Speech & Language Impairment

Created by: Kathryn Hansraj

Definition: IDEA 2004

The Individuals with Disabilities Education Act, or IDEA, defines the term “speech or language impairment” as follows:

“(11) Speech or language impairment means a communication disorder, such as stuttering,

impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s

educational performance.” [Code of Federal Regulation, Title 34, Section 300.8(C)(11)]

Source gathered from: IDEA

Criteria for DiagnosisAmerican Speech-Language-Hearing Association (ASHA) indicates that, Speech-Language assessment includes these components:Case history, including medical status, education, socioeconomic, cultural, and linguistic backgrounds and information from teachers and other related service providers. Patient/client/student and family interview. Review of auditory, visual, motor, and cognitive status.  Standardized and/or non-standardized measures of specific aspects of speech, spoken and non-spoken language, cognitive-communication, and swallowing function. This also includes observations and analysis of work samples. Follow-up services to monitor communication and swallowing status and ensure appropriate intervention and support for individuals with identified speech, language, cognitive-communication, and/or swallowing disorders.  

Those that work in medical professions use the International Classification Codes of Diseases (ICD). ICD-9 is typically used by speech pathologist to make specific diagnoses of disorders. The following is a list of ICD diagnoses:

Aphasia: loss of a previously held ability to speak or understand spoken or written language, due to disease or injury of the brain. Aphonia: loss of voice, especially due to an organic or functional disturbance of the vocal organs. Apraxia of speech: speech disorder in which a person has trouble saying what he or she wants to say correctly and consistently. The severity of apraxia of speech can range from mild to severe.Auditory processing disorderDevelopmental ArticulationDevelopmental Language DisorderDisorders of Written ExpressionDysarthria: disorders of articulation, as stammering or stuttering, caused by a nerve defect. Expressive language disorderInfantile AutismOtitis Media: inflammation of the middle ear, characterized by pain. Dizziness, and impaired hearing. Social Impairment (Symbolic Dysfunctions)Stuttering or StammeringVoice Disturbances

ICD diagnoses: Used by speech pathologist

Characteristics of SpeechCommunication is considered delayed when the individual is noticeably behind his or her peers in the acquisition of speech and/or language skills.

Speech

-Sometimes a child will understand better, rather than speaking, however this is not always the case.

-People with speech or language impairments have trouble using some speech sounds, which can also be a symptom of delay. For example, they may say “tea” when they mean to say “tree” or they may have trouble using other sounds like “r” or “I”.

-People listening to someone with speech or language impairment may have difficulty understanding that the individual is trying to say. (This was the case for my baby cousin Joshua, who at the age of 5 was seen a speech pathologist because it was hard to understand his verbal communication).

-People with speech or language impairment could also have trouble with the way their voices sound.

Characteristics of Language Language

-Improper use of words and their meanings

-Inability to express ones ideas,

-Inappropriate grammatical patterns, low vocabulary and inability to comprehend directions. Some of these characteristics may combine, especially when the individual shows signs of developmental language delay.

(In Joshua’s case, he was being confused from the three spoken languages that surrounded him. At home he would listen to his parents speak English and Spanish. However, in his daycare where he spent most of his time during the day the teachers spoke French. Joshua would come home and speak in bits and pieces of Russian.)

Source gathered from: School-psychology

-The prevalence of speech sound disorder in young children is 8 to 9 percent. By the first grade, roughly 5 percent of children have noticeable speech disorders; the majority of these speech disorders have no known cause. -It is estimated that more than 3 million Americans stutter. Stuttering affects individuals of all ages but occurs most frequently in young children between the ages of 2 and 6 who are developing language.  -Between 6 and 8 million people in the United States have some form of language disorder.  -About one million persons in the United States have aphasia (partial or complete impairment of language comprehension and expression caused by brain damage, most often from stroke). - Research suggests that the first 6 months are the most crucial to a child's development of language skills. For a person to become fully competent in any language, exposure must begin as early as possible, preferably before school age. - More than 160 cases of Landau-Kleffner syndrome (LKS)—a childhood disorder involving loss of the ability to understand and use spoken language—have been reported from 1957 through 1990. Source gathered from: National Institute on Deafness and Other Communication Disorders (NIDCD)

Prevalence

Etiology

Causes of speech and language impairments include hearing loss, brain injury, neurological disorders, intellectual disabilities, physical impairments such as cleft lip or palate, drug abuse, and vocal abuse

or misuse. However, in most cases the cause is unknown. On their website, Saint Elizabeth Regional Medical center highlight that: “There are a variety of causes of speech and language disorders.”

-Congenital syndromes-Disorders of the prenatal environment-Syndromes acquires after birth-Factors that may contribute to a speech-language disorder.

Academic - Peterson (2011) did a systematic review on the body of research that focuses on narrative-based language intervention for preschool and school age children with language impairment. He searched electronic databases that have been published since 1980. Results led author to find that nine studies met inclusion criteria.

 Literature

-Helfman (1992), observed a twelve-year-old girl by the name Sarah. Sarah is in a wheelchair and uses a communication board to speak because she has spastic cerebral palsy. The story tells about her frustration with her inability to speak the words that are “in her head.”

Research

- Kasper et al., (2011) conducted a study that evaluated the effectiveness of a systematic population based screening program for specific language impairment (SLI) in a preschool in Germany. The findings of the study showed indications of short-term positive effects from language therapies in children with SLI.

Specific Literature & Research regarding speech & language impairment

Educational Approaches IEP: If the student is found to have a disability under IDEA—such as

speech-language impairment—school staff will work with his or her parents to develop an Individualized Education Program, or IEP.

