Weeks 10-13 Final

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

Models of instruction

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. 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. Now: A new model of bilingual instruction: instruction in both languages through Grade 12. Bilingual competency in oral and written language is the goal. Ideal situation but not done everywhere due to financial limitations

Non-word repetition

Early screening test to predict later language difficulties. (e.g., Bishop et al. 1996) Not experience-based nor culturally biased. Some environments are language-rich and some are not- we know they haven't heard these words before, simply testing whether they can keep the words in short-term memory (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. Text prediction due to anticipatory structure

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 Metacognitive skills used to behave in everyday life, plan actions, and think about what we're going to do in the future Sort incoming information that we're always processing At the core of autism disorders Central coherence Getting the central idea of situations- detail is a strength but you must be able to read situations and make decisions/judgements based on how the whole picture is presented- the big picture is not a strength of autistic people Theory of mind/mentalizing/ social cognition Another core problem in autism All three of the above views are linked and it's hard to pinpoint one as a core problem.

Autism

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 "Autism" is a hugely broad diagnosis Pattern often seen: Increase in discrimination or identification of small differences between stimuli, ST (short-term) memory Excessively responsive to some stimuli or under-responsive to other stimuli Neuropsychological studies: Increase in memory, visuospatial, sensori-perceptual, single-modality problem-solving, detail Decrease in 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 qualitatively different and emotional expression is impoverished Social cognition includes understanding how other people think and feel Also called mentalizing/theory of mind/presupposition Sally Anne, Droodle, crayons, etc Trying to assess if the child has the ability to understand that other people don't think the same way that you do 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

WEEK 11

GOALS FOR LATER LANGUAGE: NARRATIVES

Fragile X syndrome

Genetic developmental disorder with intellectual and behavioral disabilities Defects in a gene on the X chromosome is the cause 1/4000 boys and 1/8000 girls Language delays often a first sign Early hypotonicity, sensory defensiveness (like with autism- over-reaction to sounds, touch, etc), poor sucking and chewing, and drooling Visual memory relative strength Can learn to read (whole-word strategy) Tendency to imitate what they see and hear Delayed onset of expressive language + slow development Syntax more affected than receptive skills and vocabulary Reduced intelligibility, speech errors like younger children Some dyspraxic qualities (planning, sequencing, execution of fluent speech) Fast, uneven speaking rate Uneven rhythm Hoarse, breathy voice quality; uneven loudness Early intervention crucial due to declining rate of development in later childhood. Genetic testing for a boy with mild- moderate IH and some of the language characteristics may be suggested.

L2 Learners

However, it may be that there is an arrested language development of the primary language after exposure to the dominant language of the community. ALD: L1 ceases to develop while the child is trying to learn L2. Also called "subtracted bilingualism "Subtracted bilingualism" L1 is subtracted and replaced by L2. L1 culture and language is less prestigious than L2

SLI-LI LD:

Identifying and describing SLI - relevant for research purposes; Very specific exclusionary criteria 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.

Autism Prevalence: U.S. Centers for Disease Control and Prevention (CDC 2014):

Prevalence numbers estimate 1/68 children < age 8. 1/54 in males 1/252 in girls (More common amongst boys) Prevalence rates have been rising since the 1960s: underlying reason unclear. Lower rates in Hispanic and African-American children suggest under-identification in these populations. Wingate et al. (2014)

Week 9 and part of week 10 are in

paper notecards

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. Children's communication checklist- parent rating scale where they can mark where they see certain behaviors Monitor changes over time Continually reassess

Arrested Language Development and Language Loss in L2 Learners:

SLP has to distinguish between the child with LEP (limited English proficiency) and the child with language-learning difficulties (who has difficulties learning ANY language). Is it a problem with learning English as a second language, or are they also struggling in their L1?

