Speech

1
Speech Language Disorders

• FRIEND CH 9,
• SPED 281
• Dr. Schneider

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LEARNING OBJECTIVES

• Definition of Speech Language Disorders
• Historic step in the field
• Characteristics of Speech Language Disorders
• Identification procedure of Speech Language
  Disorders
• Types of services for students w/ Speech
  Language Disorders
• Best Teaching strategies
• Perspectives of family members
• Issues affecting the field of Speech Language
  Disorders

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Definition of Speech Language Disorders or
Communication Disorders

• Speech language impairment communication
  disorder such as
• stuttering,
• impaired articulation,
• language or voice impairment that
• adversely affects a childs educational
  performance
• gt non-detailed DEF allows states to differ in
  interpretation of services some provide
  SLTherapy support only in combination with
  another IDEA-covered disability, others provide
  SLT only if a separately identified disability

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Historic Steps in the field

• Todays practices in SLP go back 2oo years
• Field has its roots in Europe w/ educating deaf
  individuals using either signing (manual) or
  voice (oral) methods
• End of 19th century speech clinician as
  profession established
• First formal training for SLPs in 1930s
• Professional Association ASHA (American Speech
  Hearing Association)
• 1900-1945 focus on correction of articulation
  problems

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Historic Steps in the field

• 1900-1945 focus on correction of articulation
  problems
• After WWII area expanded due to new insights
  into brain injury and language development
  insight into components of communication and the
  influence of social contexts (e.g., dialect, peer
  pressure)
• Todays practices are influenced by IDEA of 1975
  (PL 94-142)

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Characteristics of Speech Language Disorders

• Speech disorders difficulty producing sounds
  fluency of speech
• Language disorders difficulty receiving,
  understanding and responding appropriately in
  communicative situations
• Both often co-occurring with other disorders
  e.g.
• o Cleft palate
• o Autism
• o MR
• o Hearing impairments

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Characteristics of Speech Language Disorders

• Overall PURPOSE of language communicate
  effectively using culture-sensitive cues
• ELEMENTS of LANGUAGE that can show deficits
• VERBAL NON-VERBAL LANGUAGE
• NON-VERBAL LANGUAGE COMPONENTS
• Gestures
• Postures
• Facial features
• Personal physical distances between communicants
• VERBAL LANGUAGE COMPONENTS receptive
  productive
• Phonology-orthography (form)
• Morphology (content)
• Semantics (content)
• Grammar-syntax (form)
• Pragmatics (Use)

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Characteristics of Speech Language Disorders

• VERBAL LANGUAGE COMPONENTS (see separate sheet)
• Phonology (form)
• Phonological awareness knowing sounds and their
  sequence in words, how a change in sequence can
  lead to difference in meaning includes
  environmental sounds (car, fire alarm, bell)
• Phonemic awareness knowing why and how letters
  represent sounds on paper
• Phonics letter-sound pattern knowledge gt
  better term phonological-orthographic awareness
• orthography (form) print
• Morphology (content)
• Semantics (content)
• Grammar-syntax (form)
• Pragmatics (Use)

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Characteristics of Speech Language Disorders

• ELEMENTS of SPEECH
• VOICE
• Pitch (high-lowness of voice)
• Intensity (loudness)
• Quality (voice smooth-to-hoarse)
• Resonance (nasal-oral part of spoken sound
  rich/full to weak/reedy voice)- carries well or
  not so well
• ARTICULATION (ability to move the tongue, teeth,
  lips, palate to produce sounds
• FLUENCY (speaking w/o hesitation with natural
  non-flat intonation

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Characteristics of Speech Language Disorders

• SPEECH DISORDERS
• Articulation disorders (omissions, substitutions,
  additions)
• Distortions
• Apraxia of speech receptive language fine but
  speech production is disabled despite knowing
  what to do details, see www. Apraxia-kids.org/in
  dex.html
• Fluency disorder stuttering
• cluttering speaking in bursts w/
• pauses

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Characteristics of Speech Language Disorders

• LANGUAGE DISORDERS
• Specific language impairments
• Auditory discrimination problems
• Semantic differentiation problems
• Poor socio-pragmatic skills- unable to read
  social verbal non-verbal cues correctly
• Language delay (p. 332 for milestones in
  development)
• Aphasia
• Receptive or productive language is defect due to
  brain injury
• Central Auditory Processing Disorder (CAPD)
• Brain does not process meaning well when
  information is received via ears

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Characteristics of Speech Language Disorders

• COGNITIVE ACADEMIC
• Significant speech language delay leads to high
  risk of having reading difficulties and thus also
  spelling and text composition difficulties
• SOCIAL EMOTIONAL
• Those struggling to interpret non-verbal language
  and those who have expressive language
  difficulties are at risk of getting teased,
  bullied gt withdrawn
• Need explicit instruction to overcome
  social-emotional barriers
• Need positive behavior support when
  emotional-behavioral difficulties occur

