Chapter 10

Persons with Speech and Language Disorders

Speech

• Expression of language with sounds– Willed, planned, and programmed by the

central nervous system• Brain• Spinal Chord• Peripheral nervous system

– Dependent upon • Respiration• Phonation• Articulation

Language

• A code of ideas and concepts about the world– Governed by complex rules and relationships

• Phonology• Morphology• Semantics• Syntax• Pragmatics

Components of Language

• Pragmatics

• Phonology

• Morphology

• Semantics

• Syntax

• Application of social and contextual cues

• Sound discrimination and articulation

• Grammatical structure and use of words

• Understanding of word meanings

• Use of grammar and grammatical rules

Communication

• Exchange of ideas, information, thoughts, and feelings– The process does not require speech or

language• Gestures• Posture• Eye contact• Facial expression• Head and body movement

IDEA (PL 105-17) Communication Disorder

• Referred to as to “speech and language impairment”

• Eligibility includes– Stuttering– Impaired articulation– Language impairment– Voice impairment

• Must adversely affect a child’s educational performance

Speech Disorders

• A deviation so far from the speech of others that it:– Calls attention to itself– Interferes with communication– Provokes distress in the speaker or listener

(Van Riper & Erickson, 1996)

Types of Speech Disorders

• Articulation– Speech sounds

• Fluency– Rhythm and timing of speech

• Voice– Quality of speech production

Articulation Disorder

• Errors in the production of speech sound– Distortions– Substitutions– Omissions

• Therapy concentrates on– Identification and acquisition of the correct

speech sound– Generalization and maintenance of the

sounds

Fluency Disorder

• Interruption in the flow of speaking characterized by: – Atypical rate and rhythm

• Cluttering – fast and jerky speech

– Repetitions in sounds, syllables, words, and phrases

• Stuttering – rapid-fire repetition of consonant or vowel sounds

Voice Disorders

• Problems with the quality or use of one’s voice that result in an abnormal or absence of:– Pitch– Loudness– Resonance

• Hyper-nasality• Hypo-nasality

– Duration– Phonation

• Breathiness• Hoarseness• Huskiness• Straining

Language Disorders I

• Phonological disorder– Involves the abnormal organization of speech

sounds

• Apraxia of speech– Neurological, phonologic disorder attributed to

weak or slow speech muscles• Frequent omissions, substitutions, and distortions

Language Disorders II

• Morphological disorder– Difficulty using grammatical morphemes such

as nouns, verbs, and adjectives that signal different meanings (example – s added to dog, signals plurality)

• Semantic disorder– Characterized by poor vocabulary

development and the inappropriate use of word meanings

Language Disorders III

• Syntactical deficits– Difficulty acquiring the rules that govern word

order or other aspects of grammar• Often manifest in an inability to organize and

express complex ideas

• Pragmatic difficulties– Problem understanding or using language in

different social context• Unaware of conversational conventions

Language Disorder IV

• Central auditory processing disorder (CAPD)– Difficulty in the processing of sound, not

attributed to hearing loss or intellectual capacity

• Limitations in sound: transmission, analysis, transformation, elaboration, storage, and retrieval

• May be a primary or secondary disorder that affects listening skills necessary for language development

The History of Speech and Language Disorders I

• Objects of curiosity– Balbus Blaesus– Wild Boys (feral children)

• Objects of pity or scorn– Used in the context of religious practices– To be dumb, as in not able to speak

• A rewarding source of humor– Topic of jokes and cartoons

The History of Speech and Language Disorders II

• 1910 – Chicago public schools hire the first speech correction teacher

• Terminology defines attitude– Speech correctionist– Speech specialist– Speech teacher– Speech therapist– Speech-language pathologist

Etiology

• Functional – occurring after birth– Acquired: traumatic insult after birth (TBI);

disease complication, hearing loss– Developmental: environmental, emotional

disturbance

• Organic – occurring prior to birth– Congenital: Cleft palate; teratogens; deafness– Developmental: mental retardation, cystic

fibrosis, cerebral palsy

Influences on Language Learning(McCormick, 2003)

