Communication Disorders

What do these people have in common?  Joe Biden  Marilyn Monroe  Carly Simon

 Barbara Walters  Bruce Willis  Susan Olsen (Cindy Brady)

 Joe Biden (stutter)  Marilyn Monroe (stutter/breathy voice)

 Carly Simon (stutter)  Barbara Walters (speech impairment)  Bruce Willis (speech impairment)  Susan Olsen (Cindy Brady) (lisp)

Communication Disorders REBECCA CORDISCO DANIELLE JAISLE MELISSA HIGHT

EDU 581 STUDENTS WITH SPECIAL NEEDS

Communication Disorders: An Introductory Guide for Teachers

Goals for this class  At the end of the presentation you should be able to:  Understand what communication disorders are and be able to identify between speech, language, and hearing disorders.  Be able to identify key characteristics of communication disorders.  Understand the various causes of communication disorders and be able to know the warning signs for the students in your classroom.  Understand the diagnostic process and your role in that process.  Be conscious of the effect that these disorders can have on families.  Be equipped with teaching strategies as well as accommodations, modifications and adaptations for this group.

Definition  IDEA defines it as follows:  “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.”

Definition  Speech

Fluency An

interruption in the flow or rhythm of speech. Articulation Difficulties in the way sounds are formed and put together. Voice Inappropriate pitch, quality, loudness, resonance or duration.

Definition  Language  Form Phonology (how sounds are put together).  Morphology (how words are constructed).  Syntax (order and combination of words to create sentences). 

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Content 

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Semantics (what do words and sentences mean?).

Function 

How do all of these components combine to create logical sentences?

Definition  Deafness/Hard of Hearing  There are 3 major types of hearing loss: 

Conductive loss  Malfunction

of outer or middle ear, so sounds cannot be processed.

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Sensorineural loss  Damage

to inner ear or auditory nerve (sounds cannot be transferred to brain).

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Central auditory processing disorder  No

damage to the ear itself, but the brain has trouble comprehending what is heard.

Characteristics  People with communication disorders may have

difficulty…       

Following directions. Attending to a conversation. Pronouncing words. Perceiving what was said. Expressing oneself. Being understood. Being comfortable around others.

Characteristics  Problems with language include:  Expressing ideas coherently.  Learning new vocabulary.  Understanding questions.  Recalling information.  Understanding and remembering what was just said.  Reading at a satisfactory pace.  Comprehending spoken or read material.  Learning the alphabet.  Identifying sounds that correspond to letters.  Perceiving the correct order of letters in words.  Spelling.

Characteristics  Problems with speech include:  Sounding

hoarse.  Breathy or harsh voice.  Stuttering (flow of speech is interrupted).  Articulation issues such as a lisp.  Fluency.  Mutism or limited vocabulary for their age.

Causes  May be developmental or acquired.  May be based on problems such as:  Abnormalities

of brain development.  Exposure to toxins during pregnancy.  Genetic factors.

Causes  Hearing loss.  Neurological disorders.  Brain injuries.  Intellectual disabilities.  Drug abuse.  Physical impairments such as cleft lip or palate.  Vocal abuse or misuse.

 Autism Spectrum Disorders .  In many cases, the cause is unknown.

Take a look at these milestones…  1-2 months: "cooing" -ooh's and -aah's.  2-4 months: Babbling begins.  4-6 months: Begin to combine consonants (baba, yaya) but 

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baby does not know what it means. 7-12 months: Still babbling but starts to sound as though he is making sense. 13-18 months: Starts talking- uses a few words and knows what they mean (uppy, mama, dada, ball, cup). 19-24 months: Can say 50-70 words but can understand 200. Learns 10 words a day and begins making basic sentences (carry me). By 2: 3 word sentences. By 3: Vocab grows up to 300 words, can carry a conversation. By 4: 800 words.

When to be Concerned  6-12 months: Child does not attempt to make

sounds or eye contact or stops babbling.  15 months: Child is not saying a single word (including mama and dada).  19-24 months: Child rarely attempts to speak, drops consonants (ea-ut=peanut), only uses single words, and does not get frustrated when not understood.  Stuttering is normal unless it lasts more than 6 months or the child tenses their jaw or grimaces.

