Speech-Language Impairments

1. Speech-Language Impairments Tricia Hansen Oklahoma State Department of Education Instruction and Related Services Specialist

2. Introduction to Speech Or Language Impairments • The King's Speech • Marshmallow Activity • Sentence Activity • Grocery List Activity

3. Incidence • More than one million students who receive special education services under IDEA in public schools are served under that category of speech or language impairments. • Because many disabilities do impact the individuals ability to communicate, the actual incidence of children with SLI is much higher.

4. Causes for Speech Or Language Impairments (SLI) • Hearing Loss • Neurological Disorders • Muscular Disorders • Developmental Delays • Brain Injury • Mental Retardation • Autism • Cerebral Palsy • Drug Abuse • Vocal Abuse or Misuse • Physical Impairments (ex. Cleft Palate)

5. Symptoms and Signs of SLI • Interruptions in the flow or rhythm of speech such as stuttering • Articulation or phonological disorders • Improper use of words and their meanings • Inability to express idea • Reduced vocabulary • Inadequate social skills • Difficulties with vocabulary, site words, decoding, and comprehension • Difficulty writing down thoughts • Difficulties with abstract ideas • Fluency impairments

6. Signs of SLI • Signs of SLI

7. Definition of Speech or Language Impairment (SLI) • The Individuals with Disabilities Education Act defines an SLI: • As a communication disorder, such as stuttering, impaired articulation, language impairments, or a voice impairment, that adversely affects a child’s educational performance.

8. Types of Speech-Language Disorders • Types of Speech Disorders: Refers to difficulties producing speech sounds or problems with voice quality. • Articulation • Speech impairments where the child produces sounds incorrectly (ex. Lisp, difficulty with “l” or “r.”) • Fluency • Speech impairment where a child’s flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided and where there may be silent blocks or inappropriate inhalation, exhalation, or phonation patterns. • Voice • Speech impairment where the child’s voice has an abnormal quality to its pitch, resonance, or loudness.

9. Speech Disorders • sessions

10. Types of Language Disorders • Types of Language Disorders: Refer to impairments in the ability to understand and/or use words in context, both verbally, and nonverbally. • Expressive: Difficulty in expressing ideas or needs. • Receptive: Difficulty in understanding what others are saying. • Mixed: Involves a mix of expressive and receptive difficulties.

11. Expressive • Sarah Scott • Sariah

12. Real Life Application: Expressive • Fourth-grader Elliott stays in his school’s Extended Day program after school. When his mother picked him up one afternoon, he told her, “I’m glad you finally came. I was the last one here.” Elliott’s mother looked around the room and counted ten other children. Eventually, after much questioning, she ascertained that Elliott meant, “I was the last of the fourth-graders here.” • The next day, Elliott’s class was excited because the school’s principal promised to visit them with an undisclosed treat from having the best attendance in the building. Elliott’s teacher sent him to the office with this message, “Ask the principal when she is coming to our classroom.” Elliot went to the office but conveyed the slightly altered message, “My teacher wants to know if you can come to our classroom.” Based on his message, the principal thought that there was a problem and hurried to the classroom, only to find that a miscommunication had occurred.

13. Elliott • Elliott’s scenario included two examples of consistent expressive-language mistakes. • What were they? • Have you ever known someone with similar expressive-language challenges? • Is there anything you could recommend to his teacher or mother to help prevent similar communication breakdowns in the future?

14. Real Life Application • Twelve-year-old Briana was excited about the swimming pool that her grandparents were putting in their backyard. As she began to explain to her friends what it would look like, she said, “ It’s shaped like a ….” and then paused, unable to recall the word that described its shape. • After a few seconds, she continued, “It’s shaped like a circle, but the sides are longer.” • “You mean an oval?” teased one of her friends. • Briana laughed, embarrassed, and replied “Yep, that’s exactly what I mean.” • Later that day, Briana found out that she’d failed a science test made up of twenty fill-in-the blank questions. Briana was frustrated because she knew the content well. Her teacher decided to give her an alternate test-- one in which Briana could use a Word Bank to answer the same twenty questions. Because she was able to recognize and select the correct answer, rather than recall the word herself, Briana got an A on the test.

