LANGUAGE DISORDERS
Researched by: Alexa
Objectives:
1. What are primary language impairments?
2. What are secondary language impairments?
3. How are language disorders treated?
We usually notice many features when listening to someone talk such as their voice, smoothness, resonance, syntax, fluency, and many other factors that go into speech. Whether it is conscious or not, we pay attention to the way someone talks. We usually won't let the speaker know that we notice any of these problems, but the speaker may still appear frustrated or embarrassed.
What is a Language Disorder?
A language disorder is impaired comprehension and/or use of spoken, written and/or other symbol systems. The disorder may involve (1) the form of language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in communication (pragmatics) in any combination. (ASHA, 1993). Language disorders could be more outward in certain contexts or learning functions. The deficiencies or delays could occur in some or all aspects of communication such as speaking, listening, reading, or writing. Other terms may be used in place of "disorder" such as impairment, disability, specific language disorder/impairment, or language-learning disability. The terms are often related to a child's age and funding availability for services.
People with language disorders vary in many ways. Their language problems could increase in severity with age and level of education. For a preschooler, a "mild" language disorder could cause greater challenges as the child advances in school and is expected to learn more difficult information and to be able to use more complex verbal expressions and language. These problems could increase when the child is expected to learn from reading and express himself through writing.
Language Disorder vs. Language Delay
A language delay means that children might have a slow start developing but they will catch up to their peers eventually
A language disorder means that children will not catch up with their peers. The gap in language skills typically widens over time between the child and their peers.
Severity Levels of Language Disorders
Severity levels range from mild to profound and may be different depending on the communication demands.
Mild: The language disorder has some effect on the person's ability in social or educational situations, but does not effect normal activities in school or in the community.
Moderate: The language disorder shows a more significant impairment that needs special accommodations in order to participate in educational settings or in the community.
Severe: The language disorder makes it necessary for extensive support in order to function in the community and in educational activities.
Profound: The language disorder causes the person to have little or no ability to use language and is unable to function in community and educational activities.
Severity levels vary and may be a result of developmental abnormalities, accident/injury, neglect, abuse, lack of stimulation, or developmental delay.
Effects
Language disorders have emotional and social effects on all people. The disorder not only effects the individual, but also the family members of the individual. It is important to educate people about language disorders whether or not they are personally affected by it.
What is a Language Disorder?
A language disorder is impaired comprehension and/or use of spoken, written and/or other symbol systems. The disorder may involve (1) the form of language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in communication (pragmatics) in any combination. (ASHA, 1993). Language disorders could be more outward in certain contexts or learning functions. The deficiencies or delays could occur in some or all aspects of communication such as speaking, listening, reading, or writing. Other terms may be used in place of "disorder" such as impairment, disability, specific language disorder/impairment, or language-learning disability. The terms are often related to a child's age and funding availability for services.
People with language disorders vary in many ways. Their language problems could increase in severity with age and level of education. For a preschooler, a "mild" language disorder could cause greater challenges as the child advances in school and is expected to learn more difficult information and to be able to use more complex verbal expressions and language. These problems could increase when the child is expected to learn from reading and express himself through writing.
Language Disorder vs. Language Delay
A language delay means that children might have a slow start developing but they will catch up to their peers eventually
A language disorder means that children will not catch up with their peers. The gap in language skills typically widens over time between the child and their peers.
Severity Levels of Language Disorders
Severity levels range from mild to profound and may be different depending on the communication demands.
Mild: The language disorder has some effect on the person's ability in social or educational situations, but does not effect normal activities in school or in the community.
Moderate: The language disorder shows a more significant impairment that needs special accommodations in order to participate in educational settings or in the community.
Severe: The language disorder makes it necessary for extensive support in order to function in the community and in educational activities.
Profound: The language disorder causes the person to have little or no ability to use language and is unable to function in community and educational activities.
Severity levels vary and may be a result of developmental abnormalities, accident/injury, neglect, abuse, lack of stimulation, or developmental delay.
Effects
Language disorders have emotional and social effects on all people. The disorder not only effects the individual, but also the family members of the individual. It is important to educate people about language disorders whether or not they are personally affected by it.
What are primary language impairments?
A primary language impairment suggests a significant impairment of language only. It is not accompanied by cognitive impairment or any other disabilities that can be held accountable.
Specific Language Impairment (SLI)
Specific language impairment ( or primary language disorder) refers to limitations in language functioning, not related to deficits in hearing, oral structure and function, intelligence or perception. There is no general or specific cause or condition for the impairment. People with SLI typically show normal intellectual functioning. Specific language impairments are characterized more by the absence of other disorders than by clearly identifiable traits. SLI is the most common reason for early intervention and special education services in preschools.
