Communication Communication DisordersDisorders

By Carrie, Kathleen & MaggieBy Carrie, Kathleen & Maggie

Let’s Play Telephone!Let’s Play Telephone!

What is a Communication What is a Communication Disorder and Why is Disorder and Why is

Communicating Effectively Communicating Effectively Important?Important?

• Failing to transfer information from one person to another.

• Students with a CD frequently perform below grade level.

Frequency of Frequency of Communication DisordersCommunication Disorders

• 1 in 6 (16%) people in the U.S. has a communication disorder. That is approx. 42 million people.

• 10% of our population has a functional speech disorder, of which 8% to 9% of those require treatment.

A Look at Pinellas County A Look at Pinellas County StatisticsStatistics

Pinellas County has approx. 104,000 preK-12 public school students. 16% of 104,000 is approx. 16,640 students with a CD.

Speech and Language Speech and Language DisordersDisorders

• Speech Disorder – Difficulty producing sounds, as well as disorders of voice quality.

*Example: Stuttering

• Receptive Language Disorder – Difficulty comprehending what is said.

• Expressive Disorder - Difficulty using spoken language.

English as a Second English as a Second LanguageLanguage

• A language difference is not the same as a disorder. However, not speaking English can be an impediment to effective learning.

• A foreign dialect can be a problem for non-native English speakers.

Typical DevelopmentTypical Development

Five Components to Language System• Phonology – The use of sounds to make

meaningful syllables & sounds.

• Morphology – The system that governs the structure of words.

• Syntax – Rules for putting together a series of words to form sentences.

• Semantics – The meaning of what is expressed.

• Pragmatics – The use of communication in context.

Determining the CausesDetermining the Causes

• Organic Causes – Identifiable problem in the neuromuscular system.

• Functional Disorder – No identifiable neuromuscular cause.

Effects Of Socio Economic Status Effects Of Socio Economic Status (SES)(SES)

• There is a discrepancy between low SES (often including ELL) and high SES student achievement.

“On Average, children from low-income families acquire language at a slower rate & demonstrate both differences in language use and poorer language skills than children from higher income families. Low SES is also a correlate of the diagnosis of specific language disorders.”

--The MIT Encyclopedia of Communication Disorders, Raymond Kent

Speech DisordersSpeech Disorders

• Includes disorders of articulation, voice and fluency.

Articulation DisordersArticulation Disorders

• Most common disorder among the youngest students.

• Substitutions – For example, sounds such as /d/ for /th/. DOZE for THOSE.

• Omissions – Leaves a phoneme out of a word. For example “ap” for apple.

• Additions – Adding a vowel between two consonants. Ger-een for green.

Distortions – Distortions – Not producing a Not producing a phoneme correctly. Often a lisp.phoneme correctly. Often a lisp.

http://www.youtube.com/watch?v=hwjO-vWo4Ochttp://www.youtube.com/watch?v=hwjO-vWo4Oc

Speech Apraxia – Speech Apraxia – The brain The brain knows what it wants to say, but can’t deliver knows what it wants to say, but can’t deliver

the message to the mouth.the message to the mouth.http://www.youtube.com/watch?v=tYmm23EPXjUhttp://www.youtube.com/watch?v=tYmm23EPXjU

Voice DisordersVoice Disorders

• Pitch

• Intensity

• Resonance

Fluency DisorderFluency Disorder

• Fluency – The rate and rhythm of speaking.

Language ImpairmentsLanguage Impairments• Phonology - Unable to differentiate between

sounds. For example, BAT and PAT.

• Morphology - Trouble with the structure of words. For example, adding an ED to signify past tense.

• Syntax – Trouble constructing a sentence.

• Semantics – Relates to the meaning of a sentence.

• Pragmatics – Social use of language.

Evaluating Students with Evaluating Students with Communication DisordersCommunication Disorders

Determining the Presence Determining the Presence of Communication of Communication

DisordersDisorders

1. Observation• Parents & Teachers

*Child has difficulty utilizing & comprehending language.

*Child has difficulties with speaking clearly.

• Medical Personnel*Child not achieving developmental milestones

related to communication skills.*Change in communication skills.

Determining the Presence of Determining the Presence of Communication Disorders Communication Disorders

(cont.)(cont.)2. Screening (Also described as an

“Intervention” by many school districts)

• Classroom Work -- Child may be afraid to participate verbally in class due to disability. Written work may be safer form of expression.

• Vision Screening -- Limited vision may impact communication skills.

• Hearing Screening -- Child may have hearing loss or history of inner ear infection.

Determining the Presence of Determining the Presence of Communication Disorders Communication Disorders

(cont.)(cont.)3. Prereferral

• Implementation of suggestions from a school-based team.

