511 Quiz 1
So, most of the evidence in language disorders does not meet the standard of EST based on RCT
★ As an alternative we use the "best available evidence (BAE)" ★ BAE is often generated by other types of research designs
Chomsky says the environment plays a _____ role
"trivial" -No specialized language input is needed -Radio or TV will do
2. Uncontrolled, Unreplicated
-1st case study (uncontrolled, unreplicated) -Can claim improvement but not Rx effectiveness -Use only when no Rx w/ higher level evidence is available
BAs use the term imitation for referring to a nonverbal echoic- copying someones motor moments
-Imitation serves as a prompt for teaching other nonverbal skills A-mom claps to music VB-claps C-mom smiles
Our description so far is simplistic in several ways.
-In ongoing conversations, VB functions are interlocking i.e., each partner's utterance often serves as both as an A and as a C -A single VB almost always has more than one antecedent -A single word could have multiple functions, depending on A-B-C
5. Controlled, Unreplicated
-The 1st controlled experiment -Positive results support Rx effectiveness i.e., Extraneous effects are R/O by control group -Establishes cause-effect, but unknown reliability -Use w/ caution. Prefer HLE. Look for replication
1. Mand
-a VB that names its own reinforcer -a request A-child wants cookie VB-have a cookie? C-recieves item requested
5. Textual
-reading written words -SLPs would say decoding -textuals can be overt or covert A-child sees a printed word "dog" VB-Dog C- mom says, yes dog!
Listener Response (receptive)
A- touch cookie B-child touches cookie C-gets praised
Kaderavek (2015) Language Delay (LD)
- when the language of preschoolers (2-3 yr old) lags behind the typical rate ex: Child (C) does not say first word until after 18 months ✦ Other terms for the same pattern ◆ "Late talker" ◆ "Late language emergence" ✦ Note: 51% of late talkers will eventually develop language normally
Nurture
-Empiricism -It assumes that genetics and biology provide the raw materials but knowledge is gained through the senses. -"bottom-up" or data-driven view of learning -new born is a blank slate on which the environment shapes language development
Replication
-Research may be replicated or unreplicated Unreplicated: -A single study is done & never repeated -Unreplicated controlled study = the 1st experimental study of the procedure -Unreplicated Uncontrolled= the 1st case study on the procedure Not the best evidence for the use of an 30 intervention
Functional unit- a category of VB and its causes (based on their antecedents and consequences)- aka Verbal Operant
-Skinner ✦Note: behavior analysts (BAs) and Linguist's each use the term "function" differently. ◆For BAs = it means cause & effect relationship (ABC) ◆For Linguists (SLP) = it means communicative intent or "semantic function"
Shaping
-Skinner -reinforcement of successive approximations toward a target behavior -occurs when an individual is expected to produce closer approximations to the behavioral target prior to reinforcement e.g., successive approximations of "cookie" u-i --> u-gi --> goo-gi --> cookie
Chaining
-Skinner -reinforcing a progressively larger number of behaviors required to complete a complex task. e.g., teaching a child to ... complete a puzzle Arrange a picture sequence Sequence sounds in a word -- occurs when an activity requires a number of linked steps. A complex behavioral sequence is broken down into smaller units so the child can be trained to complete a multi step task. Individual components are rewarded in successive steps
7. Controlled, Systematically Replicated
-The highest level -Shows Rx is reliable across Tx, Cs, settings -The greater the # of replication, the greater the reliability and generality -This is the most preferred Rx procedure Recommend for general professional practice Supports truly EBP
6. Controlled Directly Replicated
-Tx replicates own findings -Uses different clients -No modifications in Rx or setting -Postive results suggest Rx reliability -Use with greater confidence -Prefer method with L-7 evidence -Watch for replications & contradictory evidence
The seventh term was specific language impairment (SLI)
-a language impairment in the absence of significant deficits in cognitive, auditory, or neurological functioning ✦ However, this term is not recognized by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM 5, APA, 2013) ◆ Instead, the DSM uses the terms ▶ Receptive language disorder ▶ Mixed expressive-receptive language disorder
EBP (Kadeverick)
-a process used to design and evaluate interventions based on 2 considerations 1. Support for effectiveness - Is the intervention supported by evidence of effectiveness? 2. Individual appropriateness - Is the intervention appropriate for a particular individual? SLPs use both internal & external evidence in decision-making
Replicated research
-a study is repeated by the same or different author 2 types: 1. Direct replication- same author, same methods, different participants 2. Systematic replication- variations in methods -therapists, participants, settings -establishes generality of treatment -Replications may be controlled or uncontrolled -If results are consistent, replication adds support
Empiricism is associated with the school of psychology known as _________
-behaviorism B.F. Skinner is known as the father of modern behaviorism
1. Expert opinion
-claims of effectiveness w/o evidence e.g., a panel of experts claim the treatment works -Reject this Rx until positive evidence is offered.
