop consonants are differentiated on the basis of information occurring in the first 40-50 msec (ba-ga): difficult • Vowels have critical information spread over a longer duration: easier

Statistical Properties

• Studies have shown that words with high phonotactic probability are easier to learn compared to words with low phonotactic probability. • Also high-frequency words and lowfrequency words. • Neighborhood density also matters. • = only one phoneme that is different. • Words with high neighboorhood density are usually easier to learn.

B. The Implicit Grammatical Rule Deficit (Gopnic & Crago)

• Suggests that indiviuals with SLI have difficulties in building paradigms by means of abstract rules, because their grammars lack the features necessary for rule construction. • Problems with the use of most inflectional morphemes. • Instead they use lexical strategies to memorize whole words. • Predicts that children with SLI omit inflections but also that forms be used inappropriately. • Predictions include that they should not overgeneralize regular inflections like normally developing children do. • Has not received much support.

The System for Augmenting Language

• The System for Augmenting Language (SAL) is an augmentative and alternative communication (AAC) intervention approach • Consists of five integrated components -A speech-generating device -Individually chosen visual-graphic symbols -Use in natural, everyday environments that encourage, but do not require, the child to produce symbols -Models of symbol use by communicative partners -An ongoing resource and feedback mechanism

Sentence Level: LI

• The few studies that have looked at comprehension of grammatical structures show that many children with LI have unusual difficulty in understanding meaning distinctions that are signalled by syntactic relationships or grammatical inflections. • TROG: Test of Receptive Grammar

Conjunction

• The joining of sentences, noun phrases, or verb phrases by means of a coordinating or subordinating conjunction

Clinical Reality

• The reality is that many times we do not know the underlying cause or vulnerability. • Poor comprehension is not going to affect the intervention goals we determine, BUT it will affect the intervention procedures.

Causal Chains

• There is a causal dependency among utterances: events (or states) enable/cause other events (or states). • Other utterances that are related in only an additive or temporal manner may be included within the causal chain. • Causal chains contain a problem and some resolution to that problem.

Temporal Chains

• There is a temporal dependency among utterances—changing order of utterances would change the meaning of story or story wouldn't make sense. • There are no causal relations. • About Noodle (his dog)/ he went to the doctor/ he give a shot/ he go home/ he drink milk/ he didn't drink his milk/

Assessment Goals

• To describe language behavior and relate that to some kind of standard; • to identify children with LD; • to plan intervention; • to estimate prognosis; (to determine whether differences are quantitative -delay; or qualitative - differences in F/C/U interactions).

A Common Procedure

• To match the mastery of relevant structures in children with SLI with the mastery in younger language-matched controls (usually MLU). • To study which specific areas of morpho-syntax are particularly impaired. • If we study morphosyntax in SLI, we can control for length limitations being the cause of failure to use a structure. • MLU considered a conservative matching technique.

Autism Spectrum Disorders

• Two salient characteristics: A) Deficits in social communication B) Restricted or repetitive behaviors or interests • Impairments go beyond simple immaturities (showing behaviors that would be abnormal at any age)

Complex Sentences

• Two verb relations joined together to code a relationship (2 or 3 constituents) • Emerge approximately 2.5-3 years of age • Often joined with a syntactic connective, e.g., conjunction... (but not always) • Demonstrate interaction between form (syntactic connectives and syntactic structures), content (semantic relations between propositions), and use (discourse cohesion).

Story Elicitation

• Unstructured - No stimulus - Memorable event - Unstructured play with dolls, vehicles, animals • Partially structured - Doll house, kitchen furniture - Single picture - Story starter • Highly structured - Sequencing cards - Wordless picture books - Filmstrip or film - Video

ASHA—Recommendations

• Use of informal methods, e.g., language samples to supplement testing. • However, the assumptions are the same: if the child is not found to be proficient in L1, then he may be classified as language impaired.