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. 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/ 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/ B. 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/ C. 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/ Clearly an obstacle and an attempt but not a successfully executed plan A. Conjoined causal chains (multiple causal chains, or episodes) Start out giving one causal episode and then another causal episode (linked to the first) The 1st causal episode may not be not causally related to the 2nd, but is joined in an additive or temporal fashion A. Conjoined causal chains 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/ B. Embedded causal chains 1st episode brought about 2nd episode; they're causally related, not two separate strands B. Embedded causal chains 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/ Not two separate strands- two causal episodes causally linked to one another These complex stories don't appear until early school years.

Temporal chains

There is a temporal dependency among utterances—changing order of utterances (C- units) 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/ There are no then or and then connectives used

American Psychiatric Association's Diagnostic and Statistical Manual (APA DSM IV):

This is pre-DSV V (2013), and the diagnostic criteria has changed Pervasive Developmental Disorders (PDD) Psychiatric disorders that have a more established neurological base than do behavioral disorders PDD represented a spectrum of disorders Autistic disorder Asperger's syndrome Rett's disorder Childhood disintegrative disorder PDD-NOS: Not otherwise specified- used when child did not show behaviors that met the criteria for the diagnosis of autism

Narratives vs. conversation

↑ MLU in narratives ↑ More advanced grammatical structure in narratives ↓ Fluency (more hesitation phenomena) in narratives ↓ Intelligibility in narratives E.g., Reuterskiöld-Wagner et al. (2000)

Processing deficit in specific mechanisms

2b. Processing Deficit in Specific Mechanisms: Deficits are specific but have far-reaching consequences for language development and function. Deficits in temporal processing (Tallal et al.) SLI: poor processing of stimuli of brief duration or stimuli presented in rapid succession. Deficits in phonological memory (working memory) (Baddeley & Hitch, 1974: Gathercole & Baddeley, 1990).

Sensory deficits

Blindness Deaf-blindness Hearing impairment

Discrepancy Identification (NV-IQ 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. No one really knows how NV IQ and language skills are linked

WEEK 12:

CLINICAL CATEGORIES: SLI AND CAPD

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. ASHA: in order for LEP (limited English proficiency) 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. If you don't speak the L1 language, translators and parents will not work well as an assist- likely a bilingual SLP will be needed.

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. Basically noting that those with low cognitive functioning will benefit as much as others

Intellectual disability

Cognitive skills grow throughout adulthood. Limitations in communication skills may be a first sign. Language acquisition follows a slowed-down sequence of development. They may follow the typical hierarchy/pattern- their language is delayed and won't reach the same skill level

Fast ForWord

Computerized treatment program using temporally modified speech signals at different levels of language processing. The length of time between speech sounds is increased, and gradually gets smaller as the child moves up levels 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.

Genres: hierarchy

Conversation Narration Expository: when the class studies a content area, and then you "tell" or "write" about that content Persuasive: discussion or debate (use your language skills to convince someone to see your perspective)

Deaf Blindness

Could be caused by Rubella in pregnant mother Could be caused by 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

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. Two schools of thought here: A. general processing view B. specific mechanisms view

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 (normal children are inclined to respond to the sound of the human voice) May use gestures to request, protest, and regulate other people's actions, but Do not to show and point—like other children

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.

CAPD (Central Auditory Processing Disorder):

"Limitations in the ongoing transmission, analysis, organization, transformation, elaboration, storage, retrieval and use of information contained in audible signals." Poor listening skills. Difficulty in following directions. Distractibility and inattentiveness. Problems in reading, spelling, using written language, and memory. ** note that all of the above are standard in LD** Typically diagnosed on the performance on certain audiological tests by audiologist. Poor attention could be the reason for poor performance on these tests. Typically diagnosed by an audiologist. Intervention should target language (all of the above affects language and therefore targeting language benefits CAPD sufferers)

Down syndrome

(goes under IH): Extra (third) copy of the 21st chromosome 1/800 births Occurrence increases with increased maternal age Mild-moderate IH Hypotonia of the muscles Characteristic face Hyperflexibility of joints Ear abnormalities (frequent otitis media due to narrow ear canals) Oral-motor difficulties (high palate and large tongue) Poor speech-language and hearing Rough breathy voice Poor speech intelligibility Poor articulation (oral motor control) Semantic development: an area of strength (recognizing word meanings) 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.