UG (chomsky)
-consists of abstract rules that account for a generative feature of all languages i.e., a small # of rules can account for an infinite # of utterances ✦All languages use UG ✦But UG is expressed differently in each language
Language acquisition is due almost entirely to ________ (chomsky)
-genetics - i.e., ✦All children are born with a Language Acquisition Device (LAD) containing UG ✦LAD helps children to identify how their local language applies the rules of UG ✦Exposure to language is needed, but the influence social- language input is trivial compared with UG
Nature
-nativism (rationalists) -It's the assumption that children are born with the "seeds" for all that they will ever know about language and that the skills will "blossom" as they mature -"top-down" theory of learning (learning through introspection)
3. Echoic
-repeating what is heard -imitation A-it's a dog VB-a dog C-he's a cutie, isn't he? echoic are often used as prompts for teaching other VBs
External Evidence
-well-designed and controlled experimental studies that result in experimental data ✦ Well-designed studies can tell us whether a procedure will be effective ✦ Randomized controlled trials (RCTs) are considered the "gold standard" of evidence ✦ If an intervention meets the standard of RCT, it is known as an Empirically Supported treatments (ESTs)
Language disorders of all kinds were first described in the _______. Since then, different terms have evolved at different points in history
1800s Childhood Aphasia Auditory processing disorder Language disorders Specific Language Disorder
Overall, ____ of school-age children are diagnosed with speech and language disorders
2.9% ★Subgroups of children (not included in the 2.9% group) have speech-language impairments as part of a dual diagnosis ✦ Hearing Impairment - .2% of school population ✦ Multiple disabilities - .9% ✦ Learning disabilities - 4.9% a lot of children that have language delays are relabeled with learning disabilities
Skinner described 7 verbal operants
6 Are Primary Verbal Operants 1. Mand 2. Tact 3. Echoic 4. Intraverbal 5. Textual (reading) 6. Writing (dictation) 1 is a secondary Verbal Operant 1. Autocratic All VBs represents a different function
Language difference
A variation of speech-language behaviors used by a community based on shared regional, social, or cultural/ethnic factors ✦ Regional - e.g., Bucks Co. - e.g., water = "wudder" ✦ Spanish-influenced English spoken by English Language Learners (ELLs) ✦ Chinese-Influenced English spoken by ELLs
Motor Imitation
A-person performs and action B-child imitates the same action C- gets praised
Match to Sample (MTS)
A-picture of a cookie B-picks up a similar picture of a cookie C-gets praised
Empiricism assumes that
(1) Children are born with the potential but none of the knowledge they will eventually learn (2) Language is learned through interactions with the environment
Why is EPB important
-Not all treatments (Rx) are equally effective -Some are even harmful e.g., Facilitated Communication (physical support in pointing to letters) Doug Biklen Controlled studies of Facilitated Communication indicate that the client is not authoring the messages -Subsequent studies have confirmed that clients using FC do not author their own messages -ASHA says do not use this or rapid prompting and whole language for teaching reading
Extinction
-Skinner - withholding reinforcement until an undesirable behavior is no longer emitted e.g., ignoring inappropriate behaviors that are maintained by social attention when a child's response is not reinforced, the ignored behavior will decrease or disappear
2. Tact
