Developmental Language Disorders Final Exam Study Guide PDF

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Developmental Language Disorders Final Review Fall 2019

Assessment & Interventions for Developing Language 

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Assessment: standardized tests answer the “problem/no problem” question by comparing child’s performance to the norm. o We don’t plan treatment from performance. o Use standardized tests to find general areas in which child differs from norm, then look further at those areas via criterion—referenced tests (to test ALL areas via criterion—referenced is not efficient.) Language o If results of standardized assessment indicate deficit, assess word classes that are relevant to the child’s communicative environment & focus on production in treatment. o If the child has typical receptive & poor expressive—may indicate word finding issues (difficulty recalling rather than lack of knowledge). Treatment should address ability to recall the words the child already knows, while building vocabulary size. Which classes should we consider? o Colors & spatials o Verbs o “Wh” questions o Present each > 3x Syntax and Morphology o Assess and address understanding AND production. o Consider decontextualized format as a “window” into how much linguistic comprehension the child has without the benefit of non-linguistic supports.  If does poorly on contextualized format, provide more-structured, less complex input using hybrid clinician—direct activities. Syntax and Morphology—Production o Speech sample analysis provides the most valid look how a child uses words and sentences in natural situations. o More sensitive than standardized tests to ID preschoolers with delays. o More effective for treatment planning and treatment outcome monitoring. o Should be done when standardized test indicates a deficit = performance different from the norm. Three common ways to analyze a sample: o SALT (Systematic Analysis of Language Transcripts) o Index of Productive Syntax (IPSyn)  Uses productivity criterion of two appearances of each structure of interest within a 50-100 utterance sample.

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 Norm & criterion—referenced info. o Developments Sentence Score  Norm—referenced  Looks at 8 syntactic categories  Each category has 8 developmentally ordered levels of complexity for which points are scored.  Requires 50 complete noun-verb utterances. o A disadvantage to spontaneous speech sampling is that some forms are not sampled Pragmatics: o Tells us if a child is stronger or weaker in this area compared to other languages areas so they can address it. o Identify pragmatic contexts in which forms should be practiced—we need to teach the language needs to fulfill communicative functions. o Can examine conversational skills and discourse comprehension (ability to understand a story) Intervention o Products = goals o Processes = methods o Context = physical or social environment in which intervention takes place. Phonology: o Children in the developing language period are not candidates for speech sound intervention UNLESS intelligibility is significantly compromised. o Treat morphosyntax BEFORE phonology. o Consider metaphonology—phonological awareness  Ability to detect and produce rhyme, segment words into smaller units, synthesize phonemes into words & be represented by written symbols.  Correlated with learning to read. Semantics o Children with DLD acquire language in the same sequence but need more repetitions—2x more. o Deficits are in ability to acquire labels—need enriched input with repeated opportunities to make connections. o Classes posing difficulty include verbs and state words. o Remember principle—target one new thing at a time (i.e., if ask a child to produce a complex sentence, it should be about a meaning already expressed in a similar way. If addressing new meaning, control for syntactic complexity) Syntax & Morphology o Typically, difficult for children with DLD:  Auxiliary verbs, articles, pronouns  Complex sentences o Typically, NOT difficult: irregular past tense, -ing.

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o Address both comprehension & production—don’t have to wait for comprehension first. Auditory bombardment: child sits while listening to input (word list, story). Focused Stimulation o Clinician arranges context of interaction, so child is tempted to produce utterances with obligatory context for forms targeted. o Clinician provides very high density of models of the target in a meaningful communicative context—usually play. o Child is not required to produce the target—only tempted o Particularly effective for improving comprehension & production. Indirect Language Stimulation o Provides simple accessible model of mapping between child’s actions and language used. o “tempts” child to talk by following child’s lead and providing a responsive comm. Partner. o Self-talk, parallel talk, imitate child, expansions, extensions, recasts. Use above along with activities addressing production.

