Assessment of Language in Children - CH7 Group 1 PDF

Assessment of Language in Children Chapter 7  Cognition and Language  Cognition is not a component of language; however, a child’s cognitive abilities affect language in all aspects. Mental processes for learning, remembering, and using knowledge are essential for normal language ac...

Assessment of Language in Children Chapter 7  Cognition and Language  Cognition is not a component of language; however, a child’s cognitive abilities affect language in all aspects. Mental processes for learning, remembering, and using knowledge are essential for normal language acquisition and use.  During a language assessment, it is helpful to take note of the child’s cognitive abilities, including: attention and focus, reasoning ability, perception, memory, organization of self and thoughts, and overall executive function  **Executive Function: The child’s ability to plan, make decisions, and regulate behaviors or emotions. Language Disorder Categories Language disorders can be classified into various diagnostic categories. Often, language deficiencies are not the sole significant clinical feature of these conditions. This chapter aims to provide a broad framework for understanding these disorders. Specific language impairment (SLI): language disorder where children have difficulty acquiring language with no clear cause or other conditions. They learn language in the same order as typically developing children but at a slower rate. Language-learning disability (LLD): difficulties in acquiring and using skills for listening, speaking, reading, writing, reasoning, or mathematics. It is believed to be caused by central nervous system dysfunction. Autism spectrum disorder (ASD) or pervasive development disorder (PDD): impairment in communication and social skills and stereotyped and restricted behavioral patterns. Brain injury: A neurological condition that occurs after an injury or damage to the brain is often referred to as an acquired brain injury (ABI), such as traumatic brain injury, stroke, tumor, convulsive disorder, infection, or congenital malformation. Mental retardation (MR): intellectual function that is significantly below normal. It is caused by a biological medical condition or syndrome. Deafness: A state of having minimal to no hearing. Causes may be biological or environmental. The impact of deafness on language is profound(affects language development and use).  Assessment of early Language By Development the age of five, most children develop communication skills that are almost like those of adults. The first three years of life are very important for building a strong foundation for later growth, so it's important to help young children who are having difficulties early on. Research has shown that language problems in the early years may persist well into the school years and will likely affect academic performance in all areas. Table 7-1 provides a summary of the milestones of language development  The primary sources of data in this child assessment process are based on observation of the child’s play, parent input, and structured testing.  The clinician manipulates play situations to observe key behaviors and tests, aiming to accurately reflect the child's abilities. Ideal testing occurs in the child's natural environment with familiar toys and people.  The young child’s parents are active participants in the assessment process. They play a crucial role by providing information about the child’s history, skills, behaviors in various settings, and validating the clinician's observations.  Parent-child interactions are observed to gather representative language and behavioral samples. Parents can also be called on to administer test probes when the child is reluctant or shy. By asking the parents to see if the child can identify objects in a picture book during reading time. This makes the child feel more comfortable. The assessment for early intervention has been grouped into 3 broad categories 1. For nonverbal or preverbal children: clinicians assess behaviors such as gestures, vocalizations, eye contact, toy usage, words imitations, and pointing to named objects in the environment. 2. For minimally verbal children: additional factors like naming familiar objects, understanding words, using word combinations, grammatical morphemes (e.g., -ing, - s), the mean length of utterance and conversational turns are evaluated. 3. For a child who speaks in short phrases: the assessment includes evaluating their ability to follow multiple-step commands, use appropriate syntax, variety in descriptive words, clarity of speech, phonological processes, and ability to engage in back-and-forth communication. 