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Prevalence of SL Disorders

• 1.1. Million school children receive SLT as their
  primary disability service
• 19 of all 6-21 year old students
• Almost 50 of those students also have LD
• BUT numbers are higher b/c SLT as a related
  service is not included in these numbers
• 5 of all first graders have speech disorders
• 6 of elementary school students have language
  disorders not caused by physical or sensory
  disabilities
• Same occurrence among boys girls BUT boys twice
  as often identified as girls

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Causes of SL Disorders NEVER ONE CAUSE ALONE

• Environmental
• Repeated ear infections
• Neglect or abuse
• Poverty-malnourished-poor health care, hygiene
• Biological
• o tumors
• o traumas, brain injury
• o genetic (mental retardation)
• o malformation of speech apparatus
• o muscular disease

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Identification procedure of Speech Language
Disorders

• Language tests
• (Goldman-Fristoe- Articulation)
• (Comprehensive test of phonological processing
  CTOPP)
• Fluency
• Reading
• Grammatical, pragmatic understanding
• Expressive vs. receptive vocabulary
• Observations
• Language history interviews with parents
• Difficult with English language learners!

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Identification procedure of Speech Language
Disorders

• Assessment of English Language Learners
• PROBLEMS
• Language assessments not available in native
  language
• No parent permission
• Violation of cultural norms of childs initial
  culture (speaking with a figure of authority gt
  falisfies data)
• Testing situation is unnatural gt stressful gt
  often leads to poorer results than necessary

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Identification procedure of Speech Language
Disorders

• ELIGIBILITY
• (1) Related to age significant delay or deficit
  in speech or language that can be considered a
  language impairment according to IDEA 2004
• (2) Impairment must adversely affect educational
  performance gt data must show this
• (3) Student must be able to benefit from
  intervention (problem age-factor!)

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Types of services for students w/ Speech
Language Disorders

• Responsibilities of SLP
• Prevention
• Identification of deficits
• Documentation of progress
• Sharing how to use technolog. Communication
  devices, including augmentative alternative
  communication (see p. 356)
• Case-load management
• Re-evaluation
• dismissal
• counseling
• Transition (Pre-K-gt elem.-gt middle-gt high-gt post
  sec.)

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Types of services for students w/ Speech
Language Disorders

• General data
• Almost 90 serviced outside general classroom for
  less than 20 of day
• 5 serviced outside of classroom for more than
  60 of day
• Recent trend to include SLP more in general
  classroom during inclusion services
• Early Childhood
• Elementary Secondary School Services
• Inclusive practices
• Transition into adulthood

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Best Teaching strategies

• Since so many students have co-existing LD with
  it
• Multi-sensory, structured explicit instruction of
  language patterns is helpful
• Make letter-sound patterns clear in regular class
  instruction
• Make idiomatic expressions their functions in
  speech writing clear
• Make role of dialect clear
• Explicit instruction and game-like practice of
  semantic awareness, reading non-verbal verbal
  clues
• (e.g. Tea-pot game of homophones or homographs
  semantic word river of different expressions)

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Best Teaching strategies

• Since so many students have co-existing LD with
  it
• Speech pathology training support for those with
  stuttering issues more severe pronunciation
  problems
• Explicit non-verbal awareness training e.g.,
  reading facial expressions
• Use of non-rhyming poetry to encourage
  experimentation with words
• Use of graphic organizers to enhance
  comprehension skills
• Practice visualization strategies (Bell, 1994)

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Best Teaching strategies

• Central Auditory Processing Disorder (p. 335)
• Show rather than talk
• Gesture illustrate everything clearly with
  visual clues (print, picture, drawing) that you
  say
• Teach visualization and verbalization skills
  (Bell Program)
• Teach mnemonic devices
• Teach reading spelling skills explicitly with
  hands-on experience, multisensory learning
• Point at what you say on overheads
• Role play social settings with students
• Explain processing weakness to student and
  practice compensation strategies
• Note taking
• Repeating what student has understood from oral
  information, orders

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Perspectives of family members

• Parent involvement is essential as communication
  occurs outside of school as well
• Parents can help identify the best and earliest
  speech language support possible through
  collaboration and sharing of routines
• Parents can identify problems first
• For SLT to be successful, parents are an integral
  part
• Parents can be educated in improving their
  language development support

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Issues affecting the field of Speech Language
Disorder

• Addressing speech and language problems in
  multi-cultural settings where families have
  different home languages or different dialects,
  cultural approaches to using technological
  devices and openly addressing disabilities of any
  kind
• Understanding trends in identifying students with
  central auditory processing disorder (CAPD)