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Communication and language disorders


in young learners
Receptive disorders hearing impairment,
problems in differentiating between sounds,
problems with verbal comprehension
Expressive disorders - articulation disorders,
fluency and stuttering, voice disorders
Cognitive-communication disorders attention,
memory and problem-solving disorders

Receptive Language Disorder (Language


Comprehension Deficit)
Receptive language disorder means the child has
difficulties with understanding what is said to them usually begin before the age of four years.
Children need to understand spoken language before they
can use language effectively
a child has difficulties understanding what is said to them.
In most cases, the child also has an expressive language
disorder, which means they have trouble using spoken

Receptive Language Disorder (Language Comprehension Deficit)

It is estimated that between three and 5% of


children have a receptive or expressive language
disorder, or a mixture of both.

Hearing tests are required to make sure the


problems aren't caused by hearing loss.

Treatment options include speechlanguage therapy.

Symptoms of Receptive Language Disorder


There is no standard set of symptoms that indicates receptive
language disorder, since it varies from one child to the next.
not seeming to listen when they are spoken to

appearing to lack interest when storybooks are read to


them

inability to understand complicated sentences

inability to follow verbal instructions

parroting words or phrases of things that are said to them


(echolalia)
language skills below the expected level for their age.

Cause of Receptive Language Disorder


is often unknown, but is thought to consist of a number of factors
working in
combination
- the childs genetic susceptibility
- the childs exposure to language
- general developmental and cognitive (thought and understanding)
abilities
Receptive language disorder is often associated with
developmental disorders such as autism or Down syndrome.
-

receptive language disorder is caused by brain injury such as trauma,


tumour or disease

- For some children, difficulty with language is the only developmental


problem they experience.

Treatment for Receptive Language Disorder


The childs progress depends on a range of individual factors, such as whether
or not brain injury is present.
Treatment options may include: speech-language therapy
one-on-one therapy as well as group therapy, depending on the needs of
the child
providing information to families so that they can facilitate language growth
at home
special education classes at school
integration support at preschool or school in cases of severe difficulty
referral to a psychologist for treatment (only if there are also significant

EXPRESSIVE LANGUAGE DISORDER


Expressive language disorder means a child has
difficulty conveying information in speech, writing,
sign language or gestures.
The child may not use correct grammar, may
produce very short phrases and sentences, and may
have a small vocabulary.
A speech pathologist usually assesses and treats this
impairment

Expressive Language Disorder


Expressive language
disorder means a
child has difficulty
conveying or
expressing
information in
speech, writing, sign
language or gesture.

Some children are late in


reaching typical language
milestones in the first three
years, but eventually catch up
to their peers.

For preschool
children, the
impairment is not
evident in the written
form, since they have
not started formal

Children who continue to have


difficulty with verbal
expression may be diagnosed
with expressive language
disorder or another language
impairment

These children are commonly


referred to as late-talkers.

Symptoms of Expressive Language


Disorder
Symptoms differ from one child to the next, but can include:
frequently grasping for the right word

using the wrong words in speech


making grammatical mistakes
relying on short, simple sentence construction
relying on stock standard phrases
inability to come to the point of what theyre trying to say
problems with retelling a story or relaying information
inability to start or hold a conversation

Symptoms of Expressive Language Disorder


have difficulties with the grammatical aspects of spoken language such as
using the correct verb tense (they might say I go when they mean I went)
and combining words to form accurate phrases and sentences
produce much shorter phrases and sentences than other children of the same
age, and their vocabulary (the number of words they know and use) is smaller
and more basic
usually below the average level for their age in: Putting words and sentences
together to express thoughts

using language inappropriately in a variety of settings with different people


(for example,
at home, in school, with parents and teachers)
Sounding hesitant when attempting to converse
Being unable to start or hold a conversation and not observing general rules
of communicating

Cause of Expressive Language Disorder


- expressive language disorder is associated with known developmental
difficulties or impairments (for example, Down syndrome, autism or
hearing loss).
- many children with expressive language disorder will have an
accompanying receptive language disorder, meaning that they have
difficulty in understanding language.
- can be a developmental (from birth) or acquired impairment.
An acquired impairment occurs after a period of normal development
- It can be the result of trauma or a medical condition
- Research suggests that in some cases expressive language disorder is
a genetic impairment (found frequently in more than one family member
and across generations).

