Speech and Language Development in Early Childhood

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Questions and Answers

A child between one and two years old is exhibiting potential speech, language, or communication difficulties. Which of the following would be an indicator?

  • No babbling and not responding to speech or sounds. (correct)
  • Frequent babbling and responding to some speech.
  • Consistent attempts to communicate with single words
  • Occasional lack of response to sounds and words.

What is a key sign of potential speech, language, or communication difficulties in a child between the ages of 2 and 3?

  • Frequent attempts to communicate and babbling
  • Consistent responses to spoken language.
  • Using multiple clear words in sentences.
  • Showing minimal interaction and no words. (correct)

A child who is 3 years old is speaking in short utterances. Which of the following is a possible sign of difficulty with speech, language, or communication?

  • Speaking in at most two-word utterances and not understanding simple commands. (correct)
  • An ability to understand clear, multi step instructions
  • An ease with which people understand the child when speech.
  • Using mostly phrases and sentences

Which of the following is a possible indicator of communication difficulties in a child aged between 4 and 5?

<p>Using at most three-word utterances and being difficult for strangers to understand. (A)</p> Signup and view all the answers

A child aged 5 and above is exhibiting issues with communication. Which of these is a possible sign of language or communication difficulties?

<p>Having difficulty in telling or retelling a coherent story. (C)</p> Signup and view all the answers

What does regression or stalling of language development in a child between 2 and 3 indicate?

<p>It is a sign of potential difficulties with speech, language, or communication. (D)</p> Signup and view all the answers

What is a key characteristic of a child with a language disorder?

<p>Significantly impaired social and/or educational functioning (D)</p> Signup and view all the answers

A child, over 5 years of age, talks a lot. Which of the following might suggest a possible difficulty with communication?

<p>The child struggles with reciprocal conversations despite talking a lot. (C)</p> Signup and view all the answers

A child's language difficulties are not considered a Developmental Language Disorder (DLD) if:

<p>There is an associated known biomedical condition. (A)</p> Signup and view all the answers

A child over 5 years old has issues understanding what others say, often missing the point. What might this indicate?

<p>The child regularly uses over-literal interpretations of language. (A)</p> Signup and view all the answers

Which of the following is considered a 'red flag' behavior that signals a need for further assessment in children with possible language difficulties?

<p>Communication behaviors that are definitively atypical for their age. (A)</p> Signup and view all the answers

What is the primary criteria for diagnosing Developmental Language Disorder (DLD) in a child?

<p>The child's language difficulties significantly impair social or educational functioning, with indicators of poor prognosis, and are not explained by lack of familiarity with ambient language. (B)</p> Signup and view all the answers

What is the relationship between 'associated with' and 'explained by' when considering co-occurring disorders?

<p>'Associated with' does not mean 'explained by'. (C)</p> Signup and view all the answers

According to the clinical guidance, what does 'poor prognosis' in language development generally indicate?

<p>The child’s language difficulties may be persistent and require ongoing intervention. (A)</p> Signup and view all the answers

What is important to consider when a child demonstrates more than the minimum levels of language and communication?

<p>They still might have a language disorder. (D)</p> Signup and view all the answers

Which of the following can co-occur with Developmental Language Disorder (DLD)?

<p>Attention Deficit Hyperactivity Disorder (ADHD) (C)</p> Signup and view all the answers

A child has language difficulties that are associated with a known biomedical condition. According to the text, how is this scenario classified?

<p>Language Disorder Associated with X (B)</p> Signup and view all the answers

What is one of the criteria that excludes a language difficulty from being classified as a Developmental Language Disorder (DLD)?

<p>If the language difficulty is linked to a known biomedical condition. (B)</p> Signup and view all the answers

A child's language difficulties should NOT be attributed to

<p>a lack of experience with the ambient language. (C)</p> Signup and view all the answers

What is a characteristic of children with Developmental Language Disorder (DLD) regarding their rate and progress of speech and language development?

<p>They do not follow the typical rate and progress of speech and language development. (A)</p> Signup and view all the answers

The 'red flag' behaviors are derived from:

<p>a consensus view of clinicians. (C)</p> Signup and view all the answers

Which aspect of a language disorder needs to be present for it to be considered DLD?

<p>There is often not an obvious or clear cause for the language disorder. (C)</p> Signup and view all the answers

According to the information, what is the general prognosis for children diagnosed with Developmental Language Disorder (DLD)?

<p>They will not catch up and the disorder will persist throughout their lives. (C)</p> Signup and view all the answers

Which of the following is NOT a factor that would exclude a child from receiving a diagnosis of DLD?

<p>A co-occurring diagnosis of Dyslexia. (B)</p> Signup and view all the answers

What is a key benefit of using visuals in lessons for children with DLD?

