Lesson 5: Communication and Learning Disorders PDF

LESSON 5: Communication and Learning Disorders Psychology of Exceptional Children Rhalf Jayson F. Guanco, Ph.D, RPsy, RPm, CSDP Definitions and History Learning disability: learning problems that occur in the absence of other obvious conditions – The term has been replaced in the DSM-5...

LESSON 5: Communication and Learning Disorders Psychology of Exceptional Children Rhalf Jayson F. Guanco, Ph.D, RPsy, RPm, CSDP Definitions and History Learning disability: learning problems that occur in the absence of other obvious conditions – The term has been replaced in the DSM-5 by more specific terms, communication disorders and learning disorders – Affects how individuals of at least normal intelligence take in, retain, or express information Categories of Communication Disorders Language disorder Speech sound disorder Childhood-onset fluency disorder Social (pragmatic) communication disorder Specific Learning Disorder Co-occurring problems in: – Reading – Math – Written expression Determined by achievement test results that are lower than would be expected for one’s age, schooling, and intellectual ability Language Development Infants selectively attend to parental speech sounds By age 1, a child can recognize several words as well as say a few words to express needs and emotions Over the next two years, language development increases exponentially along with the ability to formulate complex ideas and express new concepts Language Development (cont’d.) Perceptual maps are formed in the brain when children hear phonemes (basic sounds) repetitively – By 6 months - infants differentiate their own language from other languages – By age 1 - the map is complete and infants have lost the ability to discriminate sounds not important to their own language Phonological Awareness Language development – Early language problems are highly predictive of subsequent communication and learning disorders and should not be ignored Phonology – Deficits in phonology are a chief reason that individuals develop communication and learning disorders – About 80% of children can use phonemes properly by the age of 7 Phonological Awareness (cont’d.) Phonological awareness – Broad construct that includes recognition of the relationship that exists between sounds and letters – Detection of rhyme and alliteration – Awareness that sounds can be manipulated within syllables Communication Disorders Diagnostic subcategories in the DSM-5 – Language disorder – Speech sound disorder – Childhood-onset fluency disorder – Social communication disorder Language Disorder (LD) Characterized by deficits in expression despite normal comprehension of speech – LD occurs when a child’s language matures at least 12 months behind his or her chronological age Children with LD often have: – Delayed/slowed speech development; limited vocabulary; and speech marked by short sentences and simple grammatical structure Diagnostic Criteria for Language Disorder Diagnostic Criteria for Language Disorder (cont’d.) Language Disorder (cont’d.) Linguistic abilities vary significantly among those with LD Children with LD may have difficulty understanding particular types of words or statements Speech sound disorder – difficulty with articulation or sound production Prevalence and Course of Language Disorder Language disorder affects 7% of younger school-age children Communication disorders are identified twice as often in boys than girls Most children acquire normal language by adolescence 50% fully outgrow the problems LD is associated with higher-than-normal rates of Causes of Language Disorder Genetics – Temporal processing deficits Brain – Circular feedback loop in the left temporal lobe – Problems in connections between brain areas and less brain activity in left temporal region Areas of the brain involved in language functions Other Causes of Language Disorder Recurrent middle ear infections (otitis media) in first year of life may lead to speech and language delays Home environment – It is unlikely that communication disorders are caused by parents Except in cases of extreme neglect and abuse Treatment of Language Disorder LD and other similar communication disorders usually self-correct by age 6 and may not require intervention Strategies for parents to stimulate language development – Enroll child in a specialized preschool Using a combination of computer- and teacher-assisted instruction to teach early academic skills – Build on the child’s existing strengths Childhood-Onset Fluency Disorder The repeated and prolonged pronunciation of certain syllables that interferes with communication Prevalence and course – Gradual onset between ages 2 and 7; peaks at age 5 – About 3% of children are affected – Affects males about three times more often than females – 80% of those who stutter before age 5 stop after a Causes and Treatment of Childhood-Onset Fluency Disorder Genetic factors account for 70% of variance in causes Environmental factors account for remaining influences Possible treatments – Parental changes - speak to the child slowly in short sentences – Contingency management procedures – Habit reversal procedures Social (Pragmatic) Communication Disorder New addition to DSM-5 Persistent difficulties in pragmatics (social use of language and communication) Diagnostic Criteria of Social Communication Disorder Diagnostic Criteria of Social Communication Disorder (cont’d.) Specific Learning Disorder A discrepancy of more than two standard deviations between the IQ findings and the actual achievement test findings in a child Learning disorders include reading, mathematics, and writing The different learning disorders overlap and build on the same brain functions – A person can have more than one form of learning disorder SLD With Impairment in Reading Most common underlying feature is