-a VB that names a stimulus that was seen, heard, tasted, etc. -commenting or sharing JA A-child sees a balloon VB-Balloon C-I see it. It's a hot air balloon
Limitations of the Speech Chain model
1.It does not account for other linguistic modalities (it only looks at speech) 2.It does not account for the conditions that support language learning (antecedents, consequences and the social mediation)
EBP
Family Values Professional Expertise Best Evidence -a three-pronged approach to professional service delivery in which current, high-quality, published research evidence is integrated with practitioner expertise along with client preferences and values to inform assessment and treatment decisions (ASHA 2013)
Other operants
Listener Response (receptive) Motor Imitation Match to Sample
Hedge & Maul All evidence can be classified in consideration of two dimensions
✦ Control ✦ Replication
Bishop searched journals to identify the most frequently used terms for Language Disorder over 20-years
✦ She found 130 terms ✦ 33 were used 600+ times ✦ The top six were non-descriptive (non specific): ◆ Communication problems ◆ Communication needs ◆ Language problems ◆ Language difficulties ◆ Communication difficulties ◆ Language needs
★Skinner defined different categories of verbal operants in terms of functions rather than forms ★Each function involves a unique configuration of A-B-C
✦Antecedent - motivating and/or env. event ✦Behavior - the actual production ✦Consequence - the listener s reaction
Two extreme theories of language development resulting from the nature-nurture debate
✦Rationalism ✦Empiricism
Advantage of speech chain model
It can be used to analyze sources of breakdown during oral-aural communication. 1. We can consider whether a problem exists sequentially at the receptive and/or expressive levels i.e., a good communicator speaks and listens 2. We can assess whether a problem exists at any one or more of the processing levels
Extinction burst
a momentary increase of the behavior before it stops
None of the antecedents are specific to any particular linguistic structure
e.g., ✦Requesting is controlled by motivating operations(MO)-e.g., thirst ✦It can be expressed multiple forms e.g., single words, phrases, or sentences SO...Skinner proposed functional units to describe VB
Abs are controlled by A and C
★ The A involves one or more of three types ✦Motivating factors - internal states e.g., thirst, hunger, pain, physical discomfort, desire for info, etc. ✦External stimuli in the physical environment e.g., current or previous experience ✦ Prior verbal behaviors - what a speaker just said ★ Most VBs involve more than 1 antecedent
FCU model
★ skilled communicator must also integrate the components of language during each communication act i.e., ✦ The rules of pragmatics determine the selection of content and form ✦ The selection process is supported by the range of available resources (e.g., vocabulary, rules of grammar)
PBR
★PBR = replicated, uncontrolled research based on a solid theoretical foundation to meet the unique needs of an atypical learner e.g., PECS was used to meet the needs of nonvocal students with ASD ◆ It was based on an analysis of Verbal Behavior ◆ It's use was followed by systematic research ◆ It is now an evidence-based method ★See Crooke et al (2015) for more about PBR
4. Uncontrolled, systematically replicated
★The study is replicated across key features ✦ Therapists ✦ Clients ✦ Settings ✦ Slight variation in Rx ★This enhances the reliability and generality of findings ★Still can't claim Rx effectiveness w/o control, but chances of Rx effectiveness are improving -claimed improvement may be more general, but use only if a Rx w/ HLE is not available.