Models of "Mental Lexicon"

• Used to be: words stored in categories • Contemporary ideas: • Each word has a lexical entry that has a particular level of activation. When the level of activation exceeds a certain threshhold, the word is recognized. Perceptual input that matches the stored phonological information boosts the activation. • High-frequency words; low-frequency words. • Phonotactic probability. • Contextual cues.

After Beginning Syntactic Utterances (Summary)

• Vocabulary increase • New content categories emerge (e.g., locative state, state, notice) • Use of two and three primary elements of a sentence: 3-constitutent utterances • Combining content categories • Some utterances with two verbs appear (e.g., "want" or "go") • Advances in function and context of language use

Complex Sentences: FORM

• We look at connective + syntactic form • Three ways in which clauses can be joined: - Conjunction - Complementation - Relativization

Word Level

• When children with LI were taught novel words, they tended to learn those words that were phonologically similar to the words already in their vocabulary. • Children with LI may be slow at vocabulary learning because their phonological representations of words tend to be underspecified

Sentence Comprehension

• When words are put together, the whole is far greater than the sum of its parts. • Meaning is expressed by morphemes, but also by word order. • Preferential looking paradigm. • 17-month-olds understand word order before they begin to use 2-word utterances. (ie: Big Bird tickles Ernie. Ernie tickles Big Bird.)

Collecting a Representative Sample: Evidence From Research

• Younger children (2-3) produce more complex language most frequently when engaged in play. • In older children, narratives elicit more complex language than conversation (Reuterskiöld et al., 2000).

Stages of Syntactic Development (Brown, 1973)

1. Linear sematic roles (agent-action) 2. Morphological development 3. Sentence-form development 4. Embedding of sentence elements 5. Joining of clauses

Compare With C/F/U Coding

All the other systems mainly focus on Form. • In the C/F/U coding, verb tense morphemes, e.g., express the Content category temporal. • In SALT we code for some pragmatic/interactional features, but not the interaction of USE within each utterance.

Specific Disabilities Model

Attempts to profile each child's weaknesses—study underlying vulnerabilities as a cause for LD • Three major variations: - Deficit in auditory perceptual processes - Limited processing capacity - Linguistic deficits ( A lack of linguistic knowledge leading to a deficit in language processing and production—child not able to learn/use the rule system of the language. Mostly pertains to grammar/syntax)

Content category for "Big, hot, blue"

Attribution

Phase 1 Single-Word Utterances

Content words: - Substantive (nouns) • Refer to particular objects or classes of objects - Relational • Refer to relations across objects of different classes (verbs, adj., adv.) Function words: also relational (prep., conj., articles, pronouns) • Content categories: efficient taxonomy for organizing single words -Relational words combine with substantive words to form 2 word utterances in Phase 2

Child: /baba/ pointing to bubbles and looking at bubbles and then looking at the adult Adult: Yes, bubbles

Content: existence Form: SW /baba/ (consistent phonetic form) Use: Comment

Content category for "Mine"

Possession

Precursory Behaviors

Precursors of: - USE: interpersonal interaction - CONTENT: understanding objects and actions - FORM: producing sounds/babbling

Linguistic Taxonomy

• A categorization of language behaviors observed. Behaviors that are similar in some way are grouped together and labeled. • Taxonomies are generally created from one's belief system or theory of what language comprises.

USE as a Component of Level 2 Analysis

• COMMUNICATIVE FUNCTION: The same FORM can express the same CONTENT but with different USE (INTENTION) • CONTEXT: Usually in early child language there is perceptual support for the child's utterances

Rating Scales and Observation

• Low structured elicitation • Based on naturalistic observation of child • Seems more representative of how child normally communicates

Length of Language Sample

• Need at least 50 utterances to calculate a reliable MLU - 50 utterances yield 80% of the info in 100- utterance sample (Cole, Mills, & Dale, 1989). - 100 utterances give you more to work with in describing child's lang. and opportunity to elicit language in several diff. contexts.

If the child is not using conventional words, they are in level...