the inability to distinguish or separate sounds in spoken words Involves difficulty learning basic sight words, such as: the, who, what, laugh, said SLD With Impairment in Reading (cont’d.) Errors in reversals (b/d, p/q), transpositions (was/saw, scared/sacred.), inversions (m/w, u/n), and omissions (place for palace, section for selection) – These errors are common in young children Core deficits in reading disorders are in decoding rapidly enough to read the whole word – coupled with problems reading single, small words SLD with Impairment in Written Expression Writing disorders are often associated with problems with eye/hand coordination – Leads to poor handwriting Children with writing disorders: – Produce shorter, less interesting, and poorly organized essays – Are less likely to review spelling, punctuation, and grammar to increase clarity Impairment with Written Expression Example SLD With Impairment in Mathematics Difficulty in recognizing numbers and symbols, memorizing facts, aligning numbers, and understanding abstract concepts May include problems in comprehending abstract concepts or in visual-spatial ability Involves core deficits in arithmetic calculation and/or mathematics reasoning abilities Example of SLD With Impairment in Mathematics Prevalence and Course of SLDs Estimates: 2-10% of the population SLD with reading impairment – 5-17% of school-aged children – Reading difficulties may be part of reading abilities continuum, rather than a discrete phenomenon Prevalence and Course of SLDs (cont’d.) SLD with impairment in mathematics – 20% of children with learning disorders (1% of school-age children) SLD with impairment in written expression – Rare by itself – Overlap with reading and math disorders – May affect 10% of school-age children Cultural, Class, and Gender Variations in SLDs Social and cultural factors are less relevant to LDs than other types of cognitive and behavioral problems – The disorders reflect an interaction between a child’s inherent abilities and resources/opportunities available When learning to read, some teaching approaches neglect specific ethnic sound-symbol relationships SLDs are more common in males Development of SLDs Daily experience of being labeled and unable to keep up can cause children to withdraw or become angry and noncompliant Three-fourths of children with a reading disorder in elementary school continue to have problems in high school and young adulthood Psychological and Social Adjustment Students with reading disorders feel less support from parents, teachers, and peers Difficulty in managing a child with SLD – Behavior problems are about three times higher than the norm by age 8 – Co-occurring problems across ages: CD, ODD, and ADHD – About three of every four students have Percentage of Behavior Problems Among Children With and Without SLDs Adult Outcomes of SLDs May continue into adulthood because of inadequate recognition and services Many excel in nonacademic subjects Men with learning disorders perceive lower levels of social support Women with learning disorders have more adjustment problems and face greater risk of sexual assault and related forms of abuse Causes of SLDs Difficulties bringing information from various brain regions together to integrate and understand information Recent findings suggest two distinguishable types of reading disorder – Children who are persistently poor readers – Children who are accuracy-improved Heritability accounts for 60% of variance in reading Neurobiological Causes of SLDs Reading and language-based problems are associated with cellular abnormalities in the brain’s left hemisphere – This part of the brain is responsible for understanding phonemes, analyzing words, and automatically detecting words Neurobiological Causes of SLDs (cont’d.) Behavioral and physiological abnormalities in the processing of visual information Non-verbal learning disabilities are associated with deficits in right-hemisphere brain functioning How the Brain Processes Speech Social and Psychological Causes of SLDs Co-occurring emotional disturbances and other signs of poor adaptive ability – The overlap between dyslexia and ADHD ranges from 30-70% – Reading disorder is associated with deficits in phonological awareness – ADHD has effects on cognitive functioning, especially in rote verbal learning and memory Prevention and Treatment Interventions rely primarily on educational and psychosocial methods No biological treatments exist Issues of identification are important – There is a brief window of opportunity for successful treatment Prevention involves training children in phonological awareness activities at an early age The Inclusion Movement Integrate children with special needs into the regular classroom – Individuals with Disabilities Education Improvement Act (IDEA) in U.S. and provincial Educational Acts in Canada – No Child Left Behind (2002) – 14% of school-age children in the U.S. receive some level of support through special education Instructional Methods Direct instruction is best for children with LDs Early interventions must address phonological and verbal abilities Effective reading instruction focuses on: – Phonemic awareness and phonemic decoding skills, fluency in word recognition, construction of meaning, vocabulary, spelling, and writing Behavioral and Cognitive Treatments Behavioral principles of learning are used to teach systematically – Used in conjunction with complete program of direct instruction Cognitive-behavioral approaches – Teach children to monitor their own thought processes – Emphasize strategies such as self-monitoring, self- Computer-Assisted Learning Provides more academic engagement and achievement than traditional pencil-and-paper- methods – Compute programs slow down grammatical sounds allowing young children to process them more slowly and carefully