Pediatric Language Comprehensive Exam

-Logical sequence -sufficient/relevant details -appropriate sentence complexity & vocab level for age-temporal markers (sequencing words "next, then," to connect story parts) -appropriate insight into character's feelings -end at high point resolution

5 qualities to assess narrative stories for according to McCabe and Rosenthal

a. LI due to primary underlying etiology* -due to ASD

5-year old child with ASD, delayed language acquisition and significant pragmatic weaknesses a. LI due to primary underlying etiology b. Nonspecific DLD c. SLI

c. SLI* -SLI: IQ normal but language impaired

5-year old child with NVIQ of 95, core language score of 78 on CELF, and MLU of 3.2 a. LI due to primary underlying etiology b. Nonspecific DLD c. SLI

b. Nonspecific DLD* DLD: • Meet critical exclusion criteria • May include broader IQ range (above 70) • May have speech delays • May have deficits across language areas

5-year old child with borderline IQ (83), weaknesses across language components a. LI due to primary underlying etiology b. Nonspecific DLD c. SLI

True-beginning around 5-6. Kids sentences will be longer and more complex when telling a story versus in casual play, so you want a narrative sample around this age to tax the language system more and identify any potential problems in story telling abilities.

Beginning around age 5 you should collect a narrative sample in addition to a language sample (T/F)

entity-locative

Brown's Semantic Relation? baby (in) crib

attribute-entity

Brown's Semantic Relation? big ball

action-locative

Brown's Semantic Relation? jump there

possessor-entity

Brown's Semantic Relation? mommy shoe

demonstrative-identity

Brown's Semantic Relation? this cookie

~age 2

Brown's Semantic Relations are typically prevalent by ~age ____

B. 50% Standard score of 100 represents the mean. This falls at the 50th percentile, which means that the child scored as high as or higher than 50% of children his age.

Child Achieved a standard score of 100 - what percentage of the population achieved a score ABOVE this child? a. 0% b. 50% c. 100% d. 85%

D. all of the above

Child's score is equivalent to a percentile rank of 70. How is this result interpreted? a. it is within the average range b. it is between .5 and .1 SD above the mean c. it is age appropriate d. all of the above

False -language abilities are not necessarily commensurate with a child's IQ (ex. WS vs SLI)

Children with intellectual disability show predictable patterns of language impairment that are commensurate with their IQ True/False

0-1: communicative behaviors, sound repertoire

Describe early development of communicative behaviors for ages 0-1 yr.

1-2: vocabulary

Describe early development of communicative behaviors for ages 1-2 yr.

2-3: multiple word utterances, grammar

Describe early development of communicative behaviors for ages 2-3 yr.

3-4: refinement- articulation improvement, vocab growth, increased grammatical complexity

Describe early development of communicative behaviors for ages 3-4 yr.

Form: structure, distribution, and sequencing of sounds & words - phonology, morphology, syntax Content: meaning - semantics Use: how language is being used - pragmatics

Describe the 3 functional components of language (according to Lahey & Bloom) and categorize phonology/semantics/morphology/syntax/pragmatics into these 3 categories.

15, 16, 20

Gestures used in combination with vocalizations typically occur by ____ months; gestures with words usually occur around ____ months; words typically become dominant by around ____ months.

play

Language and ____ show parallel development

50, 0, 2 emerging language period (18-36 mo.)

Late talkers are defined as having a vocab of _____ words or less and ____ word combinations by ______ (age). They are typically identified in what period of early language development?

2

Phonological awareness skills develop around __ years of age.

yes -Children with lagging language are at risk for increased risk of academic failure, behavioral problems, later unemployment and economic disadvantage, and social impairment.

Should we be concerned about children's language problems (vs. letting children develop at their own pace)? a. yes b. no

False · Bias · Lang. being used in an unnatural way · Familiarity w/ test administrator

Standardized language measures are the "gold standard" for assessing language skills T/F

dynamic assessment

Systematic examination of how easily a student can acquire new knowledge or skills, perhaps with an adult's assistance.

d. All of the above

The production of "lello" for yellow demonstrates: a. Assimilation b. A phonological process c. A typical error for a 2-year-old child d. All of the above

fronting

What phonological process is this? /tuti/ for cookie -a substitution phonological process that involves the replacement of an alveolar consonant for a velar or palatal consonant

Epenthesis (insertion)

What phonological process is this? /təri/ for /tri/ (tree) -The insertion of a vowel (usually schwa) to break up a cluster

gliding

What phonological process is this? /waebIt/ for rabbit -substitution of a glide for a liquid

2 yrs: 50% 3 yrs: 75% 4-5 yrs: 100%

What should the % intelligibility be at 2, 3, and 4-5 years?