1

Precursors of Form (Lahey, 1988)

1. Imitate - (Adult imitates child motor behavior—and child copies, adult imitates child vocal behavior—and child copies, child copies adult model of new behaviors child can observe on self, child copies adult model of new behaviors child cannot observe on self) 2. Approximating adult linguistic forms - (Reduplicated CV sequences, nonreduplicated syllables (magadaba), nonsegmental features (sequences of sounds, with stress and rhythm patterns that sound sentential) 3. Nonconventional interactions - (Consistent phonetic forms for objects/actions)

If the child is not using verb relations, there are in level

2

Taxonomy of Content

CONTENT: what the child is talking about (ideas to be expressed) 1. Semantic relations (e.g., Brown, 1973) Not very useful after 2-word utterances. 2. Content categories (e.g., Bloom & Lahey, 1978) expressed with more and more advanced form

Speech Delay vs. Speech Disorder

Delay- child's language is developing in the right sequence, but at a slower rate Disorder- abnormal language development

Criterion-Referenced Assessment

• Assesses a particular language behavior to determine how well a certain behavior is established in child's repertoire The standard for productivity/achievement is established beforehand

Assessment and Intervention with the Developmental model

• Assessment focuses on describing the child's current functioning within a taxonomy of behaviors (C/F/U interactions). • Intervention targets intentional communication skills that are below expectancy when compared with typically developing children within a hierarchy of developmental phases.

/I eat big apple/

• Content category: Action + attribution • Phase 4

Goals and Procedures

• Intervention goal: represents the client's achievements in therapy • Intervention procedure: a statement about the clinician's actions • Mary (client) will code action with verb plus complement "drink juice" to comment and request object and action

Sample Assessments of Preverbal Children

• Norm-referenced method - Communication and Symbolic Behavior Scales (CSBS, 6-24 mos.) (Wetherby & Prizant) • Symbolic play, nonverbal communication, expressive and receptive language, temptations • Criterion-referenced method - Worksheet for describing precursory goals of Content, Form, and Use

Information in Standardized Tests

• Validity: testing what it is supposed to test • Reliability: consistency • Diagnostic accuracy: - Sensitivity = the degree to which the test accurately identifies a child with a disorder - Specificity = the degree to which the test accurately identifies a child as NOT having a disorder

Goals vs. Procedures

• What to modify—Goals: based on the child's highest level of performance and what we know about typical development (the plan) • How to do it—Procedures: based on the child's profile in terms of maintaining factors

Characteristics of the Categorical Model

- Child with ID will have difficulty with Content, Form, and Use - Child with HI will have the most difficulty with language Form - Child with SLI will have most difficulty with Form - Child with autism may appear to have greatest difficulty with language Use, but may also have difficulty with Content and Form All children belonging to a category should receive the same intervention BUT categories aren't helpful for describing current language performance.

Three Phases of Intervention Planning

1. Long-term goals: ultimate goal for the client -Envisioning a procedural approach including hypotheses about: A. Maintaining factors B. Principles from language-learning theories that will guide clinical interaction 2. Prioritizing short-term goals and outlining a procedural context - STG = intermediate achievements (a few months/a semester) - The procedural context = initial plan about types of materials and interactions that would facilitate language learning 3. Session goals and procedures - Behavioral objectives in order to reach the STGs + specific materials and interactions for a particular session

Mean Length of Utterance (MLU)

1. Measures morphosyntactic ability and determines the existence of language disorders (Need 100 utterances, but can be done with 50) • Varies with context • Higher MLU in narration than in conversation • Should not be viewed as a measure of grammatical development: utterance length. • MLU will identify some but not all preschool children with LI. • A low MLU can indicate an LI, but a high MLU cannot be interpreted as no LI. • No real norms for MLU.

If the child is not stringing sentences together to form narratives, there are in level ___. If they are, they're in level ___.