Assessment & Intervention for Language-for-Learning Stage   

Period is 5-12 years of age Goal of preschool children: “learning to talk” Goal of school-age: “talking to learn” o Develop a “language for learning” register o Develop a literate language style

Assessment: Standardized  Three types of standardized tests for a broad-based approach: o Comprehensive language batteries o Tests of pragmatics  Some children will not have deficits in language, form, & conten, so pragmatics is the focus. o Tests of learning—related language skills  Tap language areas impacting academic performance. Assessment: Criterion—referenced  Once deficits are noted based on standardized testing, complete criterion— referenced assessment in each area as appropriate.  Phonology: most in L4L stage do not have phonological errors.  Look at higher level phonological knowledge. How? o Production in phonologically demanding contexts (non-word repetition)— shown to be a marker of language impairment. o Phonological awareness

RAN-rapid automatized naming. (e.g., name common objects as quickly as possible, days a week) o PA & RAN is highly correlated with reading ability BUT yields info only about risk for reading difficulty. BUT REMEMBER THE GOAL OF ASSESSMENT: o Early primary grades = identify children at risk for reading issues. o Older grades = those with reading issues, the goal is to address oral language needed to support reading. Semantics o Receptive Vocabulary: (words that are common in teaching instruction— e.g., “upper right—hand corner of the paper”) o Textbook vocabulary— (e.g., however, consequently)  If words are not easily depicted, consider having the child paraphrase a sentence or have child choose the meaning from choices. Expressive Vocab o Lexical diversity—NTW & NDW more sensitive than in assessing diversity  Can obtain from a conversational sample  Can use SALT to calculate o Word retrieval  Clues = significantly higher score on receptive vocab than expressive vocab test, teacher report via a checklist o Semantic relations between clauses—major change in sentences in school in-age stage is increase in sentences that convey more than one main idea.  Look for presyntactic expression of semantic relations.  (temporal, causal conditional, epistemic, notice, specification) between propositions if complex sentences  In normal development children juxtapose clauses (e.g., “mommy here. Daddy gone.”) then conjoin with conjunctions. o Receptive:  Decontextualized (can use judgment tasks, school-age children are developmentally ready)  Judgement of semantic acceptability: including passives.  Judgment of appropriate interpretation: offer two interpretations of a sentence & ask which is correct— “Did I do it right?”  Assess Use of Comprehension Strategy  If the child responds incorrectly to decontextualized situation, assess strategies (e.g., word order-of-mention: in typically developing not used by 7 years; in children with DLD may use into adolescence, e.g. “the cow that bit the goat was called Sadie”)  Contextualized—no need to assess here if child does will with decontextualized. o Expressive o

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Sentence repetition tasks can tell us if the child differs from the norm, BUT NOT the nature of errors made in spontaneous speech.  Look at a language sample, even if scores on standardized tests are WNL—we want to know use in spontaneous utterances— language may be less elaborate or may be “winding.”  Contexts for language sample: conversation, narrative (led to more expanded phrases & use of grammatical morphemes.) o Disruptions—assess if get impression of “tangled speech” Pragmatics o Conversion  Communicative intentions (directive, interpretative, projective, relational)  Contextual variation—can assess via role play  Register variation  Discourse Management—ability to orchestrate turn and topics, repair breakdowns  Peer interaction is a good context  Consider range of demands. Narratives o Literal story comprehension o Inferencing—e.g., why characters behaved as they did, state the characters goal, feeling.  If lacking, use dynamic assessment in which you actively coach the child to take the pieces of info and put them together to draw a conclusion.  Expression—sensitive to pragmatic and structural aspects of a child’s language, even when standardized tests do not indicate such. o Look at:  1. Story Macrostructure:  Organization  Cohesion—use of cohesive ties  2. Story Microstructure:  Productivity, sentence structure--- TNW, NDW, total number of C-units, average number of words per C-unit, total number of C-units that contain and independent clause & at least one dependent clause.  Artful Storytelling: (called “sparkle” as per Peterson & McCabe, 1983)  True narratives start at 5-7 years, but artful storytelling develops via: o Increased complexity of episodes o Inclusion of increasingly elaborated high points/climax o More sophisticated linguistic forms (conjunction, elaborated noun phrases, mental verbs, adverbs) o The “Metas”

