Chapter 8
Children with
Communication,
Language, and
Speech Disorders
Historical Overviews
• In the United States during the 1800s, the focus
was on elocution, or the ability to speak with
elegance and propriety.
• Alexander Graham Bell founded the School of
Vocal Physiology in 1872 to help improve the
speech of children who were deaf or who
suffered from stuttering and/or articulation
problems (He invented the phone!)
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• In 1925, the American Speech and Hearing Association
(ASHA) was formed. Broca and Wernicke conducted
early studies that showed the areas of the brain
associated with speech and language. Refer to Figure
7.1 in the text for the parts of the brain named after these
two individuals. (Broca’s afasia: understand language
but use telegraphic speech)
http://www.youtube.com/watch?v=f2IiMEbMnPM
• http://www.youtube.com/watch?v=Fw6d54gjuvA
• During the 1960s and 1970s, Chomsky studied the
rules and sequences governing the acquisition of
language. The area of pragmatics and the social aspects
of communication is central in our current understanding
and practice in this area.
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Communication
• Exchange of thoughts, information, and ideas
– Sender
– Message
– Receiver
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Language
• An organized system of arbitrary symbols used
to express and receive meaning
– Receptive language
– Expressive language
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Language Form
• Phonology – sound system
• Morphology – meaning to words
• Syntax – order and combination of words
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Language Content
• The content of a language is the information
being communicated. Semantics is the
meaning of the words and sentences.
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Language Function
• Pragmatics
• Supralinguistics
• Pragmatics is how language is used in
different situations. The social context is
important because it helps to clarify the meaning
of the communication. Supralinguistics is the
sophisticated analysis of meaning when the
literal meaning of the word or phrase is not
the intended meaning (Salvia et al., 2007).
Being good at supralinguistics means that one
can understand sarcasm, indirect requests, and
figures of speech.
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Speech
– Normal speech is a combination of articulation,
fluency, and voice.
– Articulation is the clear pronunciation of words
– Fluency refers to the appropriate flow of the
words
– Voice is the intonation and quality of the
production (pitch, loudness, and resonance).
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• The production of speech involves (1)
respiration—the process that generates the
energy that produces sound, (2) phonation—the
production of sound by the vibration of the vocal
cords, (3) resonation—the process that gives the
voice a unique characteristic and identifies the
person (the product of sound traveling through
the person’s head and neck), (4) articulation—
the movement of the mouth and tongue that
shapes sound into phonemes (the smallest units
of sound), and (5) audition—the thought
transformed into words that is received by a
listener through hearing.
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Figure 7.4: Speech Production
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Language Development
• An infant is innately programmed to communicate through smiles,
eye contact, sounds, and gestures (the prelinguistic system). Most
children learn language through their early social interactions with
basic caregivers.
• From birth to 3 months, infants begin to socially communicate by
smiling and cooing.
• This is followed, around 4 to 6 months of age, by babbling, sounds,
and initial language use. Recognition of language by the child
begins around 7 months of age.
• Expressive vocabulary:
• 20 words at 18 mos.
• 300 words by 24 mos.
1500 words by 48 mos.
2000 words by 60 mos.
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• Actual words begin at about 12 months. Words
are then turned into sentences; by 18 months,
most children can speak in two-word sentences,
and this process continues through the
development of multiple-word sentences, usually
in place by age 3.
• By age 6, the child is a good communicator, with
the knowledge of thousands of words, though
this knowledge appears to decline when the
child begins reading and writing instruction in
school settings. Please refer to Table 7.1 in the
text for more explanation on language
development and ages.
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•
•
•
•
•
Cooing (primary vowels, some back consonants)
Babble (ba ba, da da, repetitious)
Echolalia (imitates speech sounds)
Vocal play/jargon
Holophrastic use (12-18 mos.)
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Prevalence of
Communication Disorders
• More than 1 million students having speech and
language impairments were served in special education
programs 2002
• 18.7% of children with disabilities
• Not all children with speech-language disorders are in
special education classes. In fact, 87 percent of children
with speech and language impairments are served
primarily in regular classes; only 8 percent are in
resource rooms and 5 percent in separate classes (U.S.
Department of Education, 2005). Children with speech
and language disorders are more likely than children
with other disabilities to be served in the regular
classroom
From
U.S.Department of Education, 2005.
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Classification of Disorders
• Communication Disorders
• Speech Disorders
– Disorders of articulation
– Disorders of fluency and speech timing
– Disorders of voice
• Language Disorders
– Form
– Content
– Function
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Communication Disorder
• An impairment in the ability to receive, send,
process, and comprehend concepts of 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 communication disorders. A
communication disorder may result in a primary
disability, or it may be secondary to other
disabilities (ASHA).
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Language Disorder
• An impaired in the 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 and supralinguistic) or any
combination.
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Speech: Articulation Disorder
– A speech disorder is an impairment of the articulation
of speech sounds, fluency, and/or voice. An
articulation disorder is the atypical production of
speech sounds characterized by substitutions,
omissions, additions, or distortions that may
interfere with intelligibility.