The speech chain can also be considered in relation to 3 processing levels
✦ Level 1 - Acoustic input ✦ Level 2 - Internal physical influences ◆ Speaker - coordination of speech production ◆ Listener - sound signals to the brain ✦ Level 3 - Linguistic processing component ◆ Speaker - creates meaningful linguistic info ◆ Listener - interprets signals as meaningful ★Language disorders will pertain primarily to level 3
FCU in sum from a linguistic processing perspective
✦ language has 3 components ✦ Each component is controlled by rule systems ✦ The components are integrated during any act of linguistic communication ✦ Thus, language disorders may reflect impairments of F, C, U, or all three
Two Common Frameworks for Addressing Lang Disorders
Categorical approach- evaluating & treating language in relation to expectations within a developmental category e.g., LLI, ASD, IDD, ADHD, HL, etc. Developmental descriptive approach - ✦ Evaluating a learner's communication profile and function in natural contexts ✦ Comparing his/her profile to age-expectations ✦ Supporting language growth in areas of weakness -pay less attention to the developmental literature for any category and focus exclusively on the child's performance -focuses on students' language development and function in a variety of natural contexts. Work to understand an individual's communication strengths and limitations rather than focusing on their diagnostic level.
Who supported nature or was a nativist? and what was their theory?
Chomsky is a rationalist UG
Chomsky's model tells us nothing about ____________
HOW to teach language i.e., If a C is not learning language normally, does that mean LAD is broken? ✦If so, what should we do? ◆We can't do neurosurgery ◆The environment is trivial, so we can't work with that ◆The model provides no alternatives
Levels of Evidence
Hedge & Maul based on control and replication
Language versus Verbal Behavior (VB)
Language (linguistic definition)-a conventional system of symbols used to represent ideas about the world for the purpose of communication (Bloom & Lahey, 1978) -mental structures underlying the formulation of speech ✦ Can be expressed in multiple modalities (orally, writing or pictured symbols, or manually ) Verbal behavior (behavioral definition)- a social behavior reinforced through the mediation of other persons (Skinner, 1957) -human learning is controlled by antecedents and consequences rather than mental structures -important for SLPs ✦Can be expressed in multiple modalities
Speech chain model (Denes & Pinson, 2001)
Model of communication processes that extends from a speaker's production of words to a listener's perception of what has been said. It traces the physical connections that occur within and across communication partners at any moment of communication
Why should we care about Nature- Nurture debate?
Multiple theory have evolved as variation on these themes: ✦Theoretical models have implications for how language can be taught ✦ They help us evaluate and make informed decisions about new intervention ideas e.g., practice-based research
Skinner's Laws of Behavior
Reinforcement- increases the future frequency of behavior it follows -positive and negative Punishment- decreases the future frequency of behavior it follows -positive and negative
Speech Chain The elements of the process can be divided into 3 sequential elements
Speech Production is the result of Cognitive (motivated to communicate a message) --> Linguistic (formulates message into linguistic structure) -->neuromotor events (converts linguistic structure into neuro-motor sequence resulting in an acoustic speech signal) Transmission- Acoustic (converted to mechanical energy and then hydraulic and electrical impulse) Speech Reception: Perceptual --> Linguistic --> Cognitive
This is a linguistic model developed by Bloom & Lahey (1978)
They proposed that a skilled communicator must learn the rules associated with 3 components of language ✦ Form - syntax, morphology, phonology ✦ Content - semantics (issues with vocab) ✦ Use - pragmatics (socially motivated use of language)
Skinners book about VB
VB= behavior reinforced through the mediation of other persons (1957, p. 2) ✦ VB is a special type of social behavior ✦ It includes multiple modalities: speaking, listening, reading, writing, gesturing, etc.
Language
a conventional system of symbols used to represent ideas about the world for the purpose of communication (Bloom & Lahey, 1978) -can be expressed by speech orally, writing or pictured symbols, or manually
The cookie example illustrates that
a single linguistic unit (i.e., a word) can have multiple VB functions. ★Normal learners acquire different verbal operants quickly, but not atypical learners ★For some, knowing how to tact cookie does not guarantee the ability to mand for cookie or use "cookie" as an intraverbal
Communication Disorder
an impairment of communication related to one or all three of the systems we've discussed (SLC) How would Behavior Analyst view this definition? -if the antecedents (all environmental conditions that trigger a communication behavior) and consequences (immediately follow the behavior) are deficient then VB may be deficient as well -VB is mediated by the social environment so the deficiencies in the antecedents and consequences may be due to deficiencies in the social environment
Communication
exchange of messages between a sender and a receiver -symbolic and nonsymbolic information (facial expressions, body language, gestures).