<p>They act as a permanent memory support. (D)</p> Signup and view all the answers

Why is it important to use a child's name to gain their attention?

<p>It helps the child to isolate the important information (C)</p> Signup and view all the answers

Which of the following strategies is most likely to encourage turn-taking in communication?

<p>Pausing expectantly and frequently during interactions. (C)</p> Signup and view all the answers

What does 'extending' a child's utterance involve?

<p>Repeating what the child says and adding some related new information. (D)</p> Signup and view all the answers

Which approach has traditionally been used to identify Specific Language Impairment (SLI)?

<p>A discrepancy based on non-verbal IQ. (A)</p> Signup and view all the answers

What is a key challenge with using non-verbal IQ in the diagnosis of SLI?

<p>The role of non-verbal IQ in the discrepancy criteria has been questioned. (C)</p> Signup and view all the answers

What does the term 'DLD' stand for?

<p>Developmental Language Disorder (A)</p> Signup and view all the answers

How does the text describe word-finding difficulties in children with Developmental Language Disorder?

<p>A feature that can be semantic, phonological, or both. (C)</p> Signup and view all the answers

What is a key aim of speech and language therapists working with children with DLD?

<p>To provide specialist interventions to address language and communication difficulties. (B)</p> Signup and view all the answers

Which of the following is NOT a typical task that speech and language therapists would undertake when working with children with DLD?

<p>Prescribing medication for children with DLD to improve their communication skills. (C)</p> Signup and view all the answers

Which of the following is an example of an individual level intervention for children with DLD?

<p>Teaching a specific language target such as understanding time concepts like 'today', 'yesterday', and 'tomorrow'. (C)</p> Signup and view all the answers

What is one of the roles of speech and language therapists in supporting the transition of children with DLD from primary to secondary school?

<p>Facilitating communication between the primary school and secondary school staff regarding the child's needs. (B)</p> Signup and view all the answers

What factors might indicate that a child's language difficulties are classified as a Language Disorder?

<p>There is significant impairment in social or educational functioning. (A)</p> Signup and view all the answers

Which of the following would suggest that a child's language difficulties are not due to a language barrier?

<p>Their difficulties appear regardless of the setting. (A)</p> Signup and view all the answers

What differentiates Developmental Language Disorder (DLD) from other language disorders?

<p>DLD is not explained by familiarity with the language. (D)</p> Signup and view all the answers

How should the unique profile of a child's language strengths and needs be approached?

<p>By considering individual variations in language processing. (B)</p> Signup and view all the answers

In diagnosing Developmental Language Disorder (DLD), what signifies a poor prognosis?

<p>Limited social interactions with peers. (B)</p> Signup and view all the answers

What is an important aspect to evaluate when considering a diagnosis of DLD?

<p>If there are indicators of a known biomedical condition. (D)</p> Signup and view all the answers

What does the presence of discourse difficulties typically indicate for children with language disorders?

<p>They may struggle with appropriate social communication. (D)</p> Signup and view all the answers

Which characteristic is often associated with children diagnosed with Developmental Language Disorder (DLD)?

<p>Language development rates lower than peers. (A)</p> Signup and view all the answers

Flashcards

Language

A complex process involving a chain of skills like perceiving sounds, understanding grammar, and expressing thoughts.

Phonology

The study of sound systems in a language, including how sounds are produced and combined.

Syntax

The rules governing how words are arranged into sentences and clauses.

Semantics

The meaning of words and phrases, including concepts and vocabulary.

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Pragmatics

The social rules and conventions that govern language use in various contexts.

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Discourse

The ability to produce coherent and connected stretches of speech.

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Language Disorder

A significant impairment in language development that affects social and educational functioning.

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Developmental Language Disorder (DLD)

A language disorder that is not explained by other factors like hearing loss or neurological conditions.

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Co-occurring Disorders

A language disorder occurring alongside other conditions like ADHD, dyslexia, or dyspraxia.

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Associated with a Known Biomedical Condition

A specific condition that can be linked to a language disorder, such as Down syndrome, autism, or hearing loss.

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Associated with X

A term used to describe a range of conditions affecting the brain, including Down syndrome, Klinefelter syndrome, Cerebral Palsy, and Acquired brain injury.

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Developmental Coordination Disorder (DCD)

A condition characterized by difficulties with motor skills, often impacting speech and language.

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Dyslexia

A condition affecting reading skills, often leading to difficulties with language comprehension.

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Dyspraxia

A condition affecting motor planning and coordination, often impacting speech production and language development.

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Speech Disorder

Difficulties with speech production, articulation, and fluency, potentially impacting language learning.

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Red Flag Behaviors

Indicators suggesting a child might have a language disorder. These behaviors are usually considered unusual or atypical at a specific age.