4, 5

Categories of Knowledge That Guide Planning

A. The components of speech and language •Content, Form, Use; cultural diversity) B. Nonlinguistic and linguistic factors that maintain communication disorders • Behavioral systems that affect communication performance: • Cognitive • Sensorimotor • Psychosocial • Linguistic system itself (trade-offs) • Impairment in any of the systems can contribute to the maintenance of a communication disorder C. Principles of Learning Theories that specify processes underlying the learning of new behaviors • Learning theories are belief systems about learning—sources of principles. • Example: From the perspective of behaviorism, the view is that children learn language through imitation and repetition.

Maintaining Factors

Behavioral systems that affect communication performance (maintain a language disorder) Will influence our intervention procedures: - Cognitive, Sensorimotor, Psychosocial, Linguistic system itself (trade-offs), & Impairment in any of the systems can contribute to the maintenance of a communication disorder • One important MF is language comprehension.

Child: /baba/ /baba/ !!!! Reaching for bubbles looking at bubbles and then looking at the adult Adult: Oh you want the bubbles

Content: existence Form: SW /baba/ (consistent phonetic form) Use: Direct action/obtain object

Nonmodeled Elicitation

Desired response is not present in the elicitation - Ex. 1: "Tell me how you make chocolate pudding." - Ex. 2: "Tell me a story."

Standardized Tests

Determines the existence of a problem by providing a comparison with a normative population. • All test procedures are uniform and have been standardized. • Results are reported with reference to a comparison with the normative sample (norm-referenced description).

Taxonomy of Form

FORM: the structures with which a child expresses ideas—most common area studied Object of study: - Parts of speech (nouns, adjectives, verbs, adverbs), numbers of words; word order; morphemes; grammatical rules; major constituents (subject, verb, complement) - Historically, model was adult production; children generally described in terms of what was missing when compared with adult expectations

Pragmatics and Linguistic Form

Focus on how a specific linguistic form was chosen to communicate something - Close the door! - Could you please close the door! - Is the door open? - There is a draft...

USE Phase 1-3

Nonlinguistic context • In early childhood: the child's ideas are constrained by what he can perceive through his senses • Talks about events where he is a participant • Here and now • Perceptual support Linguistic context • Good at introducing new topics • A lot of repetition/imitation is common • Few contingent utterances (connected to the topic of the previous utterance) Communicative functions • Commenting • Regulating: • Direct attention • Protest/reject • Obtain object • Obtain response • Respond • Routines (e.g., Bye-bye)

USE Phase 6-8

Nonlinguistic context • Less dependency on the "here and now" • Deictic forms: I/you, this/that, here/there, etc. Linguistic context • Listener adaptations: politeness markers, more explicit information, repairs • More contingent utterances, with added information • More questions that are contingent on prior utterances Communicative functions • Inform/report/share information • Obtain information about what someone else has said

USE Phase 4-5

Nonlinguistic context • More utterances about what others are doing • Utterances about immediate past and imminent future Linguistic context • More contingent utterances • Repairs upon request • Recoding of prior utterance with change of pronoun (I/you) Communicative functions • Obtain information (asking questions) • More variety of forms used for a range of communicative functions

Content category for "More, again, another"

Recurrence

Content category for "No".

Rejection

Verb Relation CC + Coordinations

Required: a verb relation (at least 2 constituents) + nonverb category(ies) • Nonverb categories: nonexistence, recurrence, rejection, denial, attribution, possession, quantity, temporal, specification, dative

________ ____________ are the only way to establish that a child is functioning differently than other children

Standardized tests

Taxonomy of Use

USE: function of messages and context in which the message is used Function: To inform, request information, regulate environment, protest or reject, emote, or comment Context -Nonlinguistic: perceptual support or no perceptual support -Linguistic: contingent or not on prior utterance

Why Ask Questions?

• A less demanding utterance from the adult gave more grammatically complex responses from the child. • SILENCE or COMMENTING better than asking questions. Nettelbladt, Hansson, & Nilholm (2001)

What Does Lahey Mean by a Plan of Assessment?