• Biological preparation

• Successful nurturance

• Sensorimotor experiences

• Linguistic experiences

Developmental Milestones

• Cognitive- thinking, reasoning, problem solving, understanding

• Language- expressive and receptive abilities• Motor coordination- gross/fine motor, jumping,

hopping, throwing/catching, drawing, stacking• Social interaction- initiating peer contact, group

play• Self help- dressing, eating, washing

Early Language Development I

• By age one– Recognizes name, recognizes words as symbols for

objects, imitates

• Between one and two– Understands no, combines two words, uses 10-20

words, follows simple instructions

• Between two and three– Forms some plurals, combines nouns and verbs, ask

simple questions, gives first name, carries on conversation with self and toys, 450 word vocabulary

Early Language Development II

• Between three and four– Tells a story, names one color & last name,

understands time,1000 word vocabulary• Between four and five

– Uses past tenses, points to colors and shapes, can identify abstract conditions such as hope,1500 word vocabulary

• Between five and six– Has as sentence of 5-6 words, knows

address, identifies spatial relationship, counts, opposites, asks questions for information, 2000 word vocabulary

Expressive Language Problems

• Limited use of vocabulary• Searches for the right word• Poor social language skills• Hesitates to ask questions• Jumps from topic to topic• Topics chosen are concrete rather than

abstract, temporal, or spatial• Repetitive and unspecific

Receptive Language Problems

• Encounters difficulty with oral presentation of information

• Cannot detect breakdown in communication

• Does not understand humor, figurative language, or abstract thought

• May reverse the order of sounds or confuse the sounds of letters that are similar

Speech Assessment

• Should include information on – Hearing, motor skills, oral and respiratory

mechanism, general physical condition, educational records

• Should evaluate– Articulation, voice, fluency, and sounds or

phonemes not produced correctly for the student’s age

• Should consider– Developmental level, maturity, gender,

ethnicity, and cultural background

Assessing Communication Disorders

(Cohen & Spenciner, 1998)

• Screen for possible communicative disability• Refer to professionals for formal assessment• Review eligibility for disability services indicated

by child’s strengths and weaknesses• Plan a program, formulate an IEP• Monitor student progress• Evaluate IEP and program goals for

effectiveness

Figure 10.4 Educational Placement of Students with Speech and Language Disorders

Central Auditory Processing Problems in the Classroom

• Use selective seating• Reduce external auditory distraction • Decrease environmental distraction• Gain the child’s attention before giving oral

information• Emphasize key words and eliminate

unnecessary verbiage• Check frequently for understanding• Do not ask child to listen and write at the same

time

Young Children

• PL 99-457 provides for an evaluation of toddlers between the ages of 3-5– Concentrates on an assessment of family

interaction patterns, strengths, and needs • Type of vocabulary used with child• Attempts to engage child in conversation• Quality of voice animation and body language• Response to child’s effort to communicate• Imitation of the child’s efforts

Issues of Diversity

• Approximately 9 million children do not speak European American English as their primary language– Limited English Proficient (LEP) or Potentially

English Proficient (PEP)– Lack of valid and reliable tests for bilingual

children makes it difficult to identify speech and language impairment

• May be misidentified as learning disabled, mentally retarded, or speech and language disordered

Intervention for PEP Children

• Techniques similar to those used with monolingual children – Focusing on morphology, syntax, phonology,

semantics, and pragmatics

• Incorporates techniques for second language learners– Vocabulary and syntax in context of ongoing activities– Comprehension before production– Using predictable books– Using peer buddies and parents as teaching partners

Technology

• Augmentative and alternative communication– Non electronic communication boards –

choices represented by real items, symbols or pictures

– Electronic communication boards include voice, scanning options, programmed to handle multiple templates

Trends, Issues, and Controversies

• The need for early and accurate diagnosis and intervention is confirmed by research

• Human Genome Project unlocks complexities of heredity and creates the potential for medical intervention

• Cultural diversity, non-standard English, and dialect occupy educational and political agendas

• Etiology of CAPD and stuttering remains controversial