Autism spectrum disorders

- Two salient characteristics: A) Deficits in social communication B) Restricted or repetitive behaviors or interests Impairments go beyond simple immaturities This is not a delay in development They show behaviors that would be abnormal at any age

Childhood bilingualism

1. Infant bilingualism: Both languages are spoken to the child in early infancy. Both languages develop simultaneously in naturalistic situations—truly bilingual. Used to be thought that if the languages were introduced before adolescence, they would be bilingual- now thought it's before the age of 3 2. Sequential or consecutive language learners Child hears one language at home and then later on learns the other language Hear only one language at home, and later learn L2 in preschool Hear only one language at home, and later learn L2 in school

Analysis: Story Grammar (Stein and Glenn, 1979)

1. 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. 2. 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. 3. Response state The cat gets angry and jumps onto the carriage. The baby starts to cry and the lady notices the frog and the cat. 4. Response plan The cat is going to chase off the frog. 5. Attempt He runs after it and scares it off. 6. Consequence The carriage falls over and the baby is screaming. The frog is frightened and runs off. 7. Resolution/reaction The mother takes care of her baby.

General processing limitations

2a. General Processing Limitations: Comes from the idea that the problem is more "general" in nature and related to a deficit in processing abilities. 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. Language and communication operate simultaneously on many levels Limited Processing Capacity Space - memory Energy - mental resources (shifting between processing different aspects of information) Time - rate of processing Generalized slowing hypothesis (Kail 1994) A generalized deficit in speed of processing whether the information is linguistic or non-linguistic 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. 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 (think of the contraction 's in he's- it's hard to hear). 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. 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. Latin based languages have a new verb inflection for each person in the present tense (ex: I sing = canto, you sing = canti, he sings = canta)- Italian is considered a rich morphology language, but English is a sparse morphology language English speaking children will have more issues with morphological verb inflections (for example) because we have a sparse morphology

Autism and communication

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) - they're good at maintaining within their interests Use of nonreciprocal speech (interpersonal) Talking to themselves (in a non-intelligible way) Sometimes it is intelligible but stereotypical/repetitive Use of language that is stuck in the original context when it was spoken Ex: Child in car- driver steps on the brakes- instead of saying something appropriate to context, the child says "don't go out on the balcony" over and over again- fear is triggering this phrase. Literal interpretations (lack of humor) Echolalia (may be communicative attempts or self-stimulatory) When language skills improve, echolalia decreases

Intellectual disability =

= Executive Function: Difficulties with: Directing attention to relevant aspects Discrimination tasks Organization Recall/memory Use of strategies/metacognitive skills (how to help themselves) Generalization

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) 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

Patterns of communication skills for those with IH

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. Your planning as an SLP will be different for those with IH In general, the sequence of development follows normal development. MLU levels are reached at later ages Grammatical morphemes learned in the same order but at a slower pace Fewer complex sentences, fewer elaborations and relative clauses Phonological processes used longer (in terms of sound system) More inconsistent articulation errors Vocabulary learned more easily than syntax This population struggles with higher level conceptual items such as abstract language 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 but not as a regulation of behaviors as with TD Staying on topic (topic shifts and drifts) Talking about emotions/feelings Adjusting style of talking to fit different listeners Asking questions (in a different style) 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) When language structure, social use, and restricted interests are all impacted, they will get the diagnosis of autism When they struggle with the social use of language = PLI Language structure impairment = SLI *Aspergers is no longer in DSM V- they struggle with social aspect and interest