4. For a conversational child: the assessment expands to include narrative ability, understanding humor, and responding to complex commands. Additionally, the clinician should assess broader aspects of language-learning aptitude, considering factors such as: the child’s temperament, attention span, coping behaviors, determination, ability to seek help, and visual focus on objects of interest.. Of particular interest to speech-language pathologists is the development of the concepts defined in the following list because they, in particular, are related to the ability to comprehend and use language: Imitation: Acknowledgement of the existence of a behavior and the ability to repeat it. Deferred imitation: Imitation of a behavior following a lapse of time. Means-end: Production of a volitional act to achieve a desired goal. Object permanence: An understanding that an object exists even though it is not currently seen. Functional use of objects: The use of an object as it was intended to be used. Symbolic play: The use of an object to represent something else. Late talker vs language Disordered Some children are late talkers or "late bloomers“ in verbal expression and it's hard to know whether they will have lasting Language impairments (language disordered)or outgrow them. Language delays not resolved by age 3, often persist throughout school years, exhibiting difficulties in various areas of language such as: Grammer, vocabulary, syntax pragmatics. Children with fewer than 50 expressive words or no words combination by age 2 are at higher risk for long-term language difficulties. Late talkers  Delayed language Development, but eventually catches up. Language disordered  Persist language difficulties even with intervention. Language Development survey (LDS): It's a productive tool for the identification of expressive language delays in toddlers. It's not a diagnostic tool, but a screening measure. ▪ Additional risk factors and developmental signs that help clinicians predict whether a child will or will not outgrow a language delay include: Family history of language disorders Medical conditions (e.g., frequent ear infections, hearing loss) Prematurity, especially with low birth weight Maternal drug or alcohol consumption Poor nutrition Minimal use of gestures Poor eye contact  Minimal use of gestures Poor eye contact Minimal smiling Reduced joint attention Lack of symbolic play Lack of curiosity or pointing out things of interest Delayed babbling Early phonological difficulties Limited and simplified syllable structures Limited phonetic inventories Frequent deletion of initial and final consonants Numerous vowel errors Substitution of /h/ or glottal consonants  Formal Assessment Testing involves assessing language proficiency using structured assessments that adhere to defined rules, often based on linguistic theories and research. These tests are designed to evaluate various language skills, such as grammar, vocabulary, reading comprehension, and writing, in a systematic and standardized manner. Formal assessments are standardized tests that have been scientifically developed and tested. Each test asset particular aspects of language E.g. semantic memory, Syntactic memory, Phonological memory, vocabulary. There are no tests that are right for all children or all Clinicians. otherwise on selecting appropriate tests. Each case is different, there is no one test or set of tests that are appropriate for all patients. Questions to Consider: How old is the client? What are the specific language concerns that need to be evaluated? What is the client’s ethnic background? How much time is available to administer the test? How well will the client be able to participate in testing? Is an insurance company, employer, or other agency requiring a certain test?. NOTE “ASHA (American Speech-Language-Hearing Association) stopped updating its directory of speech-language pathology assessment tools because there were too many new tools to include. It wasn't as helpful as it used to be for their members. “ Informal assessment:  is a valuable and flexible tool used in evaluating language skills through casual observations, and discussions that can be adapted to the individual’s needs rather than standardized tests.  It allows clinicians to delve deeper into specific language aspects and observe how a client uses language in real-life situations.  Cognitive abilities can also be considered. In some cases, informal assessment data is the primary source of diagnostic information.  Informal tasks can focus on receptive or expressive language skills and often require creativity from the clinician. The specific techniques used will depend on the child's age, language abilities, and the targeted behaviors to be assessed : Ask the child to: follow verbal commands count, recite the alphabet, or perform other serial tasks. name objects or pictures point to more than one of a named item. For example, “point to the pencils” (versus pencil). name items from a category or identify a category when provided examples. describe similarities and differences of objects. place an object (e.g., a block) over, under, and beside the table (to sample basic prepositional understanding). describe a picture, recount an event, or tell a short story. Tasks chosen vary depending on the individual’s : age current language skills examining their behaviors Language sampling and Analysis:  A good language sample may provide the most useful information about a client’s functional use of language.  