Diagnosis of Expressive Language Disorder


language skills assessed by a speech pathologist (speech therapist).
Do not delay an assessment, because the child may miss many
months of important therapy. It is also important to have childs
hearing assessed.
Speech pathologists perform specific assessments to identify the
areas of language that a child finds difficult. These assessments are
not stressful for the child, and parents are usually present during
these consultations.
Speech pathologists may also recommend:
o

An auditory processing test (this is different to a standard


hearing test)
o
A test for learning difficulties (for school-aged children)
o
An assessment of cognitive function (thinking and
o
intelligence by a registered psychologist.

Treatment for Expressive Language Disorder


Treatment options depend on the severity of the impairment.
Treatment may include: Group sessions with a speech
pathologist
Individual therapy sessions with a speech pathologist
School-based language intervention programs
Assistance from special education teachers
Teachers aide support for children with severe language
impairment
Speech pathology sessions combined with home programs
that
parents can use with their child.

COMMUNICATION DISORDERS
-

include problems related to speech, language and auditory processing.


Communication disorders may range from simple sound repetitions such as
stuttering to
occasional misarticulating of words to complete inability to use speech and
language for
communications (aphasia).
-

hearing loss, neurological disorders, brain injury, mental retardation, drug


abuse, physical impairments such as cleft lip or palate, emotional or
psychiatric disorders, and developmental disorders.

estimated that one in every 10 Americans, across all ages, races and
genders, has experienced or lived with some type of communication disorder
(including speech, language and hearing disorders).

Nearly 6 million children under the age of 18 have a speech or language


disorder

Communication disorders can be grouped


into two main categories:
Hearing Disorders - People with Hearing Disorders do not
hear sounds clearly. Such disorders may range from
hearing speech sounds faintly, or in a distorted way, to
profound deafness.
Speech and Language Disorders - these disorders
affect the way people talk and understand. These
disorders may range from simple sound substitutions to
the inability to use speech and language at all.

What Are the Signs of a Communication


Disorder?
Hearing
Hearing loss might be suspected when a person does not always
hear sounds such as telephone or doorbell ringing, turns his or
her ear toward the source of sound, frequently asks the speaker
to repeat, turns the TV or radio up too loud, or shows obvious
signs of confusion or misunderstanding of speech.
Speech and Language
Disorders might be present when a person's speech or language
is different from that of others of the same age, sex, or ethnic
group; when a person's speech and/or language is hard to
understand; when a person is overly concerned about his or her
own speech; or when a person frequently avoids communicating
with others.

Common Communication Disorders


Hearing
Conductive: sound is not conducted efficiently through the
outer and/or middle
ear, causing speech and other sounds to be heard less clearly
or to sound
muffled - can often be medically or surgically corrected.
Sensorineural: caused by damage in the inner ear or nerve
pathways to the
brain. Certain sounds are heard less distinctly than others,
causing distortion and
reduced understanding of speech - not medically correctable often be helped
by using a hearing aid or other amplification device.

Common Communication Disorders


Language

Delayed Language: a noticeable slowness in the


development of the vocabulary and grammar
necessary
for expressing and understanding thoughts and ideas.

Aphasia: the loss of speech and language abilities


resulting from stroke or head injury.

Common Communication Disorders


Speech Disorders
Stuttering: an interruption in the rhythm of speech
characterized by
hesitations, repetitions, or prolongations of sounds, syllables,
words, or
phrases, for example, cow . . . boy, tuh-tuh-tuh-table, ssssun.
Articulation Disorders: difficulties with the way sounds are
formed and strung
together usually characterized by substituting one sound for
another (wabbit
for rabbit), omitting a sound (han for hand), or distorting a
sound (shlip for sip).
Voice Disorders: inappropriate pitch (too high, too low, never

What is stuttering?
Stuttering, sometimes referred to as stammering or diffluent speech, is a speech
disorder. This may include repeating words or phrases, poor pronunciation of words,
leaving out words or sounds and speaking some words that are hard to recognize.

True stuttering may occur in a child who has some normal developmental speech
problems but is pressured to speak better. This child then becomes aware of his or
her speech and struggles to speak better, which actually makes the speech worse.