DSM IV and V

DSM IV: Autism spectrum disorders: several diagnostic categories Impairment in three areas of functioning Social interaction Communication Behavior/interests + PDD-NOS (pervasive developmental disorder, not otherwise specified) if you don't meet all of the above criteria DSM V (2013): Autism spectrum disorder: one diagnosis "Autism:" and you describe the area of functioning Impairment in two areas of functioning: Social communication (used to be social interaction and communication) Restrictive patterns of behaviors Comorbid conditions allowed e.g. ADHD, OCD, LLD + Social Communication Disorder/PLI Autism has to be ruled out to qualify for this diagnosis Separate diagnostic These kids are verbal, don't show as many restricted behaviors, but still have problems with social communication

Autism continued

Always take comprehension difficulties into account—simplify input. There will be comprehension difficulties in this population Always try to see how the child responds to written language. Some of these children have hyperlexia- can decode written words at very young ages- this can be used to facilitate intervention 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 Pictures used to train the child to start requesting things Signs Other visual systems Typing can be useful 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%. (Folstein & Mankoski, Am J. Hum. Genet, 2000)

Story grammar

Another level of macro analysis Model most extensively used in the SLP profession Describes an internal structure of stories that we tend to tell 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. Stein & Glenn (1979)

Autism intervention

Applied Behavior Analysis (ABA, Lovaas). Behavior modification, intensive training program. Behavioral training Has moved from stimulus-response-reinforcement to more naturalistic approaches A very clinician-directed approach ESDM (Early Start Denver Model) incorporates both ABA approaches and developmental approaches. Hybrid approach DIR (Developmental, Individual difference, Relationship) Floor time: developmental approach—naturalistic (Greenspan): child's affect and engagement are stressed Opposite of ABA Child-directed approach Child's interests and investment in activity is the core focus Sensory Integration Therapy (OTs) SLPs normally don't do this Because autistic children are hypersensitive, OT works with this

Patterns of vulnerability

Arrow up = normal progression Arrow down = delayed progression L1 ↑ L2 ↓: - Could be the child hasn't had time to develop L2/ not enough input/support for L2 L2 ↑ L1 ↓: - "Subtracted bilingualism": a lot of effort put into new language, but not much effort in preserving L1 L1 ↑ L2 ↑: Ideal Effort put into teaching the child L2 while also an explicit/implicit effort at keeping L1 going Supports Cummin's theory- outcome of L2 is determined by strength of L1 skills L1 ↓ L2 ↓: - Could be indicative of a language learning disorder/language processing problem

DSM-V 2013

Autistic disorder, Asperger's disorder, Rett's disorder, childhood disintegrated disorder, and PDD-NOS replaced by one broad umbrella term: "Autism Spectrum Disorder." 299.00 Further distinctions made according to severity levels. The severity levels are based on the amount of support needed, due to challenges with social communication and restricted interests/repetitive behaviors. Onset should occur before age 3. A person might be diagnosed with Autism Spectrum Disorder, Level 1, Level 2, or Level 3. Level 1: requires support Level 2: requires substantial support Level 3: requires very substantial support Rett's disorder is now specified as "known genetic condition."

WEEK 13

BI-/MULTILINGUALISM

Minimal story

Basic way of thinking of macro of a story Beginning state: The boy was lonely. Middle: The daddy gave him a puppy. End: Now he is happy

Deficit of linguistic knowledge

Deficit of Linguistic Knowledge: Problem is language specific and is a lack of grammatical knowledge Most theories have their roots in a Chomskyan framework such as the principles and parameters theory. Principles and parameters theory: There are common principles in language across the world (agents and action- subjects an verbs, etc) Different languages use different word orders (SVO, VSO, etc) Other theories ↓ Missing INFL Account (Radford): Missing inflection account 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. B. The Implicit Grammatical Rule Deficit (Gopnic and Crago): Suggests that individuals 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. Can't use linguistic rule system to build 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 from English-speaking data C. Extended Optional Infinitives Account (Rice et al): Children at an early stage are not aware that tense marking is obligatory. Think: the content category "temporal" doesn't come in until late in the plan They treat it as optional, using infinitives (drink juice instead of. drinking 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. Tense and agreement markings: third person singular = "he"/ if you're going to use present tense verb, you must add an -s/ must be an agreement between verb and person: he sings vs. I sing Support from data from English-speaking children with SLI.

