Language Domains: Form, Content, and Use

• Language is divided into three domains: form, content, and use.

Form

• Phonology involves individual sounds and letters, such as understanding different pronunciations of words.
• Morphology is the study of the smallest meaningful units of language and the internal structure of words, including verb tense changes.
• Syntax is the grammar aspect, combining words into phrases and sentences, like adding descriptive clauses.

Content

• Semantics deals with the meaning of words and how that meaning can change based on sentence usage, such as understanding antonyms.

Use

• Pragmatics involves using language for different purposes like sharing information, social connection, and persuasion.
• This includes adapting language based on the situation, such as speaking softly or adjusting communication style with different people.

Developmental Language Disorder (DLD)

• DLD affects 7-10% of children in the US, but awareness is low.
• It is typically diagnosed in preschool or early elementary school.
• Children with DLD often require specific intervention to improve their language abilities.

DLD Outcomes

• Children with DLD have a higher risk of behavioral problems, often due to communication difficulties.
• They commonly face academic struggles, increased risk of dropping out of school, literacy disorders like dyslexia, and unemployment.
• The Matthew Effect describes how these deficits can increase over time.

Risk and Protective Factors

• Risk factors for language disorders include being male, hearing loss, poverty, genetics, low nonverbal IQ, and reactive temperament.
• Protective factors include a persistent or sociable temperament, parental education, maternal well-being, and strong education.

The Assessment Process

• Screening is conducted in early childhood to identify children at risk for communication disorders using parent or teacher questionnaires. This isn't for diagnosing but for referring to further evaluation.
• A background/case history informs the evaluation through discussions with parents and teachers to understand their concerns, developmental history, and medications.
• Evaluation involves assessing all domains of language (receptive and expressive) and aspects of communication.
• Clinicians can be liable if they treat certain communication aspects without identifying underlying disorders.
• You might bring in other professionals and multiple tests.
• Synthesis involves comparing assessment results with screening results, background, and case history to determine impaired domains, consistency across measures, strengths, and weaknesses.

Types and Purposes of Assessments

• Norm-Referenced Assessment:
  • This compares a child's performance to other children of the same age.
  • It is used for diagnosis and is based on a normal curve.
  • It can be lengthy; examples include the Preschool Language Scale and the Peabody Picture Vocabulary Test.
• Criterion-Referenced Assessment:
  • This checks if a child meets specific criteria or benchmarks, often with a pass/fail result.
  • It assesses performance relative to age expectations and can be brief.
  • This is not ideal for comparing children.
  • Examples include DIBELS and MacArthur-Bates CDI.
• Dynamic Assessment:
  • Dynamic assessment measures the ability to learn a skill through a test-teach-retest approach.
  • It establishes a baseline, provides instruction, and then retests.
  • It indicates a child’s response to intervention and is often used for bilingual children to differentiate between a disorder and lack of English exposure.
• Multidisciplinary Assessment:
  • This involves multiple experts conducting an evaluation on an individual and combining results.
• Transdisciplinary Assessment:
  • Experts collaboratively plan and conduct assessments, using one measure to assess all areas of expertise.
• Common Core:
  • Common Core is a set of benchmarks adopted by most states in the US for ELA and Math development.
  • Documenting progress towards Common Core benchmarks is an example of a criterion-referenced assessment.
• Language Sample Analysis:
  • Language sample analysis involves recording a child’s language in a naturalistic setting, typically for 7-10 minutes, with limited examiner talk.
  • It allows for the examination of different linguistic domains like morphosyntax and semantics.
• Mean Length of Utterance (MLU):
  • MLU is calculated by dividing the total number of morphemes by the number of utterances.
  • It uses free or bound morphemes and allows examination of grammatical morphemes used.

Assessment Considerations

• Assessments should distinguish between disorders and differences, considering dialect and cultural variations, particularly for bilingual children.

