Language Disorders in Children

Language Disorders in Children

• Language Delay is when a child talks later than others but is expected to catch up.
• Language Disorder is when a child struggles to understand or use language effectively, even with help.
• Language Difference refers to variations in language use due to cultural or linguistic backgrounds, not a disorder.

Conditions Affecting Language

• Intellectual Impairment can affect a child's cognitive abilities and their capacity to learn and use language.
• Autism Spectrum Disorder (ASD) can cause challenges in communication and social interaction, leading to language disorders.
• Specific Language Impairment (SLI) involves difficulties in language acquisition without cognitive deficits such as struggling with vocabulary, grammar and sentence structure.

Signs of Language Disorders

• Difficulty speaking or understanding language (trouble forming sentences or using appropriate vocabulary).
• Challenges in social communication, like not responding to questions or not engaging in conversations.
• Limited vocabulary range and difficulty following directions or understanding complex sentences.

Teenage Struggles with Language Disorders

• Metalinguistics (ability to think about and analyze language) can be difficult, leading to trouble with humor, sarcasm, or idioms.
• Social Communication challenges can occur as they find it challenging to adjust their language use according to different social contexts, leading to misunderstandings or social isolation

How We Test for Language Problems

• Receptive Language Tasks assess a child's ability to understand spoken language such as following directions and comprehending questions.
• Expressive Language Tasks assess a child's ability to produce language including vocabulary use and sentence structure.
• Language Sampling involves observing and recording a child's spontaneous speech to analyze their natural language use.

Types of Language Tests

• Formal Assessments are standardized tests that provide a structured way to evaluate language skills and can be compared to normative data.
• Dynamic Assessment assesses a child's learning potential by observing how they respond to support and instruction.

Making a Diagnosis

• Consider the child's cultural background to avoid misinterpreting language differences as disorders.
• Clinicians should compare long-term developmental goals with short-term objectives to create a treatment plan.
• SMART Goals should be Specific, Measurable, Achievable, Relevant, and Time-based to ensure effective intervention.

Helping Kids with Language Disorders

• Traditional Therapy involves structured teaching methods, often in a clinical setting, focusing on specific language skills.
• Naturalistic Therapy emphasizes learning through play and everyday interactions.
• Techniques for Natural Learning include self-talk, parallel-talk, and expansion.

Fluency Disorders (Stuttering & Cluttering)

• Normal Disfluency includes occasional hesitations, pauses, or repetitions in speech.

What is Stuttering?

• Overt Features: Visible and audible signs like sound repetitions, prolongations, and blocks, plus secondary behaviors (facial grimaces, body movements).
• Covert Features: Emotional and psychological aspects like fear of speaking or avoidance of certain words.

Why Do Some People Stutter?

• Risk Factors: Family history, neurological differences, and the age stuttering begins.
• Theories: Stress-related triggers, neurological wiring differences, and learned behaviors.

Cluttering

• Cluttering involves rapid speech that may be hard to understand, often with slurred words and omitted sounds.

How to Test for Stuttering

• Parent Interview: Gather observations and concerns about the child's speech.
• Counting Disfluencies: Measure the frequency of disfluencies in speech samples.
• Severity Tests: Use tools like the Stuttering Severity Instrument (SSI-4) and Overall Assessment of Stuttering.

Helping People Who Stutter

• Fluency Shaping: Teach individuals to speak more smoothly via slowing speech and controlled breathing.
• Stuttering Modification: Helps to manage stuttering effectively, including techniques to ease into words and reduce tension.
• Support & Confidence: Provide emotional support to help cope with social challenges.

Voice Disorders

• Quality: Refers to the clarity or roughness of the voice.
• Pitch: The highness or lowness of the voice.
• Loudness: The strength or softness of the voice.

Common Voice Problems

• Hyperfunction: Excessive tension in the vocal cords, resulting in a strained voice.
• Hypofunction: Insufficient tension, leading to a weak or breathy voice.

Bad Vocal Habits

• Detrimental habits include excessive yelling, speaking too loudly, whispering frequently, and smoking.

Types of Voice Disorders

• Functional: Arise from poor vocal habits not physical abnormalities.
• Neurologic: Result from neurological conditions like Parkinson’s disease.
• Organic: Caused by physical damage or disease.

Specific Voice Problems

• Vocal Nodules: Small, callous-like growths on the vocal cords caused by vocal strain, leading to hoarseness.
• Polyps: Fluid-filled lesions on the vocal cords from vocal abuse or misuse.
• Laryngitis: Inflammation of the larynx, leading to voice loss or hoarseness

Testing for Voice Problems

• Otolaryngologist (ENT Doctor): Evaluates voice disorders.
• Endoscopy & Videostroboscopy: Provides a detailed view of the vocal cords.

Helping with Voice Problems

• Hygienic Therapy: Teaches healthy vocal habits.
• Physiologic Therapy: Strengthens the muscles involved in voice production.
• Symptomatic Therapy: Addresses specific symptoms of voice disorders.

What Happens After a Laryngectomy?

• Electrolarynx: Produces sound electronically.
• Esophageal Speech: Traps air in the esophagus to create sound.
• Tracheo-Esophageal Speech: Uses a special valve to allow air from the trachea to enter the esophagus for speech.

Transgender Voice Therapy

• Adjusts pitch and voice quality to align with gender identity using vocal exercises and techniques.