Characteristics that can identify a specific language impairment:
Most children with SLI under the age of three can be confused with "late talkers" or "late bloomers" and often go unrecognized. Parents are typically advised to wait and see if the child's language development improves. This causes a problem because early intervention is extremely important for children with SLI and other language disorders.
It is difficult to determine the cause of a child's specific language impairment and it is unlikely that it has a single cause. It is possible that genetics can influence which children develop SLI. However, most researchers say that specific language disorder is very complex and has many genetic as well as environmental influences.
Prevalence
Studies report that 7% to 8% of children entering kindergarten are recognized as having a specific language impairment with no other complicating disabilities. Approximately 2% more boys than girls have SLI (Erwin, 2001). More than 1 million children in American schools receive services for primary speech or language disorders.
Receptive Language Problems
Receptive language is a process by which a listener infers the meaning of a message based on context and long-term memory that relates to the information. Children with SLI usually have difficulty with receptive language. They generally have an impaired ability to understand and process information presented verbally or non-verbally. Children with SLI often have difficulty keeping up with a normal conversation and understanding direct or indirect questions. Children in junior high school tend to continue to have a weak vocabulary in relation to their peers. They understand direct statements better than indirect statements. They are very literal in their interpretation and often misuse or misunderstand statements, idioms, metaphors, and similes. They also have difficulty expressing wants, needs, thoughts, and feelings which can lead to frustration.
Expressive Language Problems
Children of all ages with SLI have difficulty with expressive language. They have a hard time expressing their wants and needs, leaving the parents confused and guessing.
Articulation and Phonological Problems
Children ages 3-4 who are difficult to understand often have specific language impairment. Their reduced speech affects their interactions with family and peers. These children are usually recognized around the time they are in primary school.
Morphological and Syntactic Problems
Children with SLI often have morphological and syntactic problems. Children's language is grammatically incorrect when there are morphological problems present. Children with morphological and syntactic problems typically speak in very short, simple sentences. These problems can increase as the child grows older and is expected to use more complex information. The messages they are trying to convey can easily become lost or misunderstood.
Word-Finding Problems
Word-finding problems occur when a child with SLI is unable to think of a specific word they want to say. Asking questions is difficult for these children because they have problems understanding the "wh" questions (who, what, where, when, why, and how). They have difficulty trying to form a question. Also, reading narratives is a challenge for these kids because it involves recalling information.
Specific Language Impairment (SLI)
Specific language impairment ( or primary language disorder) refers to limitations in language functioning, not related to deficits in hearing, oral structure and function, intelligence or perception. There is no general or specific cause or condition for the impairment. People with SLI typically show normal intellectual functioning. Specific language impairments are characterized more by the absence of other disorders than by clearly identifiable traits. SLI is the most common reason for early intervention and special education services in preschools.
Characteristics that can identify a specific language impairment:
- Slow development of speech and sounds
- Does not say "Mama" or "Dada" by 12-18 months of age
- Significant late appearance of first word (after about 18 months of age)
- Significant late use of two-word combinations (after about 30 months of age)
- Restricted vocabulary production and comprehension
- Reliance on gestures to have needs met
- Infrequent use or poor development of verbs
- Lack of "yes" or "no" responses to questions
- Difficulty initiating interactions with peers
- Difficulty with turn-taking during conversations
- Difficulty rhyming words
- Difficulty naming letters
Most children with SLI under the age of three can be confused with "late talkers" or "late bloomers" and often go unrecognized. Parents are typically advised to wait and see if the child's language development improves. This causes a problem because early intervention is extremely important for children with SLI and other language disorders.
It is difficult to determine the cause of a child's specific language impairment and it is unlikely that it has a single cause. It is possible that genetics can influence which children develop SLI. However, most researchers say that specific language disorder is very complex and has many genetic as well as environmental influences.
Prevalence
Studies report that 7% to 8% of children entering kindergarten are recognized as having a specific language impairment with no other complicating disabilities. Approximately 2% more boys than girls have SLI (Erwin, 2001). More than 1 million children in American schools receive services for primary speech or language disorders.
Receptive Language Problems
Receptive language is a process by which a listener infers the meaning of a message based on context and long-term memory that relates to the information. Children with SLI usually have difficulty with receptive language. They generally have an impaired ability to understand and process information presented verbally or non-verbally. Children with SLI often have difficulty keeping up with a normal conversation and understanding direct or indirect questions. Children in junior high school tend to continue to have a weak vocabulary in relation to their peers. They understand direct statements better than indirect statements. They are very literal in their interpretation and often misuse or misunderstand statements, idioms, metaphors, and similes. They also have difficulty expressing wants, needs, thoughts, and feelings which can lead to frustration.
Expressive Language Problems
Children of all ages with SLI have difficulty with expressive language. They have a hard time expressing their wants and needs, leaving the parents confused and guessing.
