Lecture 4

Special Populations

Prevalent types of language disorders

● Developmental language disorder
● Social communication disorder
● Intellectual disability
○ Cognitive-adaptive disorder
■ Child must have significantly impaired cognitive and adaptive skills and
have a hard time functioning in society independently
■ Diagnosed under the age of 18
○ Also described as an intellectual developmental disorder
○ A condition of arrested or incomplete development of the mind
○ Characterized by impairment of skills manifested during the developmental
period
■ E.g., Reasoning, planning, problem solving, abstract thinking, learning
● Learning disability
○ Heterogenous group of disorders that are manifested by significant difficulties in
the development and use of listening, speaking, reading, writing, reasoning, or
mathematical abilities
○ Reflects difficulties in the central nervous system (brain) not caused by other
conditions or environmental influences
○ 15% of children with LD have major difficulty with motor learning and
coordination
○ >75% have major difficulty learning and using symbols
○ ~3% of all individuals have LD
○ Risk factors
■ Gender (affects males more frequently than females)
■ Family history
■ Poor nutrition, child abuse, pregnancy-related factors
■ Damaged central nervous system (e.g., lead poising, infections, brain
injury)
● Autism Spectrum Disorder
○ An umbrella term describing a variety of developmental conditions
■ Boys are 5x as likely to have ASD than girls
■ ~25% of children with ASD also exhibit intellectual disability
○ Characterized by
■ Significant difficulties in social interactions and communication
■ Engagement in repetitive behaviors
■ Overly restricted interests
■ Emerge during childhood
■ Affect an individual’s everyday functioning
■ Include problems with social communication and interaction
 ■ Include restricted and repetitive patterns of behavior
● Brain Injury (Traumatic Brain Injury - TBI): Damage or insult to an individual’s brain
○ Traumatic brain injury (TBI): brain damage resulting from physical trauma
■ Injury to brocas area - in the left hemisphere
■ Cueing - phonemic cuing (provide a sound or a rhyming word)
■ Semantic cueing - giving a category for a word
○ Prevalence
■ Can occur in utero, perinatally, and can be acquired
■ Approximately 1.5 million persons each year are affected by brain injuries
■ By age 15, 4 of 100 males and 2.3 of 100 females will have experienced
a brain injury
○ Risk factors
■ The most common causes of TBI in children are automobile accidents,
falls, and sports injuries.
■ Infections
■ Brain tumor
■ Poisoning
Special Populations
● Autism Spectrum Disorder (ASD)
○ Why are SLPs involved in Autism?
■ Communication is always affected and language is nearly always
affected.
■ Language delay is often present
■ Language ability is a strong predictor of later success in individuals with
autism
○ Language Domains
■ Despite impairment in the language is a common feature of ASD, the
language skills of children with ASD vary widely, and the language
domains impacted differ across individuals
○ Pragmatics - How does ASD affect pragmatics?
■ Conversational turn-taking
■ Perseveration
■ Echolalia
■ Conversational skills (e.g., lack of conversational repair)
■ Stereotyped language
○ Syntax/Morphology
■ Children with autism have been shown to exhibit:
● Delay in the development of syntax
● Rigid syntax: Less syntactically complex sentences
● Impaired judgment of grammaticality of sentences (third-person
singular [he, she, his, her] and present progressive [She is
moving])
○ Semantics
 ■Generally, those with autism are unimpaired in comprehension and use of
semantic information.
○ Phonology
■ Phonology is generally intact across individuals with ASD
○ Interventions
■ Discrete Trial Teaching (DTT): Presenting a learning opportunity in which
the student’s correct response will be reinforced
● Antecedent: Instructions
● Behavior: Looking
● Consequence: Positive reinforcement
■ Floortime/Play therapy: “The idea of play therapy is to have children build
the milestones of interaction and communication, whereas the goal of
ABA/IBI is to teach skills, the principle is to follow the child’s lead and
natural interests, joining the child in his/her own world in order to pull
them into a shared world. Greenspan called his model Floortime, referring
to the imperative for the therapist/caregiver to get onto the floor and try to
understand why a seemingly inappropriate activity might be bringing joy
or pleasure
■ Picture Exchange Communication System (PECS): is a way for autistic
people to communicate without relying on speech. To communicate,
people use cards with pictures, symbols, words or photographs to ask for
things, comment on things or answer questions
● Down Syndrome
○ What is it?
■ Chromosomal abnormality (trisomy 21)
■ Present in 1 out of 800 newborns
■ Usually accompanied by moderate to severe intellectual impairment
■ IQ is usually below 50
○ Language Development
■ Language is generally more impaired than other cognitive functions
■ Production deficits exceed comprehension deficits
■ Onset of babbling and phonological development are delayed
■ Decreased intelligibility
■ Lexical development is delayed (first word is produced around 24 months)
■ Grammar is particularly impaired
■ Both production and comprehension of grammar are delayed relative to
mental age
● Particularly likely to omit function words and verbs
■ Strong pragmatic skills
○ Intervention
■ Discrete Trial Teaching
(DTT)
■ Picture Exchange Communication System (PECS)
■ Play therapy
 ■ Sign language
■ Babbling, sound play
■ Requesting
■ Increasing utterance length
■ Feeding and swallowing
● Using utensils, drinking from open cup
● Trisomy 13
○ What is it?
■ AKA Patau syndrome
■ Most cases occur because there are 3 copies of chromosome 13
○ Prevalence
■ Occurs in about 1 in 16,000 newborns (NIH)
■ Risk increases with increased mother’s age
■ Sloping forehead, cleft palate, abnormal and low set ears, small eyes
■ Heart defects (among others)
■ Shortened life expectancy
■ Severe intellectual disability
○ Communication Difficulties
■ Significantly delayed communication and developmental milestones
● First year: cooing, rolling, smiling responsively, reaching and
recognizing close adults
● 2 – 3 years: object permanence, imitation, playing baby games,
sitting independently, and recognizing words
● 4 – 6 years: commando crawling, independent playing, following
simple commands, helping with hygiene tasks, standing,
understanding cause and effect, use of signs
● Older children: identifying common objects, used a walker,
crawled, understand words and phrases, possibly walking, some
toileting skill