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Red Flags for Speech Delay (1-2 years)

A child who does not babble or respond to speech or sounds shows potential signs of difficulty with speech, language, or communication.

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Red Flags for Speech Delay (2-3 years)

A child who does not attempt to communicate, has minimal words, or shows minimal reaction to spoken language might have challenges with speech, language, or communication.

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Red Flags for Speech Delay (3-4 years)

A child using only two-word utterances, not understanding simple commands, or speaking in a way that close relatives struggle to understand shows potential difficulties with speech, language, or communication.

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Red Flags for Speech Delay (4-5 years)

A child with inconsistent or abnormal interaction, limited to three-word utterances, poor understanding of spoken language, or speaking in a way that strangers struggle to understand may have speech, language, or communication difficulties.

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Red Flags for Speech Delay (5+ Years)

A child with difficulty telling stories, understanding spoken or read material, following instructions, holding conversations, or understanding the meaning of what's said might have speech, language, or communication difficulties.

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Language Progression (4-5 Years)

Language development can change dramatically, especially between 4 and 5 years, even without intervention. However, "severe" language impairment affecting both understanding and speaking is more likely to persist.

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Understanding DLD Profiles

Each child with developmental language disorder (DLD) has a specific combination of strengths and challenges.

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Importance of Language Observation

Observing children's language skills is crucial to identify strengths and weaknesses and tailor appropriate interventions.

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Speech and Language Therapist (SLT)

A specialist who helps children with communication and language difficulties, including identifying, assessing, and providing interventions.

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Partnership with educators and families

SLTs work with teachers, parents, and others to make sure kids with language difficulties can learn and succeed in school.

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Specialist interventions for children with DLD

SLTs use a variety of methods to help children improve their language skills, including play-based activities and structured exercises.

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Assessment and detailed information about a child's language skills

SLTs help identify the strengths and weaknesses of a child's language skills to create personalized support.

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Advocating for specialist educational provision for children with DLD

Ensuring that children with DLD have access to appropriate resources and educational support.

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Supporting transition points

SLTs help children adapt to new challenges and environments, like moving from kindergarten to elementary school.

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Integrating language learning strategies into the curriculum

SLTs work with others to develop and implement strategies that promote language development across a child's learning experiences.

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Psychometric Approach

A methodology used to identify Specific Language Impairment (SLI) by assessing language skills and comparing them to non-verbal IQ. This approach is often used to establish a significant discrepancy between language and cognitive abilities.

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Exclusionary Criteria

The use of criteria to determine whether a child meets the diagnostic criteria for a particular disorder, typically involving standardized tests and assessments. This helps determine if a child has significant language impairment.

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Pragmatic Skills

The ability to adapt and change communication strategies to suit different situations, such as being able to switch between formal and informal language based on the context.

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Word Finding Difficulties

Difficulties with spoken language, often characterized by problems with finding the right words, using grammatically complex structures, and expressing ideas coherently.

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Scaffolding Independence

Providing clear and consistent opportunities for children to use language, such as labeling objects, providing scripts for routines, and encouraging turn-taking during interactions.

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Extend

The act of repeating what a child says, but adding a little more information or a different perspective to extend their understanding and encourage further communication.

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Pace

Using a gradual and deliberate pace during interactions with children, allowing ample time for them to process information, respond, and take turns in conversation.

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Study Notes

Developmental Language Disorder (DLD)

  • DLD is a language disorder
  • A quiz is suggested to assess knowledge.
  • A website provides more information (https://radld.org/about/dld/dld-quiz/)
  • Take 3 minutes to complete the quiz
  • Any incorrect answers can be discussed.

Session Outline

  • What is Developmental Language Disorder (DLD)?
  • What are the features of DLD?
  • What is the impact of DLD?
  • What are controversies around a diagnosis of DLD?

Terminology

  • Speech, Language, and Communication Needs (SLCN) is used in UK schools
  • This term covers children and young people who have difficulties communicating, including social or environmental causes, neuro-developmental difficulties, or sensory impairment
  • DLD is associated with a known biomedical condition
  • Fluency disorders, voice disorders, speech-sound disorders (e.g. verbal dyspraxia, articulation disorder, orofacial structural defects) are also included as part of the language spectrum.

Communication Chain

  • Language is complex, involving fast processing of expressive and receptive skills.
  • Language development can break down at various points.
  • Individuals are often strong communicators and may not be aware of the process involved in communication.

Introducing Language Disorder

  • Children with language disorders may have difficulties with phonology, syntax, semantics, pragmatics, discourse, verbal learning, memory, reading, writing, and processing.
  • The profile of strengths and needs differs between individuals.

Diagnostic Terminology

  • A child with significant language difficulties that impact social and/or educational functioning is a key indicator of developmental problems.
  • Indicators of poor prognosis and not explained by lack of ambient language familiarity are also considered.
  • There is a distinction between developmental language disorder and language disorders associated with a biomedical condition.