15. Briana • Briana’s scenario included two examples of a consistent expressive-language disorder. What is it? How was she able to work around her inability to recall the word oval? • What ideas or suggestions can you suggest that Briana’s teacher implement to support her during class discussions? During test-taking?

16. Expressive Language Strategies • Create opportunities for the child to interact with peers. • Pair children to share stories of what they did on the weekend and have them report it to the class (accept all child responses). • Model full sentence responses when 1:1. • Create a safe environment for all students. • Build a word wall. • Allow time for the child to process the question and formulate an answer. • Ask questions beginning with wh-words (who, when, why) rather than yes/no questions. • Model sentences by repeating the child’s message in a correct form • Prompt the child to use expressive language strategies and skills following the specific recommendations of the Speech Language Pathologist (SLP). • Prompt answers by giving choices (what it x or was it y?) • Add to the child’s message by paraphrasing and expanding on it. (ex. “It’s cold,” or “Cold air is coming in because the window is open.”)

17. Receptive Language • Receptive Language: refers to our ability to receive information. This may cause great frustration. • Students with language disorders may struggle with: • Understanding what is spoken to them • Comprehending what they read • May have difficulty with: • Complicated sentence structure (simple v. complex) • Unfamiliar vocabulary

18. Real Life Application: Receptive • Maddie reads the following passage from The Witch of Blackbird Pond (8th Grade) • Sailors began vigorously to roll out the great casks of molasses and pile them along the wharf. Two of the men lowered over the side the seven small leather trunks that held all of Kit’s belongings and piled them, one beside the other on the wet planking. Kit clambered down the ladder and stood for the second time on the alien shore that was to be her home. • Her heart sank. This was Wethersfield! Just a narrow sandy stretch of shoreline, a few piles sunk in the river with rough planking for a platform. Out of the mist jutted a row of cavernous wooden structures that must be warehouses, and beyond that the dense, dripping green of fields and woods. No town, not a house, only a few men and boys and two yapping dogs who had come to meet the boat. With something like panic Kit watched Goodwife Cruff descent the ladder and stride ahead of her husband along the wharf. Prudence, dragging at her mother’s hand, gazed back imploringly as they passed.

19. Maddie • This passage is confusing to Maddie for several reasons: • She doesn’t know what the bolded words mean, decreasing her reading comprehension. • She mistakes the word piles in the second paragraph for the word piled in the first, and imagines something being piled in the river, but wonders, “Piles of what?” • She associates the term alien with science fiction and beings from outer space, resulting in a misinterpretation of that sentence. • Some of the phrasing confuses her. • Example: She thought the phrase, “Two of the men lowered over the side” means that two men were lowered over the side.

20. Maddie • What can you do as a teacher to help students with language disorders comprehend the material and avoid confusion?

21. Practical Life Application • Myron’s teacher asks him to help her put some photographs of leaves on a bulletin board. The pictures are part of a learning center in which the students will have to look at the photos and identify key characteristics. Myron’s teacher tells him, “I wouldn’t put the photos up so high that students can’t view them easily.” He teacher’s choice of words confuses Myron; he isn’t sure whether he is or is not supposed to put the photos up high, and whether the students should or should not be able to view them easily.

22. Myron • Why do you think Myron was confused by his teacher’s instructions? • Can you come up with 2-3 instructions that would be similarly confusing? • Restate those 2-3 statements, as well as that of Myron’s teacher, to be more easily understood.