Narrative Development (Lahey):

Development of C/F interactions: macrostructure/logical-temporal structure Represents a developmental hierarchy Child is off the plan at this point This is a different developmental hierarchy Four levels of ↑ing complexity: additive, then temporal, then causal, then causal with multiple episodes

Visual impairments

Do not have as much negative effect on language development as HI Input different Semantics and pragmatics SLP consultative approach (SLP may be consulted on a regular basis to see how things are developing) Some children may need extra stimulation

Early diagnosis

Important We need to support them early on so that they have a better chance at developing speech, language, and social + emotional development Variability in early speech and language development makes diagnosis difficult You could have a non-verbal kid who ends up being totally fine- hard to distinguish Difficult to diagnose early because there are fewer typical behaviors at age 18 mos. or 2 yrs than later Must look at precursory behaviors: Joint attention, interest in looking at faces, limited response to own name Assessments CHAT: Checklist for Autism in Toddlers Checking off different behaviors to assess whether developing typically CARS: Childhood Autism Rating Scale M-CHAT: Modified Checklist for Autism in Toddlers All created to assess for warning signs

Comprehensive case history

In addition to usual information: Language use in the home (form and nature) Code-switching Start one sentence in one language and finish it in the next Use a word from the other language to clarify a word that doesn't fit in the first one/vice versa Sociocultural factors One language might be more valued in the family/in society Age of exposure/acquisition, sequential, school- setting Developmental milestones in L1 We need to know whether they were developing in a typical way before being introduced to L2 Contact with homeland, motivation

Controversial autism intervention approaches

Intervention—two controversial approaches Facilitated communication: views problems with communication as a motor handicap. A facilitator helps the individual communicate: controversial, not evidence- based Auditory integration therapy—listening to electronically manipulated music in headphones. Does not meet criteria for efficacy or safety according to ASHA. Supposed to lead to better processing capacity and better communication

Specific language impairment

Language disorder without other concomitant problems 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. **Not a term to use with parents- meant to be used within the profession** May complicate things in the explanation of the label Exclusionary criteria (if they have any of the below, they are not considered for SLI): Hearing disorders Disordered sensorimotor functioning Socio-emotional problems Nonverbal intelligence Congenital malformations of vocal tract Neurological Factors: Focal brain lesions TBI - traumatic brain injury Cerebral palsy Severe seizure disorders Stark and 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).

2b. Processing Deficit in Specific Mechanisms:

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 (20-36 mos). If the child is old enough and they don't have enough words to use to make the grammatical analysis mechanism work, the window may close and the grammatical development will be stunted A general neuro-maturational 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. In the beginning, there is no lateralization in the infant's brain- lateralization happens gradually- the maturation of the grammatical module is linked to the growth of the left hemisphere Pieces of the right hemisphere may have to take over aspects of the LH processing

The Lowest Level: Heaps: 4-Year-Old with IH (tell a story about the animals):

Lookee There monkey Monkey They're all lost There's doggy There's doggy There's duck See duck Walk walk walk Out a walk Out a walker These animals Quack quack quack Bow wow wow Here's a horsie Just pick up This may not look like a story, but in this view, the child is not using complex sentences, but there is centering around the conceptual core of animals. This is the lowest level of development

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. Gilbertson & Kamhi (1995); Young & Killen (2002)

Outcome

Many individuals continue to have subtle language difficulties during their school years and adulthood. Once children are in school, they're expected to behave and learn in a certain way... System is very taxed during school -age years 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. Nonspecific LI: (LI in child that has slightly lower cognitive level than what is required for SLI)

