Transcript Communication disorders

COMMUNICATION
DISORDERS
Melissa Sims
DEFINING COMMUNICATION DISORDERS
Legal Definition: The Individuals with Disabilities Education Act, or IDEA, defines the
term “speech or language impairment” as follows:
“(11) Speech or language impairment means a communication disorder, such as
stuttering, impaired articulation, a
language impairment, or a voice impairment, that adversely
affects a child’s educational performance.” [34 CFR §300.8(c)(11]
American Speech-Language-Hearing Association Definition:
“An impairment in the ability to receive, send, process, and comprehend concepts or
verbal, nonverbal and graphic symbol systems. A communication disorder may be
evident in the processes of hearing, language, and/or speech. A communication disorder
may range in severity from mild to profound. It may be developmental or acquired.
Individuals may demonstrate one or any combination of the three aspects of
communication disorders. A communication disorder may result in a primary disability
or it may be secondary to other disabilities.”
Smith, T. E., Polloway, E. A., Patton, J. R.,
& Dowdy, C. A. (2012)
DEFINITIONS (CONT.)
Laymen’s Terms: Simply put, communication or speech and language impairments
involve difficulty in exchanging knowledge, ideas, opinions, desires, and feelings.
Vaughn, S.R., Bos. C.S., Schumm, J.S. (2011)
Types of Speech and Language Impairments:
 Articulation: speech impairments where the child produces sounds incorrectly (e.g.,
lisp, difficulty articulating certain sounds, such as “l” or “r”)
 Fluency: speech impairments where a child’s flow of speech is disrupted by sounds,
syllables, and words that are repeated, prolonged, or avoided and where there may
be silent blocks or inappropriate inhalation, exhalation, or phonation patterns
 Voice: speech impairments where the child’s voice has an abnormal quality to its
pitch, resonance, or loudness
 Language: language impairments where the child has problems expressing needs,
ideas, or information, and/or in understanding what others say.
NICHCY Disability Fact Sheet #11 (2011)
BREAKING IT DOWN
 Articulation Errors: A child can make the following articulation errors when
producing speech sounds: Substitutions, Omissions, Distortions, and/or Additions. An
easy way to remember these is to use the acronym SODA!
 S – Substitutions: Definition: Replace one sound with another sound.
Examples: “wed” for “red,” “thoap” for “soap,” “dut,” for “duck”
 O – Omissions (also known as deletions): Definition: Omit a sound in a word.
Note: This error affects intelligibility the most, making speech more difficult for the
listener(s) to understand.
Examples: “p ay the piano” for “play the piano”, “g een nake” for “green snake”
 D – Distortions: Definition: Produce a sound in an unfamiliar manner.
Examples: “pencil” (nasalized—sounds more like an “m”) for “pencil,” “sun” (lisped—
sounds “slushy”) for “sun”
 A – Additions: Definition: Insert an extra sound within a word.
Examples: “buhlack horse” for “black horse,” “doguh,” for “dog”
Super Duper Inc. Handout
BREAKING IT DOWN
 Fluency disorders: The rate and flow of a person’s speech.
 Fluency is often affected by stressful or demanding experiences. While
anyone can experience interruptions in fluency there are factors that help
determine normal from abnormal dysfluency:
Frequency of occurrence
Duration of individual moments of dysfluency
Amount of tension present
Awareness and attitude towards dysfluency
 The most common type of fluency disorder is stuttering.
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
BREAKING IT DOWN
 Voice disorders:
 Phonation: “[Refers] to the production of sounds by the vocal folds.
Humans have two vocal folds, which are located in the larynx and lie side by
side…[Healthy] vocal folds vibrate, coming together smoothly…If the vocal
folds do not meet and come together smoothly, the voice is likely to sound
breathy, hoarse, husky, or strained.” May include pitch disorders.
 Resonance: Involves too little (hyponasality) or too much (hypernasality)
sound (resonance) coming out through the nasal passages.
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
BREAKING IT DOWN
 Language disorders: Receptive (understanding language) and Expressive (conveying
message)
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Types of deficit:
Morphological: Dealing with the rule system related to construction of
words
Syntactic: Dealing with the ordering of words so they can be
understood
Semantic: Dealing with the meaning or content of words and word
combinations
Pragmatic: Dealing with the purpose or function of communication
Metalinguistic: Dealing with thinking about, reflecting on, and analyzing language
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
Vaughn, S.R., Bos. C.S., Schumm, J.S. (2011)
BREAKING IT DOWN
 Language disorders cont.:
 Types of Language disorders:
No Verbal Language: No indication of understanding or
spontaneously using language by age 3
Quantitatively Different Language: Language is different from that of
nondisabled
Delayed Language Development: Language follows normal course
of development but is seriously behind others of same age
Interrupted Language Development: Normal language development
begins but is interrupted by some trauma, injury, or illness
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
SIGNS AND SYMPTOMS
Speech and Language Delays
Developmental Sequence for the
Production of Speech Sounds:
ASHA speech development chart
Image source
SIGNS AND SYMPTOMS
 Risk factors: “The most consistently reported risk factors
for speech and language difficulties include a family history
of speech and language delay, male gender, premature
delivery, and low birth weight. Early identification of children
with developmental delay or developmental disabilities, such
as marked hearing deficits or craniofacial abnormalities, will
lead to intervention at a young age when chances for
improvement may be best.” Wankoff, L. S. (2011)
 Warning signs: “Warning signs for referral to an SLP may be
subtle and may present in developmental, academic, behavioral, or
social–emotional realms.”