Articulation and Phonological Problems
Children ages 3-4 who are difficult to understand often have specific language impairment. Their reduced speech affects their interactions with family and peers. These children are usually recognized around the time they are in primary school.
Morphological and Syntactic Problems
Children with SLI often have morphological and syntactic problems. Children's language is grammatically incorrect when there are morphological problems present. Children with morphological and syntactic problems typically speak in very short, simple sentences. These problems can increase as the child grows older and is expected to use more complex information. The messages they are trying to convey can easily become lost or misunderstood.
Word-Finding Problems
Word-finding problems occur when a child with SLI is unable to think of a specific word they want to say. Asking questions is difficult for these children because they have problems understanding the "wh" questions (who, what, where, when, why, and how). They have difficulty trying to form a question. Also, reading narratives is a challenge for these kids because it involves recalling information.
What are secondary language impairments?
A secondary language impairment accompanies other disabilities such as intellectual disabilities/delays.Many children with language disorders also have learning disabilities. These children would be diagnosed with a language-learning disability (LLD). Many children with this diagnosis have communication problems that last throughout life. Their communication problems affect their academic achievements, choice of career, potential earning, and relationships.
Children diagnosed with LLD show difficulties across a wide range of skills such as:
Children's language problems often present themselves differently as the child advances in school. Different symptoms and severity levels are reflected by the different educational demands throughout the child's life. As the language demands increase, new symptoms could arise that were not seen before.
These symptoms often include:
Prevalence
Language-learning disabilities typically run in families. Sixty percent of children with LLD have a family member with similar problems. (Dale, Price, Bishop, & Plomin, 2003). It is estimated that LLD affects 15% of the U.S. population and affects more boys than girls. LLD can be accompanied by many other disabilities as shown in the graph below:
Children diagnosed with LLD show difficulties across a wide range of skills such as:
- Listening, processing, and comprehending auditory information
- Listening, processing, and comprehending written information
- Verbal output including vocabulary, grammar, morphology, and phonology
- Speaking/Written output
- Reasoning, decision making, and problem solving
- Math abilities
Children's language problems often present themselves differently as the child advances in school. Different symptoms and severity levels are reflected by the different educational demands throughout the child's life. As the language demands increase, new symptoms could arise that were not seen before.
These symptoms often include:
- Understanding increasingly complex verbal information
- Communicating narrative information in the classroom
- Learning to read and write
- Reading to learn
Prevalence
Language-learning disabilities typically run in families. Sixty percent of children with LLD have a family member with similar problems. (Dale, Price, Bishop, & Plomin, 2003). It is estimated that LLD affects 15% of the U.S. population and affects more boys than girls. LLD can be accompanied by many other disabilities as shown in the graph below:
SOURCE: U.S. Department of Education, Office of Special Education Programs, Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, selected years, 1979 through 2007; and Individuals with Disabilities Education Act (IDEA) database, retrieved April 14, 2009
Motor Skills
About 15% of children with learning disabilities also have major problems with fine or gross motor skills as well as coordination. This can affect a person's language because it can cause difficulty with articular movement. For example, children with apraxia of speech have trouble saying sounds, syllables, and words due to motor problems caused by brain injury or damage. Coordination disorders can also cause issues with a child's interactions with their peers. This can complicate social development for children who already have trouble with communication.
About 15% of children with learning disabilities also have major problems with fine or gross motor skills as well as coordination. This can affect a person's language because it can cause difficulty with articular movement. For example, children with apraxia of speech have trouble saying sounds, syllables, and words due to motor problems caused by brain injury or damage. Coordination disorders can also cause issues with a child's interactions with their peers. This can complicate social development for children who already have trouble with communication.
Receptive Language Problems
Adolescents with receptive language problems at an early age often continue to have problems throughtout high school and life. In general, they tend to:
1. Have a weak single-word vocabulary
2. Experience difficulty with understanding abstract words and words with more than one meaning
3. Often be confused by figurative language
4. Have difficulty following directions
5. Have problems understanding questions
6. Experience difficulty with semantics
7. Face challenges following rapid speech
8. Have poor listening skills
9. Have difficulty understanding the messages of lectures
10. Misinterpret facial expressions, body language, and gestures
Expressive Language Problems
It is possible that expressive language could be even more of a challenge than receptive language problems for people with language disorders. Messages, instructions, directions, responses, or behaviors are likely to be incomplete, inaccurate, or inappropriate. They have weak vocabularies compared to their peers. They may be able to use teenage figurative language easily, but are usually not able to express themselves with adult language. They tend to use low-content words such as "thing" or "stuff". They do not use clear pronouns which causes the listener to be confused about what they are saying. People with language-learning problems often have simple syntax and use fewer complex sentences than their peers. Verb tense also presents a challenge for these people. They often use fragmented sentences and unclear messages.