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Metalinguistic awareness—talking about talking/words. Include metapragmatic.  Metacognitive skills  Self-regulation—ability to plan, organize, and execute actions effectively using consciously selected strategies.  Self-assessment—understanding of the thinking process and the ability to consciously consider and reflect on knowledge and understanding of one’s self. Intervention Guiding Principles o Use curriculum—based instruction—needs of the curriculum guide targets. o Integrate oral & written language—provide both oral AND written opportunities to practice forms and functions.  include literary socialization  phonological awareness  written narratives (narrative build the bridge between contextualized conversation and abstract decontextualized literal style of language.  Literature indicates that we are addressing literacy when we work on oral language skills. o Focus on “metas” – talking about talking and thinking about thinking. Bring language use and comprehension (e.g., what do I know now?... and now? …and now?) to higher level of awareness o Collaborate—participate in RTI. Clinician-Directed o Drill play Child-Centered o Scaffolding Hybrid o Semantics  Vocabulary: best to actively involved in the process with activities that provide a procedure ACROSS time, rather than a one-time activity. This deepens knowledge. More effective than looking up word in the dictionary. Idea of elaborated exposure – engage with words repeatedly over many occasions.  Use semantic webs (connect part of speech, synonyms, antonyms, other related words) o Word finding- work to strengthen connections among semantic networks.  Use elaborated exposure  Visual maps  Masses practice to increase retrieval time  Incorporate phonological cues  Use cloze format  Heighten awareness to the phonological properties of a word. o Semantic Integration and Inferencing: Enhancing Comprehension  Use prediction activities

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Generate endings to stories—discuss reasons for choosing a given ending  Can address with smaller pieces of text. Syntax/Morphology o Selects targets drawn from reading and writing needed for the classroom o Provide guided practice using these targets in both spoken (listening, speaking) and written language (reading, writing). o Address advances morphology:  Root words & derivations. Highlight similarities in meaning and spelling. (e.g. videographer)  Analytic approaches—connections between words and facilitate spelling. o Literate language forms  Complex sentences (needed for reading comprehension) o Pragmatics:  Conversational discourse (use role playing)  Discourse management  Scaffolding  Address presuppositional skills—clarify and request clarification. Narrative Skills—Bridges from Oral to Literate Language o Comprehending narratives—gateway to reading comprehension  Address BEFORE reading, develop preparatory set  Activate background knowledge, look at title, relate own experiences.  Reading-thinking activities: make predictions about topic based on title and provide support.  Literature Webbing  Address WHILE Reading  Communicative strategies (CRS)—clinician poses questions during reading to help child engage in constructing meaning found to improve ability to retell stories, and index of story comprehension.  Address AFTER Reading  Graphic organizers o Story flow chart: highlight text structure—visualize relationships between events. o Internal states chart – how a character felt at different points in the story. o Character webs o Composing Narratives o Phonological Awareness o Organization and Learning Strategies o Response to Intervention (RTI)  Tier 1: consulting with classroom teacher

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Tier 2: develop and monitor small group instructions Tier 3: special education

Assessment & Intervention for Advanced Language     

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Advanced language refers to children 12 years  adulthood. (this refers to level of functioning, not necessarily CA) May have “wobbly” skills – skills that are vulnerable in more stressful or complex language situations. Important to evaluate children with history of language delays to ensure needed support provided transitioning from primary  secondary grades. o Academic AND social Make sure assessment and intervention are student-centered. Standardized Assessment o Examples:  CELF-5  CASL-2  OWLS-2  Test of Language Development – Intermediate o Use outcomes from standardized measures and narrative samples to guide criterion-referenced measures. o Look at written AND oral language. May be in the advanced language level for oral language, but not written language.  Students in L4L stage may make a few grammatical errors in speech. Writing: brief, use simple sentences, difficulty with mechanics, little organization.  Focus assessment accordingly—have basic oral and written language skills, assess beyond. Semantics: o Literate lexicon  Nouns: for curricular or technical activities  Verbs o World Definitions  If area of need-address enhanced understanding of word meanings AND practice defining words. o Word Relations  Address how words are related—multiple meanings, synonyms, compare & contrast—which word is best for a given purpose, words sharing spelling and/or pronunciation, but not meaning.  If can’t provide definitions, try dynamic assessment. Plan treatment accordingly.  Look for frequent use of the same word in writing.