• A plan for the collection and organization of data (information about a client) • Procedures during the assessment period which are guided by: - What you want to find out, and - Why you want to have this information

Equivalent Scores

• Age-equivalent scores: -Age-equivalent scores are NOT appropriate for deciding whether a child has a significant deficit. They are estimates! -Only if a child's standard score falls significantly below typical performance, 1.5 SD < mean, can we use ageequivalent scores as an easily understood metric in discussions with teachers and parents. • Grade-equivalent scores • The raw score is compared to the median score of subjects in the sample who were of a particular age or grade

Communication (McTear & Conti-Ramsden, 1992)

• An intention to communicate information to another person • Insight that successful communication demands that the other person understands my intention • Insight that the other person also has his own goals and perceptions that are different from my own

Assessment and Intervention within the Categorical model

• Assessment focuses on determining the child's diagnostic category. • Intervention targets impaired behavioral systems presumed to be implicated in the syndrome. • Implies that all children with a diagnosis should receive the same intervention.

Assessment and Intervention with Auditory perceptual deficit/working memory/limited processing deficit

• Assessment focuses on identifying impaired auditory processes or memory limitations and examples with simultaneous processing load. • Intervention targets impaired processes with the expectation that improvement of these processes with improve language.

Assessment and Intervention with Linguistic deficit

• Assessment focuses on identifying problematic linguistic features/rules (grammar/syntax). • Intervention targets these features with the expectation that improvement of these processes with improve language overall

The C/F/U Goal Plan

• Charts results of assessment & organizes assessment data as interactions of Content and Form -The same form may represent different content (meanings) • Charts C/F interactions • Margin: Use interacts with Content and Form - Communicative function - Nonlinguistic and linguistic context

Determine Intervention Goals: Language Sampling

• Collect a representative lang. sample - Use low-structured, comfortable, naturalistic setting - Don't ask for specific responses - Follow the child's lead - Don't be afraid of silences - Observe child in variety of diff. contexts - Use materials appropriate to child's interests and cognitive level

Comprehension of Implicit Information and Sharing of Relevant Information

• Comprehension of explicit and implicit information in the story. Children with LI struggle with implied information. • A subset of children struggle with relevance of utterances during story generation and story retelling.

/my cookie is allgone/

• Content category: Action + nonexistance • Phase 4

/I eat in the kitchen/

• Content category: Action + place • Phase 4

/I drink more milk/

• Content category: Action + recurrence • Phase 4

Modeled Elicitation

• Embedding of target form - A form is cued in the question. - Ex: "What did the monkey do?" (to encourage past tense) • Embedding of target content category - A content category is modeled in the question. - Ex: "How do we get the battery in the flashlight?" • Patterned elicitations - Model a similar set of productions, then ask child to produce new, analogous production. - Ex: "You eat with a fork, dig with a shovel, write with a _____."

Emergentism

• Emerging patterns of complex systems. Focuses on the simultaneous stability and variability of emerging language abilities of the child.(interaction between nervous system, input, and contextual information) • At the points of variability, the underlying dynamics of the emergence of language in children with language impairments are revealed

Major Aspects of Language Use

• Function: What is language for (purpose of utterance)? • Context: Linguistic and nonlinguistic factors surrounding utterance (who can say what to whom, when, and where—the rules of conversation or discourse)

Assessment and Intervention with Emergentism

• Intervention would focus on strengthening newly emerging states of instability and variability in a child's language skills, through changes in external contextual demands.

Developmental Model

• Language disorders reference current language functioning in the areas of Content, Form, and Use = intentional communication. • Assumes that the best approach to the description of a disorder is with reference to knowledge about typical language development.

Intervention

• Learning language involves inducing relationships among regularities the child perceives in the nonlinguistic world, the linguistic signal, and social interactions. (Lahey, p 378) • Intervention guidelines - Create meaningful situations in naturalistic contexts - Use old forms with new functions; new forms with old functions - Follow the child's lead - Use natural reinforcers (i.e., intrinsic rewards)

Early Language Terms

• Lexicon: Parent report instruments (number of diff. words, semantic classes) - MacArthur-Bates Communicative Development Inventory - Adapted to many languages • Semantic-syntactic prod. • In typical development: word combinations—when the child has approx. 50 words a. Relative frequency of word combinations b. Semantic relations • Semantic relations • Meanings that are not expressed in the words alone - Doggy bed (possessive), More milk (recurrence) - (18-36 mos.)