How are they diagnosed?  Teachers can refer a child to be evaluated if they notice delays.

Something might not seem “right” to the teacher. Parents can request that their child be evaluated. Having a child’s hearing checked is critical. When developmental delays are presented, children are referred for speech and language evaluations. Diagnosis is needed if there seems to be a delay in social interactions, academic achievement and daily living. If the results from the evaluation are “substantially below” developmental expectations, then a diagnosis is made. It may be possible for a child to have a slight impairment or difficulty but still not be considered to have a communication disorder.  This is the case if activities of daily living or education are not affected. 

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Prevalence  8-9% of young children have speech sound disorders. 

By first grade, roughly 5% have noticeable speech disorders.

 Approximately 6-8 million people in the United States   

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have some type of language impairment. Approximately 1 million people in the U.S. have aphasia. About 3 million Americans stutter. Almost 7.5 million people in the U.S. have a voice disorder. More common in boys than girls. 

Stuttering ratio of boys to girls is 3:1

 Over 24% of students in public schools receive related

services for communication disorders.

History of Communication Disorders  Ancient History  Aesop (6th century BC) was the creator of fables and had a speech problem.  Aristotle (384-322 BC) wrote about speech disorders.  Early Modern History  John Conrad Amman (1669-1724) was a Swiss physician practicing in the Netherlands who wrote about instruction for those who are hearing impaired or who have fluency problems.  Hieronymus Mercurialis (1530-1601) was a Greek and Latin scholar and physician who wrote extensively about speech disorders. 

Identified stuttering as hesitation of the tongue.

History  19th Century 

The Elocution Movement 

Workshops were created to help those in the public eye work on speeches.

 20th Century 

1900-1945 Our Formative Years 

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1945-1965 The Processing Period 

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Assessment and therapeutic approaches were developed to improve communication disorders.

1965-1975 The Linguistic Era 

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Speech and Language Pathology became a defined field.

Language disorders were treated separately from speech disorders.

1975-2000 The Pragmatics Revolution 

Reframed practices to apply to daily living.

Significant Legal Decisions  Section 504 Rehabilitation Act of 1973  Civil Rights Act that protects those with disabilities.  IDEA 1975  Ensured that children with disabilities had access to a FAPE.

 IDEA 2004  Changes were made in IEP process, due process and student discipline.  ADA (Americans with Disabilities Act)  Enacted in 1990 and prohibits discrimination based on disability.

Impact on Families  Parents    

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Embarrassment. Guilt. Emotional stress. Financial strain. Anger. Powerlessness. Denial.

 Siblings    

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Embarrassment. Bitterness. Resentment. Protective of sibling. Confusion. Worry about how others will treat their sibling. Stress.

Key Terms  Aphasia- an impairment of language ability.  Articulation- the adjustments and movements of speech organs   

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involved in pronouncing a particular sound. Cleft lip or palate- birth defects that affect the upper lip and the roof of the mouth. Cochlear implants- surgically implanted device to provide sound. Dysarthria-Difficulty in articulating words due to emotional stress or to paralysis, incoordination, or spasticity of the muscles used in speaking. Dysphasia-a partial or complete impairment of the ability to communicate resulting from brain injury. Elocution-The study of formal speaking in grammar, style, tone and pronunciation. Fluency-smoothness or flow of sounds.

Possible Medical Needs  Speech and language therapy.  Speech

and Language Pathologist.

 Cochlear implants .  Corrective surgery for cleft lip or palate.

Accommodations/Modifications/Adaptations  Elementary  Preferential seating.  Slower pace.  Use a scribe for the student.  Reduce excess noise.  Use visual aids.  Repeating the questions that other students in the class ask.  Extend test taking time.  Write unfamiliar vocabulary on the board.  Utilize an FM loop system to amplify sounds.  Have an interpreter for student.

Accommodations/Modifications/Adaptations  Middle/High School Level.  Many of the accommodations used in elementary

school transfer as students progress through school.     

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Substituting written work for oral assignments. Allow for more time to complete tasks. Untimed tests. Preferential seating. Use of computer with voice synthesizer. iPads or other related technology. Electronic communication systems.