Testing

Many standardized tests are available in other languages than English, e.g., Spanish. Standardized on monolingual English- speaking children and then translated into Spanish. Be careful: English and Spanish have different structures- what an English speaking child learns might be more or less important than what a Spanish-speaking child learns Even when standardized on a Spanish- speaking population, the normed sample consists of a monolingual Spanish- speaking population and not on speakers with Spanish as an L1 and English as an L2. Compare with the SALT program. Computer software used to analyze child language Developed at U of Wisconsin, Madison Collect language samples from naturalistic interactions and transcribe/code them by features of interest Program quantifies what you were coding for Collection of normative data on children speaking Spanish and English Good for comparison A good program to explore for bilingual children Even if it has been normed on a Spanish- speaking ESL population, the Spanish- speaking population is very heterogeneous (differs depending on what dialect/type of Spanish they're speaking) both linguistically and culturally. Thus bilingual SPLs should not rely too heavily on tests when assessing children. Use SALT program + informal methods that supplement testing Underlying assumption is the same: if they aren't proficient in L1 and struggling in L2, should suspect a language-learning problem

Cohesive tie categories

Microlevel/linguistic form analysis Synonymous with conducting a narrative cohesion analysis Different things to look at Anaphoric (endophoric) reference (referring to linguistic context- something previously mentioned): Andy and Charlie went out. They had fun. (*They is being used to refer back to Andy and Charlie) Lexical: I like my car. My car (repetition) is wonderful. It's quite an auto (synonym). It's quite a vehicle (superordinate). Instead of using the same lexical item ("my car"), using synonyms and superordinates Conjunctive (connectives) : The dog killed my cat and (additive) my mom got angry. The movie ended at 10, then (temporal) we went home. How is the child using connectives to connect C- units? Substitution: I lost my pen. I need another one. We don't need to repeat the word "pen"- "another one" refers to pen. Infrequent in stories, more frequent in conversation Ellipsis: This is my car. Where is his? /car/ Leaving out the word car Is he going with us? He said so. Do you need some money? No. /I don't need any/ Infrequent in stories.

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 (makes the story clear to the listener) Conjunction Using connectives/conjunctions to tie adjacent clauses/C- units, both within and between sentences Referencing Characters and other things must be introduced and then referenced in an appropriate way How prior mention is connected with what follows Most common referents are pronouns and definite articles Two types: exophoric and endophoric 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 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/

Otitis 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

Often seen in SLI

Mild neuromaturational delays. Poorer attention Different in their profiles of NV functioning, even if reaching the cut-off level.

More Studies on SLI English-Speaking Data:

Most studies have been done on English speakers not other languages) Problems with morpho-syntax or grammar, particularly verb-morphology. Researchers have tried to relate these problems to hypotheses of underlying deficits.

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. Leonard -99: Language test scores of -1.25 standard deviations or lower on standardized tests then we can decide that this child shows a language impairment But, tests differ and results are defined by the test used. Tests have been normed on different populations, so it's important that the tests are scrutinized

Gender

Often 2:1 or 3:1, boys/ girls in studies (clinically defined sample). (More boys than girls get this disorder) In Tomblin et.al.: 1.33:1 (epidemiological). Ratio was much closer when all kids in an age group were examined Earlier studies were only looking at pre-defined populations (special ed, etc) Boys tend to be more expressive, so this may have impacted the pre-defined samples- girls might have had LI but weren't "acting out" as much

True Narrative (5 Years NL)

Once upon a time there was a happy little family There was a little boy and there was a daddy and a mommy They were in a castle and there was a hero who lived in Boulder and then there was a bad guy that came in the house and went knocking on the door and then the hero could hear the bad guy knock on the door He know the bad guy was at the house so he came to ask this guy And then he came to the house and he started fighting with the bad guy And he took the bad guy and he threw him in the water. * This child has typical language development- starts with a conventional story starter and a conclusion.