Many adolescents with language-learning disabilities who graduate high school are able to attend college. At the college level, learning disability was the fastest growing category among students with disabilities between 1988 and 2000. In 2000 approximately 40% of university freshmen with disabilities cited a learning disability, compared with only 16% in 1988. (Henderson, 2001)
Adolescents who have language-learning disability often go on to become college students with language-learning disabilities. Whether or not these adolescents enter college or go to work, they are likely to enter adulthood with some level of language impairment and must learn to work and live within their limitations. Some of these adults become very successful despite their language and learning problems.
Adolescents with receptive language problems at an early age often continue to have problems throughtout high school and life. In general, they tend to:
1. Have a weak single-word vocabulary
2. Experience difficulty with understanding abstract words and words with more than one meaning
3. Often be confused by figurative language
4. Have difficulty following directions
5. Have problems understanding questions
6. Experience difficulty with semantics
7. Face challenges following rapid speech
8. Have poor listening skills
9. Have difficulty understanding the messages of lectures
10. Misinterpret facial expressions, body language, and gestures
Expressive Language Problems
It is possible that expressive language could be even more of a challenge than receptive language problems for people with language disorders. Messages, instructions, directions, responses, or behaviors are likely to be incomplete, inaccurate, or inappropriate. They have weak vocabularies compared to their peers. They may be able to use teenage figurative language easily, but are usually not able to express themselves with adult language. They tend to use low-content words such as "thing" or "stuff". They do not use clear pronouns which causes the listener to be confused about what they are saying. People with language-learning problems often have simple syntax and use fewer complex sentences than their peers. Verb tense also presents a challenge for these people. They often use fragmented sentences and unclear messages.
Many adolescents with language-learning disabilities who graduate high school are able to attend college. At the college level, learning disability was the fastest growing category among students with disabilities between 1988 and 2000. In 2000 approximately 40% of university freshmen with disabilities cited a learning disability, compared with only 16% in 1988. (Henderson, 2001)
Adolescents who have language-learning disability often go on to become college students with language-learning disabilities. Whether or not these adolescents enter college or go to work, they are likely to enter adulthood with some level of language impairment and must learn to work and live within their limitations. Some of these adults become very successful despite their language and learning problems.
How are language disorders treated?
A child may be referred to a speech-language pathologist (SLP) soon after birth or during early infancy if there is an identifiable problem such as cleft lip or palate. Parents or preschool teachers may refer a child to an SLP at as young as 2 or 3 years old, but more commonly around 4 or 5 years old. A child could be referred for a screening at any age in school. Information from screenings as well as case history and parent interviews lead to a diagnosis. Once the child is diagnosed, treatment can begin.
Therapy for Language Disorders
By knowing and understanding a child's particular problems, a clinician can use general and specific therapy approaches. Although an assessment has already been completed for a diagnosis, the child will continue to take assessments to document their progress and determine if their current treatment is working or needs to be adjusted. The purpose of therapy is to stimulate overall language development and to teach a repertoire of linguistic features that can be used to communicate in all contexts and in all environments. (Owens, 2008)
Target Behavior
A target behavior (or goal) is a skill that a clinician tries to teach a child that can be verbal or nonverbal. This allows the clinician to observe and measure the accuracy of a particular language behavior before therapy, during therapy, and after therapy. Goals require several specific points:
1. A specific behavior that is both observable and measurable
2. The environment in which the target behavior will be observed
3. The number of times the target behavior is to be observed
4. The percent accuracy chosen
5. The therapy stimuli to be used
In most cases, short-term goals are needed in order to reach long-term goals. Form, content, and use of language a child has not learned through the environment could take a considerable amount of time, energy and "brain work" during therapy.
Therapy for Language Disorders
By knowing and understanding a child's particular problems, a clinician can use general and specific therapy approaches. Although an assessment has already been completed for a diagnosis, the child will continue to take assessments to document their progress and determine if their current treatment is working or needs to be adjusted. The purpose of therapy is to stimulate overall language development and to teach a repertoire of linguistic features that can be used to communicate in all contexts and in all environments. (Owens, 2008)
Target Behavior
A target behavior (or goal) is a skill that a clinician tries to teach a child that can be verbal or nonverbal. This allows the clinician to observe and measure the accuracy of a particular language behavior before therapy, during therapy, and after therapy. Goals require several specific points:
1. A specific behavior that is both observable and measurable
2. The environment in which the target behavior will be observed
3. The number of times the target behavior is to be observed
4. The percent accuracy chosen
5. The therapy stimuli to be used
In most cases, short-term goals are needed in order to reach long-term goals. Form, content, and use of language a child has not learned through the environment could take a considerable amount of time, energy and "brain work" during therapy.