Possible Related Services  Speech and Language Pathologist.  School Counselor.  Psychologist.

 Psychiatrist.  Pediatrician/Medical Doctor.  Occupational therapy.

 Tutors.  Early intervention is key!

Teaching strategies/techniques  Do not rush the child.  Do not complete words for the student or speak for    

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him/her. Minimize interruptions and distractions. Expect the same quality and quantity of work from students with communication disorders. Speak with the student slowly and use pauses to allow for comprehension. Show the student you understand the CONTENT of the message, not HOW it is said. Have a one on one conversation with the student about what they need in the classroom to facilitate learning.

Teaching strategies/techniques  Have a special signal with the student when they need more time or       

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assistance. Have the entire classroom practice being good listeners. Use a chunking method so student does not become overwhelmed (break down tasks). Use facial expressions and other body language to help the student. Model appropriate behavior. Tailor assignments to the interests of the student. Praise the student frequently. Speak clearly and directly to the student. Repetition can be helpful for the student. Have the student practice reading passages aloud to assist with fluency.

Techniques for Reporting Student Progress  Individualized Family Services Plan (IFSP)  

Describes the child’s needs and services needed. Addresses the needs of the family so that proper supports can be put in place.

 An IEP will be created to address the unique needs and

services for the child.  Weekly progress notes home from teacher to the parents.  Collaboration between all school, family, and related medical personnel.  The Speech and Language Pathologist can integrate the student’s communication goals along with academic and social goals. 

Frequent assessment of these goals can be made to check progress.

Inclusion Trends  Traditionally, services were based on the medical model

which utilized individual and isolated treatment.  Pull out intervention was used where the Speech and Language pathologist would take the child to a separate room.  The Regular Education Initiative in Special Education began changing views on the pull out intervention and used a more inclusive model.  Collaborative instruction must be utilized to keep the child in the natural environment as much as possible.

Multicultural Issues  It becomes challenging for teachers to differentiate

between a communication disorder or a language barrier issue.  In order to have a diagnosis, issues must be present in both languages.

References  Accommodations. (2004). Retrieved from

http://www.niu.edu/success/accommodations.shtml  Belson, S. I. (n.d.). Famous Persons with Communication Disorders. Retrieved from http://sped.wikidot.com/famous-persons-withcommunication-disorders  Children with Communication Disorders. (2011). Retrieved from http://www.cec.sped.org/AM/Template.cfm?Section=Home&templat e=/CM/ ContentDisplay.cfm&ContentID=7500  Communication Disorders. (n.d.). Retrieved from http://www.bamaed.ua.edu/spe300/Communication_Disorders.html  Developmental Milestones.: Talking. (2012). Retrieved from http://www.babycenter.com/0_devlopmental-milestonetalking_6573.bc  Duchan, J. F. (2011). A History of Speech- Language Pathology. Retrieved from http://www.acsu.buffalo.edu/~duchan/new_history/overview.html

References  Fenell, Z. (2012). The Impact of Communication Disorders on the

Family System. Retrieved from http://www.ehow.com/facts_6175550_impactcommunication-disorders-/familysystem.html  Guitar, B. & Conture, E. (2012) 7 Tips for Talking with Your Child. Retrieved from http://www.stutteringhelp.org/7-tips-talking-your-child  IDEA- The Individuals with Disabilities Education Act. (2012). Retrieved from http://nichcy.org/laws/idea  Inclusive Practices for Children and Youths with Communication Disorders. (1996). Retrieved from http://www.asha.org/policy/TR1996-00245.htm  Scott, L. (2012). 8 Tips for Teachers. Retrieved from http://www.stutteringhelp.org/8-tips- teachers

References  Section 504. (2012). Retrieved from

http://www.uwec.edu/CSD/insights/school/504.ht

m  Sibling Issues. (2012). Retrieved from http://nichcy.org/families-community/siblings  Speech-Language Disorders and the Speech-Language Pathologist. (2012). Retrieved from http://www.asha.org/careers/professions/sld.htm  Speech and Language Impairments. (2011). Retrieved from http://nichcy.org/disability/specific/speechlanguag e