50% word combo freq

What word combination frequency (%) is typical for a 24-month-old?

False -relative strengths and weaknesses

When a child has a language disorder, ALL components of language (phonology, morphology, etc.) are usually affected to a similar extent (e.g., mildly vs. moderately vs. severely affected) T/F

~10 months

When should joint attention develop?

d. identfy children with a functional disability-problems are interfering with everyday life or academic achievement f. identify children with low scores (at least 1 or 1.5 SD below population mean) on standardized language tests -For purpose of CLINICAL diagnosis, look for evidence of impairment, largely do away with cognitive referencing, and keep diagnosis as inclusive as possible (minimize exclusion criteria).

Which TWO practices are best for identifying language problems in children? a. ensure that there is a mismatch between language and nonverbal skills b. exclude children with hearing loss c. exclude children from low SES backgrounds d. identfy children with a functional disability-problems are interfering with everyday life or academic achievement e. exclude children with phonological problems f. identify children with low scores (at least 1 or 1.5 SD below population mean) on standardized language tests

cluster reduction epenthesis gliding voicing stopping metathesis

Which phonological processes may persist past age 3? (there are 6)

weak syllable deletion final consonant deletion consonant assimilation reduplication fronting

Which phonological processes should be disappearing by age 3? (there are 5)

b. "Eat cookie"

Which utterance is an example of the semantic relation ACTION-OBJECT? a. "Dada go" b. "Eat cookie" c. "Mommy car" d. "Baby eat"

children's language is usually much more complex when telling a story than when playing so you can see what they are truly capable of

Why might assessing narrative skills be better than assessing play for slightly older children?

prematurity

______________ is a definite risk factor for language impairment and will usually automatically qualify the child for services.

50 utterances

a proper language sample should contain how many utterances?

~18 months

around when does the "word spurt" occur?

emerging language stage (18-36 mo.)

at what stage are "late talkers" usually identified?

MLU

average number of morphemes per utterance

variegated babbling definition

babbled sequences in which the syllable content varies (ex. ba-na-ga)

GAP verbs

general, all-purpose verbs (did, went)

3-syllable level

in a Non-word repetition task, at what point do children with LI tend to break down?

semantic relations chart (Brown)

what can you use as a blueprint for goal/treatment targets when trying to elicit word combinations?

NDW

what is considered better assessment information--NDW or TTR?

typically MLU should be close to the child's age--most obvious at 2, 3, & 4

what is important to remember about MLU values and age?

age 3 3-word combinations emerge

when do children typically start using grammatical morphemes? why?

when expressive vocabulary has reached ~50

when do word combinations typically emerge?

-more complex than nouns -important for the transition from one-word utterances to sentences

why are verb milestones so important to pay attention to?

stopping

What phonological process is this? /tit/ for feet -substitution of a stop for a fricative or affricate

68%

% of scores falling within 1 SD of the mean

95%

% of scores falling within 2 SD of the mean

a. Language sample: look for heavy use of GAP verbs b. Nonword Repetition (NWR): looking at child's ability to hold sounds in their working memory --> children with SLI tend to exhibit difficulties around 3 syllable length c. Working memory and processing skills = both markers for SLI

A child comes in with a referral of language specific problems and no identifiable risk factors. What are some appropriate measurements to administer, and what are important things to look for when assessing?

d. All of the above

A child says, "Mommy go work!" Which statement is accurate? a. The child is omitting grammatical morphemes b. The child is using telegraphic speech c. The child is conveying intent (communicating) d. All of the above

c. Speech

A child speaks in complete sentences and interacts appropriately with peers but has poor intelligibility. This child primarily has difficulty in: a. Communication b. Language c. Speech d. All of these

a. yes Z-score: reflects distance of given score from the mean

A child's raw score is converted to a z-score of -0.4. Is this within the average range? a. yes b. no

a. yes this falls more than 2 SD below the mean

A child's score falls at the 2nd percentile for his age level. Is there cause for concern? a. yes b. no

b. no

A child's score is 3 standard deviations below the mean. Does this fall within the average range? a. yes b. no