*Teachers model speech sounds, increase student’s language.

*Parents may implement suggestions from the team if child has been identified before entering school.

4. Referral• Child referred to multidisciplinary team if he

or she still performs poorly in academics or continues to have communication impairments.

Determining the Presence of Determining the Presence of Communication Disorders Communication Disorders

(cont.)(cont.)5. Nondiscriminatory Evaluation Procedures and Standards

•Speech Assessments*Articulation – evaluates student’s ability to produce speech sounds in single words, sentences and conversation. Appearance, strength and abilities of lips, tongue, palate and jaw are also evaluated at this time (Oral Motor Exam).

*Voice – evaluates voice problems and factors affecting voice quality such as pitch, intensity, nasality.

*Fluency – measures the amount of dysfluency (impairment of the ability to produce smooth, fluent speech)and duration of dysfluency while student is speaking.

Determining the Presence of Determining the Presence of Communication Disorders (cont.)Communication Disorders (cont.)

• Language Assessments

*Focus on phonology, semantics, syntax and overall expressive/receptive language.

*SLP observes child in different environments and with different people including friends, teachers, classmates.

Determining the Presence of Determining the Presence of Communication Disorders (cont.)Communication Disorders (cont.)

6. Determination• SLP determines if the

child has a communication disorder and if this disorder affects the child’s learning.

• SLP utilizes culturally sensitive therapies for bilingual students.

Multicultural Multicultural ConsiderationsConsiderations

• Bilingual or multilingual students need specialized speech/language assessments. Difficult to make fair assessments of these students.

• Should the student be tested in their native language or in English?

• SLP normally tests students in their dominant language.

• SLP must determine – Is it a language difference or a disability?

Role of Speech Language Role of Speech Language Pathologists Pathologists

Direct contact with students is majority of workload.

Programming augmentative communication devices and educating paraprofessionals on how to use them.

Align IEP goals with teachers and paraprofessionals.

The American Speech-Language-Hearing Association identified four different types of activities that SLP’s use in schools:

1. Direct services to schools2. Indirect services to implement student’s

education programs3. Indirect services to support students in

the general education curriculum4. Activities as members of the community

of educators

A Speech Language A Speech Language Pathologist Speaks About Pathologist Speaks About

Student AssessmentStudent Assessmenthttp://www.youtube.com/watch?v=Ssz_cutETTE&list=FLs36MXXg507Hju44DEWLTZQ&index=http://www.youtube.com/watch?v=Ssz_cutETTE&list=FLs36MXXg507Hju44DEWLTZQ&index=1&feature=plpp_video1&feature=plpp_video

Accommodations in the Accommodations in the ClassroomClassroom

PresentationPresentation• Do adaptations need to be made to

instruction & materials? *Keep a slow paced delivery & speak

clearly (If needed, allow students to tape the lecture on a recorder.)

*Provide step by step directions *Use visual support to help the student

understand (gestures, pictures, printed handouts, graphic organizers)

*Stay well-organized. Don’t rush transitions to new topics & activities

The Importance of Graphic Organizers

• During a lecture, they provide a visual representation and can be used as a reference during discussions later on.

• During reading, they help guide organization and make great study guides.

• Visually links together groups of important information for the students!

ResponseResponse• Do adaptations need to be made to

assignments & assessments in order for students to successfully participate?

*Allow student extra time to verbally respond to questions. (Cues and advanced notice can be used to help students prepare and reduce anxiety)

*Written assignments & exams might be used in place of oral presentations or reports.

*Multiple choice/True & False formats can be used to avoid long written or oral responses.

*Extra time might also be needed for tests.

SettingSetting

• Do adaptations need to be made to the learning environment?

*Reduce noise and talking in the classroom.

*Have the student sit at the front of the class during instruction & lectures.

*Alternate ways for student to contribute vocally to class & group discussions.

*Allow use of special communication devices.

Assistive TechnologyAssistive TechnologyAlternative Vs. Augmentative Alternative Vs. Augmentative

Low tech Vs. Hi Tech Low tech Vs. Hi Tech

• Kidsperation Software • Portable Communication Devices (Go talk systems, Iphone/Ipad Apps.)

• Graphic Organizers

• Communication Message Boards

• Communication Bracelets

• Picture Books/Boards

ELL Students with ELL Students with Communication Communication

DisordersDisorders• Use pictures as often as possible, visual images are much easier to understand than audio. • Collaborate with the ESL teachers, SLPs & parents on objectives and goals.• Consider the cultural and linguistic factors that affect delivery.• Encourage Peer Buddies and class interactions.

You Can Conquer Communication Disorders!

Just Ask these Familiar Faces!