SHS 431 Final: Secondary Developmental Language disorders

__________ deficits associated with ID: - 50% of individuals with ID have language skills = MA (mental age) - 50% of individuals with ID have language skills < MA 1. 1/2 exhibit poorer expressive only 2. 1/2 exhibit both receptive/expressive relatively poorer - syntax and morphology 1. MLU < 3 ID = MA 2. MLU > 3 ID < MA 3. still acquire in developmental order - *phonology*: increased incidence of speech problems in ID populations - *semantics*: ID = MA, yet overall tend to be more literal and concrete than peers - *pragmatics*: acquisition similar but difficulty with pronouns and requesting clarification

Language

Intellectual disability (ID) affects __ to __% of the population and make up 15% of SLPs' caseloads

1-3%

What causes language disorders?

1. we don't know 2. many different things

Trisomy _____ - 3 copies of chromosome 13 - 13 copies in 400-1000 births - risk increases with mother's age - sloping forehead, cleft palate, abnormal and low set ears, small eyes - heart defects (among others) - shortened life span expectancy - severe intellectual disability

13

Intellectual disability is manifested in early development, before age ______ years old.

18

Chromosomal disorder: Down syndrome - most common chromosomal abnormality - the 21st chromosome affected - between 1 in _____ births - correlated with advanced maternal age

750

_____________ disorders in Down syndrome - phonological and motor speech delays - significantly compromised intelligibility - relative strengths in receptive vocabulary and pragmatics - difficulties with syntax and morphology (telegraphic speech) - under-developed MLU - better receptive than expressive language - difficulty with fluency > speech has unusual rhythm - poor working memory - feeding and swallowing difficulties

Communication

Form, content, and use within ID: _________ syndrome: - significant phonological deficits - reduced respiratory control = articulation affected (ex: shorter sentences) - morphosyntax skills are very impaired - vocabulary development is generally equivalent to or above nonverbal IQ

Down

Interventions for children with ________ syndrome and other intellectual disabilities: - DTT, PECS, play therapy, sign language - babbling, sound play - early pragmatic functions (requesting, commenting, protesting) - increase utterance length - feeding and swallowing > using utensils, drinking from open cup

Down

Physical characteristics of ________ syndrome - low muscle tone (babies appear "floppy") - flat facial features, with a small nose - upward slant to the eyes - small skin folds on the inner corner of the eyes - small, abnormally shaped ears - single deep crease across the center of the palm - immature gait (walk is abnormal) - poor fine motor skills (ex: tying shoes)

Down

__________ syndrome: - 1 in 750 births - prevalence increased by 30% from 1979 to 2003 - shorter life expectancy - 50% likely to have congenital heart defects - extra copy of Chromosome 21 - genetic - can be diagnosed before birth - as mother's age 35, risk of having child with ________ syndrome increases - more likely to have eye defect, hearing loss - is an intellectual disability

Down

____________ Syndrome - 3 diagnostic criteria: 1. pre- and postnatal growth defects 2. facial dysmorphology 3. neural behavior defects - difficult to diagnose without knowledge of maternal alcohol use

Fetal Alcohol Syndrome (FAS)

Form, content, and use within ID: ___________ syndrome: - language ability is consistent with IQ - develop receptive skills at one-half the rate of children developing typically - develop expressive ability at one-third the rate of children who are TD - usually also diagnosed with ASD

Fragile X

Sex chromosome disorder: ____________ syndrome - most common form of inherited intellectual disability in boys - genetic inheritance pattern - males: 1 in 4000

Fragile X

Who helps children with ____________? - Physicians (cardiologists, ENTs) - Teachers - Speech-language pathologists - Occupational therapists - Physical therapists - Special educators - Regular educators - Surgeons - Audiologists

Intellectual disability (ID)

__________ approaches for children with ID: - Milieu training - Peer-training - Functional Communication Training - Integrated Treatment is Fun (IT's Fun)

Intervention

____________ and language impairment - 5 types (Nelson) 1. physical 2. sexual 3. emotional 4. physical neglect 5. emotional neglect - "mutual influence" (extreme example: "Genie") - children adopted from Russian orphanages: > more overall behavior problems than for other international adoptees > impairment of attachment > hyperactivity and conduct disorders > cognitive impairments in problem-solving abilities and cause-and-effect thinking

Neglect/abuse

Limitations of _________-referenced Assessments for individuals with ID - The majority of the tests evaluated receptive and expressive vocabulary, syntax, and grammar; no recent test evaluated pragmatic ability - The lack of a pragmatic assessment is of particular concern because pragmatic ability often is weak in individuals with ID

Norm

Communication difficulties for children with ____________ - feeding and swallowing - significantly delayed communication and developmental milestones > first year: cooing, rolling, smiling responsively, reaching and recognizing close adults > two & three years: sitting supported, object permanence, imitation, playing baby games, sitting independently and recognizing words > four to six years: commando crawling, independent playing, following simple commands, helping with hygiene tasks, standing, understanding cause and effect, and use of signs > older children: identified common objects, used a walker, crawled, understand words and phrases

Trisomy 13

The incidence of TBI is increasing in infants and preschoolers: - One of the primary forms of abuse is ____________ - often is triggered when a caregiver loses control in response to an infant's crying - used to describe the constellation of signs and symptoms resulting from violent shaking or hitting the head of an infant or small child

shaken baby syndrome (SBS)

ID and cognitive skills: - cognitive development is _________ - attention to salient features, symbolism, organization and recall relatively poorer (language is a symbol system)

slower

Accommodating cognitive processing subskills: For ___________, rehearsal, repetition, or chunking of information to aid memory

memory

Most complex developmental problems are _____________

multi-factorial

Accommodating cognitive processing subskills: For _____________, teach strategies such as chunking and word association to aid in faster and more efficient information retrieval

organization

Accommodating cognitive processing subskills: For ____________, manipulate the task and teach self-monitoring skills (meta-cognitive)

discrimination

Intellectual disability usually affects two or more areas of ___________ deficit: - communication - self-care/home living/social skills - community use/health and safety - functional academics/leisure/work

adaptive

Causation = __________ - what conditions co-exist with language impairments - ____________ refers to the conditions with which language disorders commonly co-exist (ex: Knowing that language disorder is usually associated with Fragile X syndrome doesn't mean that we really understand how the disorder that typically accompanies the syndrome is caused)

association

Accommodating cognitive processing subskills: For __________, increase "wait time," so individuals with ID have time to respond

attention

Cigarette smoking and _______/development: - possible outcomes: > low birth weight > premature > growth retardation (stunted growth) > Sudden Infant Death Syndrome > cognitive limitations

birth

___________ and birth/development: - possible outcomes of exposure: 1. premature 2. congenital defects (small head) 3. negative birth history (born with difficulty) - newborn characteristics: > irritable, poor feeding, high-pitched cry, abnormal sleep patterns, tremors, stiffness > often recover in first year - developmental problems are similar to those seen in children in chaotic homes

cocaine/crack

Two aspects of intellectual disability: - deficits in ___________ and in ______________

cognitive and adaptive behavior

Individuals with intellectual disability usually have __________ intelligence (IQ 70-75 or below, 2 SDs or 2nd percentile)

sub-average

Accommodating cognitive processing subskills: For __________, teach children with ID simple meta-cognitive strategies which improve transfer of learning

transfer skills