True narrative (highest level)

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

Predictors for Reading and Writing

Phonological awareness: (being able to think about language form and not just language content)- You're thinking of language as a code/structure- "caterpillar" is a long word for something little/"train" is a short word for something long Clapping syllables would be an example of phonological awareness Narrative skills: In kindergarten, predicts academic success in general, but especially reading comprehension Word recognition: - phonological awareness and rapid naming (Catts,1993) Raping naming is a word retrieval test in which they name pictures as fast as they can. Is a predictor for literacy learning Also letter recognition in Kindergarten The more interest the child takes in learning letters, the better the outcome for literacy learning Reading comprehension: measures of spoken language comprehension

Poor Non-word Repetition in Children with LI:

Poor working memory skills (short-term phonological memory skills) - measured by non-word repetition: a core problem in language impairment. The child gets to repeat the sound sequence of the word without interference of semantic lexical content

Autism

Prognosis: related to two factors Cognitive skills Language skills Functional speech by 6 = better prognosis Lifelong condition

Prevalence

Range between 2-12% in different studies, depending on population, tests, and cut- offs. Tomblin et. al. (1997): 7000+ five-year-olds in Iowa and Illinois, SLI: 7.4%. Epidemiological study: all children in age group included and assessed with wide net to look at prevalence numbers

Parallel Structures

Recurrence of a grammatical structure throughout one or more successive clauses Three types: Global: the structure and the lexical content of an entire clause is repeated /this goes here, this goes here and this goes here/ 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/ 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/

Purpose of exclusionary criteria

Research purposes Makes sure that more variables are eliminated Clinical purposes Having exclusionary criteria helps for discussion amongst clinical staff, although SLI is not a term that's used for offering services or in communication with parents

SLI and Autism

Several research groups have been searching for genes that contribute to autism and SLI. Non-word repetition is a common symptom of SLI, and has been used in testing to match to genetic information 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

Additive chains

Simple listing: a monkey/ a dog/ a book/ Not a story, but shows that they're stringing units together Repeated actions: the dog went on the puppet/ the puppet went on the house/ the house went on the pigeon/ Additive chain, no connectives 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/

Working memory

The core problem in SLI is a problem with short-term phonological memory Kids can't keep new strings of sounds in their short term memory storage (phonological loop) New words can only be kept in the phonological loop for a few seconds before it disappears, unless you connect it to a new concept. The central executive sends new information to the phonological loop for analysis- it either disappears or is sent to vocabulary storage We test short-term phonological memory through nonword repetition

Childhood bilingualism (sequential)

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 (ability to think about language as a structure/code). The school-age bilingual child may not have any trouble with social communication, but may have trouble with cognitive/academic language skills.

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.

Narrative Level Analysis Children 2-5 (Appelbee (1978)):

Two concepts: Centering: a story nucleus, core, or theme Chaining: when children develop a sense of time (and then, and then, and then) Centering is earlier, children focus on some aspect that interests them Six levels of developmental patterns (as described by Appelbee)

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: newborn doesn't need to do anything- body will show a physiological response Ratings: Mild Moderate (/s/, some vowel- information) Severe Profound Total Deafness: hearing loss of more than 70 dB—cannot understand conversational speech

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 Use several of these elicitation strategies and analyze which is best for the child (how are they doing with unstructured tasks)

Goals of Use Interacting With Content/ Form:

Use = how child is including listener in the story Are they including an orientation? (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

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.

Clinical examination

We should always examine: Hearing screening Oral motor structure and function Language testing (looking for. That -1.25 SD below the mean) Language sample (F/C/U) Observation of motor function Observation of level of attention

Analysis

What are we looking at when looking at these narratives? Transcription (the story isn't written out- we must do that). Segmentation into utterances or C-units Prosody: pause time, intonation- helps determine where one utterance ends/begins C-units: a main clause and all attached dependent clauses or modifiers Macrostructure and microstructure Macrostructure: how they are organizing the content units (different events, concerned with types of content units that the child is including and how they're being organized) Microstructure: linguistic structure: how are they using their language skills to put the story together cohesively (looks at connectives and how they use pronouns/referring to characters/features introduced early in the story).

Ellipsis

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 nonlinguistic context Endophoric: refers to the linguistic context