By collecting and examining spontaneous language samples from individuals with communication difficulties to assess their skills, identify impairments, and tailor intervention strategies.  There are several aspects of collecting a language sample that are important for assessing language disorders Consider:  Language use.  Rate of speaking.  Sequencing of events.  Computerized profiling. Steps for sampling  Collect multiple samples.  They have to be representative.  Based on a real conversation.  In various contexts and activities (to assess different aspects of language).  Get other people involved in the interaction (such as the parent or friend).  Video-record the sample for later analysis. Analysis When analyzing the language sample, make observations about the following features of language: 1. Form of language: checking the child's sentences’ type and structure (one word or full sentence?/ active sentences only or also passive ones?) 2. Understanding of semantic intent: Does the child confuse words from different semantic classes? Does he respond well to different questions about different topics? 3. Language use: in communication and different settings by allowing the conversation to be efficient and taking turns. 4. Rate of speaking: pauses and silence (stuttering and cluttering). 5. Sequencing: Does the child relate events in a sequential fashion based on the order of occurrence? I.e. storytelling. Assessment of Morphologic Features:  To identify the morphologic structures a client uses correctly and incorrectly.  checking free and bound morphemes (for both inflection and derivational processes) if some features are missing in the sample of the client, use structured questions to identify them in the client's answers. Mean length utterance MLU  (MLU) is the average number of morphemes or words that produces in an utterance.  It is one indicator of a language delay or disorder.  This method of interpretation is very general and must, of course, be used with caution when diagnosing or ruling out language disorders. Remember, children develop language at varying rates. Roger Brown Made a classic study of pre-school age to understand the relation between MLU and language development. Brown’s stages of language development 1:2 years first words , linear simple sentences 2 : 2.5 years linear simple sentences with grammatical morphemes 2.5 : 3 years noun phrases, auxiliary verbs , different sentences modalities (e.g., questions ,negatives ,imperatives) 3 : 3.5 years complex sentences, embedding sentence elements Traditional method of calculating MLU MLU is to divide the number of morphemes by the number of utterances the MLU for words by dividing the number of words by the number of utterances(But this don’t reflect use of bound morphemes) 150 morphemes ÷ 50 utterances = 3.0 MLU Assessment of pragmatic skills: Pragmatics is the study of the use of language in communicative interactions. It refers to the social use of language in various contexts and refers to both the verbal and nonverbal behaviors that contribute to the appropriate use, adaptation, and interpretation of language in context based on practical rather than theoretical considerations. Pragmatic behaviors are helpful to assess pragmatic skills in a variety of situations. So, the assessment of pragmatic skills allows the clinician to assess 15 pragmatic behaviors in a semi structured manner. Several suggestions are provided for each behavior for eliciting pragmatic responses. Making a diagnosis: A child with a language disorder will typically demonstrate one or more of the following deficiencies : Delayed onset of Limited amount of Deficient cognitive language language skills Limited language Academic problems Poor listening skills comprehension A general Limited conversational Limited ability to inappropriate use of skills narrate experiences language Deficiencies in syntactic, semantic, and morphologic components ‫‪Group 1‬‬ ‫مريم مصطفى مسعد مصطفى‬ ‫مريم محمد هالل محمد‬ ‫مرام رجب سعدي‬ ‫محمد هشام محمد‬ ‫شهد محمد حسين‬ ‫عاليا سامح محمد محمد‬ ‫رحمة محمد حنفي عبد القادر‬ ‫روان فريد شوقي‬ ‫فيرونيا نادر سعيد‬ ‫روان حسين الشافعي‬ ‫نور حنا إبراهيم عيسى‬ ‫ريم عيد علي بالل‬ ‫فرحة عبد الوهاب‬ ‫روان أيمن‬ ‫حبيبة أشرف أحمد البدوي‬ ‫سلمى محمد عبد المنعم زهوي‬ ‫سماح محمود حسن محمود‬ Extra Resources “ASHA” https://www.asha.org/ “Directory of speech _language pathology “ https://www.asha.org/practice-portal/resources/assessment-tools-techniques-and- data-sources/  Thanks! 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