Language Disorder Associated with

  • Genetic conditions (Down Syndrome, Klinefelter syndrome)
  • Cerebral Palsy
  • Acquired brain injury
  • Sensorineural hearing loss
  • Severe intellectual disability
  • Autism

Co-occurring Disorders

  • Additional conditions like ADHD, DCD, Dyslexia, Dyspraxia, Speech, and SEMH may accompany language disorders.

General Considerations for DLD

  • Language disorders often lack a clear cause.
  • Children do not follow typical speech and language development.
  • Language difficulties persist throughout childhood.
  • Children with a language disorder may also have a significant learning disability, but some do not.

Activity 1: DLD Videos

  • Videos of children with language disorders are recommended for viewing.
  • Focus on the skills and needs of each child with DLD.
  • Example links are provided to YouTube videos.

Activity 2: Signs of DLD (previously SLI)

  • Watch a Youtube clip with information about signs of language difficulties.
  • Determine what the signs of SLI (now DLD) are from the information.
  • Additional links to videos are provided.

DLD and Grammar

  • Potential issues with verb endings and syntactic structures.
  • Words may be omitted, especially in more complex sentences.

DLD and Word Finding Difficulties

  • Children with DLD may stutter or have trouble retrieving words.
  • Difficulty in finding correct words can be for a variety of reasons.

A Lexical Representation

  • Young children's mental representation of words combines semantic and phonological information.

Examples of Word Finding Difficulties (3)

  • Examples of specific difficulties in retrieving words are provided.

What Work Do Speech and Language Therapists Do?

  • Therapists help with inclusion for children with DLD
  • They offer interventions for DLD.
  • Work is done in partnership with teachers and families.
  • They remove barriers in learning.
  • They support the development of spoken and written language.
  • They provide detailed information on strengths and difficulties.
  • They advocate for specialist educational provisions

What Work Do Speech and Language Therapists Do? (2)

  • Therapists conduct identification, diagnosis, regular monitoring of progress, and modifications to management.
  • Support transition, devising and delivering therapy pathways.
  • Integrate strategies into the curriculum to support language learning.
  • Skill up others in facilitative and/or augmentative communication approaches.
  • Raise awareness and train professionals.

Individual Level Examples

  • Work on understanding time concepts, understanding language, increasing word-finding proficiency, tier 2 words, and teaching verbs are examples of individual-level interventions.
  • Delivery of narrative interventions and working on functional targets (e.g., bus home or lunchtimes) are other areas addressed at this level.
  • Development of comprehension monitoring, social stories, and support for understanding diagnoses are additional points.

School Level Examples

  • Sharing information about communication profiles and strategies.
  • Advocacy for pre-teaching language.
  • Increasing use of visual supports and communication.
  • Increasing support for literacy and oracy.
  • Altering class time for processing questions.
  • Alert students to likely questions
  • Demonstrate, mentor, and coach learning support staff.
  • Joint planning/Team teaching

Co-professional Practice

  • Speech and Language Therapists (SLTs) train teachers and parents to use visual support and language strategies.
  • This impact is small if training is not consistently reinforced by coaching, observation and feedback.

Slides 39-44

  • These slides provide further information on supportive strategies for intervention for DLD.

Principles of Word Learning

  • Explicit discussions, opportunities to derive meaning across contexts, deep understanding, and generalisation to real-life contexts are principles for supporting word learning.

Teaching Words

  • Semantic information (meaning, category, appearance, location, function, synonyms) and phonological information (first/last sound, syllables, rhyming) are two aspects needed for teaching words effectively.

Classroom Strategies

  • The use of visual supports (e.g Boardmaker)
  • Consistency with lessons to build independence
  • Extra time for processing and as memory aids
  • Specific language scaffolding strategies for repetition, signing/gestures, sentence completion, giving choices, and expansion.

Classroom Strategies (2)

  • Slow pace in conversations, encouraging turn taking, confirming responses, commenting, extending responses, and labelling actions, are additional classroom strategies.

Conclusions

  • DLD is heterogeneous and can present with various speech, language, and communication strengths and difficulties.
  • Word-finding difficulties can be semantic, phonological, or both.
  • Psychometric approaches to identifying SLI may be outdated and can be problematic when non-verbal IQ is used in assessment methods.
  • Diagnostic criteria require review and consensus.

Follow up - Core Reading

  • Relevant resources for further study are available on Blackboard.
  • This includes excellent RCSLT webinars and case studies in DLD.
  • Relevant research articles and reports are presented as recommendations for further study.

Questions...

  • Questions from the course session are anticipated.

Thank you

  • The presenter expresses thanks to the attendees.
  • Contact information is provided for further inquiries.

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