Wankoff, L. S. (2011)
WARNING SIGNS
 3–4 year olds
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Typically not intelligible to strangers.
Little or no conversational competence, i.e., lack of topic initiation, maintenance, or
change; little turn-taking.
Little or no vocabulary growth.
Minimal use of grammatical markers for tense, person, and number.
Does not discuss non-present events; has not begun to tell narratives.
Apparent noncompliance, inattentiveness, anxiety, or oppositionality, which can be
comorbid with language comprehension deficits.
 Kindergarten children
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Very poor intelligibility.
Poor expressive language.
Deficient listening comprehension.
Resistance to learning concepts about print, phonological awareness games (e.g., sound
games), or letter-sound correspondence.
Numbers 2–6 above.
Wankoff, L. S. (2011)
WARNING SIGNS CONT.
 First and second graders
 Difficulty learning to read.
 Poor expressive language skills (e.g., weaknesses in vocabulary, word retrieval, making
inferences or ambiguity detection, and conversational skills).
 Challenges in listening comprehension skills for conversation, television shows, movies, or
jokes.
 Apparent noncompliance, inattentiveness, anxiety, or oppositionality, which can be
comorbid with language comprehension deficits.
 Third and fourth graders
 Poor expressive language (i.e., difficulty answering questions or formulating verbal
messages or managing conversations).
 Deficits in listening and/or reading comprehension.
 Challenges in decoding unfamiliar words.
 Apparent noncompliance, inattentiveness, anxiety, or oppositionality, which can be
comorbid with language comprehension deficits.
Wankoff, L. S. (2011)
SIGNS AND SYMPTOMS
 Characteristics:
Check out this National Dissemination Center for Children with
Disabilities Fact Sheet for Characteristics of Speech and Language
impaired children
 Social/Emotional/Behavioral characteristics:
 Desire not to draw attention to self
 Lack of peer acceptance
 Poor self-concept
 Easily frustrated
 Inappropriate classroom behavior
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
PREVALENCE
 “The second most common disability of students ages 6 through 21
served under IDEA is speech and language impairment.” Smith, T. E.,
Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
 The actual number of students receiving services for speech and
langugage disorders in 2005 is reported at 18.7%. Vaughn, S.R., Bos. C.S.,
Schumm, J.S. (2011)
 90% of students receiving services are 6-11 years of age. Smith, T. E.,
Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
 5% of all students are served by speech-language pathologists and twothirds of this 5% are boys. Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A.
(2012)
TEACHING STRATEGIES
While referring students the speech-language pathologist is the most common strategy
for speech and language impairment there are some things that teacher’s can do in the
inclusion classroom
SPEECH DISORDERS:
 Establish and maintain a positive classroom climate
 Help students learn to monitor their own speech
 Pair students for practice
 Teach students affirmations and positive self-talk
 Differentiate instruction and materials
 Encourage parents to work with their children
 Teach student their own strategies
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
TEACHING STRATEGIES
LANGUAGE DISORDERS:
 Teach some prerequisite imitation skills
 Give students opportunities for facilitative play
 Improve comprehension in the classroom
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Practice following directions
Pairing and practice descriptions
Work on categorizing
 Encourage students to talk with their teachers and peers
 Develop pragmatic language skills
 Classroom interactions
 Social interactions
 Personal interactions
 Use naturalistic techniques and simulated real-life activities to increase language use
 Encourage students’ conversational skills through story reading
 Use music and play games to improve language
 Use challenging games with older students
 Adapt strategies to develop students’ learning tools
Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012)
RESOURCES
 National Dissemination Center for Children with Disabilities
 American Speech-Language-Hearing Association
 ASHA: Responsiveness to Intervention: New Roles for Speech-Language
Pathologists
 Categories of Disability Under IDEA
WORKS CITED
 Daymut, J.A. Types of Articulation Errors – A Simple Guide (2009).
http://www.superduperinc.com/handouts/pdf/201_TypesofArticulationErrors.pdf .
Retrieved 14 September, 2012.
 National Dissemination Center for Children with Disabilities (NICHCY). Categories of
Disability Under IDEA. http://nichcy.org/disability/categories . Retrieved 14. September,
2012.
 National Dissemination Center for Children with Disabilities (NICHCY) (2011). Speech-
Language Impairment. http://nichcy.org/wp-content/uploads/docs/fs11.pdf . Retrieved 14
September, 2012.
 Smith, T. E., Polloway, E. A., Patton, J. R., & Dowdy, C. A. (2012). Teaching students with special
needs in inclusive settings, sixth edition. Upper Saddle River, NJ: Pearson
 Vaughn, S.R., Bos, C.S., Schumm, J.S. (2011). Teaching Students Who Are Exceptional, Diverse,
and At Risk in the General Education Classroom (5th ed.). Upper Saddle River, NJ: Pearson.
 Wankoff, L. S. (2011), Warning Signs in the Development of Speech, Language, and
Communication: When to Refer to a Speech-Language Pathologist. Journal of Child and
Adolescent Psychiatric Nursing, 24: 175–184.