Early Language

• One and two-syll words first • CV, CVC, CVCV • Receptive vocabulary larger than expressive • Large variation in normal development at this age • Cognitive milestones (Piaget): Object permanence, tool use, symbolic play • Play scales (e.g., Westby, 1980). • Relationship between early play skills and language not clear. • Language and communication level has to be assessed in a context of play at this age.

Content/Form/Use

• Only systematic description by Bloom and Lahey 1978; Lahey, 1988 • A guide for describing interactions of form, content, and use for all children with language disorders regardless of etiology • Most of the framework based on typically developing children (Phases 2, 3, 4); other phases based on other research • Suggested that intervention for children learning language with difficulty should be based on what typically children do on the way to achieving adult language, not on the adult final product

Underlying Theory of Use: Pragmatic Theory

• Pragmatics of language deals with the way language works in interaction. • Goal of pragmatic theory: to characterize communicative competence. Includes: - Structural knowledge (form) - Knowledge of presuppositions (theory of mind) - Knowledge of conversational rules

Prelinguistics

• Precursors of language use include • Gazing interpersonally • Joint attention • Turn-taking in routines (peek-a-boo) • Making reference (point, show, and give) • Regulate (obtain object or action)

Early Words

• Relational: words code relations (no, allgone, that, up), not names of objects. (The earliest words) • Substantive: object names (Early utterances are connected to the immediate context) • Vocabulary spurt at the end of Phase 1. • Relational words combine with substantive words to form 2 word utterances in Phase 2

Arguments Against Auditory Perceptual Model

• Represents a "bottom-up" view of language processing: lower-level processes (e.g., auditory discrimination) affect higher-level processes (e.g., sentence comprehension) • Lower-level processes depend on prior knowledge (existing concepts and associations) • While results of auditory processing tests correlate with language performance, the relationship may not be causal • No evidence that working on auditory skills alone improves naturalistic language skills

Pragmatics and Semantics

• Semantics: conventional, literal meaning • Pragmatic level: interpretation beyond the literal meaning, inferencing

Determining the Child's Prognosis

• Severity statement • Prognostic statement—relevant factors - Age - Social environment (e.g., family involvement) - Child's personality and temperament - Impaired behavioral systems - Severity of communication deficit - Previous intervention attempts

Measurements

• Standardization: norming sample • Measures of central tendency and variability: mean, SD, percentiles, stanines • Standard score (Z-scores): • Mean = 0, +1SD = +1, -1SD = -1 • Mean = 100, +1SD = 115, -1SD = 85 • SEM: standard error of measurement • Any score is just an estimate of the client's true score. Tests may have tables so you can obtain a confidence interval.

Standard Error of Measurement (SEM)

• Test scores are estimates of behavior • Standard error of measurement—determined by: - Scores from someone of avg. ability who took test many times - Scores would form normal curve and mean would be true score - 68% of the time the score would fall within 1 SD or 1 SEM; 95% the score would fall within 2 SEMs • Confidence band for true score: - Observed score +/- SEM • If a client gets a standard score of 86 (mean = 100) • The manual tells us that the SEM around this score is 7 points • With 90% confidence, we can say that the true score fell between 79 and 93

Conversation Analysis

• There is a structure to all interaction. • All contributions to the conversation are context dependent and context creating. • Nothing can be discharged as irrelevant. • Naturalistic interaction. • No hypotheses in advance. • Studies of child-child dialogues and adultchild dialogues (initiative-response method). • Adult-child dialogues are more assymetrical, with many strong initiatives for the child to respond to

Value of Standardized Tests

• To measure real progress in intervention, we would want the post-intervention score to move above the confidence interval for the pretest. • Because of their construction and measurement errors, standardized tests are NOT the best way to measure change in an intervention program.