Language Disabilities in Children Developmental Language Delays School Age Language Disabilities Developmental Language Delays DLD Delay in language skills compared to peers o Can be in any part of language Form Content Use o Not language differences dialects o Infant and pre school ages Wide variety o Delays may be Expressive or receptive Mild or severe Can occur even before the child uses first words o Pre language skills Gestures joint attention poor social skills Language Disabilities in Children Symptoms Causes o First sign late onset of first words o Slow progression to 2 words and more o Slow vocabulary and concept development o Slow to use language to interact socially o Delays pre reading and early academic skills o May also be slow in developing speech o Prenatal during gestation Maternal age Adequacy of prenatal care Maternal health and nutrition Drug use during pregnancy Family history of developmental delays o Perinatal at or around the time of birth Prematurity Low birth weight Brain hemorrhage Respiratory problems Hyperbilirubinemia o Postnatal after birth Bonding and attachment issues Socioeconomic status Educational level of parents Chronic otitis media Conditions that may include DLD o Genetic and chromosomal disorders o Sensory deficits o Neurological impairments o Exposure to drugs and alcohol o Autism and pervasive developmental disorders o Specific language impairment Genetic and chromosomal disorders o Down syndrome o Fragile X syndrome o Usually display global developmental disorders delays o Develop speech language skills in same order as typically developing children but at a slower rate Developmental Language Delays Sensory deficits hearing and vision o Visual impairment alone o Some genetic and or birth defects affect both o Hearing deficits Neurological Conditions o Cerebral palsy o Many have delays in language development and many have cognitive deficits o Motor control and speech deficits common o Many need an augmentative alternative communication system language semantics Conditions that may include DLD Genetic and chromosomal disorders Sensory deficits hearing vision Neurological impairments Exposure to drugs alcohol Autism and pervasive developmental disorders PDD Specific language impairment SLI Aphasia Stroke Causes of Aphasia Stroke Facts o Risk factors o Most common cause is a stroke cerebral vascular accident Loss of blood supply to part of the brain which controls language left side million people have strokes per year in the US o Prognostic Factors how a person will recover after a stroke History of previous stroke High blood pressure Smoking High cholesterol Diabetes Obesity Age Severity of damage General health Family support Etiology of damage Educational level Spontaneous Recovery o Right after stroke aphasia is at its worst o As swelling in brain decreases some of the mildly injured tissue will function again o Spontaneous recovery makes it difficult to judge how well therapy works o Spontaneous recovery makes it difficult to judge how well therapy works Other Etiologies For Aphasia Stroke most common way to acquire aphasia Tumor both cancerous and benign Loss of blood supply due to decreased oxygen Bacterial or viral diseases Assessment for Aphasia Language to look at all areas o Expressive language naming picture description conversation o Receptive language yes no questions following commands answering o Reading comprehension not reading out loud but understanding what wh Q s you read o Writing ability to produce grammatically correct sentences spelling Assessing Speech and Swallowing o Most likely with Broca s aphasia o Looking for disorders of speech and swallowing that may be caused by brain damage called motor speech disorders Articulation slurred speech Phonation Treatment of Aphasia Restorative Compensatory Efficacy of Treatment answered o Counting on one area of brain taking over for another o Working on alternative approaches to communication o Research shows therapy helps but there are many questions still to be 11 2 Ischemic Strokes Complete or part occlusion of arteries o Most common type A lot of recovery right away recovery slows down Blood clot may travel from other part of body heart hip Thrombosis clogging of arteries in brain Hemoragic Stroke Ischemic Stroke o Recovery at beginning is slower recover fast o Recovery is quick at right then slows down Neither has better prognosis both about 6 months long Traumatic Brain Injury Most often young adults males 18 25 o Take more risks play more sports Common causes car or motorcycle accidents Damage is more generalized affects more of brain due movement of brain in skull doesn t affect specific area of brain o Damage in wider area from side to side or front to back brain rickasheas Mild cases of traumatic brain injury concussion Not really aphasia in fact these patients do well on aphasia testing o Aphasia can only be on left side of brain o This is through whole brain Primarily cognitive linguistic deficits o Not specific problems general ones Cognitive Linguistic Deficits Attention Memory word finding problems o Often cant remember what happened to them o Have trouble coming up with words that they want like aphasia Learning difficulties esp for NEW info Decreased inhibition poor pragmatic skills o Say rude things to doctors etc Organizational skills frontal lobe planning and executing actions problem solving o Frontal lobe is most commonly injured o Ex Couldn t spread past topic cats reds hard to do specific tasks Recovery from TBI Go through stages that are relatively predictable 8 stages Rancho Los Amigos Scale Need ongoing evaluation and treatment o Changing everyday Often going from comatose to re entry into community o Depends on severity of brain injury Often may have swallowing and or speech problems as well as cognitive linguistic ones o Usually think of brain injury as a language problem but often have frontal lobe damage where motor skills are may have swallowing speech movement problems Right Hemisphere Disorders RHD NOT APHASIA More difficult to detect o Not quite as obvious to family members or care givers Include some cognitive linguistic problems memory orientation awareness of deficits don t really believe there is anything wrong with them o Could have paralysis of left side crosses over o Left side might not be working and still say they have to leave hospital to go to work deny deficits like there s nothing wrong with them o Sometimes don t think