Chomsky's model tells us something about the ___________
hierarchy of syntactic complexity This can be considered when deciding which language structures to target first
Language Disorder
impaired comprehension an/or use of spoken, written, and/or other symbol systems ★Types ✦ Receptive language disorder ✦ Expressive language disorder ✦ Mixed receptive-expressive disorder
Within this model of learning theory, VB is both _____________
observable and modifiable i.e., Unlike Chomsky's LAD, learning theory has huge implications for S/L instruction ✦ By manipulating the antecedents and consequences of existing responses... ◆We can help C learn target behaviors ◆We can teach complex behavior sequences
Rationalism
philosophy that reason is the source of knowledge -You are born with all the mental structures you need to learn about the world -knowledge is gained via top-down processing -Introspection and consensus "Any reasonable person will agree that ....." -No evidence-based practice
positive reinforcement
pleasant stimulus is added following a target behavior e.g., Parent gives permission for more iPad time
negative punishment
pleasant stimulus is removed following a target behavior e.g., Parent removes child's iPad
4. Intraverbal
responses in which a speaker's words are controlled only by the words of the conversational partner but sound different from the words produced by the partner -conversation -ritualized fill-in-the-blanks are the earliest to be developed A- Ready, set _______ VB-Go! C- child gets pushed on the swing A-where's the book? VB-on the chair C-thanks! A-I watched the game last night VB-so did i C-cool A-one day, toms dog went missing VB- he looked everywhere C-listeners waiting to hear the next statement
Behavior Theory aka "empiricist model" aka "behaviorist model"
skinner is father of modern behaviorism
6. Writing
spelling a word on paper -taking dictation -hearing a VB & writing the corresponding word(s) A-child hears the word dog VB-writng d-o-g C- mom says nice
FCU in sum from a behavioral perspective
the FCU model lacks attention to the antecedents, consequences, and social mediation that may also impact language learning.
Speech
the production of conventional auditory signals used as language symbols -articulation and rate (fluency) of speech sounds and quality of individuals voice.
positive punishment
unpleasant stimulus is added following a target behavior e.g., Parent tells child, "stop that"
negative reinforcement
unpleasant stimulus is removed following a target behavior e.g., Parent reduces the # chores
Nativism is associated with two school of thought in psychology:
▶Mentalism = knowledge derives from inborn mental processes ▶Structuralism = knowledge derives from inborn structures e.g., Chomsky's theory of universal grammar
EBP in Sum
★ EBP requires the considerations of three variables for choosing and evaluating clinical procedures ✦ Family values ✦ Clinician expertise ✦ Empirical evidence of procedural effectiveness ◆ ESTs if available ◆ BAEs as an alternative
Language Disorders can occur in 2 general contexts
★ In isolation without any other obvious developmental diagnosis ★ As part of a dual diagnosis i.e., occurring together with another developmental or acquired disorder e.g., ASD, IDD, ADHD, HL, many others
Skinner viewed the linguistic model of language as too structural to be useful for describing how language is learned. i.e., phonemes, morphemes, phrases, syntax, etc. do not address the reasons that people talk
★ Instead, he looked for variables that caused or controlled verbal behavior i.e., antecedents and consequences in A-B-C
Practice-Based Research
★ Normally, procedures in clinical practice are generated in reference to evidence based on primary research e.g., The MLU measure is based on Brown's (1983) study of normal language development ★ These applications work well for assessment, to determine how a child with a potential problem compares with the expected performance of typical, same-age children
Randomized controlled trials
★ Unfortunately, RCTs are very difficult and time-consuming to complete ✦ Few such studies have assessed language intervention (Rx) procedures ✦ Few interventions have met the RCT criteria ★ Also, evidence of effectiveness for one population may not generalize to another e.g., ASD, HL, IDD, ADHD, etc.