Metathesis

What phonological process is this? /pvk/ for cup -when two consonants within a syllable are placed in a different order

c. 95%

Approximately what percentage of scores falls between z-scores of -2 and +2? a. 50% b. 68% c. 95% d. 99%

b. showing joint attention

At approximately 10 months, a child should be: a. Producing first words b. Showing joint attention c. Speaking intelligibly d. Producing narratives

weak syllable deletion

What phonological process is this? /tefon/ for telephone -omission of an unstressed syllable

fast-mapping

What a child needs to do when they learn words—map new words onto an object

the knowledge that underlies our use of language for communicative functions, pragmatic knowledge helps us transmit information to others in ways that are socially appropriate

What are pragmatics?

vocabulary knowledge

What are semantics?

Phonology, Semantics, Morphology, Syntax, Pragmatics

What are the 5 components of language?

reflexive crying vegetative sounds

What behaviors do we expect to see in phonological development stage 1 (0-2 mo)?

cooing and laughter

What behaviors do we expect to see in phonological development stage 2 (2-4 mo)?

vocal play, velar consonants, front consonants

What behaviors do we expect to see in phonological development stage 3 (4-6 mo)?

canonical babbling

What behaviors do we expect to see in phonological development stage 4 (6-10 mo)?

variegated babbling

What behaviors do we expect to see in phonological development stage 5 (~12 mo)?

impaired comprehension and/or use of spoken, written, and/or other symbol systems

What is a language disorder?

< 5.5 lbs

What is considered low birth weight? LBW

< 3.3 lbs

What is considered very low birth weight? VLBW

the system for combining units of meaning to form words

What is morphology?

sounds and the sound systems of language

What is phonology?

the grammatical rules that govern how words are combined into sentences and the appropriate word order for conveying ideas

What is syntax?

b. 68%

What percentage of scores falls between z-scores of -1 and +1? a. 50% b. 68% c. 75% d. 100%

Reduplication

What phonological process is this? /baba/ for bottle -repetition of a syllable of a word

Consonant Harmony/Assimilation

What phonological process is this? /guk/ for duck -A consonant is affected by the place of articulation of another consonant

consonant cluster reduction

What phonological process is this? /kul/ for school -one or more consonants are deleted from a cluster of two or more in order to simplify production

Final consonant deletion

What phonological process is this? /pa/ for pot

50, 0, 24

late talker: a child with less than a _____-word expressive vocab and ______ word combinations at ____ months

Pre-intentional period: 1-8 months Transition to Intentionality: 9-12 months Emerging Language: 18-24 months

list the 3 Early Stages of Language Development

early oral language and later literate language

narrative skills are the bridge between ____________________________ and _________________________

CSBS-DP Infant Toddler Checklist

o Free norm-referenced screener of communicative intent, 7 key language predictors o Functional Communication age 6-24 mo. o 3 components: checklist, caregiver questionnaire, 30-min behavior sample o Shown to help pediatricians detect ASD, LD, DD at 1 yr. of age

canonical babbling definition

repetition of simple consonant-vowel combinations in well-formed syllables (ex. ba-ba-ba, ma-ma-ma)

1.5 or 2.0 -Although it may depend on your setting for what score will qualify for services (school, insurance, early intervention, etc.), below 1.5 is definitely concerning even if it doesn't technically qualify

scores greater than _____ or _____ SD below the mean are clinically significant

telegraphic speech

speech that is devoid of function morphemes and consists mostly of content words, ex. "mommy drive car"

validity

the accuracy of a measure

Reliability

the consistency of a measure

16 months

the proportion of consonants should be greater than vowels by ____ months

-personal narrative (memorable experience like a trip) -script narrative (routine series of events, "how to...") -fictional narrative (generate a story)

useful narrative types for assessment (3)

Non-word repetition task fast-mapping

what 2 assessments are considered free of cultural and language bias?

~50% different words

what NDW % should a child have at 2 years?

increase and become more consistent

what can you expect of the frequency of communicative intent as children age?