23. Receptive Language Strategies • Signal the teacher when directions have not been understood • Ask for Repetition of directions • Ask for clarification of directions • Sit close to the teacher and white board • Sit in a quiet place • Pre-teach specific vocabulary • Build a word wall • Review previously learned material • Connect new vocabulary or information with that previously learned • Use direct requests (“Please close the window”, instead of “It’s cold in here”) • Give directions in a time-ordered sequence (first, then, etc) • Pair directions with gestures or visual cues • Reduce visual distractions • Gain student’s attention before giving directions or instructions • Use a phrase or visual prompt before giving directions or instruction • Speak clearly • Stress key words in a sentence • Provide additional response time • Avoid asking the child to listen and write simultaneously • Use visual aids, such as pictures, diagrams, graphs, or written key words

24. Pragmatic Language Disorders • Pragmatic Language: refers to the appropriate use of language in social contexts. • Students with language disorders may have trouble with language-based social interactions. • Characteristics may include: • Difficulty interacting with peers and/or adults • Violates conversational rules • Has limited eye contact • Interrupts frequently • Makes odd, irrelevant comments • Violates personal space • Inability to interpret and use non-verbal cues • Dominates conversation • Has poor topic maintenance

25. Pragmatic Language Strategies • Practice appropriate body language. • Make facial expressions and ask students to tell you how they think you feel (mad, happy) • Teach conversational skills in the classroom • Components of conversational skills: • Turn-taking • Recognizing and responding to a topic • Ensuring clarity of your part of the conversation • Requesting clarification • Topic transitions and time factors • Terminating a topic

26. Pragmatic Language Strategies • Strategies for Teaching Conversational Skills • Start with short conversations on one topic. • Provide additional cues if the student does not respond (gestures, clarification) • Provide the student with time to process information when beginning a conversation. • Keep the conversation going by asking questions. • Keep from asking yes/no questions. • Encourage the student to listen to others as they speak.

27. Real Life Application • Two six-year-olds are playing a game on the playground when a third child approaches them and says, “That looks fun!” and is invited to join the game. A fourth child also asks, “Can I play?” and, once given approval, joins the game. However, through six-year-old Lela likewise wants to join the game, she is uncertain how to approach the others to initiate an interaction. She wanders around the general vicinity where the children are playing, approaches them several times, but walks away without saying anything. Finally, she joins in the game without asking. Although the others let her play, they are uncomfortable because she did not follow the normal social conventions.

28. Lela • What should Lela have done in order to join the girls’ game? • What pragmatics skills does she need to develop?

29. Real Life Application • Eleven-year-old Libby has trouble following conversational rules. She approaches a group of classmates in the hallways and says, “Hey Abigail, guess what?” Abigail, who was already in a conversation with someone else, does not hear her and continues talking with her friend. Libby does not pick up on this social cue and instead proceeds to tell Abigail about her weekend, even though Abigail is still talking. When Abigail does acknowledge Libby and starts talking to her, the conversation breaks down further.

30. Real Life Application • Libby responds to some of Abigail’s comments with remarks that are not relevant to the conversation. She doesn’t allow the usual give-and-take, instead taking longer conversational turns, and often talks at the same time Abigail does. In frustration, Abigail finally says, “Libby, you never listen to anything I say!” and walks away. Other girls who witness the scene agree that Libby is frustrating to talk to and decide amongst themselves that she is “weird.”

31. Libby • What social cues did Libby fail to recognize? • How did this affect her conversation with Abigail? • How do you think her peers’ perceptions of them could be negatively affected because of their language disorder.

32. The Role of the Special Education Teacher • Consult or collaborate with the Speech-Language Pathologist on specific needs and helpful strategies for the individual child. • The Special Education Teacher may work on child’s goals throughout the week in addition to the child meeting with the SLP. • Ensure classroom accommodations are being followed. • All additional responsibilities of a classroom teacher.

33. Instructional Strategies • Powerful strategies to support the learning of students with SLI impairments: • Always assume competence. • Incorporate Literacy • Provide Visual Input • Model Fluent Reading (choral reading, paired reading, etc.) • Use multiple types of Reading Strategies (prediction, reader’s theatre, etc.) • Divide academic goals into smaller units • Present only one concept at a time • Use tactile and visual cues • Offer Maximal social interaction opportunities

34. A Story of Hope • Hope • Hope 2