Provide speech-language pathology services: Almost every student with speech or language impairment will need speech-language benefit from

these services. IDEA defines this service as: 

(15) Speech-language pathology services includes—(i) Identification of children with speech or language impairments;(ii) Diagnosis and appraisal of specific speech or language impairments;(iii) Referral for medical or other professional attention necessary for the habilitation of speech or language impairments;(iv) Provision of speech and language services for the habilitation or prevention of communicative impairments; and(v) Counseling and guidance of parents, children, and teachers regarding speech and language impairments. [Code of Federal Regulation, Title 34, Section 300.34(C)(15)]

Source gathered from: IDEA

Assistive technology (AT): is another educational approach that is very helpful for students. Especially, for students whose physical condition makes it difficult for them to communicate with others. There are a wide range of devices to help assist students with a speech and language impairment. Some of them are: Electronic communication system- this would allow nonspeaking students to engage and share their thoughts. Ipads, computers, dry-erase boards, dictionary, etc. -ACC: is the use of symbols, aids, strategies, and techniques that can help enhance the communication process. Sign Language and other communication boards can help a student who has speech or language impairment.

Educational Approaches continued…

Teachers with students who have speech or language impairment

Teacher’s attitude:

It’s important that teachers with students with speech or language impairment include and engage them in all classroom activities. When it comes to communicating with a students with speech or language impairment the following should be kept in mind:

Be patient with the student, do not rush her or him to finish their sentence. (Also if you try and complete words or phrases for the student it may cause frustration on the student).

Avoid correcting improper speech or language usage. This can make the student feel embarrassed. It’s important to model correct speech patterns.

It’s important to focus on the content of the conversation, rather than how it was delivered. As long as you can make meaning and understand what the student is saying.Try to communicate with the student in a natural setting where they may feel comfortable.

Classroom Implementation:  There are several things a teacher can do help foster a positive learning environment for a student with speech or language impairment. -Provide the student pen, crayons, markers, or even dry erase boards.-If possible allowing the student to use a computer or ipad that has word processor or word prediction software can also be very helpful to the student.

-Perhaps incorporate the use of social media in order to get the student to interact with their peers and have the opportunity to share her or his thoughts. For example: a teacher can use a blogging website and require students to make post. A student with speech or language impairment may feel more comfortable and open to share his or her thoughts, views and feelings in digital format.

 Classroom setting:

-Teachers can reduce unnecessary classroom noise as much as possible. (This helps the child focus without distractions).-Repeat instructions and provide verbal cues so that students can have the chance to hear. Speak slowly and deliberately. -Also utilizing visual cues can be helpful to the student motivate the student to share or speak.

Educational approaches in the classroom

References Assessment and Evaluation of Speech-Language Disorders in Schools. (n.d.).

Assessment and Evaluation of Speech-Language Disorders in Schools. Retrieved October26, 2013, from http://www.asha.org/SLP/Assessment-and-Evaluation-of-SpeechLanguage-Disorders-in-Schools/

Causes of speech and language disorders. (n.d.). Saint ElizabethRegional Medical Center. Retrieved October 26, 2013, fromhttp://www.saintelizabethonline.com/index.php?option=com_content&taskview&id=294 

Helfman, E. S., & Saffioti, L. (1992). On being Sarah. Morton Grove, Ill.: A. Whitman. 

IDEA - Building The Legacy of IDEA 2004. (n.d.). IDEA - Building The Legacy of IDEA 2004. Retrieved October 26, 2013, from http://idea.ed.gov/explore/voew/p/%2Croot%2Cregs%2C300%2CA%2C300%252E8%2Cc%2C11%2C 

IDEA - Building The Legacy of IDEA 2004. (n.d.). IDEA - Building The Legacy of IDEA 2004. Retrieved October 28, 2013, from http://idea.ed.gov/explore/view/p/%2Croot%2Cregs%2C300%2CA%2C300%252E34%2Cc%2C15%2C Jupo, F. (1967). Atu, the silent one.. New York: Holiday House. 

Kasper, J., Kreis, J., Scheibler, F., Möller, D., Skipka, G., Lange, S., & von dem Knesebeck, O. (2011). Population-Based Screening of Children for Specific Speech and Language Impairment in Germany: A Systematic Review. Folia Phoniatrica Et Logopaedica, 63(5), 247-263. doi:10.1159/000321000 

Marshall, J., Stojanovik, V., & Ralph, S. (2002). 'I never even gave it a second thought': PGCE students' attitudes towards the inclusion of children with speech and language impairments. International Journal Of Language & Communication Disorders, 37(4), 475-489. doi:10.1080/1368282021000008892 

Petersen, D. B. (2011). A Systematic Review of Narrative-Based Language Intervention With Children Who Have Language Impairment. Communication Disorders Quarterly, 32(4), 207-220. doi:10.1177/1525740109353937 

Speech and Language Disorders. (n.d.). School Psychology. Retrieved October 27, 2013, from http://school-psychology.org/speech-and-language disorders 

Statistics on Voice, Speech, and Language. (n.d.). Statistics and Voice, Speech, and Language [NIDCD Health Information]. Retrieved October 27, 2013, from http://www.nidcd.nih.gov/health/statistics/Pages/vsl.aspx

  

References continued…

A few questions for you:Do you know someone who has speech or language impairment? If yes, can you explain what it’s like trying to communicate with this individual?

 What are your thoughts as an educator on teaching students who may

have speech or language impairment? (Would you feel frustrated, unprepared, and confident or open-minded? (Please elaborate on your

response.) 

As an educator what could you do to encourage other students to interact and communicate positively with students with speech or language

impairments? 

How may speech or language impairment affect the school performance of a student?