Controlled single subject designs
★Control can be provided in several ways ✦ Rx reversal (aka withdrawal) e.g., ABAB design (baseline, intervention, baseline, intervention) ✦ Staggered Rx e.g., multiple baseline across participants. (baseline and intervention but intervention is staggered (4wks, 6wks, 8wks)) It was the onset of intervention and not the passage of time or maturation that was related to increases in the target behavior e.g., alternating treatments
FCU Model cont.
★Language impairments might impair individual components or more than one component. ★This could result in ... ✦ Disorders of form (syntax, morphology, phonology) ✦ Disorders of content (vocabulary development and development of relational meanings) ✦ Disorders of use (social-communication) ✦ Disorders involving all three components (more typical of all the four)
3. Uncontrolled, directly replicated
★Replicated case study - same Tx, same Rx, different Client (C) ★If C shows improvement, then can claim reliable improvement but not treatment effectiveness -Evidence may be more reliable than level 2, but use only when no Rx w/ higher level of evidence (HLE) is available
Controlled Research
★Research designed to rule out the effects of maturation or other variables that might influence the target skill ★When controlled designs show improvement, we can conclude that the treatment caused the improvement ★Two kinds of controlled research ✦ Controlled group studies ✦ Controlled single subject design studies
Uncontrolled Research
★Research that utilizes an AB design (baseline intervention) ✦ This is typical of clinical practice ✦ It usually uses an AB design ✦ also known as (aka) a Case Study ★Rx may be associated with improvement ★But we can't know if Rx caused the improvement ✦ There is no non-Rx comparison group ✦ Maybe C improved for other reasons e.g., maturation, classroom instruction, etc.
Control
★Uncontrolled research - does not account for the effects of extraneous variables ★Controlled research - designed to account for the effects of extraneous variables that may affect a person's performance
Chomsky's application
✦ A theoretical linguist ✦ Applied rationalist methods to linguistic analysis Chomsky's assumptions: -Language is a species—specific, genetically-programmed organ of the mind. e.g., like eyes are an organ of vision -All humans are born with knowledge of a universal grammar (UG)
Controlled Group Designs
✦ An experimental (E) group is compared with a no-treatment control (C) group. ✦ Both groups must be similar before Rx (at risk children) ◆ Use random selection & random assignment ✦ Two kinds of group designs may be used ◆ pre-post-test designs with control group ◆ Post-test only with control group
These kinds of statement are usually prompted by two things:
✦ Evidence refuting the intervention ✦ Harm caused prior to the completion of the research that refuted the intervention e.g., Charges of sexual abuse based on a messages produced via FC
Internal Evidence
✦ Family values - a client's perspective and beliefs ✦ Professional expertise - an SLPs experience and knowledge of the assessment and intervention options
In 2019 Victorino et al conducted a search of the ASHA journals between 2008-2017 for commonly used but not overly general terms
✦ Frequency of use based on 249 articles... ◆ 59% SLI (i.e., 59% of articles used SLI) ◆ 31% LLI (Language learning impairment) ◆ 31% LI (Language impairment) ◆ 5% PLI (Primary language impairment) ◆ 3% LLD (Lang. learning disability) ◆ 2% DLD (Developmental language disorder) -SLI don't present with obvious symptoms of other disabilities but subtle weakness in other areas (short term memory, or symbolic play) the term specific seemed somewhat deceptive
How does the FCU model compare with the VB model?
✦ The FCU model is a linguistic model i.e., Its focus is on the linguistic products of learning, especially the rules underlying form, content, and use -quite mentalistic ✦ The VB model is a behavioral model i.e., Its focus is on the conditions (antecedents and consequences) that support the acquisition of behaviors associated with form, content, and use
One linguistic form ("cookie") Five Verbal Operants
✦Knowing the number of words in a child's vocabulary does not tell you all you need to know about their range of VB functions ✦Some children with disabilities need explicit support to learn each function