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Ask student to substitute a word in a given sentence or provide an antonym and then discuss meanings—involves metalinguistic ability as well. o Figurative Language  Similies, metaphors, idioms, proverbs – ask student to explain. o Verbal Reasoning  Ability to use language to extend thinking, consider various viewpoints.  Address analogies and practice talking through logical problems. o Syntax &Morphology  Comprehension: should understand all sentence types and comprehension strategies should NOT be active.  Production:  Sample contexts for literate language  Compare complexity in oral and written forms  How to elicit narrative sample: o Story retell then generate an ending—is the student stronger with visuals.  How to elicit expository sample o Suggest asking the student to explain a game or sport OR conflict resolution.  Literature document that students are more likely to make phonological errors in writing rather than oral language. o Microstructure in writing  Example: cause density—subordination indexratio of total number of clauses summed across C-units/number of units o Macrostructure in writing  Example: internal response is the last component of story grammar to develop in TD children. Pragmatics o Look at initiations and responsiveness, Turn-taking & repair, Topic structure, Cohesion/coherence o Conversational pragmatics  Structure observations  Natural peer-peer conversation may not lead to all needed opportunities.  Role playing  Negotiation strategies—use hypothetical situation  Register variation Intervention  Semantics o Vocabulary development: provide multiple opportunities to interact with new words

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o Word Study o Visual Mapping o Multiple Meanings o Figurative Language Syntax o By 11 years TD students have syntax near adult level, so consider addressing complex sentences if only simple sentences are noted.  Use sentence—combining activities  Prompt cards Pragmatics o Conversation Narrative Comprehension o Address strategies used BEFORE, DURING, and AFTER reading. o Use graphic organizers  K-W-H-L Strategy (know? Want to know? how can I learn? Learned?)  Summarizing Skills  Understanding expository text comprehension- narrative comprehension dos not necessarily carry over. Narrative production o Use graphic organizers—persuasive, narrative Expository text production o Address writing process strategies o Use brainstorming & organizational think—sheets/planning sheets

Dyslexia What is dyslexia? Unexpected difficulty in reading for an individual who has the intelligence to be a better reader. Most commonly due to a difficulty in phonological processing (the appreciation of the individual sounds of spoken language), which affects the ability of an individual to speak, read, spell, and often learn a second language. Diagnosis: deficit at the level of phonologic module impairs ability to segment the spoken word into its underlying phonologic parts and then link each letter to its corresponding sound.  Reader experiences difficulty decoding, then identifying it.  Due to this sound-based difficulty in accessing and retrieving the phonological codes, may experience difficulty with word retrieval  output DN represent knowledge.  Problems with spoken language are observed o Late talker o Mispronunciations o Difficulties with word retrieval o Increased time to give oral response  Diagnosis is made by:

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o History o Unexpected difficulty with reading o Linguistic problems at the phonologic processing level o No single test score is diagnostic In preschool, risk factors: o History of language delay o Early signs of phonologic difficulties (poor attention to sounds-trouble learning nursery rhymes, playing rhyming games, confusing similar sounds) o Difficulty learning to recognize letters and learn names of letters o Family history In school age, risk factors: o Poor school performance o History of delayed first word o DN learn letters by kindergarten o DN learn to read by first grade o Difficulty consistently sounding out words o Parents and teachers are puzzled—child is intelligent, grasps concepts easily, but struggles to learn to read o Even after learning to decode, remains a slow reader—don’t become automatic/fast readers. o Spoken language includes fillers, mispronunciations, circumlocutions, difficulties with word retrieval. o Listening comprehension usually robust. Assessment o Prior to the age when the child is expect...