While every child is different and will learn to speak at different times, the following
are some of the speech styles that are part of true stuttering:
Repeating words, sounds, or syllables.
Talking slowly or with a lot of pauses.
The rate of speech is not even.
An increase in the stuttering when the child is tired, excited or under stress.
A child that is afraid to talk

Fluency disorders, also called rhythm disorders occur when


an individual speaks in an uneven rhythm.
Naturally flowing speech moves at an appropriate rate with an
easy rhythm and smoothness that is both effortless and
automatic and appropriate for the childs age
Children with fluency disorders may repeat or add words or
sounds when talking
They may also pause in the middle of phrases or frequently
correct their pronunciation while talking. They may also say
certain words longer than normal.
The most well-known fluency disorder is stuttering, which is
characterized by the repetition or prolonged pronunciation of
words or sounds

Cognitive Communication Disorders


What is a Cognitive Communication Disorder?
- also referred to as cognitive-linguistic disorders. These types
of disorders involve the thinking processes associated with
communication as well as language (linguistic) skills
- used to describe a wide range of specific communication
problems that can
result from damage to regions of the brain that control the
ability to think
(cognition).
- may struggle with memory, organization and problem
solving that can
make it difficult to properly speak, listen, read, write or

Damage to the right hemisphere of the


brain (RHD), often due to stroke, can
result in a variety of deficits in cognition
and communication.
Cognitive deficits affect one or all of the
following areas:

attention
memory
problem solving
reasoning
organizing
planning
awareness of deficits

These deficits impact


communication by decreasing the
efficiency and effectiveness of
comprehension, expression and
pragmatics
Specific language deficits often
affect non-literal language,
alternative meanings, and other
subtleties of language.
Conversation may focus on
insignificant details and speech
may be rambling. Speechlanguage problems associated
with RHD may be sufficient to
interfere with the communication

The symptoms of Cognitive-communication Disorders


There are many different symptoms when it comes to cognitivecommunication disorders and because every child is different, each child
may experience symptoms differently.

difficulty keeping normal sleep and wake cycles.


simple sound repetitions, such as stuttering

a decline in previously established play and language skills.


struggles to pay attention, especially in a distracting environment.
memory problems or appear to be forgetful.
difficulty to remember information the child has previously learned or
memorized, like
birthdate, address or parents phone number.

Types of Cognitive Communication Disorders


1. Speech and voice disorders may include:

Fluency Disorders - Interruption in the flow of speech thats


characterized by an unusual rate or rhythm of speech,
hesitations, repetition of sounds or words, or prolongations of
nouns, syllables, words, or phrases. Symptoms may be
accompanied by excessive tension, struggle behavior, and
secondary mannerisms.

Articulation Disorders - Difficulties with the way sounds are


formed and assembled, often characterized by omitting, adding,
substituting, or distorting sounds.

Voice Disorders - Characterized vocal quality, pitch, loudness,


resonance, or duration which is inappropriate for an individual's
age or gender, or both.

2. Language disorders may include:

Aphasia - Loss of speech and language abilities


as a result
of a stroke or some other form of damage to the
brain.

Delayed Language - Slowness in the


development of the
language skills necessary for conveying and
understanding
thoughts and ideas

Causes of Cognitive Communication Disorders


Causes of cognitive communication problems may include:
strokes
traumatic brain injuries (TBI) or strokes involving the right
side of the brain
aging
tumors
disease
neurological disorders
birth defects
certain medications
alcohol and drug abuse

Symptoms
difficulties in the areas of language, social interaction skills,
attention and perception as well as thinking skills.
Individuals with cognitive-communication disorder may exhibit:
socially inappropriate or impulsive behaviour, e.g. saying things
to the wrong
person at the wrong time
inappropriate conversational behaviours, e.g. talking non-stop,
going off topic
difficulty understanding complex material e.g. humour.
difficulty expressing and interpreting emotions
difficulty solving problems and making judgments
poor attention, easily distracted
poor insight

What is involved in assessment and treatment?


When a brain injury is diagnosed or suspected, your physician may refer
you to a speech-language pathologist and/or neuropsychologist for
evaluation. Comprehensive testing will cover the following areas:
Short- and long-term memory (short-term or working memory includes
retaining information for up to ten minutes while doing something; longterm memory may involve recalling things hours or days later)
Problem-solving and reasoning (this includes judgment in a variety of
situations, visual and verbal problem solving, determining a solution
given partial information, etc.)
Planning and organization abilities (this is sometimes referred to as
"executive functioning" and includes your ability to begin a task,
complete steps in proper order and follow through to completion)

Treatment

Language skills:
Receptive language (understanding what you hear or read)
Expressive language (conveying your ideas effectively though
speaking or writing)
Results of this testing will help identify your areas of ability and
focus treatment on areas of weakness.
Therapy to address each of the above areas can help to improve
skills in these areas or provide you with strategies to help you
compensate for these acquired difficulties.
Treatment is typically individualized and based on your specific
needs and goals, such as resuming school or returning to work.

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