Assessment Psychometrics

• Validity in norm-referenced assessments:
  • It is the most important feature, ensuring results reflect a child’s actual abilities and measure what the test intends to measure.
  • Construct validity checks if the test aligns with current theories by sending it to experts for feedback.
  • Content validity looks at specific questions to ensure they only require the skills being measured and are fully accessible.
  • Criterion-related validity assesses if results correspond with results from similar assessments.
  • Predictive validity determines how well the result predicts a child’s future performance.
• Reliability:
  • This measures if test results can be replicated across forms, examiners, and time, reported as a correlation from 0 to 1.0.
  • Assessments should aim for at least 0.90 reliability.
  • Inter-rater reliability checks consistency across examiners.
  • Test-retest reliability assesses if an examinee achieves similar scores on different administrations.
  • Alternate form reliability ensures both forms are similar.
  • Sensitivity and Specificity
  • Sensitivity accurately identifies individuals with a disorder (minimizing false positives).
  • Specificity correctly excludes those without a disorder (minimizing false negatives).
• Scoring Norm-Referenced Tests
  • Scoring should follow a normal distribution.
  • Standard scores are calculated from raw scores and indicate position on a normal curve.
• Basals and Ceilings
  • In assessments normed on a wide range of ages, there are multiple starting points based on age to avoid giving the entire assessment.
• Composite Scores
  • Some assessments combine multiple component scores into one.
• Standard Error of Measurement (SEM) and Confidence Interval (CI)
  • SEM estimates the distribution for one person repeatedly taking the assessment.
  • CI is the range of possible scores surrounding the achieved score.
• Calculating MLU
  • Transcribe a language sample.
  • Count each morpheme in the sentence (free and bound).
  • Use Brown’s Grammatical Morphemes as a guide, typically not counting derivational morphemes.
  • Divide the total morphemes by the total child utterances.

Counting Morphemes

• Do not count interjections or false starts.
• Compound words, proper names, diminutives, reduplications, irregular past tense verbs, and irregular plurals each count as one morpheme.
• "Can't" and "Don't" count as one morpheme, but other contractions count as two.
• Catenatives count as one morpheme.

Intervention Policies

• History:
  • Brown v. Board of Education (1954) declared racial segregation in schools unconstitutional.
  • The Civil Rights Movements of the 1950s-1960s led to the Elementary and Secondary Education Act of 1965, which funded primary and secondary education.
• IDEA (Individuals with Disabilities Education Act)
  • IDEA (1975, renamed in 1990) mandates FAPE (Free, Appropriate, Public Education) for children with disabilities.
  • Education must be appropriate for their abilities without expenses and meet state standards.
  • LRE (Least Restrictive Environment) ensures inclusion with typically developing peers to the fullest extent appropriate, with exclusion only to the degree necessary.
• LRE Test
  • Inclusion benefits children with disabilities through peer modeling and social integration.
  • There is no evidence that inclusion negatively impacts the learning of non-disabled children.
  • Differentiated Instruction involves educators tailoring instruction to each child’s abilities in an inclusive classroom.
• Push In vs. Pull Out
  • Push-in services align with IDEA.
  • Only around ⅓ of SLPs provide these services.
• Direct vs. Indirect Services
  • Direct services involve face-to-face interactions.
  • Indirect services involve the SLP acting as a consultant to the teacher.
  • This is useful for children with mild deficits or those transitioning off an IEP.
  • Both require transdisciplinary collaboration.
• RTI (Response to Intervention) Model
  • Developed in response to the “wait to fail” model, RTI is illustrated as a triangle or pyramid and incorporates both assessment and instruction.
  • Instruction is delivered in different tiers.
  • About 80% of children should progress with a strong curriculum, while 20% may still struggle.
  • The model identifies struggling children early through universal screening and provides Tier 2 (targeted group interventions) or Tier 3 (intensive, individual interventions) services.
  • Tier 1 is core instructional intervention for all students, preventive, and proactive.
  • Progress monitoring is continuous.
• IEP (Individualized Education Program)
  • All children receiving special services have an IEP, outlining special education services, educational goals, and school-provided services.
  • It is a legal contract ensuring services are provided free. IDEA part C covers birth to 3 years, with children having IFSPs (Individual Family Service Plans) with family-based goals instead of IEPs.
• IEP Meetings
  • Meetings are held at least annually with family, educators, school representatives, and service providers to agree on goals and services.
• IEP Considerations
  • Treatment must be documented due to the legally binding nature of IEPs.
  • School districts are responsible for paying for necessary services (FAPE).
  • Children receiving Tier 1 and 2 supports might not have an IEP.
• Appropriate Evaluation
  • Appropriate evaluations minimize Type 1 (false positive) and Type 2 (false negative) errors.
  • They include children from diverse cultural/linguistic backgrounds who may be misidentified.
  • A variety of assessment tools should be used to reduce over-reliance on any single tool.
• Parent and Teacher Participation
  • Their input is essential, and parents must have the opportunity to participate in IEP meetings and be informed of any IEP changes.

Legislation

• No Child Left Behind (2001):
  • This included Title I provisions for disadvantaged students and promoted standards-based education reform with annual testing.
• Every Student Succeeds Act (2015):
  • This is the reauthorization of NCLB, making states accountable for testing.