Chapter 2

1. Chapter 2 Syndromes, Developmental Disabilities, and Motor and Sensory Impairments that Affect Language and Speech

2. Objectives • Identify the primary characteristics of a variety of disorders associated with pediatric language deficits • Differentiate between sequence and a syndrome • Differentiate between the descriptive terms genetic, chromosomal, and heredity • Describe the effects of hearing loss on a child’s development of form, content, and use of language, then discuss the impact of cochlear implantation on language and speech • Discuss the impact of prematurity on cognition and language development • Discuss the effects of alcohol, nicotine, and other drugs on speech, language, and cognitive development

3. ASHA Definition of “Language Disorder” • Impaired _______________, ______ and/or other ___________. The disorder may involve (1) the form of language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in communication (pragmatics) in any combination.

4. Genetic VS Chromosomal • Genetic - Specific characteristics or traits passed from __________________. • Genetic Disorders – Disorders carried on _____. May be ______ (gene undergoes mutation), or may be ________ • Chromosomal Disorders – A disorder in the structure or number of __________ or both. May be inherited or acquired, as well.

5. Sequence VS Syndrome • Sequence – a disorder where many of the anomalies are actually ________ disorders, caused by a ________ anomaly which sets off a chain reaction of changes in the developing embryo that result in other anomalies • Syndrome – the presence of _______ anomalies in the same individual, with all of those anomalies having a ____________.

6. Down Syndrome • Down Syndrome is a _________________ • Presence of ___ copies of chromosome ___ rather than ___. • _____ – _____ births are Down Syndrome • Cognitive ability ranges _____ to ______

7. Characteristics of Down Syndrome • Dysplagia – ________________ • Prognathism – ______________ • Hypotonia – ________________ • Small ___________ • Mouth breathers; open _____________ • Large ___________ • Late ____________ • Hard palate is _____ and _________ • Possible ______________ • Motor, speech and language delays are present in ______ down syndrome children

8. Although the degree of disability varies, all babies with Down syndrome show a ____________ with regards to their motor, speech, and language development. • Studies show little difference in the quality and quantity of vocalizations in babies with DS up to ____ months of age • Delay becomes more apparent at 12 months, and DS children often do not begin to use words until ______ months

9. Oral Development Palate

10. Speech and Language Skills • Articulation errors tend to be ________ with typical children • Voice quality ________, _______ and _______ • ________ is fairly common • Receptive language is _____ ______ than expressive language • Use more ________ especially when their __________ of lexicon exceed 100 words • Very ________ • Language skills tend to plateau at about ___ years of age • As DS child gets older gap _________

11. Speech and Language Skills • Dissociated verbal comprehension and production • As DS child gets older gap widens • Particularly in syntax and morphology (expressive language) • Issues with vocabulary use • Typical MLU _____ words at ___ years, ____ words at ___ years, and ____ words at ___ years of age

12. Hearing Impairments in Down Syndrome • Small___________ • Congenital malformation of the _________ • Congenital malformation of the ____________ • Suffer from impacted ___________ • Frequent _______________ • Conductive hearing loss, coupled with frequent middle ear infections can affect ______________ • ____ of DS children suffer a hearing loss

13. Fragile X • Caused by a long arm on the __ chromosome • AKA _________ syndrome • Mild to moderate _____________ • Linked to 2-3% of all cases of ______ • More prevalent in _____ than ______ • 1 in 1000 males; 1 in 2000 females

14. Characteristics of Fragile X • _________________ is linked to 1/3 to ½ of the cases of mental handicaps • Characteristics are often not apparent until late in ______________. • Large ______ • Prominent _____ • Generally _________

15. Speech and Language Skills of Fragile X • _________ delays • Language Deficits – more _______ than __________ • Auditory Reception • Grammatic Closure • Auditory sequential memory • Severity can be mild to nonverbal • Use of echolalia • Perseveration • Word Finding issues – impacts their ability to answer direct questions • Delayed syntax • Pragmatic deficits

16. Motor and Sensory Deficit Static Encephalopathy - AKA – __________ May affect a child’s _________ skills due to muscle tone Hearing Impairment Depends on the ___________ and the ____ at which the child becomes hearing impaired (or when the hearing loss is detected), as to the language disorder associated with the hearing impairment

17. Let’s Talk “Think About It” page 73 in text book

18. Hearing Impairment • ASHA definition – page 74 • Deaf • Hard of Hearing • Language disorders of a hearing impaired individual can be variable – based on when the impairment occurred

19. Other factors are: • Whether or not the hearing loss is ______________ • Whether it is ________________ • What _________ of hearing loss the child demonstrates • How much __________ the child has received • Family __________

20. Types and Levels of Hearing Loss • _________ Hearing Loss • __________ Hearing Loss • ________ Hearing Loss • _______ Hearing Loss Prelingual and Postlingual Hearing Loss • Prelingual hearing loss – the acquisition of a hearing loss _____ to the development of speech and language • Postlingual hearing loss – the acquisition of a hearing loss _____ the development of speech and language.

21. Otitis Media and Otitis media with effusion • OM – ________________ • OME – Inflammation of the middle ear accompanied by the ____________________________ Problems that may occur • Both cause _______________ depending on presence of fluid in the middle-ear system

22. Fetal Alcohol Syndrome • .6 – 3 in every 1000 children are diagnosed with FAS • One of the leading causes of ________disabilities. • _____ preventable

23. Diagnosing FAS • Diagnosis of FAS must include _________________ The child must exhibit three primary symptoms • _________________ • _________________ • _________________

24. Alcohol Related Neurodevelopmental Disorder – Fetal Alcohol Effect • Diagnosis when all three primary symptoms are _____ ______ • Diagnosis found __ times more than fetal alcohol syndrome (FAS)

25. Physical Characteristics • Kidney __________ • _______ • Minor ______________ • Abnormal __________ • ___________ • Generalized __________ • Insufficient development of _______________ • Short __________ • Small ___________ • Possible ______ fingers and/or toes • Abnormal __________ • Hip ___________

26. Language Deficits found in FAS • _________ • __________ • Expressive language skills are ______ than receptive language skills • Word _______ • Word ___________ • Issues with ___________ • Also impacting Learning and Language are: • _________ problems • _________ deficits • ___________ • ___________

27. In the classroom a child with FAS may exhibit: • Conceptual deficits such as ____ and _____ • Comprehension of both ________ and _____ material • Basic ____________ • ______ and ______ memory deficits

28. Let’s Talk • “Think About It” page 72 in text book

29. Intellectual Disability • Descriptive criteria for labeling a child intellectually disabled is: • Difficulty ______________ • Delays in __________________ • _____________ • Lack of ______________ • Delay in development of __________ such as self-help or self-care skills

30. Intellectual Disability is based on IQ Classification • Borderline 70 – 80 • Mild 50 – 69 • Moderate 35 – 49 • Severe 20 – 34 • Profound Below 20

31. Acquired Language Disorders • A result of illness • ________________ • ________________ • ________________