– In classifying the disorders from mild to severe, one
looks at the number and kinds of misproductions.
Disabling conditions associated with disorders of
articulation-phonology are cleft palate, hearing
impairment, cerebral palsy, and sometimes stuttering.
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Common Articulation Errors
1.
2.
3.
4.
5.
6.
7.
8.
We yive in a yeyow house. (Substitution)
I like dis ball. (Substitution)
Did you see the wed twuck? (Substitution)
Oh, ook at the kitty. (Omission)
Did you see the moufse? (Addition)
I am seben years old. (Substitution)
I have fi fingers. (Omisson)
Can we play footsball. (Addition)
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Speech: Fluency disorder
• A fluency disorder is an interruption in the flow of
speaking characterized by atypical rate, rhythm,
and repetitions in sounds, syllables, words, and
phrases. This may be accompanied by
excessive tension, struggle behavior, and
secondary mannerisms. Because fluency is the
flow of speech, the most common type of
fluency disorder is stuttering. For some children
who stutter there is a genetic component (Yairi,
Ambrose, & Cox, 1995). Many children recover
spontaneously by school age (Bloodstein, 1995).
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Speech: Voice disorder
• Voice is the production of sound in the larynx and the
selective transmission and modification of that sound
through resonance and loudness. Associated with voice
are (1) quality of sound or resonation, (2) pitch, and (3)
loudness. A voice disorder is characterized by the
abnormal production and/or absences of vocal quality,
pitch, loudness, resonance, and/or duration, which is
inappropriate for an individual’s age and/or sex.
Dysphonia (disorder of voice quality) can be related to
phonation and/or resonation. Variation or distortion in
pitch can be an indicator of hearing impairment.
• Dysphonia : Resonation (hyponasalilty,
hypernasality), Phonation (breathy, hoarse, harsh),
Pitch (male or female, young or old), Loudness
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Identification and Assessment
• Early language is the product of social and
family interactions, and if the child comes from a
background in which the language of the
schools is not the home language, other
considerations must be taken into account.
Teachers must be multiculturally aware and
knowledgeable about linguistic diversity so that
they do not inappropriately refer a child for
assessment.
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• Children who come from homes in which English
is not the primary language must be assessed in
their primary language to determine if a
communication disorder exists. Even if English
is the primary language, dialect differences may
exist. A dialect difference may mask a
communication disorder. Refer to Table 7.3 to
discuss other problems in the area of
communication, language, and speech that may
accompany other disability areas.
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Table 7.4: Identification
and Assessment
Source: Adapted from J. Salvia, J.E. Ysseldyke, and S. Bolt (2007). Assessment in special and inclusive education, 10th ed. (Boston: Houghton Miffl in)
Reprinted by permission of Houghton Miffl in Harcourt Publishing Company.
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Educational Adaptations
•
•
•
•
Adapting the Learning Environment
Adapting the Curriculum
Adapting Teaching Strategies
Assistive Technology
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• The three levels of intervention explained in the
RTI approach is an excellent method for
adapting the learning environment for a student
with a communication disorder. Inclusion (Tier I)
is the typical option because most children with
primary speech disorders respond well to the
regular education program if they receive
additional help for their special communication
needs.
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• The regular education teacher can use a variety of
strategies to provide a positive learning environment for
the student with a communication disorder. The
strategies can include methods to promote student-tostudent communication, cooperative learning strategies,
as well as ideas from the speech-language pathologist.
• Tier II of the RTI model includes collaborative
interventions, such as small-group language activities,
working directly with the speech-language pathologist in
the regular classroom, and weekly conferences with the
speech-language pathologist and the regular classroom
teacher. to meet the individual needs of the student.
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• At Tier II, the speech-language pathologist helps
by suggesting strategies that encourage talk,
expand talk, and model correct forms and
usage. She may help the teacher set up
effective peer-mediated social supports) and
may help teach students self-advocacy skills so
that they can communicate their needs
• Tier III of the RTI model includes the
individualized educational services stated in the
student’s IEP.
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• Because we know that children without communication
disorders learn language through play and in naturalistic
settings, this strategy becomes very important when
working with the child who has communication disorders.
Additional strategies include modeling the correct form,
operant conditioning strategies, functional intervention
programs based on social learning theory that use
natural opportunities to promote appropriate speech and
language through incidental teaching, and augmented
and alternative communication such as American Sign
Language (ASL) or communication boards. disorders
(see page 325 of the text).
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• The classroom teacher can improve a student’s
self-esteem by (1) disregarding moments of
nonfluency, (2) showing acceptance of what the
child has expressed rather than how it was said,
(3) treating a child who stutters like any other
member of the class, (4) acknowledging
nonfluency without labeling the child, (5) helping
the child feel in control of his or her speech, and
(6) accepting nonfluency. It is equally important
for the teacher to be aware of the terminology
associated with communication
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Life Span Issues
• Teaching parents to model appropriate speech
is crucial for the child with a communication
disorder. Important changes have come about in
helping students with communication disorders
make transitions from high school to college and
to the workplace. Many colleges and universities
have support services and special programs for
these students.
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